Artículos de revistas: "Network safety assessments"

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Budzyński, Marcin, Jacek Szmagliński, Kazimierz Jamroz, Krystian Birr, Sławomir Grulkowski y Joanna Wachnicka. "Assessing Tram Infrastructure Safety Using the Example of the City of Gdańsk". Journal of KONBiN 49, n.º 3 (1 de octubre de 2019): 293–322. http://dx.doi.org/10.2478/jok-2019-0060.

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Abstract Analysis of Gdańsk tram network statistics shows that incidents are quite frequent (about 650 within five years) and mostly involve collisions and crashes. As well as reducing the tram systems’ efficiency and reliability, incidents have a negative effect on road safety. As Polish cities extend their tram networks, they must also ensure that their existing networks are safe. This is to be achieved by conducting safety assessments. The article presents different assessment methods, at different stages of tram infrastructure lifecycle, providing a basis for a comprehensive diagnosis and recommendations for improvement. The objective of the study was to conduct a comprehensive safety assessment and analysis of the existing and planned tram network across Gdańsk, using different study methods and tools.

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Mäkelä, Marjukka, Minna Kaila y Ken Stein. "Mind sharpeners for scientists: The EQUATOR Network". International Journal of Technology Assessment in Health Care 27, n.º 2 (24 de marzo de 2011): 99–100. http://dx.doi.org/10.1017/s0266462311000158.

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Scientific reports should be orderly, clear, and unambiguous. Clarity is even more important for health technology assessments (HTAs), which aim at supplying reliable and up-to-date evidence on the effectiveness, safety, and cost of healthcare interventions. Increasingly assessments also provide information about the effects of technologies on organization of care, as well as relevant legal, social, and ethical considerations.

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Mundy, Linda, Tracy L. Merlin, Adriana Parrella, Wendy J. Babidge, Dianne E. Roberts y Janet E. Hiller. "The Australia and New Zealand Horizon Scanning Network". Australian Health Review 29, n.º 4 (2005): 395. http://dx.doi.org/10.1071/ah050395.

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UP UNTIL 1982, new health technologies, procedures or services were introduced into the health system in an uncontrolled, unregulated manner. This had the potential for wide-ranging impact on the public health care system including ballooning costs, a lack of preparedness by training and accreditation organisations, and consequent patient safety concerns. Health technology assessment was introduced into Australia in 1982 when the National Health Technology Assessment Panel was formed. This original panel has undergone numerous name changes and evolved into the Australian Government-funded Medical Services Advisory Committee (MSAC).1 The primary role of the MSAC is to inform the Federal Minister for Health and Ageing on the safety, effectiveness and costeffectiveness of new medical technologies and procedures using the available evidence.2 Assessments of the safety, effectiveness and cost-effectiveness of these technologies may occur only after the technology has diffused and is practised widely.3 Early identification of such technologies may avoid the detrimental consequences of their indiscriminate introduction and could result in the adoption of beneficial and cost-effective technologies and the elimination of technologies that are unsafe or for which there is no evidence of cost-effectiveness.4

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Budzyński, Marcin, Kazimierz Jamroz y Wojciech Kustra. "Road safety inspection as a tool for road safety management – the polish experience". Journal of KONBiN 42, n.º 1 (1 de junio de 2017): 43–62. http://dx.doi.org/10.1515/jok-2017-0017.

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Abstract In Poland, road inspections were implemented in June 2014 on all national roads. Previous traffic surveys mainly looked at the technical condition of roads, signs and markings; other safety issues were overlooked. The main problem of the inspections is that the qualitative assessment is subjective which affects the classification of the sources of hazard on the road. The paper presents an analysis of the variability of the qualitative assessments of road defects when they are assessed by different teams of inspectors. On this basis, guidelines were developed for the classification of risks based on the relationship between sources of road hazard and the personal and economic losses involved in road accidents. These relationships are quantified using mathematical models to simulate the effect of hazard variability on the consequences of selected road accident causes on sections of the road network.

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Heijer, C. (Kees) Den, Dirk T. J. A. Knipping, Nathaniel G. Plant, Jaap S. M. Van Thiel de Vries, Fedor Baart y Pieter H. A. J. M. Van Gelder. "IMPACT ASSESSMENT OF EXTREME STORM EVENTS USING A BAYESIAN NETWORK". Coastal Engineering Proceedings 1, n.º 33 (25 de octubre de 2012): 4. http://dx.doi.org/10.9753/icce.v33.management.4.

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This paper describes an investigation on the usefulness of Bayesian Networks in the safety assessment of dune coasts. A network has been created that predicts the erosion volume based on hydraulic boundary conditions and a number of cross-shore profile indicators. Field measurement data along a large part of the Dutch coast has been used to train the network. Corresponding storm impact on the dunes was calculated with an empirical dune erosion model named duros+. Comparison between the Bayesian Network predictions and the original duros+ results, here considered as observations, results in a skill up to 0.88, provided that the training data covers the range of predictions. Hence, the predictions from a deterministic model (duros+) can be captured in a probabilistic model (Bayesian Network) such that both the process knowledge and uncertainties can be included in impact and vulnerability assessments.

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Zhu, Baikang, Xu Yang, Jun Wang, Chuanhui Shao, Fei Li, Bingyuan Hong, Debin Song y Jian Guo. "Third-Party Damage Model of a Natural Gas Pipeline Based on a Bayesian Network". Energies 15, n.º 16 (21 de agosto de 2022): 6067. http://dx.doi.org/10.3390/en15166067.

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Natural gas plays an important role in the transition from fossil fuels to new energy sources. With the expansion of pipeline networks, there are also problems with the safety of pipeline network operations in the process of transportation. Among them, third-party damage is a key factor affecting the safety of pipelines. In this paper, the risk factors of third-party damage are analyzed, and an evaluation model of natural gas pipeline damage is established using the GeNIe Modeler. Through Bayesian network reverse reasoning and a maximum cause chain analysis from the four aspects of personnel, environment, management, and equipment, it was found that the top five factors that have significant influence on third-party damage, are safety investment, the completeness of equipment, safety inspection frequency, the management of residents along the pipeline, and safety performance, with the posteriori probability in the model of 97.3%, 95.4%, 95.2%, 95.1%, 95.1%, respectively. Consequently, it is necessary for pipeline operation companies to secure investment on safety, to make sure that the safety equipment (system) works and is in a good condition, to maintain the safety inspection frequency in an organization, to build a management system for residents along the pipeline, and to conduct routine safety performance assessments accordingly.

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Li, Mengchu y Jingchun Wang. "Intelligent Recognition of Safety Risk in Metro Engineering Construction Based on BP Neural Network". Mathematical Problems in Engineering 2021 (30 de abril de 2021): 1–10. http://dx.doi.org/10.1155/2021/5587027.

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With the rapid development of urban economy, the development of urban rail transit is becoming more and more rapid. As an energy-saving, land-saving, and environment-friendly green travel mode, the subway provides realistic and feasible solutions to the increasingly prominent traffic environment and other urban diseases in our country and brings a booming development in the subway construction industry with efforts to promote and build in many large cities. For a large number of subway constructions, it is particularly important to judge the construction safety status in time during the entire safety management process. Regularly conducting safety risk assessments on subway construction status can accurately predict and judge the types of accidents that occur. In order to solve the current safety risk assessment problems in the process of subway construction in our country, this paper is based on the BP neural network to intelligently identify the safety risks of subway construction, choosing from three aspects: human factors, management factors, and risk factors. We evaluate the construction safety of subway projects under construction through the model, predict the types of accidents that may occur, so that the construction unit can take corresponding preventive and improvement measures, improve the relevant safety technology of subway construction in a targeted manner, and propose corresponding reductions. We provide suggestions and measures for risk probability, to ensure that the construction unit discovers the danger in time and takes safety measures. The rectification measures provided theoretical basis and guidance.

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Hu, Jun, Xuecai Xie, Xueming Shu, Shifei Shen, Xiaoyong Ni y Lei Zhang. "Fire Risk Assessments of Informal Settlements Based on Fire Risk Index and Bayesian Network". International Journal of Environmental Research and Public Health 19, n.º 23 (25 de noviembre de 2022): 15689. http://dx.doi.org/10.3390/ijerph192315689.

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The specific risk assessment of informal settlements (IS) is important for the management of IS and protection of environmental safety and public health. In this paper, we introduced the different types of IS in China, and conducted the fire risk assessment on 26 burning buildings in these IS, providing a semi-quantitative and scenario fire risk perception of IS in China for the readers. Two methods, the risk index and the Bayesian network, are proposed and adopted for the fire risk assessment in IS. First, a risk index system with a total of 69 factors is used to assess the degree of fire risk of buildings in IS semi-quantitatively, and the result shows that fire equipment and fire safety management on IS are seriously lacking. Then, a Bayesian network of building fire risk with a total of 66 nodes was established to assess the fire risk from ignition to spread as well as the safety evacuation. Overall, the possibility of ignition is high, but due to the role of fire equipment and fire protection design, the possibilities of fire from ignition to spread is gradually reduced. Finally, we also put forward some feasible suggestions for occupants in IS, community organizations and emergency managers to reduce the fire risk from the aspects of fire equipment and fire safety management.

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Chen, Haoran. "A Contrastive Analysis of Classroom-Based Language Assessments". English Language Teaching 13, n.º 5 (27 de abril de 2020): 110. http://dx.doi.org/10.5539/elt.v13n5p110.

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Classroom-based language assessments mainly include formative assessment and summative assessment, which are the most commonly used evaluation methods. The present study adopts a contrastive method to analyze the two types of assessments. Results of the study show that: 1) the characteristics of formative assessment contain teachers’ adaptation to classes and immediate feedback provided for teachers, while summative assessment, as a high-risk one, needs a high standard control and safety for dependability and effectiveness; 2) formative assessment is suitable for any places with multiple standards for the judgement of learners’ achievements while summative assessment evaluates the educational effect or the whole process of special education at a certain time point, and both assessments can always be conducted on network platforms nowadays; 3) evidence and interpretation are taken into consideration in formative assessment and summative assessment respectively while the two types of assessment complement each other for the related teaching goals; 4) more attention may be paid to both assessment for learning (AfL) and assessment as learning (AaL) in the future development of assessment. The contrastive study is expected to provide a reference for classroom-based language teaching and learning.

