Background Liver transplantation(LT)is a life-saving treatment for patients with end-stage liver disease,with significant improvements in short-term survival over the decades.However,long-term survival and trends in L...Background Liver transplantation(LT)is a life-saving treatment for patients with end-stage liver disease,with significant improvements in short-term survival over the decades.However,long-term survival and trends in LT indications and outcomes remain areas of active research.This registry-based study evaluates 40 years of LT in Finland,assessing patient and graft survival,retransplantation rates,changing recipient and donor demographics,indications and benchmarking outcomes against international standards.Methods Data were extracted from the nationwide Finnish LT registry,covering all LTs performed in Finland between 1982 and 2024.Survival analyses were estimated using the Kaplan–Meier methodology and retransplantation rates were assessed using the cumulative incidence function.Benchmark cases were defined by international criteria.Results A total of 1763 LTs were performed,with a mean recipient age of 46 years.The most common aetiologies were alcohol-related liver disease(19%)and primary sclerosing cholangitis(PSC;16%).Over time,recipient and donor age,body mass index and prevalence of diabetes increased.One-year patient survival improved from 83%in the 1980s to 96%in 2020–2024,with the overall 5-year,10-year,20-year and 30-year patient survival being 83%,73%,53%and 28%,respectively.The retransplantation rate was 13%at 30 years overall and 28%in PSC.Benchmark cases had one-year patient and graft survival rates of 97%and 96%,respectively.Acute rejection rates declined from 62%during 1980–1989 to 19%during 2022–2023.Post-transplant kidney-replacement therapy peaked at 26%in 2010–2021,thereafter decreasing to 8%after the year 2022.Conclusion The Finnish LT programme demonstrates sustained improvements in short-and mid-term survival,with evolving indications and recipient and donor demographics.Benchmark analyses confirm high-quality outcomes.Continued efforts are needed to optimise long-term survival and reduce the need for retransplantation,especially in PSC.展开更多
Based on the empirical analysis of data contained in the International Software Benchmarking Standards Group （ISBSG） repository, this paper presents software engineering project duration models based on project effo...Based on the empirical analysis of data contained in the International Software Benchmarking Standards Group （ISBSG） repository, this paper presents software engineering project duration models based on project effort. Duration models are built for the entire dataset and for subsets of projects developed for personal computer, mid-range and mainframe platforms. Duration models are also constructed for projects requiring fewer than 400 person-hours of effort and for projects requiring more than 400 person-hours of effort. The usefulness of adding the maximum number of assigned resources as a second independent variable to explain duration is also analyzed. The opportunity to build duration models directly from project functional size in function points is investigated as well.展开更多
Uganda has been implementing the Global Health Security Agenda(GHSA)since 2015 to build its capacity according to World Health Organization(WHO)Benchmarks on International Health Regulations Capacities.The country rem...Uganda has been implementing the Global Health Security Agenda(GHSA)since 2015 to build its capacity according to World Health Organization(WHO)Benchmarks on International Health Regulations Capacities.The country remains prone to outbreaks,with more than 20 disease outbreaks reported in the past five years,including Ebola virus disease,Crimean-Congo haemorrhagic fever,Marburg haemorrhagic fever,measles,yellow fever,coronavirus disease 2019(COVID-19),and cholera.Antimicrobial resistance(AMR)is an ongoing challenge.Uganda scored capacity level 3 on infection prevention and control(IPC)and antimicrobial stewardship(AMS)in the 2017 Joint External Evaluation(JEE)assessment.Identified gaps were being addressed after a self-assessment in 2021.This paper describes the technical assistance approaches provided to Uganda by the Medicines,Technologies,and Pharmaceutical Services Program,funded by the United States(U.S.)Agency for International Development,and implemented by Management Sciences for Health.The program,through a One Health approach,supported systematic capacity strengthening based on the JEE's capacity advancement framework for global health security,specifically relating to AMR.The program's interventions impacted 32 WHO benchmark actions(7 for AMR multisectoral coordination,16 for IPC,and 9 for AMS),contributing to Uganda's strengthened GHSA capacity.Leveraging success built on the AMR platform,the program trained 745 health workers in IPC for the Ebola virus and provided support for simulation exercises by eight district IPC teams.The program also worked with the Ministry of Health to coordinate IPC for the COVID-19 response in five health regions,covering 45 districts and reaching 5,452 health workers at 858 health facilities.展开更多
基金supported by Finska Läaresälskapet,Academy of Finland(#338544),Sigrid Jusélius Foundation,Mary and Georg Ehrnrooth Foundation,Medicinska Understösföening Liv&Häsa and Wilhelm and Else Stockmann Foundation.
