Familiarity influences social networks in dairy cows after regrouping.

Regrouping is common practice when managing dairy cow groups, and it is known to have disruptive effects on behavior and production. The presence of a small group of familiar cows upon regrouping may provide social support and mitigate some of the negative effects. In this study we investigated (1) how regrouping affects social relationships among familiar cows and (2) if cows prefer familiar individuals over unfamiliar ones as social partners after regrouping. We used 3 established groups of cows to create 2 new groups, each containing 14 cows, using subgroups of familiar animals (i.e., 4, 6, and 4 cows) from the original groups. The new groups were similar in respect to the age, parity, and sire of cows. The frequencies of grooming and displacements were determined in the walking alley, lying stalls, and feed bunk by observing 48 h of continuous video before regrouping, directly after regrouping, and 1 wk later. First, social network analysis was applied to investigate the effects of regrouping on the relationships within the subgroups of familiar cows. Second, we determined if familiar cows were more or less connected than would be expected by chance (i.e., assortment), considering displacement, grooming, and feed bunk neighbor networks (derived from electronic feeder data) after regrouping. Regrouping increased the number of displacements, especially in the walking alley. Within the subgroups of familiar cows, regrouping resulted in slightly more displacements, but the network structure did not change. The frequency of grooming among familiar cows remained stable across all observation periods, and the network structure was not affected by regrouping. We found positive assortment in grooming and feed bunk neighbor networks, thereby suggesting that cows preferred familiar individuals as grooming partners and feeding neighbors directly after regrouping and, to a smaller extent, 1 wk later. The effect of familiarity on displacements depended on the pen area. The weak assortment directly after regrouping at the feed bunk indicated that familiar cows displaced each other more than unfamiliar ones, possibly because they were neighbors more often. Our results indicated that a small group of familiar cows may provide ongoing social buffering after regrouping. Further research with multiple groups and larger group sizes is needed to determine whether similar effects are consistently present when groups of familiar cows are subjected to regrouping.

Globus Nexus: A Platform-as-a-Service Provider of Research Identity, Profile, and Group Management.

Globus Nexus is a professionally hosted Platform-as-a-Service that provides identity, profile and group management functionality for the research community. Many collaborative e-Science applications need to manage large numbers of user identities, profiles, and groups. However, developing and maintaining such capabilities is often challenging given the complexity of modern security protocols and requirements for scalable, robust, and highly available implementations. By outsourcing this functionality to Globus Nexus, developers can leverage best-practice implementations without incurring development and operations overhead. Users benefit from enhanced capabilities such as identity federation, flexible profile management, and user-oriented group management. In this paper we present Globus Nexus, describe its capabilities and architecture, summarize how several e-Science applications leverage these capabilities, and present results that characterize its scalability, reliability, and availability.

An education-based telehealth group improves the management and clinical outcomes of patients with inflammatory bowel disease in China (THEIM study).

BACKGROUND: Although poor medication adherence has a negative impact on disease prognosis in patients with inflammatory bowel disease (IBD), finding proven solutions remains a challenge. In this study, we developed a telehealth management model based on education and patient-centered medical care (PCEB) using the social media platform WeChat. OBJECTIVE: To investigate the effect of PCEB on adherence and clinical outcomes. METHODS: In this retrospective cohort, 543 IBD patients (274 in the PCEB group and 269 in the routine group) at the IBD center of Renmin Hospital (Wuhan University, Wuhan, China) were enrolled between January 2020 and September 2022. The routine group received routine follow-up and management, while for PCEB patients, a comprehensive IBD education program and PCEB were conducted. Medication adherence and clinical outcomes were also evaluated. RESULTS: There were no differences between the PCEB and routine groups in terms of patient demographics and clinical characteristics, including disease classification, duration, biological treatment, and educational background at baseline. Compared with routine treatment, PCEB greatly improved patient medication adherence, as assessed by compliance with oral medication, enteral nutrition, biological infusion, and scheduled endoscopic assessment. Clinical and endoscopic remission in patients with PCEB increased during short-term (month 4) and long-term (month 12) follow-ups, along with a decrease in relapse rates for CD (13.3% vs. 31.8%) and UC (19.8% vs. 37.2%). CONCLUSION: The telehealth model applied to the PCEB group improved medication adherence and clinical outcomes in patients with IBD. This is a new and powerful solution for the long-term management of this chronic and progressive disease.

Expert group syndrome at high altitude.

