Standard Principles Research Articles

Functional Anatomy in Relation to Peritoneal Surface Malignancies (PSM): Lessons Learnt after 254 Cases of Peritonectomy at a Tertiary Oncology Centre in India

Introduction: Peritoneal Surface Malignancies (PSMs) are a heterogenous group of diseases. They are still considered terminal in many tertiary care centers in India. Cytoreductive Surgery (CRS) including peritonectomy has been the main stay of treatment of PSMs. In this article, we elaborate the applied anatomy of peritoneum from macroscopic to microscopic structure, the mechanism of spread, common sites of involvements and the techniques of perfection in CRS leading to better surgical outcomes based on our experience. Methods: We have performed 254 cases of peritonectomy-Total Parietal Peritonectomy (TPP) in 104 cases (40.9%) and disease selective in 150 cases (59.1%) from 2014 to 2021. We have performed TPP in cases of Pseudomyxoma Peritonei (PMP), Malignant Peritoneal Mesothelioma (MPM) and post NACT cytoreduction in all patients of PSMs Results: In all cases of CRS we removed the primary tumor as per standard oncological principles. Apart from this we removed total greater omentum, lesser omentum, omental bursa and all lymph nodes pertaining to respective diseases. The distribution of our patients was Ovarian carcinoma (n = 152), Colorectal (n = 43), PMP (n = 34), MPM (n = 11), Sarcomatosis (n = 7), Gastric Cancer (n = 3) and Miscellaneous (n = 4). With our 7 years’ experience we share our inputs on the anatomical basis of peritoneal carcinomatosis and sarcomatosis. Conclusion: We have performed 254 peritonectomy procedures. On the basis of our experience and evidence, we conclude that anatomy of peritoneum is very important as it is the most common site of recurrence in PSMs after CRS. We recommend TPP in all cases of PMP, MPM and in interval cytoreduction setting. Keywords: CRS; HIPEC; Peritoneum; Peritoneal carcinomatosis; Sarcomatosis

Discovery of Knowledge in the Incidence of a Type of Lung Cancer for Patients through Data Mining Models

This paper presents the research results on the contribution of user-centered data mining based on the standard principles, focusing on the analysis of survival and mortality of lung cancer cases. Researchers used anonymized data from previously diagnosed instances in the health database to predict the condition of new patients who have not had their results yet. Medical professionals specializing in this field provided feedback on the usefulness of the new software, which was constructed using WEKA data mining tools and the Naive Bayes method. The results of this article provide elements of interest to discuss the value of identifying or discovering relationships in apparently “hidden” information to propose strategies to counteract health problems or prevent future complications and thus contribute to improving the quality of care. Life of the population, as would be the case of data mining in the health area, has shown applicability in the early detection and prevention of diseases for the analysis of genetic markers to determine the probability of a satisfactory response to medical treatment, and the most accurate model was Naive Bayes (91.1%). The Naive Bayes algorithm's closest competitor, bagging, came in second with 90.8%. The analysis found that the ZeroR algorithm had the lowest success rate at 80%.

THE LIQUIDATING VALUE OF A COMPANY'S ASSETS IN A BANKRUPTCY PROCEEDING

Abstract The companies avoid going to the bankruptcy process, they do it late and a great majority finish with liquidation; probably because the bankruptcy process does not meet the objective of restructuring companies with financial problems. If the active resources and the granted credit were in balance (standard accounting principle); this problem would disappear; but it certainly is not the case and the problem persists. Thus, our work aims to determine the degree of impairment shown by the assets in bankruptcy proceedings to try to reveal the variables that could explain the greater or lesser impairment. This work highlights the lack of efficiency of the bankruptcy process due to the poor credit satisfaction of its creditors in liquidation. This helps to establish a cause, specifically, the low liquidation value of the assets. This implies that the culture in the bankruptcy process must change one should go to the process as soon as possible and try to balance assets and equity and payable at all times. Keywords: bankruptcy proceeding, liquidation value, efficiency, risk, illiquidity.

