bluuebunny/crossref_metadata_2025 huggingface dataset:
Structured light for touchless 3D registration in video-based surgical navigation
Authors: Baptista Tânia , Marques Miguel , Raposo Carolina , Ribeiro Luís , Antunes Michel , Barreto Joao P.
Published: May 2024

Purpose

Arthroscopic surgery, with its inherent difficulties on visibility and maneuverability inside the joint, poses significant challenges to surgeons. Video-based surgical navigation (VBSN) has proven to have clinical benefits in arthroscopy but relies on a time-consuming and challenging surface digitization using a touch probe to accomplish registration of intraoperative data with preoperative anatomical models. This paper presents an off-the-shelf laser scanner for noninvasive registration that enables an increased area of reachable region.

Methods

Our solution uses a standard arthroscope and a light projector with visual markers for real-time extrinsic calibration. Nevertheless, the shift from a touch probe to a laser scanner introduces a new challenge—the presence of a significant amount of outliers resulting from the reconstruction of nonrigid structures. To address this issue, we propose to identify the structures of interest prior to reconstruction using a deep learning-based semantic segmentation technique.

Results

Experimental validation using knee and hip phantoms, as well as ex-vivo data, assesses the laser scanner’s effectiveness. The integration of the segmentation model improves results in ex-vivo experiments by mitigating outliers. Specifically, the laser scanner with the segmentation model achieves registration errors below 2.2 mm, with the intercondylar region exhibiting errors below 1 mm. In experiments with phantoms, the errors are always below 1 mm.

Conclusion

The results show the viability of integrating the laser scanner with VBSN as a noninvasive and potential alternative to traditional methods by overcoming surface digitization challenges and expanding the reachable region. Future efforts aim to improve hardware to further optimize performance and applicability in complex procedures.
Engineering punching shear strength of flat slabs predicted by nature-inspired metaheuristic optimized regression system
Authors: Truong Dinh-Nhat , To Van-Lan , Truong Gia Toai , Jang Hyoun-Seung
Published: May 2024

Reinforced concrete (RC) flat slabs, a popular choice in construction due to their flexibility, are susceptible to sudden and brittle punching shear failure. Existing design methods often exhibit significant bias and variability. Accurate estimation of punching shear strength in RC flat slabs is crucial for effective concrete structure design and management. This study introduces a novel computation method, the jellyfish-least square support vector machine (JS-LSSVR) hybrid model, to predict punching shear strength. By combining machine learning (LSSVR) with jellyfish swarm (JS) intelligence, this hybrid model ensures precise and reliable predictions. The model’s development utilizes a real-world experimental data set. Comparison with seven established optimizers, including artificial bee colony (ABC), differential evolution (DE), genetic algorithm (GA), and others, as well as existing machine learning (ML)-based models and design codes, validates the superiority of the JS-LSSVR hybrid model. This innovative approach significantly enhances prediction accuracy, providing valuable support for civil engineers in estimating RC flat slab punching shear strength.
Low-dose azithromycin prophylaxis in patients with atrial fibrillation and chronic obstructive pulmonary disease
Authors: Bucci Tommaso , Wat Dennis , Sibley Sarah , Wootton Dan , Green David , Pignatelli Pasquale , Lip Gregory Y. H. , Frost Freddy
Published: May 2024

Low-dose azithromycin prophylaxis is associated with improved outcomes in people suffering frequent exacerbations of chronic obstructive pulmonary disease (COPD), but the use of macrolides in patients with cardiovascular disease has been debated. To investigate the risk of adverse events after COPD exacerbations in patients with atrial fibrillation (AF) treated with azithromycin prophylaxis. Retrospective cohort study within the TriNetX Platform, including AF patients with COPD exacerbations. Risks of primary and secondary outcomes were recorded up to 30 days post-COPD exacerbations and compared between azithromycin users and azithromycin non-users. The primary outcomes were the risks for a composite of (1) cardiovascular (all-cause death, heart failure, ventricular arrhythmias, ischemic stroke, myocardial infarction, and cardiac arrest), and (2) hemorrhagic events (intracranial hemorrhage (ICH), and gastro-intestinal bleeding). Cox-regression analyses compared outcomes between groups after propensity score matching (PSM). After PSM, azithromycin users (n = 2434, 71 ± 10 years, 49% females) were associated with a lower 30-day risk of post-exacerbation cardiovascular (HR 0.67, 95% CI 0.61–0.73) and hemorrhagic composite outcome (HR 0.45, 95% CI 0.32–0.64) compared to azithromycin non-users (n = 2434, 72 ± 11 years, 51% females). The beneficial effect was consistent for each secondary outcomes, except ICH. On sensitivity analyses, the reduced risk of adverse events in azithromycin users was irrespective of smoking status, exacerbation severity, and type of oral anticoagulation. Azithromycin prophylaxis is associated with a lower risk of all-cause death, thrombotic and hemorrhagic events in AF patients with COPD. The possible role of azithromycin prophylaxis as part of the integrated care management of AF patients with COPD needs further study.
Placenta-targeted Treatment Strategies for Preeclampsia and Fetal Growth Restriction: An Opportunity and Major Challenge
Authors: Cui Jianjian , Yang Zejun , Ma Ruilin , He Wencong , Tao Hui , Li Ya’nan , Zhao Yin
Published: May 2024

