bluuebunny/crossref_metadata_2025 huggingface dataset:
Customer Satisfaction, Advertising Competition, and Platform Performance
Authors: Yang Chaolin , Guo Liang , Zhou Sean X.
Published: November 2021

We study how customer satisfaction affects platforms’ advertising competition and their equilibrium market shares and profits. Consider a market with multiple competing (online) platforms, all of which decide advertising outlay to maximize their own average profit. A customer chooses which platform to visit depending on her experience of the last purchase and on the platforms’ advertising outlays. After purchasing from a platform, with certain probability (satisfaction probability), the customer would be satisfied. A satisfied customer is more likely to repurchase from the platform than if she is dissatisfied. There are two types of customers in the market: loyal and switcher. Conditional on either satisfaction outcome, the loyal is more likely to repurchase from the last‐visited platform than the switcher. In the duopoly, we show that lower a platform's customer satisfaction or a higher proportion of switcher may alleviate the advertising competition. Consequently, a platform does not necessarily get a higher profit when its customer satisfaction is higher; and the platform with higher (lower) customer satisfaction benefits from a larger proportion of loyal (switcher). We then study the case with more than two competing platforms. Under the symmetric market, the equilibrium advertising outlay first increases and then decreases as the number of platforms increases. Every platform spends more on advertising and gets a lower profit when customer satisfaction improves. The equilibrium profit of platform is always increasing in the proportion of switcher. Under the fragmented market, we find that similar to the duopoly, the platforms with higher (lower) customer satisfaction benefit more when facing the loyal (switcher) than when facing the switcher (loyal). Several extensions are considered: two‐period impact of purchasing experience, an outside option for customers, endogenous satisfaction probabilities, and asymmetric information between platforms.
Psychosocial safety climate improves psychological detachment and relaxation during off‐job recovery time to reduce emotional exhaustion: A multilevel shortitudinal study
Authors: Yulita  , Idris Mohd Awang , Abdullah Siti Salina
Published: November 2021

Psychosocial safety climate (PSC) is a facet‐specific climate for psychological health and safety which constitutes an important organizational resource for creating a conducive work environment. The process to regain/restore energy expended at work, known as “recovery,” also plays a pivotal role for individuals; however, this process, together with PSC, remains largely underexplored. The main purpose of this study is to investigate the role of PSC in enhancing the moderating role of individuals’ psychological detachment and relaxation during weekends on the relationship between daily job demands in Week 1 and daily emotional exhaustion in Week 2. Data from a shortitudinal study of 178 teachers (in total, 534 diaries) in Terengganu, Malaysia, over two consecutive weeks, were operationalized at the individual level and daily level using Hierarchical Linear Modeling (HLM) software. The analysis showed that the daily experience of job demands in the prior week led to an increment of emotional exhaustion in the following week. Interestingly, the interaction role of PSC*psychological detachment and PSC*relaxation moderated the relationship between daily job demands and daily emotional exhaustion. Overall, this study highlights the importance of individual off‐job recovery time and that building good PSC at work is fundamental in compensating for the adverse relationships between job demands and its consequences.
Learning acquired from a computer game‐based early algebra intervention
Authors: Engledowl Christopher , Al‐younes Mohammad , Chamberlin Barbara , Stanford Ted
Published: November 2021

Algebra has long been a gatekeeper to more advanced mathematics and to tertiary education. International assessments, such as PISA, have also shown that this trend extends beyond borders, making the topic of when algebra should be learned quite political. Many reforms have been instituted since the early 1990s to infuse algebraic thinking into elementary grade levels—a domain of learning that has since been termed early algebra. In this study, we draw on Rasch Analysis results to report on the levels of sophistication that 457 upper elementary students across 10 schools and 28 classrooms exhibited on an early algebra assessment after completing a computer game‐based early algebra intervention. Findings indicate that half of the students improved by at least one level of sophistication, and about ¼ were observed to improve from largely thinking of quantity from a numeric standpoint to being able to think about a generalized quantity in the form of variable expressions. Despite the small change in students engaging in thinking about generalized quantity, the relatively short intervention period implies promising results to support a long‐term intervention in future research. Further research is also needed on the influence of student contextual factors, including teacher and school effects.
Reference Fixing and the Contingent A Priori
Authors: Stalnaker Robert
Published: November 2021

Kripke's arguments in Naming and Necessity that there are necessary truths that are knowable only a posteriori are convincing, but his examples that purport to be cases of contingent truths that can be known a priori are more problematic. These examples bring out something important about reference and meaning, but this paper argues that the knowledge of speakers who fix the reference of a name or word by stipulation is not appropriately classified as a priori knowledge. The paper discusses the factual presuppositions required for the success of the acts that establish semantic connections between both simple names and theoretical terms and the objects, properties, and relations to which they refer.
A simplified CT‐volumetry method for the canine liver
Authors: Israeliantz Nicolas , Lodzinska Joanna , Woods Glynn , Pontes Joana , Parys Maciej , Schwarz Tobias
Published: November 2021

