Improving baseline serological investigations for dental workers at specialized dental center

Objective: Serological tests for dental workers have been suggested by different international agencies to ensure the safety of dental practitioners and, subsequently, their patients. In our organization, the percentage of dental workers who underwent serological tests was low (26%). Material and Methods: An intervention was designed using three sequential PDSA cycles to test changes proposed by team members. The percentage of dental workers who underwent these tests was used as the measure. Results: During the project period, the percentage of dental workers who underwent serological tests within nine months increased from 24% to 87%. Amongst the three interventions, the final one exhibited the most prominent change leading to major improvement. Conclusion: Serological tests are essential investigational data used to ensure the safety of dental workers, which subsequently also enhances patient safety. Further interventions are highly recommended to maximize the number of dental workers who undergo serological investigation.

About the need to introduce a presumption of consent for organs transplantation and other human anatomical materials

The purpose of the article is to discuss the need to introduce a presumption of consent for the transplantation of organs and other human anatomical materials in Ukraine. Therefore, the object of the study is the presumption of consent for organ transplantation. The authors of the article have used methods of deduction, analysis and synthesis, comparative, and legal methods. The need to make amendments to the legislation of Ukraine regarding the introduction of the presumption of consent for the transplantation of organs and other human anatomical materials from a person and the feasibility of the practical implementation of these changes, namely, mean a major improvement and elimination of problems in the field of transplantation. It is concluded that at present one of the main problems governing the matter is the absence of presumption of consent for transplantation in Ukrainian legislation and, at the same time, the lack of significant funding of the medical sector, together with the low awareness of the rights of actors involved in organ transplant processes.

Project "Homeopathy for L'aquila" Classical Homeopathy applied in the case of earthquake as a medical assistance plan

Background: The project “Homeopathy for L’Aquila” was developed in order to provide humanitarian and professional assistance to the people of L’Aquila, who were the victims of a devastating earthquake during the night of April 6th, 2009. This project was promoted by the Federazione Italiana Associazioni Medici Omeopati (FIAMO) and supported by the governmental organization for Emergencies (Protezione Civile). Aim: This paper is the report of that experience in the state of absolute emergency, which lasted 17 months. It aims to be a feasibility study as well as a model for further emergencies. Methodology: A medical office was located in a container of 60 square meters which was open from Monday to Friday, beginning in August 2009 and lasting until December 2010. This was provided by Protezione Civile with all the basic equipment, including a reception with a secretary. There were 16 homeopathic physicians and 2 acupuncturists, coming from all over Italy. Every month they rotated to offer free consultations of Classical Homeopathy, as well as Acupuncture and Neuraltherapy. Only people coming from the earthquake area were admitted: all of them signed an informed consent. An operational protocol was defined for the data collection. Each consultation was reported in a special register. The follow-up period lasted 17 months. The protocol consisted of the first consultation and at least 3 control visits, when possible at 30, 60 and 120 day intervals. As a primary outcome the main complaint of the patient was considered in its relation to the quality of life. This evaluation followed a slightly modified criterion of a qualitative scale: Outcome in Relation to Impact on Daily Living (ORIDL). A statistical analysis with some non parametric tests was carried out (Kolmogorof, ). Even the most frequently prescribed homeopathic medicines were taken into consideration. Results: 674 patients were visited from August 2009 to December 2010. In total 1,542 medical visits and treatments were carried out (1,070 as Homeopathy; 280 as Neuraltherapy; 192 as Acupuncture). 366 patients received Classical Homeopathy. The most frequently treated syndromes were of the “psychiatric” type (162 cases=44%), prevalently due to the consequences of the earthquake, such as sleeping disturbances, phobic states, anxious-depressive syndromes, etc. The drop-outs were 235 out of 366 (=64%). 107 patients presented for a minimum 3 follow-ups. Here are the results: cured (52%), major improvement (33%), moderate and slight improvement (12%), no change (3%), deterioration (0%). The statistical analysis (D = 51 > 1,949; = 48,039 > 10,83) showed a significance higher than 1‰. Within this group, 68 patients suffering from psychiatric syndromes, who came for a 3rd follow up, showed a similar trend: cured (50%), major improvement (24%), moderate and slight improvement (19%), no change (7%), deterioration (0%). Also in this case the statistical analysis indicated a significance higher than 1‰ (D = 30 > 1,949). The most frequently prescribed medicines were Pulsatilla, Sepia, Arsenicum Album, Argentum Nitricum and Lycopodium. Discussion: The numerous inconveniences due to the emergency certainly did not permit the usual control visits. Moreover a strict observance of the protocol was not always possible, which could explain such a high number of drop-outs. Those patients who completed the therapy had an incremental improvement in their health between the 1st and the 3rd follow-up visit. In the final analysis a series of “strengths” and “weaknesses” in the project were noted. This knowledge could be helpful for future emergencies. Conclusions: The project “Homeopathy for L’Aquila” allowed, for the first time in Italy, an official implementation of Homeopathy in an emergency plan of great impact, on the one hand; and, on the other hand, made a precious human and professional experience possible. Moreover the results obtained have demonstrated that Homeopathy can play an important role socially as well as therapeutically. To the present date there have neither been internationally recognized guidelines nor publications with similar data concerning emergencies. Therefore this project could represent an important reference point for similar events.

