Development of performance indicators by the Delphi study for foodservice operations in senior welfare centers: application of the balanced scorecard.

With the rapid growth of the elderly population, the number of elderly welfare centers has expanded significantly. However, the current regulations and standards for foodservice management in these centers are inadequate. To address this issue, this study aimed to develop objective and integrated performance indicators based on the Balanced Scorecard for foodservice programs in elderly welfare centers. To evaluate the validity and reliability of the performance indicators, two Delphi studies were conducted in April 2017. The Delphi survey included the evaluation of strategic goals, financial perspective, customer perspective, learning and growth perspective, and the internal process perspective. The degree of consensus among experts was assessed using Kendall's W-test. As a result of the study, the study ultimately identified 33 performance indicators from 12 strategic goals in four perspectives, which could be used as an efficient tool to evaluate, supplement, and improve foodservice in elderly welfare centers. Supplementary Information: The online version contains supplementary material available at 10.1007/s10068-023-01468-x.

Quantification of surgical workflow during robotic proctectomy.

BACKGROUND: Surgical workflow assessments offer insight regarding procedure variability. We utilised an objective method to evaluate workflow during robotic proctectomy (RP). METHODS: We annotated 31 RPs and used Spearman's correlation to measure the correlation of step time and step visit frequency with console time (CT) and total operative time (TOT). RESULTS: Strong correlations were seen with CT and step times for inferior mesenteric vein dissection and ligation (ρ = 0.60, ρ = 0.60), lateral-to-medial splenic flexure mobilisation (SFM) (ρ = 0.63), left rectal dissection (ρ = 0.64) and mesorectal division (ρ = 0.71). CT correlated strongly with medial-to-lateral (ρ = 0.75) and supracolic SFM visit frequency (ρ = 0.65). TOT correlated strongly with initial exposure time (ρ = 0.60), and medial-to-lateral (ρ = 0.67) and supracolic SFM visit frequency (ρ = 0.65). CONCLUSION: This study correlates surgical steps with CT and TOT through standardised annotation, providing an objective approach to quantify workflow.

Conventional in vitro fertilisation rather than intracytoplasmic sperm injection when only one oocyte is retrieved: Time to overcome irrational fears.

BACKGROUND: The use of intracytoplasmic sperm injection (ICSI) currently extends beyond male factor infertility, notably replacing conventional in vitro fertilisation (IVF) in scenarios like limited oocyte availability, where it is used as a precaution against complete fertilisation failure. While existing studies on the use of conventional IVF in such situations provide some reassurance, the available evidence is somewhat insufficient and ICSI is commonly used. AIMS: To evaluate whether conventional IVF can be a feasible option when only one oocyte is retrieved. MATERIALS AND METHODS: A retrospective study was performed to evaluate the fertilisation rate with conventional IVF in women retrieving only one oocyte and whose partner had normal semen. The study aimed at evaluating whether the fertilisation rate was aligned with the threshold indicated by recognized IVF laboratory performance indicators (Vienna Consensus). Clinical pregnancy and live birth rates were secondary outcomes. RESULTS: Out of 304 cycles with a single oocyte inseminated with conventional IVF, 209 achieved normal fertilisation and 82 did not. Thirteen had no mature oocytes. The fertilisation rate was 69% (95% CI: 63-74%) and increased to 72% (95% CI: 66-77%) when immature oocytes were excluded. The fertilisation rate surpassed the minimum competency threshold of the Vienna Consensus (60%), even if below the benchmark value (75%). Clinical pregnancy and live birth rates per oocyte retrieval were 10% and 8%, respectively. Univariate and multivariate analyses failed to identify any predictive factor of fertilisation. CONCLUSION: Conventional IVF with one oocyte met Vienna Consensus standards even if it fell short of higher benchmarks.

Data-Driven AI Models within a User-Defined Optimization Objective Function in Cement Production.

This paper explores the energy-intensive cement industry, focusing on a plant in Greece and its mill and kiln unit. The data utilized include manipulated, non-manipulated, and uncontrolled variables. The non-manipulated variables are computed based on the machine learning (ML) models and selected by the minimum value of the normalized root mean square error (NRMSE) across nine (9) methods. In case the distribution of the data displayed in the user interface changes, the user should trigger the retrain of the AI models to ensure their accuracy and robustness. To form the objective function, the expert user should define the desired weight for each manipulated or non-manipulated variable through the user interface (UI), along with its corresponding constraints or target value. The user selects the variables involved in the objective function based on the optimization strategy, and the evaluation is based on the comparison of the optimized and the active value of the objective function. The differential evolution (DE) method optimizes the objective function that is formed by the linear combination of the selected variables. The results indicate that using DE improves the operation of both the cement mill and kiln, yielding a lower objective function value compared to the current values.