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Pakoksung, Kwanchai, Anawat Suppasri, Panon Latcharote, Abdul Muhari y Fumihiko Imamura. "Global Tsunami Risk Assessment: Collaboration Between Industry and Academia in the Willis Research Network (WRN)". Journal of Disaster Research 13, n.º 7 (1 de diciembre de 2018): 1272–87. http://dx.doi.org/10.20965/jdr.2018.p1272.

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We present outcomes of our collaborative research between tsunami engineering laboratory, Tohoku University and the Willis Research Network (WRN) on global tsunami risk assessment since 2010. First we assessed tsunami hazards in Indian Ocean and west Pacific from major earthquakes based on historical records. After the 2011 Japan tsunami, various kind of fragility functions were developed for human casualty, buildings, marine vessels, etc based on the actual data. Especially, detailed tsunami hazard assessments were performed in many areas using fine bathymetry and topography data all over Japan including hazards from the worst case tsunamigenic earthquakes provided by central government and local governments in Hokkaido, Japan Sea and Nankai Trough. These results from the detailed hazard and vulnerability assessment were used for detailed tsunami risk in Japan. The Willis’s Japan tsunami model was then first released in December 2014. The model have been updating based on the updated or revised tsunami sources model and fragility functions. Detailed tsunami hazards from potential tsunami events in the Bay of Bengal, South China Sea and some parts of Indonesia were also performed in 2014. In October 2016, our contribution on the historical and future tsunami hazard assessment in global scale based on historical records over the last 400 years was conducted as an activity to increase tsunami awareness as part of World Tsunami Awareness Day. The current activities are to extend the target areas in Japan to Okinawa and assessing disaster risk reduction based on the present and planned tsunami countermeasures. We present the outcomes of the collaborative research done since 2010 by the Tsunami Engineering Laboratory of Tohoku University and the Willis Research Network (WRN) on global tsunami risk assessment. First, we assessed, based on historical records, the tsunami hazards in the Indian Ocean and western Pacific from major earthquakes. Since the 2011 Japan tsunami, various kinds of fragility functions have been developed for human casualties, buildings, marine vessels, etc., based on the actual data. Detailed tsunami hazard assessments have been performed in many areas of Japan using fine bathymetry and topography data from all over Japan, including data on hazards from the worst-case tsunamigenic earthquakes. These data have been provided by the Cabinet Office, Japan. The results from the detailed hazard and vulnerability assessments were used for detailed tsunami risk assessments in Japan. The Willis Japan tsunami model was then released in December 2014. The model has been updated based on the updated or revised tsunami source model and fragility functions. Detailed tsunami hazards from potential tsunami events in the Bay of Bengal, South China Sea, and some parts of Indonesia were also performed in 2014. In October 2016, our contribution to the historical and future tsunami hazard assessment on a global scale based on historical records over the last 400 years was conducted as an activity to increase tsunami awareness as part of World Tsunami Awareness Day. The current activities are to extend the target areas in Japan to Okinawa and to assess the disaster risk reduction based on the present and planned tsunami countermeasures.

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Oskarbski, Jacek, Lucyna Gumińska, Tomasz Marcinkowski, Krystian Mowiński, Izabela Oskarbska, Grzegorz Oskarbski, Marcin Zawisza y Karol Żarski. "Methodology of research on the impact of ITS services on the safety and efficiency of road traffic using transport models". MATEC Web of Conferences 231 (2018): 02008. http://dx.doi.org/10.1051/matecconf/201823102008.

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The current assessment of the impact of Intelligent Transport System (ITS) services on the level of traffic safety and efficiency is based mainly on expert assessments, statistical surveys or several traffic safety models requiring development. There is no structured, uniform assessment method that would give the opportunity to compare the impact of ITS services and their different configurations. The paper presents the methodology for researching the effectiveness of ITS services implementation using transport models and key indicators allowing such an assessment. An approach was used in which the impact of ITS services is analysed using macro, meso and microscopic models. Macro and mesoscopic models allow estimation of the impact of ITS services on the efficiency of transport network operation and constitute the basis of analyses at the microscopic level, which takes into account the behaviour of drivers through the use of car following and lane change models. As part of the analyses, road network test models (for motorways and expressways along with an alternative route) were developed. Test models include road class, network topology, and different traffic intensity. The models were calibrated using real data (data from the traffic measurement station, data measured in the field, traffic distribution data from the VIATOLL charging system) and data from the vehicle simulator.

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Pietrucha-Urbanik, Katarzyna y Barbara Tchórzewska-Cieślak. "Approaches to Failure Risk Analysis of the Water Distribution Network with Regard to the Safety of Consumers". Water 10, n.º 11 (17 de noviembre de 2018): 1679. http://dx.doi.org/10.3390/w10111679.

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Contemporary risk assessment makes reference to current world trends, whereby there is increased emphasis on safety. This paper has thus sought mainly to present new approaches to failure risk assessment where the functioning of a water distribution network (WDN) is concerned. The framework for the research involved here has comprised of: (a) an analysis of WDN failure in regard to an urban agglomeration in south-east Poland; (b) failure rate analysis, taking account of the type of a water pipe (mains, distribution, service connections (SC)) and months of the year, with an assessment of results in terms of criterion values for failure rate; (c) a determination—by reference to analyses performed previously—of the compatibility of experts’ assessments in terms of standards of failure and obtained results, through rank analysis; and (d) the proposing of a modified Multi-Criteria Decision Analysis with implementation of an Analytical Hierarchy Process, to allow failure risk assessment for the WDN to be performed, on the basis of the calculated additive value of obtained risk. The analysis in question was based on real operating data, as collected from the water distribution company. It deals with failures in the WDN over a period of 13 years in operation, from 2005 to 2017.

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Colonias, Athanasios, David S. Parda, Stephen M. Karlovits, Russell Fuhrer, Mark G. Trombetta, Staci Strickland, Marc Luick, Richard Billy, T. Horrigan y E. Day Werts. "A Radiation Oncology Based Electronic Health Record in an Integrated Radiation Oncology Network". Journal of Radiation Oncology Informatics 3, n.º 1 (28 de septiembre de 2017): 3–11. http://dx.doi.org/10.5166/jroi-3-1-16.

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Purpose: The goal of this ongoing project is to develop and integrate a comprehensive electronic health record (EHR) throughout a multi-facility radiation oncology network to facilitate more efficient workflow and improve overall patient care and safety. Methodology: We required that the EHR provide pre-defined record and verify capability for radiation treatment while still providing a robust clinical health record. In 1996, we began to integrate the Local Area Network Treatment Information System (LANTIS®) across the West Penn Allegheny Radiation Oncology Network (currently including 9 sites). By 2001, we began modifying and expanding the assessment components and creating user-defined templates and have developed a comprehensive electronic health record across our network. Results: In addition to access to the technical record and verify information and imaging obtained for image-guided therapy, we designed and customized 6 modules according to our networks needs to facilitate information acquisition, tracking, and analysis as follows: 1) Demographics/scheduling; 2) Charge codes; 3) Transcription/clinical documents; 4) Clinical/technical assessments; 5) Physician orders 6) Quality assurance pathways. Each module was developed to acquire specific technical/clinical data prospectively in an efficient manner by various staff within the department in a format that facilitates data queries for outcomes/statistical analyses and promotes standardized quality guidelines resulting in a more efficient workflow and improved patient safety and care. Conclusions: Development of a comprehensive EHR across a radiation oncology network is feasible and can be customized to promote clinical/technical standards, facilitate outcomes studies, and improve communication and peer review. The EHR has improved patient care and network integration across a multi-facility radiation oncology system and has markedly reduced the flow and storage of paper across the network.

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Lin, Wen-Kuang, Shwu-Jiuan Lin, Woan-Ruoh Lee, Chia-Chieh Lin, Weei-Chin Lin, Hua-Ching Chang, Chi-Tsun Cheng y Jason C. Hsu. "Effectiveness and Safety of Immunosuppressants and Biological Therapy for Chronic Spontaneous Urticaria: A Network Meta-Analysis". Biomedicines 10, n.º 9 (1 de septiembre de 2022): 2152. http://dx.doi.org/10.3390/biomedicines10092152.

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Chronic spontaneous urticaria (CSU) is the most common phenotype of chronic urticaria. We compared treatment effects and safety profiles of the medications in patients with CSU. We searched PubMed, MEDLINE, and Web of Science for randomized control trials (RCTs), from 1 January 2000 to 31 July 2021, which evaluated omalizumab and immunosuppressants. Network meta-analyses (NMAs) were performed with a frequentist approach. Outcome assessments considered the efficacy (Dermatology Life Quality Index (DLQI) and weekly urticaria activity score (UAS7)) and tolerability profiles with evaluations of study quality, inconsistencies, and heterogeneity. We identified 14 studies which we included in our direct and indirect quantitative analyses. Omalizumab demonstrated better efficacy in DLQI and UAS7 outcomes compared to a placebo, and UAS7 assessments also demonstrated better outcomes compared to cyclosporine. Alongside this, omalizumab demonstrated relatively lower incidences of safety concerns compared to the other immunosuppressants. Cyclosporin was also associated with higher odds of adverse events than other treatment options. Our findings indicate that omalizumab resulted in greater improvements in terms of the DLQI and UAS7 with good tolerability in CSU patients compared to the other immunosuppressants.

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Laurinavičius, Alfredas, Lina Juknevičiūtė-Žilinskienė, Kornelija Ratkevičiūtė, Ineta Lingytė, Laura Čygaitė, Vytautas Grigonis, Rasa Ušpalytė-Vitkūnienė et al. "POLICY INSTRUMENTS FOR MANAGING ROAD SAFETY ON EU-ROADS". TRANSPORT 27, n.º 4 (21 de diciembre de 2012): 397–404. http://dx.doi.org/10.3846/16484142.2012.751934.

