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Scheduling is a complex task due to the need to optimise multiple competing objectives and react to unpredictable events that may occur during production execution. The strategy of predictive-reactive scheduling can be used to reconcile the conflict between the original schedule and the current shop floor situation. This study seeks to present an inventory data-driven predictive-reactive production scheduling model that supports the evolving concepts of the Industry 4.0. Periodically, a machine learning technique provides predictive scheduling considering a best-case scenario according to an established Key Performance Indicator (KPI). Then, material non-availability causes disruptions in production, which triggers the Simulation-Based Optimization (SBO) method to handle these events. Thus, SBO provides a reactive schedule with the best set of priority rules to sequence jobs on each machine according to the data on the shop floor. This model was validated with a real case study using data collected from a metal-mechanical company. Considering the service level KPI, the results showed that the model is able to find a better solution in the compared scenarios. Therefore, even in a dynamic and stochastic scenario, with machine breakdowns, quality problems, raw material delays, and accuracy issues, the model proved efficient in mitigating these variations' effects. [ABSTRACT FROM AUTHOR]

Numerous studies have focused on digital twins (DTs) and their applications. However, a common method for evaluating the performance of DTs is lacking. Digital twins performance assessment mechanism is crucial when improving or monitoring any process or system in a business, such a strategy could serve as a guide to help researchers and practitioners create more effective digital twins. Guided by these challenges, we propose a structured method for measuring the performance and flexibility of digital twins, and our study provides a procedure for quantitative calculation of the performance of DTs based on four key performance indicators (KPIs). Moreover, we propose a new KPI, DTflex, for determining the flexibility of digital twins. We evaluated the performance of DTflex as a KPI to demonstrate its use as a simple tool for designers and practitioners to quickly compare different DT methodologies, which might provide valuable input for the iterative improvement of DTs to increase their efficiency in future applications. The knowledge provided along with the method proposed in this paper is expected to help researchers and practitioners working in different fields to compare DT methodologies and DT performance which will lead to higher efficiency DT solutions and increased re-usage of existing DTs. [ABSTRACT FROM AUTHOR]

Purpose: The main goal of the article is to determine the mediating role of HRM outcomes in the relationships between staffing the organization and company performance results and to establish whether there are any identifiable regularity in this scope in the pre-pandemic and pandemic period in the HQs and foreign subsidiaries of MNCs. Design/methodology/approach: The empirical research included 200 MNCs headquartered in Central Europe. To capture the actual relations between the variables under study the raw data in the variables were adjusted with the efficiency index (EI). The Partial Least Squares Structural Equation Modeling (PLS-SEM) was used to verify the research hypotheses and assess the mediating effects. Findings: The research findings show that, with the exception of the HQs in the pandemic period, when staffing had a negative effect on the company performance results in quality, in other cases it had a positive effect on results in HRM, finance, innovativeness and quality, both in the pre-pandemic and pandemic period, although this effect was not always statistically significant. Furthermore, the company's performance results in HRM mediate positively the relationships between staffing and the other three categories of company performance results, regardless of the organizational level (HQs' or subsidiaries') and time period under consideration. Additionally, during the pandemic, the company's performance results in HRM mediate the relationships between staffing and the other company's performance results stronger than in the pre-pandemic time. Originality/value: In addition to confirming the results of some other studies, the article also provides new knowledge. It determines the mediating role of HRM outcomes in the relationship between staffing and company performance results in finance, innovativeness and quality. Moreover, it identifies certain regularities in the four studied contexts, which is a novelty in this type of research. It also uses an innovative approach to including employee KPIs as the efficiency index in analyzing the relationships between the variables under study. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Conclusions Hawthorne effect refers to changes in clinician behavior in response to being observed. It has been minimally evaluated in trauma and surgical research, especially in low‐ and middle‐income countries (LMICs).We used data from the first (control) phase of a randomized clinical trial in Ghana (2020‐21). Trained observers were stationed in emergency units in eight non‐tertiary hospitals to observe the achievement of key performance indicators (KPI) (KPIs) of trauma care. We hypothesized that the observers' presence would create a Hawthorne effect, resulting in clinicians (doctors, nurses) performing above their usual level, with performance highest immediately after the observers were introduced, and with performance then declining over time toward the usual baseline.We enrolled 2067 injured patients. Achievement of 13 out of 16 KPIs declined significantly over the 14 months after the introduction of observers. For example, airway assessment declined from 77% initially to 60% at the end of the phase (p < 0.001). Chest examination declined from 66% to 31% (p < 0.001). Distal pulses checked declined from 45% to 7% (p < 0.001). The slope of decline in KPI achievement ranged from 0.8%/month (mobility assessed) to 15.9%/month (distal pulses checked).The decline in KPI achievement over time is consistent with the hypothesis that clinicians performed above their usual level just after the observers were introduced, with performance then declining toward the usual baseline. This study is among the first to provide quantitative data on the Hawthorne effect for trauma research in LMICs. These data are useful for the design of future observational studies and clinical trials. [ABSTRACT FROM AUTHOR]

Today's market with more frequent but smaller deliveries complicates the realization of logistics processes and activities. Customers expect products within 24 h or 48 h. This poses a logistics challenge for companies in fulfilling the expected time window. In these situations, companies can either perform self-distribution or they can outsource it. When outsourcing, companies must define key performance indicators (KPIs) to measure the efficiency of the distribution process. One such KPI is On-Time In-Full (OTIF). OTIF fulfillment is increasingly becoming a fundamental requirement not only in distribution but also throughout the entire supply chain. Two essential prerequisites for successful outsourcing collaboration are ensuring that orders are delivered on time and in full. A review of the existing literature revealed that no studies simultaneously address this complex issue. This was exactly the main motive for developing a model that simultaneously takes into account the utilization of logistics resources on one hand, and OTIF on the other when calculating the efficiency. The model developed in this paper was tested on the data of a company operating in the Serbian market. The results showed that seven of the company's warehouses are inefficient. A two-stage matrix analysis with the three most important indicators (operational efficiency, on-time delivery, and in-full delivery) was performed based on the obtained results. Other than the obvious scientific contributions, the proposed model can help companies increase their resource utilization efficiency as well as OTIF fulfillment. [ABSTRACT FROM AUTHOR]

Simple Summary: Bladder cancer is the ninth most commonly diagnosed form of cancer in both sexes worldwide and the fifth in Europe. The most common form, non-muscle-invasive bladder cancer, is highly prevalent with high recurrence rates and has wide range of outcomes that is partially due to the variability in the treatment delivered. Therefore, some recommendations have been done by the European Association of Urology to standardize their management. Several quality control indicators have been proposed to monitor the adherence of urologists and hospitals to these recommendations. A quality control indicator program has been initiated in the hospitals that are a part of the Flemish Hospital Network in June 2013 using a specific prospective registry. We have recently published the first analysis of these quality control indicators, which showed significant differences between the hospitals. Before publishing the second analysis with more patients and additional quality control indicators, we aimed to describe the characteristics of the cohort in this study. Purpose: Bladder cancer (BC) is a heterogeneous disease with varying outcomes, influenced by disease heterogeneity and variability in treatment and follow-up. Risk groups have been established for non–muscle-invasive BC (NMIBC) to standardize therapy, and several quality control indicators (QCIs) monitor adherence to these risk group-based guidelines. However, controversial results had been obtained regarding the oncological benefits of these QCIs until recent high-quality studies from large registries showed their usefulness. To improve adherence to the European Association of Urology (EAU) Guidelines and benchmark current care in Flemish hospitals within Vlaams Ziekenhuisnetwerk–KU Leuven (VZNKUL), a QCI program for NMIBC was initiated in 2013. This study aims to describe the demographic, clinical, and treatment data of patients enrolled in this program. Participants: The VZNKUL–NMIBC Quality Indicators Program Registry is a prospective cohort including patients treated and followed up with at seven academic and non-academic Flemish hospitals since June 2013. Data collection includes patient characteristics, tumor data, treatment, and oncological outcomes. Findings to date: From June 2013 to December 2020, 4744 transurethral resections of bladder tumors (TURBTs) from 2237 unique patients were analyzed. Most patients (80%) were men with a median age of 73. The median time from diagnosis to TURBT was 19 days. A single tumor was detected in 37% of TURBTs. Tumors larger than 3 cm were found in 20.8% of cases. In 46% of TURBTs, a reTURBT was scheduled according to guidelines. The complication rates were 7.5% and 2.4% for bladder perforation and bleeding, respectively. Postoperative single intravesical instillation of chemotherapy (SIVIC) was administered to 56.9% of 1533 indicated patients with a median time to administration of 4.7 h. Among the cohort, 60.4% had NMIBC, and 9.3% had muscle-invasive BC. Of 972 high-risk patients, 60.7% received adequate BCG induction, while 39.4% received adequate maintenance. After BCG induction ± maintenance, 39.7% were tumor-free, with 17.7% recurrence and 4% progression to muscle-invasive BC. BCG treatment was terminated early for 17% of patients due to intolerance. Early cystectomy was performed for 2.4% of the BCG-naïve patients, and 27.7% of patients with BCG failure underwent a BCG rechallenge. For intermediate-risk patients, 2.1% received adequate BCG, and 23% received intravesical chemotherapy. The median follow-up was 57 months. Five-year recurrence-free, progression-free, cancer-free, overall, and cancer-specific survival rates were 53%, 91.6%, 89%, 70.6%, and 95.6%, respectively, for the NMIBC patients. Of 400 non-metastatic MIBC patients, 217 (54.3%) underwent radical cystectomy (RC), of whom 46% received neoadjuvant chemotherapy, while 18 (4.5%) refused RC, and 74 (18.5%) were considered unfit for the surgery. Future plans: The VZNKUL–NMIBC Quality Indicators Program Registry will continue collecting data to evaluate QCIs and monitor treatment quality, enabling hospitals to benchmark their performance and improve patient care. Additionally, the registry's real-world data can support research and international collaboration. Trial registration: The study was registered on ClinicalTrials.gov (NCT04167332). [ABSTRACT FROM AUTHOR]