Defining quality indicators, pharmaceutical care bundles and outcomes of clinical pharmacy service delivery using a Delphi consensus approach.

BACKGROUND: Clinical pharmacy quality indicators are often non-uniform and measure individual activities not linked to outcomes. AIM: To define a consensus agreed pharmaceutical care bundle and patient outcome measures across an entire state health service. METHOD: A four-round modified-Delphi approach with state Directors of Pharmacy was performed (n = 25). They were asked to rate on a 5-point Likert scale the relevance and measurability of 32 inpatient clinical pharmacy quality indicators and outcome measures. They also ranked clinical pharmacy activities in order from perceived most to least beneficial. Based upon these results, pharmaceutical care bundles consisting of multiple clinical pharmacy activities were formed, and relevance and measurability assessed. RESULTS: Response rate ranged from 40 to 60%. Twenty-six individual clinical pharmacy quality indicators reached consensus. The top ranked clinical pharmacy quality indicator was 'proportion of patients where a pharmacist documents an accurate list of medicines during admission'. There were nine pharmaceutical care bundles formed consisting between 3 and 7 activities. Only one pharmaceutical care bundle reached consensus: medication history, adverse drug reaction/allergy documentation, admission and discharge medication reconciliation, medication review, provision of medicines education and provision of a medication list on discharge. Sixteen outcome measures reached consensus. The top ranked were hospital acquired complications, readmission due to medication misadventure and unplanned readmission within 10 days. CONCLUSION: Consensus has been reached on one pharmaceutical care bundle and sixteen outcomes to monitor clinical pharmacy service delivery. The next step is to measure the extent of pharmaceutical care bundle delivery and the link to patient outcomes.

Achieving Benchmarks for National Quality Indicators Reduces Recurrence and Progression in Non-muscle-invasive Bladder Cancer.

BACKGROUND: Noncompliance with evidence-based interventions and guidelines contributes to significant and variable recurrence and progression in patients with non-muscle-invasive bladder cancer (NMIBC). The implementation of a quality performance indicator (QPI) programme in Scotland's National Health Service (NHS) aimed to improve cancer outcomes and reduce nationwide variance. OBJECTIVE: To evaluate the effect of hospitals achieving benchmarks for two specific QPIs on time to recurrence and progression in NMIBC. DESIGN, SETTING, AND PARTICIPANTS: QPIs for bladder cancer (BC) were enforced nationally in April 2014. NHS health boards collected prospective data on all new BC patients. Prospectively recorded surveillance data were pooled from 12 collaborating centres. INTERVENTION: QPIs of interest were (1) hospitals achieving detrusor muscle (DM) sampling target at initial transurethral resection of bladder tumour (TURBT) and (2) use of single instillation of mitomycin C after TURBT (SI-MMC). OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The primary and secondary endpoints were time to recurrence and progression, respectively. Kaplan-Meier and Cox multivariable regression analyses were performed. KEY FINDINGS AND LIMITATIONS: Between April 1, 2014 and March 31, 2017, we diagnosed 3899 patients with new BC, of which 2688 were NMIBC . With a median follow up of 60.3 mo, hospitals achieving the DM sampling target had a 5.4% lower recurrence rate at 5 yr than hospitals not achieving this target (442/1136 [38.9%] vs 677/1528 [44.3%], 95% confidence interval [CI] = 1.6-9.2, p = 0.005). SI-MMC was associated with a 20.4% lower recurrence rate (634/1791 [35.4%] vs 469/840 [55.8%], 95% CI = 16.4-24.5, p < 0.001). On Cox multivariable regression, meeting the DM target and SI-MMC were associated with significant improvement in recurrence (hazard ratio [HR] 0.81, 95% CI = 0.73-0.91, p = 0.0002 and HR 0.66, 95% CI = 0.59-0.74, p < 0.004, respectively) as well as progression-free survival (HR 0.62, 95% CI = 0.45-0.84, p = 0.002 and HR 0.65, 95% CI = 0.49-0.87, p = 0.004, respectively). We did not have a national multicentre pre-QPI control. CONCLUSIONS: Within a national QPI programme, meeting targets for sampling DM and SI-MMC in the real world were independently associated with delays to recurrence and progression in NMIBC patients. PATIENT SUMMARY: Following the first 3 yr of implementing a novel quality performance indicator programme in Scotland, we evaluated compliance and outcomes in non-muscle-invasive bladder cancer. In 2688 patients followed up for 5 yr, we found that achieving targets for sampling detrusor muscle and the single instillation of mitomycin C during and after transurethral resection of bladder tumour, respectively, were associated with delays in cancer recurrence and progression.

