BackgroundOver 50 000 patients with malignant pleural effusion (MPE) are seen annually in the UK. The majority develop recurrent symptomatic disease requiring definitive treatment. MPE is most ...frequently managed with talc slurry pleurodesis via intercostal chest drain. This involves a lengthy inpatient stay and has a success rate of around 70%, with no means of predicting which patients will suffer pleurodesis failure. Thoracic ultrasound (TUS) is widely used by respiratory physicians, and data from animal and human studies suggest it can identify pleural adhesions (through the absence of normal lung sliding) in a range of conditions. By extension, TUS may allow clinicians to diagnose the presence or absence of adhesions post-pleurodesis in MPE, identifying patients suitable for discharge or needing further intervention.Abstract P233 Table 1Ultrasonographic pleurodesis score at day 0 (pre-pleurodesis) and day 1 (24 hours post-pleurodesis) in patients being treated for malignant pleural effusionSuccessful pleurodesis n=11/15 (73.3%) patientsFailed pleurodesis n=4/15 (26.7%) patients p value unpaired t-test Day 0 pleurodesis score (mean±SD, total out of 18)10.89±3.986.50±1.290.054 Difference=4.39 (95% CI −0.09 to 8.86)Day 1 pleurodesis score (mean±SD, total out of 18)13.45±2.636.75±2.940.002 Difference=6.70 (95% CI 3.08 to 10.33)Change from day 0 to 1 (mean±SD)2.57±3.980.25±3.590.326 Difference=2.32 (95% CI −2.59 to 7.23)MethodWe recruited 18 adult patients with MPE undergoing drainage and talc slurry pleurodesis to a prospective single-centre cohort study. Patients underwent standardised TUS assessment pre- and post-pleurodesis, evaluating pleural sliding and adhesions at nine points (three anterior, three lateral, three posterior) across the affected hemithorax. Lung sliding was graded as per Zhu et al.,1 creating a total pleurodesis score out of 18. Pleurodesis failure was defined as radiological and symptomatic fluid recurrence in the same hemithorax requiring further intervention at any point up to 3 months post-pleurodesis. Patients also completed a questionnaire addressing satisfaction with TUS assessment.Results3/18 patients (16.7%) died before 1 month follow-up. Of 15 patients seen at one month, 11 (73.3%) had successful pleurodesis and 4 (26.7%) had failed. No patient had delayed pleurodesis failure between 1 and 3 month follow-up. There was a significant difference observed in the day 1 TUS pleurodesis score between patients who went on to have successful pleurodesis and those who failed during follow-up (table 1). TUS assessment was acceptable to patients, with none considering it either time-consuming or unwilling to have it again if needed.ConclusionOur data suggest TUS assessment 24 hours post-pleurodesis for MPE predicts success or failure of this intervention, with significant implications for clinical care. A larger randomised study is now underway to further evaluate this hypothesis.ReferenceChest2005;128(2):934–9.
Mapa empresarial de sucesso de pequenas empresas Albuquerque, Alexandre Farias; Escrivão Filho, Edmundo; Mendonça, Paulo Sergio Miranda
GeSec : Revista de Gestão e Secretariado,
09/2023, Letnik:
14, Številka:
3
Journal Article
Recenzirano
Odprti dostop
O objetivo do artigo é apresentar os fatores de sucesso da pequena empresa sistematizados a partir de um mapa representativo da dinâmica empresarial. Assim, apresenta a pequena empresa como uma ...categoria de estudo diferente da grande empresa e, por isso, exige princípios, técnicas e modelos administrativos adequados à sua realidade. O artigo faz um levantamento dos fatores determinantes do sucesso da pequena empresa relacionado ao seu ciclo de vida. O ensinamento principal tirado com a elaboração do mapa é a de que nenhum fator isoladamente pode explicar o sucesso ou a mortalidade precoce das pequenas empresas. Os fatores relacionados ao dirigente, à empresa e ao ambiente empresarial são interdependentes e contribuem para o sucesso ou insucesso empresarial. Outro ensinamento é que o fator de sucesso mais citado na literatura, o planejamento/plano formal, é pouco compreendido e gere resultados conflitantes entre as pesquisas realizadas.