Objective: To apply the 2019 joint American Academy of Neurology (AAN) and American Headache Society (AHS) quality measures for headache management to a cohort of neurology resident physicians and then assess outcomes related to guideline adherence. Background: The optimization of headache management is essential to reduce both the individual and systemic impact of these disorders. In 2014, the AAN developed 10 quality measures for evidence‐based management of patients with headache. A workgroup updated and condensed its headache quality measures in 2019, narrowing the set to six measurements, four of which would primarily focus on the management of migraine and two of which would address the management of cluster headache. Methods: This quality improvement study was conducted using a pretest‐posttest study design. A pre‐intervention survey based on retrospective analysis of five clinic notes for adherence to the measures was designed and distributed to all neurology residents (n = 32) at a large, academic tertiary referral center. The intervention included the creation of an electronic medical record template to aid residents in following the measures during clinical encounters, as well as the provision of direct feedback based on pre‐intervention results. Finally, a post‐intervention survey was distributed for completion based on notes written during the intervention period. Analysis was limited to migraine, given the low percentage of cluster headache seen in clinic. Results: An increase in adherence was seen in three of the four migraine‐related quality measures, with the Use of Abortive Medications for Migraine and Documentation of Counseling on Modifiable Lifestyle and Chronification Factors demonstrating statistically significant improvements (75.8% to 88.0% [p = 0.013] and 83.9% to 94.0% [p = 0.029] adherence, respectively). For secondary outcomes, the increase in the utilization of appropriate diagnostic criteria (82.6% to 93.2%, p = 0.018) was significant, and the self‐assessed confidence rating for adherence to guidelines was significant (p < 0.001). Conclusions: This study provides evidence that the quality improvement intervention led to increased adherence to the AAN and AHS migraine‐related measures. It is anticipated that increased adherence may lead to improved patient outcomes. Plain Language Summary: In 2019, the American Academy of Neurology and the American Headache Society worked together to create a set of quality measures to guide clinicians in the care of patients with headache; however, we do not know if these guidelines are being followed. This study aimed to see if resident neurologists at a large academic medical center would better follow these guidelines if they were part of a standardized electronic medical record template. Overall, this study showed that applying the headache quality measures in a real clinical setting is feasible and can improve best‐care practices. [ABSTRACT FROM AUTHOR]

Purpose: Evidence surrounding swallowing impairment in sporadic inclusion body myositis (IBM) is based on nonstandardized and nonvalidated assessment methods. We investigated (a) IBM’s impact on swallowing function and oral intake status using well-tested assessment frameworks; (b) changes in swallowing over time; and (c) age, sex, and swallowing impairment severity’s influence on oral intake status. Method: We conducted a secondary analysis of Modified Barium Swallow Impairment Profile (MBSImP) and Functional Oral Intake Scale (FOIS) data from 13 patients with IBM (seven females; Mage = 60.2 [±13.6] years) and 13 ageand sex-matched healthy controls. We compared MBSImP Overall Impression (OI), Oral Total (OT), Pharyngeal Total (PT), and FOIS scores between groups. Specific to the IBM cohort, we analyzed repeated OT and PT scores and calculated whether age, sex, and OT and PT scores predicted FOIS scores. Results: The IBM cohort demonstrated poorer OI scores across six swallowing components than healthy controls (each p < .05). Unlike OT scores (p = .84), PT (p = .033) and FOIS (p < .001) scores were worse in the IBM cohort. Repeated OI scores revealed changes in three swallowing components (each p < .05), but repeated OT (p = .16) and PT (p = .30) scores did not significantly change. Age, sex, and OT and PT scores did not influence FOIS scores (each p > .05). Conclusions: Pharyngeal impairments were most prominent in the IBM cohort, and their oral intake status was adversely affected. Our preliminary data showcase the application of robust assessment methods to investigate swallowing function in IBM, enhancing standardization and comparability across studies. [ABSTRACT FROM AUTHOR]

To establish whether there are geographic differences in treatments and outcomes for patients with kidney cancer (KC) in England which could potentially be improved by the creation of national guidelines. A multidisciplinary group convened by the charity Kidney Cancer UK developed Quality Performance Indicators (QPIs) for the treatment of KC. Adherence to these QPIs was reported for all patients with a histological diagnosis of KC diagnosed in England between 2017 and 2018. Utilising data extracted from national datasets, logistic and linear probability models were used to estimate geographic variation in the delivery of surgery and systemic anti-cancer therapy at Cancer Alliance and NHS trust levels. Results were adjusted for a priori confounders, including age at diagnosis, area deprivation of residence, and Charlson Comorbidity Index. Differences in overall survival are reported. The cohort comprised 18,640 tumours in 18,421 patients. Of tumours diagnosed, median patient age was 68 (interquartile range 58–77) years and 63.4% were in males. When stratified by Cancer Alliance, the proportions of T1a/T1b/N0/M0 KC that had radical nephrectomy (RN), nephron sparing surgery or ablation ranged from 53.3% (95% CI [48.7, 57.8]) to 80.3% (95% CI [73.0, 86.0]). For stage T1b-3 cancers, the proportion that received RN ranged from 65.6% (95% CI [60.3, 70.5]) to 77.3% (95% CI [72.1, 81.7]). Patients with M0 (n = 12,365) and M1 KC (n = 3312) at diagnosis had 24-month survival of 87.5% and 25.1%, respectively. Of patients diagnosed with M1 KC, 50.3% received systemic anti-cancer therapy, ranging from 39.7% (95% CI [33.7, 46.1]) to 70.7% (95% CI [59.6, 79.8]) between Cancer Alliances. The six-month survival of these patients was 77.4% compared to 27.6% for those that did not receive SACT. These major geographical differences in surgical and systemic therapy practice have led to national guideline development. • Analysis of 18,421 patients with Kidney Cancer presenting in England 2017–18. • Marked variations between Cancer Alliances in rates of surgery for primary kidney cancer. • Systemic anti-cancer therapy improves outcomes in metastatic kidney cancer patients. • Significant variations between Cancer Alliances in systemic anti-cancer therapy use. • Low rates of clinical trial recruitment. [ABSTRACT FROM AUTHOR]

Aims: The aim of the study was to develop a set of nursing‐sensitive quality indicators for acute poisoning in emergency departments. Design: A two‐round e‐Delphi study was conducted from July to November 2023. Methods: Subject‐matter experts from 19 tertiary hospitals across four provinces of China participated in the survey. Potential indicators identified through a literature review were rated on a 5‐point Likert scale and comments solicited. Descriptive statistics were used to demonstrate convergence of expert opinion, and consensus was reached in two rounds. Weights of each indicator were determined by analytic hierarchy process. There were 20 expert responses in Round 1 and 18 in Round 2. Results: After two rounds, experts reached a consensus on definitions, calculation formulas, and data collection methods for these indicators. Three primary and 11 secondary indicators were included in the final nursing‐sensitive quality indicators for acute poisoning in the emergency department. Conclusion: A set of indicators about acute poisoning care, applicable to the Chinese context, was developed in collaboration with emergency nurse specialists. Implications for the Profession and Patient Care: The lack of supervision of the nursing quality for acute poisoning leads to great variability in clinical practice in different medical institutions. The results can help in their standardization in China and in other countries lacking regulation. Our study also offers nursing managers a concrete and operable evaluation tool for quality supervision. Normative nursing behaviours are conducive to increase safety and enhance patients' experience of medical treatment. Impact: The indicators identified in this study closely approach clinical practice and exhibit the characteristics of sensitivity and practicality. Although developed in the Chinese healthcare system, there is potential for adoption or adaption in other healthcare settings. Reporting Method: This study was reported in line with the Conducting and REporting of DElphi studies (CREDE) guidance on Delphi studies. Patient or Public Contribution: No patient or public contribution in this study. Contribution to the Wider Global Clinical Community: The nursing quality of acute poisoning in emergency departments remains a growing attention, but the relevant assessment tools are lack. This study provides a set of nursing‐sensitive quality indicators for acute poisoning to guide the quality monitoring of nursing managers. Study recommendations have broad applicability to all healthcare professionals who are engaged in emergency nursing. [ABSTRACT FROM AUTHOR]

