Development and Application of Integrated Indicators for Assessing Healthcare Waste Management Systems in Kenyan Hospitals

Healthcare waste management (HCWM) is an important aspect of healthcare delivery globally because of its hazardous and infectious components that have potential for adverse health and environmental impacts. The paper introduces a set of indicators for assessing HCWM systems in hospitals. These indicators are: HCWM policies and standard operating procedures, management and oversight, logistics and budget support, training and occupational health and safety, and treatment, disposal and waste treatment equipment housing. By plotting a mark on a continuum which is defined as good and poor on the extremes and is connected with all other marks in a spoke arrangement, it’s possible to describe a baseline for HCWM in any specific hospital. This baseline can be used to improve awareness of the actors and policy-makers, compare the same hospital at a different point in time, to compare observations by different evaluators and to track improvements. Results suggest that in Kenya, the application of such indicators is useful for evaluating which priorities should be addressed to improve outcomes in HCWM systems. Systematic sampling technique was used to identify and collect data by use of observational checklist, interviews, visual verification and review of documents and a HCWM assessment tool. The objective is to suggest an integrated management tool as a method to identify prevailing problems with a HCWM system. The method can be replicated in other contexts worldwide, with a focus on the developing world. The integrated indicators focus on management of HCW and not its potential impact on human health and environment, an area recognized to be critical for future research.

Progress in the Study of Laboratory Indicators Related to Acute Pancreatitis

Acute pancreatitis (AP) is one of the more common gastrointestinal diseases in clinics and is characterized by rapid progression, many complications, and high mortality. When it develops into severe pancreatitis, its prognosis is poor. Therefore, early assessment of the degree of inflammatory response plays a crucial role in the treatment plan and prognosis of patients. More and more studies have shown that the levels of D-dimer (D-D), angiotensin-2 (Ang-2), phosphate, heparin-binding protein (HBP), retinol-binding protein-4 (RBP4), and osteoblastic protein (OPN) are closely related to the severity of acute pan-creatitis and can be used as effective indicators for early assessment of AP. In this paper, the research progress of the above indicators in assessing the severity of AP is summarized.

Risk Prediction Model for Hypertensive Disorders of Pregnancy Based on Routine Laboratory Indicators and Risk Factors: A Retrospective Analysis

Background: Hypertensive disorder of pregnancy (HDP) is a group of diseases in which pregnancy and elevated blood pressure coexist. There is still a lack of reliable clinical tools to predict the incidence of HDP. The purpose of this study was to establish and validate a nomogram prediction model for assessing the risk of HDP in pregnant women based on laboratory indicators and HDP risk factors. Method: A total of 307 pregnant women who were hospitalized in the obstetrics and gynecology department of our hospital were included in this study, and were randomly divided into a training cohort and validation cohort at a ratio of 7:3. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for the development of HDP on laboratory indicators as well as risk factors for HDP in the training cohort of patients. The results of the multivariate regression model were visualized by forest plots. A nomogram was constructed based on the results of multivariate logistic regression to predict the risk of HDP in pregnant women. The validity of the risk prediction model was evaluated by the area under the receiver operating characteristic curve (AUC), the consistency index (C-index), the calibration curve and the decision curve analysis (DCA). Results: BMI ≥ 25 Kg/m2, total cholesterol in early pregnancy, uric acid and proteinuria in late pregnancy were independent risk factors for HDP. The AUC and C-index of the nomogram constructed by the above four factors were both 0.848. The calibration curve is closely fitted with the ideal diagonal, showing a good consistency between the nomogram prediction and the actual observation of HDP. The DCA has demonstrated the great clinical utility of nomogram. Internal verification proves the reliability of the predicted nomograms. Conclusion: The BTUP nomogram model based on laboratory indicators and risk factors proposed in this study showed good predictive value for the risk assessment of HDP. It is expected to provide evidence for clinical prediction of the risk of HDP in pregnant women.

