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Time of day of cardiac surgery and postoperative outcomes in the UK: a secondary analysis of linked national datasets
No full textIntroductionUncertainty remains regarding whether the time of day that cardiac surgery is performed affects postoperative outcomes or if the observed variation can be explained by patient or surgical factors.MethodsA secondary analysis of prospectively collected data was conducted to examine the association between time of cardiac surgery and clinical outcomes. Data were derived from four linked UK datasets: the National Adult Cardiac Surgery Audit; the Case Mix Programme; Hospital Episode Statistics; and Office for National Statistics mortality records. The primary outcomes were hazard of death due to cardiovascular disease and time to hospital readmission for myocardial infarction or acute heart failure. Secondary outcomes included duration of postoperative hospital stay; occurrence of major cardiovascular events; and all-cause mortality.ResultsLinked data for 24,068 patients were identified. Surgeries performed in late morning (10:00 to 11:59) had the highest mean (SD) predicted risk of death (3.7% (4.6)), compared with 3.2% (3.7) for early morning (07:00 to 09:59), 2.8% (3.4) for early afternoon (12:00 to 13:59) and 3.1% (3.6) for late afternoon (14:00 to 19:59) surgeries, respectively. The primary outcome measures showed an increased hazard of death from cardiovascular disease in the late morning (adjusted hazard ratio 1.18, 95%CI 1.00–1.39), with no difference in hazard of readmission for myocardial infarction or acute heart failure (adjusted hazard ratio 0.97, 95%CI 0.85–1.11). There were no differences in the secondary outcome measures.DiscussionTime-of-day variation in postoperative death due to cardiovascular disease following cardiac surgery was observed, with the highest risk seen in late morning procedures. These findings suggest that intra-operative or organisational factors specific to this period may influence outcomes. Future research should explore whether individual circadian phenotypes or chronotypes contribute to this variation, supporting a move towards precision and personalised scheduling of cardiac surgery to optimise patient outcomes
Efficacy of two rounds of albendazole treatment on soil-transmitted helminths in schoolchildren, Yunnan Province, China
No full textMass drug administration (MDA) of albendazole to at-risk populations remains the primary strategy for controlling soil-transmitted helminths (STH). Despite its widely use, its efficacy varies among different STH species and remains sub-optimal, particularly in the treatment of T. trichiura. Currently, studies investigating the optimal dose and regimens for albendazole are lacking. A longitudinal cohort study was conducted to assess the efficacy of two single-dose albendazole 400 mg treatments given four weeks apart targeting STH infections compared with just one single-dose albendazole 400 mg on 375 schoolchildren in Bulang Shan, Menghai county, Yunnan Province, China from October to December 2015. The first round of albendazole resulted in cure rates (CR) of 92.5%, 63.1% and 5.1%, and egg reduction rates (ERR) of 99.2%, 87.9% and 41.1% for A. lumbricoides, hookworms and T. trichiura, respectively. With the second round, efficacy remains high against A. lumbricoides (98.9% CR), is increased against hookworm (92.2% CR), and remains low against T. trichiura (6.3% CR). The second round increased the ERR to 99.6%, 99.8% and 74.1% for the same species, respectively. In this setting, albendazole is thus highly effective against A. lumbricoides, reasonably effective against hookworm, but has low efficacy against T. trichiura following two rounds of treatment
Risk and Mitigation Report: STRIDE-based threat model of the Metaverse (Deliverable D2.4 of the Shaping the Metaverse (Phase II) project)
No full textASTRO: a semi-automated grading and feedback system for programming assignments
No full textThis innovative practice full paper describes the design, implementation, and evaluation of the Abstract Syntax Tree Reviewer and Output Tester (ASTRO), a semi-automated grading system for programming assignments. The motivation for this work stems from the challenges associated with manual grading in large programming courses, including time inefficiency, inconsistent evaluation, and limited actionable feedback for students. ASTRO addresses these issues by leveraging automated processes to improve scalability and reliability while providing detailed feedback tailored to individual student submissions. ASTRO integrates static code analysis, runtime testing, and semantic evaluation to deliver consistent and actionable assessments. Its unique features include the ability to process nonstandard submissions, handle runtime anomalies, and categorize student performance into conceptual bands. Unlike many automated systems that prioritize correctness alone, ASTRO emphasizes conceptual understanding and provides feedback that is deterministic, transparent, and actionable. The system was implemented to streamline grading for a first-year software engineering course, reducing grading time while maintaining fairness and pedagogical rigor. The development of ASTRO draws on established literature in automated grading systems and programming pedagogy. Systems like Web-CAT and SALP informed ASTROs design, particularly in integrating dynamic and static analysis for assessment. However, ASTRO advances beyond existing tools by addressing limitations in handling edge cases and providing conceptual feedback, as highlighted by recent research in automated assessment and semantic analysis. ASTRO was evaluated using a cohort of 128 students, comparing its performance with manual grading methods used in the previous academic year. Results showed that ASTRO reduced grading time from three weeks to two days. Statistical analysis revealed that ASTRO produced grades comparable to manual grading while offering a broader grade distribution, enabling clearer differentiation between performance levels. Qualitative feedback from instructors highlighted its efficiency and ease of use. Challenges, such as handling edge cases and providing feedback for non-compiling code, were identified, underscoring future areas for refinement. By addressing limitations in existing systems and offering a scalable, transparent, and efficient framework, this version of ASTRO sets a foundation for future iterations that aim to further improve programming practical assessment grading.<br/
Project delivery system selection via overlapping strategy: a multi-mode resource-constrained scheduling model
No full textThe continuous evolution of the project delivery system (PDS) in recent years has posed a conundrum to practitioners in choosing the appropriate PDS for a project. This study tries to solve this challenge from the perspective of the overlapping strategy. An optimal PDS should balance overlapping and rework by analysing the relationships between project activities. This study develops a multiple overlapping modes resource-constrained project scheduling problem with a generalised precedence relations (MOM-RCPSP-GPR) model. This model generalises the traditional precedence constraints between activities and extends the search space for better resource usage compared to the current overlap literature. It adopts innovative hybrid methods based on heuristics and genetic algorithms. Computational experiments and a case study are conducted to verify the effectiveness and efficiency of the framework and its application in practice. The results show that the proposed model can better reflect the overlapping role compared to existing research, and the adopted hybrid approach can effectively solve this problem. Hence, this study contributes to the literature on overlapping and PDS selection and has substantial practical applicability.<br/