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Directive 2008/96/EC on road infrastructure safety management requires the establishment and implementation of procedures relating to road safety impact assessments (RSIA), road safety audits (RSA), ranking of high accident concentration sections and network safety ranking (NSR) and road safety inspections (RSI). The aim of this article is to present the outputs of BALTRIS project. The goal of the international project BALTRIS is to elaborate the road and street infrastructure safety management procedures and teaching material consistently explaining the above mentioned infrastructure management procedures. Four Baltic Sea region countries (Sweden, Estonia, Latvia, and Lithuania), represented by universities and national road administrations participate in the elaboration of these procedures and teaching material. This article describes the scope of NSR, RSA and RSI procedures prepared in the frame of BALTRIS project, also article provides detailed implementation and execution of procedures for the EU Member States. NSR means a method for identifying, analysing and classifying parts of the existing road network according to their potential for safety development and accident cost savings. Ranking of high accident concentration sectionsmeans a method to identify, analyse and rank sections of the road network which have been in operation for 3÷5 years and upon which a large number of fatal/injury accidents in proportion to the traffic flow or compared to respective conditions have occurred. RSI is a strategic comparative analysis of the impact of the new road or a substantial modification to the existing network on the safety performance of the road network. RSA is a formal safety performance examination of the existing or future road or intersection by an independent audit team.

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ROBINSON, Claire, Christopher J. PORTIER, Aleksandra ČAVOŠKI, Robin MESNAGE, Apolline ROGER, Peter CLAUSING, Paul WHALEY, Hans MUILERMAN y Angeliki LYSSIMACHOU. "Achieving a High Level of Protection from Pesticides in Europe: Problems with the Current Risk Assessment Procedure and Solutions". European Journal of Risk Regulation 11, n.º 3 (16 de abril de 2020): 450–80. http://dx.doi.org/10.1017/err.2020.18.

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The regulation of pesticides in the European Union (EU) relies on a network of hard law (legislation and implementing acts) and soft law (non-legally binding guidance documents and administrative and scientific practices). Both hard and soft laws govern how risk assessments are conducted, but a significant role is left to the latter. Europe’s pesticide regulation is one of the most stringent in the world. Its stated objectives are to ensure an independent, objective and transparent assessment of pesticides and achieve a high level of protection for health and environment. However, a growing body of evidence shows that pesticides that have passed through this process and are authorised for use may harm humans, animals and the environment. The authors of the current paper – experts in toxicology, law and policy – identified shortcomings in the authorisation process, focusing on the EU assessment of the pesticide active substance glyphosate. The shortcomings mostly consist of failures to implement the hard or soft laws. But in some instances the law itself is responsible, as some provisions can only fail to achieve its objectives. Ways to improve the system are proposed, requiring changes in hard and soft laws as well as in administrative and scientific practices.

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Zhang, Peng, Xiangsu Chen y Chaohai Fan. "Research on a Safety Assessment Method for Leakage in a Heavy Oil Gathering Pipeline". Energies 13, n.º 6 (13 de marzo de 2020): 1340. http://dx.doi.org/10.3390/en13061340.

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At present, the number of oil and gas gathering and transportation pipelines is numerous, and leakage accidents occur frequently. Each year, due to pipeline failure, there are immeasurable consequences for people and the environment around the affected pipelines. In order to reduce the risk of leakage accidents in heavy oil gathering pipelines and prevent the occurrence of major spills, it is of great significance to carry out safety assessments of them. However, failure data of these pipelines is seriously deficient and statistical methods used to evaluate pipeline safety are incompatible. Therefore, this paper proposes a risk assessment system for heavy oil gathering pipelines in the absence of failure data. Firstly, a Bayesian network (BN) for the leak safety evaluation of heavy oil gathering pipelines is established via mapping from a bow-tie (BT) model. Then, information diffusion theory is combined with fuzzy set theory to obtain the failure probability of each factor affecting the pipeline failure, and then the failure probability of the pipeline is obtained by the full probability formula. In addition, in order to assess the extent of consequences due to accidents, variable fuzzy set theory is used to comprehensively consider the consequences of the leakage of heavy oil gathering pipelines. Finally, the above two parts are combined to form a safety assessment system to realize risk management and control for pipelines, which is necessary to ensure the safety of heavy oil gathering pipelines.

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Alvarado, Alembert Eistein Lino, Diego Antonio de Oliveira Rosa, Sara Gomes Mello, Marcelo Sanches Dias, Mario Fernando Barbosa, Kelvis do Nascimento Barros, Bruno Alexandre Lemos et al. "Quality assessment of emergency corrective maintenance of critical care ventilators within the context of COVID-19 in Sao Paulo, Brazil". Global Clinical Engineering Journal 4, n.º 1 (1 de marzo de 2021): 27–36. http://dx.doi.org/10.31354/globalce.v4i1.108.

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This technical report presents the quality assessment process for the emergency corrective maintenance of critical care ventilators in a node, IPT-POLI, of a voluntary network that is part of the initiative +Maintenance of Ventilators, led by the National Service of Industrial Training (SENAI) and its Integrated Manufacturing and Technology Center (CIMATEC) to perform maintenance on unused mechanical ventilators in the context of the COVID-19 pandemic in Brazil. A procedure was established for the quality assessment of equipment subjected to corrective emergency maintenance, covering the essential aspects of the three primary standards (ABNT NBR IEC 60601-1: 2010+A1:2016, ABNT NBR ISO IEC 62353: 2019, and ABNT NBR ISO 80601-2-12:2014) for performance and safety assessment. A set of nine critical care ventilators was evaluated considering the following parameters: leakage current, protective ground resistance, control accuracy, delivered oxygen test, and alarms. The evaluated ventilators underwent corrective emergency maintenance before performance and safety assessments. In the electrical safety tests, all equipment presented values prescribed for the standard. However, the assessment of ventilator parameters revealed that their performance was below the standard. Finally, quality assessment reports were sent to the clinical engineering departments at hospitals. Thus, it can be concluded that criteria selection for the quality assessment in critical care ventilators is crucial and of great significance for future pandemic scenarios, such as the situation experienced during the COVID-19 pandemic.

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Kuzmanić Skelin, Ana, Lea Vojković, Dani Mohović y Damir Zec. "Weight of Evidence Approach to Maritime Accident Risk Assessment Based on Bayesian Network Classifier". Transactions on Maritime Science 10, n.º 2 (21 de octubre de 2021): 330–47. http://dx.doi.org/10.7225/toms.v10.n02.w07.

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Probabilistic maritime accident models based on Bayesian Networks are typically built upon the data available in accident records and the data obtained from human experts knowledge on accident. The drawback of such models is that they do not take explicitly into the account the knowledge on non-accidents as would be required in the probabilistic modelling of rare events. Consequently, these models have difficulties with delivering interpretation of influence of risk factors and providing sufficient confidence in the risk assessment scores. In this work, modelling and risk score interpretation, as two aspects of the probabilistic approach to complex maritime system risk assessment, are addressed. First, the maritime accident modelling is posed as a classification problem and the Bayesian network classifier that discriminates between accident and non-accident is developed which assesses state spaces of influence factors as the input features of the classifier. Maritime accident risk are identified as adversely influencing factors that contribute to the accident. Next, the weight of evidence approach to reasoning with Bayesian network classifier is developed for an objective quantitative estimation of the strength of factor influence, and a weighted strength of evidence is introduced. Qualitative interpretation of strength of evidence for individual accident influencing factor, inspired by Bayes factor, is defined. The efficiency of the developed approach is demonstrated within the context of collision of small passenger vessels and the results of collision risk assessments are given for the environmental settings typical in Croatian nautical tourism. According to the results obtained, recommendations for navigation safety during high density traffic have been distilled.

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Cantisani, Giuseppe, Chiara Caterina Borrelli, Giulia Del Serrone y Paolo Peluso. "Optimizing Road Safety Inspections on Rural Roads". Infrastructures 8, n.º 2 (8 de febrero de 2023): 30. http://dx.doi.org/10.3390/infrastructures8020030.

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Road safety depends on a complex balance between all the factors that compose the road system: user, vehicle, environment, and infrastructure. Directive 2008/96/EC introduces procedures to improve the European Transport Network (TEN-T) safety, recognizing an important role for safety inspections, but focusing them on freeways and highways. This paper proposed methods and criteria useful to optimize current inspection procedures and adapt them also to secondary and local rural roads. It is often complex to determine the severity and weight of the different risk factors in this context, since deficiencies and faults can be found both in the road infrastructure and in the other components of the system. The proposed survey method was applied to a stretch of the SS7 Appia state road (Lazio, Italy). Producing video capture and using GPS sensors to geolocalize the data proved to be very useful for the compilation of the survey forms. The results showed a good consistency between the safety assessments obtained from the scoring of the inspection forms and the historical accident rate. Therefore, the proposed methodology can be a valuable aid in understanding safety concerns and in defining the improvement actions.

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Hui, Wen, Chuanjie Wu, Wenbo Zhao, Huan Sun, Jun Hao, Hongyan Liang, Xian Wang et al. "Efficacy and Safety of Recanalization Therapy for Acute Ischemic Stroke With Large Vessel Occlusion". Stroke 51, n.º 7 (julio de 2020): 2026–35. http://dx.doi.org/10.1161/strokeaha.119.028624.