Computed tomographic (CT) liver volumetry using the slice addition technique is an accurate, but a time‐consuming method. Commonly used DICOM‐viewing software only allows contouring of one area per image, which can be troublesome in the transverse plane as different lobes are separated. In this prospective, experimental, methods comparison study, we aimed to determine if hepatic contouring using sagittal reformatting and a reduced number of images would yield accurate results. Computed tomographic studies were performed in five canine cadavers and reviewed using sagittal reformatting. For each dog, the number of images that included the liver was used to create four stacks with progressively fewer images in which the liver would be contoured, each with the following median number of images: A: 60, B: 31, C: 16, and D: 9. Liver volume was calculated by three observers using the different stacks of images. After CT examination, the cadavers were dissected, the liver was removed, and its volume was determined by water displacement. Single score intraclass correlation coefficient was calculated to assess interobserver agreement. Kruskal‐Wallis test was used to compare water displacement and CT‐based volumes. There was excellent agreement between observers (intraclass correlation coefficient = 0.957; 95% confidence interval, 0.908‐0.982, P < 0.0001). No significant difference was found between the volumes obtained by CT‐volumetry using each of the stacks and the volumes obtained by water displacement. Using sagittally reformatted images and hepatic contouring in as few as nine images can be an accurate and simple method for CT‐volumetry of the canine liver.
Consumption of dietary fat causes loss of olfactory sensory neurons and associated circuitry that is not mitigated by voluntary exercise in mice
Authors: Chelette Brandon M. , Loeven Ashley M. , Gatlin Destinee N. , Landi Conde Daniel R. , Huffstetler Carley M. , Qi Meizhu , Fadool Debra Ann
Published: November 2021

Excess nutrition causes loss of olfactory sensory neurons (OSNs) and reduces odour discrimination and odour perception in mice. To separate diet‐induced obesity from the consumption of dietary fat, we designed pair‐feeding experiments whereby mice were maintained on isocaloric diets for 5 months, which prevented increased fat storage. To test our hypothesis that adiposity was not a prerequisite for loss of OSNs and bulbar projections, we used male and female mice with an odorant receptor‐linked genetic reporter (M72tauLacZ; Olfr160) to visualize neural circuitry changes resulting from elevated fat in the diet. Simultaneously we monitored glucose clearance (diagnostic for prediabetes), body fat deposition, ingestive behaviours, select inflammatory markers and energy metabolism. Axonal projections to defined olfactory glomeruli were visualized in whole‐mount brains, and the number of OSNs was manually counted across whole olfactory epithelia. After being pair fed a moderately high‐fat (MHF) diet, mice of both sexes had body weight, adipose deposits, energy expenditure, respiratory exchange ratios and locomotor activity that were unchanged from control‐fed mice. Despite this, they were still found to lose OSNs and associated bulbar projections. Even with unchanged adipocyte storage, pair‐fed animals had an elevation in TNF cytokines and an intermediate ability for glucose clearance. Albeit improving health metrics, access to voluntary running while consuming an ad libitum fatty diet still precipitated a loss of OSNs and associated axonal projections for male mice. Our results support that long‐term macronutrient imbalance can drive anatomical loss in the olfactory system regardless of total energy expenditure.

image

Key points

Obesity can disrupt the structure and function of organ systems, including the olfactory system that is important for food selection and satiety.

We designed dietary treatments in mice such that mice received fat, but the total calories provided were the same as in control diets so that they would not gain weight or increase adipose tissue.

Mice that were not obese but consumed isocaloric fatty diets still lost olfactory neuronal circuits, had fewer numbers of olfactory neurons, had an elevation in inflammatory signals and had an intermediate ability to clear glucose (prediabetes).

Mice were allowed access to running wheels while consuming fatty diets, yet still lost olfactory structures.

We conclude that a long‐term imbalance in nutrition that favours fat in the diet disrupts the olfactory system of mice in the absence of obesity.
Diagnostic of Injury Risk in the Anterior Cruciate Ligament Based on Shape Context Description of the Intercondylar Notch Curvature
Authors: Dias João Paulo , Bhuiyan Ariful , Shamim Nabila
Published: November 2021

An estimated number of 300,000 new anterior cruciate ligament (ACL) injuries occur each year in the United States. Recent studies have pointed out a correlation between the curvature of the femur intercondylar notch and the risk of noncontact ACL injury. Although several magnetic resonance (MR) imaging-based ACL diagnostics methods have already been proposed in the literature, most of them are based on machine learning or deep learning strategies, which are computationally expensive. In this paper, we propose a diagnostics framework for the risk of injury in the ACL based on the application of the inner-distance shape context (IDSC) to describe the curvature of the intercondylar notch from MR images. First, the contours of the intercondylar notch curvature from 91 MR images of the distal end of the femur (70 healthy and 21 with confirmed ACL injury) were extracted manually using standard image processing tools. Next, the IDSC was applied to calculate the similarity factor between the extracted contours and reference standard curvatures. Finally, probability density functions of the similarity factor data were obtained through parametric statistical inference, and the accuracy of the ACL injury risk diagnostics framework was assessed using receiver operating characteristic analysis (ROC). The overall results for the area under the curve (AUC) showed that the method reached a maximum accuracy of about 66%. Furthermore, the sensitivity and specificity results showed that an optimum discrimination threshold value for the similarity factor can be pursued that minimizes the incidence of false positives and false negatives simultaneously.
Growth of the intrinsic superlattice material Bi4Se3 by DC magnetron sputtering: Layered to faceted growth
Authors: Corbett Joseph P. , Brown Margaret M. , Muratore Tobin C. , Laing Ryan P. , Brown Jeff L. , Gupta Jay A. , Reed Amber N.
Published: November 2021

