Interrelationships among critical success factors for the planning of municipal solid waste management PPP projects in India using structural equation modelling.

This research aims at investigating the interrelationships between critical success factors (CSFs) in municipal solid waste management (MSWM) projects taken up in public-private partnership (PPP) mode in India and studies the extent to which they can affect project success. A three-step procedure was followed to identify the CSFs in MSWM. A conceptual structural equation model (SEM) was developed using cluster groupings of the identified CSFs to show their interrelationships. Data collection from the public sector and private sector waste management managers was done through a questionnaire survey. The respondents' data were analysed in analysis of moment structures (AMOS) using structural equation modelling. The SEM analysis of the respondents' data gives the most exemplary fitting measurement model with the 17 CSFs taken as components of five latent variables: external environment, financial characteristics, project planning and procurement, project operation and management and project stakeholders. The model shows the relationships between the constructs of CSFs for project success. This study contributes to current ideas by empirically identifying the interrelationships between the MSWM CSFs, which can help waste management professionals handle the CSFs rationally. Furthermore, the study shows that all the groups have a direct and positive impact on project success. The findings may only portray the opinion of solid waste management managers in India.

Modeling Resources Allocation in Attacker-Defender Games with "Warm Up" CSF.

Like many other engineering investments, the attacker's and defender's investments may have limited impact without initial capital to "warm up" the systems. This article studies such "warm up" effects on both the attack and defense equilibrium strategies in a sequential-move game model by developing a class of novel and more realistic contest success functions. We first solve a single-target attacker-defender game analytically and provide numerical solutions to a multiple-target case. We compare the results of the models with and without consideration of the investment "warm up" effects, and find that the defender would suffer higher expected damage, and either underestimate the attacker effort or waste defense investment if the defender falsely believes that no investment "warm up" effects exist. We illustrate the model results with real data, and compare the results of the models with and without consideration of the correlation between the "warm up" threshold and the investment effectiveness. Interestingly, we find that the defender is suggested to give up defending all the targets when the attack or the defense "warm up" thresholds are sufficiently high. This article provides new insights and suggestions on policy implications for homeland security resource allocation.

An evaluation framework for low performers and human resource management planning: Application to a life insurance company in Korea.

This study comprehensively explores the factors that lead to low performers in an organization. A thorough literature review was conducted to construct an interview guide and obtain classification criteria for the factors that lead to low performers. Managers and low performers at multiple firms were interviewed individually to understand the various phenomena related to low performers in organizations. Based on the content of these interviews, 12 factors, classified into individual, leader, work, and organizational dimensions, were identified after three rounds of revisions by business administration experts. Next, a case study of Korea's S Life Insurance Company was conducted to examine the practical implications of the factors that contribute to creating low performers. In this case study, the analytic hierarchy process (AHP), involving eight departmental heads S Life Insurance Company's HR division, was utilized to identify the main factors that must be considered when evaluating low performers. While previous studies have examined low performers either at the individual, organizational, or institutional levels, this study presents a comprehensive and integrated evaluation framework of the factors that cause low performers. The proposed framework facilitates the identification and evaluation of low performers in various organizations and industries, and thus has practical implications in terms of establishing strategies to manage low performers more efficiently and improve organizational performance.

Appraising critical success factors in sustainable housing projects: A comparative study of PPP modalities in Saudi Arabia.

This study examines the critical success factors (CSFs) crucial for the effective deployment of public-private partnership (PPP) models in sustainable housing projects in the Kingdom of Saudi Arabia (KSA), underpinning the nation's Vision 2030. Through a robust methodology that incorporates a profound literature review, structured interviews, and a survey involving key stakeholders, the study prioritizes fourteen significant CSFs integral to PPP efficacy. Employing Analytical Hierarchy Process analysis, key outcomes underscore the paramount importance of technical aspects with an emphasis on sustainability, tailoring risk-sharing and allocation to encompass green technologies and eco-friendly practices, and economic stability in the light of long-term environmental sustainability in fostering successful sustainable housing projects. Notably, the Build-Operate-Transfer (BOT) model is categorized as the most effective PPP modality, attaining a mean importance score of 4.07. This model is contrasted with other modalities such as Design-Build-Operate (DBO) and Build-Own-Lease-Transfer (BOLT), which scored lower in effectiveness. This comprehensive evaluation provides crucial insights for policymakers and practitioners, emphasizing the strategic selection of PPP modalities and the prioritization of CSFs to enhance the sustainability and effectiveness of housing projects in KSA.

A Unique Multiplex ELISA to Profile Growth Factors and Cytokines in Cerebrospinal Fluid.