The placenta plays a crucial role in maintaining normal pregnancy. The failure of spiral artery remodeling (SAR) is a key factor leading to placental ischemia and poor perfusion which is strongly associated with obstetric diseases, including preeclampsia (PE) and fetal growth restriction (FGR). Existing interventions for PE and FGR are limited and termination of pregnancy is inevitable when the maternal or fetus condition deteriorates. Considering the safety of the mother and fetus, treatments that may penetrate the placental barrier and harm the fetus are not accepted. Developing targeted treatment strategies for these conditions is urgent and necessary. With the proven efficacy of targeted therapy in treating conditions such as endometrial cancer and trophoblastic tumors, research on placental dysfunction continues to deepen. This article reviews the studies on placenta-targeted treatment and drug delivery strategies, summarizes the characteristics proposes corresponding improvement measures in targeted treatment, provides solutions for existing problems, and makes suggestions for future studies.

Graphical abstract
Adherence to the dietary approaches to stop hypertension diet reduces the risk of diabetes mellitus: a systematic review and dose-response meta-analysis
Authors: Quan Xiyan , Shen Xiaoming , Li Chun , Li Yayuan , Li Tiangang , Chen Baifan
Published: May 2024

Background

Despite several epidemiological studies reporting a significant association between adherence to the Dietary Approaches to Stop Hypertension (DASH) diet and the risk of diabetes mellitus, the results remain controversial. In this systematic review and meta-analysis, we aimed to summarize the existing evidence from published observational studies and evaluate the dose-response relationship between adherence to the DASH diet and diabetes mellitus risk.

Methods

We performed a systematic search for relevant articles published up to September 2023 using electronic databases of PubMed, Embase, Scopus, and China National Knowledge Infrastructure (CNKI). A random-effects model was applied to calculate the combined relative risks (RR) with 95% confidence intervals (CIs) for the highest compared to the lowest categories of DASH score in relation to diabetes mellitus risk. Heterogeneity among the included studies was assessed using the Cochran’s Q test and I-squared (I2) statistic. Literature search, study selection, data extraction, and quality assessment were performed by two independent reviewers.

Results

Fifteen studies involving 557,475 participants and 57,064 diabetes mellitus cases were eligible for our analyses. Pooled analyses from included studies showed that high adherence to the DASH diet was significantly associated with a reduced risk of diabetes mellitus (RR: 0.82; 95% CI: 0.76–0.90, P < 0.001). Moreover, the dose-response meta-analysis revealed a linear trend between adherence to the DASH diet and diabetes mellitus (RR:0.99; 95%CI: 0.97–1.02, Pdose-response = 0.546, Pnonlinearity = 0.701). Subgroup analyses further revealed a significant inverse association between adherence to the DASH diet and diabetes mellitus risk in case-control studies (RR: 0.65; 95%CI: 0.29–1.43, P < 0.001), with a marginal inverse association in cohort studies (RR:0.83; 95%CI: 0.76–0.91, P < 0.001). Additionally, we conducted analyses separately by comparison and found a significant inverse association between DASH diet and diabetes mellitus risk in T3 vs T1 comparison studies (RR = 0.74; 95%CI: 0.64–0.86, P = 0.012).

Conclusion

The findings of this study demonstrate a protective association between adherence to the DASH diet and risk of diabetes mellitus. However, further prospective cohort studies and randomized controlled trials are needed to validate these findings.
Support from Physicians as a Key Enabling Factor for Rehabilitation Utilization in Migrants with Back Pain: A Longitudinal Analysis
Authors: Banaschak Hannes , Fauser David , Sternberg Annika , Zimmer Julia-Marie , Golla André , Mau Wilfried , Bethge Matthias
Published: May 2024

In Germany, medical rehabilitation is provided to promote work ability and health in the case of chronic illness and to avoid early disability pensions. Studies have shown that employees with a history of migration are less likely to seek medical rehabilitation. The aim of this paper was to examine which factors influence the use of medical rehabilitation services in migrants with back pain.

We used data from a German cohort study also including migrant employees aged 45 to 59 years. Participants reported back pain in the last 3 months and completed a baseline questionnaire in 2017. Data on rehabilitation utilization was extracted from administrative records covering the period until the end of 2018. Proportional hazard models were fitted to identify factors that were associated with utilized rehabilitation measures.

Data of 552 participants were included, and 25 individuals utilized rehabilitation during follow-up. Sex (women: HR = 3.05; 95% CI: 1.10; 8.45), higher job insecurity (HR = 1.02; 95% CI: 1.00; 1.03), support from physicians and therapists (HR = 2.22; 95% CI: 1.52; 3.24), proportion of foreigners (HR = 3.27; 1.17; 9.15), and the self-reported need for rehabilitation (HR = 3.23; 95% CI: 1.12; 8.60) were associated with utilization.