The Bi4Se3 system is an intrinsic superlattice of two topological materials, a 2D Bi2 sheet and a quintuple layer (QL) slab of Bi2Se3. Both the QL slab and 2D sheet host distinct topologically protected states; this, in turn, allows for the selection of the topologically protected electronic state with the choice of surface layer termination. The Bi4Se3 films were grown by direct current magnetron sputtering under an additional external magnetic field to further confine the plasma region. We developed a recipe to transition from an atomically smooth layered growth to a smooth faceted granular growth. We characterized the morphology, composition, and local crystal orientation of grown films via scanning electron microscopy, energy dispersive x-ray spectroscopy, and electron backscattered diffraction. Additionally, characterization by scanning tunneling microscopy/spectroscopy confirmed the presence of the topologically protected surface states in these films. This work buttresses the commercial scalability of sputtering materials with tunable Bi4Se3 morphology, which provides the option of tuning the surface topological state and thus expanding the possibilities for the production of devices with this material systems.
The harmonic quantum Szilárd engine
Authors: Davies P. C. W. , Thomas Logan , Zahariade George
Published: November 2021

The Szilárd engine is a mechanism (akin to Maxwell's demon) for converting information into energy, which seemingly violates the second law of thermodynamics. Originally a classical thought experiment, it was extended to a quantized treatment by Zurek. Here, we examine a new, elegant model of a quantum Szilárd engine by replacing the traditional rigid box with a harmonic potential, extending the scope of the model. Remarkably, almost all calculations are exact. This article is suitable for students, researchers, and educators interested in the conceptual links among information, entropy, and quantum measurement.
On the ubiquity of classical harmonic oscillators and a universal equation for the natural frequency of a perturbed system
Authors: Bissell J. J.
Published: November 2021

A new perspective on the ubiquity of classical harmonic oscillators is presented based on the two-variable Taylor expansion of a perturbed system's total energy E(q,q̇), where q(t) is the system displacement as a function of time t and q̇(t)=dq/dt. This generalised approach permits derivation of the lossless oscillator equation from energy arguments only, yielding a universal equation for the oscillation frequency ω=(∂2E/∂q2)/(∂2E/∂q̇2) which may be applied to arbitrary systems without the need to form system-specific linearised models. As illustrated by a range of examples, this perspective gives a unifying explanation for the prevalence of harmonic oscillators in classical physics, can be extended to include damping effects and driving forces, and is a powerful tool for simplifying the analyses of perturbed systems.
Classical and quantum confocal parabolic billiards
Authors: Villarreal-Zepeda Bárbara K. , Iga-Buitrón Héctor M. , Gutiérrez-Vega Julio C.
Published: November 2021

The classical and quantum description of a free particle moving inside a confocal parabolic billiard is studied. From a classical approach, we derive the characteristic equations for periodic trajectories, discuss the Poincaré maps, and explore interesting geometrical properties of the orbits inside the billiard. From a quantum description, we determine the eigenstates and energy spectrum of the confined particle. The confocal parabolic billiard is an integrable system that exhibits two degrees of freedom and two constants of motion. The way to establish a correspondence between the classical and quantum solutions is by equating the constants of motion for both descriptions. The parabolic billiard provides a well-motivated and relatively straightforward example of the Hamilton–Jacobi theory in a way that is seldom discussed in the undergraduate curriculum.
Therapeutic Alliance and Its Potential Application to Physical Activity Interventions for Older Adults: A Narrative Review
Authors: Powell Andrew
Published: November 2021

Increasing the physical activity (PA) levels of inactive older adults to promote healthy aging and to reduce preventable health conditions is a public health priority. However, there remains uncertainty on what constitutes the most important components and characteristics of effective PA interventions for older adults, and previous research has largely focused on the cognitive and behavioral strategies they adopt to increase uptake and adherence to PA. This narrative review puts forward the novel idea, with supporting evidence, that the strength, quality, and collaborative nature of the professional–client relationship, a concept drawn from the field of psychotherapy and known as therapeutic alliance, may be a vital and foundational element of effective PA interventions. This article will offer a new understanding, and a new direction of research to aid the future conceptualization, design, and development of interventions that aim to increase the PA levels of older adults.
Broadcaster Choice and Audience Demand for Live Sport Games: Panel Analyses of the Korea Baseball Organization
Authors: Kim Kihan , Sung Hojun , Noh Yeayoung , Lee Kimoon
Published: November 2021

