Utilization of ambulatory physician encounters, emergency room visits, and hospitalizations by systemic lupus erythematosus patients: A 13-year population health study

Objective: To determine total physician encounters, emergency room (ER) visits and hospitalizations in an incident cohort of systemic lupus erythematosus (SLE) cases and matched control patients over 13 years. Methods: A retrospective cohort study was performed utilizing administrative health care data from approximately 1 million people with access to universal healthcare. Using ICD-9 and ICD-10 diagnostic codes, 7 SLE case definitions were used. Each case was matched by age and gender to 4 randomly selected controls. Data included physician billings, ER visits and hospital discharges over 13 years. Results: The number of incident SLE cases varied from 564 to 4,494 depending up the case definition. The mean age varied from 47.7 to 50.6 years and the proportion of females from 78.0 to 85.1%. SLE utilization of physicians was highest in the index year, declining significantly thereafter for all case definitions. By the fourth year, encounters with subspecialty physicians fell by 60% (Rheumatologists), 50% (Internal medicine) and 31% (other physicians). In contrast, visits to family physicians fell by only 9%. Visits to the ER and hospital admissions for SLE cases were also more frequent early in the disease and fell significantly over the study for both ER visits (all case definitions) and hospitalizations (2 of 7 case definitions). Conclusion: In SLE patients, health care utilization is highest in the first few years following the diagnosis which is also the time of maximal involvement by rheumatologists. Utilization declines over time and encounters with patient's family physicians predominate over other physician groups. This article is protected by copyright. All rights reserved

Design and implementation of laser based intelligent embedded dual modes cruise control system using FPGA

Cruise control system is also known as speed control which use to take over the car from the driver and stabilize the car with the speed had been set. It is one of the important elements in the intelligent vehicles. Currently, driver has to accelerate the car until certain speed in order to activate cruise control system. After it had been activated, driver still needs to put on attention to decelerate the car when there is another one in front and possibility to get accident is high. To overcome this problem and enhance current cruise system, this project has two laser-based working modes. First one is normal mode that following the same current cruise system procedure. Second is pre-set mode that allow driver to enter required speed without necessity to use petrol pedal. Both modes will use laser transceivers to add on perception feature to cruise control system. The system is designed and implemented using FPGA as main processing technology. Also, Quartus II 13.0 SP is used and DE0-Nano board is utilized as project platform. The input management is implemented to handle all sensors data and feed main processing unit with proper data stream. The result is efficient in term of system response, accurate cruise control and trustable design as well. The implement system is achieved up to 1.3GHz and 1,337 logic elements are consumed

The Mediating Effect of Organizational Prestige on Extrinsic Rewards and Employee Retention

Employee turnover intention poses significant challenges for organizations globally, incurring financial costs and productivity losses while disrupting workflows and impeding innovation. Effective human resource practices, including extrinsic rewards such as financial incentives and non-monetary benefits, are critical in retaining high-performing employees. However, the influence of these rewards on employee retention is not always straightforward, and organizational prestige—perceived as an indicator of a company’s reputation and status—may play a crucial mediating role. This study explores the mediating effect of organizational prestige on the relationship between extrinsic rewards and employee retention intention within the Klang Valley region, Malaysia. Utilizing partial least squares structural equation modeling (PLS-SEM), the research investigates how financial incentives, promotion opportunities, and relationships with supervisors and peers’ impact organizational prestige and, consequently, employees’ intention to stay. Findings indicate that while financial incentives do not significantly influence organizational prestige, promotion opportunities, supervisor relations, and peer relations positively affect it. Moreover, organizational prestige significantly mediates the effects of supervisor and peer relations on retention intention, highlighting its critical role in enhancing employee commitment. The study provides valuable insights for organizations seeking to improve retention strategies by emphasizing the importance of fostering a prestigious organizational image and cultivating positive workplace relationships. The limitations of this study include the use of a single geographical region and the focus on specific types of extrinsic rewards, suggesting that future research should explore additional contexts and reward types to generalize findings across different settings.fals

Renal artery stenosis-when to screen, what to stent?

Renal artery stensosis (RAS) continues to be a problem for clinicians, with no clear consensus on how to investigate and assess the clinical significance of stenotic lesions and manage the findings. RAS caused by fibromuscular dysplasia is probably commoner than previously appreciated, should be actively looked for in younger hypertensive patients and can be managed successfully with angioplasty. Atheromatous RAS is associated with increased incidence of cardiovascular events and increased cardiovascular mortality, and is likely to be seen with increasing frequency. Evidence from large clinical trials has led clinicians away from recommending interventional revascularisation towards aggressive medical management. There is now interest in looking more closely at patient selection for intervention, with focus on intervening only in patients with the highest-risk presentations such as flash pulmonary oedema, rapidly declining renal function and severe resistant hypertension. The potential benefits in terms of improving hard cardiovascular outcomes may outweigh the risks of intervention in this group, and further research is needed

LIFE DISRUPTED AND REGENERATED : COPING WITH THE ‘NEW NORMAL’ CREATIVE ARTS IN THE TIME OF CORONAVIRUS

A global pandemic caused by COVID-19 virus since December 2019 has developed into a fearsome situation more than any common global contagion. In combating COVID-19 worldwide, governments instigated a precautionary cordon sanitaire in various degrees. Live music, cinema and film festivals were inevitably cancelled, causing artists to become alienated from their audience. This paper aims to illuminate how practitioners of the creative industry cope with t as the means of regenerating ‘life’, which refers to that of a creative artist in a narrower sense, and to that of the industry in a broader sense. Adopting a combined methodology of autoethnography and virtual ethnography, the authors explore their encounters with the informants and the development of the creative arts scene. The subject of disruption and regeneration in the creative arts industry is approached through feasible methods and tools they could render in this unique lived experience. They hope to construct a view containing some perspectives on the transcendence of creative practitioners from the disruption to the survival of the pandemic’s impact, as well as the regeneration of how creative arts would persevere in the ‘new normal’ of the post-COVID-19 era

Effect of sulodexide in patients with non-proliferative diabetic retinopathy: diabetic retinopathy sulodexide study (DRESS).

PURPOSE: To evaluate the effectiveness of sulodexide for the treatment of hard exudates (HE) in non-proliferative diabetic retinopathy (NPDR). METHODS: This was a randomized, placebo-controlled, multicenter trial involving 130 patients (65 for each group) who had mild-to-moderate NPDR with macular HE. Participants were given a daily dose of either 50 mg sulodexide or a matching dose of placebo orally for 12 months. Main outcome measure was an improvement in HE defined as a decrease in severity by at least two grades on a 10-grade severity scale. This was evaluated by fundus photography over 12-month period. RESULTS: The sulodexide group showed significantly greater improvement in HE severity than that shown by the placebo group (39.0 % vs. 19.3 %; chi square, P = 0.005). Logistic regression analysis yielded an odds ratio of 2.790 (95 % confidence interval, 1.155-6.743; P = 0.023) for the effect of treatment once adjustments were made for demographic, prognostic and disease confounders. Intention to treat and per-protocol analysis yielded similar results. Sulodexide's safety was comparable to that of the placebo. CONCLUSIONS: Oral sulodexide therapy over 12 months improved macular HE in patients with mild-to-moderate NPDR, without leading to detectable adverse events. The study protocol was registered on clinicaltrial.gov under identifier NCT01295775