Standardized Usage Research Articles

The rapidly changing field of predictive biomarkers of non-small cell lung cancer.

Lung cancer is a leading cause of cancer-related death worldwide in both men and women, however mortality in the US and EU are recently declining in parallel with the gradual cut of smoking prevalence. Consequently, the relative frequency of adenocarcinoma increased while that of squamous and small cell carcinomas declined. During the last twodecades a plethora of targeted drug therapies have appeared for the treatment of metastasizing non-small cell lung carcinomas (NSCLC). Personalized oncology aims to precisely match patients to treatments with the highest potential of success. Extensive research is done to introduce biomarkers which can predict the effectiveness of a specific targeted therapeutic approach. The EGFR signaling pathway includes several sufficient targets for the treatment of human cancers including NSCLC. Lung adenocarcinoma may harbor both activating and resistance mutations of the EGFR gene, and further, mutations of KRAS and BRAF oncogenes. Less frequent but targetable genetic alterations include ALK, ROS1, RET gene rearrangements, and various alterations of MET proto-oncogene. In addition, the importance of anti-tumor immunity and of tumor microenvironment has become evident recently. Accumulation of mutations generally trigger tumor specific immune defense, but immune protection may be upregulated as an aggressive feature. The blockade of immune checkpoints results in potential reactivation of tumor cell killing and induces significant tumor regression in various tumor types, such as lung carcinoma. Therapeutic responses to anti PD1-PD-L1 treatment may correlate with the expression of PD-L1 by tumor cells. Due to the wide range of diagnostic and predictive features in lung cancer a plenty of tests are required from a single small biopsy or cytology specimen, which is challenged by major issues of sample quantity and quality. Thus, the efficacy of biomarker testing should be warranted by standardized policy and optimal material usage. In this review we aim to discuss major targeted therapy-related biomarkers in NSCLC and testing possibilities comprehensively.

A Simple Strategy to Reduce Contrast Media Use and Risk of Contrast-Induced Renal Injury during PCI: Introduction of an "Optimal Contrast Volume Protocol" to Daily Clinical Practice.

Contrast-induced acute kidney injury is the leading cause of iatrogenic acute nephropathy. Development of contrast-induced nephropathy (CIN) increases the risk of adverse long- and short-term patients outcomes, the hospital costs, and length of hospitalization. There are a couple of methods described for CIN prevention (statin prescription, prehydration, contrast media (CM) clearance from the blood system, and decrease amounts of contrast volume). The CM volume to patient's creatinine clearance ratio is the main factor to predict the risk of CIN development. The safe CM to creatinine clearance ratio limits have been established. The usage of CM amount depends on personal operators habits and inside center regulations. There is no standardized contrast usage protocol worldwide. The aim of this study was to establish an easy to use, cheap, and efficient protocol to estimate a personalized safe CM dose limit for every patient based on their kidney function. These limits are announced during the "Time Out" before the procedure. Our study included 519 patients undergoing interventional coronary procedures: 207 patients into the "Optimal Contrast Volume" arm and 312 into the control group. Applying the protocol into a daily clinical practice leads to a significant reduction in CM volume used for all type of procedures and the development of CIN in comparison with a control group.

Translation of soundscape perceptual attributes from English to Turkish

The International Standard Organization (ISO) published the standard series on soundscape for the identification, data collection and data analysis. However, since all these standards are in English language, the reliable standardized usage in other languages and its applicability is questionable. Thus, this two-staged study aims: i) to determine the Turkish equivalences of the 8 soundscape perceptual attributes that are published in ISO/TS 12913–2:2018 and ISO/TS 12913–3:2019, ii) to analyze if the determined Turkish attributes have concept equivalence to the original ones, and iii) to determine if the translated Turkish scale is reproducible. The first stage involved the translation of the attributes by focus group discussions and finalization by Turkish linguistic experts. As a result, the attributes ‘eventful’, ‘vibrant’, ‘pleasant’, ‘calm’, ‘uneventful’, ‘monotonous’, ‘annoying’, and ‘chaotic’ are translated to Turkish as ‘hareketli’, ‘coşkulu’, ‘keyifli’, ‘sakin’, ‘durağan’, ‘tekdüze’, ‘rahatsız edici’, and ‘karmaşık’, respectively. The second stage involves the analysis of reproducibility in terms of inter-rater reliability and conceptual validity. It is found that the Turkish scale is reproducible based on high inter-rater reliability in all attributes. Context validity at a conceptual level is analyzed both in terms of the difference between the average scores given to the English attributes and their corresponding Turkish equivalences and the correlation between the English and Turkish scores given to each attribute. The highest difference between the average scores (around 10 points on a slider scale of 0 to 100) is found to be in the translation of ‘vibrant’ while the lowest correlated one (slightly lower than 0.5) is found in ‘chaotic’ attribute as in line with literature. Despite this result, when the scores are reduced to 2 dimensions as pleasantness and eventfulness, it is seen that there is a high correlation between the English and Turkish scales. It is considered that the results obtained from this research could act as a base in the future for the establishment of Turkish Standards on soundscape and standardization of the translated and validated Turkish soundscape perceptual attributes and the ‘perceived affective quality’ scale defined under ISO/TS 12913–2:2018 in English.