Evidence-Based Nursing Practice of Reducing Immune-Related Skin Toxicity of Tumor Patients Guided by Sensitive Indicators

Purpose research on nursing sensitive indicators in tumor Patients application effect in immune-related skin toxicity management. Method select our hospital April to June, 202360 cases patients with immune therapy settings as the control group. August-October, 2023 60 cases the patients treated with immune therapy were the experimental group. The control group adopted regular nursing methods, while the experimental group sensitive Indicators, evidence-based give preventive care. The social situation, psychological state, physical function, quality of life score, incidence of skin toxicity caused by immune checkpoint inhibitors, moderate and above of the two groups of patients were compared. Incidence of skin toxicity. Result: experience group SAS score, SDS score higher than the control group, the difference was statistically significant (P < 0.05);The incidence of skin toxic reactions caused by immune checkpoint inhibitors and the incidence of moderate and above skin toxic reactions in the experimental group are lower than those in the control group, and the difference is statistically significant (P < 0.05). Conclusion: sensitive indicator guidance evidence-based preventive care can reduce the degree of immune-related skin toxicity, improve the psychological state and quality of life of tumor patients treated with immune therapy and reduce the incidence of adverse reactions, improve nursing quality and patient satisfaction.

Investigating the causal associations between five anthropometric indicators and nonalcoholic fatty liver disease:Mendelian randomization study

BACKGROUND Although the etiology of nonalcoholic fatty liver disease(NAFLD)has not been thoroughly understood,the emerging roles of anthropometric indicators in assessing and predicting the risk of NAFLD have been highlighted by accumulating evidence.AIM To evaluate the causal relationships between five anthropometric indicators and NAFLD employing Mendelian randomization(MR)design.METHODS The Anthropometric Consortium provided genetic exposure data for five anthropometric indicators,including hip circumference(HC),waist circumference(WC),waist-to-hip ratio(WHR),body mass index(BMI),and body fat percentage(BF).Genetic outcome data for NAFLD were obtained from the United Kingdom Biobank and FinnGen Consortium.Genome-wide significant single nucleotide polymorphisms were chosen as instrumental variables.Univariable MR(UVMR)and multivariable MR(MVMR)designs with analytical approaches,including inverse variance weighted(IVW),MR-Egger,weighted median(WM),and weighted mode methods,were used to assess the causal relationships between anthropometric indicators and NAFLD.RESULTS Causal relationships were revealed by UVMR,indicating that a higher risk of NAFLD was associated with a perunit increase in WC[IVW:odds ratio(OR)=2.67,95%CI:1.42-5.02,P=2.25×10^(−3)],and BF was causally associated with an increased risk of NAFLD(WM:OR=2.23,95%CI:1.07-4.66,P=0.033).The presence of causal effects of WC on the decreased risk of NAFLD was supported by MVMR after adjusting for BMI and smoking.However,no causal association between BF and NAFLD was observed.In addition,other causal relationships of HC,WHR(BMI adjusted),and BMI with the risk of NAFLD were not retained after FDR correction.CONCLUSION This study establishes a causal relationship,indicating that an increase in WC is associated with a higher risk of NAFLD.This demonstrates that a suitable decrease in WC is advantageous for preventing NAFLD.

Study on Temperature Disaster Indicators of Passion Fruit in Southwest Fujian, China

In China, meteorological forecasting relies on meteorological data obtained from regional and national stations. However, there were discrepancies between the data collected from the meteorological station at the passion fruit growing base and the data from regional and national stations. Consequently, the high and low temperature disaster indicators determined by the meteorological station at the passion fruit growing base cannot be applied to meteorological forecasting. To address this issue and facilitate the monitoring and early warning of high and low temperature disasters in passion fruit cultivation in Fujian, China, we used multi-source hourly temperature data (including the data from meteorological observation stations in passion fruit growing bases, the nearest regional stations, and national surface conventional meteorological observation stations) in three cities in southwestern Fujian (Longyan, Sanming, and Zhangzhou) spanning the years 2020 to 2022. By employing comprehensive statistical analysis methods (0.5 interval division and Cumulative frequency), we identified that passion fruit in southwestern Fujian was susceptible to high temperature disasters during the blooming-fruiting period, as well as low temperature disasters during the sprouting period. Consequently, we developed high and low temperature disaster indicators based on data from regional and national stations for different phenological periods of passion fruit in this region.

