Use Of Resources Research Articles

Remote prescribing consultations: exploring the principles of effective practice.

There has been a rapid increase in remote patient consultations, including remote prescribing - partly in response to the coronavirus disease 2019 (COVID-19) pandemic, but also as part of the move towards a 'digital first' NHS. There are various benefits associated with remote prescribing, such as convenience for patients and judicious use of healthcare resources. However, it is also associated with several risks, for example the use of inappropriate medicines or doses if the prescriber does not have full access to the patient's records. This article considers some of the benefits and challenges of remote prescribing, and discusses the main principles of effective practice in relation to patient safety, informed consent and documentation.

Ethics, transparency and finances in state public universities in Mexico

The UPE in Mexico are entities that financially operate by means of subsidies granted by the federation and the federal entities, which are used to fulfill their substantive and administrative functions; the subsidies are public resources subject to auditing according to various federal provisions; This article highlights the importance of ethics, transparency and accountability in state public universities in Mexico, by means of a non-experimental analysis of quantitative and correlational type and having as results those issued by the Superior Audit Office of the Federation (ASF) in the fiscal year 2020 where it made an average of 20 observations for each UPE of which 3. In addition, there is a moderate correlation between observations made and observations not solved, concluding that ethics, transparency and accountability are determining factors in the efficient use of financial resources in the UPE in Mexico.

The mediating effect of self-efficacy on family functioning and psychological resilience in prostate cancer patients

AimsProstate cancer patients face impaired body image and psychological distress during the diagnosis and treatment of the disease, which leads to changes in mood, cognition and behavior. Psychological resilience has been shown to buffer shocks and stresses from the disease. Therefore, this study investigates the relationship between family functioning and psychological resilience in prostate cancer patients and the mediating role of self-efficacy between family functioning and psychological resilience to provide a relevant theoretical basis for improving patients' psychological status by providing relevant theoretical basis.MethodUsing a cross-sectional design, participants were 215 patients with prostate cancer admitted to and treated in a tertiary hospital in Jiangsu province, China. Questionnaires were administered using the general information questionnaire, the Connor-Davidson Resilience Scale (CD-RISC), the Family Adaptation, Partnership, Growth, Affection, and Resolution Index (APGAR), and the General Self-efficacy Scale (GSES). Data were analyzed using descriptive and correlational analyses and the bootstrap mediation test was used to test the effect relationship between the variables.ResultsFamily functioning, self-efficacy and psychological resilience were significantly and positively correlated (r = 0.526, P < 0.01; r = 0.378, P < 0.01; r = 0.358, P < 0.01). The mediating effect of psychological resilience between family functioning and psychological resilience was significant, accounting for 42.56%.ConclusionFamily function and self-efficacy have been shown to increase the level of psychological resilience in prostate cancer patients. Attention should be paid to the mental health problems of prostate cancer patients, early screening and intervention, and the use of patients' family resources to improve their confidence in recovering from the disease, thus increasing their psychological resilience and improving their mental health.

Management of low-risk papillary thyroid cancer. Minimally-invasive treatments dictate a further paradigm shift?

Current management options for PTMC include lobo-isthmectomy and active surveillance (AS). Recently, ultrasound-guided minimally invasive procedures (MITs) are offered as a nonsurgical therapy for PTMC because they do not require hospitalization and general anaesthesia, and do not result in loss of thyroid function or cosmetic damage. MITs are reported to consistently provide, mostly in large retrospective series of patients, a rapid, safe, and cost-effective way to eradicate low-risk thyroid malignancies. However, conclusive data from well-conducted prospective studies on the histologically-proven completeness of tumor ablation and the long-term clinical advantages versus AS are still lacking. This study aimed to evaluate the efficacy and safety of ultrasound-guided minimally invasive treatments (MITs) for PTMC in comparison to traditional surgical methods and active surveillance, and to assess their role in current clinical practice. A structured literature review was conducted using keywords related to PTMC, MIT, and comparative techniques. Studies were evaluated based on treatment modality, patient selection, follow-up duration, complication rates, and clinical outcomes. MITs have shown promising results in the management of PTMC. These treatments offer several advantages over surgery, such as reduced use of surgical resources, lower costs, minimal work disruption, and fewer major complications. However, there are still limitations, including the need for long-term surveillance and the potential risk of incomplete tumor ablation. MITs represent a promising non-surgical option for managing low-risk PTMC, especially for patients ineligible for or refusing surgery. Despite favorable outcomes, more robust prospective data are needed to confirm their long-term benefits and completeness of tumor ablation. Interdisciplinary discussions and thorough patient education on the advantages and limitations of MITs are crucial for informed decision-making.