In summary, informational and practical support provided by physicians and therapists on medical rehabilitation services seems to be a key predictor of rehabilitation utilization. Our findings, therefore, support the call for transcultural competence to be more widely incorporated into the education of medical and health professionals to counteract health care disparities.
Trade-offs and synergies of digital choice environments: Towards a taxonomy and configurational model
Authors: Gottschewski-Meyer Phillip Oliver , Auf der Landwehr Marvin , Lüddemann Nicole , von Viebahn Christoph
Published: May 2024

The advancing digitalization of daily life has led to an increasing number of choices in the digital sphere. User interfaces that require either a judgment or a decision, the so-called digital choice environments (DCEs), are essential focal points for interventions to alter behaviors towards individual or societal welfare. However, there is a lack of descriptive and prescriptive knowledge within the field of DCEs. In this research, we follow a multi-stage approach to classify the characteristics of DCEs from a choice-centric viewpoint and disclose configurational trade-offs. To achieve this, we first build a taxonomy of DCEs that we validate through expert interviews. Subsequently, we use cluster analysis to identify four configurations of DCEs, which serve as the basis for the development of a configurational model that outlines configuration-specific user outcomes. Our results contribute to the existing knowledge of digital value creation as well as the explanatory understanding of trade-offs among different DCEs.
The Health Benefits of Probiotic Lactiplantibacillus plantarum: A Systematic Review and Meta-Analysis
Authors: Aljohani Amal , Rashwan Noha , Vasani Shruti , Alkhawashki Ahmed , Wu Tong Tong , Lu Xingyi , Castillo Daniel A. , Xiao Jin
Published: May 2024

To ensure effective administration of probiotics in clinical practice, it is crucial to comprehend the specific strains and their association with human health. Therefore, we conducted a systematic review and meta-analysis to evaluate the scientific evidence on the impact of Lactiplantibacillus plantarum probiotic consumption on human health. Out of 11,831 records, 135 studies were assessed qualitatively, and 18 studies were included in the meta-analysis. This systematic review demonstrated that probiotic supplementation with L. plantarum, either alone or in combination, can significantly improve outcomes for patients with specific medical conditions. Meta-analysis revealed notable benefits in periodontal health, evidenced by reduced pocket depth and bleeding on probing (p < 0.001); in gastroenterological health, marked by significant reductions in abdominal pain (p < 0.001); and in infectious disease, through a reduction in C-reactive protein levels (p < 0.001). Cardiovascular benefits included lowered total cholesterol and low-density lipoprotein cholesterol in the L. plantarum intervention group (p < 0.05). Our study’s clinical significance highlights the importance of considering probiotic strain and their application to specific diseases when planning future studies and clinical interventions, emphasizing the need for further research in this area.
Predicting Mechanical Properties in Geopolymer Mortars, Including Novel Precursor Combinations, Through XGBoost Method
Authors: Yilmaz Yildiran , Cakmak Talip , Kurt Zafer , Ustabas Ilker
Published: May 2024

Concrete is the most widely used material in the building industry due to its affordability, durability, and strength. However, considering carbon emissions, it is believed that concrete will be replaced by geopolymers in the future. As numerous parameters significantly affect the strength of geopolymers, the performance of potential algorithms for strength prediction needs to be evaluated for different binders to select an appropriate algorithm. This study employs machine learning approaches to provide the best prediction method for the flexural strength and compressive strength of geopolymers. A new dataset containing 533 compressive strength and 533 flexural strength values of geopolymers with different binders such as waste glass (GW), obsidian (OB), and fly ash was created. The best prediction solution, with R
2 = 0.981 for compressive strength and R
2 = 0.898 for flexural strength, was obtained from the extreme gradient boosting (XGBoost) algorithm. Additionally, several other machine learning models were employed, including linear regression, k-nearest neighbors, deep neural network, and random forest, with corresponding determination coefficient (R
2) values of 0.763, 0.804, 0.93, and 0.96, respectively. These models were trained and evaluated using a dataset encompassing features such as binder types, age, and heat, to forecast the mechanical properties of geopolymers. Among these models, XGBoost demonstrated the highest R
2 value, indicating superior performance in predicting both compressive and flexural strengths. The findings of this study provide valuable insights into the selection of appropriate machine learning algorithms for predicting mechanical properties in geopolymers, thus contributing to advancements in sustainable construction materials.
Machine Learning to Predict Adult Cochlear Implant Candidacy
Authors: Patro Ankita , Freeman Michael H. , Haynes David S.
Published: May 2024

Purpose of Review

The purpose of this review is to summarize candidacy criteria and commonly used referral guidelines for adult cochlear implant (CI) patients. This review describes how machine learning can be used to predict CI candidacy and the potential impact of an automated referral guideline.

Recent Findings

Less than 2% of eligible adults are receiving CIs under traditional and expanded candidacy criteria. Lack of understanding of referral criteria, both among providers and patients, significantly contributes to the underutilization of CIs. Recently, a novel machine learning-based CI referral algorithm has been developed that shows high sensitivity, specificity, and accuracy in predicting CI candidacy among adults.