文摘Background Liver transplantation(LT)is a life-saving treatment for patients with end-stage liver disease,with significant improvements in short-term survival over the decades.However,long-term survival and trends in LT indications and outcomes remain areas of active research.This registry-based study evaluates 40 years of LT in Finland,assessing patient and graft survival,retransplantation rates,changing recipient and donor demographics,indications and benchmarking outcomes against international standards.Methods Data were extracted from the nationwide Finnish LT registry,covering all LTs performed in Finland between 1982 and 2024.Survival analyses were estimated using the Kaplan–Meier methodology and retransplantation rates were assessed using the cumulative incidence function.Benchmark cases were defined by international criteria.Results A total of 1763 LTs were performed,with a mean recipient age of 46 years.The most common aetiologies were alcohol-related liver disease(19%)and primary sclerosing cholangitis(PSC;16%).Over time,recipient and donor age,body mass index and prevalence of diabetes increased.One-year patient survival improved from 83%in the 1980s to 96%in 2020–2024,with the overall 5-year,10-year,20-year and 30-year patient survival being 83%,73%,53%and 28%,respectively.The retransplantation rate was 13%at 30 years overall and 28%in PSC.Benchmark cases had one-year patient and graft survival rates of 97%and 96%,respectively.Acute rejection rates declined from 62%during 1980–1989 to 19%during 2022–2023.Post-transplant kidney-replacement therapy peaked at 26%in 2010–2021,thereafter decreasing to 8%after the year 2022.Conclusion The Finnish LT programme demonstrates sustained improvements in short-and mid-term survival,with evolving indications and recipient and donor demographics.Benchmark analyses confirm high-quality outcomes.Continued efforts are needed to optimise long-term survival and reduce the need for retransplantation,especially in PSC.
基金Funding for this research was partially provided by Bell Canada and by the Vatural Sciences and Engineering Research Council of Canada. The opinions expressed in this paper are solely those of the authors
文摘Based on the empirical analysis of data contained in the International Software Benchmarking Standards Group （ISBSG） repository, this paper presents software engineering project duration models based on project effort. Duration models are built for the entire dataset and for subsets of projects developed for personal computer, mid-range and mainframe platforms. Duration models are also constructed for projects requiring fewer than 400 person-hours of effort and for projects requiring more than 400 person-hours of effort. The usefulness of adding the maximum number of assigned resources as a second independent variable to explain duration is also analyzed. The opportunity to build duration models directly from project functional size in function points is investigated as well.
基金possible by the generous support of the American people through the US Agency for International Development(USAID)contract no.7200AA18C00074.
文摘Uganda has been implementing the Global Health Security Agenda(GHSA)since 2015 to build its capacity according to World Health Organization(WHO)Benchmarks on International Health Regulations Capacities.The country remains prone to outbreaks,with more than 20 disease outbreaks reported in the past five years,including Ebola virus disease,Crimean-Congo haemorrhagic fever,Marburg haemorrhagic fever,measles,yellow fever,coronavirus disease 2019(COVID-19),and cholera.Antimicrobial resistance(AMR)is an ongoing challenge.Uganda scored capacity level 3 on infection prevention and control(IPC)and antimicrobial stewardship(AMS)in the 2017 Joint External Evaluation(JEE)assessment.Identified gaps were being addressed after a self-assessment in 2021.This paper describes the technical assistance approaches provided to Uganda by the Medicines,Technologies,and Pharmaceutical Services Program,funded by the United States(U.S.)Agency for International Development,and implemented by Management Sciences for Health.The program,through a One Health approach,supported systematic capacity strengthening based on the JEE's capacity advancement framework for global health security,specifically relating to AMR.The program's interventions impacted 32 WHO benchmark actions(7 for AMR multisectoral coordination,16 for IPC,and 9 for AMS),contributing to Uganda's strengthened GHSA capacity.Leveraging success built on the AMR platform,the program trained 745 health workers in IPC for the Ebola virus and provided support for simulation exercises by eight district IPC teams.The program also worked with the Ministry of Health to coordinate IPC for the COVID-19 response in five health regions,covering 45 districts and reaching 5,452 health workers at 858 health facilities.
