Purpose: This study aims to analyze stakeholder mapping as a model for strengthening the role of stakeholders in election management. This model explores the success of election management using a ...collaborative approach between election management bodies, namely the General Election Commission, the Election Supervisory Body, and election stakeholders.
Method: The object of study is limited to the 2019 elections in West Nusa Tenggara (NTB) Province. This study uses a qualitative method with a case study approach. The findings of the research show that the stakeholders collaborating in election management are mapped using the hepta-helix model, namely the collaboration model of seven stakeholders: (1) the election management body; (2) the government; (3) the business world; (4) NGOs; (5) mass media; (6) universities; and (7) political parties.
Results and Conclusions: This finding proves that election management has implemented the concept of collaborative governance. Nonetheless, collaborative governance in election management does not place all collaborative actors in decision-making. Specifically for the decision-making stage, this is the function of the election management body, while other actors function as a support system in the management of election management. The weakness of collaborative election management practices is that the categories and functions of each actor as a stakeholder have not been mapped.
Research implications: This study recommends that the application of the collaborative governance model in election management should be preceded by the preparation of stakeholder mapping into the main, key, and secondary stakeholder categories with their respective functional roles.
Originality/value: The findings of stakeholder mapping in election management emphasize that the application of the concept of collaborative governance from Anssel and Gash which is well established in the science of public administration will only be successful if it is supported by stakeholder mapping initiated by Grimble and Wellard, as well as the election stakeholder model initiated by Allen Wall.
In multicenter studies, tight glycemic control targeting a normal blood glucose level has not been shown to improve outcomes in critically ill adults or children after cardiac surgery. Studies ...involving critically ill children who have not undergone cardiac surgery are lacking.
In a 35-center trial, we randomly assigned critically ill children with confirmed hyperglycemia (excluding patients who had undergone cardiac surgery) to one of two ranges of glycemic control: 80 to 110 mg per deciliter (4.4 to 6.1 mmol per liter; lower-target group) or 150 to 180 mg per deciliter (8.3 to 10.0 mmol per liter; higher-target group). Clinicians were guided by continuous glucose monitoring and explicit methods for insulin adjustment. The primary outcome was the number of intensive care unit (ICU)-free days to day 28.
The trial was stopped early, on the recommendation of the data and safety monitoring board, owing to a low likelihood of benefit and evidence of the possibility of harm. Of 713 patients, 360 were randomly assigned to the lower-target group and 353 to the higher-target group. In the intention-to-treat analysis, the median number of ICU-free days did not differ significantly between the lower-target group and the higher-target group (19.4 days interquartile range {IQR}, 0 to 24.2 and 19.4 days IQR, 6.7 to 23.9, respectively; P=0.58). In per-protocol analyses, the median time-weighted average glucose level was significantly lower in the lower-target group (109 mg per deciliter IQR, 102 to 118; 6.1 mmol per liter IQR, 5.7 to 6.6) than in the higher-target group (123 mg per deciliter IQR, 108 to 142; 6.8 mmol per liter IQR, 6.0 to 7.9; P<0.001). Patients in the lower-target group also had higher rates of health care-associated infections than those in the higher-target group (12 of 349 patients 3.4% vs. 4 of 349 1.1%, P=0.04), as well as higher rates of severe hypoglycemia, defined as a blood glucose level below 40 mg per deciliter (2.2 mmol per liter) (18 patients 5.2% vs. 7 2.0%, P=0.03). No significant differences were observed in mortality, severity of organ dysfunction, or the number of ventilator-free days.
Critically ill children with hyperglycemia did not benefit from tight glycemic control targeted to a blood glucose level of 80 to 110 mg per deciliter, as compared with a level of 150 to 180 mg per deciliter. (Funded by the National Heart, Lung, and Blood Institute and others; HALF-PINT ClinicalTrials.gov number, NCT01565941 .).