Multiplex arrays designed for enzyme-linked immunosorbent assays (ELISAs) are robust and cost-effective for profiling biomarkers. Identification of relevant biomarkers in biological matrices or fluids helps in the understanding of disease pathogenesis. Here, we describe a sandwich ELISA-based multiplex assay to assess growth factor and cytokine levels in cerebrospinal fluid (CSF) samples derived from multiple sclerosis patients, amyotrophic lateral sclerosis patients, and control subjects without any neurological disorder. Results indicate that multiplex assay designed for the sandwich ELISA method is a unique, robust, and cost-effective method for profiling growth factors and cytokines present in CSF samples.

Identification of Key Factors for Optimized Health Care Services: Protocol for a Multiphase Study of the Dubai Vaccination Campaign.

BACKGROUND: Mass vaccination of the global population against the novel COVID-19 outbreak posed multiple challenges, including effectively administering millions of doses in a short period of time while ensuring public safety and accessibility. The government of Dubai launched a mass campaign in December 2020 to vaccinate all its citizens and residents, targeting the population aged >18 years against COVID-19. The vaccination campaign involved a transformation of multiple commercial spaces into mass vaccination centers across the city of Dubai, the largest of which was the Dubai One Central (DOC) vaccination center. It was operational between January 17, 2021, and 27 January 27, 2022. OBJECTIVE: The multiphase research study aims to empirically explore the opinions of multiple health care stakeholders, elicit the key success factors that can influence the effective delivery of emergency health care services such as a COVID-19 mass vaccination center, and explore how these factors relate to one another. METHODS: To understand more about the operations of the DOC vaccination center, the study follows a multiphase design divided into 2 phases. The study is being conducted by the Institute for Excellence in Health Professions Education at Mohammed Bin Rashid University of Medicine and Health Sciences between December 2021 and January 2023. To elicit the key success factors that contributed to the vaccination campaign administered at DOC, the research team conducted 30 semistructured interviews (SSIs) with a sample of staff and volunteers who worked at the DOC vaccination center. Stratified random sampling was used to select the participants, and the interview cohort included representatives from the management team, team leaders, the administration and registration team, vaccinators, and volunteers. A total of 103 people were invited to take part in the research study, and 30 agreed to participate in the SSIs. To validate the participation of various stakeholders, phase 2 will analytically investigate one's subjectivity through Q-methodology and empirically investigate the opinions obtained from the research participants during phase 1. RESULTS: As of July 2022, 30 SSIs were conducted with the research participants. CONCLUSIONS: The study will provide a comprehensive 2-phase approach to obtaining the key success factors that can influence the delivery of high-quality health care services such as emergency services launched during a global pandemic. The study's findings will be translated into key factors that could support designing future health care services utilizing evidence-based practice. In line with future plans, a study will use data, collected through the DOC vaccination center, to develop a simulation model outlining the process of the customer journey and center workflow. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/42278.

A Simon's two-stage design trial evaluating the potential role of a kind of honey in preventing chemotherapy-hematopoietic toxicities.

BACKGROUND AND AIM: Hematopoietic toxicities are a serious consequence of myelosuppressive CT that may result in dose reductions, delays or even discontinuation of CT, which, in turn, may compromise patient outcomes. Concerns about tolerability and costs of CSFs are still ongoing, therefore the potential use of supportive therapeutics agents are still of interest. EXPERIMENTAL PROCEDURE: We performed a monocentric, phase II study using Simon's two-stage design. The primary endpoint was the evaluation of the potential clinical benefit of a special kind of honey (Life-Mel Honey) administered prophylactically to reduce the incidence of hematopoietic toxicities following chemotherapy. We have enrolled patients undergoing adjuvant or first-line chemotherapy. RESULTS AND CONCLUSION: From November 2013 to May 2014 (First stage) and from November 2014 to April 2016 (Second stage), 39 patients were enrolled at our Institution. The majority of patients was male (24/39, 61.5%), medium age was 60.4 years (range 34-77 years). The median follow up was 74.5 days (SD +/- 28.5). Overall, the majority of patients could underwent their chemoterapy with a regular schedule (25/39, 64.1%), while 9/39 patients (23.1%) need to delay chemotherapy due to hematological adverse events of various grade. Ten/39 patients (25.6%) had a grade 1 neutrophils count decreased, 56.4% a grade 1 platelets count decrease and 64.1% a grade 1 hemoglobin decrease. Therefore, Life-Mel Honey showed an interesting profile to reduce hematological toxicities. The proportion of responses is sufficiently high to recommend this honey to go to a next step in the clinical trial phase.

The effects of granulocyte colony-stimulating factors (G-CSFs) in leucocytes.

Granulocyte colony-stimulating factors may be responsible for a set of laboratory findings in the peripheral blood film that may be confused with those associated with important diseases like myeloproliferative neoplasms, infection, or megaloblastic anaemia. We present a case report of a 29-year-old woman where these laboratory findings are described.

Clinical deterioration during neutropenia recovery after G-CSF therapy in patient with COVID-19.

