Comparative Evaluation of the Prognosis of Septic Shock Patients from before to after the Onset of the COVID-19 Pandemic: A Retrospective Single-Center Clinical Analysis

In this study, we investigated the mortality of septic shock patients visiting emergency departments (ED) before and after the coronavirus disease (COVID-19) pandemic onset. We retrospectively reviewed medical records and National Emergency Department Information System data of septic shock patients who visited the ED of a tertiary medical center in South Korea from February 2019 to February 2021. Following the COVID-19 pandemic onset, revised institutional ED processes included a stringent isolation protocol for patients visiting the ED. The primary goal of this study was to determine the mortality rate of septic shock patients from before and after the onset of the COVID-19 pandemic. Durations of vasopressor use, mechanical ventilation, intensive care unit stay, and hospitalization were investigated. The mortality rates increased from 24.8% to 35.8%, before and after COVID-19-onset, but the difference was not statistically significant (p = 0.079). No significant differences in other outcomes were found. Multivariable analysis revealed that the Simplified Acute Physiology Score III (SAPS III) was the only risk factor for mortality (OR 1.07; 95% CI 1.04-1.10), whereas COVID-19 pandemic was not included in the final model. The non-significant influence of the COVID-19 pandemic on septic shock mortality rates in the present study belies the actual mortality-influencing potential of the COVID-19 pandemic.

The influence of corneal density and thickness on tonometry measurement with goldmann applanation, non-contact and iCare tonometry methods

Purpose To evaluate the effect of corneal density and thickness on the accuracy of tonometry readings obtained via three most used techniques. Method Intraocular pressures of 45 patients’ right eyes were measured using Goldmann Applanation, iCare, and non-contact tonometry methods. Corneal parameters were obtained using the Pentacam Camera System. Data obtained were analyzed using Paired t Test, Pearson’s correlation coefficient, multiple linear regression analysis, and Bland–Altman plots. Results The mean corneal thickness was 545.4 ± 3.93 μm. The mean corneal density of total, stromal, 0–2 mm, and 2–6 mm zones were 27.85 ± 6.23 GSU, 24.61 ± 6.05 GSU, 20.76 ± 2.96 GSU, and 20.81 ± 3.51 GSU respectively. IOP readings had a statistically significant correlation with corneal stromal thickness, as well as with total and stromal density. The stromal density, however, showed higher correlation with the three tonometry methods than did the total density (iCare: − .482 (0.001) stromal density versus− .464 (0.001) total density, NCT: − .376 (0.011) versus − .353 (0.017), GAT: − .306 (0.041) versus − .296 (0.048)). Statistical differences were found in comparing the iCare readings with GAT (P < 0,00) and with NCT (P < 0,00), with mean differences of 1.8 mmHg ± 2.6 and 2.0 mmHg ± 2.6 respectively. GAT and NCT measurements showed no statistical difference (P > 0.05). Conclusion This study shows that both central corneal thickness and stromal density are significant influential factors of reliable IOP readings. It is necessary to consider more corneal biomechanical properties, as well as exercise a high degree of caution in any new attempts towards adjusting an IOP-correction equation.

An Integrated Approach for Crop Production Analysis from Geographic Information System Data using SqueezeNet

Predictions and estimations are very important for agriculture applications. The estimation results on crop production may have a huge impact in the economy of a country by changing their export and import data. The estimation of crop production was started by collecting information manually from the fields and analyzing it using a computer. However, the accuracy was not up to the mark due to the error caused by manual collection of data. The Geographic Information System (GIS) applications are developed to store the information observed from the satellite images on change detection in town planning, disaster management, business development and vegetation management. The proposed work estimates the crop production of Indian states from a GIS dataset with a SqueezeNet algorithm. The performance of the SqueezeNet algorithm is compared with the traditional Inception and ResNet algorithms.

Relevancy technological innovation and community economic development in Indonesia

It is undeniable that there is a relevance between advances in science and technology, especially information and communication technology, which has an impact on the progress of the development of the economic sector and human welfare. This paper aims to obtain evidence of the study of technological innovation on economic capacity and development. Supporting data for this study are a number of scientific journal publications, books and websites that discuss issues of technology and economic welfare. Before answering this question, we conducted a data analysis involving a data evaluation system, data coding and deep interpretation to obtain valid and convincing answers. Based on the analysis, the discussion of our results confirms that through the evidence of the study there is a very deep relevance of technological development and innovation impact on economic development. Therefore, the policy-making parties should take advantage of any technological developments for the development of the Indonesian economy.