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Background and Purpose: The optimal recanalization strategy for acute ischemic stroke with large vessel occlusion continues to be an area of active interest. Network meta-analysis can provide insight when direct comparative evidence is lacking. Methods: A systematic review of the literature using PubMed, Embase, the Cochrane Central Register of Controlled Trials, and SinoMed was performed, and a search was conducted for clinical trials on ClinicalTrials.gov, the World Health Organization International Clinical Trials Registry Platform, and StrokeCenter.org. Four independent reviewers conducted the study selection, data abstraction, and quality assessments. Results: The literature review identified 17 trials including 3236 patients and 8 ongoing clinical trials. Sample sizes ranged from 7 to 656 participants. Intravenous thrombolysis (IVT) was the most common intervention, followed by IVT plus mechanical thrombectomy (MT), IVT plus intraarterial thrombolysis, intraarterial thrombolysis alone, and MT alone. In the pooled network meta-analysis, IVT+MT was associated with a higher rate of independent functioning. In contrast, IVT was ranked as the most ineffective treatment strategy with respect to neurological functions, while direct MT was ranked as the least safe intervention with respect to all-cause mortality. Also, irrespective of assessment tools, endovascular treatment plus IVT led to higher successful recanalization rate than thrombolysis alone. Conclusions: Compared with other recanalization treatments, IVT+MT seems to be the most effective strategy, without increasing detrimental effects, for thrombolysis-eligible patients with large vessel occlusion-acute ischemic stroke. To improve the current evidentiary basis for recanalization treatment, future trials and real-world studies are warranted and should use unified definitions of symptomatic intracranial hemorrhage and recanalization.

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Slashchov, Ihor, Anton Slashchov, Illya Siromaschenko, Volodymyr Kurinnyi y Maksym Ikonnikov. "Development of digital technologies for the systems of remote mining safety monitoring". E3S Web of Conferences 168 (2020): 00065. http://dx.doi.org/10.1051/e3sconf/202016800065.

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The article is devoted to development of methodology and digital technologies for assessing, forecasting and determining scenarios of geomechanical process evolution. A new digital technology is proposed for remote mining safety monitoring, which integrates a network personnel management system and expert subsystems for decision-making support taking into account geomechanical factors presenting risk of the mine roadway stability loss. Elements of the expert subsystems analyze data in real time, and are used to determine potential risks on basis of criteria and assessments of the production environment state in mines. It is proposed to identify the forecast safety indicators with the help of geomechanical models and by assessing scenarios of the “support-rocks” system stressstrain state evolution. In order the expert assessment of the rock massif and mine roadway stability, integral indicators of emergency potential risk for each geotechnical system elements are specified by values of informative parameters at a certain time point, as well as deviations rates of parameters from the equilibrium point over a period of time. Job safety is provided through the improved effectiveness of personnel interaction and its stricter disciplinary responsibility, as well as by making early decisions on keeping the mine roadways in a trouble-free condition.

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Antenucci, Andrea y Giovanni Sansavini. "Adequacy and security analysis of interdependent electric and gas networks". Proceedings of the Institution of Mechanical Engineers, Part O: Journal of Risk and Reliability 232, n.º 2 (30 de octubre de 2017): 121–39. http://dx.doi.org/10.1177/1748006x17715953.

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In this article, adequacy and security assessments on the coupled operations of the electric and gas networks are performed. Extreme operating conditions and fault of components are considered as events that can impact the interdependent systems. The electric and gas networks are represented by an event-based direct current power flow model and by a transient one-dimensional mass flow model, respectively. Furthermore, the automations and safety strategies enforced by transmission system operators are represented within an original modelling approach. A quantitative analysis is performed with reference to the simplified energy infrastructures of Great Britain. Results highlight the contingencies which can jeopardize security and identify the components that are prone to fail and induce large gas pressure instabilities and loss of supply, and the locations in the gas grid that are susceptible to pressure violation. Moreover, a simulated 30% increase of the peak gas demand in 2015 is a limit for safe operations of the gas network, but the coupled systems are robust enough to avoid the spread of a cascading failure across networks. These results allow preventing critical operating conditions induced by the interaction between networks and can guide safety-based decisions on system reinforcements and the development of mitigating actions.

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Tawfeek, Mostafa H. y Karim El-Basyouny. "Network-level comparison of various Forward Collision Warning algorithms". SIMULATION 95, n.º 4 (8 de junio de 2018): 313–25. http://dx.doi.org/10.1177/0037549718777613.

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Rear-end collisions represent a quarter to one-third of the total number of collisions occurring on North American roads. Consequently, Forward Collision Warning (FCW) algorithms have been developed to mitigate this type of critical collision by warning drivers about an impending rear-end event. The algorithms are typically tested to ensure their effectiveness in reducing specific events, such as rear-end conflicts and/or collisions, or by assessing the change in the frequency and severity of braking maneuvers. Such assessments are usually microscopic in nature and deal with isolated (independent) situations. This paper aims at assessing six FCW algorithms at a network level with varying market penetration rates using a calibrated micro-simulation model. The algorithms were assessed in terms of their safety (rear-end conflicts frequency), mobility (travel times), and environmental impacts (emissions and fuel consumption). Based on the results of this study, most of the FCW algorithms did not have a significant effect on mobility nor environmental impacts at various market penetration rates. On the contrary, all the algorithms showed significant safety improvements, in terms of reducing rear-end conflicts, as the market penetration rates increased. The only exception was a single algorithm that tends to be more conservative in terms of braking distance. The results showed that situational improvements (on a driver level) caused by using FCW systems will generally translate into systematic improvements (on a network level). This is important due to the anticipated gradual increase in intelligent vehicles, which are expected to be equipped with FCW systems, on our roads soon.

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Ortega, Johis, Maria Cristina Cometto, Rosa A. Zárate Grajales, Silvina Malvárez, Silvia Cassiani, Carmen Falconi, Daniel Friedeberg y Nilda Peragallo-Montano. "Distance learning and patient safety: Report and evaluation of an online patient safety course". Revista Panamericana de Salud Pública 44 (20 de mayo de 2020): 1. http://dx.doi.org/10.26633/rpsp.2020.33.

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Patient safety is a critical topic in health care globally, with implications for nurses, physicians, administrators, and most importantly, patients and their well-being. Online distance learning (ODL) is widely accepted among most disciplines in higher education and has been used to promote patient safety knowledge among health care students and professionals in diverse contexts. This article reports on an online Nursing and Patient Safety course developed in 2012 by the University of Miami School of Nursing and Health Studies in conjunction with the Pan American Health Organization and the International Network for Nursing and Patient Safety. The study’s objectives are to describe the implementation of an international ODL program to enhance patient safety knowledge in nurses and nursing students, and to examine the participants’ assessments of this online approach as an effective learning tool. Most participants who completed the Nursing and Patient Safety ODL course reported being satisfied with the course content and experience, and demonstrated increased knowledge on patient safety, as measured by post-module quizzes and self-report. Limitations of the study include the lack of a comparison group, disparity in the number of participants across the course’s language formats (English, Portuguese, Spanish), and the large number of participants who registered for but did not complete the course. Future research should identify obstacles to course completion, explore participants’ awareness of patient safety issues and perceived need for more instruction, and look at ways to disseminate the course to the broadest international population of nurses and nursing students.

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Serra Parajes, Javier, Adolfo Crespo Márquez y Antonio Sola Rosique. "Criticality analysis for preventive maintenance optimization purposes in gas network infrastructures". Proceedings of the Institution of Mechanical Engineers, Part O: Journal of Risk and Reliability 232, n.º 4 (agosto de 2018): 464–72. http://dx.doi.org/10.1177/1748006x18785289.

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Identification and quantification of cost and value of industrial assets is a field in which much terminology has been developed. When we try to analyze the importance of an asset for our business, the discussion about its costs should not be separated from the value provided by the asset. Most of the time, managers use the term “cost” because it seems to be more objective. The concept of value is more subjective and more difficult to define. However, we shall henceforth use definitions as amortization, inflation, or replacement value in order to simplify the concept of “value” to improve our decisions. The economic retribution of the facilities is based on a legal normative for regulated companies, so the concept of “cost” may turn out to be quite useless. Therefore, it is important to use a methodology that allows us to estimate the value of our assets. We have developed a criticality analysis of our infrastructure in order to assess the relative value of these items for the company. The target is to optimize the operation and maintenance strategies at a corporate level. This must have a relevant impact on the OPEX of our company, and there may also be an impact on future CAPEX. This article is a case study of the methodology and presents clear examples of how operation and maintenance strategy is transformed according to criticality assessments.

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Stevenson, Bill, Wubshet Tesfaye, Julia Christenson, Cynthia Mathew, Solomon Abrha, Gregory Peterson, Indira Samarawickrema y Jackson Thomas. "Comparative efficacy and safety of interventions for treating head lice: a protocol for systematic review and network meta-analysis". BMJ Paediatrics Open 5, n.º 1 (mayo de 2021): e001129. http://dx.doi.org/10.1136/bmjpo-2021-001129.

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BackgroundHead lice infestation is a major public health problem around the globe. Its treatment is challenging due to product failures resulting from rapidly emerging resistance to existing treatments, incorrect treatment applications and misdiagnosis. Various head lice treatments with different mechanism of action have been developed and explored over the years, with limited report on systematic assessments of their efficacy and safety. This work aims to present a robust evidence summarising the interventions used in head lice.MethodThis is a systematic review and network meta-analysis which will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement for network meta-analyses. Selected databases, including PubMed, Embase, MEDLINE, Web of Science, CINAHL and Cochrane Central Register of Controlled Trials will be systematically searched for randomised controlled trials exploring head lice treatments. Searches will be limited to trials published in English from database inception till 2021. Grey literature will be identified through Open Grey, AHRQ, Grey Literature Report, Grey Matters, ClinicalTrials.gov, WHO International Clinical Trials Registry and International Standard Randomised Controlled Trials Number registry. Additional studies will be sought from reference lists of included studies. Study screening, selection, data extraction and assessment of methodological quality will be undertaken by two independent reviewers, with disagreements resolved via a third reviewer. The primary outcome measure is the relative risk of cure at 7 and 14 days postinitial treatment. Secondary outcome measures may include adverse drug events, ovicidal activity, treatment compliance and acceptability, and reinfestation. Information from direct and indirect evidence will be used to generate the effect sizes (relative risk) to compare the efficacy and safety of individual head lice treatments against a common comparator (placebo and/or permethrin). Risk of bias assessment will be undertaken by two independent reviewers using the Cochrane Risk of Bias tool and the certainty of evidence assessed using the Grading of Recommendations, Assessment, Development and Evaluations guideline for network meta-analysis. All quantitative analyses will be conducted using STATA V.16.DiscussionThe evidence generated from this systematic review and meta-analysis is intended for use in evidence-driven treatment of head lice infestations and will be instrumental in informing health professionals, public health practitioners and policy-makers.PROSPERO registration numberCRD42017073375.