SRE_BBC: A Self-Adaptive Security Enabled Requirements Engineering Approach for SLA Smart Contracts in Blockchain-Based Cloud Systems.

Current blockchain-based cloud (BBC) systems have several security vulnerabilities regarding smart contracts (SC), and several attacks have been reported recently. The SC development lacks standard design processes that follow software lifecycle principles to model secure SC. Secondly, the security mechanisms in the SC are not constantly evolved to resist evolving adversary attacks. BBC systems lack self-adaptive security capability to make spontaneous decisions when adversarial attacks are encountered. To build a self-adaptive secure BBC system that follows standard software development lifecycle principles to model secure SC, we propose the so-called self-adaptive security RE_BBC framework. The framework would utilize the MAPE-BBC adaptation loop to make decisions internally based on the threat models, goal models, and service level agreement (SLA) SC security specifications. The framework identifies vulnerabilities and threats and takes precautionary measures using self-adaptive SC agents. We validated the proposed methodology theoretically and empirically, and statistically proved the research questions and hypothesis using the t-test and Mann–Whitney U test. Subsequently, we compare our proposed approach with the Security Quality Requirements Engineering approach (SQUARE). The feasibility results and the replicated study results indicate that the proposed approach outperformed the SQUARE approach in terms of artifacts quality, self-adaptive security evaluation quality, efficiency in response time, complexity, and usefulness of the proposed approach for the Healthcare Data Management (HDM) system. SC security developers can immensely benefit from our proposed methodology. They need not reengineer SC from scratch; depending on their security needs and plan, the contract can be adapted to execute a new plan.

Impact of Secondhand smoking on Dyslipidaemia among non-smokers: findings from the 2015-2016 NHANES dataset in the United States

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): This research was supported by the Brain Pool Program supported through the National Research Foundation of Korea, funded by the Ministry of Science and ICT (2020H1D3A1A04081265). Background Dyslipidemia is a prominent risk factor of mortality globally. While active smoking has been implicated in the burden of cardiovascular disease (CVD) worldwide, there is little understanding on the impact of subtle secondhand smoke exposure (SHSE) on dyslipidaemia among non-smokers. Purpose This study assessed the association of SHSE with dyslipidaemia among non-smoking adults from the 2015-2016 National Health and Nutrition Examination Survey (NHANES) in the United States. Method Participants for this study were 3,064 non-smoking adults (≥18years) identified through a multistage sampling method in the United States. Data on sociodemographic, lifestyle and history of CVD were collected using standard operating principles. Also, fasting blood samples were collected by trained personnel to determine blood lipid profiles. SHSE was defined as exposure to smoke from a burning cigarette (exhaled by a smoker) in an indoor environment or a blood cotinine concentration ≥ 0.05 ng/ml. Dyslipidemia was defined according to the National Cholesterol Education Program guidelines. Logistic regression was adopted to estimate the multivariable-adjusted odds ratio (aOR) and 95% confidence interval (CI) for the association between SHSE and dyslipidaemia at a two-sided P < 0.05. Results The mean age of respondents was 46.4 ± 18.0years, 63.2% were females, 36.2% reported SHSE, and 59.6% had dyslipidemia. The aOR and 95% CI among respondents with SHSE was 1.148 (1.147-1.149) in the entire sample. Similarly, odds of dyslipidaemia in the light of SHSE was 1.130 (1.129-1.131) among those < 60 years, 1.304 (1.300-1.308)] among those ≥ 60 years, 1.165 (1.163-1.167) among males and 1.214 (1.212-1.215) among females. Conclusion(s) SHSE was associated with higher odds of dyslipidaemia and might be an often missed risk factor in the risk of dyslipidaemia. Primary prevention strategies(s) might be necessary to reduce the impact of SHSE on the burden of dyslipidaemia and CVD worldwide.

