bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence and determinants of psychotropic medication use in Poland
Authors: Pisarska Agnieszka , Stokwiszewski Jakub , Moskalewicz Jacek
Published: June 2023

Cel pracy

Celem badań była ocena rozpowszechnienia przyjmowania leków psychotropowych wśród osób dorosłych w Polsce w ciągu ostatnich 12 miesięcy, a także analiza związku pomiędzy stosowaniem tych leków a zmiennymi socjodemograficznymi oraz doświadczanymi przez respondentów zaburzeniami zdrowia psychicznego.

Metoda

Badania zrealizowano na próbie mieszkańców Polski w wieku 18-64 lat wylosowanych z systemu PESEL. W badaniach wykorzystano rekomendowany przez WHO instrument WHO – CIDI 3.0. Zrealizowano 10 tysięcy wywiadów przy poziomie realizacji próby 50,4%.

Wyniki

W generalnej populacji leki psychotropowe w ciągu ostatnich 12 miesięcy stosowało około 5% badanych. Po leki częściej sięgały kobiety, osoby z najstarszej grupy wiekowej, legitymujące się co najwyżej ukończonym gimnazjum, emeryci, renciści, bezrobotni, osoby samotne oraz mieszkańcy małych i dużych miast. Spośród osób doświadczających problemów zdrowia psychicznego w ostatnich 12 miesiącach leki psychotropowe przyjmowało około 17% badanych. Leczenie farmakologiczne najczęściej potwierdzały osoby z symptomami depresji oraz zaburzeń nastroju (ponad 40%), przy czym leki przeciwdepresyjne przyjmowało około 25% osób ze stwierdzoną depresją. Różnice w przyjmowaniu leków psychotropowych pomiędzy kobietami i mężczyznami, u których zdiagnozowano zaburzenia zdrowia psychicznego były niewielkie i w większości przypadków nieistotne statystycznie.

Wnioski

Wyniki wskazują na potrzebę poprawy dostępu do lecznictwa psychiatrycznego oraz lepszego przygotowania lekarzy pierwszego kontaktu do prawidłowego diagnozowania i leczenia zaburzeń zdrowia psychicznego.
Hub Network Design Problem with Capacity, Congestion, and Stochastic Demand Considerations
Authors: Bayram Vedat , Yıldız Barış , Farham M. Saleh
Published: June 2023

Our study introduces the hub network design problem with congestion, capacity, and stochastic demand considerations (HNDC), which generalizes the classical hub location problem in several directions. In particular, we extend state-of-the-art by integrating capacity acquisition decisions and congestion cost effect into the problem and allowing dynamic routing for origin-destination (OD) pairs. Connecting strategic and operational level decisions, HNDC jointly decides hub locations and capacity acquisitions by considering the expected routing and congestion costs. A path-based mixed-integer second-order cone programming (SOCP) formulation of the HNDC is proposed. We exploit SOCP duality results and propose an exact algorithm based on Benders decomposition and column generation to solve this challenging problem. We use a specific characterization of the capacity-feasible solutions to speed up the solution procedure and develop an efficient branch-and-cut algorithm to solve the master problem. We conduct extensive computational experiments to test the proposed approach’s performance and derive managerial insights based on realistic problem instances adapted from the literature. In particular, we found that including hub congestion costs, accounting for the uncertainty in demand, and whether the underlying network is complete or incomplete have a significant impact on hub network design and the resulting performance of the system.

Funding: This work was supported by Türkiye Bilimsel ve Teknolojik Araştırma Kurumu [Grant 218M520].

Supplemental Material: The online appendices are available at https://doi.org/10.1287/trsc.2022.0112 .
Waiting to Light Up the Server
Authors: Edwards Chris
Published: June 2023

How the use of fibre-optic interconnects is helping to re-architect the concept of the server.
Effects of Irrigation Methods and Scheduling on Water and Onion Productivity in Semi-Arid Areas of Ethiopia
Authors: Gebremicael Tesfay Gebretsdakan Gebretsadkan , Haile Gebremedhin Gebremeskel , Kifle Mulubrhan , Gebremedhin Teferi , Deitch Matthew J. , Reda Kidane Welde , Reda Abbadi
Published: June 2023

Highlights

Irrigation experiments on onion productivity were conducted at two sites for two consecutive years in Ethiopia.