Aim: To examine the personal experiences and perceptions of people with dark skin tones and their carers, in relation to pressure injury. Design: Qualitative study using semi‐structured interviews. Methods: Twenty‐two interviews with people with dark skin tone and/or their family carers, who were known to and visited by community nurses for pressure area management or who had been identified as being at high risk for developing a pressure injury were carried out. Results: Thematic analysis of the interview transcripts revealed that skin discolouration towards a darker hue than usual was the commonest symptom identified by participants as a sign of altered skin integrity and potential pressure damage. Four main overarching themes were revealed through comprehensive analysis of the transcripts: (1) indicators of pressure injury; (2) experienced symptoms of pressure damage; (3) trust in healthcare workers; and (4) improving care for populations with dark skin tones. Conclusion: The findings from this study clearly present how early‐stage pressure damage is identified among people with dark skin tones. Implications for the Profession and/or Patient Care: These findings have the potential to reduce health inequality by influencing and informing clinical policies and strategies in practice. Findings could also lead to the development of patient‐informed educational strategies for nurses and health workers which will enable the early identification of pressure ulcers among people with dark skin tones. Further research is needed to better understand health disparities in relation to preventable patient safety harm. Impact: The findings demonstrate the importance of engaging with and listening to the stories and experiences of people living with pressure damage to help in the early recognition of pressure injuries. Reporting Method: The Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines for qualitative research were followed. Patient or Public Contribution: A project steering group reviewed information sheets for participants and checked the interview questions were relevant and suitable. [ABSTRACT FROM AUTHOR]

Practitioners in construction management primarily focus on two key indicators of project success: total cost and completion time. Heavy equipment and machinery play pivotal role in determining these measures, representing significant cost elements in various heavy construction projects such as road construction. Consequently, there is a pressing need for an efficient approach to determining the optimal scheduling of these heavy resources to minimize costs and shorten completion times. This paper proposes an innovative approach to address this challenge by introducing a mixed integer linear programming (MILP) model. The aim is to identify the optimal configuration for heavy equipment in earthmoving operations. The dynamic nature of the configuration process is adopted, enabling daily updates to the schedule based on the contractor's available resources. Moreover, environmental considerations are integrated into the decision-making process, ensuring a comprehensive approach to project optimization. To demonstrate the superiority of the developed model, three case projects from the literature have been solved. The proposed model led to a significant improvement in project cost, with an average enhancement of 25%, and in completion time, with an average improvement of 50% compared with the literature case studies. Practical Applications: This paper presents a novel MILP model designed to optimize earthmoving operations, focusing on dynamic fleet configurations and emission costs. Unlike existing models, this approach provides daily fleet setups for multiple cut and fill sites, considering the contractor's available resources. It calculates optimal soil quantities to be moved, monitors soil levels at sites, and estimates daily trips between them. In the realm of project bidding and management, this model offers valuable insights and practical applications. It empowers project managers with a robust tool for optimizing fleet configurations during bid preparation, enabling contractors to determine the most cost-effective and time-efficient setups, enhancing their competitiveness. Moreover, the model facilitates the assessment of different parameters' impacts, such as resource additions or equipment upgrades, on project cost and completion time. This dynamic approach enables contractors to make informed decisions during project execution, ensuring projects remain on track and within budget. Additionally, by considering emission costs, the model aligns with the growing emphasis on sustainability in construction projects. Optimizing fleet configurations to minimize emissions not only reduces environmental impact but also helps contractors comply with stringent regulations and meet client demands for eco-friendly practices. [ABSTRACT FROM AUTHOR]

The aim of this study is to explore and assess the significance of social media in terms of their impact on market performance indicators, including product development, market development, and consumer loyalty. This study utilized a sample of 279 companies operating in the HoReCa sector (Hotel, Restaurant, and Cafeteria) in Kosovo. To assess the impact of social networks on the gastronomy sector, a structural equation model was employed to analyse the collected data. Based on our research, the results indicate a positive relationship between social media and performance indicators. However, it is worth noting that the correlation between social media and performance indicators was not particularly strong. This study adds to the existing body of literature on digital marketing strategies from an academic standpoint, highlighting the positive outcomes derived from the influence of social media through performance indicators. From a practical standpoint, the findings of this research suggest that the gastronomy sector can benefit from investing in a comprehensive digital marketing strategy based on the insights gained. Given that many businesses within this sector have a clear requirement for digital marketing and the appropriate platform design, effective management of the HoReCa sector can enable the development of an effective social media strategy that amplifies the impact of performance indicators. Consequently, the paper begins with a theoretical explanation of the terms of digital marketing of social media, analysing the theoretical aspect of performance indicators such as product development, market development and customer loyalty. Then the paper continues with the hypotheses of the paper and presentation of the conceptual model. By giving the paper the practical part of the work, the distribution of the questionnaires and finally the analysis of the results. For clarification, in the paper we have relied on various literatures that have dealt with such variables and we have dealt with our case in Kosovo of these variables that we have called. This research study makes unique contributions to the existing literature on social media and performance indicators specifically within the gastronomy sector. The novelty of this study lies in its efforts to enhance the comprehension of social media's impact through performance indicators, ultimately leading to improved performance in gastronomy services. [ABSTRACT FROM AUTHOR]

The environmental, social, and governance (ESG) integration finds itself in a transition with rapid developments worldwide, given that the pandemic incentivized companies and investors to focus on other social and governance measures such as ESG ratings. However, the divergence of ratings from the ESG and a lack of transparency lead the companies to report voluntary indicators without standardization. This study aimed to identify the ESG criteria and the most suitable set of key performance indicators (KPIs) in the airline industry after the impact of COVID-19. Furthermore, the second objective was to determine the appropriate weights and ranking of the identified criteria. The multi-criteria decision-making analytical hierarchical process was applied for this purpose. Additionally, the use of intuitionistic variables delivers a comprehensive model for rating the airlines according to their ESG performance. The most relevant criteria found in the study were critical risk management, greenhouse gas emissions, and systemic risk management. Regarding the KPIs, the top-3 weights were the number of flight accidents, jet fuel consumed and sustainable aviation used, and the number of digital transformation initiatives. [ABSTRACT FROM AUTHOR]

Motivated by a critical issue of airline planning process, this paper addresses a new two-stage scenario-based robust optimization in operational airline planning to cope with uncertainty and possible flight disruptions. Following the route network scheme and generated flight timetables, aircraft maintenance routing and crew scheduling are critical factors in airline planning and operations cost management. This study considers the simultaneous assignment of aircraft fleet and crew to the scheduled flight while satisfying a set of operational constraints, rules, and regulations. Considering multiple locations for airline maintenance and crew bases, we solve the problem of integrated Aircraft Maintenance Routing and Crew Rostering (AMRCR) to achieve the minimum airline cost. One real challenge to the efficiency of the planning results is the possible disruptions in the initial scheduled flights. Due to the fact that disruption scenarios are expressed discretely with a specified probability, and we provide adjustable decisions under disruption to deal with this disruption risk, we provide a Two-Stage Scenario-Based Robust Optimization (TSRO) model. In this model, here-and-now or first-stage variables are the initial resource assignment. Furthermore, to adapt itself to different disruption scenarios, the model considers some adjustable variables, such as the decision to cancel the flight in case of disruption, as wait-and-see or second-stage variables. Considering the complexity of integrated models, and the scenario-based decomposable structure of the TRSO model to solve it with better computational performance, we apply the column and row generation (CRG) method that iteratively considers the disruption scenarios. The numerical results confirm the applicability of the proposed TSRO model in providing the AMRCR problem with an integrated and robust solution with an acceptable level of computational tractability. To evaluate the proposed TSRO model, which solves the AMRCR problem in an integrated and robust manner, five Key Performance Indicators (KPIs) like Number of delayed/canceled flights, Average delay time, and Average profit are taken into account. As key results driven by conducting a case study, we show the proposed TSRO model has substantially improved the solutions at all indicators compared with those of the sequential/non-integrated and nominal/non-robust models. The simulated instances used to assess the performance of the proposed model and CRG method reveal that both CPLEX and the CRG method exhibit comparable and nearly optimal performance for small-scale problems. However, for large-scale instances the proposed TSRO model falls short in terms of computational efficiency. Conversely, the proposed CRG method is capable of significantly reducing computational time and the optimality gap to an acceptable level. [ABSTRACT FROM AUTHOR]