An automated, machine learning-based referral guideline can mitigate the lack of clarity regarding when to refer a patient and help bridge the large gap in CI care delivery that currently exists. Future research needs to externally validate such an algorithm and evaluate its uptake in routine clinical settings.
Evaluating the Impact of Learner Control and Interactivity in Conversational Tutoring Systems for Persuasive Writing
Authors: Wambsganss Thiemo , Benke Ivo , Maedche Alexander , Koedinger Kenneth , Käser Tanja
Published: May 2024

Conversational tutoring systems (CTSs) offer a promising avenue for individualized learning support, especially in domains like persuasive writing. Although these systems have the potential to enhance the learning process, the specific role of learner control and inter- activity within them remains underexplored. This paper introduces WritingTutor, a CTS designed to guide students through the pro- cess of crafting persuasive essays, with a focus on varying levels of learner control. In an experimental study involving 96 students, we evaluated the effects of high-level learner control, encompassing con- tent navigation and interface appearance control, against a benchmark version of WritingTutor without these features and a static, non- interactive tutoring group. Preliminary findings suggest that tutoring and learner control might enhance the learning experience in terms of enjoyment, ease-of-use, and perceived autonomy. However, these differences are not significant after pair-wise comparison and appear not to translate to significant differences in learning outcomes. This research contributes to the understanding of learner control in CTS, offering empirical insights into its influence on the learning experience.
Screening the optimal Cox/CeO2(110) (x = 1–6) catalyst for methane activation in coalbed gas
Authors: Huang Li’nan , Li Danyang , Jiang Lei , Li Zhiqiang , Tian Dong , Li Kongzhai
Published: May 2024

The challenges posed by energy and environmental issues have forced mankind to explore and utilize unconventional energy sources. It is imperative to convert the abundant coalbed gas (CBG) into high value-added products, i.e., selective and efficient conversion of methane from CBG. Methane activation, known as the “holy grail”, poses a challenge to the design and development of catalysts. The structural complexity of the active metal on the carrier is of particular concern. In this work, we have studied the nucleation growth of small Co clusters (up to Co6) on the surface of CeO2(110) using density functional theory, from which a stable loaded Co/CeO2(110) structure was selected to investigate the methane activation mechanism. Despite the relatively small size of the selected Co clusters, the obtained Cox/CeO2(110) exhibits interesting properties. The optimized Co5/CeO2(110) structure was selected as the optimal structure to study the activation mechanism of methane due to its competitive electronic structure, adsorption energy and binding energy. The energy barriers for the stepwise dissociation of methane to form CH3*, CH2*, CH*, and C* radical fragments are 0.44, 0.55, 0.31, and 1.20 eV, respectively, indicating that CH* dissociative dehydrogenation is the rate-determining step for the system under investigation here. This fundamental study of metal-support interactions based on Co growth on the CeO2(110) surface contributes to the understanding of the essence of Co/CeO2 catalysts with promising catalytic behavior. It provides theoretical guidance for better designing the optimal Co/CeO2 catalyst for tailored catalytic reactions.
RETRACTED ARTICLE: Multiclass skin lesion classification using deep learning networks optimal information fusion
Authors: Khan Muhammad Attique , Hamza Ameer , Shabaz Mohammad , Kadry Seifeine , Rubab Saddaf , Bilal Muhammad Abdullah , Akbar Muhammad Naeem , Kesavan Suresh Manic
Published: May 2024

A serious, all-encompassing, and deadly cancer that affects every part of the body is skin cancer. The most prevalent causes of skin lesions are UV radiation, which can damage human skin, and moles. If skin cancer is discovered early, it may be adequately treated. In order to diagnose skin lesions with less effort, dermatologists are increasingly turning to machine learning (ML) techniques and computer-aided diagnostic (CAD) systems. This paper proposes a computerized method for multiclass lesion classification using a fusion of optimal deep-learning model features. The dataset used in this work, ISIC2018, is imbalanced; therefore, augmentation is performed based on a few mathematical operations. After that, two pre-trained deep learning models (DarkNet-19 and MobileNet-V2) have been fine-tuned and trained on the selected dataset. After training, features are extracted from the average pool layer and optimized using a hybrid firefly optimization technique. The selected features are fused in two ways: (i) original serial approach and (ii) proposed threshold approach. Machine learning classifiers are used to classify the chosen features at the end. Using the ISIC2018 dataset, the experimental procedure produced an accuracy of 89.0%. Whereas, 87.34, 87.57, and 87.45 are sensitivity, precision, and F1 score respectively. At the end, comparison is also conducted with recent techniques, and it shows the proposed method shows improved accuracy along with other performance measures.
The mediating role of self-directed ageism on frailty and quality of life in community-dwelling older people
Authors: Vanleerberghe Patricia , Claes Claudia , Campens Jorrit , Verté Dominique , De Witte Nico
Published: May 2024

Purpose

The purpose of this study was to explore the role of self-directed ageism in the relationship between frailty and quality of life in community-dwelling older adults.

Methods

Secondary data-analysis on data from the Belgian Ageing Studies. A stratified sample of 1895 participants, based on census data by gender and age, was drawn between 2017 and 2019. Frailty, quality of life and self-directed ageism were assessed by the Comprehensive Frailty Assessment Instrument, a numeric rating scale and a newly developed self-directed ageism scale, respectively. The validity of this new scale was assessed by exploratory factor analysis, while mediation analysis was used to explore if self-directed ageism mediates the relationship between frailty and quality of life.

Results

The self-directed ageism scale proved highly reliable (Cronbach’s α = 0.898, Spearman-Brown = 0.906), explaining 58.86% of the variance in self-directed ageism. Respondents scored an average of 23.6 on 40 for self-directed ageism, 26.94 on 100 for frailty, and a median of 8 on 10 for quality of life. Mediation analysis showed that frailty negatively correlates with quality of life, and that this relationship is partially mediated by self-directed ageism.