Identifying and prioritizing the key performance indicators for hospital management dashboard at a national level: Viewpoint of hospital managers.

Participation of main users in identifying key performance indicators (KPIs) for management dashboards contributes to their success. The aim of this study was to identify and prioritize the KPIs of hospital management dashboards from the viewpoint of hospital managers. This study was conducted on managers of public hospitals at a national level in Iran in 2020. Data were collected using a self-administrated questionnaire. The KPIs were classified into five categories, namely financial, operational, human resources, safety and quality of care, services provided to patients. A total of 234 hospital managers participated in this study. Totally, 25 KPIs were determined for the hospital management dashboard, including the patient falls rate, waiting time for patients in the emergency department, patient satisfaction, total hospital revenue, financial balance, bed occupancy rate, patients' discharge with own agreement, average length of stay, and personnel satisfaction. For designing hospital management dashboards, the domains of services provided to patients, safety and quality of care, financial resources, human resources, and operational are important from the hospital managers' viewpoint, respectively. The results of this study can be helpful for developers of business intelligence tools, such as hospital management dashboards, to visualize the most important indicators for managers.

Preventing fatal accidents in construction through the management of barriers.

The research presented in this article addresses the construction industry's need for a real-time safety performance indicator for use in managing the risk of fatal accidents. It involves the development and testing of an indicator of the availability of barriers against fatal accidents when carrying out construction work. In designing the indicator, knowledge and experience from different fields have been utilized including classic barrier theory, barrier management in major-accident hazard industries, quality management, and safety performance measurement in construction. The main aim of the research has been to evaluate the barrier indicator in practical use. The evaluation is based on results from field tests of the barrier indicator at two construction sites and on data from fatal accidents in the construction industry. It provided support for the assumption in the design of the barrier indicator that a few types of hazards dominate the statistics of fatal accidents. The field tests demonstrated the usefulness of the barrier indicator, both in checking the status of the barriers in individual construction activities and in measuring the overall standard of barriers against fatal accidents on the construction site. The possibilities and limitations of the method are discussed based on general criteria for assessing safety performance indicators. Another aim has been to use the experiences from the field tests as input to the design of a method for barrier management through the phases of a construction project. This work resulted in a model that integrates the barrier indicator and underlying methods and tools into a barrier management system. There is significant potential for effective barrier management by integrating the indicator and associated methods and tools into the management systems in the construction industry utilizing digital technology.

Quantification of Surgical Workflow during Robotic Proctectomy.

Aim: Assessments of surgical workflow offer insight regarding procedure variability, case complexity and surgeon proficiency. We utilize an objective method to evaluate step-by-step workflow and step transitions during robotic proctectomy (RP). Methods: We annotated 31 RPs using a procedure-specific annotation card. Using Spearman's correlation, we measured strength of association of step time and step visit frequency with console time (CT) and total operative time (TOT). Results: Across 31 RPs, a mean (± standard deviation) of 49.0 (± 20.3) steps occurred per procedure. Mean CT and TOT were 213 (± 90) and 283 (± 108) minutes. Posterior mesorectal dissection required most visits (8.7 ± 5.0), while anastomosis required most time (18.0 [± 8.5] minutes). Inferior mesenteric vein (IMV) ligation required least visits (1.0 ± 0.0) and lowest duration (0.9 [± 0.5] minutes). Strong correlations were seen with CT and step times for IMV dissection and ligation (ρ = 0.60 for both), lateral-to-medial splenic flexure mobilization (SFM) (ρ = 0.63), left rectal dissection (ρ = 0.64) and mesorectal division (ρ = 0.71). CT correlated strongly with medial-to-lateral and supracolic SFM visit frequency (ρ = 0.75 and ρ = 0.65). There were strong correlations with TOT and initial exposure time (ρ = 0.60), as well as visit frequency for medial-to-lateral (ρ = 0.67) and supracolic SFM (ρ = 0.65). Descending colon mobilization was nodal, rectal mobilization convergent and rectal transection divergent. Conclusion: This study correlates individual surgical steps with CT and TOT through standardized annotation. It provides an objective approach to quantify workflow.