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Zhang, W. W., Z. M. Ye, Y. Jin, S. Y. Wang, L. S. Zhang y X. F. Pei. "Management of mycotoxin contamination in food and feed in China". World Mycotoxin Journal 7, n.º 1 (1 de enero de 2014): 53–62. http://dx.doi.org/10.3920/wmj2013.1553.

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Mycotoxins have a significant impact on human and animal health as well as economy and international trade. A number of steps have been taken to minimise mycotoxin contamination worldwide. China, one of the largest importers and exporters of food and animal feed, has implemented management strategies to protect consumers from mycotoxins and ensure safe trading of food and feed. The development and status of these management strategies are of interest to many stakeholders, however, no comprehensive review of these strategies has been published to date. The objective of this article is to review these strategies, including associated regulations, risk assessments, contamination monitoring practices, and processes for the supervision and management of associated production, distribution and consumption chains. There are 49 mycotoxin-related regulations in China; these include maximum levels for seven mycotoxins, standard methods for detecting 17 mycotoxins, and a code of practice for the prevention and reduction of mycotoxin contamination in cereals. Twelve mycotoxins found in daily food are covered by the Chinese contamination monitoring network. A new risk assessment organisation is required to systematically implement and manage food safety risk assessments in China. In addition, self-control by companies and daily supervisions and inspections by government departments are quite effective in preventing the consumption of mycotoxin-contaminated food and feed. This article provides information to all those who wish to understand more about the current safety management systems for combating mycotoxin contamination of food and feed in China.

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Perpoil, Antoine, Gael Grimandi, Stéphane Birklé, Jean-François Simonet, Anne Chiffoleau y François Bocquet. "Public Health Impact of Using Biosimilars, Is Automated Follow up Relevant?" International Journal of Environmental Research and Public Health 18, n.º 1 (29 de diciembre de 2020): 186. http://dx.doi.org/10.3390/ijerph18010186.

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Biologic reference drugs and their copies, biosimilars, have a complex structure. Biosimilars need to demonstrate their biosimilarity during development but unpredictable variations can remain, such as micro-heterogeneity. The healthcare community may raise questions regarding the clinical outcomes induced by this micro-heterogeneity. Indeed, unwanted immune reactions may be induced for numerous reasons, including product variations. However, it is challenging to assess these unwanted immune reactions because of the multiplicity of causes and potential delays before any reaction. Moreover, safety assessments as part of preclinical studies and clinical trials may be of limited value with respect to immunogenicity assessments because they are performed on a standardised population during a limited period. Real-life data could therefore supplement the assessments of clinical trials by including data on the real-life use of biosimilars, such as switches. Furthermore, real-life data also include any economic incentives to prescribe or use biosimilars. This article raises the question of relevance of automating real life data processing regarding Biosimilars. The objective is to initiate a discussion about different approaches involving Machine Learning. So, the discussion is established regarding implementation of Neural Network model to ensure safety of biosimilars subject to economic incentives. Nevertheless, the application of Machine Learning in the healthcare field raises ethical, legal and technical issues that require further discussion.

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Sirisha, Aswadati, Kosaraju Chaitanya, Komanduri Venkata Sesha Sai Rama Krishna y Satya Sandeep Kanumalli. "Intrusion Detection Models Using Supervised and Unsupervised Algorithms - A Comparative Estimation". International Journal of Safety and Security Engineering 11, n.º 1 (28 de febrero de 2021): 51–58. http://dx.doi.org/10.18280/ijsse.110106.

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Intrusion Detection is a protection device that tracks and identifies inappropriate network behaviors. Several computer simulation methods for identifying network infiltrations have been suggested. The existing mechanisms are not adequate to cope with network protection threats that expand exponentially with Internet use. Unbalanced groups are one of the issues with datasets. This paper outlines the implementation and study on classification and identification of anomaly in different machine learning algorithms for network dependent intrusion. A number of balanced and unbalanced data sets are known as benchmarks for assessments by NSLKDD and CICIDS. For deciding the right range of options for app collection is the Random Forest Classifier. The chosen logistic regression, decision trees, random forest, naive bayes, nearest neighbors, K-means, isolation forest, locally-based outliers are a group of algorithms that have been monitored and unmonitored for their use. Results from implementations reveal that Random Forest beats the other approaches for supervised learning, though K-Means does better than others.

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Varasano, Antonietta, Maria Lepore, Marina Zonno y Salvatore Capotorto. "A “Smartly Functional” Urban 3D Model: A New Way to Preserve the State of Health and Quality of a Complex Masonry Structure". Heritage 4, n.º 1 (25 de febrero de 2021): 437–65. http://dx.doi.org/10.3390/heritage4010027.

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The 3D model is the primary information of an integrated support system for the assessment of structural safety under vertical loads and seismic vulnerability of a masonry building. The available approaches for evaluating seismic demand and capacity still appear inadequate and today aims to improve the process of knowledge of the seismic behavior of masonry structures and of the reliability of the numerical analysis of evaluation methods. Discrete modeling approaches (macro-elements) can lead to more reliable results if accurate surveys of the geometry and construction details of the masonry structure are used, especially in contexts where advise against the execution of invasive on-site tests for assessments both under vertical and seismic loads, limiting the investigation campaigns. In order to improve digital processes, oriented to the knowledge of the state of health and quality of a masonry structure, this study illustrates a new overture to virtual modeling and assessment of the structural safety of this type of work. The survey and relief methodology here proposed integrates digital data sensors—configured within an IoT (Internet of Things) network—in a geometric model with a level of accurate and precise detail, processed downstream of the laser scanner and photogrammetric survey of the single masonry building, as “S. Domenico Church in the “Sassi” of Matera.

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Hammit, Britton E., Rachel James, Mohamed Ahmed y Rhonda Young. "Toward the Development of Weather-Dependent Microsimulation Models". Transportation Research Record: Journal of the Transportation Research Board 2673, n.º 7 (28 de abril de 2019): 143–56. http://dx.doi.org/10.1177/0361198119844743.

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Adverse weather conditions severely affect transportation networks. Decades of research have been dedicated to analyzing these impacts and developing countermeasures to reduce their negative effects on travelers and infrastructure. Recent developments in technology have enabled the introduction of intelligent transportation system applications used for network planning, safety assessments, countermeasure evaluation, and roadway operations. One such application is microsimulation modeling, which is a powerful tool used to emulate traffic flow. Agencies are interested in using microsimulation to forecast the effects on safety and mobility of adverse weather conditions; however, there is limited knowledge on how to calibrate the model to reflect different weather conditions. This paper contributes a methodology for calibrating car-following behavior required for successful development of microsimulation models. This research was completed using SHRP2 Naturalistic Driving Study (NDS) data to capture realistic driving behavior in a variety of weather conditions. This study has two primary objectives. First, calibrate the Wiedemann 1999 car-following model for a subset of NDS trips, cluster trips with similar weather conditions, and identify an optimal parameter set to represent that condition. Second, apply the optimal model parameters in a realistic microsimulation network to assess the predicted traffic flow in each weather condition. Findings support the hypothesis that the calibration of driving models for use in microsimulation results in more realistic estimations of traffic flow. Moreover, this research illustrates that the use of high resolution trajectory-level data can successfully capture weather-dependent driving behaviors.

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Rex, Malin, Thomas Brezicka, Eric Carlström, Margda Waern y Lilas Ali. "Coexisting service-related factors preceding suicide: a network analysis". BMJ Open 12, n.º 4 (abril de 2022): e050953. http://dx.doi.org/10.1136/bmjopen-2021-050953.

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ObjectivesThe overall objective was to analyse service-related factors involved in the complex processes that precede suicide in order to identify potential targets for intervention.Design and settingExplorative network analysis study of post-suicide root cause analysis data from Swedish primary and secondary healthcare.Participants217 suicide cases reported to the Swedish national root cause analysis database between 2012 and 2017.Primary and secondary outcome measuresA total of 961 reported incidents were included. Demographic data and frequencies of reported deficiencies were registered. Topology, centrality indices and communities were explored for three networks. All networks have been tested for robustness and accuracy.ResultsLack of follow-up, evaluations and insufficient documentation issues emerged as central in the network of major themes, as did the contributing factors representing organisational problems, failing procedures and miscommunication. When analysing the subthemes of deficiencies more closely, disrupted treatments and staffing issues emerged as prominent features. The network covering the subthemes of contributing factors also highlighted discontinuity, fragile work structures, inadequate routines, and lack of resources and relevant competence as potential triggers. However, as the correlation stability coefficients for this network were low, the results need further investigation. Four communities were detected covering nodes for follow-up, evaluation, cooperation, and procedures; communication, documentation and organisation; assessments of suicide risk and psychiatric status; and staffing, missed appointments and declined treatment.ConclusionThe results of this study suggest that healthcare providers may improve patient safety in suicide preventive pathways by taking active measures to provide regular follow-ups to patients with elevated suicide risk. In some cases, declined or cancelled appointments could be a warning sign. Tentative results show organisational instability, in terms of work structure, resources and staffing, as a potential target for intervention, although this must be more extensively explored in the future.

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Hamilton, MG, M. Williams, R. Holubkov, S. Nagel, J. Wisoff, T. Zwimpfer, R. Edwards et al. "P.160 Safety and effectiveness of the assessment and treatment of idiopathic normal pressure hydrocephalus (iNPH) in the Adult Hydrocephalus Clinical Research Network (AHCRN)". Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 49, s1 (junio de 2022): S49. http://dx.doi.org/10.1017/cjn.2022.242.