BACKGROUND: Granulocyte colony stimulating factors (G-CSFs) induce neutrophils proliferation and cytokines production. It has often been used to treat neutropenia without solid evidence of efficacy. It has been demonstrated that respiratory distress is associated with neutropenia recovery but not with G-CSFs. In general, G-CSFs are known to be safe and well tolerated in most clinical settings. However, the safety of G-CSFs in an overwhelming inflammatory disease like coronavirus disease 2019 (COVID-19) is largely unknown. CASE SUMMARY: We report a case with COVID-19 and neutropenia who rapidly deteriorated after administration of G-CSF. CONCLUSION: We observed a faster neutropenia recovery than previously known after administration of G-CSF in our case and in three similar cases previously reported in literature. This rapid neutropenia recovery and the robust inflammatory response in COVID-19 raise concerns about G-CSF safety in patients with COVID-19.

Could SCGF-Beta Levels Be Associated with Inflammation Markers and Insulin Resistance in Male Patients Suffering from Obesity-Related NAFLD?

One of the pathologic hallmarks of obesity is macrophage infiltration of adipose tissue that has been confirmed as source of multipotent adult stem cells. Stem cell growth factor-beta (SCGF-ß) shows activity on granulocyte/macrophage progenitor cells in combination with granulocyte macrophage colony-stimulating factor (GM-CSF) and macrophage colony-stimulating factor (M-CSF). Obesity-associated inflammation induces insulin resistance (IR), which is central to nonalcoholic fatty liver disease (NAFLD) or hepatic steatosis (HS). We searched for relationship between levels of SCGF-ß and those of C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-ß (TNF-ß), interleukin-12p40 (IL-12p40), interleukin-10 (IL-10), ferritin, GM-CSF and M-CSF and between SCGF-ß concentrations and IR in obese patients with HS. Eighty obese patients were retrospectively studied. Serum cytokines levels were appreciated by magnetic bead-based multiplex immunoassays. IR was evaluated by homeostatic model assessment (HOMA), HOMA-derived ß-cell function (HOMA-B%), quantitative insulin sensitivity check Index (QUICKI) and single point insulin sensitivity estimator (SPISE). HS and spleen volume were assessed by ultrasonography (US). SCGF-ß and IL-6 levels predicted HOMA values (p = 0.032 and 0.041, respectively) only in males. In male patients, CRP and IL-6 levels (p = 0.007) predicted SCGF-ß concentrations (p = 0.03 and 0.007, respectively), which in turn predicted HS at US, p = 0.037. SCGF-ß levels were linked to IR and HS severity with the mediation role of CRP. IL-10 levels negatively predicted SCGF-ß concentrations (p = 0.033). M-CSF levels predicted serum concentration of both TNF-ß and IL-12p40 (p = 0.00), but did not predict serum IL-10 (p = 0.30). Prediction of HOMA values by SCGF-ß levels, likely mediated by markers of inflammation, characterizes this study, shedding some light on mechanisms inducing/worsening IR of male patients with obesity-related NAFLD.

Genomic analysis of the prognostic value of colony-stimulating factors (CSFs) and colony-stimulating factor receptors (CSFRs) across 24 solid cancer types.

BACKGROUND: The prognostic roles of granulocyte-/granulocyte-macrophage colony-stimulating factor (G-/GM-CSF) and its receptors (CSFRs) from the genomic perspective remain controversial. The aim of our study was to evaluate their prognostic value in multiple cancer types by analyzing omics data. METHODS: The omics data of G-/GM-CSF and receptors were obtained from the cBioportal database. Cutoff values were determined by X-tile. Overall survival (OS) was assessed by Kaplan-Meier curves. Differentially expressed genes (DEGs) and common regulated genes were analyzed using R software and Venny 2.1.0, while enrichment pathway analyses were performed by Metascape. RESULTS: A comprehensive mRNA analysis was performed in 8,565 patients across 24 cancer types. The combination subgroup of CSF2 and its receptors with high expression and favorable prognosis was associated with the activation of immune-related pathways, while the subgroup with unfavorable prognosis was associated with the activation of inflammatory and cellular pathways. As for the combination subgroup of CSF3 and its receptor, the high expression and poor prognosis subgroup was accompanied by the activation of inflammation and signaling transduction pathways. CONCLUSIONS: The prognostic value of CSFs and CSFRs are cancer-type dependent. Therefore, personalized risk stratification based on CSF and CSFR pathway should be considered for cancer patients.

Spatio-chromatic information available from different neural layers via Gaussianization.