Conclusion

Most respondents were identified as mild frail, experienced self-directed ageism, and those 80 or older rated their quality of life lower. The present study showed that frailty negatively correlates with quality of life and this relationship is partially mediated by self-directed ageism. We conclude that every effort should be made to prevent frailty, ageism and self-directed ageism as they impact community-dwelling older people’s quality of life.
Quality aspects of marula (Sclerocarya birrea) fruit, nutritional composition, and the formation of value-added products for human nutrition: a review
Authors: Lekhuleni Isobel Lerato , Shabalala Ayanda , Maluleke Mdungazi K.
Published: May 2024

The review aimed to explore the reported biochemical, nutritional, and quality aspects of marula fruit and its value-added products for enhancement of human nutrition. Marula (Sclerocarya birrea) fruit is one of the underutilised indigenous fruits that grows naturally across the northern and eastern regions of Southern Africa. A search on Google Scholar, Scopus, Science Direct, and Web of Science databases was conducted in September and November of 2023. Use the following search “terms’’ to find relevant literature: “Marula fruit, underutilised African fruit crops, “Nutritional composition of marula fruit”, “biochemical constituents of marula fruit, “marula fruit value-added products, function in human health and nutrition”. Available literature shows that almost every part of a tree, namely the leaves, bark, roots, and fruit, have known nutritional benefits for human health and nutrition. The fruit contains valuable biochemical constituents such as vitamin C, carotene, flavonoids, phenols, calcium, magnesium, iron, and zinc. Its value-added products, such as alcoholic beverages, juice, jam, and nuts, contain biochemical constituents with potential enrichment of human health and nutrition, endorsing a compelling case for potential commercialisation globally. The different nutritional and biochemical properties were compared against the human recommended daily intake to determine their potential role in human health and nutrition. The study reveals that the marula fruit and its value-added products may be vital in providing the required nutrients to meet human nutritional daily needs and could play a pivotal role in accelerating the Sustainable Development Goals 1 and 2 (no poverty and zero hunger). Therefore, there is a need for more research on agroprocessing of marula fruit to create nutritious value-added products, for potential commercialisation. As a result, the objective of the study was to examine the literature on the biochemical components of marula fruit and its value-added products, comparing them to the daily recommended intake, while assessing their possible significance in human nutrition for possible commercialisation.
Transcriptional modules and hormonal metabolic pathways reveal the critical role of TgHB12-like in the regulation of flower opening and petal senescence in Tulipa gesneriana
Authors: Meng Lin , Yang Haipo , La Yue , Wu Yikun , Ye Tiantian , Wang Yaping , Xiang Lin , Qu Lianwei , Chan Zhulong , Wang Yanping
Published: May 2024

Tulips (Tulipa gesneriana) are one of the most widely cultivated bulbous plants with substantial ornamental value. However, the lack of well-documented reference genomes has limited the research progress and molecular breeding of tulips. In the present study, a full-length transcriptome of a commercial tulip cultivar was obtained using single-molecule long-read sequencing (PacBio Iso-Seq). In total, 244,357 full-length transcripts were identified, which had an average length of 2,044 bp and an N50 value of 3,861; 67,350 of these were annotated to databases. An inaugural integrated analysis of the transcriptome and phytohormone profiles during flower opening and petal senescence was performed using Illumina RNA-seq, coupled with Mfuzz (an R pakage, http://mfuzz.sysbiolab.eu) and weighted gene coexpression network analysis (WGCNA). A total of 16 gene coexpression and six transcription factor (TF) modules were constructed. Additionally, 26 hormone analogs were comprehensively profiled. Finally, a prominently novel gene, Tulipa gesneriana Homeobox12-like (TgHB12-like), which encodes an homeodomain–leucine zipper (HD-zip) TF, was identified as a pivotal regulator of petal senescence. Overall, this work facilitates the identification of hormones and TFs in plants related to flower opening and senescence in tulips. It also provides an important and valuable genetic basis for further research in them.
Informational Nudges to Promote Preferences for Goat Meat
Authors: Hambaryan Meri , Lai John , Kassas Bachir
Published: May 2024

Goat meat consumption has grown in recent years due to dietary and cultural changes. US demand has surpassed domestic supply, presenting an opportunity for industry expansion. This study provides valuable insights into consumer preferences for goat meat. A sample of 1,015 Floridians was randomly assigned to a control and three treatment groups that included information about the health and/or environmental benefits of goat meat. Results show a significant difference in willingness to pay for goat meat under different information treatments. Persuasive marketing campaigns can increase consumers’ preferences for goat meat by raising awareness of the health and environmental benefits.
Moving from prove to improve: A collaborative continuous quality improvement process for advancing Clinical and Translational Science
Authors: Fishman Ariel Y. , Lounsbury David W. , Lechuga Claudia , Patena John , Marantz Paul , Kim Mimi , Keller Marla J.
Published: May 2024