The most important goal of revaluation is providing reliable fair price information close to economic realities for different decision-makers. Emphasising conservatism, this research comparatively studies the relationship between book values of assets concerning the performance indicators of companies. The statistical population of the research includes 146 companies listed on the Tehran Stock Exchange from 2009 to 2020. The research methodology is correlational and post-event causal, and the correlation and regression tests are used to test hypotheses. The results show a significant direct relationship between the book value of assets and the rates of return on assets and equity. In addition, conditional conservatism significantly negatively affects the relationship between the asset value after revaluation and the future cash flows. It also has a significant positive effect on the relationship between the book value of assets and the rate of return on assets. [ABSTRACT FROM AUTHOR]

Aim Method Results Conclusion Large nonpedunculated colorectal polyps (LNPCPs) have a greater than average risk of malignancy, incomplete resection/recurrence and complications associated with treatment. Appropriate management of these lesions is crucial to prevent cancer and reduce harm. The British Society of Gastroenterologists (BSG) and the Association of Coloproctologists of Great Britain and Ireland (ACPGBI) published guidelines for the management of LNPCPs in 2015. The aim of this work was to evaluate the case mix and outcomes from a single centre's multidisciplinary approach to managing such lesions against the key performance indicators (KPIs) set within these national guidelines.Cohort study from a single centre over a 2‐year period, January 2020 to December 2022.After exclusions, a total of 229 cases were discussed. Most complex polyps were treated endoscopically, with conservative management recommended in 22 cases where patients had significant comorbidities and were unlikely to benefit from therapy. The overall surgical intervention rate (including transanal endoscopic microsurgery/per anal excision) was 14%. Of the cases treated endoscopically, there was residual polyp detected in 3.9% at 12‐months’ follow‐up. Complications were rare. There was a single case of perforation following endoscopic submucosal dissection and no significant postprocedure bleeds. There were no perforations following endoscopic mucosal resection, although postpolypectomy bleeding requiring admission occurred in 4%. Sixty‐eight per cent of patients were treated within 56 days of multidisciplinary team (MDT) discussion, despite the timeframe being within a period of huge disruption due to the global COVID pandemic. KPI standards published by the BSG were therefore met.MDT management of complex polyps (LNPCPs) is effective and meets the standards set by national guidance. Patient outcomes following treatment for complex polypectomy are improved when the most appropriate procedure is performed by the most appropriate operator. Discussion at a complex polyp MDT can facilitate this approach. [ABSTRACT FROM AUTHOR]

Introduction: The objective of this study was to evaluate quality indicators of secondary health care in chronic kidney disease (CKD). Methods: This retrospective longitudinal study was conducted in an outpatient medical nephrology clinic of the Brazilian Unified Health System (UHS) and a multidisciplinary outpatient clinic of a private health plan (PHP). The inclusion criteria were age ≥ 18 years, ≥ 3 medical appointments, and follow‐up time ≥ 6 months. Results: Compared to PHP patients (n = 183), UHS patients (n = 276) were older (63.4 vs. 59.7 years, p = 0.04), had more arterial hypertension (AH) (91.7% vs. 84.7%, p = 0.02) and dyslipidemia (58.3 vs. 38.3%, p < 0.01), and had a lower estimated baseline glomerular filtration rate (eGFR) (29.9 [21.5–42.0] vs. 39.1 [28.6–54.8] mL/min/1.73 m2, p < 0.01). Compared to PHP patients, UHS patients had a lower percentage of diabetics with glycated hemoglobin < 7.5% (46.1% vs. 61.2%, p = 0.03), fewer people with potassium < 5.5 mEq/L (90.4% vs. 95.6%, p = 0.04), and fewer referrals for hemodialysis with functioning arteriovenous fistula (AVF) (9.1% vs. 54.3%, p < 0.01). The percentages of people with hypertension and blood pressure < 140 × 90 mmHg were similar between the UHS and PHP groups (59.7% vs. 66.7%; p = 0.17), as was the percentage of people with parathyroid hormone control (85.6% vs. 84.8%; p = 0.83), dyslipidemia and LDL‐cholesterol < 100 mg/dL (38.3% vs. 49.3%; p = 0.13), phosphorus < 4.5 mg/dL (78.5% vs. 72.0%; p = 0.16), and 25‐OH‐vitamin‐D > 30 ng/mL (28.4% vs. 36.5%; p = 0.11). The crude reduction in eGFR was greater in the UHS group than in PHP (2.3 [−0.1; 5.9] vs. 1.1 [−1.9; 4.6] mL/min/1.73 m2; p < 0.01). In the multivariate linear mixed‐effects model, UHS patients also showed faster CKD progression over time than PHS ones (group effect, p < 0.01; time effect, p < 0.01; interaction, p < 0.01). Conclusions: Quality of care for patients with CKD can be improved through both services, and multidisciplinary care may have a positive impact on the control of comorbidities, the progression of CKD, and the planning of the initiation of hemodialysis. [ABSTRACT FROM AUTHOR]

AbstractObjectiveMethodsResultsConclusionThe main aim of this study is to know the loopholes in the feedback system, strategies to remove these loopholes, and to measure the effects of an efficient feedback system in an institution.This research has three stages. In the first stage, we tried to find out the flaws in the feedback system of the institution based on published benchmarks. Then we tried to remove these flaws with the collaboration of different stakeholders. In the last stage of the study, we tried to measure the effectiveness of these corrective procedures by certain key performance indicators (KPIs).After improvement strategies, there was a significant improvement in the KPIs like, the knowledge and attitude toward the feedback improved from 3.1 to 4.23 in students, and from 3.46 to 4.34 in faculty members, on a five-point scale, and the teaching standards improved as measured by students’ performance in different courses in terms of learning objectives achievement, for example in internal medicine from 70.8% to 75.3%. Similar improvement was recorded in other KPIs as well.An efficient feedback system is the backbone of education and by adopting effective feedback, individuals and institutions can excel in the field of medical education. [ABSTRACT FROM AUTHOR]

This paper analyzes the quantitative quality parameters of a mobile communication network in a controlled drone logistic use-case scenario. Based on the analysis of standards and recommendations, the values of key performance indicators (KPIs) are set. As the main network-impacting parameters, reference signal received power (RSRP), reference signal received quality (RSRQ), and signal to interference and noise ratio (SINR) were selected. Uplink (UL), downlink (DL), and ping parameters were chosen as the secondary ones, as they indicate the quality of the link depending on primary parameters. The analysis is based on experimental measurements performed using a Latvian mobile operator's "LMT" JSC infrastructure in a real-life scenario. To evaluate the altitude impact on the selected network parameters, the measurements were performed using a drone as transport for the following altitude values: 40, 60, 90, and 110 m. Network parameter measurements were implemented in automatic mode, allowing switching between LTE4–LTE2 standards, providing the opportunity for more complex analysis. Based on the analysis made, the recommendations for the future mobile networks employed in controlled drone flights should correspond to the following KPI and their values: −100 dBm for RSRP, −16 dB for RSRQ, −5 dB for SINR, 4096 kbps for downlink, 4096 kbps for uplink, and 50 ms for ping. Lastly, recommendations for a network coverage digital twin (DT) model with integrated KPIs are also provided. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To assess the congruence between patient assignment and established patients as well as their association with Healthcare Effectiveness Data and Information Set (HEDIS) quality performance. STUDY DESIGN: A retrospective cross-sectional analysis from January 2020 to February 2022. METHODS: The study setting is a fully integrated health care delivery system in Phoenix, Arizona. The study population includes Medicaid patients who received primary care services or were assigned to a primary care physician (PCP) at the study setting by 5 Medicaid managed care organizations (MCOs). We identified 4 possible relationships between the established patients (2 primary care visits) and the assigned patients (assigned by the MCO to the study setting): true-positive, false-positive, true-negative, and false-negative classifications. Precision and recall measures were used to assess congruence (or incongruence). Outcome measures were HEDIS quality metrics. RESULTS: A total of 100,030 Medicaid enrollees (adults and children) were established and/or assigned to the study setting from 5 separate payers. Only 15% were congruently established and assigned to the physician (true-positive). The overall precision was 21%, and the overall recall was 37%. The HEDIS quality performance was significantly higher (P< .05) for established patients for 5 of 6 metrics compared with patients who were not established. CONCLUSIONS: The vast majority of assigned patients were not treated by the assigned PCP, yet better patient outcomes were seen with an established patient. As the health system rapidly adopts value-based payments, more rigorous methodologies are essential to identify physician-patient relationships. [ABSTRACT FROM AUTHOR]