This study investigated the determinants of television viewership and its relation to broadcasters’ choices of matches for live telecasts. Also, factors driving the broadcasters’ choices were examined. A panel data set from the 2018 Korea Baseball Organization league pennant race was analyzed. Broadcasters’ choice order of matches and the actual television ratings of each match were regressed on a series of antecedent factors related to the game characteristics and audience preferences. It was found that the broadcasters’ choice order of matches positively affected the television ratings, suggesting that the broadcasters’ decisions were well reflected in the actual viewership. It also appeared that broadcasters’ choices were based on popularity and team performance/quality, whereas viewers showed preference for current games’ on-field performance. There was no evidence of audience preference for games with higher outcome uncertainty, whereas the broadcasters tended to choose games with more certain, rather than uncertain, outcomes. Theoretical and practical implications of the findings were discussed.
Thirty-Second Single-Leg Stance Identifies Impaired Postural Control in Children After Concussion: A Preliminary Report
Authors: Saleem Ghazala T. , Slomine Beth S. , Suskauer Stacy J.
Published: November 2021

Context: Objective and expedient assessments of standing postural control incorporating static and dynamic tasks are necessary for identifying subtle motor deficits and clearing children to return to high-risk activities after concussion. The Revised Physical and Neurological Examination for Subtle Signs (PANESS) gaits and stations tasks evaluate both static and dynamic aspects of postural control. While the PANESS gaits and stations subscale is sensitive to concussion in youth, the benefit of each specific task for this purpose is unknown. Purpose: This study evaluated whether specific PANESS tasks identify postural impairments after youth concussion. Design: Cross-sectional study. Setting: Academicallyaffiliated research laboratory. Participants: Sixty youth, ages 10–17 years, comprised 3 groups: (1) youth symptomatic from concussion (4–14 d postinjury [n = 18]), (2) clinically-recovered youth (27–122 d postinjury [n = 15]), and (3) age- and gender-matched never-concussed controls (n = 27). Main Outcome Measure: PANESS gaits and stations tasks (6 dynamic and 3 static) at the time of the initial research visit. Results: Kruskal–Wallis statistic identified a significant main effect of group on standing on one foot (a 30-s task). Both symptomatic and clinically-recovered youth showed deficits on standing on one foot relative to controls. Conclusions: Single-leg tasks of longer duration may maximize the ability to detect residual postural deficits after concussion and can be readily incorporated in targeted sport rehabilitation protocols.
A Photoactivable Natural Product with Broad Antiviral Activity against Enveloped Viruses, Including Highly Pathogenic Coronaviruses
Authors: Meunier Thomas , Desmarets Lowiese , Bordage Simon , Bamba Moussa , Hervouet Kévin , Rouillé Yves , François Nathan , Decossas Marion , Sencio Valentin , Trottein François , Tra Bi Fézan Honora , Lambert Olivier , Dubuisson Jean , Belouzard Sandrine , Sahpaz Sevser , Séron Karin
Published: November 2021

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak has highlighted the need for broad-spectrum antivirals against coronaviruses (CoVs). Here, pheophorbide a (Pba) was identified as a highly active antiviral molecule against human CoV-229E after bioguided fractionation of plant extracts.
Randomized Controlled Study of Tenofovir versus Lamivudine Followed by Tenofovir in Severe Exacerbation of Hepatitis B
Authors: Lu Chia-Ming , Cheng Jin-Shiung , Sun Wei-Chih , Chen Wen-Chi , Tsay Feng-Woei , Wang Huay-Min , Tsai Tzung-Jiun , Kao Sung-Shuo , Li Yun-Da , Li Yuan-Rong , Lin Huey-Shyan , Yin Chun-Hao , Tsai Wei-Lun
Published: November 2021

Spontaneous severe acute exacerbation (SAE) is not uncommon in the natural history of chronic hepatitis B (CHB). Lamivudine (LAM) has the advantages of low price, quick onset, good efficacy, and no drug resistance within 24 weeks.
Solid as a rock: Tectonic control of graben extension and dike propagation
Authors: Kolzenburg S. , Kubanek J. , Dirscherl M. , Hamilton C.W. , Hauber E. , Scheidt S.P. , Münzer U.
Published: November 2021

The 2014–2015 CE rift event associated with the Bárðarbunga eruption at Holuhraun, Iceland, offers a unique opportunity to study the spatial and temporal evolution of a rift graben. We present the first four-dimensional (three-dimensional plus time) monitoring of the formation and evolution of a graben during active magma transport using a suite of digital elevation models spanning from shortly before the eruption throughout 6 months of magma transport and up to 4.5 years after the eruption. This multiscale data set enables investigations of how magma supply and eruption dynamics affect tectonic structures that feed eruptions. After formation (time scale of a few days), the graben is remarkably stable throughout the eruption and for years beyond. It is unaffected by large changes in eruptive activity and effusion and seismicity rates within the plumbing system. These data document that (1) there was no direct feedback between eruptive dynamics and graben topography, and (2) graben formation is near instantaneous on tectonic time scales. These results challenge the overarching role ascribed to magma transport in recent studies of tectonomagmatic relationships in rift events, favoring regional tectonics as the fundamental driving force.
Income support for parents of children with chronic conditions and disability: where do we draw the line? A policy review
Authors: Chua Clara , Bull Claudia , Callander Emily Joy
Published: November 2021

Objective

The aim of this review was to identify and describe whether parents who have had to stop paid employment to care for a child with a chronic condition or disability are eligible for unemployment, family and children, and disability and carer government-provided financial benefits.