Structured processes to improve the quality and impact of clinical and translational research are a required element of the Clinical and Translational Sciences Awards (CTSA) program and are central to awardees’ strategic management efforts. Quality improvement is often assumed to be an ordinary consequence of evaluation programs, in which standardized metrics are tabulated and reported externally. Yet evaluation programs may not actually be very effective at driving quality improvement: required metrics may lack direct relevance; they lack incentive to improve on areas of relative strength; and the validity of inter-site comparability may be limited. In this article, we describe how we convened leaders at our CTSA hub in an iterative planning process to improve the quality of our CTSA program by intentionally focusing on how data collection activities can primarily advance continuous quality improvement (CQI) rather than strictly serve as evaluative tools. We describe our CQI process, which consists of three key components: (1) Logic models outlining goals and associated mechanisms; (2) relevant metrics to evaluate performance improvement opportunities; and (3) an interconnected and collaborative CQI framework that defines actions and timelines to enhance performance.
Perceived Political Polarization and its Differential Impact on Political Participation: Evidence from Japan (2005–2019)
Authors: Yin Yue
Published: May 2024

Political polarization has been a growing concern in Japan, particularly in recent years with the upsurge of nationalism and populism. However, little research has examined how it relates to the political behavior of the Japanese people. Using data from the 2005–2019 Japanese Electoral Studies (JES), this study shows that political polarization manifests itself in different ways depending on the specific policy domains that citizens perceive as divergent. Specifically, I discover that people who perceive higher levels of policy divergence between left- and right-wing parties on domestic and international policies are more likely to vote and participate in politics through publicly accessible networks, while there appears to be no evidence showing that perceiving high levels of policy divergence on economic issues has a meaningful effect on any type of political participation. Implications of these findings as well as directions for future research are discussed.
Rheological measurements and transition to turbulence for moderate Reynolds number inertial suspensions
Authors: Song Yichuan , Hunt Melany L.
Published: May 2024

Particulate flows at moderate particle Reynolds numbers are important in critical engineering and geological applications. This experimental study explores neutrally buoyant suspensions in an outer-rotating coaxial rheometer for solid fractions,$\phi$, from 0.1 to 0.5, and particle Reynolds number,$Re$, from 0.5 to 800, covering laminar, transitional and turbulent regimes;$Re$is defined in terms of the square of the particle diameter and the shear rate. For$0.1 < \phi < 0.4$and$0.5 < Re <10$, the direct torque measurements normalised by the laminar flow torque,$M/M_{lam}$, are independent of$Re$, but depend on$\phi$. For the same range of$\phi$and for$10< Re<100$, the normalised torques depend on both$\phi$and$Re$, and show an increasing dependence on$Re$. As$Re$increases, the flow transitions to turbulence. Small particles delay the turbulent transition for$\phi \leqslant 0.3$, while large particles augment the transition. A modified Reynolds number,$Re^\prime$, that depends linearly on the particle diameter and the maximum velocity,$U_{o}$, is introduced for both laminar and turbulent flows and shows a better correlation of the results as compared with$Re$. For$\phi = 50\,\%$, the normalised torque minus the torque at zero rotational speed is nearly independent of$Re^\prime$. Rheological models based on$Re^\prime$and the Krieger–Dougherty relative viscosity are proposed in the laminar regime for$10< Re^\prime <500$; in the turbulent regime, a correlation is proposed in terms of$Re^\prime$and$\phi$for$1000< Re^\prime < 6000$.
Physician-Based Approaches to Price Transparency: A Solution in Search of a Problem?
Authors: Glied Sherry
Published: May 2024

Physician-based transparency approaches have been advanced as a strategy for informing patients of the likely financial consequences of using services. The structure of health care pricing and insurance coverage, and the low uptake of existing tools, suggest these approaches are likely to be unwieldy and unsuccessful. They may also generate new ethical challenges.
A Rule-Based Solution to Opaque Medical Billing in the U.S.
Authors: Bobier Christopher A.
Published: May 2024

Patients and physicians do not know the cost of medical procedures. Opaque medical billing thus contributes to exorbitant, rising medical costs, burdening the healthcare system and individuals. After criticizing two proposed solutions to the problem of opaque medical billing, I argue that the Centers for Medicare and Medicaid Services should pursue a rule requiring that patients be informed by the physician of a reasonable out-of-pocket expense estimate for non-urgent procedures prior to services rendered.
“A Most Equitable Drug”: How the Clinical Studies of Convalescent Plasma as a Treatment for SARS-CoV-2 Might Usefully Inform Post-Pandemic Public Sector Approaches to Drug Development
Authors: Grundy Quinn , Campbell Chantal , Ali Ridwaanah , Herder Matthew , Holloway Kelly
Published: May 2024

Interventional clinical studies of convalescent plasma to treat COVID-19 were predominantly funded and led by public sector actors, including blood services operators. We aimed to analyze the processes of clinical studies of convalescent plasma to understand alternatives to pharmaceutical industry biopharmaceutical research and development, particularly where public sector actors play a dominant role. We conducted a qualitative, critical case study of purposively sampled prominent and impactful clinical studies of convalescent plasma during 2020-2021.
Toward Transparency and Trust: Assessing and Addressing Key Ethical Concerns in Normothermic Regional Perfusion
Authors: Buster Amanda , Meltzer Ellen C. , Trost Lisa , Courtright-Lim Amanda , Ingall Timothy , Tilburt Jon
Published: May 2024