Marketing System Construction and Risk Analysis Based on Random Forest of Machine Learning

This paper analyses the innovative marketing model of enterprises in the new era from the perspective of the characteristics of enterprises and the problems of innovative marketing strategies and puts forward solution strategies and suggestions to provide reference for enterprises to get faster and better development in the new era. Based on the connotation of credit in the random forest, this paper follows the principles of science, standardization, fairness, and objectivity, draws on various credit factor analysis methods and famous credit scoring systems (such as FICO and Sesame Credit), closely links with relevant government and enterprise policy documents, combines with the actual situation of enterprise market, and finally builds a credit factor from three aspects of enterprise market: foundation, marketing, and monopoly. The credit index system consists of 3 primary indicators, 10 secondary indicators, and 22 tertiary indicators.

Single and multigeneration Rankine cycles with aspects of thermodynamical modeling, energy and exergy analyses and optimization: A key review along with novel system description figures

• Giving potential system design ideas with novel general system description figures. • Enabling standardization and comparison with novel system description figures. • Summarizing and comparing the studies effectively with novel flow chart tables. • Emphasizing the main points and literature lack with novel literature review tables. The energy crises caused by the rapidly increasing population density around the world and the economic, environmental and health threats, that have reached significant dimensions, emphasize the importance of the concept of sustainable energy more and more every day. For this reason, to ensure the sustainability of energy, not only sustainable energy sources, but also optimum system designs are developed, which can be integrated with these sources and where waste heat recovery mechanisms are effective. At this point, Rankine cycle systems (RCSs) are an extremely good opportunity to close this gap due to their structural features. In this study, we grouped the RCSs existing in the literature and made a comprehensive evaluation of these systems from broad perspectives, such as exergo-economics, exergoenvironment, optimization, and system design, results and effects. The potential system designs revealed by compiling studies in the literature for the system type in question, through the novel general system description figures, were drawn with a completely original approach. For comparing the system designs in the studies examined with each other more easily and seeing the possible effects, the systems considered were originally and completely drawn by the authors of this paper, based on the principle of standardization. We summarized the examined study in terms of system design, the applied energy, exergy, economic analyzes and optimization processes, the obtained general results, input and output parameters affecting the system and their interaction with system components in a single table with novel flow chart tables. We presented an effective, easy-to-understand comparison method based on a strong visualization principle and expect that in this way one can inspire potential studies and understand easily the gaps in the literature. Also, we prepared a novel comprehensive comparison table for all types of RCSs in terms of techno-economic and environmental considerations. The main findings indicated that the maximum power, heating and cooling output rates, thermal and exergy efficiency values, mean total production cost rate, payback period and greenhouse gas emission ranges were 1040–329750 kW, 15.2–2500 kW, 567–22500 kW, 12.8–73.8%, 51.6–75.5%, 85.39 $/h, 3.6 years and 0.098 t/MWh, respectively, for cogeneration RCSs. The mean greenhouse gas emission, total production cost rate and payback period values were lower compared to other RCS types with higher exergy efficiencies and production outputs. It may be concluded that in terms of exergoeconomic and environmental perspectives, cogeneration RCSs form a better optimum configuration for many cases with utilization of influent waste heat recovery opportunities compared to other choices.

Campus: University or a Modern Urban Structure?