Design

Policy review.

Setting

Group of seven high-income countries.

Main outcome measures

All policies related to unemployment, family and children, and disability and carer benefits were included. Information regarding the policy type and description, parent/carer qualification, amount of financial support payable, eligibility criteria and information source were extracted. Payment schedules were converted into 2020 US dollars, using Purchasing Power Parities. Maximum monthly benefit payments were compared with standardised per capita monthly costs of living to determine payment support suitability.

Results

Fifty-eight policies relevant to unemployment, family and children, and disability and carer benefit supports were identified. Germany had the highest number of welfare policies for individuals not in employment (n=11), followed by the USA (n=6). Parents or carers of children with chronic conditions or disability who were not in employment qualified for 31 of the 58 policies (53.4%). Most policies required a child to have an impaired ability to function, not just a chronic condition or disability.

Conclusions

Greater support for parents and carers to continue their paid employment alongside caring responsibilities is necessary. Graded benefit schedules will also be critical to supporting the spectrum of childhood chronic conditions and disability, and the subsequent spectrum of caring responsibility.
Group programmes for weight loss may be more effective than one-to-one sessions
Authors: Saul Helen , Gursul Deniz
Published: November 2021

The study

Abbott S, Smith E, Tighe B, Lycett D. Group versus one-to-one multi-component lifestyle interventions for weight management: a systematic review and meta-analysis of randomised controlled trials.
J Hum Nutr Diet
2021;34:485-93.

To read the full NIHR Alert, go to:
https://evidence.nihr.ac.uk/alert/group-weight-loss-programmes-more-effective-than-one-to-one-sessions/
Opportunities to catalyse improved healthcare access in pluralistic systems: a cross-sectional study in Haiti
Authors: Klarman Molly , Schon Justin , Cajusma Youseline , Maples Stace , Beau de Rochars Valery E M , Baril Chantale , Nelson Eric J
Published: November 2021

Objective

To identify determinants of intended versus actual care-seeking behaviours in a pluralistic healthcare system that is reliant on both conventional and non-conventional providers and discover opportunities to catalyse improved healthcare access.

Design

Cross-sectional study.

Setting and participants

In Haiti 568 households (incorporating 2900 members) with children less than 5 years of age were randomly sampled geographically with stratifications for population density. These households identified the healthcare providers they frequented. Among 140 providers, 65 were located and enrolled.

Outcome measures

Household questionnaires with standardised cases (intentions) were compared with self-recall of health events (behaviours). The connectedness of households and their providers was determined by network analysis.

Results

Households reported 636 health events in the prior month. Households sought care for 35% (n=220) and treated with home remedies for 44% (n=277). The odds of seeking care increased 217% for severe events (adjusted OR (aOR)=3.17; 95% CI 1.99 to 5.05; p<0.001). The odds of seeking care from a conventional provider increased by 37% with increasing distance (aOR=1.37; 95% CI 1.06 to 1.79; p=0.016). Despite stating an intention to seek care from conventional providers, there was a lack of congruence in practice that favoured non-conventional providers (McNemar’s χ2test p<0.001). Care was sought from primary providers for 68% (n=150) of cases within a three-tiered network; 25% (n=38/150) were non-conventional.

Conclusion

Addressing geographic barriers, possibly with technology solutions, should be prioritised to meet healthcare seeking intentions while developing approaches to connect non-conventional providers into healthcare networks when geographic barriers cannot be overcome.
Addressing rural and Indigenous health inequities in Canada through socially accountable health partnerships
Authors: Markham Ray , Hunt Megan , Woollard Robert , Oelke Nelly , Snadden David , Strasser Roger , Betkus Georgia , Graham Scott
Published: November 2021

Background

There are few examples of the practical application of the concepts of social accountability, as defined by the World Bank and WHO, to health system change. This paper describes a robust approach led by First Nations Health Authority and the Rural Coordination Centre of British Columbia. This was achieved using partnerships in British Columbia, Canada, where the health system features inequities in service and outcomes for rural and Indigenous populations. Social accountability is achieved when all stakeholders come together simultaneously as partners and agree on a path forward. This approach has enabled socially accountable healthcare, effecting change in the healthcare system by addressing the needs of the population.

Innovation

Our innovative approach uses social accountability engagement to counteract persistent health inequities. This involves an adaptation of the Boelen Health Partnership model (policymakers, health administrators, health professionals, academics and community members) extended by addition of linked sectors (eg, industry and not-for-profits) to the ‘Partnership Pentagram Plus’. We used appreciative inquiry and deliberative dialogue focused on the rural scale and integrating Indigenous ways of knowing along with western scientific traditions (‘two-eyed seeing’). Using this approach, partners are brought together to identify common interests and direction as a learning community. Equitable engagement and provision of space as ‘peers’ and ‘partners’ were key to this process. Groups with varying perspectives came together to create solutions, building on existing strengths and new collaborative approaches to address specific issues in the community and health services delivery. A resulting provincial table reflecting the Pentagram Plus model has fostered policies and practices over the last 3 years that have resulted in meaningful collaborations for health service change.

