Hasil untuk "Office management"

P. Muntner, D. Shimbo, R. Carey et al.

The accurate measurement of blood pressure (BP) is essential for the diagnosis and management of hypertension. This article provides an updated American Heart Association scientific statement on BP measurement in humans. In the office setting, many oscillometric devices have been validated that allow accurate BP measurement while reducing human errors associated with the auscultatory approach. Fully automated oscillometric devices capable of taking multiple readings even without an observer being present may provide a more accurate measurement of BP than auscultation. Studies have shown substantial differences in BP when measured outside versus in the office setting. Ambulatory BP monitoring is considered the reference standard for out-of-office BP assessment, with home BP monitoring being an alternative when ambulatory BP monitoring is not available or tolerated. Compared with their counterparts with sustained normotension (ie, nonhypertensive BP levels in and outside the office setting), it is unclear whether adults with white-coat hypertension (ie, hypertensive BP levels in the office but not outside the office) have increased cardiovascular disease risk, whereas those with masked hypertension (ie, hypertensive BP levels outside the office but not in the office) are at substantially increased risk. In addition, high nighttime BP on ambulatory BP monitoring is associated with increased cardiovascular disease risk. Both oscillometric and auscultatory methods are considered acceptable for measuring BP in children and adolescents. Regardless of the method used to measure BP, initial and ongoing training of technicians and healthcare providers and the use of validated and calibrated devices are critical for obtaining accurate BP measurements.

Chia-Hao Yu, K. Doppler, C. Ribeiro et al.

S. Blandin Knight, P. Crosbie, H. Balata et al.

Lung cancer is the leading cause of cancer-related death in the world. It is broadly divided into small cell (SCLC, approx. 15% cases) and non-small cell lung cancer (NSCLC, approx. 85% cases). The main histological subtypes of NSCLC are adenocarcinoma and squamous cell carcinoma, with the presence of specific DNA mutations allowing further molecular stratification. If identified at an early stage, surgical resection of NSCLC offers a favourable prognosis, with published case series reporting 5-year survival rates of up to 70% for small, localized tumours (stage I). However, most patients (approx. 75%) have advanced disease at the time of diagnosis (stage III/IV) and despite significant developments in the oncological management of late stage lung cancer over recent years, survival remains poor. In 2014, the UK Office for National Statistics reported that patients diagnosed with distant metastatic disease (stage IV) had a 1-year survival rate of just 15–19% compared with 81–85% for stage I.

M. Fall, A. P. Baranowski, C. Fowler et al.

G. Aus, C. Abbou, M. Bolla et al.

D. Muram

D. Covell, G. Uman, P. R. Manning

Aiko Fias, Md Umar Hashmi, Geert Deconinck

The integration of photovoltaic (PV) generation and electric vehicle (EV) charging introduces significant uncertainty in electricity consumption patterns, particularly at the distribution level. This paper presents a comparative study for selecting metrics for uncertainty quantification (UQ) for net load profiles of residential, industrial, and office buildings under increased DER penetration. A variety of statistical metrics is evaluated for their usefulness in quantifying uncertainty, including, but not limited to, standard deviation, entropy, ramps, and distance metrics. The proposed metrics are classified into baseline-free, with baseline and error-based. These UQ metrics are evaluated for increased penetration of EV and PV. The results highlight suitable metrics to quantify uncertainty per consumer type and demonstrate how net load uncertainty is affected by EV and PV adoption. Additionally, it is observed that joint consideration of EV and PV can reduce overall uncertainty due to compensatory effects of EV charging and PV generation due to temporal alignment during the day. Uncertainty reduction is observed across all datasets and is most pronounced for the office building dataset.

Erum Iftikhar, Wei Wei, John Cartlidge

Blockchain-based decentralised lending is a rapidly growing and evolving alternative to traditional lending, but it poses new risks. To mitigate these risks, lending protocols have integrated automated risk management tools into their smart contracts. However, the effectiveness of the latest risk management features introduced in the most recent versions of these lending protocols is understudied. To close this gap, we use a panel regression fixed effects model to empirically analyse the cross-version (v2 and v3) and cross-chain (L1 and L2) effectiveness of liquidation mechanisms, measured through TVL and total revenue as proxies for performance of the two most popular lending protocols, Aave and Compound, during the period Jan 2021 to Dec 2024. Our analysis reveals that liquidation events in v3 of both protocols lead to an increase in total value locked and total revenue, with stronger impact on the L2 blockchain compared to L1. In contrast, liquidations in v2 have an insignificant impact, which indicates that the most recent v3 protocols have better risk management than the earlier v2 protocols. We also show that L1 blockchains are the preferred choice among large investors for their robust liquidity and ecosystem depth, while L2 blockchains are more popular among retail investors for their lower fees and faster execution.