Objetivo: Este estudo tem como objetivo analisar o mapeamento de partes interessadas como um modelo para fortalecer o papel das partes interessadas na gestâo eleitoral. Este modelo explora o sucesso ...da gestâo eleitorai usando uma abordagem colaborativa entre os órgaos de gestâo eleitoral, nomeadamente a Comissao Eleitoral Gerai, o Orgâo de Supervisao Eleitoral e as partes interessadas nas eleiçöes. Método: O objeto de estudo limita-se as eleiçöes de 2019 na provincia de West Nusa Tenggara (NTB). Este estudo utiliza um método qualitativo com uma abordagem de estudo de caso. Os resultados da pesquisa mostram que as partes interessadas que colaboram na gestâo eleitoral sao mapeadas usando o modelo hepta-hélice, ou seja, о modelo de colaboraçao de sete partes interessadas: (1) o orgâo de gestâo eleitorai; (2) o go verno; (3) o mundo dos negocios; (4) ONGs; (5) midia de massa; (6) universidades; e (7) partidos políticos. Resultados e Conclusôes: Esta constataęao pro va que a gestâo eleitorai implementou o conceito de governança colaborativa. No entanto, a governança colaborativa na gestâo eleitorai nao coloca todos os atores colaborativos na tomada de decisoes. Específicamente para a fase de tomada de decisâo, esta é a funçâo do órgao de gestâo eleitorai, enguanto outros atores funcionam como um sistema de apoio na gestâo da gestâo eleitoral. A fraqueza das práticas de gestâo eleitoral colaborativa é que as categorías e funçôes de cada ator como parte interessada nao foram mapeadas. Implicaçöes da pesquisa: Este estudo recomenda que a aplicaçâo do modelo de governança colaborativa na gestâo eleitoral seja precedida pela preparaçâo do mapeamento das partes interessadas nas categorias principais, principais e secundarias de partes interessadas com seus respectivos papéis funcionáis. Originalidade/valor: As descobertas do mapeamento de partes interessadas na gestâo eleitoral enfatizam que a aplicaçâo do conceito de governança colaborativa de Anssel e Gash, que está bem estabelecido na ciencia da administraçâo pública, só tera sucesso se for apoiada pelo mapeamento de partes interessadas iniciado por Grimble e Wellard, bem como o modelo de participaçâo eleitoral iniciado por Allen Wall.
In some studies, tight glycemic control with insulin improved outcomes in adults undergoing cardiac surgery, but these benefits are unproven in critically ill children at risk for hyperinsulinemic ...hypoglycemia. We tested the hypothesis that tight glycemic control reduces morbidity after pediatric cardiac surgery.
In this two-center, prospective, randomized trial, we enrolled 980 children, 0 to 36 months of age, undergoing surgery with cardiopulmonary bypass. Patients were randomly assigned to either tight glycemic control (with the use of an insulin-dosing algorithm targeting a blood glucose level of 80 to 110 mg per deciliter 4.4 to 6.1 mmol per liter) or standard care in the cardiac intensive care unit (ICU). Continuous glucose monitoring was used to guide the frequency of blood glucose measurement and to detect impending hypoglycemia. The primary outcome was the rate of health care-associated infections in the cardiac ICU. Secondary outcomes included mortality, length of stay, organ failure, and hypoglycemia.
A total of 444 of the 490 children assigned to tight glycemic control (91%) received insulin versus 9 of 490 children assigned to standard care (2%). Although normoglycemia was achieved earlier with tight glycemic control than with standard care (6 hours vs. 16 hours, P<0.001) and was maintained for a greater proportion of the critical illness period (50% vs. 33%, P<0.001), tight glycemic control was not associated with a significantly decreased rate of health care-associated infections (8.6 vs. 9.9 per 1000 patient-days, P=0.67). Secondary outcomes did not differ significantly between groups, and tight glycemic control did not benefit high-risk subgroups. Only 3% of the patients assigned to tight glycemic control had severe hypoglycemia (blood glucose <40 mg per deciliter 2.2 mmol per liter).
Tight glycemic control can be achieved with a low hypoglycemia rate after cardiac surgery in children, but it does not significantly change the infection rate, mortality, length of stay, or measures of organ failure, as compared with standard care. (Funded by the National Heart, Lung, and Blood Institute and others; SPECS ClinicalTrials.gov number, NCT00443599.).