Modern cities face a range of problems, such as the need to redevelop inefficiently used former industrial territories, traffic congestion in cities, air, water and soil pollution and the disappearance of cities' last remaining natural areas. These issues require rethinking methods for the redevelopment and renovation of city districts. The campus model for the formation of sustainable territorial units in a city is set to replace conventional zoning (residential area, industrial area, city centre, recreational area). In campus structures, like in university campuses, everything is grouped together: residential and recreational facilities, schools and workplaces. Meanwhile, the environment, with elements of an individually-branded design code, is an area for likeminded people (residents of the campus) to interact. New social and economic models, as well as new global ideas, contribute to the appearance of new campus city blocks and micro- and macro-structures that are comparable to smart cities – the showcases of contemporary intellectual communities. In such urban areas, nature also plays a different role: it ceases to be a passive background, a means of featureless landscaping based on standard principles. The present research offers a description, analysis and classification of campus urban structures, based on the preliminary study of historical types of landscape organization in university campuses. Based on comparative historical analysis and experimental modeling, it distinguishes five types of the architectural and landscape organization of campuses: the enclosed model, the communicative model, the podium model, the nature-oriented model and the nature-equivalent model. In nature-equivalent campuses, nature becomes the main participant in the environment. Such urban structures become natural elements themselves, as they become parts of the ecosystem: environmentally safe, sustainable and self-regulating components of the natural and anthropogenic global landscape. The material laid out in the present research is of practical importance for students of architecture and campus designers.

V01-09 URETEROCALICOSTOMY IN TWO PATIENTS WITH MULTIPLE FAILED PYELOPLASTIES

You have accessJournal of UrologyCME1 May 2022V01-09 URETEROCALICOSTOMY IN TWO PATIENTS WITH MULTIPLE FAILED PYELOPLASTIES Michael Gross, Jason Scovell, and Robert Stein Michael GrossMichael Gross More articles by this author , Jason ScovellJason Scovell More articles by this author , and Robert SteinRobert Stein More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002520.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Success rates for primary repair of a ureteropelvic junction obstruction (UPJO) are excellent, however recurrent strictures do occur in a subset of patients. Secondary UPJO presents complex and variable surgical challenges and there is no one-size-fits all solution. Ureterocalicostomy, where a healthy segment of ureter is anastomosed to a lower pole calyx, is a reasonable approach as shown in two recent patients. METHODS: Case one is a 25 year old female with a history of left UPJO who underwent primary laparoscopic pyeloplasly followed by endopyelotomy for recurrent UPJO. She additionally experienced severe gross hematuria necessitating embolization of a lower pole branch renal artery. The resulting area of ischemia and parenchymal thinning presented a particularly favorable location for ureterocalicostomy to circumvent her UPJO. This was also felt to be a more anatomic drainage pattern in an otherwise malrotated kidney. The second case is a 31 year old female with UPJO repaired with open pyeloplasty followed by robotic pyeloplasty 13 years later for secondary UPJO who presented with persistent pain and hydronephrosis. This patient was not initially planned for ureterocalicostomy, however the ureter was severely scarred to the lower pole and the more proximal tissue did not appear dissectible or suitable for a buccal mucosal graft and the decision to proceed with ureterocalicostomy was reached intraoperatively. RESULTS: Both patients recovered without complications and experienced symptomatic resolution. Beyond standard principles for dissecting the ureter in pyeloplasty, there is a role for ultrasound in these cases to identify the optimal location for the calicostomy. A nephropexy can also be utilized to reposition the kidney and decrease tension on the anastomosis. Meticulous suturing technique is necessary to ensure apposition of the mucosa to minimize scarring and failure of the repair. CONCLUSIONS: Ureterocalicostomy is a feasible option in select patients and may be an elegant solution to circumvent dense scar tissue and to take advantage of pathologic anatomy. Source of Funding: No source of funding © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e54 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Michael Gross More articles by this author Jason Scovell More articles by this author Robert Stein More articles by this author Expand All Advertisement PDF DownloadLoading ...