Background: One strategy for supporting a hospital or health system's board of directors (Board), with their quality oversight responsibility is to review the organization's performance on quality measures. But for large systems, the number of measures needing review is quite burdensome and makes priority setting difficult. Our goal was to develop a scoring method that summarizes multiple quality measures together, while still maintaining the Board's opportunity to examine individual measures where there are specific concerns. Methods: We calculated an overall health system-level composite performance score using six publicly reported healthcare-associated infections reported by the Centers for Medicare and Medicaid Services on their Care Compare website [central-line associated bloodstream infections (CLABSI), catheter-associated urinary tract infections (CAUTI), surgical site infections (SSIs) for colon surgery and abdominal hysterectomy, hospital-onset Methicillin-resistant Staphylococcus aureus bacteremia (MRSA), and hospital-onset Clostridioides difficile (C. diff)], where relative weights assigned to each infection type reflect the severity of patient harm. We also calculated a health-system composite performance target. For individual infection types, we calculated system-wide scores and targets and categorized individual hospital performance into three performance categories. Results: The health system's composite score between 2015 and 2019 ranged from a high of 1.10 to a low of 0.71. The health system's composite score in 2017–2019 was better than the composite target. Of the 34 measures used to calculate the 2019 composite score, 20 were better than internal standardized infection ratio (SIR) targets, seven were between internal targets and SIR of 1.0, and seven were worse than SIR of 1.0. Discussion: The Board communicated they find this composite score reporting approach helpful for streamlining their understanding of HAI performance, as compared to traditional approaches of reporting out individual performance measures. Approaches that streamline Board review of quality and safety performance are important as we hold Board members accountable for overseeing quality, seek greater engagement from the Board, and work to minimize measure review overload. [ABSTRACT FROM AUTHOR]

The discourse regarding globalisation and particularly 'global competition' has appeared in a range of socio-economic areas and higher education is no exception. Global competition has been the policy context in which a range of national excellence initiatives have been developed. These have often involved competitive processes with significant funding as a core incentive for universities to participate. Several countries have implemented these to build 'World Class Universities' (WCU) but often this concept is linked to global rankings and a western model of what world class is. The aim of this study is to critically examine the characteristics of China's WCU policies, particularly as a competition discourse. It aims to go beyond Western-centric paradigms to capture a more inclusive and diverse understanding of competitive dynamics across various cultural and regional contexts. The article first draws upon critical globalisation studies, then it reviews 'indigenous' Chinese policy concepts of 'world class-ness' in HE, next it examines the construction of higher education (HE) competition in the Chinese national and institutional contexts, and finally it conducts a thematic review of the main Chinese WCU policies and the strategy and implementation documents of the 'core' WCU institutions with respect to the indigenous concepts. Our study's findings will contribute to a nuanced understanding of competition in HE settings – it examines and challenges the tendency of the competition discourse to reduce distinctions between national contexts. [ABSTRACT FROM AUTHOR]

Competition in higher education is intensifying worldwide and gaining increasing scholarly attention. However, it is not always easy to observe how competition actually takes place. Our research focuses on one example where competition becomes not only visible but also analyzable: State-led funding contests exemplified by the Excellence Initiative (EI) in Germany. While funding contests in Germany have been established as contests between universities, at the same time they have changed the rules of competitive games between federal states. In our contribution we demonstrate and analyze the multiplicity of competition at the interface between universities and federal states. By reconstructing how federal states play different roles in relation to universities' performances in funding contests, we shed light on a twofold relationship. On the one hand, federal states are folded into competition between universities because they support 'their own' universities with advice and financial resources when the universities prepare to participate in the contests. The federal states are therefore important for the positions universities can take as organizational actors in competition. On the other hand, universities are folded into the competition between federal states because the states at least partly take agency when they view their competitive position vis-à-vis the other federal states as being dependent on 'their' universities' performance in the contests. In this context, they become competitive actors. [ABSTRACT FROM AUTHOR]

Seeing that the culture and governance of competition determines relations among social actors, we turn to the concept of referentiality to investigate the institutional order of competition in higher education. Defining referentiality as the description of a model standard for comparison, this study explores how higher education organizations (HEOs), specifically universities and colleges in Israel, conceive of their positions in a landscape of multiple competitions. Through text analysis of 33 excellence statements made by Israeli HEOs since 2020, the study identifies components of referentiality, namely the substantive dimension of excellence (such as research, innovation, teaching, or sports), the basis for referencing (ranking scales and agencies), and the referent (global or local models). Findings reveal that the multiplicity of components for comparability, as well as the multiple categories of HEOs, create a complex array of referentiality and competition and outline the reference universe of Israeli HEOs. Our study underscores the performative and agentic nature of referentiality in shaping organizational identity and status in the expansive and highly competitive global academic field. [ABSTRACT FROM AUTHOR]

Background: Currently, there are no agreed quality standards for post‐stroke aphasia services. Therefore, it is unknown if care reflects best practices or meets the expectations of people living with aphasia. We aimed to (1) shortlist, (2) operationalise and (3) prioritise best practice recommendations for post‐stroke aphasia care. Methods: Three phases of research were conducted. In Phase 1, recommendations with strong evidence and/or known to be important to people with lived experience of aphasia were identified. People with lived experience and health professionals rated the importance of each recommendation through a two‐round e‐Delphi exercise. Recommendations were then ranked for importance and feasibility and analysed using a graph theory–based voting system. In Phase 2, shortlisted recommendations from Phase 1 were converted into quality indicators for appraisal and voting in consensus meetings. In Phase 3, priorities for implementation were established by people with lived experience and health professionals following discussion and anonymous voting. Findings: In Phase 1, 23 best practice recommendations were identified and rated by people with lived experience (n = 26) and health professionals (n = 81). Ten recommendations were shortlisted. In Phase 2, people with lived experience (n = 4) and health professionals (n = 17) reached a consensus on 11 quality indicators, relating to assessment (n = 2), information provision (n = 3), communication partner training (n = 3), goal setting (n = 1), person and family‐centred care (n = 1) and provision of treatment (n = 1). In Phase 3, people with lived experience (n = 5) and health professionals (n = 7) identified three implementation priorities: assessment of aphasia, provision of aphasia‐friendly information and provision of therapy. Interpretation: Our 11 quality indicators and 3 implementation priorities are the first step to enabling systematic, efficient and person‐centred measurement and quality improvement in post‐stroke aphasia services. Quality indicators will be embedded in routine data collection systems, and strategies will be developed to address implementation priorities. Patient and Public Contribution: Protocol development was informed by our previous research, which explored the perspectives of 23 people living with aphasia about best practice aphasia services. Individuals with lived experience of aphasia participated as expert panel members in our three consensus meetings. We received support from consumer advisory networks associated with the Centre for Research Excellence in Aphasia Rehabilitation and Recovery and the Queensland Aphasia Research Centre. [ABSTRACT FROM AUTHOR]

Background and Objectives: Previous studies have shown that improving quality management in the central sterile supply department (CSSD) is an effective measure to control and decrease hospital-acquired infections. This study aimed to establish nursing-sensitive quality indicators for CSSD nursing in China. Methods: We drafted nursingsensitive quality indicators on the basis of the Structure-Process-Outcome model, and then conducted 2 rounds of consultation with experts using a modified Delphi method to determine the indicators and scientific methods of measurement. Results: We identified five CSSD nursing-sensitive quality indicators. Recovery rates of the 2 rounds of valid questionnaires were 100%. Expert authority coefficients were 0.810 and 0.902, respectively. Kendall's coefficients of concordance were 0.168 and 0.210, respectively (P< .05). Conclusion: Evidence-based nursing-sensitive quality indicators for the CSSD were established. [ABSTRACT FROM AUTHOR]

Background: Efforts to increase transparency and accountability of nursing homes, and thus improve quality, now include information about changes in nursing home ownership. However, little is known about how change in ownership affects nursing home quality. Methods: We conducted a retrospective cohort study of 15,471 U.S. nursing homes between January 2016 and December 2022, identifying all changes in ownership during that period. We used logistic regression to measure the association between nursing home characteristics and the odds of a change in ownership. A difference‐in‐differences model with multiple time periods was used to examine the impact of a change in ownership on the Medicare Nursing Home Compare 5‐star ratings. Results: One in five (23%) facilities changed ownership between 2016 and 2022. Nursing homes that were urban, for‐profit, part of a chain, located in the South, had >50 beds, lower occupancy, higher percentage of stays covered by Medicaid, higher percentage of residents with non‐white race, or a 1‐star (poor) rating were more likely to undergo a change in ownership. There was a small statistically significant decrease in 5‐star ratings after a change in ownership (−0.09 points on a 5‐point scale; 95% CI −0.13 to −0.04; p < 0.001), driven primarily by a decrease in staffing ratings (−0.19 points; 95% CI −0.24 to −0.14; p < 0.001), and health inspections ratings (−0.07 points; 95% CI −0.11 to −0.03; p = 0.001). This was mitigated by an increase in quality measure ratings (0.15 points; 95% CI 0.10–0.20; p < 0.001). Conclusion: Nursing Home Compare ratings decreased slightly after a change in facility ownership, driven by lower staffing and health inspection ratings and mitigated somewhat by higher quality measure ratings. These conflicting trends underscore the need for transparency around changes in facility ownership and a better understanding of consequences of changes in ownership that are salient to patients and families. [ABSTRACT FROM AUTHOR]

