BACKGROUND Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. METHODS WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. FINDINGS Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0-4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2-6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. INTERPRETATION In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates. FUNDING European Society of Intensive Care Medicine, European Respiratory Society.

Objective: Romania began its COVID-19 immunization programme with approved vaccinations in three stages, as follows: The first step of vaccination is for health and social professionals, the second stage is for high-risk persons and the third stage is for the remainder of the general public. This study aims at assessment of knowledge, attitude and practice towards COVID-19 and vaccination against COVID-19 in the Romanian population during the third wave of the pandemic. Methods: This cross-sectional study was based on a Bosnian and Herzegovinian study on COVID-19 vaccination during the country’s third wave of COVID-19 pandemic. Results: Our study sample, dominantly female (629; 61.0%), with a bachelor’s degree (734; 71.2%), either single (539; 52.3%) or in a relationship (363; 35.2%), engaged in intellectual labour (910; 88.3%) and living in an urban environment (874; 84.8%) with a mean age of 25.07 ± 8.21 years, 294 (28.5%) people with COVID-19 symptoms and 86 (8.3%) were tested COVID-19 positive, had a mean knowledge score of 16.38 ± 4.0 with correct answer rates on questions ranging from 30.1% to 88.2%. Being single (odds ratio = 3.92, p = 0.029) or in a relationship (odds ratio = 3.79, p = 0.034), having a bachelor’s degree and higher (odds ratio = 1.61, p = 0.006) and being COVID-19 tested (odds ratio = 1.82, p < 0.001) were associated with higher knowledge test scores. Our sample had relatively optimistic attitudes towards final COVID-19 disease containment (712; 69.1%) and vaccination programmes (679; 65.9%). The majority of the sample followed socio-epidemiological measures and did not visit places of mass social gatherings (666; 64.1%) and wore masks (992; 95.7%) while being outside their home. In terms of vaccination rates, 382 (37.0%) of the individuals were presently immunized against COVID-19. Higher knowledge test scores (>15 points) (odds ratio = 1.66, p = 0.002) and positive attitudes of this study (odds ratio = 1.59, p = 0.001, odds ratio = 4.16, p < 0.001) were identified as independent predictors for vaccinating against COVID-19. Conclusion: Romanian citizens have had good knowledge, optimistic attitudes and appropriate practices towards COVID-19 vaccination during the third wave of COVID-19 outbreak in the country. Higher knowledge regarding the disease and vaccination against it not only increased attitudes towards the end of the pandemic, but also increased the willingness to be vaccinated and to avoid infection risk factors.

Abstract The use of multi-criteria decision-making (MCDM) methods to select the most appropriate one from a range of alternatives considering multiple criteria is a suitable methodology for making informed decisions. When constructing a decision or objective matrix (DOM) for MCDM procedure, either crisp numerical values or fuzzy linguistic terms can be used. A review of relevant literature indicates that decision experts often prefer to give linguistic terms (instead of crisp numerical values) based on their domain knowledge, to establish a fuzzy DOM. However, previous research articles have not adequately studied the selection between fuzzy and crisp DOM in MCDM, especially under the context of assessing the financial performance (FP) of listed firms – a notably complex decision-making problem. As such, the primary motivation of this study is to bridge this research gap through comparative analyses of fuzzy and crisp DOM in MCDM. Along this path, and in order to handle fuzzy DOM, this work also proposes two new fuzzy MCDM methods: fuzzy preference ranking on the basis of ideal-average distance (PROBID) and fuzzy sPROBID (simpler PROBID), extending the applicability of the original crisp PROBID and sPROBID methods. Moreover, for the first time in the literature, this work compares the FP rankings obtained using fuzzy MCDM methods with an objective benchmark we have identified, i.e., the real-life stock return (SR)-based ranking. The case study of ranking the FP of 32 listed firms demonstrates that the fuzzy MCDM methods produce higher correlation results with the SR-based ranking. The results also suggest that the proposed fuzzy sPROBID method with triangular fuzzy DOM performs the best for assessing the FP of firms in terms of Spearman’s rank correlation coefficient with the SR-based ranking. Overall, the contributions of this work are three-fold: first, it proposes two new fuzzy MCDM methods (i.e., fuzzy PROBID and fuzzy sPROBID); second, it advances the application of fuzzy MCDM methods in assessing and ranking the FP of listed firms to make rational investment decisions in the financial market; third, it studies the selection between fuzzy and crisp DOM through comparisons with an objective benchmark.

The positive effects of green infrastructure in the urban environment are nowadays widely known and proven by research. Yet, greening, which serves to improve the indoor climate and people’s well-being, is integrated very limited in public facilities such as schools. Reasons for this are seen in a lack of knowledge and financing opportunities. A focus, among others, of the MehrGrüneSchulen research project is the interdisciplinary development of cost-effective greening solutions for schools. The designs were developed in close collaboration with students of a technical college (HTL) and a horticultural school. This study describes the development process and presents the results of the first implementations of greening systems at the HTL-building complex and at nine other schools in Austria.

We study nonlinear networked control systems (NCS), where the controller is implemented over multiple processors via an emulation-based approach. We start with a stable and centralised NCS commonly considered in the literature. Then, we show how to implement the centralised controller over multiple processors inspired by parallel computing techniques, so that stability is preserved (semi-globally and practically) under sufficiently fast computations. An example is given to illustrate the main results.

the most important precondition for designing green strategies and policies, and elements of that can be recognized in the current socio-political life in BiH.

Faced with a changing business environment and increasing competition, enterprises have started looking for innovative solutions be­yond hierarch organizational boundaries. The community of crowds can be employed as a valuable factor in an enterprise’s innovation process to cre­ate value and upgrade its knowledge base. The present paper seeks to un­derstand the role of the crowdsourcing mechanism through the intellectu­al capital framework, resulting in a renewed knowledge base. The model was empirically tested using a data set obtained through a questionnaire fulfilled by representatives of enterprises in the Republic of Srpska, Bosnia and Herzegovina, using partial least squares structural equation modelling. The findings reveal that crowdsourcing causes significant linkages between intellectual capital dimensions among which crowdsourcing-human cap­ital and crowdsourcing-structural capital contribute more to enterprise re­newal of knowledge base. Research results could assist managers in strate­gic decisions in resource allocation in promoting and sustaining knowledge dissemination to increase the renewal capability of enterprises.

The article presents the contribution of socio-demographic, socio-economic, employment status and level of education of parents/guardians to students’ school success. The aim of this article is to discover the causes of school (un)success given the contribution of predictor variables. The predictor set of variables consists of four scales: socio-demographic status (total number of brothers, total number of sisters, marital status of parents, distance from home to school and number of members households), socio-economic status (total monthly income of parents/guardians, place to study in the house/apartment, possession of laptop/computer, constant internet access in the house/apartment and the way they come to school), employment status of parents/guardian and educated status of parent/guardian. In addition to the set of predictors, a criterion variable was used, which consists of three dimensions, namely school success at the end of the sixth, seventh and eighth grade of primary school. The results of the research confirm a statistically significant correlation between socio-demographic, socio-economic, employment status and the level of education of parents/guardians and school success of children, provided that socio-demographic status has a higher predictive power on students’ school success. It was confirmed that students have a positive attitude about the importance of the grade as well as that they perceive that their parents have the same attitude.