Systematic review of performance-enhancing health worker supervision approaches in low- and middle-income countries

Background The strength of a health system—and ultimately the health of a population—depends to a large degree on health worker performance. However, insufficient support to build, manage and optimize human resources for health (HRH) in low- and middle-income countries (LMICs) results in inadequate health workforce performance, perpetuating health inequities and low-quality health services. Methods The USAID-funded Human Resources for Health in 2030 Program (HRH2030) conducted a systematic review of studies documenting supervision enhancements and approaches that improved health worker performance to highlight components associated with these interventions’ effectiveness. Structured by a conceptual framework to classify the inputs, processes, and results, the review assessed 57 supervision studies since 2010 in approximately 29 LMICs. Results Of the successful supervision approaches described in the 57 studies reviewed, 44 were externally funded pilots, which is a limitation. Thirty focused on community health worker (CHW) programs. Health worker supervision was informed by health system data for 38 approaches (67%) and 22 approaches used continuous quality improvement (QI) (39%). Many successful approaches integrated digital supervision technologies (e.g., SmartPhones, mHealth applications) to support existing data systems and complement other health system activities. Few studies were adapted, scaled, or sustained, limiting reports of cost-effectiveness or impact. Conclusion Building on results from the review, to increase health worker supervision effectiveness we recommend to: integrate evidence-based, QI tools and processes; integrate digital supervision data into supervision processes; increase use of health system information and performance data when planning supervision visits to prioritize lowest-performing areas; scale and replicate successful models across service delivery areas and geographies; expand and institutionalize supervision to reach, prepare, protect, and support frontline health workers, especially during health emergencies; transition and sustain supervision efforts with domestic human and financial resources, including communities, for holistic workforce support. In conclusion, effective health worker supervision is informed by health system data, uses continuous quality improvement (QI), and employs digital technologies integrated into other health system activities and existing data systems to enable a whole system approach. Effective supervision enhancements and innovations should be better integrated, scaled, and sustained within existing systems to improve access to quality health care.

Economic, Ecological and Social Analysis Based on DEA and MCDA for the Management of the Madrid Urban Public Transportation System

The aim of this research is to help public transport managers to make decisions on the type of buses that should compose their public transport fleet, taking into account economic, environmental and social criteria from the point of view of sustainability. This paper fills a knowledge gap by including the social dimension of sustainability in addition to the economic and environmental dimensions. The original nature of this study lies in analyzing complementarities in the structuring of an efficiency and multicriteria problem. Our research analyzes Madrid public bus system data; the problem is structured in a comparative way between two analytical methods, a Data Envelopment Analysis (DEA) and an ELimination Et Choice Translating REality (ELECTRE) III. Our research results show that two main groups of vehicles could play a part in part the theoretical solution. The main conclusions of this research are that (a) plug-in and induction electric vehicles are not comparable to GNC and diesel–hybrid vehicles in terms of cost, pollution and service; and (b) the ELECTRE III model provides more information in solving this problem than the DEA model.

Differences Between Sexual and Nonsexual Homicides of Women in the United States: Findings From the National Violent Death Reporting System

Sexual homicide (SH) is the most severe outcome of sexual violence and disproportionately affects women. While SH is rare (<1% in the U.S.) and gravely understudied, it is among the most violent, feared, and well publicized forms of murder. Thus, examining predictors is pertinent to identifying targets for prevention and response efforts. Secondary analysis of 2015–2018 National Violent Death Reporting System data on 6461 female homicide victims age 20–64 was conducted to determine if SH represents a unique killing characterized by specific offender, victim, and incident profiles. Law enforcement and coroner/medical examiner narratives were reviewed to identify cases with sexual elements ( N=324). Logistic regression estimated odds ratios with 95% confidence intervals. Findings highlight important differences between SH and non-SH. SH victims were more likely to be single (AOR=1.7, p=.006), have a substance abuse problem (AOR=1.4, p=.04), or engaged in prostitution (AOR=10.4, p<.001). SH suspects were more likely to be male (AOR=2.5, p=.04), use an illicit substance in the preceding hours (AOR=1.6, p=.03), or had recent contact with police (AOR=1.6, p=.01). SH was more likely to occur in a hotel/motel (AOR=3.0, p=.002), by asphyxiation (AOR =13.38, p<.001), be perpetrated against an acquaintance (AOR=1.64, p=.007), or be precipitated by another serious crime (AOR=2.1, p<.001). Findings advance our understanding of SH victim, suspect, and incident profiles, which can help to better inform police/investigative practices and crime prevention strategies/interventions as well as to improve how SH cases are managed in correctional programs for offenders who have the opportunity for release back into society.