Implementation of international standards of child-friendly justice to the administrative legislation of Ukraine

The article is devoted to the peculiarities of the implementation of the basic principles of justice for children in cases of administrative offenses. It is noted that every year in Ukraine more than ten thousand juveniles are brought to administrative responsibility for administrative offenses. But it is in this type of jurisdictional proceedings that the norms of Ukrainian legislation take the least into account the specifics of the administration of justice for children, which are determined by international standards and guidelines for the protection of children's rights. The purpose of the article is to clarify the content of international standards and guidelines for the administration of child-friendly justice and to identify existing problems of their implementation in the Ukrainian legislation on administrative offenses. It is established that the basis for the protection of the rights of juveniles prosecuted for administrative offenses is a set of interrelated and principles of administrative tort and international legal standards (rules) of treatment of children in the administration of justice. The second group of principles consists of the following principles, such as: ensuring the best interests of the child; access of the juvenile to the court and obtaining the necessary information in a form and manner accessible to the child; participation of the minor in the administrative tort proceedings against him (the principle of active participation, including the presumption of the child's ability to be a full participant in this relationship and the mandatory participation of the minor in the administrative case against him); free expression of the child's views and consideration of his opinion (the principle of being heard); the use of detention and forced detention of children only as an exceptional measure and for the shortest possible time; presumption of vulnerability of administrative and procedural rights of the child. These principles need to be more actively implemented in the norms of Ukrainian administrative law.

Promoting a sense of belonging, engagement, and collegiality to reduce burnout: a mixed methods study among undergraduate medical students in a non-Western, Asian context

BackgroundBurnout is a psychological condition induced by work-related chronic interpersonal stressors. Interventions creating a sense of belonging and collegiality have been proposed as approaches for alleviating burnout. The current study aimed to: (1) explore the relationships between burnout, sense of belonging (relatedness with others), and work engagement; and (2) identify the key elements perceived by undergraduate medical students as positively contributing to collegiality, engagement, and a sense of belonging, in an undergraduate medical training setting.MethodsAn exploratory sequential mixed-methods design using questionnaires and semi-structured individual interviews collected quantitative and qualitative data among undergraduate medical students at Mahidol University, Thailand. The Maslach Burnout Inventory-Student Survey questionnaire was used to measure burnout. The Basic Psychological Need Satisfaction at Work Scale (BPNSS-21) and the Utrecht Work Engagement Scale-Student Version (UWESS-9) measured students’ basic psychological needs satisfaction at work and work engagement, respectively. Descriptive statistical analysis and confirmatory factor analysis were performed on BPNSS-21 and UWESS-9 data. Spearman’s correlation coefficient was used to identify the correlation between burnout and other factors. Twenty undergraduate medical students participated in the qualitative study. Qualitative analysis was conducted iteratively using constant comparison and the standard principles of primary, secondary, and tertiary coding for thematic analysis.ResultsThai versions of the BPNSS-21 and UWESS-9 showed an acceptable fit for the Thai cultural context. Burnout had significant weak inverse associations with engagement (r = − 0.39, p < 0.005) and basic psychological needs satisfaction (r = − 0.37, p < 0.005). Sense of belonging had a significant weak inverse relationship with burnout (r = − 0.25, p < 0.005). The main themes emerging from qualitative analysis were relevant tasks and learning activities, safety in the learning environment, peer interaction, program design factors, dynamics of collegiality while progressing through medical school, and personal stance and social skills.ConclusionsSense of belonging, engagement, and collegiality were related to burnout. The key features for promoting collegiality, the sense of belonging, and engagement were relevant tasks and learning activities, safety in the learning environment, peer interaction, program design factors, dynamics of collegiality while progressing through medical school, and personal stance and social skills.

Comparative Evaluation of Stress Acting on Abutment, Bone, and Connector of Different Designs of Acid-Etched Resin-Bonded Fixed Partial Dentures: Finite Element Analysis.