Purpose: Post-stroke patients constitute a large group suffering from disabilities that require rehabilitation long after discharge. Quality indicators (QIs) that specify the minimum expected standard of quality in outpatient rehabilitation could contribute to the valuation of the effectiveness of rehabilitation on decision-makers, health professionals, patients, and relatives. This review aims to identify QIs focusing on physiotherapists' outpatient rehabilitation of stroke patients. Materials and methods: The databases Cinahl, Cochrane, Embase, PubMed, and Scopus were searched for publications, and the grey literature was also searched. Through a pragmatic appraisal and assessment with the modified AGREE II-QI instrument, relevant QIs were selected. Results: A total of 1129 papers were retrieved, and five papers presenting 91 QIs were included. Thirty-six QIs were considered relevant to physiotherapy in outpatient rehabilitation. The QIs cover structure, process, and outcome and concern basic mobility, spasticity, organisation and content of the training, patient-reported outcome measures, education of patients and relatives, and follow-up and goal setting. Conclusions: The study appraised 36 QIs relevant for outpatient rehabilitation of stroke survivors conducted by physiotherapists. A Delphi panel is required to develop the final set of QIs for physiotherapists and, subsequently, the development of a core set of multidisciplinary QIs. [ABSTRACT FROM AUTHOR]

Objective: Clinical care ratios are used to quantify and benchmark the activity of allied health professionals. This study aims to review previous recommendations and identify what variables may influence them. Method: Data was collected from the core allied health professions (audiology, nutrition and dietetics, occupational therapy, physiotherapy, podiatry, prosthetics and orthotics, psychology, social work and speech pathology) across eight Australian hospitals. Data for 113 staff who were casual or from smaller professions (audiology, podiatry, prosthetics and orthotics and psychology) were excluded due to insufficient numbers for analysis. The remaining data were analysed according to profession, seniority (tiers 1, 2 and 3) and employment status (permanent versus casual staff). A two-way ANOVA was performed to assess the association of clinical care ratios with tier, profession, employment status and gender. Results: Data from 1246 staff from the five larger professions at participating hospitals were analysed. There were no interactions between profession and gender (P = 0.185) or employment status (P = 0.412). The relationship between clinical care ratio and profession was modified by tier (interaction term, P = 0.014), meaning that differences in clinical care ratios between professions depended on the tier. Conclusion: This research has confirmed that clinical care ratios are a useful tool in workload management and determining staffing levels for allied health professionals. The recommendations from this research provide a starting point that can be finessed with reference to profession, model of care, workforce structure, governance and training requirements. This will lead to increased staff wellbeing and improved patient outcomes. What is known about this topic? Clinical care ratios are a useful tool to quantify, monitor and compare workloads of allied health professionals. What does this paper add? This paper confirms that clinical care ratios are a useful workforce planning tool and that when developing roles and models of care, clinical care ratios need to be incorporated into staffing requests and considered as part of workload management tools. What are the implications for practitioners? Clinical care ratios enable the quantification and benchmarking of direct and clinical support activity components of a workload and can be used when planning new services and reviewing current services. [ABSTRACT FROM AUTHOR]

Rationale: Though it is crucial to contribute to patient recovery through access, diversity, continuity and regularity of outpatient care, still today most of these are deemed nonoptimal. Identifying patient profiles based on outpatient service use and quality of care indicators might help formulate more personalized interventions and reduce adverse outcomes. Aims and Objectives: This study aimed to identify profiles of individuals with mental disorders (MDs) patterned after their outpatient care use and quality of care received, and to link those profiles to individual characteristics and subsequent outcomes. Methods: A cohort of 5669 individuals with MDs was considered based on data from the 2013–2014 and 2015–2016 Canadian Community Health Survey, which were linked to administrative data from the Quebec health insurance registry. Latent class analysis generated profiles based on service use over the 12 months preceding each respondent's interview, and comparative analyses were used to associate profiles with sociodemographic and clinical characteristics, and health outcomes over the three following months. Results: Four profiles were identified. Profile 1 (P‐1) was labelled 'Low service use'; P‐2 'Moderate general practitioner (GP) care and continuity and regularity of care'; P‐3 'High GP care, continuity and regularity of care, and low psychiatrist care'; and P‐4 'High psychiatrist care and regularity of care, and low GP care'. Profiles 3 and 4 (~50% of the cohort) were provided with better care, but showed worse outcomes, mainly acute care use due to more complex conditions and unmet needs. Profiles 1 and 2 had better outcomes as they showed fewer risk factors such as being younger and having better social conditions. Conclusion: Intensity, diversity and regularity of care were higher in profiles with more complex MDs, chronic physical illnesses, and worse perceived health conditions. Adapting specific interventions for each profile, such as assertive community treatment or intensive case management for Profile 4, is recommended. [ABSTRACT FROM AUTHOR]

Background: Patients with emergency surgical conditions (ESCs) experience higher complication rates than those without emergency conditions. Our purpose was to improve time-based key performance indicators (KPIs) of care for ESC patients, including diagnostic workup, empiric stabilization, and referral to definitive care. Methods: A rapid response program (ESTAT) was developed to screen for and coordinate optimal, timely care for a spectrum of high-risk ESCs, from the patient's index clinical encounter up to definitive care. The Mann-Whitney test assessed whether any differences in KPIs were statistically significant (P < .05) before compared to after the implementation of ESTAT. Results: 98 patients were identified: 44 in ESTAT group (70% age ≥55, 57% male); 54 in control group (57% age ≥55, 44% male). There were significant decreases from time of index clinical encounter to resuscitation (5 min. vs 34 min., P < .001), to diagnostic imaging (52 min. vs 1 hr. 19 min., P = .004), and to definitive care (2 hr. 17 min. vs 3 hr. 51 min., P = .007) in the ESTAT group compared to the control group, respectively. Discussion: Improving time-based KPIs for delivery of clinical services is a common goal of medical emergency response systems (MERS) in numerous specialties. Implementation of an ESTAT program provides a screening tool for at-risk patients and reduces time to stabilize, diagnose and triage to definitive surgical intervention. These time benefits may ultimately translate to reduced complication rates for ESC patients. ESTAT may also represent a patient onboarding mechanism for surgical specialty verification programs promoted by quality improvement committees of various professional societies. [ABSTRACT FROM AUTHOR]

Background: Children with IgA Vasculitis (IgAV) may develop renal complications, which can impact their long-term prognosis. This study aimed to build a machine learning model to predict renal damage in children with IgAV and analyze risk factors for IgA Vasculitis with Nephritis (IgAVN). Methods: 50 clinical indicators were collected from 217 inpatients at our hospital. Six machine learning algorithms—Logistic Regression, Linear Discriminant Analysis, K-Nearest Neighbor, Support Vector Machine, Decision Trees, and Random Forest—were utilized to select the model with the highest predictive performance. A simplified model was developed through feature importance ranking and validated by an additional cohort with 46 patients. Results: The random forest model had the highest accuracy, precision, recall, F1 score, and area under the curve, with values of 0.91, 0.98, 0.70, 0.79 and 0.94, respectively. The top 11 features according to the importance ranking were anti-streptolysin O, corticosteroids therapy, antihistamine therapy, absolute eosinophil count, immunoglobulin E, anticoagulant therapy, C-reactive protein, prothrombin time, age at onset, D-dimer, recurrence of rash ≥ 3 times. A simplified model using these features demonstrated optimal performance with an accuracy of 84.2%, a sensitivity of 89.4%, and a specificity of 82.5% in external validation. Finally, we provided a web tool based on the simplified model, whose code was published on https://github.com/mulanruo/IgAVN%5fPrediction. Conclusion: The model based on the random forest algorithm demonstrates good performance in predicting renal damage in children with IgAV, providing a basis for early clinical diagnosis and decision-making. [ABSTRACT FROM AUTHOR]