Conclusion

This paper presents the application of the ‘Partnership Pentagram Plus’ approach and uses appreciative inquiry and deliberative dialogue to bring about practical and positive change to rural and Indigenous communities.
What influences patient satisfaction after total knee replacement? A qualitative long-term follow-up study
Authors: Klem Nardia-Rose , Smith Anne , O'Sullivan Peter , Dowsey Michelle M , Schütze Robert , Kent Peter , Choong Peter FM , Bunzli Samantha
Published: November 2021

Objectives

To explore whether a conceptual model of patient satisfaction previously developed 1–2 years post-total knee replacement (TKR) is still relevant 3–4 years post-TKR. Specifically, (i) what is the stability in satisfaction levels 3–4 years post-TKR? and (ii) does the existing conceptual model of patient satisfaction after TKR apply at this later follow-up?

Design

A constructivist grounded theory qualitative follow-up study. The present study was theoretically governed by the findings of the initial qualitative inquiry. One-on-one semi-structured interviews were used to test the assumptions of the model developed from the findings of the previous study.

Setting

An urban Australian public hospital

Participants

From 40 people who participated in the original study, 11 participants were purposively sampled based on their level of satisfaction and factors driving satisfaction as reported in their first interview. There were six women and five men, the average time since TKR was 3 years and 5 months, and the average age at time of interview was 77 years.

Results

Satisfaction levels were mostly stable with the exception of three participants; two transitioned in a positive direction; one in a negative direction. The meaning of satisfaction and the factors that influenced satisfaction were consistent with the original findings. However, beliefs relating to the influence of ageing on persistent knee symptoms and functional limitations were more dominant in the present study.

Conclusions

The findings provide support for patient satisfaction being a multifactorial construct that is potentially modifiable over time. Clinicians may apply the conceptual model we have described to optimise satisfaction in patients up to 3–4 years post-TKR.
How do healthcare providers construe patient complexity? A qualitative study of multimorbidity in HIV outpatient clinical practice
Authors: Ben-Menahem Shiko , Sialm Anastassja , Hachfeld Anna , Rauch Andri , von Krogh Georg , Furrer Hansjakob
Published: November 2021

Introduction

Patient complexity is an increasingly used concept in clinical practice, policy debates and medical research. Yet the literature lacks a clear definition of its meaning and drivers from the health provider’s perspective. This shortcoming is problematic for clinical practice and medical education in the light of a rising number of multimorbid patients and the need for future healthcare providers that are adequately trained in treating complex patients.

Objectives

To develop an empirically grounded framework of healthcare providers’ perceptions of patient complexity and to characterise the relationship between case complexity, care complexity and provider experience as complexity-contributing factors.

Design

Qualitative study based on semistructured in-depth interviews with healthcare practitioners.

Setting

A Swiss hospital-based HIV outpatient clinic.

Participants

A total of 31 healthcare providers participated. Participants volunteered to take part and comprised 17 nurses, 8 junior physicians (interns) and 6 senior physicians (residents, fellows and attendings).

Results

Perceived patient complexity arises from the combination of case complexity drivers, the provider’s perceived controllability, and a set of complexity moderators at the levels of the patient, the care provider and the broader care context. We develop a conceptual framework that outlines key relationships among these complexity-contributing factors and present 10 key questions to help guide medical professionals in making complexity more explicit and more manageable in daily practice.

Conclusions

The framework presented in this study helps to advance a shared understanding of patient complexity. Our findings inform curriculum design and the teaching of essential skills to medical students in areas characterised by high patient complexity such as general internal medicine and geriatrics. From a policy perspective, our findings have important implications for the design of more effective healthcare interventions for complex patients.
Quantification of disparities in the distribution of lifestyle and metabolic risk factors, prevalence of non-communicable diseases and related mortality: the Belgian Health Interview Surveys 1997–2018
Authors: Mertens Elly , Sagastume Diana , Peñalvo José L
Published: November 2021

Objectives

Comprehensively measure the trends in health disparities by sociodemographic strata in terms of exposure to lifestyle and metabolic risks, and prevalence and mortality of non-communicable diseases (NCDs) during the last 20 years in Belgium.

Design

Cross-sectional analysis of periodic national-representative health interview surveys and vital statistics.

Setting

Population-based study of adult residents in Belgium between 1997 and 2018.

Participants

Adults aged 25–84 years and resident in Belgium in the years 1997 (7256 adults), 2001 (8665), 2004 (9054), 2008 (7343), 2013 (7704) and 2018 (8358).

Main outcome measure

Age-standardised prevalence rates of modifiable lifestyle risks (poor diet, smoking, excessive alcohol use and leisure-time physical inactivity), metabolic risks (high body mass index (BMI), blood pressure and cholesterol levels) and major NCDs (type 2 diabetes mellitus (T2DM), cardiovascular diseases (CVDs), cancer, asthma and chronic obstructive pulmonary disease (COPD)), with their relative health disparities across strata by age, sex, region of residence, nationality, education and income level, and according to high versus low engagement in the four lifestyle risks, calculated from a survey-weighted age-adjusted logistic regression.