Influence of reduced-port laparoscopic surgery on perioperative indicators, postoperative recovery, and serum inflammation in patients with colorectal carcinoma

BACKGROUND Conventional five-port laparoscopic surgery,the current standard treatment for colorectal carcinoma(CRC),has many disadvantages.AIM To assess the influence of reduced-port laparoscopic surgery(RPLS)on perioperative indicators,postoperative recovery,and serum inflammation indexes in patients with CRC.METHODS The study included 115 patients with CRC admitted between December 2019 and May 2023,52 of whom underwent conventional five-port laparoscopic surgery(control group)and 63 of whom underwent RPLS(research group).Comparative analyses were performed on the following dimensions:Perioperative indicators[operation time(OT),incision length,intraoperative blood loss(IBL),and rate of conversion to laparotomy],postoperative recovery(first postoperative exhaust,bowel movement and oral food intake,and bowel sound recovery time),serum inflammation indexes[high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),and interleukin-6(IL-6)],postoperative complications(anastomotic leakage,incisional infection,bleeding,ileus),and therapeutic efficacy.RESULTS The two groups had comparable OTs and IBL volumes.However,the research group had a smaller incision length;lower rates of conversion to laparotomy and postoperative total complication;and shorter time of first postoperative exhaust,bowel movement,oral food intake,and bowel sound recovery;all of which were significant.Furthermore,hs-CRP,IL-6,and TNF-αlevels in the research group were significantly lower than the baseline and those of the control group,and the total effective rate was higher.CONCLUSION RPLS exhibited significant therapeutic efficacy in CRC,resulting in a shorter incision length and a lower conversion rate to laparotomy,while also promoting postoperative recovery,effectively inhibiting the inflammatory response,and reducing the risk of postoperative complications.

Quality indicators in respiratory therapy

Quality indicators in healthcare refer to measurable and quantifiable parameters used to assess and monitor the performance,effectiveness,and safety of healthcare services.These indicators provide a systematic way to evaluate the quality of care offered,and thereby to identify areas for improvement and to ensure that patient care meets established standards and best practices.Respiratory therapists play a vital role in areas of clinical administration such as infection control practices and quality improvement initiatives.Quality indicators serve as essential metrics for respiratory therapy departments to assess and enhance the overall quality of care.By systematically tracking and analyzing indicators related to infection control,treatment effectiveness,and adherence to protocols,respiratory care practitioners can identify areas to improve and implement evidence-based changes.This article reviewed how to identify,implement,and monitor quality indicators specific to the respiratory therapy departments to set benchmarks and enhance patient outcomes.

Optimization Management of Industrial Organizations Based on Performance Indicators

This paper proposes an intelligent management system (IMS) to help managers in their delicate and tedious task of exploiting the plethora of data (indicators) contained in management dashboards. This system is based on intelligent agents, ontologies and data mining. It is implemented by PASSI (Process for Agent Societies Specification and Implementation) methods for agent design and implementation, the Methodology for Knowledge Modeling and Hot-Winters for data prediction. Intelligent agents not only track indicators but also store the knowledge of managers within the company. Ontologies are used to manage the representation and presentation aspects of knowledge. Data mining makes it possible to: make the most of all available data;model the industrial process of data selection, exploration and modeling;and transform behaviors into predictive indicators. An instance of the IMS named SYGISS, currently in operation within a large brewery organization, allows us to observe very interesting results: the extraction of indicators is done in less than 5 minutes whereas manual extraction used to take 14 days;the generation of dashboards is instantaneous whereas it used to take 12 hours;the interpretation of indicators is instantaneous whereas it used to take a day;forecasts are possible and are done in less than 5 minutes whereas they did not exist with the old management. These important contributions help to optimize the management of this organization.

Comparative Study of Evaluation Indicators for Learning Cities and the Implications

With the development of society,more and more cities are participating in the initiative to build learning cities.Constructing an evaluation indicator system for learning cities to monitor the progress and promote their growth has become increasingly important.This paper analyzes the preliminary framework of the UNESCO Global Learning City Index and R3L+Quality Framework.The comparison is made from the aspects of design philosophy,criteria of indicator,and the cycle of evaluation process.The findings suggest that the construction of an evaluation indicator system should be focused more on the diversity of learning city development,the construction of an evaluation process cycle,and the significance of building cooperative networks.