How much visual information about the retinal images can be extracted from the different layers of the visual pathway? This question depends on the complexity of the visual input, the set of transforms applied to this multivariate input, and the noise of the sensors in the considered layer. Separate subsystems (e.g. opponent channels, spatial filters, nonlinearities of the texture sensors) have been suggested to be organized for optimal information transmission. However, the efficiency of these different layers has not been measured when they operate together on colorimetrically calibrated natural images and using multivariate information-theoretic units over the joint spatio-chromatic array of responses.In this work, we present a statistical tool to address this question in an appropriate (multivariate) way. Specifically, we propose an empirical estimate of the information transmitted by the system based on a recent Gaussianization technique. The total correlation measured using the proposed estimator is consistent with predictions based on the analytical Jacobian of a standard spatio-chromatic model of the retina-cortex pathway. If the noise at certain representation is proportional to the dynamic range of the response, and one assumes sensors of equivalent noise level, then transmitted information shows the following trends: (1) progressively deeper representations are better in terms of the amount of captured information, (2) the transmitted information up to the cortical representation follows the probability of natural scenes over the chromatic and achromatic dimensions of the stimulus space, (3) the contribution of spatial transforms to capture visual information is substantially greater than the contribution of chromatic transforms, and (4) nonlinearities of the responses contribute substantially to the transmitted information but less than the linear transforms.

Critical Success Factors of a Drug Traceability System for Creating Value in a Pharmaceutical Supply Chain (PSC).

The general objective of this study was to identify and prioritize the critical success factors required for the adoption of a system to create value for pharmaceutical supply chain stakeholders, and the pharmaceutical supply network as a whole, by using a multi-perspective framework that combines elements of the technology-organization-environment (TOE) contexts for enterprises. The methodology is based on a literature review and expert interviews following the analytic hierarchy process (AHP). This paper identifies and prioritizes 18 critical success factors from three categories: technological, organizational, and environmental. From a practical point of view, this research contributes to the literature by providing expert insight on the topic of drug traceability, especially in terms of how possible values can be captured by companies.

Comparing granulocyte colony-stimulating factor filgrastim and pegfilgrastim to its biosimilars in terms of efficacy and safety: A meta-analysis of randomised clinical trials in breast cancer patients.

BACKGROUND: Granulocyte colony-stimulating factors (G-CSFs) are widely used to prevent neutropenia in cancer patients undergoing myelosuppressive chemotherapy. Several biosimilar medicines of G-CSF are now available, with their development involving a step-wise series of comparisons to demonstrate similarity to reference biologics. Randomised clinical trials (RCTs) are considered confirmatory, and for G-CSF biosimilars, patients with breast cancer (BC) undergoing myelosuppressive chemotherapy are the most sensitive population in which to confirm similarity. This meta-analysis aimed to compare the clinical efficacy and safety of approved or proposed G-CSF biosimilars (filgrastim or pegfilgrastim) with reference G-CSF in patients with BC. METHODS: A Medline literature search up to March 2017 identified RCTs comparing biosimilar G-CSF to reference in BC patients. The primary efficacy end-point was mean difference in duration of severe neutropenia (DSN). Secondary efficacy end-points were differences in depth of absolute neutrophil count (ANC) nadir, time to ANC recovery and incidence of febrile neutropenia. Safety analyses included calculation of risk ratios for bone pain events, myalgia events and serious adverse events. Random effect models were fitted to obtain the pooled estimates of the mean difference for continuous outcomes and the risk ratio for dichotomous outcomes and their corresponding 95% confidence intervals (CIs). FINDINGS: Eight eligible RCTs were included in this meta-analysis. Overall difference in DSN between reference and biosimilar medicines was not statistically significant (0·06 d [95% CI -0·05, 0·17]). The analysis of secondary efficacy end-points showed no significant differences between reference biologics and biosimilar medicines, as well as the analysis of bone pain events, myalgia events and serious adverse events. INTERPRETATION: This meta-analysis showed no significant differences in clinical efficacy and safety between biosimilar and reference G-CSF in BC patients.

An Analytic Hierarchy Process-based Method to Rank the Critical Success Factors of Implementing a Pharmacy Barcode System.

Pharmacy barcode scanning is used to reduce errors during the medication dispensing process. However, this technology has rarely been used in hospital pharmacies in Saudi Arabia. This article describes the barriers to successful implementation of a barcode scanning system in Saudi Arabia. A literature review was conducted to identify the relevant critical success factors (CSFs) for a successful dispensing barcode system implementation. Twenty-eight pharmacists from a local hospital in Saudi Arabia were interviewed to obtain their perception of these CSFs. In this study, planning (process flow issues and training requirements), resistance (fear of change, communication issues, and negative perceptions about technology), and technology (software, hardware, and vendor support) were identified as the main barriers. The analytic hierarchy process (AHP), one of the most widely used tools for decision making in the presence of multiple criteria, was used to compare and rank these identified CSFs. The results of this study suggest that resistance barriers have a greater impact than planning and technology barriers. In particular, fear of change is the most critical factor, and training is the least critical factor.