Development of big data assisted effective enterprise resource planning framework for smart human resource management.

The planning of human resources and the management of enterprises consider the organization's size, the amount of effort put into operations, and the level of productivity. Inefficient allocation of resources in organizations due to skill-task misalignment lowers production and operational efficiency. This study addresses organizations' poor resource allocation and use, which reduces productivity and the efficiency of operations, and inefficiency may adversely impact company production and finances. This research aims to develop and assess a Placement-Assisted Resource Management Scheme (PRMS) to improve resource allocation and usage and businesses' operational efficiency and productivity. PRMS uses expertise, business requirements, and processes that are driven by data to match resources with activities that align with their capabilities and require them to perform promptly. The proposed system PRMS outperforms existing approaches on various performance metrics at two distinct levels of operations and operating levels, with a success rate of 0.9328% and 0.9302%, minimal swapping ratios of 12.052% and 11.658%, smaller resource mitigation ratios of 4.098% and 4.815%, mean decision times of 5.414s and 4.976s, and data analysis counts of 6387 and 6335 Success and data analysis increase by 9.98% and 8.2%, respectively, with the proposed strategy. This technique cuts the switching ratio, resource mitigation, and decision time by 6.52%, 13.84%, and 8.49%. The study concluded that PRMS is a solid, productivity-focused corporate improvement method that optimizes the allocation of resources and meets business needs.

Integration of Chemical Looping Combustion to a Gasified Stream with Low Hydrogen Content

Global population growth requires the use of various natural resources to satisfy the basic needs of humanity. Fossil fuels are mainly used to produce electricity, transportation and the artificial air conditioning of habitats. Nevertheless, countries around the world are looking for alternative energy sources due to the decrease in the availability of these fuels and their high environmental impact. The mixture of hydrogen and carbon monoxide (H2 + CO), commonly called syngas, is a high-value feedstock for various industrial applications. By varying the composition of syngas, especially the H2/CO molar ratio, it can be used to produce methanol, fuels or synthetic natural gas. However, when this ratio is very low, the separation of this gas usually represents a great problem when making the energy balance, which is why it is proposed to adapt a combustion process in chemical cycles, taking advantage of the energy of this gas, reducing the energy impact of the process. During the present project, mass and energy balances were developed for combustion in chemical cycles, using ilmenite as a carrier, integrating heat exchangers to take advantage of the residual energy at the output of the process, to preheat the inlet current in the regenerator. Here, a comparative was made at different temperatures of the air stream and evaluating the mechanism of the ilmenite when a syngas stream is used as fuel.

Evaluating the use of marine subsidies by Arctic foxes without direct coastal access; insights from stable isotopes

AbstractThe trophic structures of tundra ecosystems are often viewed as a result of local terrestrial primary productivity. However, other resources can be brought in through long-distant migrants or be directly accessible in coastal areas. Hence, trophic structures may deviate from predictions based on local terrestrial resources. The Arctic fox (Vulpes lagopus) is a small canid that may use marine resources when available. We used stable isotope values in Arctic fox fur and literature data on potential prey to evaluate Arctic fox summer resource use in a mountain tundra without coastal access. The dietary contribution of local prey, presumably mostly rodents, declined with declining rodent abundance, with a subsequent increased contribution of migratory prey relying on marine resources. Stable isotope values did not differ between this terrestrial area and an area with direct coastal access during years of high rodent abundance, but isotope values during low rodent abundances suggested less marine input than in a coastal population feeding primarily on marine prey. Our study shows that marine resources may be used by animals in areas without any coastal access, and we highlight that such partial coupling of ecosystems must be included in the modeling and assessments of tundra environments.