Contribution of the MERISE-Type Conceptual Data Model to the Construction of Monitoring and Evaluation Indicators of the Effectiveness of Training in Relation to the Needs of the Labor Market in the Republic of Congo

This study proposes the use of the MERISE conceptual data model to create indicators for monitoring and evaluating the effectiveness of vocational training in the Republic of Congo. The importance of MERISE for structuring and analyzing data is underlined, as it enables the measurement of the adequacy between training and the needs of the labor market. The innovation of the study lies in the adaptation of the MERISE model to the local context, the development of innovative indicators, and the integration of a participatory approach including all relevant stakeholders. Contextual adaptation and local innovation: The study suggests adapting MERISE to the specific context of the Republic of Congo, considering the local particularities of the labor market. Development of innovative indicators and new measurement tools: It proposes creating indicators to assess skills matching and employer satisfaction, which are crucial for evaluating the effectiveness of vocational training. Participatory approach and inclusion of stakeholders: The study emphasizes actively involving training centers, employers, and recruitment agencies in the evaluation process. This participatory approach ensures that the perspectives of all stakeholders are considered, leading to more relevant and practical outcomes. Using the MERISE model allows for: • Rigorous data structuring, organization, and standardization: Clearly defining entities and relationships facilitates data organization and standardization, crucial for effective data analysis. • Facilitation of monitoring, analysis, and relevant indicators: Developing both quantitative and qualitative indicators helps measure the effectiveness of training in relation to the labor market, allowing for a comprehensive evaluation. • Improved communication and common language: By providing a common language for different stakeholders, MERISE enhances communication and collaboration, ensuring that all parties have a shared understanding. The study’s approach and contribution to existing research lie in: • Structured theoretical and practical framework and holistic approach: The study offers a structured framework for data collection and analysis, covering both quantitative and qualitative aspects, thus providing a comprehensive view of the training system. • Reproducible methodology and international comparison: The proposed methodology can be replicated in other contexts, facilitating international comparison and the adoption of best practices. • Extension of knowledge and new perspective: By integrating a participatory approach and developing indicators adapted to local needs, the study extends existing research and offers new perspectives on vocational training evaluation.

Preliminary Study on Overseas Applicability of Chinese Architectural Design Standards:Taking China-Aided Construction Projects in Asia Since the Belt and Road Initiative as Examples

This research takes China-aided construction projects in Asia since the Belt and Road Initiative as examples to explore the applicability of Chinese architectural design standards in other Asian countries.So far,the standards demonstrated the highest applicability in South Asia is the best followed by Southeast Asia.Chinese architectural design standards for educational buildings showed the highest applicability,followed by office,medical,and sports buildings.This study puts forward some strategies to improve the applicability of Chinese architectural design standards.These strategies include integrating regionalism and local cultural traditions,optimizing energy efficiency,and aligning designs with local usage habits.This study serves as a reference for similar projects in the future.

Comprehensive applicability evaluation of four precipitation products at multiple spatiotemporal scales in Northwest China