Exploring the potential of roof greening for low-carbon landscapes.

As one type of urban artificial ecosystems, roof greening exhibits carbon source/sink characteristics during their life cycle. The carbon cycle mechanism is complex. The lack of exhaustive carbon performance quantification methods and assessment indicators hinders the promotion and implementation of green roof urban decarboni-zation. Focusing on the quantification of roof greening low-carbon landscape potential, we analyzed the internal carbon cycle mechanism of green roof systems and explored four carbon reduction and sink pathways (P1-P4): biogenic carbon sink, embodied carbon, operational carbon, and bioenergy supply. Based on the dual performance indicators of normalized value of carbon emissions and carbon payback time, we summarized the normalized value measurement method of each pathway. The potential and characteristics of each pathway were quantified by extracting data from the literature. The results showed that the quantified potential values for P1 to P4 were 9.54, -2.26, 2.96 and 0.35 kg CO2·m-2·a-1, respectively, and that the potential values for each pathway were strongly influenced by plant types, climate, and other factors. The imperfect base database and the heterogeneity of assessment scenarios impacted the accuracy of the measurements. The integrated low carbon landscape potential of extensive green roofs was discussed in sub-scenarios, with the 40-year-life cycle integrated carbon reduction ranging from 92.24 to 433.42 kg CO2·m-2 and the carbon payback period ranging from 5 to 14 years. Finally, we summarized the problems in the assessment to facilitate future updates and improvements.

Optimizing the Relationship Between Perioperative Personnel and Infection Preventionists to Reduce Surgical Site Infections.

Prevention of surgical site infections (SSIs) is a critical aspect of ensuring positive patient outcomes. One of the challenges of SSI prevention is the communication barrier between perioperative staff members and infection preventionists (IPs), which may lead to frontline staff members who are primarily responsible for infection prevention being unaware of pertinent hospital SSI data. To overcome this challenge, IPs and perioperative staff members should develop a partnership that facilitates the sharing of feedback on SSI case review data and effective key performance indicators. A partnership also can help engage perioperative staff members in quality improvement efforts and increase collaboration with IPs. Perioperative leaders should identify effective methods to improve data transparency, SSI case reviews, audit and feedback programs, and education for perioperative team members. A strong perioperative-IP partnership and increased sharing of data in accessible formats may improve engagement and interest in SSI prevention.

Ambient temperature, refrigerator food load, and door openings effect on a preservation performance indicator based on chicken temperature data and predictive microbiology.

Home preservation depends on the food matrix, refrigerator design/technology, consumer actions, and ambient temperature. Storing different food matrices in product-relevant refrigerator locations generating different temperature histories can be used to develop an indicator of how refrigerator technology, consumer habits, and environment conditions impact the refrigerator food preservation performance. In this study, poultry, particularly prone to spoilage reflecting its pH, nutrient availability, and high aw, was used to evaluate refrigerator preservation performance as affected by compressor technology (single [SS] and variable speed [VS]), ambient temperature (21.1°C [LT] and 32.2°C [HT]), and refrigerator load (22.5 kg [RL] and 39 kg [HL]). Time-temperature values collected for chicken breast stored in a drawer independently controlled at 0°C in a refrigerator set 5°C, and a Pseudomonas predictive microbiology model, were used to estimate a normalized refrigerator performance indicator (RPI). Values <1, ∼1, and >1 described excellent, good, or poor performance, respectively. A first analysis revealed that up to 54% of chicken breast temperatures were above its recommended refrigerated storage value. When ignoring variability sources, SS technology yielded RPI values ranging 0.61-0.70, whereas the more energy efficient VS compressor yielded values ranging 0.86-1.14. The higher and wider VS RPI range reflects a compressor control logic optimized for energy efficiency compliance while disregarding effects on food preservation. When considering the variability of model parameters and temperature measurements through one-sided 95% confidence intervals yielded RPI reaching 1.16. Although the independently controlled drawer preservation performance was near optimal, it can improve by considering energy use and preservation impact when optimizing the compressor speed control protocol. PRACTICAL APPLICATION: Worldwide poultry meat consumption has reached 15 kg per person. Refrigeration is widely used for its safety and quality preservation. Efficiency regulations decreased the energy use of residential refrigerators by nearly tenfold even though their size increased by 50% in the last half century. In this study, we provide quantitative evidence that their preservation performance must be improved. This is particularly true for upper end units typically equipped with quieter and more energy-efficient variable speed compressors. The same methodology can be used to evaluate the preservation performance of the storage units, trucks, and display cases used for refrigerated products.