Prevalence and Factors Associated with the Use of Standard Helmets among Motorcyclists among workers in Indonesia

Information about wearing standardized and fastened helmets has yet to be explicitly conveyed at the national level to workers in Indonesia. This study aims to determine related factors to standardized helmet usage (use of helmets that meet national standards and fastened clasp) among workers in Indonesia in 2018. The analysis used secondary data from the Indonesian Basic Health Research in 2018. The research design was cross-sectional, with the number of samples that met the inclusion criteria being 278,404 workers of productive age (18-64 years) from 34 provinces in Indonesia. The variables used consist of socio-demographic data, socioeconomic status, and knowing how to use helmets for workers in Indonesia. The data analysis used multivariate logistic regression statistical methods to determine the relationship between the type of work and other factors in standardized helmet use. Most respondents are workers in the informal sector (77.0%), whereby 40.6% used standardized helmets. The multivariate logistic regression model showed that the factors associated with standardized helmet use include education, place of residence (urban), occupation, and social status. The higher the level of education and social status of the worker, the higher their awareness of standardized helmet usage when driving. Therefore, it is necessary to increase awareness of standardized helmet usage, especially for workers in the informal sector with low education and socioeconomic status. Standardized helmet usage by workers provides greater protection against head injuries and reduces the severity of injuries among motorcyclists.

The Poesis and Politics of English-es in Singapore: Intersubjective Worlding in the Poetry of Joshua ip And Hamid Roslan

This research article discusses developments in contemporary Anglophone Singapore poetry where a proliferation of writers' groups and literary initiatives has led to efforts to define a localized Anglophone poetic tradition. Focusing on the debut collections of two young poets, Joshua Ip and Hamid Roslan, we argue that the presence of Singlish in their work functions as a site of hermeneutical openness that challenges a neocolonial articulation of Singaporean cultural formations centered on ideologies of standardized English usage, which have homogenized ethnic identities and supported a narrative of national progress. This article theorizes the heteroglossic potentialities of the intersubjective lifeworld found in Ip's and Hamid's poetics by discussing how they eschew any naturalized relationship between language as a semiotic system and sociohistorical being, in favor of a renewed query into Anglophone writing as an accumulation of asymmetrical and uneasy cultural relations.

Evaluating performance of an untargeted urban food security scheme in India

PurposeThe purpose of this study is to evaluate the efficiency of the relative performances of Mother’s canteen across the regions of Tamil Nadu and find out the determinants of inefficiencies in the scheme.Design/methodology/approachAn untargeted food security scheme called Amma (Mother's) canteen was started in Tamil Nadu, India, with an aim to provide the urban poor with hygienic and healthy food at an affordable price. Along with secondary data, interviews were conducted to understand the operational details of Mother's canteen. Data envelopment analysis (DEA) was used to find the relative efficiency of the scheme operated by nine corporations.FindingsBased on the daily expenditure, number of meals served and revenue, seven of nine corporations were found to be inefficient. Further, sensitivity analyses found that among six procurement variables, procurement (quantity and price) of black gram and cooking oil were determinants of inefficiency.Research limitations/implicationsAs an untargeted scheme, the cost of delivering service-based evaluation was used for performance evaluation. Policymakers could use centralized procurement instead of open market procurement at the corporation level and standardized ingredients' usage (quantity) to further reduce the cost of the food security scheme.Practical implicationsThe proposed DEA model may be used by policymakers to empirically evaluate the food security scheme's delivery effectiveness across various corporations in a region. Inefficient branches are identified here with empirical support for further performance improvement changes.Originality/valueThere are limited number of studies evaluating untargeted schemes. This paper presents the challenges of evaluating an untargeted scheme which allows self-selection of beneficiaries. The outcome of this study will help in identifying inefficient corporations, and further, improve the performance and cost of delivering untargeted food security scheme.