The Resilience of Electrical Support in UAV Swarms in Special Missions

Unmanned aerial vehicle (UAV) swarms serve as a dynamic platform for diverse missions, including communication relays, search and rescue operations, and environmental monitoring. The success of these operations crucially depends on the resilience of their electrical support systems, especially in terms of battery management. This paper examines the reliability of electrical support for UAV swarms engaged in missions that require prioritization into high and low categories. The paper proposes a dynamic resource allocation strategy that permits the flexible reassignment of drones across different-priority tasks, ensuring continuous operation while optimizing resource use. By leveraging the Markov chain theory, an analytical model for the evaluation of the resilience of the battery management system under different operational scenarios was developed. The paper quantitatively assesses the impact of different operational strategies and battery management approaches on the overall system resilience and mission efficacy. This approach aims to ensure uninterrupted service delivery for critical tasks while optimizing the overall utilization of available electrical resources. Through modeling and analytical evaluations, the paper quantifies the impact of various parameters and operating strategies on overall system resilience and mission availability, considering the utilization strategies of batteries and their reliability and maintenance metrics. The developed models and strategies can inform the development of robust battery management protocols, resource allocation algorithms, and mission planning frameworks, ultimately enhancing the operational availability and effectiveness of UAV swarms in critical special missions.

Cost-effectiveness analysis of procalcitonin and lung ultrasonography guided antibiotic prescriptions in primary care.

Antimicrobial resistance comes with high morbidity and mortality burden, and ultimately high impact on healthcare and social costs. Efficient strategies are needed to limit antibiotic overuse. This paper investigates the cost-effectiveness of testing patients with lower respiratory tract infection with procalcitonin, either at the point-of-care only or combined with lung ultrasonography. These diagnostic tools help detect the presence of bacterial pneumonia, guiding prescription decisions. The clinical responses of these strategies were studied in the primary care setting. Evidence is needed on their cost-effectiveness. We used data from a cluster-randomized bi-centric clinical trial conducted in Switzerland and estimated patient-level costs using data on resource use to which we applied Swiss tariffs. Combining the incremental costs of the two strategies and the reduction in the 28-days antibiotic prescription rate (APR) compared to usual care, we calculated Incremental Cost-Effectiveness Ratios (ICER). We also used the Cost-Effectiveness Acceptability Curve as an analytical decision-making tool. The robustness of the findings is ensured by Probabilistic Sensitivity Analysis and scenario analysis. In the base case scenario, the ICER compared to usual care is $2.3 per percentage point (pp) reduction in APR for the procalcitonin group, and $4.4 for procalcitonin-ultrasound combined. Furthermore, we found that for a willingness to pay per patient of more than $2 per pp reduction in the APR, procalcitonin is the strategy with the highest probability to be cost-effective. Our findings suggest that testing patients with respiratory symptoms with procalcitonin to guide antibiotic prescription in the primary care setting represents good value for money.

The favourable alliance between CardioMEMS and levosimendan in patients with advanced heart failure.