During a training session for the university diploma of Mountain medicine delivered by University Sorbonne Paris Nord for medical doctors, one of the participants developed signs of maladaptation to high altitude at 3 600 m, the severity of which was incorrectly interpreted. Information was sparingly given by the patient (an anesthetist) to several of his colleagues and no one was in charge to collect clinical data, take a history, and provide appropriate treatment. The combination of the absence of designation of a supervising doctor and the difficulty of communicating with the patient led to a lack of coordinated management and to an evolution of the symptoms towards severe acute mountain sickness. Fortunately, the very rapid management of the patient and a rapid helicopter evacuation, as soon as the symptoms worsened towards the onset of a suspected high altitude cerebral and/or pulmonary edema, allowed rapid resolution without sequelae. Environmental, medical, psychological, and managerial factors led to this Expert Group Syndrome.

Lean Thinking to manage a national working group on physics aspects of Stereotactic Body Radiation Therapy.

PURPOSE: To report how the adoption of a Lean Thinking mindset in the management of a national working group (WG) on the physics of stereotactic body radiation therapy (SBRT) contributed to achieve SBRT standardization objectives. METHODS: Vision for the WG has been established as fragmentation reduction and process harmonization enhancement in SBRT for Italian centers. Two main research themes of the technical aspects of SBRT emerged as areas with major standardization improvement needs, small field dosimetry and SBRT planning comparisons, to be investigated through multi-institutional studies. The management of the WG leveraged on the Lean concept of fostering self-organization in a non-hierarchical environment. Four progressive involvement levels were defined for each study. No specific "scientific" pre-experience was required to propose and coordinate a project, just requiring a voluntary commitment. People engagement was measured in terms of number of published articles. The standardization goals have been conducted through a simplified "5S" (Sort, Set in Order, Shine, Standardize, and Sustain) methodology, first considering a phase of awareness (the first three "S"), then identifying and implementing standardization actions (the last two "S"). RESULTS: Since the beginning, 157 medical physicists joined the AIFM/SBRT-WG. Twenty-four papers/reviews/letters have been published in the period 2014-2019 on major radiation oncology journals, authored by >100 physicists (>50% working in small hospitals). Six over 12 first authors worked in peripheral/small hospitals, with no prior publication as first author. These studies contributed to the awareness and standardization phases for both small-field dosimetry and planning. In particular, errors in small-field measurements in 8% of centers were detected thanks to a generalized output factor curve in function of the effective field size created by averaging data available from different Linacs. Furthermore, planner's experience in SBRT was correlated with dosimetric parameters in the awareness phase; while sharing median dose volume histograms (DVHs) reduced variability among centers while keeping the same level of plan complexity. Finally, all the dosimetric parameters statistically significant to the planner experience during the awareness phase, were no longer significantly different in the standardization phase. CONCLUSIONS: The experience of our SBRT-WG has shown how a Lean Thinking mindset could foster the SBRT procedure standardization and spread the physics of SBRT knowledge, enhancing personal growth. Our expectation is to inspire other scientific societies that have to deal with fragmented contexts or pursue processes harmonization through Lean principles.

Practice and effect analysis of scientific research group-based model in a county-level hospital / 中华医学科研管理杂志

Objective:To explore the effect of scientific research group-based model on the improvement of nursing scientific research ability in a county-level hospital.Methods:A nursing research group was established, the composition of team members and work contents of the group were clarified, tiered focused scientific research training was implemented through progressive research content and flexible training methods, and individual and progressive research guidance was provided through research counseling application forms, while literature reading activities were conducted through article reports and literature debriefings. Retrospective analysis of the nursing research practice, the number of scientific research outputs, and research capacity were applied to evaluate the effect of the nursing research group-based model.Results:Within 2 years of the establishment of the nursing research group, 37 training programs were conducted, 33 scientific research materials were pushed to the WeChat public account, 23 scientific research projects were tutored, and 6 research projects were successfully declared. The scientific research ability score of nursing staff participating in literature reading debriefing increased from 44.24±19.12 to 53.57±13.86( P<0.001). Conclusions:The application of the nursing research group-based model can improve the nursing scientific research ability of the county-level hospital.