Results

Greater avoidable disparities were observed between extremes of education and income strata. The most marked disparities were found for exposure to lifestyle risks (except excessive alcohol use), prevalence of high BMI as well as T2DM, asthma and COPD, with disparities of daily smoking and COPD worsening over time. Still, NCD-specific mortality rates were significantly higher among men (except asthma), residents of Wallonia and Brussels (except cerebrovascular disease), and among the native Belgians (except T2DM and asthma). High engagement in lifestyle risks was generally observed for men, residents of the region Wallonia, and among lower education and income strata. This subgroup (20%) had a worse health profile as compared with those who had a low-risk lifestyle (25%), shown by prevalence ratios varying between 1.1 and 1.6 for metabolic risks, and between 1.8 and 3.7 for CVD, asthma and COPD.

Conclusions

Improving population health, including promoting greater health equity, requires approaches to be tailored to high-risk groups with actions tackling driving root causes of disparities seen by social factors and unhealthy lifestyle.
Value, challenges and practical considerations when designing, conducting and analysing a longitudinal qualitative study in family medicine
Authors: Wanat Marta , Boylan Anne-Marie , Borek Aleksandra J
Published: November 2021

Qualitative longitudinal design has a long tradition in a variety of social science disciplines and is increasingly used in applied healthcare research, including family medicine. While there are many definitions of longitudinal qualitative research (LQR), its most common characteristics are multiple data collection points and its focus on temporality, which prioritise the study of change and continuity. Thus, LQR can provide insights into the nature, causes and consequences of change (or its absence). In this paper, we discuss the key steps and considerations related to designing and conducting LQR in family medicine and community health. These include (1) deciding on the length of data collection and timing and number of interviews, (2) planning recruitment: attrition versus oversampling, (3) approaching data collection: asking the same or different questions, (4) planning and conducting the analysis and writing up findings, and (5) conducting ethical LQR. We also highlight what LQR can offer family medicine and community health, including (1) allowing exploration of views and experiences of a variety of participants over time; (2) following participants through important transitions; (3) studying implementation of new practices, processes or interventions; (4) exploring the importance of historical change and/or macro context on individuals’ lives; and (5) developing a deeper understanding of phenomena under study. While a lot of attention has been paid to using LQR when studying patients’ and/or carers’ experiences, we highlight its value when studying a variety of actors relevant to family medicine, including healthcare professionals and policy makers.
Predictors and clinical outcomes of poor symptomatic improvement after transcatheter aortic valve replacement
Authors: Yoshijima Nobuhiro , Saito Tetsuya , Inohara Taku , Anzai Atsushi , Tsuruta Hikaru , Shimizu Hideyuki , Fukuda Keiichi , Naganuma Toru , Mizutani Kazuki , Yamawaki Masahiro , Tada Norio , Yamanaka Futoshi , Shirai Shinichi , Tabata Minoru , Ueno Hiroshi , Takagi Kensuke , Watanabe Yusuke , Yamamoto Masanori , Hayashida Kentaro
Published: November 2021

Objective

Transcatheter aortic valve replacement (TAVR) improves clinical symptoms in most patients with severe aortic stenosis (AS). However, some patients do not benefit from the symptom-reducing effects of TAVR. We assessed the predictors and clinical outcomes of poor symptomatic improvement (SI) after TAVR.

Methods

A total of 1749 patients with severe symptomatic AS undergoing transfemoral TAVR were evaluated using the Japanese multicentre TAVR registry. Poor SI was defined as readmission for heart failure (HF) within 1 year after TAVR or New York Heart Association (NYHA) class ≥3 after 1 year. A logistic regression model was used to identify predictors of poor SI. One-year landmark analysis after TAVR was used to evaluate the association between poor SI and clinical outcomes.

Results

Among the overall population (mean age, 84.5 years; female, 71.3%; mean STS score, 6.3%), 6.6% were categorised as having poor SI. Atrial fibrillation, chronic obstructive pulmonary disease, Clinical Frailty Scale ≥4, chronic kidney disease and moderate to severe mitral regurgitation were independent predictors of poor SI. One-year landmark analysis demonstrated that poor SI had a higher incidence of all-cause death and readmission for HF compared with SI (p<0.001). Poor SI with preprocedural NYHA class 2 had a worse outcome than SI with preprocedural NYHA class ≥3.

Conclusions

Poor SI was associated with worse outcomes 1 year after the procedure. It had a greater impact on clinical outcomes than baseline symptoms. TAVR may be challenging for patients with many predictors of poor SI.