Normothermic Regional Perfusion, or NRP, is a method of donated organ reperfusion using cardiopulmonary bypass or a modified extracorporeal membrane oxygenation (ECMO) circuit after circulatory death while leaving organs in the dead donor’s corpse. Despite its potential, several key ethical issues remain unaddressed by this technology.
Assessing Impacts of “Anti-Equity” Legislation on Health Care and Public Health Services
Authors: Hodge James G. , White Erica N. , Piatt Jennifer L. , Laude Camille
Published: May 2024

A deluge of state “anti-equity” legislative bills seek to reverse prevailing trends in diversity, equity, and inclusion; withdraw protections of LGBTQ+ communities; and deny access to gender-based care for trans minors and adults. While the political and constitutional fate of these acts is undetermined, profound impacts on patients and their providers are already affecting the delivery of health care and public health services.
Minor Consent for Vaccination: Ethically Justified, Politically Fraught
Authors: Colgrove James
Published: May 2024

Policies allowing some minors to consent to receive recommended vaccines are ethically defensible. However, a policy change at the federal level expanding minor consent for vaccinations nationwide risks triggering a political backlash. Such a move may be perceived as infringing on the rights of parents to make decisions about their children’s health care. In the current post-COVID environment of heightened anti-vaccination activism, changes to minor consent laws may be unadvisable, and policy makers should proceed with caution.
Exploring the patchwork of personal names in ancient Cyrenaica with the help of digital tools
Authors: Dobias-Lalou Catherine
Published: May 2024

We know plenty of personal names from Cyrenaica and most of them are known to us through inscriptions. Although the bulk of them are Greek, with some local dialectal features, we also find already in the Classical period some Libyan names. Later on, two new influxes become clear in local onomastics: Jewish and Roman names which appear in great number. In 1987 (LGPN 1), these names were collected, with the main emphasis on Greek, and were studied both from a linguistic and a sociohistorical point of view. The publication of digital corpora in 2017 and 2020 and other digital resources now make it possible to update the corpus and to search it much more easily. Some new results are presented here with the stress on Libyan and Jewish names.
Energy supplementation of beef steers or inclusion of legumes in temperate pastures in crop-livestock integration area
Authors: Scheeren Fernanda Bernardi , Sartor Laércio Ricardo , Danna Mirella , Kuss Fernando , Paris Wagner , Bianchin Alessandra , Andriotti Nathalia Marques , Menezes Luís Fernando Glasenapp de
Published: May 2024

The most common way of using the crop-livestock integration system in subtropical regions is cultivating soybeans or corn during the summer and temperate pastures in the winter. The objective of this study was to evaluate different beef cattle finishing systems in an area of crop-livestock integration. The inclusion of legumes and supplementation on black oat (Avena strigosa Schreb) and ryegrass pastures (Lolium multiflorum L.) were evaluated. Data from three years of research (2017, 2018 and 2020) were evaluated. Thus, 54 steers (18 per year) were used, with initial age of 22 ± 3 months and 413.08 ± 4.56 kg of initial live weight. They were randomly divided into nine paddocks of 0.7 hectares. The experimental design was randomized blocks with three replicates (paddock with two animals). Supplementation provided greater carrying capacity (1406.0 vs. 1269.6 kg/ha), average daily weight gain (1.4 vs. 1.1 kg/day), and, consequently, greater gain per area (384.5 vs. 302 kg BW/ha). Animals that received energy supplementation presented higher slaughter weight (536 vs. 510 kg), weight (287.1 and 286.2 vs. 266.2 and 265.3 kg), and hot (53.6 vs. 52.1%) and cold (53.4 vs. 52%) carcass yield, as well as higher fat content in the carcass (265 vs. 234 g/kg). The legume in the pasture did not affect the performance or characteristics of the animal carcasses. The supplementation increased the performance and carcass parameters, but did not influence the qualitative characteristics of the meat. In addition to individual performance, supplementation increased the pasture's carrying capacity, improving the system's productivity.
Six-dimensional constraints and force feedback for robot-assisted teleoperated fracture reduction
Authors: Lei Jingtao , Song Guangqing
Published: May 2024

Robots have the capability to perform precise and minimally invasive surgeries. For the robot-assisted teleoperated fracture reduction surgery, the operating accuracy largely depends on visual reference through fluoroscopy. The operator needs to adjust several times according to computed tomography (CT) image. During the robot reduction surgery, there are large muscle forces generated by the numerous muscles surrounding the fractured segments. However, there is no effective reduction force feedback to the master robot. In this paper, in order to improve the operating accuracy of the fracture reduction with teleoperated surgery mode, six-dimensional constraints of the master robot are studied by utilizing the virtual fixture method, which can restrict the position and orientation through the force and visual guidance. The six-dimensional force sensor is used to collect information of the reduction force. For the master robot, a motor stall control method based on the current loop is adopted to provide feedback of the reduction force, which can enhance the surgeon’s sense of operational presence. To verify the effectiveness of virtual fixture and force feedback, the fracture reduction experiments are conducted on the fractured model with simulating lager muscle force. Experimental results show that the reduction errors are within acceptable ranges:
$0.03\pm 0.73\textrm{mm}$
,
$0.54\pm 0.43\textrm{mm}$
,
$0.46\pm 1.05\textrm{mm}$
,
$1.05\pm 1.31^{\circ}$
,
$1.15\pm 1.91^{\circ}$
,
$1.09\pm 2.61^{\circ}$
. The number of fluoroscopy procedures required ranges from 1 to 2 and the average operation time is approximately 170 s. Compared to traditional methods and other teleoperation methods, the fracture reduction accuracy and surgical efficiency of method in this paper are significantly improved.
From the Body of the King to the Body of the Nation: Sovereignty, Sodomy, and the English Revolution of 1688
Authors: Cohen Aylon
Published: May 2024