We report the results of a real-world study based on heart failure (HF) patients' continuous remote monitoring strategy using the CardioMEMS system to assess the impact of this device on healthcare outcomes, costs, and patients' management and quality of life. We enrolled seven patients (69.00±4.88years; 71.43% men) with HF, implanted with CardioMEMS, and daily remote monitored to optimize both tailored adjustments of home therapy and/or hospital infusions of levosimendan. We recorded clinical, pharmacological, biochemical, and echocardiographic parameters and data on hospitalizations, emergency room access, visits, and costs. Following the implantation of CardioMEMS, we observed a 50% reduction in the total number of hospitalizations and a 68.7% reduction in the number of days in the hospital. Accordingly, improved patient quality of life was recorded with EQ-5D (pre 58.57±10.29 vs. 1year post 84.29±19.02, P=0.008). Echocardiographic data show a statistically significant improvement in both systolic pulmonary artery pressure (47.86±8.67 vs. 35.14±9.34, P=0.022) and E/e' (19.33±5.04 vs. 12.58±3.53, P=0.023). The Quantikine® HS High-Sensitivity Kit determined elevated interleukin-6 values at enrolment in all patients, with a statistically significant reduction after 6months (P=0.0211). From an economic point of view, the net savings, including the cost of CardioMEMS, were on average €1580 per patient during the entire period of observation, while the analysis performed 12months after the implant vs. 12months before showed a net saving of €860 per patient. The ad hoc analysis performed on the levosimendan infusions resulted in 315days of hospital avoidance and a saving of €205158 for the seven patients enrolled during the observation period. This innovative strategy prevents unplanned access to the hospital and contributes to the efficient use of healthcare facilities, human resources, and costs.

CuO nanoflowers: Multifaceted implications of various precipitating agents on rectification behaviour

In order to achieve the best possible use of traditional energy resources for the preservation of the environment, semiconductor-based optoelectronic devices are one of the most intriguing methods for converting light energy into electrical energy. CuO has been extensively explored as a material for energy conversion and the development of photo-detectors due to its notable characteristics among other metals, especially its non-toxicity, abundance, high efficiency, electrochemical stability and low cost/promising photodiode. However, some drawbacks limit its practical application in white light and photo-detector, including the rapid recombination rate of photo-generated electron-hole pairs and destitute response to visible light. As a result, several strategies have been developed from an optoelectronics perspective to eradicate these deficiencies and make an effort to enhance CuO photodiode activities. In this research work, the electrical characteristics and rectification behaviour of CuO with various precipitating agents have been examined. The CuO nanoparticles can be synthesized by co-precipitation technique prepared with different precipitants. Through this research, several parameters, such as the structural, functional, morphological, optical and electrical characteristics, were investigated by changing the precipitants. The functional group formation of pure CuO phase was confirmed by FT-IR studies. UV–Vis absorption measurements indicate that the band gap of the CuO nanoparticles was ranging from 2.40 to 2.85 eV. As a diode, CuO/p-Si exhibits a non-ideal behaviour and under light conditions with Na2CO3 precipitant, the better ideality factor is about 2.35. The barrier height is determined by the thermionic emission theory to be 0.77 and 0.79 eV in the dark and light conditions respectively.

ТРАНСФОРМАЦІЯ МЕНЕДЖМЕНТУ БУДІВЕЛЬНИХ ПРОЄКТІВ В УМОВАХ ГЛОБАЛЬНОЇ ЦИФРОВІЗАЦІЯ

Introduction. The article discusses the need for systemic qualitative changes in the management structure and requirements for the construction project management process in the context of digital transformation, characterized by a combination of advanced technologies and the integration of physical and digital systems. The importance of considering the problems and aspects of digital transformation in the context of new generations (a qualitatively new cluster of human capital), digital talent, changing the mindset of project managers, as well as key changes in construction project management systems in the digital environment is highlighted. Problem statement. The construction industry is a fundamental sector of the economy of any country. A construction project is a structural element of the “construction” system, which allows to form the economic effect of the industry's development as a whole. Modern construction project management includes a set of interconnected but heterogeneous subsystems that together should increase the level of economic profitability. The defining subsystems are: 1. Strategic risk management: Given the volatility of raw material markets and the high value of some materials, the introduction of circular approaches in construction management can help reduce the vulnerability of projects to risks associated with fluctuations in material prices. 2. Efficient use of resources: A central goal of construction management is to optimize the use of resources to achieve project goals. The use of circular economy principles will allow to use resources more efficiently and reduce the cost of purchasing new materials.