Background: Nursing quality indicators (NQIs) are essential for evaluating and managing care, yet few validated NQIs exist for emergency nursing. The dynamic nature of this field demands specific, validated indicators. Purpose: The purpose of this review was to identify NQIs in adult emergency nursing using Donabedian's quality categories (structure, process, outcome) and explore their validation. Methods: A scoping review was conducted including articles from 2010 to February 2023, using the Cumulative Index to Nursing and Allied Health Literature and Medline (Ovid) databases. Results: Among 936 screened articles, 18 were included, identifying 85 NQIs across structure (n = 14), process (n = 45), and outcome (n = 26) in emergency nursing. However, the validation of these NQIs was limited. Conclusions: NQIs evaluate emergency nursing quality, primarily in process assessment. Future work should validate the NQIs identified in this review for adult emergency nursing and search for potential new ones. [ABSTRACT FROM AUTHOR]

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Table tennis requires a combination of anaerobic and aerobic energy systems, agility, short reaction times, and precise motor skills. The aim of this study is to investigate gender-specific physiological profiles and performance measures in young elite table tennis players. The objectives are to identify key physical and anthropometric attributes contributing to table tennis performance, compare these attributes between male and female athletes, and develop targeted training recommendations. The study involved sixteen players (8 males and 8 females) within the age range of 10 to 18 years who train regularly at Istanbul Pendik Sports Hall. Inclusion criteria required training at least three times per week and participating at championship levels. Anthropometric measurements were taken using a Seca 220R stadiometer and a Seca 710R weighing scale, with body fat percentage estimated via a Tanita scale. Performance tests included vertical jump height (Witty Microgate device), reaction times (custom device), and heart rates (Activio Sport System). Assessments were carried out between 4:00 PM and 6:00 PM. Male athletes had higher mean values in height (159.00 ± 13.29 cm), weight (50.00 ± 12.06 kg), and vertical jump height, whereas female athletes had better reaction times (1.17 ± 0.14 seconds). No statistically significant differences were found in body fat percentage and mean heart rate. t-Tests revealed that gender differences in most performance metrics were not statistically significant, but correlation analysis showed statistically significant relationships between various physical characteristics and performance outcomes (p<0.05). As a result, physical fitness and reaction time are crucial for table tennis performance. Tailored training programs should focus on these attributes to enhance performance in young elite players. Future studies should follow these metrics longitudinally to understand their impact on competitive success. [ABSTRACT FROM AUTHOR]

Visual attention capacity impacts performance in different laboratory and real-world tasks positively. The present field-study extends for the first time performance gains from individuals to team performance. Our study examined the attention capacity of 88 soccer players to create low vs. high attention capacity teams (LACT vs. HACT) who competed in a controlled field-study. Positional data were gathered using player tracking systems (1 Hz) in a standardised 11 vs. 11 soccer game. Key performance indicators (KPIs), which have been established in match analysis research, were measured to reflect tactical performance of the teams. As predicted from attention frameworks, HACT outperformed LACT in five out of seven KPIs, suggesting that attention capacity might play a crucial role for/in searching and gathering important space on the pitch. These findings provide evidence for attention being a predictor of team success. Practice task designs with an emphasis on attention capacity therefore could be a useful tool to study the emergent behavioural dynamics in a real-world environment. [ABSTRACT FROM AUTHOR]

This paper introduces the conceptual framework of the multi-criteria decision-making (MCDM) rank model, which embodies the integration and harmonization of the aggregation method, the weighing method, the decision matrix normalization technique, and the selection of distance metrics. This definition serves to broaden the spectrum of acceptable MCDM methodologies for problem-solving and specifiing the associated tools. A Multi-Method Model (3M) approach is employed for multi-criteria selection to enhance the reliability of the results. The methodology is outlined for adjusting the rankings of alternatives to account for the distinguishability of ratings in a particular MCDM model using the Relative Performance Indicator (RPI) of alternatives. Through RPI, four methods are established for aggregating individual characteristics of alternatives that yield identical results: Weighted Sum Model (WSM), Multi-Attributive Border Approximation area Comparison (MABAC), Technique for Order Preference by Similarity to Ideal Solutions (TOPSIS (L1)), and Ratio System approach (RS), eliminating the need to duplicate these methods in the 3M approach. A comprehensive comparison of numerous multi-criteria methods is conducted based on two lists: ranking and rating. Additionally, a method for step-by-step linear transformation of alternative ratings obtained from various MCDM models is defined, facilitating comparison and aggregation of ratings. [ABSTRACT FROM AUTHOR]

This paper explores the evolution, applications, and prospective developments of a very popular multi-criteria decision-making (MCDM) method called Measurement of Alternatives and Ranking according to COmpromise Solution Method (MARCOS). Employing an extensive bibliometric analysis, the study examines 115 pertinent papers sourced from the Scopus database spanning over the years from 2020 to 2024. This study also provides an evaluation of the methodological significance and outlines potential future directions of MARCOS method. The outcomes indicate "Sustainable supplier selection in healthcare industries using a new MCDM method: Measurement of alternatives and ranking according to COmpromise solution (MARCOS)" by Stević et al. (2020) as the most cited paper. Journals such as "Sustainability (Switzerland)", "Mathematics" and "Expert Systems with Applications" stand out among the most cited journals. "University of East Sarajevo" is an institution distinguished for its prolific research in this field. "Stević Ž." Has been identified as the most cited and published author. The most frequently used keywords are "MARCOS", "MARCOS method", and "MCDM". CRiteria Importance Through Intercriteria. Correlation (CRITIC) method is a weighting model often integrated with MARCOS method. The results of the study provide researchers and practitioners in the field of MCDM with an important insight into the current state of the MARCOS methodology, highlighted studies and potential future developments. It also provides a comprehensive overview of the importance of this method in the multi-criteria decision-making literature, shedding light on future research directions. [ABSTRACT FROM AUTHOR]

In the 21st century, the software industry has achieved great development, and the development complexity and volume of software projects are also continuously increasing. Therefore, the design of software engineering supervision network plans is becoming increasingly important. The Pareto optimal solution set construction method, global extremum selection method, and fitness value determination method of the multi-objective particle swarm optimization algorithm have been improved in response to the poor optimization performance and poor convergence and distribution of optimal solutions in existing network planning algorithms. However, traditional methods only optimize one or two objectives of network planning, resulting in inconsistency with actual engineering. Thus, this study establishes a multiobjective model based on resources, duration, cost, and quality for comprehensive optimization. Based on the results, the Pareto optimal solution curves obtained by the proposed algorithm on three classic test functions were consistent with the actual theoretical Pareto frontier curves. The proposed method was applied to engineering project examples. 10 solutions that met the schedule requirements were obtained. Most engineering projects had a quality of over 80%, which verified the practicality of the algorithm. The algorithm has achieved good results in optimizing engineering quality. Therefore, this model can consider various indicators such as resources and costs to obtain software engineering quality improvement plans. It has certain application potential. [ABSTRACT FROM AUTHOR]

In vehicle routing problems (VRP), the optimal allocation of transportation by considering factors such as route hardness, driver experience and vehicle worn-out has a significant effect on costs reduction and approaching realworld conditions. In this paper, a novel fuzzy mixed integer non-linear mathematical model to address the two-echelon allocation-routing problem under uncertainty is proposed by applying route and fleet conditions. The cost of allocating drivers to diverse vehicles is computed at the first echelon of the problem, considering factors such as vehicle type, vehicle wear-out, and driver experience. Additionally, different routes are defused with varying levels of hardness. The goal of the second echelon of the model is to improve reliability by defining the reliability of routes within each section. To solve the model, the Torabi and Hessini (TH), the Selimi and Ozkarahan (SO) methods, and a newly proposed approach (PIA) were utilized to transform the multiobjective model into a single-objective one. Numerical tests and performance indicators were used to validate the effectiveness of both the multi-objective mathematical model and the proposed solution method. The validation computation results indicate that the proposed solution approach outperforms both the TH and SO approaches. [ABSTRACT FROM AUTHOR]

The construction industry plays an important role in China's economy. However, traditional construction quality inspection methods have problems such as low efficiency, high leakage rate, and poor real-time performance. Therefore, taking the appearance quality defects of reinforced concrete engineering as an example, this study combines building information models and computer vision technology. By this way, it can achieve automatic quality inspection and intelligent quality problem prevention, to improve the quality management level during the construction process. In this study, ResNet50 network was pre-trained and classified using a self-made defect image database. After transfer learning, the accuracy values of the training and testing sets remained stable at around 0.95 and the loss value remained stable at around 0.10 after 10 epochs, indicating a significant improvement in learning performance. In the defect area quantification experiment, four corner coordinates of the defect image were calculated. These corner coordinates are simultaneously obtained and saved during on-site image acquisition. According to the calculation results, the defect area of honeycomb is approximately 67.67 square centimetres. These results confirm that this method improves the efficiency and accuracy of quality inspection and has potential application in quality inspection of prefabricated building construction. [ABSTRACT FROM AUTHOR]