Factors from irrigation interval and irrigation method analyzed independently and factorially.

Basin irrigation and fixed irrigation produced higher bulb yields and water productivity.

Farmers’ income can be enhanced using improved irrigation practices for increased onion productivity.

Abstract. How to meet the crop water demand and improve crop productivity is a particular concern for small-scale farmers, where the availability of water resources is limited. This study evaluated three different irrigation methods (furrow, basin and border) and two types of irrigation scheduling (CROPWAT schedule and farmers’ practices) with three replications for two consecutive years (2016-2017) at two sites using onion crops. The results showed that the CROPWAT schedule, basin irrigation method, and their interactions showed better performances and produced higher yield and water productivity. An average of 26 and 27 metric tons/hectare of onion were obtained under the basin irrigation method and basin irrigation with CROPWAT schedule combined, respectively. The water productivity (WP) and irrigation water productivity (IWP) also showed higher results under the basin irrigation method compared to other treatment combinations. The basin irrigation method produced higher marketable onion bulbs with firm medium bulb sizes that are essential for onion producers to earn maximum profit. The findings of this study also indicate that focusing on enhanced irrigation scheduling techniques and irrigation methods is paramount for better onion productivity in irrigation water-limited areas. Keywords: Irrigation interval, Irrigation methods, Irrigation practices, Onion productivity, Water management.
Greenhouse gas monitoring instrument on the GF-5 satellite-II: on-orbit spectral calibration
Authors: Han Yunfei , Shi Hailiang , Li Zhiwei , Luo Haiyan , Ding Yi , Xiong Wei , Hu Zhongzheng
Published: June 2023

The greenhouse gas monitoring instruments were carried on the
Gaofen-5-II satellite, which was launched into orbit from the Taiyuan
Satellite Launch Center on September 7, 2021. In order to improve the
on-orbit data quantification level, a calibration device based on
diffuse reflector system was designed, which can realize on-orbit
spectral and radiation calibration. In this paper, the principle of
standard spectral line selection is given, and the characteristic
spectral lines that can be used for on-orbit spectral calibration are
extracted. The wavelength deviation evaluation function is established
by using the method of matching the high-resolution reference spectrum
after the linear function of the convolution instrument with the
on-orbit calibration measurement spectrum, and finally using the
Levenberg–Marquardt algorithm to evaluate the function. The
optimization solution is the on-orbit wavelength calibration result.
According to the above method, the on-orbit calibration data are
processed. After calibration, the maximum deviation of the on-orbit
spectral offset is changed from 0.133 to 0.009cm−1, and variations in magnitude less
than 10% of the spectral resolution for CO2 (1.57 µm) band have
been detected.
TDEC metric in 50G-PON: analytical and experimental investigation on several implementation aspects
Authors: Casasco Mariacristina , Caruso Giuseppe , Cano Ivan N. , Nesset Derek , Valvo Maurizio , Ferrero Valter , Gaudino Roberto
Published: June 2023

We analyze the metrology of transmitter and dispersion eye closure (TDEC) as defined in a 50G passive optical network (50G-PON) for assessing transmitter quality. First, we present a theoretical evaluation for adapting TDEC to 50G-PON, where equalized bandwidth limited avalanche-photodiode-based receivers are expected. We optimize the parameters for a proper numerical evaluation and provide some guidelines for implementing the metric. We also show that TDEC can be measured with both sampling and real-time oscilloscopes provided that there are enough samples for the latter. A comparison of two techniques, one noiseless and one considering noise enhancement, for computing the coefficients of the equalizer is also provided. Finally, an experimental comparison between a Mach–Zehnder modulator and an electroabsorption-modulated-laser-based transmitter is carried out with different extinction ratios and fiber lengths, showing that TDEC can effectively predict the receiver sensitivity penalty.
Capacity scaling in metro-regional aggregation networks: the multiband S-BVT
Authors: Nadal L. , Casellas R. , Fàbrega J. M. , Vílchez F. J. , Svaluto Moreolo M.
Published: June 2023