Background: Finite element analysis (FEA) is one of the best methods for evaluating the stress distribution of restorations, such as fixed partial dentures. The development of resin cement has transformed prosthesis bonding and retention properties. Resin-bonded fixed partial dentures (RBFPD) have been considered minimally invasive treatment options for the prosthetic rehabilitation of single missing teeth. Objectives: The aim of this study was to evaluate the stress load and distribution in four different designs of acid-etched RBFPDs using FEA. Materials and Methods: The designs included standard tooth preparation principles and additional features. The first premolar and first molar abutments replaced the missing second premolar. Designs 1, 2, 3, and 4 included (1) lingual wings and occlusal rests; (2) wings and proximal slices; (3) wings, rests, and grooves; and (4) wings, rests, grooves, and occlusal coverage. The prepared models were restored with RBFPDs. A load of 100 N was applied to the central groove of the pontic to simulate occlusal forces. The materials used in the models were considered to be isotropic, homogeneous, and linearly elastic. FEA was used to reveal stresses acting on the abutment, bone, and connector in all prosthesis designs. Results: The stresses transmitted to the abutment and bones were lowest for design 3, using wings, rests, and grooves. The stresses acting on the connector were the weakest in design 2. The stresses transmitted to the abutment and bone were highest in designs 1 and 4. The stresses transmitted to the connector were highest in design 3. Conclusion: The wings, rests, and grooves design is possibly the ideal and conservative tooth preparation design to receive a posterior RBFPD. This design transmits less stress to the abutments and less bone resorption in the FEA. It is most likely to be successful in the clinical provision and ensures the longevity of the prosthesis.

Pandemic has Recaste Media Template

In August 2021, nearly 200 million people globally were believed to have had Covid-19 since the first case was reported in China in late 2019. The reported global death toll topped 4.26 million even as the World Health Organisation (WHO) expressed grave concern over the coronavirus, its mutations and the ever growing list of symptoms. The Covid-19 pandemic has rightly been regarded as the worst disaster befalling the global social and economic landscape in the last almost 100 years. Whilst previous natural or manmade disasters viz. earthquakes, floods, epidemics and World War I/II were largely confined to a continent or two, the magnitude of coronavirus contagion is still unfolding for mankind. The pandemic, which quickly spread far and wide due to an interconnected world, faster travel modes and voluminous international trade, has impacted every facet of life and society, business being no exception. During these troubled times, the conventional mass media of newspapers, periodicals and news channels were at the forefront of informing the public about the outbreak and the aftermath of the pandemic, which is believed to have originated from a discreet lab in Wuhan, China. The media has been tirelessly disseminating news about Covid-19, lockdown, restrictions on trade and movement, the development of vaccines, probe into its genesis, collaboration between nations, vaccination process et al. The media has dextrously been highlighting the radical shift in the pre-Covid norms of society as also business, trade and industry. The crystallisation of new normal taking shape in these domains has lucidly been narrated and presented by the mass media for the general public.Ironically, while the media resiliently dispensed a yeoman’s service to the community by informing and educating on the crisis, it also underwent an irreversible metamorphosis itself! Beyond the noble purpose of serving as a vital pillar of democracy, a news organisation is intrinsically a business or a non-profit entity, as the case may be according to its constitution, for sustenance and growth. It also follows the standard principles that power the biggest of the global corporations to the more modest trading or industrial units locally. With the entire value and supply chains of the industrial and commercial world getting disrupted, thus bringing about a sudden shift in the conventional processes and the work hierarchies, the media could no longer afford the luxury of a status quo.