Pattern selection is crucial for optimizing the calibration process of optical proximity correction (OPC) models in computational lithography. However, it remains a challenge to achieve a balance between representative coverage and computational efficiency. This work presents a comprehensive evaluation of the feature vectors' (FVs') effectiveness in pattern selection for OPC model calibration, leveraging key performance indicators (KPIs) based on Kullback–Leibler divergence and distance ranking. Through the construction of autoencoder-based FVs and fast Fourier transform (FFT)-based FVs, we compare their efficacy in capturing critical pattern features. Validation experimental results indicate that autoencoder-based FVs, particularly augmented with the lithography domain knowledge, outperform FFT-based counterparts in identifying anomalies and enhancing lithography model performance. These results also underscore the importance of adaptive pattern representation methods in calibrating the OPC model with evolving complexities. [ABSTRACT FROM AUTHOR]

Texas Medicaid improved infant well-child visit rates by participating in a national learning collaborative. The two-year program encouraged creativity and innovation in care for Medicaid recipients through partnerships with managed care organizations (MCOs). The MCO projects discovered valuable practices in member outreach and were disseminated in shared learning experiences. At the completion of the learning collaborative, Texas Medicaid surveyed the MCO participants to assess the impact of their projects on Medicaid beneficiaries in Texas as well as the quality improvement project format. Collectively, the MCOs raised the infant well-child visit rate year-over-year. All of the partner MCOs stated they plan to continue focused work on improving infant well-child visit rates after the learning collaborative. [ABSTRACT FROM AUTHOR]

Background: Depression in type 2 diabetes mellitus (T2DM) impacts glycemic control and complications. This study examines the influence of depression on compliance with recommended annual diabetes assessments in patients within the Local Healthcare Authority of Romagna. From a clinical health psychology perspective, understanding how depression influences patients' engagement in managing their conditions is crucial. This insight can help improve healthcare services by ensuring they address mental health needs and thereby enhance treatment effectiveness and overall patient outcomes. Methods: This retrospective cohort study included residents of Romagna with incident T2DM from 2015 to 2017, followed from 1 January 2018 to 31 December 2022. Depression was identified via hospital discharge records or antidepressant prescriptions. Adherence to diabetes care guidelines was measured using the Guideline Composite Indicator (GCI). Results: The study included 13,285 patients, with a mean age of 61.1 years. Prevalence of post-diabetes depression increased from 3.0% in 2018 to 8.9% in 2022. Initial analyses showed higher GCI rates among patients with depression. However, propensity-score adjustment revealed that by 2021–2022, patients with pre-diabetes depression had 5% lower compliance rates (p-value ≤ 0.05). Older adults with depression had reduced adherence, while younger adults with post-diabetes depression had higher adherence rates. Conclusions: Depression significantly affects adherence to diabetes care guidelines in T2DM patients, particularly among older adults. Integrated care models addressing both diabetes and depression are crucial for improving health outcomes. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to design and test a platform of key performance indicators (KPIs) and indices emphasizing achievements and improvement and helping decision-making. Methods: An operations research study was designed to analyze data from the Hospital Management Information System (HMIS) from July 2017 to June 2018 at the Research Institute of Ophthalmology (RIO), Giza, Egypt. The HMIS data were submitted to reform covering parameters in service delivery and corresponding indicators and indices. Data were grouped into four themes: human resources and outpatient, inpatient, and surgical operations. A total of 14 performance indicators were deployed to four specific indices and total performance indices and applied to six teams of ophthalmologists at RIO. The decision matrices were deliberated to demonstrate achievements and provide recommendations for subsequent improvements. Results: Throughout 1 year, six teams of ophthalmologists (n = 222) at RIO provided the following services: outpatient (n = 116,043), inpatient (n = 8,081), and surgical operations (n = 9,174). Teams 2, 1, and 6 were the top teams in the total performance index. Team 4 had plunges in the outpatient index, and Team 5 faced limitations in the inpatient index. Conclusion: The study provided a model for upgrading the performance of the management information system (MIS) in health organizations. The KPIs and indices were used not only for documenting successful models of efficient service delivery but also as examples of limitations for further support and interventions. [ABSTRACT FROM AUTHOR]

The aim of this study was to explore the types and frequency of decision-making situations of rugby league players during defensive situations and examine whether they were predictive of key performance indicators (KPI). Fifteen elite rugby league matches were coded using notational analysis methods. Specific defensive situations were analysed, including the number of: one-on-one situations with an opposing attacker (1-on-1), two-on-one situations (2-on-1), and combined 1-on-1 and 2-on-1 situations (i.e., total decisions; TDs). There was no relationship between the game outcome and game KPIs for TDs or 1-on-1 decision-making situations. However, successful tackles and missed tackles were predictive of 2-on-1 decision-making situations. Positional differences revealed that back rowers were exposed to the greatest number of decision-making situations, while wingers had the lowest exposure. The total number of decisions and the number of 1-on-1 decisions made by the centres and wingers were significant predictors of line breaks. Additionally, 2-on-1 decisions were significant predictors of line breaks for backrowers. The findings of this study suggest that the type and frequency of decision-making situations in Rugby League are position specific. Practical applications for coaches are discussed to ensure that practice approaches are representative of the various defensive decision-making demands players experience during a game, based on their position. [ABSTRACT FROM AUTHOR]

This study identified which key performance indicators that predict the probability of winning are similar and specific for the top CONMEBOL and UEFA leagues. The analysis covered 12,289 games from the 2017/2018 to 2021/2022 seasons, excluding draws to focus on decisive results. Performance metrics were extracted using the InStat Scout® web platform, evaluating 55 offensive and defensive performance variables from the CONMEBOL and UEFA leagues. For data analysis, binary logistic regression was performed with the Forward Stepwise method. 14 similar predictive variables were identified between the CONMEBOL and UEFA leagues. We also identified 6 win-predictor variables specific to CONMEBOL, 2 win-predictor variables specific to UEFA, and 1 contextual variable that was predictive of victory for the CONMEBOL and UEFA leagues. The KPIs that are associated with an increased likelihood of winning games were identified. These include offensive actions, such as creating scoring chances, entering the final third of the opponent's field, shooting on goal, and being effective in counterattacks, converting penalties, and direct free kicks and making important passes and passes. For defensive actions, it was found that fouls, recoveries, possession interceptions, and low block defensive pressures are also associated with an increased likelihood of winning in the five main CONMEBOL and UEFA leagues. Particularly, for CONMEBOL leagues, counter-attacking actions, ball possession (%), free-kicks and efficiency for high pressing can also be associated with increased probability of winning. Specific to UEFA leagues, advancing actions down the left flanks and efficiency for team pressing are associated with increased probability of winning. [ABSTRACT FROM AUTHOR]

To comprehend the complexity of rugby union performance, it is crucial to correlate technical and tactical, and kinematic elements specifically for playing roles. Hence, this study investigated the relationship between game-related metrics and running activities in sub-elite senior males. Technical and tactical performance and running activity of 36 sub-elite senior players (age mean = 25 years; total performances = 200) were assessed in relation to 17 key performance indicators (KPIs). A series of general linear mixed models were performed to evaluate the relationship between KPIs according to roles (backs, forwards and scrum halves), including subjects and games as random effect. The main finding was that the tactical context relates distinctly running activities, and this effect varies between backs and forwards. Tackling mainly involves impacts and deceleration, whereas carrying the ball is associated with impacts and accelerations. Furthermore, the percentage of missed tackles is related to higher occurrences of acceleration events. These findings offer a more profound understanding of the physiological requirements in sub-elite rugby performance, especially given the limited evidence on the interaction between technical and tactical performance and running activities in sub-elite rugby union games. As a result, coaches and physical practitioners should design and execute diverse training sessions that consider both the tactical context and the players' positions. [ABSTRACT FROM AUTHOR]

The study provided further validity for the use of the PWOL (percentage of matches which the winner outscored the loser) method within elite hard-court tennis. Over half of the ATP/WTA competitive calendar (January-March and August-November) is played on hard courts so is an important progression. Data from 810 men's and 586 women's hard-court matches across Grand Slams and ATP/WTA World Tours (i.e. Masters, 500s and 250s) between 2019 and 2023 was used for analysis. PWOL was validated alongside two traditionally used statistical methods (paired t -test, point-biserial correlation). Very high agreement between all approaches was shown using Spearman's correlation analysis for both men and women (>0.97). The study further identified the indicators most related to winning performance, identifying baseline points won, first serve points won, points won of 0-4 rally length and Winners:UE Ratio to be most strongly associated with success, whilst forced errors were most associated with losing. Ball three indicators lacked association with match outcome, suggesting any major focus training 'one-two punches' on serve should be approached with caution. PWOL has proven to be a valid method for assessing success in elite hard-court tennis (offering potential for wider sports application) to ultimately aid coach decision-making. [ABSTRACT FROM AUTHOR]