Enhancing healthcare quality and outcomes for peritoneal dialysis patients in Thailand: An evaluation of key performance indicators and PDOPPS cohort representativeness.

AIM: To assess whether the peritoneal dialysis (PD) centres included in the Peritoneal Dialysis Outcomes and Practise Patterns Study (PDOPPS) in Thailand are representative of other PD centres in the country, based on 8 key performance indicators (KPIs 1-8). METHODS: A retrospective analysis was conducted comparing PD-related clinical outcomes between PD centres included in the PDOPPS (the PDOPPS group) and those not included (the non-PDOPPS group) from January 2018 to December 2019. Logistic regression analysis was used to identify predictors associated with achieving the target KPIs. RESULTS: Of 181 PD centres, 22 (12%) were included in the PDOPPS. PD centres in the PDOPPS group were larger and tended to serve more PD patients than those in the non-PDOPPS group. However, the process and outcome KPIs (KPIs 1-8) were comparable between the 2 groups. Large hospitals (≥120 beds), providing care to ≥100 PD cases and having experience for >10 years were independent predictors of achieving the peritonitis rate target of <0.5 episodes/year. Most PD centres in Thailand showed weaknesses in off-target haemoglobin levels and culture-negative peritonitis rate. CONCLUSIONS: The PD centres included in Thai PDOPPS were found to be representative of other PD centres in Thailand in terms of clinical outcomes. Thus, Thai PDOPPS findings may apply to the broader PD population in Thailand.

Pharmacy student contribution to direct patient care during inpatient hospital experiential rotations: a scoping review.

OBJECTIVES: The aim of this scoping review was to identify and characterise pharmacy students' contributions to extend pharmacist's direct patient care during inpatient hospital experiential rotations. METHODS: A search of PubMed, Embase and CINAHL databases from 2000 to July 2021 was conducted. Articles were included if they involved pharmacy students during experiential rotations, described student's contribution to direct patient care in the inpatient hospital setting, and reported outcomes. Included articles were categorised according to clinical pharmacy key performance indicators (cpKPIs) and non-cpKPI care activities. Students' contributions to reported outcomes were extracted and summarised. KEY FINDINGS: Thirty-six of 1182 identified articles were included which were either descriptive or quasi-experimental design. Studies reported student involvement in the delivery of single or multiple cpKPIs: medication reconciliation on admission (n = 13), pharmaceutical care (n = 13), interprofessional care rounds (n = 4), patient education during hospital stay (n = 6), medication reconciliation at discharge (n = 7) and patient education at discharge (n = 10). Eight studies reported student involvement in non-cpKPI activities, including clinical interventions (n = 5), clinical services (n = 2) and postdischarge follow-up (n = 1). Reported outcomes included service measure counts, process and clinical outcome measures. SUMMARY: This review identified the contributions of pharmacy students in the provision of a range of direct patient care services and associated outcomes during experiential rotations in the inpatient hospital setting. Students delivering care as part of the pharmacy team as 'care extenders' has the potential to expose more patients to key pharmacist activities that have been linked to demonstrated positive outcomes.

360 Health Analysis (H360)-A Comparison of Key Performance Indicators in Breast Cancer Management across Health Institution Settings in Portugal.