XU Weicheng, SUN Hongyu

Building China into a maritime power is inseparable from the high-quality development of the marine economy, and innovation is an important driving force for high-quality development. Based on the panel data of coastal cities at and above prefecture-level from 2008 to 2020, this paper empirically examines the impact of marine economic development pilot policies on urban innovation ability by using the difference-in-difference method and the mediating effect model. This paper shows that marine economic development pilot policies significantly improve urban innovation ability and pass a series of robustness tests. Heterogeneity analysis shows that marine economic development pilot policies present a significant promotion effect in the central and southern economic zones, cities with less pressure on economic growth, and cities with higher levels of science and education. The mechanism test shows that marine economic development pilot policies enhance the city's innovation ability through the agglomeration effect of talents and enterprises. This paper not only provides empirical evidence for the economic consequences of marine economic development pilot policies, but also provides policy insights for enhancing urban innovation ability and promoting the high-quality development of the marine economy.

Ashkan Pourabhari Langroudi, Yosef Farzi, Golaleh Almasi et al.

Abstract Tobacco smoking is a significant global public health challenge, responsible for 8 million deaths annually. This study aimed to analyze the age of smoking initiation and its sociodemographic determinants among Iranian adults, based on data from the 2021 STEPwise approach to surveillance (STEPS) survey, to inform targeted public health interventions. The analysis of 27,874 adults revealed that the average initiation ages for cigarette and hookah smoking were 22.2 years and 24.9 years, respectively. Men typically began smoking earlier than women, with average ages of 21.9 years for males and 27.7 years for females. No significant differences were observed in smoking initiation ages between rural and urban areas. Education level and marital status were also influential, with the youngest initiators having 7–12 years of education and being single. This study highlights the significant roles of gender, education, and urban-rural differences in smoking initiation in Iran. The findings underscore the need for targeted public health strategies conforming to the WHO’s MPOWER initiatives and the Framework Convention on Tobacco Control (FCTC). Increased investment in public health, focusing on education and preventive measures, is crucial to reduce early smoking initiation and its associated health risks, ultimately supporting broader health policy goals.

Finn Klessascheck, Ingo Weber, Luise Pufahl

Given the continuous global degradation of the Earth's ecosystem due to unsustainable human activity, it is increasingly important for enterprises to evaluate the effects they have on the environment. Consequently, assessing the impact of business processes on sustainability is becoming an important consideration in the discipline of Business Process Management (BPM). However, existing practical approaches that aim at a sustainability-oriented analysis of business processes provide only a limited perspective on the environmental impact caused. Further, they provide no clear and practically applicable mechanism for sustainability-driven process analysis and re-design. Following a design science methodology, we here propose and study SOPA, a framework for sustainability-oriented process analysis and re-design. SOPA extends the BPM life cycle by use of Life Cycle Assessment (LCA) for sustainability analysis in combination with Activity-based Costing (ABC). We evaluate SOPA and its usefulness with a case study, by means of an implementation to support the approach, thereby also illustrating the practical applicability of this work.

Pavinee Pongpunpurt, Nattawin Chawaloesphonsiya, Thaksina Poyai et al.

This study addresses the significant contribution of shopping malls to plastic waste management by assessing alternatives that balance environmental and economic impacts. Data were collected through a mixed-methods approach (in-depth interviews and questionnaires) and analyzed using the thematic analysis. The research highlights the pivotal role of policymakers in fostering collaborations essential for effective plastic waste management. A novel business model centered on resource recovery is proposed based on the analysis of the plastic waste landscape from both macro-factors and key stakeholders' perspectives. Due to the enhancement in plastic recycling rates, this model could reduce greenhouse gas emissions by up to 19.88 tCO2-eq per year and generate an annual revenue of USD 584. The findings advocate for collaborative efforts between mall stores and office spaces to increase the availability of recyclable plastics. The outcomes contribute to the formulation of evidence-based environmental policies tailored to shopping malls, promoting sustainable solutions aligned with circular economy principles and offering a framework that can be adopted by stakeholders across the plastic ecosystem.