Effect of propiconazole on plastic film microplastic degradation: Focusing on the change in microplastic morphology and heavy metal distribution

With the rapid increase in the use of plastic films, microplastic (MP) pollution in agricultural soils has become a global environmental problem. Propiconazole is widely used in agriculture and horticulture; however, its role in plastic film degradation remains elusive. Butylene adipate-co-terephthalate (PBAT) and polyethylene (PE) films were used to analyze the effects of propiconazole on plastic film and MP degradation. We identified the surface morphologies of PBAT and PE at different propiconazole concentrations and soil pH values, as well as the adsorption and release characteristics of heavy metals during the degradation process via scanning electron microscopy, Fourier transform infrared spectroscopy and inductively coupled plasma mass spectrometry. Propiconazole accelerated the degradation of MPs, adsorption of heavy metals (Ni and Zn), and release of Sn at low concentrations (≤40 mg/kg); however, these effects were evidently absent at a high concentration (120 mg/kg). Furthermore, MPs were more prone to degradation in acidic or alkaline soils than in neutral soil when they coexisted with propiconazole. Hence, we suggest that PBAT and PE plastic films may not be suitable for application in acidic and alkaline soils with propiconazole, because of shorter rupture time and more heavy metal adsorption. PBAT degraded faster, absorbed and released more heavy metals than PE. Under all tested conditions, the heavy metal contents in MPs gradually approached those in soil, which proves that MPs are carriers of heavy metal pollutants. These results may help in assessing the impact of MPs on soil environments and provide a theoretical basis for the standardized propiconazole and plastic film usage.

A DESCRIPTIVE STUDY TO ASSESS THE USAGE AND ATTITUDES TOWARDS MEDIA AND TECHNOLOGY AMONG STUDENTS AT SELECTED COLLEGE, DEHRADUN

Introduction: Technology has revolutionized the world over the past 20 years but that revolution didnt come without a price. Digital and new media technologies are profoundly reshaping how people communicate, seek entertainment and education, conduct commercial activity and access community-based services. Digital technologies are almost ubiquitous in post industrial societies, and considerable research illustrates that those at risk of social and economic marginalization are especially vulnerable to digital nonparticipation or under participation, which potentially compounds disadvantage and lack of opportunity. People rely on digital media and technology as part of their everyday lives in order to: stay informed remain connected to family, friends and community purchase goods and services gain an education participate as digital citizens seek employment or remain employed in contemporary work settings access government services. Although, communication through technology helps in certain times, like during loneliness, it does not substitute or compare with face-to face verbal communication. Particularly for these younger students, who have not lived lives without the often immersive and pervasive presence of media technology in their lives, it came as almost a surprise or at least unexpected thought that there could be life without media technology and that a life without its presence could possibly be something one would want. Social networking has become an important part of a students social life. It is now considered as a learning platform which helps in improving student engagement and capabilities in schools, colleges. Problem statement: A study to assess the usage and attitude towards the media and technology among students at selected college, Dehradun. Aims: To assess the usage and attitude towards the media and technology among students at selected college, Dehradun. Objectives 1. To assess the usage towards the media and technology among students. 2. To assess the attitude towards the media and technology among students. 3. To find out the correlation between usage and attitude towards the media and technology among students. 4. To find out the association between usage and attitude towards the media and technology and selected demographic variables. Methodology: The nature of the study was quantitative approach and descriptive research design. Non probability sampling technique was used in this study. The content validity done by 4 experts in the field of nursing. The study was conducted at Shri Guru Ram Rai University, College of Nursing, Dehradun is a private institute and running various programs. This study included 60 respondents and their how does they use and have attitude towards media and technology was assessed by using standardized usage and attitude scale. The study was explained to the respondent and their consent was obtained. The data collection was done by self administrative method. The collected data was analyzed and interpreted by using descriptive and inferential statistics. Results: Maximum percentage of students 73.3% were of 20-23 years of age. All the samples are 60 in number out of which maximum percentage 83.3% were females. The highest percentage 93.3 of subjects belongs to Hindu religion. Majority 81.7% of students to belongs nuclear family. Family income shows that 58.3% of subjects have above Rs 31000 family income. Students fathers occupation were 55%the government employee. Maximum the mothers of student, 73.3% were home maker. Majority 71.7% of the subjects belongs to urban area. Study showed that correlation between the usage and attitude towards media and technology is 1.So, there is strongly correlation between usage and attitude towards media and technology. There is significant association between usage towards media and technology and religion among students. Thus, research hypothesis is accepted. There is significant association attitude towards media and technology and occupation of mother, area of living among students. Thus, research hypothesis is accepted. Summary:The results revealed that 63.3% have positive attitude towards media and technology. So, it has a strong positive relationship between the usage and the attitude among the respondents. Mean score is 53.5 and SD is 9.98.