BACKGROUND: The increased focus on quality indicators (QIs) and the use of clinical registries in real-world cancer studies have increased compliance with therapeutic standards and patient survival. The European Society of Breast Cancer Specialists (EUSOMA) established QIs to assess compliance with current standards in breast cancer care. METHODS: This retrospective study is part of H360 Health Analysis and aims to describe compliance with EUSOMA QIs in breast cancer management in different hospital settings (public vs. private; general hospitals vs. oncology centers). A set of key performance indicators (KPIs) was selected based on EUSOMA and previously identified QIs. Secondary data were retrieved from patients' clinical records. Compliance with target KPIs in different disease stages was compared with minimum and target EUSOMA standards. RESULTS: A total of 259 patient records were assessed. In stages I, II, and III, 18 KPIs met target EUSOMA standards, 5 met minimum standards, and 8 failed to meet minimum standards. Compliance with KPIs varied according to the type of hospital (particularly regarding diagnosis) and disease stage. Although small differences were found in KPI compliance among institutions, several statistical differences were found among treatment KPIs according to disease stage, particularly in stage III. CONCLUSIONS: This study represents the first assessment of the quality of breast cancer care in different hospital settings in Portugal and shows that, although most QIs meet EUSOMA standards, there is room for improvement. Differences have been found across institutions, particularly between oncology centers and general hospitals, in diagnosis and compliance with KPIs among disease stages. Stage III showed the greatest variability in compliance with treatment KPIs, probably related to the lower specificity of the guidelines in this disease stage.

Energy efficiency in wastewater treatment plants: A framework for benchmarking method selection and application.

Utilities produce and store vast amount of data related to urban wastewater management. Not yet fully exploited, proper data analysis would provide relevant process information and represents a great opportunity to improve the process performance. In the last years, several statistical tools and benchmarking methods that can extract useful information from data have been described to analyse wastewater treatment plant (WWTP) energy efficiency. Improving energy efficiency at WWTPs is however a complex task which involves several actors (both internal and external to the water utility), requires an exchange of different types of information which can be analysed by a broad selection of methods. Benchmarking method therefore must not only be selected based on whether they provide a clear identification of inefficient processes; it must also match the available data and the skills of those performing the assessment and objectives of stakeholders interpreting the results. Here, we have identified the requirements of the most common benchmarking methods in terms of data, resources, complexity of use, and information provided. To do that, inefficiency is decomposed so that the analyst, considering the objective of the study and the available data, can link each element to the appropriate method for quantification and benchmarking, and relate inefficiency components with root-causes in wastewater treatment. Finally, a framework for selecting the most suitable benchmarking method to improve energy efficiency in WWTPs is proposed to assist water sector stakeholders. By offering guidelines on how integrates and links data, methods and actors in the water sector, the outcomes of this article are expected to move WWTPs towards increasing energy efficiency.

Key performance indicators used by dairy consultants during the evaluation of reproductive performance during routine visits.

Dairy farms need thorough and efficient reproduction control. Consultants specialized in reproduction use key performance indicators (KPI) to monitor the reproductive performance of farms and must be able to decipher between the approach in a first visit and routine visits. A total of 49 consultants specialized in dairy reproduction from 21 countries responded to an online survey conducted to determine the most suitable parameters during routine visits every 2 to 4 weeks. The survey was comprised of 190 questions, 178 of them rated from 0 (irrelevant) to 10 (maximum importance) points. The questions were divided into five sections: (1) consultant and farm model, (2) general data of the farm, (3) cow reproduction, (4) postpartum and metabolic disease, and (5) heifer reproduction. The median, interquartile range, minimum and maximum values, and 95% confidence interval were determined for each question. Afterward, a multivariate analysis, using between-group linkage via Ward's hierarchical clustering was conducted to generate clusters of consultants according to their response pattern. Finally, a chi-square test was conducted to assess the association between years of experience of the consultant and farm size within the clusters generated in each section of the questionnaire. The majority of the consultants considered 34 parameters to be highly important (rated 8-10) to analyze during routine visits. The consultants used several KPI (in variable quantitative range) to evaluate any of the presented sections and considered that all the five sections are critical to control. They are aware of using KPI that reflect heat detection, fertility, and farming efficiency as well as KPI that can provide information on reproductive efficiency in the near future for cows, such as postpartum and metabolic diseases. However, parameters that are relatively old and ineffective, in terms of reproductive performance control, are still highly regarded by the majority of consultants in a routine-visit scenario. Farm size and years of experience of the consultant did not influence the type or number of parameters chosen as KPI during routine visits. The parameters rated with the highest importance (rate 10) that could be considered for an easy, fast, and universal use in routine visits to assess the reproductive status were: First service CR (%), Overall pregnancy rate (%) for cows, and age at first calving (d) for heifers.