Marcellin Mengouo Nimpa, Aimé Cikomola Mwana-Wabene, John Otomba et al.

Abstract Background The Democratic Republic of Congo (DRC) has one of the highest numbers of un and under-vaccinated children as well as number of refugees and internally displaced persons (IDPs) in the world. This study aims to determine and compare the proportion and characteristics of zero-dose (ZD) and under-vaccinated (UV) children among refugees and IDPs in the DRC, as well as the reasons for incomplete vaccination schedules. Methods Data from a rolling vaccination coverage survey conducted from September 10, 2022, to July 03, 2023, among refugees and IDPs in 12 provinces of the DRC. ZD was defined as a child aged 12–23 months who had not received any dose of pentavalent vaccine DTP-Hib-Hep B (by card or recall) and UV as a child who had not received the third dose of pentavalent vaccine. The proportions of non and under-vaccination and the associated factors using a logistic regression model are presented for ZD and UV children. The reasons for non-vaccination of these children are described using the WHO-Immunization behavioral and social-drivers-conceptual framework and compared using Pearson’s Chi2 test. Results Of 692 children aged 12 to 23 months included in the analysis, 9.3% (95% CI: 7.2–11.7%) were ZD and 40.9% (95% CI: 95%: 37.2–44.6%) UV. The Penta1/Penta3 drop-out rate was 34.9%. After adjustment, ZD children had a significant history of home or road birth. And UV children were significantly associated with mothers/caregivers being under 40, uneducated, farmers, ranchers, employed, rural residents, as well as with home or road births. Reasons linked to people’s perceptions and feelings were cited much more often for ZD (50.0%) than for UV (38.3%). Those related to social reasons were cited much more often by ZD (40.6%) than by UV (35.7%). Reasons related to “programmatic and practical issues” were cited less for ZD (90.5%) than for UV (97.1%). Conclusions ZD and UV children represent significant proportions in refugee and IDPs sites in the DRC. However, the proportion of ZD is less than for the entire country, while the proportion of UV is comparable, reflected in a very high drop-out rate. Similarly to studies in the general population in DRC, the reasons for ZD children were mainly linked to challenges in caregiver motivation to vaccinate, while for UV children, they were more often linked to pro-grammatic and practical problems of the health system.

Anastasiya S. Sazhina, Olga N. Kurochkina, Aleksandr V. Baranov et al.

Aim – to identify predictors of the risk of adverse events over a three-year period in patients with chronic heart failure (CHF). Material and methods. A retrospective study was conducted on 278 people diagnosed with CHF in patients with coronary heart disease (CHD). A sample of data was made, survival assessment, Charson comorbidity index was calculated. Statistical data processing was carried out using Excel and XLSTAT programs with linear regression calculations. Results. A statistically significant direct relationship between three-year survival was identified with the following indicators: age over 66 years, stage IIB-III CHF, Echo-CG data (low LVEF, left ventricular diameter, systolic pressure in the pulmonary artery (SPAP), the presence of hypertension (HBP) and atrial fibrillation (AF), Charlson comorbidity index of more than 5 points, glomerular filtration rate (GFR) less than 60 ml/min, complete blood count (CBC) data - a decrease in hemoglobin level below 131 g/l and an increase in ESR level above 14 mm/h. Surgical interventions such as coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) were associated with better patient survival. Conclusion. In order to ensure qualified monitoring of patients with CHF and ensure continuity of management of these patients, it seems relevant to create a specialized office for the management of patients with CHF.

Humisar Sihombing, Dina Sarah Syahreza, Hendra Saputra et al.