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Background: Idiopathic Normal Pressure Hydrocephalus (iNPH) is a disorder of the elderly with progressive worsening of gait and balance, cognition, and urinary control which requires assessment using criteria recommended by International iNPH guidelines. Methods: Adult Hydrocephalus Clinical Research Network (AHCRN) prospective registry data from 5-centers over a 50-month interval included entry criteria; demographics; comorbidities; examination findings using standard AHCRN gait and neuropsychology assessments; shunt procedures, complications of CSF drainage, complications within 30 days of surgery, and 1-year postoperative follow-up. Results: 547 patients were referred for assessment of suspected-iNPH. 123 patients(21.6%) did not meet clinical criteria to proceed with further testing. 424 patients(74.4%;mean age 76.7 ± 6.0 years;males=269) underwent an LP or lumbar drain, and 193(45.6%) underwent insertion of a ventriculoperitoneal shunt. By 8-12 months after shunt surgery, gait velocity was 0.96±0.35m/s (54% faster than pre-CSF-drainage). Mean MoCA scores increased from 21.0 ± 5.0(median=22.0) at baseline to 22.6±5.5(median=24) 12-months post-surgery. Gait and cognitive improvements were clinically significant. No deaths occurred. 8% of shunt-surgery patients experienced minor complications. The 30-day reoperation rate was 4.1%. Conclusions: This AHCRN study demonstrated that CSF-drainage testing of patients with suspected-iNPH successfully identified those who could undergo CSF-shunt surgery with a high rate of improvement and a low rate of complications.

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Ahmed, A., S. Mishra, A. K. Singh y A. Azad. "3D Monitoring & its Significance in Tunneling: Special Emphasis on Tunnel T-74R of USBRL Project, India". IOP Conference Series: Earth and Environmental Science 1032, n.º 1 (1 de junio de 2022): 012039. http://dx.doi.org/10.1088/1755-1315/1032/1/012039.

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Abstract Nowadays, Tunnels are the major transportation network throughout the world. The importance of tunnel and its associated system also increases as the demand of Tunnel construction increases day by day. It has its significant importance in water conveyance networks as well as communication networks. As it is spreading fast over the world, the assessments of deformations are becoming an important part of tunneling system. The paper deals with the 3D monitoring system for the safety perspective and to make proper judgement about the condition of tunnels related to the information obtained in the measuring equipments. It also enables to react under various rock setting with the precise and reliable monitoring results. As we observed in the T-74R tunnel, where deformation of the tunnel’s support system is a natural occurrence, the T-74R’s main support system was also affected. The groundmass is prone to deformation due to its poor state and proximity to the principal thrust. The finding of the T-74R tunnel utilising 3D monitoring devices is important. They have provided the information about actual ground behaviour conditions.

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Gupalo, V. S., K. S. Kazakov, V. A. Minaev, D. A. Ozerskiy, S. A. Ustinov y I. O. Nafigin. "Results of studies in the existing wells of the Yeniseyskiy subsurface site including those performed to identify the main fracture systems and rock anisotropy". Radioactive Waste 14, n.º 1 (2021): 76–86. http://dx.doi.org/10.25283/2587-9707-2021-1-76-86.

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The conditions in the crystalline geological massif, which determine the long-term safety of radioactive waste disposal, are reduced to two fundamental factors - the features of the host rocks and the fracture network inherent in the studied area of the massif [3]. Refinement of the parameters identified at the early stages of geological study of cracks is one of the highest priority tasks in the safety assessments of the radioactive waste disposal. These parameters should also be taken into account in the formation of requirements for the composition and structure of the system of engineering barriers preventing the release of radionuclides outside the disposal. The presented material contains a description of the work and the approaches applied in processing the results of borehole surveys of the prospecting and appraisal stages of geological exploration of the Yeniseisky area, performed using the specialized probe with video logging equipment.

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Pirbhulal, Sandeep, Vasileios Gkioulos y Sokratis Katsikas. "Towards Integration of Security and Safety Measures for Critical Infrastructures Based on Bayesian Networks and Graph Theory: A Systematic Literature Review". Signals 2, n.º 4 (2 de noviembre de 2021): 771–802. http://dx.doi.org/10.3390/signals2040045.

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In recent times, security and safety are, at least, conducted in safety-sensitive or critical sectors. Nevertheless, both processes do not commonly analyze the impact of security risks on safety. Several scholars are focused on integrating safety and security risk assessments, using different methodologies and tools in critical infrastructures (CIs). Bayesian networks (BN) and graph theory (GT) have received much attention from academia and industries to incorporate security and safety features for different CI applications. Hence, this study aims to conduct a systematic literature review (SLR) for co-engineering safety and security using BN or GT. In this SLR, the preferred reporting items for systematic reviews and meta-analyses recommendations (PRISMA) are followed. Initially, 2295 records (acquired between 2011 and 2020) were identified for screening purposes. Later on, 240 articles were processed to check eligibility criteria. Overall, this study includes 64 papers, after examining the pre-defined criteria and guidelines. Further, the included studies were compared, regarding the number of required nodes for system development, applied data sources, research outcomes, threat actors, performance verification mechanisms, implementation scenarios, applicability and functionality, application sectors, advantages, and disadvantages for combining safety, and security measures, based on GT and BN. The findings of this SLR suggest that BN and GT are used widely for risk and failure management in several domains. The highly focused sectors include studies of the maritime industry (14%), vehicle transportation (13%), railway (13%), nuclear (6%), chemical industry (6%), gas and pipelines (5%), smart grid (5%), network security (5%), air transportation (3%), public sector (3%), and cyber-physical systems (3%). It is also observed that 80% of the included studies use BN models to incorporate safety and security concerns, whereas 15% and 5% for GT approaches and joint GT and BN methodologies, respectively. Additionally, 31% of identified studies verified that the developed approaches used real-time implementation, whereas simulation or preliminary analysis were presented for the remaining methods. Finally, the main research limitations, concluding remarks and future research directions, are presented

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Mason, Dougal y Pathmanathan Brabhaharan. "Characterisation of transport resilience and measures to enhance resilience in the recovery after the 2016 Kaikōura earthquake". Bulletin of the New Zealand Society for Earthquake Engineering 54, n.º 2 (1 de junio de 2021): 69–81. http://dx.doi.org/10.5459/bnzsee.54.2.69-81.

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The Ward to Cheviot section of State Highway 1 is a key lifeline transport route that runs through the Kaikōura township. It is a strategically important link in the national state highway network, connecting the North Island via the Wellington-Picton ferry to the city of Christchurch in the South Island. Its strategic importance and vulnerable location between the mountainous Kaikōura range and the Pacific Ocean make it a critical transportation route in the national transport network. The route has been a focus for understanding the resilience of transport networks from as far back as 2000, when this section was used as a pilot study in early research into transport resilience. A further resilience assessment of this section was completed as part of a national state highway resilience study in mid-2016. Subsequently, the Mw 7.8 Kaikōura earthquake struck the northeast of the South Island on 14 November 2016, triggering thousands of large landslides and causing severe disruption to the transport network. The damage and disruption caused by the earthquake was comparable to that assessed in pre-earthquake studies of the resilience of the state highway. Landslides and embankment failures caused the most damage and disruption to the transport infrastructure, with the Main North Line railway closed for over 9 months and State Highway 1 closed for over a year. Post-earthquake landslides and debris flows triggered by storms caused additional damage and disruption during the recovery phase. Post-earthquake assessment of the corridor resilience was carried out to identify measures to enhance resilience as part of the recovery works. These measures included realigning the road and rail away from the steep hillsides, engineered works to reduce the potential for slope failure, and engineered works to reduce the potential for inundation of the corridor. The resilience assessments also enabled tactical and operational measures to be put in place to ensure safety while allowing the recovery operations to proceed in the context of enhanced risk associated with storm events and potential aftershocks.

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Knieß, Tobias, Hermann Stefan y Peter Brodisch. "Diagnosis of epilepsy – consequences for work and professional activities". Journal of Epileptology 23, n.º 2 (1 de diciembre de 2015): 103–12. http://dx.doi.org/10.1515/joepi-2015-0032.

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Summary Introduction. The correct diagnosis of epileptic seizures and non-epileptic attacks has a decisive influence on treatment, counseling and duration of possible work limitations. Diagnostic efforts should aim towards classifying the seizure as precisely as possible. For risk assessments, e.g. at the workplace, a close cooperation and networking of all professionals involved in the epilepsy treatment, care and consultation processes is required. Aim. To present guidelines for assessment of occupational capacity of persons with epilepsy and to discuss their value in clinical practice. Method and Material. The German employer’s liability insurance association has recently published the new revised BGI 585 Risk Assessment Guidelines (DGUV information 250-001) framework and assistance in epilepsy in view of protection against unfair dismissal. These guidelines provide information on safety and health in the workplace. Throughout all the German federal states, 24 Network teams were established. During the period January 2010 and December 2013, 374 employees with epilepsy were consulted by an expert member of Network Epilepsy and Work (NEA) Team, of which 80 were prospectively included in a study and scientifically evaluated. Guidelines and discussion. While conducting the risk assessment, a special medical fact check in accordance with the guidelines was used. In addition to medical aspects, the individual vocational and occupational situation was considered. Based on this assessment an individual recommendation was made relating to continuation of employment. The project NEA established regional teams of physicians, therapists, consultants from social services, employment offices and rehabilitation authorities across Germany in order to link by networks the complex medical and social aspects of reducing the risk of people with epilepsy losing their job. Results. It was shown that support and consultation through the NEA team led to an endangered position of employment being maintained in 70% of cases. Conclusion. In many cases, loss of employment can be prevented by consequent application of DGUV information 250-001 (recently revised from BGI 585) for risk assessment of epilepsy in employment, together with improved networking between medical professionals, occupational health professionals and social services.

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Li, Bo. "Efficacy and Safety of Surgical Interventions for Treating Multilevel Cervical Spondylotic Myelopathy via Anterior Approach: A Network Meta-Analysis". Pain Physician 4, n.º 22;4 (11 de julio de 2019): E275—E285. http://dx.doi.org/10.36076/ppj/2019.22.e275.