Assessing the impact of COVID-19 pandemic on the performance indicators of safety management using the analytic hierarchy process (AHP) in an electricity industry.

Introduction: The importance of evaluating the performance of different management systems in industries necessitates examining the performance of the Health, Safety, and Environment (HSE) management system along with other management systems. Particularly during the COVID-19 pandemic, there is a greater need than ever to assess the impact of the COVID-19 spread on the performance of the HSE management system compared to before this pandemic. This research aims to investigate safety performance indicators (SPIs) on the performance of the HSE management system and the impact of the COVID-19 spread on these indicators. Methods: This cross-sectional, descriptive-analytical study was conducted to evaluate the influence of the COVID-19 outbreak on the safety performance to revise the industry safety index in an electricity distribution company using the multi-criteria decision-making method before and after the disease epidemic in three stages. In the first part, the safety indicators were identified according to the comprehensive safety indicators available in the industries and experts' opinions. In the second part, safety indicators were ranked, weighted, and prioritized using the Analytic Hierarchy Process (AHP). In the third part, these indicators were calculated and compared in the periods before and after the outbreak of COVID-19. Results: Two main criteria, namely the "effectiveness criterion" and the "applicability/calculation criterion", were identified for the evaluation and pairwise comparisons of performance indicators. Among these two criteria, the applicability/calculation criterion had higher priority and importance for the evaluation of indicators. Pairwise comparisons of the indicators indicated that the "accident frequency rate" and "safe T-factor" indicators (with weights of 0.238 and 0.023 respectively) had the highest and lowest priorities, respectively, for the assessment of organizational safety performance among the SPIs. Conclusion: Based on the calculations of the indicators and their analyses before and after the outbreak of COVID-19, the current status of the safety performance of the HSE unit was not significantly affected by this pandemic. However, the investigations carried out while collecting the data needed to calculate the indicators and evaluate the performance of this unit demonstrated that some indicators were not considered sufficiently in the studied electricity industry. Since conducting regular performance evaluations greatly impacts the achievement of continuous improvement, more attention should be paid to compiled indicators, which should be periodically assessed in the organization to achieve continuous improvement.

Identifying potential significant factors impacting zero-inflated proportion data.

Classical supervised methods like linear regression and decision trees are not completely adapted for identifying impacting factors on a response variable corresponding to zero-inflated proportion data (ZIPD) that are dependent, continuous and bounded. In this article we propose a within-block permutation-based methodology to identify factors (discrete or continuous) that are significantly correlated with ZIPD, we propose a performance indicator quantifying the percentage of correlation explained by the subset of significant factors, and we show how to predict the ranks of the response variables conditionally on the observation of these factors. The methodology is illustrated on simulated data and on two real data sets dealing with epidemiology. In the first data set, ZIPD correspond to probabilities of transmission of Influenza between horses. In the second data set, ZIPD correspond to probabilities that geographic entities (eg, states and countries) have the same COVID-19 mortality dynamics.

Reliability and validity of the 21-m shuttle-run test and its application to youth soccer players during the preseason training.

PURPOSE: This study has two purposes: first to assess the reliability and validity of the 21-m shuttle-run test (21-m SRT) and, second, to evaluate the practicality of the 21-m SRT for youth soccer players during preseason training. METHODS: Twenty-seven youth soccer players (15.9 ± 0.7 yrs., males) participated in the present study. To assess the reliability of the test, each player performed the 21-m SRT twice, on separate days. Criterion validity of the 21-m SRT was determined by examining the relationship between directly measured V3 O2max and 21-m SRT performance. To test the practicality of the 21-m SRT, three 21-m SRTs and two graded exercise tests on a treadmill were performed by each youth soccer player during preseason training. RESULTS: Results revealed that the 21-m SRT has high correlation coefficients (r = 0.87) between test and retest and has moderate correlation coefficients (r = 0.465) between V3 O2max and SRT performance. As V3 O2max significantly increased after the training period, SRT performance (distance and heart rate immediately after the 67th shuttle run) also positively changed during the preseason training period. CONCLUSION: The 21-m SRT has high reliability with moderate validity, and it is an effective tool for coaches to examine aerobic capacity and the efficacy of a training program for youth soccer players during the preseason training period.