Feasibility of self-administered acupressure for allergic rhinitis: a pilot randomized controlled trial and lessons learnt for future studies.

Allergic rhinitis (AR) is an immunoglobulin (Ig)E-mediated inflammatory condition that is highly prevalent worldwide. The aim of this pilot trial was to evaluate the feasibility and safety of self-administered acupressure for AR. A randomized, single-blind, non-specific controlled clinical trial was conducted at Royal Melbourne Institute of Technology (RMIT) University, Melbourne, Australia. Fifteen AR patients were randomized into two groups: self-administered acupressure at five specific acupressure (SA) points or five non-specific acupressure (NSA) points (1 min/point, twice a day), and treated for 4 weeks with an 8-week follow-up period. The primary outcome was the change in 7-point scale symptom severity. Secondary outcomes included the rhinoconjunctivitis quality of life questionnaire and standardized activities (RQLQs), medication usage, adverse events and participants' opinions of the blinding method. The Statistical Package for the Social Science (SPSS) version 26 was used for data analyses. Fourteen participants completed the study and no major adverse events were reported. No statistically significant differences between SA and NSA groups were identified in 7-point scale symptom severity scores, RQLQs or medication usage. However, participants in the SA group believed that SA was useful for AR and recommended it for self-care. The credibility of the blinding method was successful. No adverse effects were considered to be related to the intervention. Acupressure is feasible and appears to be safe for self-administration by AR sufferers. Experience from this pilot study has guided minor amendments to the protocol. A large-scale randomized controlled trial is warranted to further investigate the efficacy and safety of self-administered acupressure for the management of AR.

Scalable Thermal Masking Technique for Postprocessing of Flexible Electronics

Flexible electronics have found a wide variety of applications, especially in biomedical engineering, where their intrinsic safety and conformability provide for configurations of sensors and actuators that can accommodate complex anatomies and movement. Current scalable techniques in the manufacture of flexible electronics are limited by the challenges of working with novel, intrinsically stretchable materials, or using cost‐intensive clean room fabrication techniques needed to create strain accommodating geometries. Recently, a technique that allows for scalable postprocessing of flexible printed circuit boards (flex PCBs) to convert them to stretchable configurations is described. Herein, a mechanism for understanding this process based on a thermal masking phenomenon is described. Thermal simulation provides an understanding of the phenomenon and various aspects of the process. Copper traces are modeled along with Kapton insulating layer on ANSYS workbench and a Gaussian waveform is introduced to simulate a laser beam. An inhouse laser cutter is used to calibrate the simulations and an accurate predictive model is used to determine working conditions, resolution, and other parameters that affect the standardized usage of this process for various thicknesses of copper and Kapton that can be produced by most mass manufacturers. This process provides a path for cost‐effective manufacture of stretchable electronics.

Neurogenic bowel dysfunction score in spinal cord-injured patients: translation and validation of the Dutch-language NBD score.