Modalities of the Sacred in the Lumad Struggle for Sustainabilities and Futures

Indigenous peoples enact and cultivate local knowledge based on their own developed practices of resource use, which are entwined with their struggle for self-determination. This article seeks to demonstrate how these actions are configured in multiple ways, as in the case of the Lumad of Mindanao, who, like other indigenous groups worldwide, are engaged in the struggle for national liberation. An elaboration of the Lumad-Manobo’s notions of sacred spaces and myths is presented. This includes the production and reproduction of sustenance, resource use, and political mobilization. This article also seeks to trace the movements and modalities of value as an aspiration among displaced Lumad children and the more concrete forms of labor involved in producing these values in indigenous knowledge of sacred spaces.

Medicines for an aging population: The EMA perspective and policies.

The European Medicines Agency adopted their Geriatric Medicines Strategy more than a decade ago. The strategy aims at elucidating the evidence basis for marketing authorization of new medicines which will be used in the older population, and at ensuring the appropriate communication of findings to the patient and healthcare provider. During the past decade new tools and data sources have emerged to support the strategy goals, and their use should be considered. Possible concrete actions are presented to improve the design of clinical trials, the data collection both pre- and post-approval, the assessment of the findings, and the communication to assist informed prescription and safe medicine taking. Implementation and prioritization of these actions should be done from the perspective of addressing the needs of patients while maximizing efficient use of resources, with the aim of integrating geriatric aspects into routine medicines development and assessment.

The complexity of physician power.

Inequitable variation in physician effort and resource use is revealed.

ЕКОЛОГІЧНІ РИЗИКИ ВПРОДОВЖ ЖИТТЄВОГО ЦИКЛУ АВТОМОБІЛЬНОЇ ДОРОГИ

Introduction. The conditions of economic development and social changes in Ukraine require accelerated development of road transport infrastructure, which includes the road industry, motor roads and facilities located on them. During the construction, operation and repair of motor roads, operating vehicles emit pollutants from fuel combustion products into the air, and generate noise and vibration. Pollution of soils, groundwater, and then water bodies can occur due to the deposition of pollutants and dust emitted from running car engines on the road surface, as well as dust from worn tires, road markings, car parts, the road surface itself, used industrial oil, oil leaks, and de-icing materials (in winter). Problem statement. Today, the country is faced with the task of actively working to modernize, expand and improve the entire road network. However, economic development and the scale of natural resource use should not be a hazard to ecological balance. Objective. Taking into account environmental aspects in the design and operation of the motor road and transport infrastructure facilities intended for its maintenance can lead to an increase in the service life of these structures, a decrease in energy and material consumption for their restoration. Materials and methods. The life cycle assessment method allows for a comprehensive approach that recognizes strategies to reduce environmental impacts throughout all stages of transport infrastructure facilities life cycle, from design to end of life (if there is no possibility of their further restoration).

Building a Green Future: The Role of Environmental Accounting in the Public Sector

This article aims to understand the role of environmental accounting in the public sector and how it can contribute to the development of a green and sustainable future. Using a qualitative approach and research instruments such as interviews and document analysis, this study finds that environmental accounting can be an important strategic tool for the public sector. In this context, environmental accounting can assist in (1) Informing decision-making by providing relevant information on the environmental costs and benefits of various actions and policies. (2) Increasing transparency and accountability by reporting on the environmental impacts of public sector activities. (3) Identify opportunities for efficiency and savings by tracking and analyzing resource use. (4) Encourage innovation by highlighting opportunities for the development of new processes or products that are more environmentally friendly. (5) And, support the achievement of sustainable goals by assisting in setting, tracking, and achievement of sustainable goals. This research contributes to our understanding of the strategic role of environmental accounting in promoting sustainability in the public sector, demonstrating that its adoption can help build a green and sustainable future. Keywords: environmental accounting, public sector

‘In the company of cheerful ladies’: whether female entrepreneurs are more productive?