Application evaluation of interactive group management in puerpera with diastasis recti abdominis / 中国实用护理杂志

Objective:To explore the application effect of interactive group management mode in puerpera with postpartum diastasis recti abdominis, and to provide reference for optimizing the health management of puerpera with rectus abdominis separation.Methods:This study was a randomized controlled trial. Convenience sampling method was used to select 114 puerpera with postpartum diastasis recti abdominis who were treated in Maternal and Child Health Hospital of Zhenjiang City from January to June 2022 as the research objects. According to the random number table method, the postpartum women were divided into an intervention group and a control group with 57 cases each. The intervention group received interactive group management for 12 weeks, while the control group received routine health guidance. Before and after the intervention, the two groups were evaluated by diastasis recti abdominis, rehabilitation knowledge-attitude-practice, general self-efficacy, and the duration of the first-level test results of the eight-level abdominal bridge.Results:The 55 cases were included in the final intervention group, while 56 cases were included in the control group. After intervention, the separation distance of rectus abdominis of the intervention group was (2.27 ± 0.47) cm, and that of the control group was (2.48 ± 0.39) cm. The difference between the two groups was statistically significant ( t = 2.53, P<0.05). The knowledge-attitude-practice total score and each item score of diastasis recti abdominis rehabilitation in the intervention group were (106.84 ± 5.78), (61.53 ± 4.29), (25.42 ± 2.26), (19.89 ± 1.89) points respectively while in the control group were (73.77 ± 8.33), (38.48 ± 7.56), (20.73 ± 3.07), (13.55 ± 1.99) points. The differences between the two groups were statistically significant ( t values were 9.16 -24.28, all P<0.01). The general self-efficacy score of the intervention group was (27.47 ± 3.16) points, and that of the control group was (26.05 ± 3.43) points. The difference between the two groups was statistically significant ( t = 2.26, P<0.05). The first-level test time of eight-level abdominal bridge in the intervention group was (80.29 ± 11.50) s, which was significantly higher than (29.39 ± 6.09) s in the control group, and the difference was statistically significant ( t = 29.20, P<0.01). The completion rate of exercise in the intervention group was (90.20 ± 1.83)%. Higher than (69.52 ± 8.04)% in the control group, with a statistically significant difference ( t = 13.73, P<0.01). Conclusions:Interactive group management can significantly ameliorate the separation distance of diastasis recti abdominis, increase the level of knowledge-attitude-practice of diastasis recti abdominis rehabilitation and the compliance of rehabilitation exercise, improve the self-efficacy, prolong the first-level test time of eight-level abdominal bridge, and improve the abdominal core muscle strength for puerpera.

Pedigree analysis for the genetic management of group-living species.

Captive breeding programs are an important tool for the conservation of endangered species. These programs are commonly managed using pedigrees containing information about the history of each individual's family, such as breeding pairs and parentage. However, there are some species that are kept in groups where it is hard to distinguish between particular individuals within the group, making it very difficult to record any information at an individual level. Currently, software and methods commonly used for registering and analyzing pedigrees to help manage populations at an individual level are not adequate for managing these group-living species. Therefore, there is a need to further develop these tools and methodologies for pedigree analysis to better manage group-living species. PMx is a program used for the management of ex situ populations in zoos and aquariums. We adapted the pedigree analysis method implemented in PMx to analyze pedigrees (records of descendant lineages) of group-living species. In addition, we developed a group pedigree data entry sheet and group2PMx, a converter program that enables group datasets to be imported into PMx. We show how pedigree analysis of a group-living species can be used for population management using the studbook of the endangered Texas blind cave salamander Eurycea rathbuni. Such analyses of the pedigree of groups can improve the management of group-living species in ex situ breeding programs. Firstly, it enables better management decisions based on more accurate genetic measures between groups, allowing for greater control of inbreeding. Secondly, it can improve the conditions in which group-living species are held by adapting husbandry practices to better reflect conditions of these species living in the wild. The use of the spreadsheet and group2PMx extends the application of PMx, allowing conservation managers and other institutions outside the zoo and aquarium community to easily import and analyze their pedigree data.

Benchmarking Academic Anatomic Pathologists: The Association of Pathology Chairs Survey.