OPEN REDUCTION AND INTERNAL FIXATION BY A TRADITIONAL BONE SETTER AND QUACKS - A CASE REPORT AND REVIEW OF LITERATURE

Purpose: Open reduction and internal fixation of fractures is surgical procedure guided by standard principles and often performed by Orthopaedic specialists. Unfortunately, some quacks now dabble into performing these complex procedures resulting in several complications. However, it has becoming a serious public health concern in that a traditional bone setter in collaboration with some health workers (quacks who were community health extension workers) engaged in performing an open reduction and internal fixation for a femoral fracture in our index patient with very severe complications.&#x0D; Methodology: We present this case of open reduction and internal fixation by traditional bone setters and quacks to illustrate the extent of malpractices by traditional bone setters aided by quacks who have either been assisting Orthopaedic surgeons in the theatre or have been watching these procedures as they are frequently been carried out in the operating room.&#x0D; Results: This index patient, a university undergraduate presented via our outpatient clinic having been mismanaged by a traditional bone setter in collaboration with a Community health extension work. An informed consent was duly taken from the patient concerning the reporting of the case and he was fully clerked, investigated and managed until he left against medical advised due to financial constraints.&#x0D; Unique contribution to theory, practice and policy: We strongly recommend legislation and enforcement of laws that restrict traditional bone setters to limit their practices within their capacities under supervision if they must be allowed for any reason to practice management of simple fractures. The Community Health Extension Workers(CHEW) are to be under strict regulation by the Medical councils to prevent this unwholesome practices.

Feasibility study on the formulation of air non-point source emission standard in China

Emission standards of air pollutants are the legal basis for environmental management. Compared with the point source emission, the non-point source pollution of the air is mostly unorganized, which has the characteristics of large scope, random, hidden and difficult to control. It is difficult to take effective measures to control pollution, and the emission standard of atmospheric non-point source pollution is basically blank. In order to design a scientific and reasonable standard system, we have summarized the characteristics of atmospheric non-point source pollution, summarized the difficulties that dates back to the atmospheric non-point source emission standard in China, analyses the problems in the process of atmospheric non-point source emissions standards, put forward the principles for atmospheric non-point source emission standards. Finally we present the feasibility of typical atmospheric non-point source emission standards in China.

The effects of educational intervention on operating room nurses' use of electrosurgical units

BackgroundElectrosurgical units are used in over 80% of operations worldwide. The consequences of incorrect use of electrosurgical units for patients and the surgical team include skin burns, inhalation of electrosurgical smoke, fire, and disruption to the functioning of cardiac pacemakers. Training operating room personnel in the correct use of electrosurgical units and evaluating their performance plays a crucial role in making optimal use of the units and extending their lifetime, reducing occupational hazards for surgical teams, and enhancing the safety of patients. Therefore, the present study was done to investigate the effects of an educational intervention on electrosurgical units by operating room nurses. MethodsIn this quasi-experimental research, the performance of 100 operating room nurses concerning their application of electrosurgical units in 200 operations (100 before and 100 one month after the educational intervention) was observed and evaluated. The data collection instruments consisted of a Demographic Information Questionnaire, a surgery checklist, and the checklist for the use of electrosurgical units by operating room nurses. The content of the poster was based upon the standard principles of using electrosurgical units based on the guidelines by the Association of periOperative Registered Nurses (AORN), Association of Surgical Technologists (AST), and the Association for PeriOperative Practice (AFFP). ResultsThe average age of the participating nurses were 31.540 ± 6.772 years. Before (18.330 ± 2.666) and after (20.820 ± 3.400) the educational intervention, the results showed a statistically significant difference between the means and standard deviations of the scores of electrosurgical units by operating room nurses. ConclusionIntroducing operating room nurses to the standard guidelines for applying electrosurgical units can improve the quality of services provided by the nurses, increase the safety of patients, and reduce occupational hazards. Thus, medical managers and policymakers should pay more attention to on-the-job training programs to improve the professional performance of operating room nurses in the use of electrosurgical units.