Precipitation plays a crucial role in the water cycle of Northwest China.Obtaining accurate precipitation data is crucial for regional water resource management,hydrological forecasting,flood control and drought relief.Currently,the applicability of multi-source precipitation products for long time series in Northwest China has not been thoroughly evaluated.In this study,precipitation data from 183 meteorological stations in Northwest China from 1979 to 2020 were selected to assess the regional applicability of four precipitation products(the fifth generation of European Centre for Medium-Range Weather Forecasts(ECMWF)atmospheric reanalysis of the global climate(ERA5),Global Precipitation Climatology Centre(GPCC),Climatic Research Unit gridded Time Series Version 4.07(CRU TS v4.07,hereafter CRU),and Tropical Rainfall Measuring Mission(TRMM))based on the following statistical indicators:correlation coefficient,root mean square error(RMSE),relative bias(RB),mean absolute error(MAE),probability of detection(POD),false alarm ratio(FAR),and equitable threat score(ETS).The results showed that precipitation in Northwest China was generally high in the east and low in the west,and exhibited an increasing trend from 1979 to 2020.Compared with the station observations,ERA5 showed a larger spatial distribution difference than the other products.The overall overestimation of multi-year average precipitation was approximately 200.00 mm and the degree of overestimation increased with increasing precipitation intensity.The multi-year average precipitation of GPCC and CRU was relatively close to that of station observations.The trend of annual precipitation of TRMM was overestimated in high-altitude regions and the eastern part of Lanzhou with more precipitation.At the monthly scale,GPCC performed well but underestimated precipitation in the Tarim Basin(RB=-4.11%),while ERA5 and TRMM exhibited poor accuracy in high-altitude regions.ERA5 had a large bias(RB≥120.00%)in winter months and a strong dispersion(RMSE≥35.00 mm)in summer months.TRMM showed a relatively low correlation with station observations in winter months(correlation coefficients≤0.70).The capture performance analysis showed that ERA5,GPCC,and TRMM had lower POD and ETS values and higher FAR values in Northwest China as the precipitation intensity increased.ERA5 showed a high capture performance for small precipitation events and a slower decreasing trend of POD as the precipitation intensity increased.GPCC had the lowest FAR values.TRMM was statistically ineffective for predicting the occurrence of daily precipitation events.The findings provide a reference for data users to select appropriate datasets in Northwest China and for data developers to develop new precipitation products in the future.

The evolution of robotics:research and application progress of dental implant robotic systems

The use of robots to augment human capabilities and assist in work has long been an aspiration.Robotics has been developing since the 1960s when the first industrial robot was introduced.As technology has advanced,robotic-assisted surgery has shown numerous advantages,including more precision,efficiency,minimal invasiveness,and safety than is possible with conventional techniques,which are research hotspots and cutting-edge trends.This article reviewed the history of medical robot development and seminal research papers about current research progress.Taking the autonomous dental implant robotic system as an example,the advantages and prospects of medical robotic systems would be discussed which would provide a reference for future research.

Abatement of Helminth Eggs and Bacterial and Viral Indicators in Soil after Land Application of Treated Sludges

The reduction of helminth eggs, fecal coliforms and somatic coliphages present in sewage sludge after treatments and abatement by application to soil was determined. Traditional stabilization processes produced small changes in the concentrations of the parameters studied. In contrast, thermal treatments and liming produced dramatic reductions. Fecal coliforms were the most affected by both types of treatments;somatic coliphages showed some persistence after 30 minutes at 60°C;and both somatic coliphages and helminth eggs showed some persistence to storage in quick lime. However, both treatments supplied biosolid suitable for unrestricted application in agriculture. Abatement in soils in the climatic conditions tested (mild to cold temperatures and high relative humidity) was slow and took several months to reach the background levels. These results suggest that environmental conditions (temperature and humidity) play the main role in inactivating the microorganisms, since abatement was similar in different soil types. The extended permanence of pathogens and microbial indicators in soil after the application of treated sludges indicates that, in the normal weather conditions of the areas where the study was performed and the amounts of sludges applied, contaminant microbes are not easily mobilized from the complex matrixes that constitute the treated sludges and that consequently in normal conditions their release as diffuse pollution is of lesser importance.

Potential industrial applications of photo/electrocatalysis: Recent progress and future challenges

Nowadays,the rapid development of the social economy inevitably leads to global energy and environmental crisis.For this reason,more and more scholars focus on the development of photocatalysis and/or electrocatalysis technology for the advantage in the sustainable production of high-value-added products,and the high efficiency in pollutants remediation.Although there is plenty of outstanding research has been put forward continuously,most of them focuses on catalysis performance and reaction mechanisms in laboratory conditions.Realizing industrial application of photo/electrocatalytic processes is still a challenge that needs to be overcome by social demand.In this regard,this review comprehensively summarized several explorations in thefield of photo/electrocatalytic reduction towards potential industrial applications in recent years.Special attention is paid to the successful attempts and the current status of photo/electrocatalytic water splitting,carbon dioxide conversion,resource utilization from waste,etc.,by using advanced reactors.The key problems and challenges of photo/electrocatalysis in future industrial practice are also discussed,and the possible development directions are also pointed out from the industry view.