The most common benchmarks for faculty productivity are derived from Medical Group Management Association (MGMA) or Vizient-AAMC Faculty Practice Solutions Center® (FPSC) databases. The Association of Pathology Chairs has also collected similar survey data for several years. We examined the Association of Pathology Chairs annual faculty productivity data and compared it with MGMA and FPSC data to understand the value, inherent flaws, and limitations of benchmarking data. We hypothesized that the variability in calculated faculty productivity is due to the type of practice model and clinical effort allocation. Data from the Association of Pathology Chairs survey on 629 surgical pathologists and/or anatomic pathologists from 51 programs were analyzed. From review of service assignments, we were able to assign each pathologist to a specific practice model: general anatomic pathologists/surgical pathologists, 1 or more subspecialties, or a hybrid of the 2 models. There were statistically significant differences among academic ranks and practice types. When we analyzed our data using each organization's methods, the median results for the anatomic pathologists/surgical pathologists general practice model compared to MGMA and FPSC results for anatomic and/or surgical pathology were quite close. Both MGMA and FPSC data exclude a significant proportion of academic pathologists with clinical duties. We used the more inclusive FPSC definition of clinical "full-time faculty" (0.60 clinical full-time equivalent and above). The correlation between clinical full-time equivalent effort allocation, annual days on service, and annual work relative value unit productivity was poor. This study demonstrates that effort allocations are variable across academic departments of pathology and do not correlate well with either work relative value unit effort or reported days on service. Although the Association of Pathology Chairs-reported median work relative value unit productivity approximated MGMA and FPSC benchmark data, we conclude that more rigorous standardization of academic faculty effort assignment will be needed to improve the value of work relative value unit measurements of faculty productivity.

Application of specialized nursing group in management of patients' venous thromboembolism / 中华护理杂志

In order to better regulate nursing work of venous thromboembolism(VTE) prevention in the hospital,and provide standardized VTE care for hospitalized patients,in 2012,our nursing department established the VTE specialist nursing group.Group members were provided "three steps" training.They performed VTE risk assessment and prevention,and conducted disease management of patients with VTE in hospital.Through development of specialist nursing group,nurses' knowledge of VTE was improved from 53.48±11.56 to 58.36-±14.68,and patients were provided standardized VTE nursing care,which was of great significance to promote the management of VTE in the hospital.

Effect of group management mode on compliance of pelvic floor function exercise for patients with post ;partum urinary incontinence / 中国实用护理杂志

Objective To explore the effect of group management mode on compliance of pelvic floor function exercise for patients with post partum urinary incontinence (PPUI). Methods A total of 80 cases of patients with PPUI were randomly divided into the observation group and the control group. Patients in the control group received one-to-one routine health guidance. Patients in the observation group received group management mode including special subject teaching guidance, induction and communication between patients. Three months after the intervention, two groups of patients were evaluated at six months after postpartum by the pelvic floor muscle strength, one-hour urine pad test and pelvic floor muscle function exercise compliance. Results Six months after postpartum, the cure rate of the pelvic floor muscle strength was 100%(40/40) for typeⅠmuscle, 100%(40/40) for typeⅡmuscle in the observation group. In the control group, the cure rate for typeⅠmuscle was 70%(28/40) and 65%(26/40) for type Ⅱmuscle. The difference between these two groups was statistically significant (χ2=14.118, 16.970, P=0.000). The total effective rate of urinary incontinence was 100.0%(40/40) in the observation group, 67.5% (16/40) in the control group, and there was statistical significance (χ2=25.232, P=0.000). Evaluation of the compliance of pelvic floor function exercise showed that the rates were 72.5% (29/40) for complete compliance, 27.5%(11/40) for incomplete compliance and 0 for total non-compliance in the observation group. In the control group, these rates were 2.5%(1/40), 55.0%(22/40), 42.5%(17/40). And there was statistical significance as well (χ2=54.847, P=0.000). Conclusions Group management mode can improve the compliance of pelvic floor muscle function exercise and the strength of pelvic floor muscle, and improve the degree of urinary incontinence in postpartum patients with urinary incontinence.

The role of scientific evidence in the management of high-risk groups using genetic information

Genetic factors are important host factors that play a role in the development of all diseases through their interaction with environmental factors. Most genetic disorders are the direct result of a mutation in a single gene. However, one of the most difficult challenges currently faced by researchers is the identification of ways in which genes contribute to diseases with complex inheritance patterns, such as cancer, diabetes, asthma, and mental illness. In all of these cases, no single gene determines whether a person will develop a disease. Several genes may contribute to an individual's susceptibility to a disease; genes may also affect how an individual reacts to environmental factors. In this study, we attempted to classify high-risk groups using up-to-date genetic knowledge. We also briefly discuss the role of scientific evidence in the identification (through genetic screening) and management of high-risk subgroups in the population.