This research was conducted in Desa Laut Dendang, Kecamatan Percut Sei Tuan. The population for this study consists of all oyster mushroom farms, totaling 150 individuals, with a sample size of 60 individuals selected using Random Sampling. The data collection instrument was a multiple-choice questionnaire that had been tested for validity and reliability. Classical assumption tests included tests for normality, multicollinearity, and heteroscedasticity. Hypothesis testing was conducted using multiple linear regression analysis, F-test, and t-test. The validity test results showed that rhitung > rtabel for each questionnaire item, and the reliability test yielded Cronbach's alpha values of 0.842 for variable X1, 0.725 for variable X2, and 0.680 for variable Y. These values are greater than the significant level of rtabel, which is 0.361. Data analysis for each variable produced the multiple regression equation Y = 8.839 + 0.344X1 + 0.227X2 + e. The R2 value of 0.544 indicates that X1 and X2 explain 54.4% of the variance in variable Y, while the remaining 45.6% is explained by other variables not included in this study. The partial test results indicate that each independent variable significantly affects the dependent variable, with a significance level less than 0.05. The simultaneous test results show an F-value of 6.812 with an Ftabel of 3.160, meaning Fhitung > Ftabel at a significance level (α) of 0.012 < 0.05. This means the hypothesis is accepted, indicating that Capital and Labor significantly affect the Income of Oyster Mushroom Farming in Desa Laut Dendang, Kecamatan Percut Sei Tuan.

Xinxin Zhang, Fangfang Wang, Bing Xu et al.

Background Patients with chronic heart failure (CHF) often have a long duration of illness, difficulty in attending follow-up visits, and poor adherence to treatment. As a result, they frequently cannot receive guideline-directed medical therapy (GDMT) at the desired or maximum tolerable drug dosage. This leads to high hospitalisation and mortality rates for HF patients. Therefore, effective management and monitoring of patients with HF to ensure they receive GDMT is crucial for improving the prognosis.Design and methods This is a multicentre, open-label, randomised, parallel-group study involving patients with CHF across five centres. The study aims to assess the impact of an optimised GDMT model for HF patients, established on a mobile health (mHealth) platform, compared with a control group. Patients must have a left ventricular ejection fraction of less than 50% and be receiving medication titration therapy that has not yet reached the target dose, with a modest increase in N-terminal pro-B-type natriuretic peptide level. The primary composite outcome is worsening HF events (hospitalisation or emergency treatment with intravenous fluids) or cardiovascular death.Ethics and dissemination On 22 December 2021, this study received ethical approval from the Ethics Review Board of the First Affiliated Hospital of Nanjing Medical University, with the ethics number 2021-SR-530. All study participants will be informed of the research purpose and their participation will be voluntary. Informed consent will be obtained by providing and signing an informed consent form. We will ensure compliance with relevant laws and regulations regarding privacy and data protection. The results of this study will be published in a peer-reviewed academic journal. We will ensure that the dissemination of study results is accurate, clear and timely.Trial registration number ChiCTR2200056527.

F. Giardiello, John I. Allen, J. Axilbund et al.

Zhengyong Jiang, Jeyan Thiayagalingam, Jionglong Su et al.

In this paper, we present a novel trading strategy that integrates reinforcement learning methods with clustering techniques for portfolio management in multi-period trading. Specifically, we leverage the clustering method to categorize stocks into various clusters based on their financial indices. Subsequently, we utilize the algorithm Asynchronous Advantage Actor-Critic to determine the trading actions for stocks within each cluster. Finally, we employ the algorithm DDPG to generate the portfolio weight vector, which decides the amount of stocks to buy, sell, or hold according to the trading actions of different clusters. To the best of our knowledge, our approach is the first to combine clustering methods and reinforcement learning methods for portfolio management in the context of multi-period trading. Our proposed strategy is evaluated using a series of back-tests on four datasets, comprising a of 800 stocks, obtained from the Shanghai Stock Exchange and National Association of Securities Deal Automated Quotations sources. Our results demonstrate that our approach outperforms conventional portfolio management techniques, such as the Robust Median Reversion strategy, Passive Aggressive Median Reversion Strategy, and several machine learning methods, across various metrics. In our back-test experiments, our proposed strategy yields an average return of 151% over 360 trading periods with 800 stocks, compared to the highest return of 124% achieved by other techniques over identical trading periods and stocks.

Lutfiah Hafizah Siahaan

Organizational support on organizational citizenship behavior through organizational commitment at PT Astra. Path analysis research design is used as an analytical tool to determine how the influence between independent and dependent variables is mediated by mediating variables. This study uses associative research with a quantitative approach. The population and samples used in this study were all 125 employees of PT Astra. The results of this research indicate that the variables of leader member exchange and perceived organizational support have a significant effect on organizational citizenship behavior and the variable organizational commitment significantly mediates the relationship between the variables of leader member exchange and perceived organizational support on organizational citizenship behavior.