With the advancement in sensor and communication technology, autonomous systems have been incrementally reshaping the execution of tasks in commercial and military sectors. Since the systems are ...designed to complete tasks without or with minimal human intervention, fault diagnosis based on sensor data has been crucial to preventing accidents and fatalities. In this paper, fault diagnosis for autonomous systems is designed based on nonlinear adaptive observers, tested in numerical simulations, and implemented in a robotic platform. To this end, we utilize the persistence of excitation conditions on the parametric model of the faults. We derive sufficient conditions for the nonlinear adaptive observer in terms of linear matrix inequality to ensure the convergence of the estimates. Furthermore, we consider one‐sided Lipschitz conditions to obtain less conservative results. The main advantage of using the nonlinear adaptive observer is that the method converges quickly to the actual fault and requires minimum computational effort. However, solving the linear matrix inequality might not be trivial. Numerical simulations based on a single‐link flexible joint robot model and experimental tests in an autonomous quadcopter are performed to validate the effectiveness of the proposed method.
After a mobile health (mHealth) app is created, an important step is to evaluate the usability of the app before it is released to the public. There are multiple ways of conducting a usability study, ...one of which is collecting target users' feedback with a usability questionnaire. Different groups have used different questionnaires for mHealth app usability evaluation: The commonly used questionnaires are the System Usability Scale (SUS) and Post-Study System Usability Questionnaire (PSSUQ). However, the SUS and PSSUQ were not designed to evaluate the usability of mHealth apps. Self-written questionnaires are also commonly used for evaluation of mHealth app usability but they have not been validated.
The goal of this project was to develop and validate a new mHealth app usability questionnaire.
An mHealth app usability questionnaire (MAUQ) was designed by the research team based on a number of existing questionnaires used in previous mobile app usability studies, especially the well-validated questionnaires. MAUQ, SUS, and PSSUQ were then used to evaluate the usability of two mHealth apps: an interactive mHealth app and a standalone mHealth app. The reliability and validity of the new questionnaire were evaluated. The correlation coefficients among MAUQ, SUS, and PSSUQ were calculated.
In this study, 128 study participants provided responses to the questionnaire statements. Psychometric analysis indicated that the MAUQ has three subscales and their internal consistency reliability is high. The relevant subscales correlated well with the subscales of the PSSUQ. The overall scale also strongly correlated with the PSSUQ and SUS. Four versions of the MAUQ were created in relation to the type of app (interactive or standalone) and target user of the app (patient or provider). A website has been created to make it convenient for mHealth app developers to use this new questionnaire in order to assess the usability of their mHealth apps.
The newly created mHealth app usability questionnaire-MAUQ-has the reliability and validity required to assess mHealth app usability.
Metabolic disorders represent a growing worldwide health challenge due to their dramatically increasing prevalence. The gut microbiota is a crucial actor that can interact with the host by the ...production of a diverse reservoir of metabolites, from exogenous dietary substrates or endogenous host compounds. Metabolic disorders are associated with alterations in the composition and function of the gut microbiota. Specific classes of microbiota-derived metabolites, notably bile acids, short-chain fatty acids, branched-chain amino acids, trimethylamine N-oxide, tryptophan and indole derivatives, have been implicated in the pathogenesis of metabolic disorders. This review aims to define the key classes of microbiota-derived metabolites that are altered in metabolic diseases and their role in pathogenesis. They represent potential biomarkers for early diagnosis and prognosis as well as promising targets for the development of novel therapeutic tools for metabolic disorders.
The gut microbiota is a crucial actor in human physiology. Many of these effects are mediated by metabolites that are either produced by the microbes or derived from the transformation of ...environmental or host molecules. Among the array of metabolites at the interface between these microorganisms and the host is the essential aromatic amino acid tryptophan (Trp). In the gut, the three major Trp metabolism pathways leading to serotonin (5-hydroxytryptamine), kynurenine (Kyn), and indole derivatives are under the direct or indirect control of the microbiota. In this review, we gather the most recent advances concerning the central role of Trp metabolism in microbiota-host crosstalk in health and disease. Deciphering the complex equilibrium between these pathways will facilitate a better understanding of the pathogenesis of human diseases and open therapeutic opportunities.
Many metabolites are involved in host-microbiota interactions. Agus et al. review recent advances concerning the central role of tryptophan metabolism in microbiota-host crosstalk in health and disease. This review examines the direct effect of the gut microbiota in producing tryptophan-derived bioactive molecules and its indirect control of host tryptophan metabolism.
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