Abstract only Introduction The use of balloon guide catheters (BGC) during endovascular thrombectomy (EVT) has been suggested to lower the risk of distal embolization and improve first pass ...revascularization rates in patients with acute ischemic stroke. However, a recent large randomized controlled trial suggests there is no significant difference in initial and final revascularization scores among EVT performed with a BGC versus without. We assessed the influence of BGC use during EVT on first pass (FP) and revascularization (RV) success in a historical database from a multi‐hospital health system. Methods Patients with anterior circulation large vessel occlusion undergoing EVT with stent‐retriever or aspiration between 2012 and 2018 at three Kaiser Permanente Southern California (KPSC) region hospitals were identified from the database. BGC use was determined through manual chart review. A chi‐squared test compared the relationship of BGC use with the primary outcomes. The primary outcomes were FP and RV success using a dichotomized TICI score of 2b or greater. Results 218 patients were included in the study. BGC was used in 35/218 (16%) of patients. There was no significant difference in age (p = 0.65), gender (p = 0.92), presenting NIHSS (p = 0.45), hypertension (p = 0.66), diabetes (p = 0.85), atrial fibrillation (p = 0.36), serum glucose (p = 0.43), or pre‐EVT TPA administration (p = 0.36). Among EVT with BGC, FP success was 13/35 (37%) and EVT without BGC had a FP success of 76/183 (42%); p = 0.71. Successful final RV with BGC occurred in 30/35 (86%) while EVT without BGC had a successful final RV of 162/183 (89%); p = 0.78. Because BGC use occurred only with stent‐retriever treatment, subgroup analysis was performed comparing the BGC group (N = 35) with the non‐BGC stent‐retriever (N = 88) and aspiration thrombectomy (N = 95) groups. There was no significant difference in FP (p = 0.88) or RV success (p = 0.42) between the BGC (37% FP and 86% RV), non‐BGC stent‐retriever (42% FP and 92% RV), and aspiration thrombectomy groups (41% FP and 86% RV). Conclusions Among our population, BGC use was not associated with higher first pass or final revascularization success.
Male urethral stricture disease is prevalent and has a substantial impact on quality of life and health-care costs. Management of urethral strictures is complex and depends on the characteristics of ...the stricture. Data show that there is no difference between urethral dilation and internal urethrotomy in terms of longterm outcomes; success rates range widely from 8–80%, with long-term success rates of 20–30%. For both of these procedures, the risk of recurrence is greater for men with longer strictures, penile urethral strictures, multiple strictures, presence of infection, or history of prior procedures. Analysis has shown that repeated use of urethrotomy is not clinically effective or cost-effective in these patients. Long-term success rates are higher for surgical reconstruction with urethroplasty, with most studies showing success rates of 85–90%. Many techniques have been utilized for urethroplasty, depending on the location, length, and character of the stricture. Successful management of urethral strictures requires detailed knowledge of anatomy, pathophysiology, proper patient selection, and reconstructive techniques.
La contribution rapporte les résultats d’une recherche-action ayant intégré un outil numérique d’analyse de phrases à des activités d’apprentissage auprès d’élèves du primaire (n=35) et du secondaire ...(n=36) québécois en vue d’améliorer l’orthographe grammaticale. Les résultats au prétest et au posttest indiquent notamment des augmentations significatives dans la réussite des accords au primaire, mais des résultats plus mitigés pour le secondaire. En outre, les régressions multiniveaux réalisées indiquent dans l’ensemble de l’échantillon qu’un haut taux de réussite dans l’identification de la classe des mots prédit un haut taux de réussite dans les accords. Les résultats sont discutés à la lumière des différences dans l’intervention en contexte pandémique selon le niveau scolaire, et également à la lumière de travaux antérieurs ayant montré le rôle des habiletés métalinguistiques dans la réussite des accords.
Using a digital sentence analysis tool for the learning of grammatical spelling in elementary and secondary schools in Quebec.
The contribution reports the results of an action-research that integrated a digital sentence analysis tool into learning activities with primary (
n=
35) and secondary (
n=
36) students in Quebec in order to improve grammatical spelling. The results at the pretest and at the post-test indicate significant increases in the success of agreements at the primary level for instance, but more mixed results for the secondary level. In addition, the multilevel regressions carried out indicate in the whole sample that a high rate of success in the identification of the class of words predicts a high rate of success in the agreements. These results are discussed in light of the differences in the intervention in the pandemic context according to the school level, and also in light of previous work that has shown the role of metalinguistic skills in the success of agreements.
This study examined the role of career attitudes and behaviors and employability enhancement factors in predicting project managers’ career success facets, over and above the availability of clear ...career paths. An online survey was completed by 552 Italian project managers. Clear career paths, employability culture, and protean career attitude positively predicted both objective and subjective (along with objective boundarylessness) career success. Dominance analysis showed the prevailing role of protean career, employability culture, and clear career paths. Results built a bridge between project management literature and career studies, particularly informing about the significance of the protean career. Organizational and individual implications for practices are discussed.
The article is devoted to the theoretical and empirical study of the relationship between the moral normativity of a professional teacher and the motivation for success. The article analyzes the ...concept of moral normativity (from the point of view of the proposed conventional approaches) as a predictor of the teacher's professional activity. In the context of the study of the influence of moral normativity on the success of professional activity, the authors turn to the phenomenon of "macchiavelism", which reflects the existence of a high correlation of the need to achieve goals with a low moral normativity of the individual.The empirical part of the study presents the results of the correlation analysis of the indicator of moral normativity with various indicators that determine the motivation for success, on a sample of 150 future teachers of physical culture and sports profile (graduates of the Volga State University of Physical Culture, Sports and Tourism, Kazan). The results obtained indicate the ambiguity of the relationship between moral normativity and motivation for success in the context of professional pedagogical activity.
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