This is a prospective validation study. The neurogenic bowel dysfunction (NBD) score is a widely used symptom-based questionnaire evaluating bowel dysfunction and its impact on quality of life (QoL) in spinal cord-injured patients. This study aimed to translate and validate a Dutch-language NBD score in patientswith SCI. Patientswith SCI visiting the urology department or general practitioner (GP) in Rotterdam, the Netherlands. Standardized guidelines were followed for the translation and validation process of the NBD score. Adult patientswith SCI visiting our urology department were asked to participate by filling in a set of questionnaires: the NBD score, the Fecal Incontinence Quality of Life scale (FIQL), the Fecal Incontinence Severity Index (FISI), and the European Quality of life 5-Dimension 3-Level questionnaire (EQ-5D-3L) at baseline and 1-2 weeks afterward. A control group recruited at a GP office completed the questionnaires once. The following measurement properties were evaluated: content validity, internal consistency, reproducibility, criterion-, and construct validity. Fifty-eight patients and 50 references were included. Content validity was adequate, internal consistency was moderate (Cronbach's alpha 0.56 and 0.30) and reproducibility was adequate (ICC 0.87). Criterion validity was confirmed; NBD score correlated significantly with the FIQL, FISI, and EQ-5D-3L. NBD scores in the patient group were significantly higher than in references, demonstrating good construct validity. The Dutch-language version of the NBD score showed moderate to good measurement properties, and therefore is a reliable tool to measure bowel dysfunction in patientswith SCI. We recommend standardized usage of this questionnaire for clinical evaluation and research purposes.

Computed tomography angiography-derived area stenosis calculations overestimate degree of carotid stenosis compared with North American Symptomatic Carotid Endarterectomy Trial-derived diameter stenosis calculations

ObjectiveThe degree of carotid artery stenosis, calculated using catheter-based angiography and the North American Symptomatic Carotid Endarterectomy Trial (NASCET) method, has been shown to predict the stroke risk in several, large, randomized controlled trials. In the present era, patients have been increasingly evaluated using computed tomography (CT) angiography (CTA) before carotid artery revascularization, especially as the use of transcarotid artery revascularization has increased. Interpretation of CTA findings regarding the degree of carotid stenosis has not been standardized, with both NASCET methods and the area stenosis used. We performed a single-institution, blinded, retrospective analysis of CTA studies using both the NASCET method and the CT-derived area stenosis to assess the concordance and discordance between the two methods when evaluating ≥70% and ≥80% stenosis. MethodsThe UMass Memorial Medical Center vascular laboratory database was queried for all carotid duplex ultrasound scans performed from 2008 to 2017. The included patients were limited to those with duplex-defined ≥70% stenosis (defined as a peak systolic velocity of ≥125 cm/s and an internal carotid artery/common carotid artery ratio of ≥4), and a correlative CTA study performed within 1 year of the duplex ultrasound examination. A blinded review of all correlative CTA studies using centerline measurements on a three-dimensional workstation (Aquarius iNtuition Viewer; Terarecon, Durham, NC) was performed to characterize the degree of carotid stenosis using the NASCET method and the area stenosis method. Patients were excluded if revascularization had been performed between the two imaging studies. ResultsOf the 37,204 carotid duplex ultrasound scans reviewed (performed from 2008 to 2017), 3480 arteries met the criteria for duplex ultrasound-defined ≥70% stenosis. A correlative CTA study within 1 year of the duplex ultrasound examination was identified in 460 arteries, of which 320 were adequate quality for blinded review. The median interval between the duplex ultrasound and CTA examinations was 9.5 days. Concordance between the area stenosis and NASCET methods was poor for both ≥70% (κ = 0.32) and ≥80% (κ = 0.25) stenosis. Of the 247 arteries considered to have ≥70% area stenosis, 127 (51.4%) were considered to have ≥70% stenosis using the NASCET method. Of the 169 arteries considered to have ≥80% area stenosis, 44 (26.0%) were considered to have ≥80% stenosis using the NASCET method. ConclusionsThe area stenosis CTA calculations of carotid artery stenosis dramatically overestimated the degree of carotid stenosis compared with that calculated using the NASCET method. Given that stroke risk estimates have been determined from trials that used the NASCET method, the area stenosis method likely overestimates the risk of stroke. Therefore, area stenosis calculations could lead to unnecessary carotid revascularization procedures. This model highlights the need for standardized usage of the NASCET method when using CTA as the imaging modality to determine the threshold for carotid revascularization.