Trial registration number

This registry, associated with the University Hospital Medical Information Network Clinical Trials Registry, was accepted by the International Committee of Medical Journal Editors (UMIN-ID: 000020423).
What gets resident physicians stressed and how would they prefer to be supported? A best–worst scaling study
Authors: Wu Andrew , Parris Ritika S , Scarella Timothy M , Tibbles Carrie D , Torous John , Hill Kevin P
Published: November 2021

Introduction

Physician burnout has severe consequences on clinician well-being. Residents face numerous work-stressors that can contribute to burnout; however, given specialty variation in work-stress, it is difficult to identify systemic stressors and implement effective burnout interventions on an institutional level. Assessing resident preferences by specialty for common wellness interventions could also contribute to improved efficacy.

Methods

This cross-sectional study used best–worst scaling (BWS), a type of discrete choice modelling, to explore how 267 residents across nine specialties (anaesthesiology, emergency medicine, internal medicine, neurology, obstetrics and gynaecology, pathology, psychiatry, radiology and surgery) prioritised 16 work-stressors and 4 wellness interventions at a large academic medical centre during the COVID-19 pandemic (December 2020).

Results

Top-ranked stressors were work-life integration and electronic health record documentation. Therapy (63%, selected as ‘would realistically consider intervention’) and coaching (58%) were the most preferred wellness supports in comparison to group-based peer support (20%) and individual peer support (22%). Pathology, psychiatry and OBGYN specialties were most willing to consider all intervention options, with emergency medicine and internal medicine specialties least willing to consider intervention options.

Conclusion

BWS can identify relative differences in surveyed stressors, allowing for the generation of specialty-specific stressor rankings and preferences for specific wellness interventions that can be used to drive institution-wide changes to improve clinician wellness. BWS surveys are a potential methodology for clinician wellness programmes to gather specific information on preferences to determine best practices for resident wellness.
A feasible and practically secure quantum bit commitment protocol
Authors: Li Li , Shi Run-Hua
Published: November 2021

As a fundamental cryptographic primitive, bit commitment has lots of important and practical applications in modern cryptography. All previously proposed non-relativistic quantum bit commitment protocols cannot evade the Lo–Chau and Mayers attacks. Furthermore, relativistic quantum bit commitment protocols require rigorous spacetime constraints. In this paper, we present a simple, feasible but practically secure quantum bit commitment protocol without any spacetime constraint. The security of the proposed protocol is based on non-relativistic quantum mechanics, but it can resist all known attacks, including the Lo–Chau and Mayers attacks in practice.
Theory space of one unitary matrix model and its critical behavior associated with Argyres–Douglas theory
Authors: Itoyama H. , Yano Katsuya
Published: November 2021

The lowest critical point of one unitary matrix model with cosine plus logarithmic potential is known to correspond with the [Formula: see text] Argyres–Douglas (AD) theory and its double scaling limit derives the Painlevé II equation with parameter. Here, we consider the critical points associated with all cosine potentials and determine the scaling operators, their vacuum expectation values (vevs) and their scaling dimensions from perturbed string equations at planar level. These dimensions agree with those of [Formula: see text] AD theory.
Optical solitons for the Kaup–Newell equation by collective variables method
Authors: Al Qarni A. A. , Alshaery A. A. , Bakodah H. O.
Published: November 2021

In this work, we present a collective variable (CV) approach to establish dispersive solitary wave solutions for the Kaup–Newell Equation (KNE). The full CV theory has been utilized to enunciate the soliton molecules through its ground-laying parameters including the power of each pulse, phase and center-of-mass. Additionally, the dynamics of an ultra short pulse has been analyzed by using CV. This work may be utilized for various dynamics of solitons as well as the influence the amplitude, temporal position, frequency, phase and chirp on the solitons’ nonlinear parameters. Moreover, the numerical simulations have been designed by means of appropriate parameter values to explain more on the obtained results.
Propagation of new dynamics of longitudinal bud equation among a magneto-electro-elastic round rod
Authors: Khater Mostafa M. A. , Jhangeer Adil , Rezazadeh Hadi , Akinyemi Lanre , Akbar M. Ali , Inc Mustafa
Published: November 2021

In this survey, structure solutions for the longitudinal suspense equation within a magneto-electro-elastic (MEE) circular judgment are extracted via the implementation of two one-of-a-kind techniques that are viewed as the close generalized technique in its field. This paper describes the dynamics of the longitudinal suspense within a MEE round rod. Nilsson and Lindau provided the visual proof of the arrival concerning longitudinal waves within thin metal films. They recommended removal of anomalies between the ports concerning emaciated ([Formula: see text] Å) Ag layers preserved on amorphous silica because of being mildly [Formula: see text]-polarized at frequency tier according to the brawny plasma frequency. Anomalies have been due to confusion over the longitudinal waves mirrored utilizing the two borders. The wavelength is connected according to this wave’s property, which is an awful lot smaller than the wave over light. The wave is outstanding only for altogether superfine films. However, metallic movies defended amorphous substrates that are intermittent within the forward levels of their evolution. This made researchers aware of the possibility on getting ready altogether few layers with a desire to discussing the promulgation about longitudinal waves up to expectation colorful each among reverberation or transport on [Formula: see text]-polarized light. The mated options via the use of generalized Riccati equation mapping method or generalized Kudryashov technique show the rule and effectiveness regarding its methods then its ability because of applying one kind of forms over nonlinear incomplete differential equations.