This article explores how rumors of monarchical sodomy at the turn of the eighteenth century became entangled with newly emerging conceptions of the nation and nationalized space. After the 1688 Revolution in England, accusations of the king's sodomy increasingly mobilize territorial rather than theological understandings of sodomy's danger, transforming sodomy's terror from a satanic threat to the Christian kingdom to a national threat to the English nation. While historical studies on the territorialization of sovereignty often focus on structural transformations to the state, these accounts rarely attend to transformations in political feeling. This article shows how a novel discourse of national sodomy helped unsettle long-standing attachments to the king as the embodiment of sovereign power. Moreover, this article methodologically innovates the study of state sovereignty by attending to conceptual problems of political attachment through the study of an affectively loaded concept such as sodomy.
Kleinunternehmen – eine unterschätzte Zielgruppe für den Arbeits- und Gesundheitsschutz
Authors: Zimber Andreas , Horchler Julika , Weiser Imke , Gregersen Sabine , Prüße Martin , Schumacher Karin , Pietrzyk Ulrike , Schmitt-Howe Britta
Published: May 2024

Zusammenfassung: Die Umsetzung der Vorgaben zum Arbeits- und Gesundheitsschutz (AGS) ist in Kleinunternehmen insgesamt unterdurchschnittlich. Über die AGS-Aktivitäten der Unternehmer_innen und ihre Einflussgrößen wurde bisher nur wenig geforscht. In dieser qualitativen Studie wurden N = 27 Geschäftsführer_innen ausführlich zu ihren Aktivitäten und hierfür relevanten Einflussgrößen interviewt. Die Aussagen wurden induktiv bzw. deduktiv inhaltsanalytisch ausgewertet. Die Interviewten berichteten ein breites Spektrum von Aktivitäten, das vom traditionellen Arbeitsschutz über betriebliche Gesundheitsförderung bis hin zu konkreten Führungstätigkeiten reichte. Aussagen zu relevanten Einflussgrößen konnten überwiegend gut in das „Theoretical Domains Framework (TDF)“ ( Michie, Johnston, Abraham, Lawton, Parker & Walker, 2005 ) eingeordnet werden. Wie Subgruppenanalysen zeigten, machten engagierte Kleinunternehmer_innen signifikant mehr Aussagen zu positiven Einflussgrößen. Weniger Engagierte nannten dagegen häufiger Ressourcenmangel, kognitive Überlastung und negative Emotionen. Aus den Erkenntnissen lassen sich gezielt Maßnahmen zur Förderung der Umsetzungsmotivation von Kleinunternehmer_innen ableiten.
Boundary Layer Structures Over the Northwest Atlantic Derived From Airborne High Spectral Resolution Lidar and Dropsonde Measurements During the ACTIVATE Campaign
Authors: Xu Y. , Mitchell B. , Delgado R. , Ouyed A. , Crosbie E. , Cutler L. , Fenn M. , Ferrare R. , Hair J. , Hostetler C. , Kirschler S. , Kleb M. , Nehrir A. , Painemal D. , Robinson C. E. , Scarino A. J. , Shingler T. , Shook M. A. , Sorooshian A. , Thornhill K. L. , Voigt C. , Wang H. , Zeng X. , Zuidema P.
Published: May 2024

The Planetary Boundary Layer height (PBLH) is essential for studying PBL and ocean‐atmosphere interactions. Marine PBL is usually defined to include a mixed layer (ML) and a capping inversion layer. The ML height (MLH) estimated from the measurements of aerosol backscatter by a lidar was usually compared with PBLH determined from radiosondes/dropsondes in the past, as the PBLH is usually similar to MLH in nature. However, PBLH can be much greater than MLH for decoupled PBL. Here we evaluate the retrieved MLH from an airborne lidar (HSRL‐2) by utilizing 506 co‐located dropsondes during the ACTIVATE field campaign over the Northwest Atlantic from 2020 to 2022. First, we define and determine the MLH and PBLH from the temperature and humidity profiles of each dropsonde, and find that the MLH values from HSRL‐2 and dropsondes agree well with each other, with a coefficient of determination of 0.66 and median difference of 18 m. In contrast, the HSRL‐2 MLH data do not correspond to dropsonde‐derived PBLH, with a median difference of −47 m. Therefore, we modify the current operational and automated HSRL‐2 wavelet‐based algorithm for PBLH retrieval, decreasing the median difference significantly to −8 m. Further data analysis indicates that these conclusions remain the same for cases with higher or lower cloud fractions, and for decoupled PBLs. These results demonstrate the potential of using HSRL‐2 aerosol backscatter data to estimate both marine MLH and PBLH and suggest that lidar‐derived MLH should be compared with radiosonde/dropsonde‐determined MLH (not PBLH) in general.