Estimating population immunity to poliovirus in Lebanon: Results from a seroprevalence survey, 2016

IntroductionCirculation of poliovirus in neighboring countries and mass population movement places Lebanon at risk of polio and other vaccine-preventable disease outbreaks. Determining population immunity levels is essential for guiding program planning and implementation of targeted supplementary immunization activities (SIAs) in governorates and subpopulations with low seroprevalence. MethodsA cross-sectional multi-stage cluster survey was conducted during February-December 2016 in all six governorates of Lebanon adapted from the World Health Organization (WHO) recommended Expanded Progamme on Immunization (EPI) methodology. Sera from selected children aged 12–59 months were tested for poliovirus neutralizing antibodies. ResultsOf 2,164 children recruited in this study, 1,893 provided sufficient quantity of serum samples for laboratory testing. Seroprevalence for all three poliovirus serotypes was greater than 90% in all six governorates. Poliovirus vaccine coverage with three or more doses, based on vaccination cards or parental recall, ranged between 54.1% for children aged 36–47 months in the North and 83.5% for children aged 48–59 months in Beirut. ConclusionImmunity to polioviruses was high in Lebanon in 2016 following a series of supplementary immunization activities. It is essential to continue strategies that increase vaccination coverage in order to sustain the considerably high immunity levels and prevent reintroduction and transmission of poliovirus. Educating caregivers and training health care workers on the standardized usage of home-based vaccination records is needed to guarantee the accuracy of records on children’s vaccination status.

Encountering COUNTER 5

To make fiscally and academically responsible selection and deselection of subscribed content, it is critically important to have reasonably accessible usage data for those resources. To this end, the organizers of Project Counting Online Usage of NeTworked Electronic Resources (COUNTER) initiated the development of a standard known as the COUNTER Code of Practice. Beginning with the year 2019, COUNTER 5 standardized usage reports are available for most commercially published electronic information resources such as online journals, aggregated research databases, and ebooks. This column explores some of the differences between the COUNTER 5 Title Master Report-Journal Report (TR-JR1) report and the COUNTER 4 JR1 report for online journal usage and offers some assistance in extracting specific data from the TR-JR1 report that is not as readily visible as it was in COUNTER 4 reports.

Decreases in Antimicrobial Use Associated With Multihospital Implementation of Electronic Antimicrobial Stewardship Tools.

Antimicrobial stewards may benefit from comparative data to inform interventions that promote optimal inpatient antimicrobial use. Antimicrobial stewards from 8 geographically dispersed Veterans Affairs (VA) inpatient facilities participated in the development of antimicrobial use visualization tools that allowed for comparison to facilities of similar complexity. The visualization tools consisted of an interactive web-based antimicrobial dashboard and, later, a standardized antimicrobial usage report updated at user-selected intervals. Stewards participated in monthly learning collaboratives. The percent change in average monthly antimicrobial use (all antimicrobial agents, anti-methicillin-resistant Staphylococcus aureus [anti-MRSA] agents, and antipseudomonal agents) was analyzed using a pre-post (January 2014-January 2016 vs July 2016-January 2018) design with segmented regression and external comparison with uninvolved control facilities (n = 118). Intervention sites demonstrated a 2.1% decrease (95% confidence interval [CI], -5.7% to 1.6%) in total antimicrobial use pre-post intervention vs a 2.5% increase (95% CI, 0.8% to 4.1%) in nonintervention sites (absolute difference, 4.6%; P = .025). Anti-MRSA antimicrobial use decreased 11.3% (95% CI, -16.0% to -6.3%) at intervention sites vs a 6.6% decrease (95% CI, -9.1% to -3.9%) at nonintervention sites (absolute difference, 4.7%; P = .092). Antipseudomonal antimicrobial use decreased 3.4% (95% CI, -8.2% to 1.7%) at intervention sites vs a 3.6% increase (95% CI, 0.8% to 6.5%) at nonintervention sites (absolute difference, 7.0%; P = .018). Comparative data visualization tool use by stewards at 8 VA facilities was associated with significant reductions in overall antimicrobial and antipseudomonal use relative to uninvolved facilities.

1058. Decreases in Antibiotic Use Associated with the Implementation of Electronic Antibiotic Visualization Tools for Stewards at Eight Veterans Affairs (VA) Healthcare Facilities