Search for variability in Newton’s constant using local gravitational acceleration measurements

In a recent work, Dai [1] searched for a variability in Newton’s constant G using the IGETS based gravitational acceleration measurements. However, this analysis, obtained from χ 2 minimization, did not incorporate the errors in the gravitational acceleration measurements. We carry out a similar search with one major improvement, wherein we incorporate these aforementioned errors. To model any possible variation in the gravitational acceleration, we fit the data to four models: a constant value, two sinusoidal models, and finally, a linear model for the variation of gravitational acceleration. We find that none of the four models provides a good fit to the data, showing that there is no evidence for a periodicity or a linear temporal variation in the acceleration measurements. We then redid these analyses after accounting for an unknown intrinsic scatter. After this, we find that although a constant model is still favored over the sinusoidal models, the linear variation for G is marginally preferred over a constant value, using information theory-based methods.

sunny-as2: Enhancing SUNNY for Algorithm Selection

SUNNY is an Algorithm Selection (AS) technique originally tailored for Constraint Programming (CP). SUNNY is based on the k-nearest neighbors algorithm and enables one to schedule, from a portfolio of solvers, a subset of solvers to be run on a given CP problem. This approach has proved to be effective for CP problems. In 2015, the ASlib benchmarks were released for comparing AS systems coming from disparate fields (e.g., ASP, QBF, and SAT) and SUNNY was extended to deal with generic AS problems. This led to the development of sunny-as, a prototypical algorithm selector based on SUNNY for ASlib scenarios. A major improvement of sunny-as, called sunny-as2, was then submitted to the Open Algorithm Selection Challenge (OASC) in 2017, where it turned out to be the best approach for the runtime minimization of decision problems. In this work we present the technical advancements of sunny-as2, by detailing through several empirical evaluations and by providing new insights. Its current version, built on the top of the preliminary version submitted to OASC, is able to outperform sunny-as and other state-of-the-art AS methods, including those who did not attend the challenge.

Enhanced Water Age Performance Assessment in Distribution Networks

Water age is frequently used as a surrogate for water quality in distribution networks and is often included in modelling and optimisation studies, though there are no reference values or standard performance functions for assessing the network behaviour regarding water age. This paper presents a novel methodology for obtaining enhanced system-specific water age performance assessment functions, tailored for each distribution network. The methodology is based on the establishment of relationships between the chlorine concentration at the sampling nodes and simulated water age. The proposed methodology is demonstrated through application to two water distribution systems in winter and summer seasons. Obtained results show a major improvement in comparison with those obtained by published performance functions, since the water age limits of the performance functions used herein are tailored to the analysed networks. This demonstrates that the development of network-specific water age performance functions is a powerful tool for more robustly and reliably defining water age goals and evaluating the system behaviour under different operating conditions.

Basic science approaches to common hand surgery problems

The field of hand surgery is constantly evolving to meet challenges of populations with increasing age and higher demands for active living. While our surgical care has improved over the last decades, it seems that future major improvement in outcomes of clinical treatment will come through advances in biologics and the translation of major discoveries in basic science. This article aims to provide an update on where basic science solutions may answer some of the most critical issues in hand surgery, with a focus on augmentation of tissue repair.

Epidemiology and Management of Pediatric Tracheomalacia

Tracheomalacia is excessive trachea collapse, usually upon expiration. Severe symptoms accompany congenital types. Often milder versions occur following the neonatal period. Adult malacia is mostly linked to pulmonary chronic obstruction. There's still no standardized functional bronchoscopy. Dynamic CT airway is an excellent diagnostic tool. Bronchoscopy and stent insertion led to a major improvement, although with a high incidence of complication. Surgical lateropexia, excision of trachea and external surgical stabilization are possibilities. Aortopexy is the most common operation in children.

MAPPING A SYSTEMS APPROACH TO EXISTING HEALTHCARE DESIGN, DELIVERY AND IMPROVEMENT METHODS

Design, delivery and improvement processes in healthcare is of great challenge due to increasing pressures on healthcare systems alongside inherent complexities, resulting in limited benefits or unforeseen consequences. A recent Systems Approach framework has aimed at responding to the calls about implementing a more holistic approach. Though being an approach in its own right that can iteratively and systematically structure, guide, and/or facilitate design and improvement projects in healthcare, it can also augment existing approaches that have already place in healthcare designers' and improvement practitioners' agendas. Thus, the objective of this paper is to compare and contrast the questions, activities, and tools of the Systems Approach with processes of other major improvement approaches in healthcare to demonstrate their coverages, overlaps, and extended and new opportunities to pursue in the light of the Systems Approach.

Systematic study of SYBR green chromophore reveals major improvement with one heteroatom difference

Five nucleic acid binding cyanine dyes were synthesized and their photophysical characteristics were evaluated. Changing a heteroatom in the chromophore caused major differences in properties between dyes improving upon available commercial products.