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Background: Anterior cervical discectomy, with or without interbody fusion, is a common technique to treat cervical spondylotic myelopathy (CSM). To date, controversy still exists among spine surgeons regarding the anterior surgical approach to be used for the treatment of multilevel CSM. Objectives: To evaluate the effectiveness and safety of anterior cervical discectomy and fusion (ACDF), anterior cervical corpectomy and fusion (ACCF), cervical total disc replacement (CTDR), and hybrid surgery (HS) in the treatment of multilevel CSM. Study Design: Network meta-analysis (NMA) of randomized or nonrandomized controlled studies for the treatment of multilevel CSM. Methods: The databases such as PubMed, CENTRAL, and EMBASE were used to search and identify the clinical trials involving the evaluations for the treatment of multilevel CSM. The Newcastle-Ottawa Scale was used for the assessment of methodological qualities, whereas the Cochrane Collaboration tool was used for assessing the risk of bias. Outcome assessments included duration of surgery, Neck Disability Index (NDI) scores, and complications. Odds ratio was used to express dichotomous outcomes, whereas mean difference with a 95% confidence interval was used to express continuous outcomes. Results: Sixteen relevant studies were identified, and 1,639 patients were included in this analysis. CTDR demonstrated a prominently decreased NDI score and total incidence of complications compared with ACDF, ACCF, and HS. In addition, ACDF resulted in shorter operation times compared with ACCF, CTDR, and HS. The ranked order of NDI score improvement in decreasing order was: CTDR, HS, ACDF, followed by ACCF. The rank order for reduction in operation time increased progressively from ACDF, HS, ACCF to CTDR. The total incidence of complications also showed a decreasing trend in the decreasing order— CTDR, ACDF, HS, ACCF, and finally CTDR with the lowest complication rate. Limitations: The limitations of this NMA include inconformity of the follow-up times and surgical skill, and implants of different treatment centers vary. Conclusions: The analysis of this study has shown that the best method for improvement of functional outcome and reduction in total incidence of complications for multilevel CSM is CTDR. Key words: Multilevel cervical spondylotic myelopathy, anterior cervical discectomy and fusion, anterior cervical corpectomy and fusion, cervical total disc replacement, hybrid surgery, effectiveness, safety, network meta-analysis

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Yamaguchi, Mitsune, Satomi Inomata, Sayoko Harada, Yu Matsuzaki, Maiko Kawaguchi, Mayuko Ujibe, Mari Kishiba et al. "Establishment of the MID‐NET ® medical information database network as a reliable and valuable database for drug safety assessments in Japan". Pharmacoepidemiology and Drug Safety 28, n.º 10 (29 de agosto de 2019): 1395–404. http://dx.doi.org/10.1002/pds.4879.

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Yunus, F., W. Teresa, M. Jahanzeb, F. Karen, S. Minhaus, R. Yunus, P. Sydow, M. Merkel, R. Kersey y S. Gray. "Technology exchange for cancer health network". Journal of Clinical Oncology 25, n.º 18_suppl (20 de junio de 2007): 19598. http://dx.doi.org/10.1200/jco.2007.25.18_suppl.19598.

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19598 Background: The Technology Exchange for Cancer Health Network (TECH-Net) is a collaborative, multi-state effort to implement a systematic care program to improve cancer management in the rural communities of west Tennessee, north Mississippi and east Arkansas. This Health Information Technology (HIT) project uses a two-pronged approach to total clinical decision support: (1) provide access to oncology, hematology, and other specialists through the dedicated telehealth network of the University of Tennessee's Health Science Center in conjunction with the University of Tennessee Cancer Institute; and (2) rely on a distributed electronic health record (EHR) with integrated decision support systems for online management of cancer protocols, electronic orders, and medication management. Methods: Patients with a cancer diagnosis requiring treatment for at least one year are eligible to participate. The ultimate goal for this project is to enroll 250 patients (125 rural, 125 urban) and compare quality, safety, and cost outcomes for patients receiving rural Telehealth care versus “routine” urban care. Telehealth patients see their oncologist in person at the rural sites for initial care, and see their physician via telemedicine for approximately one-half of their subsequent visits. This approach allows the clinician to make in-person clinical assessments on a regular basis while still taking advantage of the time savings associated with telemedicine. Results: 163 patients have been enrolled in the study (127 rural, 36 urban) over 18 months. Patient satisfaction has been high - 95 % of patients indicated their telemedicine visit was as good as or better than an in-person office visit. Cost analysis comparing cost savings (physician travel time) with telemedicine costs (equipment, high speed lines) indicates that the cost-benefit depends critically on distance to the rural facility and number of physician trips avoided. Initial cost data indicate that telemedicine must save at least 5 hours of physician travel time per month to break even. Conclusions: Telemedicine offers a feasible method for increasing access to oncology care in rural areas that is well-accepted by both patients and clinicians. No significant financial relationships to disclose.

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Hassel, Martin, Ingrid Bouwer Utne y Jan Erik Vinnem. "An allision risk model for passing vessels and offshore oil and gas installations on the Norwegian Continental Shelf". Proceedings of the Institution of Mechanical Engineers, Part O: Journal of Risk and Reliability 235, n.º 1 (21 de septiembre de 2020): 17–32. http://dx.doi.org/10.1177/1748006x20957481.

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This article presents a new risk model for estimating the probability of allision risk (the impact between a ship under way and a stationary installation) from passing vessels on the Norwegian Continental Shelf (NCS). Offshore petroleum operators on the NCS are required by the Norwegian Petroleum Safety Authority (PSA) to perform risk assessments to estimate the probability of impacts between ships and offshore installations, both for field related and passing (merchant) vessels. This has typically been done using the aging industry standard COLLIDE risk model, but this article presents a new risk model based on a Bayesian Belief Network (BBN) that can replace the old COLLIDE model for passing vessels. The new risk model incorporates a wider range of risk influencing factors (RIFs) and enables a holistic and detailed analysis of risk factors, barrier elements and dependencies. Even though the risk of allision with passing vessels is very small, the potential consequences can be critical. The new risk model is more transparent and provides a better understanding of the mechanisms behind allision risk calculations. The results from the new model are aligned with industry expectations, indicating an overall satisfactory performance. The article discusses several key elements, such as the use of expert judgement to estimate RIFs when no empirical data is available, model sensitivity, and a comparative assessment of the new risk model to the old COLLIDE model.

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Gupta, Alind, Darren Brenner y Paul Arora. "Multistate Markov modelling of long-term outcomes in immunotherapy for metastatic renal cell carcinoma (mRCC) using machine-learned dynamic Bayesian networks." Journal of Clinical Oncology 38, n.º 15_suppl (20 de mayo de 2020): e14049-e14049. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.e14049.

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e14049 Background: Patient-level heterogeneity in response to treatment remains a major challenge in cancer immunotherapy. Long-term individual-level modelling of survival, tumour response and safety outcomes jointly can help improve efficacy and durable clinical benefits. Machine-learned Bayesian networks provide a solution to the “black box” problem of other machine-learning approaches. Objectives: To develop a dynamic Bayesian network model for multivariate risk prediction, survival modelling and long-term simulations of immunotherapy patients using a simulated trial dataset. Methods: A simulated randomized clinical trial dataset for second line immunotherapy of patients with renal cell carcinoma was used for analysis. We machine-learned a dynamic Bayesian network from censored data with incorporation of prior clinical knowledge. Classification performance, probability calibration, goodness-of-fit metrics and prognostic variables were calculated following TRIPOD guidelines. Results: The machine-learned graphical model encoded expected relationships between variables with minimal prior information. Visual and numerical goodness-of-fit checks for survival extrapolations showed that the model fitted data well and was appropriate. Probability calibration was < 10% from ideal. Classification performance for overall survival was high ( c-statistic ~0.85) soon after treatment initiation and gradually plateaued over time. Prognostic variables were calculated by treatment arm for overall survival and severe adverse events. Conclusions: Dynamic Bayesian network model was useful for transparently representing joint relationships between all variables in the trial dataset, for multivariate risk prediction and long-term extrapolations that can be used in economic evaluations for health technology assessments in oncology.

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de Vries, Simone, Katharina Abraham, Sylvana Magrin Sammut, Antonia Formosa, Isaac Corro Ramos, Matthijs Verteegh, Rudy Dupree, Annemieke van der Waal, Margreet Franken y Wim Goettsch. "PP70 Enhancing HTA Processes In The Maltese System For Introducing New Medicines". International Journal of Technology Assessment in Health Care 38, S1 (diciembre de 2022): S63. http://dx.doi.org/10.1017/s0266462322002021.

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IntroductionMost European countries use Health Technology Assessment (HTA) as input for decisions on reimbursement of (new) medicines. In 2018, following the approval of European Social Funding, the Directorate for Pharmaceutical Affairs (DPA) within the Malta Ministry for Health led a specific Work Package aimed at enhancing knowledge, skills and HTA processes to inform reimbursement decisions.MethodsSince the start of the project, the Institute for Medical Technology Assessment (iMTA) and the National Health Care Institute of the Netherlands (ZIN) collaborate in providing guidance and training to DPA on relative effectiveness assessments (REAs) and pharmacoeconomic assessments (PEAs) of pharmaceuticals. Several activities were organized: site visits, face-to face interviews with stakeholders, a qualitative assessment of the core process of the Maltese system, health economics training and tutorials, meetings introducing the European Network for Health Technology Assessment (EUnetHTA) and Dutch HTA processes, development of a new framework for assessment, and a shadow assessment.ResultsOur assessment identified important methodological challenges and crucial processes interdependencies to optimize within the Maltese system. Based on the learnings, DPA created a template based on the EUnetHTA REA assessment format. IMTA created a template to perform PEAs. Currently, a shadow assessment is ongoing in which DPA performs the REA and PEA of a pharmaceutical using the new templates. ZIN and iMTA will provide feedback to DPA on several aspects, including, but not limited to, the PICO, assessment of therapeutic efficacy and safety, identifying uncertainties, input costs and effects, and formulating a clear discussion of the assessment. If necessary, the templates will be adapted during the process. The project will be evaluated and finalized in 2022.ConclusionsWith the guidance and training provided by iMTA and ZIN, DPA structured and aligned their REA and PEA to enhance their assessment process and to improve the presentation of their HTA report to the two appraisal committees. This project emphasizes the importance of international collaboration to enhance HTA processes within the

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Meluseva, I. A., I. V. Ozden, D. I. Shevchenko y A. A. Kudryavtsev. "Разработка тренажерных установок для подготовки персонала нефтеперерабатывающих предприятий". Occupational Safety in Industry, n.º 10 (octubre de 2021): 82–87. http://dx.doi.org/10.24000/0409-2961-2021-10-82-87.