BackgroundTo identify areas for improved antibiotic use, we developed and pilot-tested visualization tools to quantify antibiotic use at 8 VA facilities. These tools allow a facility to review its patterns of total use, and use by antibiotic class, compared with patterns of use at VA facilities with similar (or user-selected) complexity levels.MethodsAntibiotic stewards from 8 VA facilities participated in iterative report development and implementation, with the final product consisting of two components: an interactive web-based antibiotic dashboard and a standardized antibiotic usage report updated at user-selected intervals. Stewards also participated in monthly learning collaboratives. The percent change in average monthly antimicrobial use (all antibiotics; anti-methicillin-resistant S. aureus agents (anti-MRSA); and broad-spectrum agents predominantly used for hospital-onset/multi-drug-resistant organisms (anti-MDRO)) was analyzed using a pre-post (January 2014–January 2016 vs. July 2016–January 2018) with un-involved controls (all other inpatient VA facilities, n = 132) design modeled using Generalized Estimation Equations segmented regression.ResultsIntervention sites had a 2.1% decrease (95% CI = [−5.7%,1.6%]) in all antibiotic use pre-post-intervention, vs. a 2.5% increase (95% CI = [0.8%, 4.1%]) in nonintervention sites (P = 0.025 for difference). Anti-MRSA antibiotic use decreased 11.3% (95% CI = [−16.0%,−6.3%]) at intervention sites vs. a 6.6% decrease (95% CI=[−9.1%, −3.9%]) at nonintervention sites (P = 0.092 for difference). Anti-MDRO antibiotic use decreased 3.4% (95% CI = [−8.2%,1.7%]) at intervention sites vs. a 3.6% increase (95% CI = [0.8%,6.5%]) at nonintervention sites (P = 0.018 for difference) (Figure 1). Examples of graphs include overall antibacterial use (Figure 2), and usage of broad-spectrum Gram-negative therapy (Figure 3) in intensive care units.ConclusionThe use of data visualization tools use and participation in monthly learning collaboratives by antimicrobial stewards in a pilot implementation project at eight VA facilities was associated with decreases in antimicrobial use relative to uninvolved sites. Disclosures All authors: No reported disclosures.

COLLECTION AND ANALYSIS OF ELECTRONIC RESOURCE USAGE STATISTICS ACCORDING TO COUNTER 5

The development of COUNTER usage statistics code of practice (de facto standard) during 2003–2016 is considered. It is demonstrated what issues in developing four successive versions of standard resulted in its substantial redesign fulfilled during 2016–2018 and implemented in COUNTER 5. New conceptual structure of COUNTER 5 (effective from January 1st, 2019) with its three components “objects — metrics — attributes” is described. New opportunities of statistical reports generation allowing to combine different attributes and metrics are analyzed. New standard reports are described and commented. Differences in summary statistics data compared to previous year data are explained. The importance of standardized usage data from content providers not COUNTER compliant yet is stressed.

Experts' suggestions of normative application of amiodarone

Amiodarone is a commonly used antiarrhythmic drug. With the continuous renewal of the concept of arrhythmia treatment, the clinical application of amiodarone is also changing. There still exist some irregular uses in clinical practice. The present expert panel recommendation introduces amiodarone from its indications, pharmacology, dosage, follow-up and side effects, and emphasizes its standardized clinical usage. Some controversial issues are also discussed in the recommendation.

Reviewing the DATAS of aviation research data: Diversity, availability, tractability, applicability, and sources

The field of aviation research is entering the era of big data. While data-driven advancements in aviation have clearly brought about applicable models and results with immediate implications, we argue that the influx of aviation data should be better characterized and documented to enable more efficient and standardized usage. To this end, we examine 200 well-cited research articles from sub-disciplines ranging from revenue management to air traffic control published on or after 2010 in order to analyze the diversity, availability, tractability, applicability, and sources (DATAS) of data utilized in aviation research. We find high levels of data diversity within aviation research, with 16 data categories ranging from air traffic flow management-type data to data from distributed sensors in line with the Internet-of-Things (IoT) paradigm. We identified a dominance of proprietary, non-public data in aviation research, with 68% of the 200 research articles utilizing solely proprietary data in deriving their results, and a further 8% utilizing a mixture of proprietary and publicly available data. The pervasiveness of proprietary data has implications on reproducibility and extending research results. We also highlight the increasing tractability of the data by surveying the computational power required to process the data sets, and present vignettes of applications and results that stem from these data-driven studies. Finally, we propose several recommendations regarding standardizing data source nomenclature as well as increasing the availability of and usage of publicly available data.

Lots of data, lots of hurdles: aggregating usage information from distributed Open Access repositories

This article reflects the results of the project “Open Access Statistics”, which was designed to collect standardized usage figures for scientific documents. The data gathered were primarily intended to provide impact values based on document usage for Open Access documents as these were excluded from databases used to provide citation based impact scores. The project also planned the implementation of more sophisticated procedures such as network analyses, but was confronted with complex legal requirements.