AbstractAfter over two decades, the debate on the female underperformance hypothesis remains not concluded. This study sheds some new light on the hypothesis by (i) showing that surrounding institutional forces play an important role in determining how female businesses perform and (ii) arguing that to understand gender differences (or lack of those) in performance, we need to look at productivity alongside profitability, revenues, and growth. Specifically, we posit that, in certain developing countries, female entrepreneurs devise specific strategies to cope with challenging institutional contexts. In such contexts, female entrepreneurs have less opportunity to realize economic rents compared to males, but they respond to these constraints by becoming more efficient in resource use through relying on female employment. Investigating a large set of longitudinal data from Vietnam, we find that female businesses are more productive than male businesses, and that this effect is stronger when female owner-managers employ more female employees, or even female employees only. However, we also find that these positive effects are weakened with increased corruption. This provides important implications for female entrepreneurs and policymakers in developing countries.

Updating and validating seagrass ecosystem knowledge in the gulf of California: a comprehensive review

Seagrasses are globally acknowledged as crucial habitats as they provide a variety of ecosystem services. Mexico’s legislation protects most of these marine plants; however, the protection often fails in application. The Gulf of California, despite being a biodiversity hotspot, has scant data on seagrasses. Here, human activity and climate change increasingly threaten these coastal ecosystems, with conservation and research efforts lacking coordination at a regional level. Our manuscript aimed to review and standardize existing data on Gulf of California seagrass species, ensuring open access for data updates; pinpointing conservation deficiencies; and guiding future research. We have added new records to the official public data, but we were able to recapture only 25% of the seagrass locations meaning a potential reduction in their historical distribution of 45.8%. Even though Mexico’s legislation protects some species of seagrasses, it protection often fails in the application. We identified that only 6.1% of the seagrass locations are within protected areas that recognize their presence in their management plans (e.g., the Balandra Flora and Fauna Protected Area and the Upper Gulf of California and Colorado River Delta Biosphere Reserve). At least 55.9% of seagrass records are associated with potentially damaging activities like pollution, coastal modification or biological resources use, while 23% are exposed to higher frequency of marine heatwaves. Given the importance of seagrass meadows under Mexican law and their internationally recognized ecological value, sharing current information and guiding research is essential. Our study seeks to galvanize renewed research initiatives and raise more awareness on the conservation of the Gulf of California’s seagrasses.

Cost Effectiveness of Adding Fenfluramine to Standard of Care for Patients with Dravet Syndrome in Sweden.

This study evaluated, in a Swedish setting, the cost effectiveness of fenfluramine (FFA) as an add-on to standard of care (SoC) for reducing seizure frequency in Dravet syndrome, a severe developmental epileptic encephalopathy. Cost effectiveness of FFA+SoC compared with SoC only was evaluated using a patient-level simulation model with a lifetime horizon. Patient characteristics and treatment effects, including convulsive seizures, seizure-free days and mortality, were derived from FFA clinical trials. Resource use and costs included cost of drug acquisition, routine care and monitoring, as well as ongoing and emergency resources. Quality of life (QoL) estimates for patients and their caregivers were derived from clinical trial data. Robustness was evaluated by one-way sensitivity analysis, probabilistic sensitivity analysis and scenario analyses. Lifetime cost of FFA+SoC was ~3 million SEK per patient compared with ~1.5 million SEK for SoC only. FFA+SoC generated 15% more QALYs than SoC only (21.2 vs 18.5 over a lifetime), resulting in an incremental cost-effectiveness ratio (ICER) of ~540,000SEK. Moreover, FFA+SoC had a higher probability of being cost effective than SoC only from a willingness-to-pay threshold of 710,000SEK. Results remained generally consistent across scenario analyses, with only few exceptions (exclusions of carer utility or FFA effect on sudden unexpected death in epilepsy). Due to better seizure control, FFA is a clinically meaningful add-on therapy and was estimated to be a cost-effective addition to current SoC for patients with this rare disease in Sweden at a willingness-to-pay threshold of 1,000,000 SEK.