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In modern conditions of fierce competition in the energy market, the enterprises of the Russian Federation widely use new technologies, introduce modern equipment and automation systems. This leads to the increased requirements for the quality of management and maintenance of industrial objects, including oil refining facilities. When training the personnel of a hazardous production facility, the most important factor in assessing the results of training is the availability of not only theoretical knowledge, but also practical skills of work, including in emergency situations, which is difficult to learn in real production conditions. According to the number of studies, in the presence of practiced practical skills, the probability of error decreases significantly. Simulator training is one of the most efficient methods of practical training. Various versions are considered related to the simulators implemented on the computers and connected to the computer network; they simulate the workplace of specialists as much as possible. Integrated training systems are a set of interactive equipment and are designed to increase the level of fire and industrial safety of oil and gas facilities in the normal and emergency operating modes. The purpose of creating educational and training complexes is to conduct primary training of personnel of the enterprises for forming the managerial skills and an idea of the essence and features of the technological process. Thus, the future specialists can acquire skills in managing these processes in various situations. The substantiation and features of the use of quantitative assessments of the results of practical exercises and trainings for the specialists of oil refineries are given, as well as a method for calculating the direct assessment of the probable damage.

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Marchetti, Monia, Paolo Rivela, Claudia Bertassello y Manuela Canicattì. "Comparative Clinical Value of Pharmacologic Therapies for B-Cell Chronic Lymphocytic Leukemia: An Umbrella Analysis". Journal of Clinical Medicine 11, n.º 7 (28 de marzo de 2022): 1868. http://dx.doi.org/10.3390/jcm11071868.

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Several new drugs are progressively improving the life span of patients with B-cell chronic lymphocytic leukemia (CLL). However, the rapidly evolving standard of care precludes robust assessments of the incremental clinical value of further innovative drugs. Therefore, we systematically reviewed comparative evidence on newly authorized CLL drugs, as reported by standard and network meta-analyses (MA) published since 2016. Overall, 17 MAs addressed the relative survival or safety of naïve and/or refractory/relapsed (R/R) CLL patients. In R/R patients, therapies including BTK- and BCL2-inhibitors reported progression free survival (PFS) hazard ratios ranging from 0.08 to 0.24 (versus chemotherapy) and a significant advantage in overall survival (OS). In naïve patients, the PFS hazard ratios associated with four recent chemo-free therapies (obinutuzumab- and/or acalabrutinib-based) ranged from 0.11 to 0.61 versus current standard treatments (STs), without a significant OS advantage. Ten MAs addressed the risk of cardiovascular, bleeding, and infective events associated with BTK inhibitors, with some reporting a different relative safety in naïve and R/R patients. In conclusion, last-generation therapies for CLL consistently increase PFS, but not OS, and minimally decrease safety, as compared with STs. Based on available evidence, the patient-customized adoption of new therapies, rather than universal recommendations, seems desirable in CLL patients.

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Haselman, Jonathan T., Jennifer H. Olker, Patricia A. Kosian, Joseph J. Korte, Joseph A. Swintek, Jeffrey S. Denny, John W. Nichols, Joseph E. Tietge, Michael W. Hornung y Sigmund J. Degitz. "Targeted Pathway-based In Vivo Testing Using Thyroperoxidase Inhibition to Evaluate Plasma Thyroxine as a Surrogate Metric of Metamorphic Success in Model Amphibian Xenopus laevis". Toxicological Sciences 175, n.º 2 (16 de marzo de 2020): 236–50. http://dx.doi.org/10.1093/toxsci/kfaa036.

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Abstract Chemical safety evaluation is in the midst of a transition from traditional whole-animal toxicity testing to molecular pathway-based in vitro assays and in silico modeling. However, to facilitate the shift in reliance on apical effects for risk assessment to predictive surrogate metrics having characterized linkages to chemical mechanisms of action, targeted in vivo testing is necessary to establish these predictive relationships. In this study, we demonstrate a means to predict thyroid-related metamorphic success in the model amphibian Xenopus laevis using relevant biochemical measurements during early prometamorphosis. The adverse outcome pathway for thyroperoxidase inhibition leading to altered amphibian metamorphosis was used to inform a pathway-based in vivo study design that generated response-response relationships. These causal relationships were used to develop Bayesian probabilistic network models that mathematically determine conditional dependencies between biochemical nodes and support the predictive capability of the biochemical profiles. Plasma thyroxine concentrations were the most predictive of metamorphic success with improved predictivity when thyroid gland sodium-iodide symporter gene expression levels (a compensatory response) were used in conjunction with plasma thyroxine as an additional regressor. Although thyroid-mediated amphibian metamorphosis has been studied for decades, this is the first time a predictive relationship has been characterized between plasma thyroxine and metamorphic success. Linking these types of biochemical surrogate metrics to apical outcomes is vital to facilitate the transition to the new paradigm of chemical safety assessments.

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Pang, Lan-Lan, Jia-Di Gan, Yi-Hua Huang, Jun Liao, Yi Lv, Wael Abdullah-Sultan Ali, Li Zhang y Wen-Feng Fang. "Investigation of the optimal platinum-based regimen in the postoperative adjuvant chemotherapy setting for early-stage resected non-small lung cancer: a Bayesian network meta-analysis". BMJ Open 12, n.º 6 (junio de 2022): e057098. http://dx.doi.org/10.1136/bmjopen-2021-057098.

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ObjectiveThis study aimed to compare the efficacy and safety of different platinum adjuvant chemotherapy regimens for early-stage resected non-small-cell lung cancer (NSCLC).DesignSystematic review with network meta-analysis of randomised trials.Data sourcesPubMed, EMBASE, The Cochrane Library, Web of Science and Scopus Google Scholar were searched through 12 March 2021.Eligibility criteriaEligible randomised controlled trials (RCTs) comparing the postoperative platinum chemotherapy regimen with the observation-controlled group or comparing two platinum chemotherapy regimens head-to-head were included.Data extraction and synthesisThe primary outcome was the efficacy of adjuvant chemotherapy regimens including relapse-free survival (RFS), overall survival (OS), 2-year, 3-year, 5-year RFS rate and OS rate. The secondary outcome was the rate of grade 3–4 toxicity assessments. Cochrane Handbook (V.5) was used for the risk of bias assessment. Analyses were performed using R software V.4.3.1.Results20 RCTs with a sample size of 5483 were enrolled in meta-analysis. The chemotherapy group had a significant RFS and OS advantage compared with the observation group (HR 0.67; 95% CI 0.56 to 0.81, p<0.0001; HR 0.80; 95% CI, 0.73 to 0.88, p<0.0001, respectively). Compared with the observation arm, only the ‘cisplatin_vinorelbine’ regimen had a significant RFS and OS advantage (HR 0.63; 95% CI 0.43 to 0.87; HR 0.74; 95% CI 0.63 to 0.87, respectively) while the remaining chemotherapy regimens had no significant difference of efficacy compared with the observation group. In terms of the safety of adjuvant chemotherapy, the incidence of haematological toxicities and nausea/vomiting was not significantly higher in the ‘cisplatin_vinorelbine’ arm than in other chemotherapy group.ConclusionThis study summarised the adjuvant cytotoxicity chemotherapy regimens for patients with early-stage resected NSCLC. Our analysis may provide some guiding significance for the clinicians when determining the optimal chemotherapy regimen.

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Mayer, Julia, Sabine Ettinger y Anna Nachtnebel. "VP76 European Collaboration In Health Technology Assessment – Experiences And Possible Benefits". International Journal of Technology Assessment in Health Care 33, S1 (2017): 184–85. http://dx.doi.org/10.1017/s026646231700349x.

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INTRODUCTION:Consistently high-quality health care is expected throughout Europe while concurrently, financial resources of member states are decreasing. National Health Technology Assessment (HTA) institutes are informing evidence-based reimbursement decisions in the national context, leading to redundancies in HTA production and tying up limited resources. Since 2006, the European Union project, the European Network for HTA (EUnetHTA) is aiming at enhancing the efficient use of HTA resources and facilitating transnational collaboration. Our aim is to present previous experience in joint assessment of medical devices. Furthermore, possible benefits of European collaboration for stakeholders will be discussed.METHODS:Processes and challenges of the completed EUnetHTA Joint Action (JA) 2 are summarized and discussed. Benefits, aims and opportunities of the ongoing EUnetHTA JA 3 are described.RESULTS:Six rapid assessments of medical devices, focusing on the assessment of effectiveness and safety, were published during EUnetHTA JA 2. Challenges in European medical device assessment encompass the choice of topics, the time point of assessments and the lack of European standards for systematic patient involvement. Characteristics of medical devices, like learning curves, call for monitoring them throughout their lifecycle.The benefit of European collaboration for stakeholders is manifold: uncertainty with regard to actual added value of a technology is minimized through Early Dialogues; harmonized and transparent assessment processes increase the quality of reports; work division among HTA organizations allows a resource-efficient assessment of a bigger amount of technologies; patient involvement ensures consideration of patient relevant endpoints.The importance of cross-border collaboration in HTA is shown in the continuation of the EUnetHTA project, which aims to sustainably strengthen international collaboration even after expiration of EU-funding.CONCLUSIONS:European collaboration in medical device assessment can ensure cross-border health care and efficient cooperation of national health systems. The focus should be set on a wide implementation of jointly established methods and quality standards. The European collaboration can lead to a concrete benefit for various stakeholders.

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