Sustainable low-input urban park design based on some decision-making methods

Shortage of resources, mostly water, and lack of attention to Life Cycle Costs (LCC) have challenged urban landscape development and require methodological development for more sustainable urban landscape designs. In this research, decision-making methods, including Value Engineering (VE), Multi-criteria Decision Making (MCDM), and Risk Management (RM) techniques, which are essential tools for optimal use of resources, were integrated to optimize the design of a city park, especially towards economic sustainability. This research was carried out on a case study design in Mashhad, Iran, where open space was designed as a park space based on two methods. A conventional base plan was developed based on the general and standard principles of park design. In contrast, in a proposed Low-Input plan, the sustainable output indicators of economic, social, and environmental were applied to design a park with minimum cost inputs in the design and maintenance stages. The results showed that by using the VE and MCDM methods to choose sustainability indicators, the consumption of resources and maintenance costs used for the LCC decreased, while initial park construction costs were higher. The proposed Low-Input plan was expected to reduce costs by 62.7% compared to the conventional base plan. Therefore, VE can balance costs and improve design quality and be a valuable tool in the design and maintenance of urban parks.

WHO-led consensus statement on vaccine delivery costing: process, methods, and findings

BackgroundDifferences in definitions and methodological approaches have hindered comparison and synthesis of economic evaluation results across multiple health domains, including immunization. At the request of the World Health Organization’s (WHO) Immunization and Vaccines-related Implementation Research Advisory Committee (IVIR-AC), WHO convened an ad hoc Vaccine Delivery Costing Working Group, comprising experts from eight organizations working in immunization costing, to address a lack of standardization and gaps in definitions and methodological guidance. The aim of the Working Group was to develop a consensus statement harmonizing terminology and principles and to formulate recommendations for vaccine delivery costing for decision making. This paper discusses the process, findings of the review, and recommendations in the Consensus Statement.MethodsThe Working Group conducted several interviews, teleconferences, and one in-person meeting to identify groups working in vaccine delivery costing as well as existing guidance documents and costing tools, focusing on those for low- and middle-income country settings. They then reviewed the costing aims, perspectives, terms, methods, and principles in these documents. Consensus statement principles were drafted to align with the Global Health Cost Consortium costing guide as an agreed normative reference, and consensus definitions were drafted to reflect the predominant view across the documents reviewed.ResultsThe Working Group identified four major workstreams on vaccine delivery costing as well as nine guidance documents and eleven costing tools for immunization costing. They found that some terms and principles were commonly defined while others were specific to individual workstreams. Based on these findings and extensive consultation, recommendations to harmonize differences in terminology and principles were made.ConclusionsUse of standardized principles and definitions outlined in the Consensus Statement within the immunization delivery costing community of practice can facilitate interpretation of economic evidence by global, regional, and national decision makers. Improving methodological alignment and clarity in program costing of health services such as immunization is important to support evidence-based policies and optimal resource allocation. On the other hand, this review and Consensus Statement development process revealed the limitations of our ability to harmonize given that study designs will vary depending upon the policy question that is being addressed and the country context.

Inter-Slice Mobility Management in 5G: Motivations, Standard Principles, Challenges, and Research Directions

Mobility management in a sliced 5G network introduces new and complex challenges. In a network-sliced environment, user mobility has to be managed among not only different base stations or access technologies but also different slices. Managing user mobility among slices, or inter-slice mobility, motivates the need for new solutions. This article, presented as a tutorial, focuses on the problem of inter-slice mobility from the perspective of 3GPP standards for 5G. It provides a detailed overview of the relevant 3GPP standard principles. Accordingly, key technical gaps, challenges, and corresponding research directions are identified toward achieving seamless inter-slice mobility within the current 3GPP network slicing framework.

The Aleph and Other Alleged Mereological Curiosities

Standard principles of mereology, such as the transitivity and asymmetry of proper parthood, have been questioned, using various multi-location scenarios. The most famous of these is Borges’s Aleph, although the literature is rife with other examples that allegedly show that some mereological principle is at odds with some form of multi-location. However, the scenarios only support this conclusion given various bridge principles that link location to parthood. I argue that the bridge principles that guarantee the desired conclusion are controversial partly because they give the wrong result in other situations, in particular cases of co-location. Moreover, less controversial bridge principles do not provide an incompatibility result between standard mereological principles and multi-location. Hence, multi-location does not threaten any standard mereological principles.