Drilling-based measuring method for the c-φ parameter of rock and its field application

The technology of drilling tests makes it possible to obtain the strength parameter of rock accurately in situ. In this paper, a new rock cutting analysis model that considers the influence of the rock crushing zone(RCZ) is built. The formula for an ultimate cutting force is established based on the limit equilibrium principle. The relationship between digital drilling parameters(DDP) and the c-φ parameter(DDP-cφ formula, where c refers to the cohesion and φ refers to the internal friction angle) is derived, and the response of drilling parameters and cutting ratio to the strength parameters is analyzed. The drillingbased measuring method for the c-φ parameter of rock is constructed. The laboratory verification test is then completed, and the difference in results between the drilling test and the compression test is less than 6%. On this basis, in-situ rock drilling tests in a traffic tunnel and a coal mine roadway are carried out, and the strength parameters of the surrounding rock are effectively tested. The average difference ratio of the results is less than 11%, which verifies the effectiveness of the proposed method for obtaining the strength parameters based on digital drilling. This study provides methodological support for field testing of rock strength parameters.

Driver at 10 MJ and 1 shot/30 min for inertial confinement fusion at high gain:Efficient,compact,low-cost,low laser-plasma instabilities,beam color selectable from 2ω/3ω/4ω,applicable to multiple laser fusion schemes

The achievement of ignition at the National Ignition Facility(NIF)has prompted a global wave of further research on inertial fusion energy(IFE).However,IFE requires a target gain G of 30-100,and it is hard to achieve fusion at such high gain with the energy,configuration,and technical approach of the NIF.Here,we present a conceptual design for a next-generation laser driver that is applicable to multiple laser fusion schemes and provides 10 MJ,2-3 PW at 3ω(or 2ω,in which case the energy and power can be higher),and one shot per 30 min,with the aim of achieving G>30.It is also efficient,compact,and low in cost,and it has low susceptibility to laser-plasma instabilities.

Establishing Standardized Nursing Quality Sensitive Indicators

This is a pilot research project was prepared to assess the impact of implementing essential standardized nursing quality sensitive indicators in monitoring, evaluating, and controlling the nursing services and activities which implemented in daily nursing care works with the patients in a health institute, aiming for emphasizing the concept of “nursing quality sensitive indicators” which is valuable to elaborate nursing care performance, and for continuous upgrading of daily nursing care, which hopefully will result in more beneficial outcomes, and lesser negative or undesirable outcomes in all aspects of nursing care, and consequently the health care process, particularly regarding patient safety, patient satisfaction and nursing performance improvement. This pilot research project for the essential standardized nursing quality sensitive indicators was applied in intensive care unit (ICU) department in Qurayyat general hospital, and resulted in excellent improvement of all outcomes correlated with the essential standardized nursing quality sensitive indicators. These essential standardized nursing quality sensitive indicators are hopefully be accepted and accredited by the higher health authorities as standardized nursing quality sensitive indicators in health institutes.

Indicator Selection for Quality Measurement in Maternal Neonatal and Child Health Services: Application of Random Forest Classifier

Quality of Maternal, Neonatal and Child (MNCH) care is an important aspect in ensuring healthy outcomes and survival of mothers and children. To maintain quality in health services provided, organizations and other stakeholders in maternal and child health recommend regular quality measurement. Quality indicators are the key components in the quality measurement process. However, the literature shows neither an indicator selection process nor a set of quality indicators for quality measurement that is universally accepted. The lack of a universally accepted quality indicator selection process and set of quality indicators results in the establishment of a variety of quality indicator selection processes and several sets of quality indicators whenever the need for quality measurement arises. This adds extra processes that render quality measurement process. This study, therefore, aims to establish a set of quality indicators from a broad set of quality indicators recommended by the World Health Organization (WHO). The study deployed a machine learning technique, specifically a random forest classifier to select important indicators for quality measurement. Twenty-nine indicators were identified as important features and among those, eight indicators namely maternal mortality ratio, still-birth rate, delivery at a health facility, deliveries assisted by skilled attendants, proportional breach delivery, normal delivery rate, born before arrival rate and antenatal care visit coverage were identified to be the most important indicators for quality measurement.