New technological advancements and solutions should be investigated to overcome the stringent performance and societal requirements that 6G networks will pose in terms of capacity scaling, performance, efficiency, and sustainability. In this regard, the design and implementation of modular, scalable, cost-effective, and programmable transceiver architectures are key towards meeting future 6G network targets. In this paper, multiband (MB) sliceable bandwidth/bitrate variable transceivers with advanced capabilities are proposed and experimentally assessed, enabling full reconfigurability, sliceability, and scalability following a pay-as-you grow approach. Different transceiver building blocks will be enabled/disabled and will operate within different spectral bands beyond the C-band, according to the network condition. The proposed architecture enables point-to-point and point-to-multipoint operation maximizing the network’s resiliency, efficiency, and sustainability. 60 Gb/s MB transmission (C + S) is demonstrated over a metro-regional aggregation network path of 25.2 km. Scalability towards multi-Tb/s transmission is envisioned by exploiting the whole available spectral bands.
High-directionality SiN-assisted grating antenna for optical phased array
Authors: Wang Zheng , Yang Yibo , Cui Langlin , Yu Lei , Ma Pengfei , Luo Shuai , Wang Pengfei , Song Zhigang , Ji Zhimin , Pan Jiaoqing , Su Yanmei , Zhang Yejin
Published: June 2023

In the realm of consumer electronics, automotive, and robotics, lidar has proven to be a valuable technology. However, current lidar solutions such as mechanical, microelectromechanical, and flash lidar are associated with drawbacks such as high cost, low resolution, and a limited ranging distance. To address these issues, optical phased array (OPA) technology has been proposed as a promising solution due to its high resolution, rapid response times, long ranging distance, and low cost. Despite these advantages, OPA is still in the developmental stages and further optimization is required to address issues such as loss, field of view (FOV), and beam divergence. To address the FOV and beam divergence issues, SiN-assisted grating antenna has been used. However, the directionality of an SiN-assisted antenna is relatively low and may introduce additional loss for OPA. To overcome this limitation, this paper proposes a dual-layer SiN-assisted grating antenna with more than 94% directionality in 1550 nm. Moreover, the wavelength bandwidth of more than 90% directionality is over 80 nm, making it a promising solution for OPA devices.
Compact and efficient 1064 nm up-conversion atmospheric lidar
Authors: Chen Qianyuan , Mao Song , Yin Zhenping , Yi Yang , Li Xiang , Wang Anzhou , Wang Xuan
Published: June 2023

A model was developed to simulate lidar signals and quantify the relative errors of retrieved aerosol backscattering. The results show that a 1064 nm atmospheric aerosol lidar has a small relative error, which can be attributed to the presence of a sufficient molecular signal to facilitate calibration. However, the quantum efficiency of 1064 nm photons using silicon avalanche photodiode detectors is about 2%. To improve the quantum efficiency at 1064 nm band, this study used up-conversion techniques to convert 1064-nm photons to 631-nm photons, optimizing the power of the pump laser and the operating temperature of the waveguide to enable detection at higher efficiencies, up to 18.8%. The up-conversion atmospheric lidar is designed for optimal integration and robustness with a fiber-coupled optical path and a 50 mm effective aperture telescope. This greatly improves the performance of the 1064 nm atmospheric aerosol lidar, which enables aerosol detection up to 25 km (equivalent to 8.6 km altitude) even at a single laser pulse energy of 110 µJ. Compared to silicon avalanche photodiode detectors, up-conversion single photon detectors exhibit superior performance in detecting lidar echo signals, even in the presence of strong background noise during daytime.
3D-deep optical learning: a multimodal and multitask reconstruction framework for optical molecular tomography
Authors: Li Shuangchen , Wang Beilei , Yu Jingjing , Kang Dizhen , He Xuelei , Guo Hongbo , He Xiaowei
Published: June 2023

Optical molecular tomography (OMT) is an emerging imaging technique. To date, the poor universality of reconstruction algorithms based on deep learning for various imaged objects and optical probes limits the development and application of OMT. In this study, based on a new mapping representation, a multimodal and multitask reconstruction framework-3D deep optical learning (3DOL), was presented to overcome the limitations of OMT in universality by decomposing it into two tasks, optical field recovery and luminous source reconstruction. Specifically, slices of the original anatomy (provided by computed tomography) and boundary optical measurement of imaged objects serve as inputs of a recurrent convolutional neural network encoded parallel to extract multimodal features, and 2D information from a few axial planes within the samples is explicitly incorporated, which enables 3DOL to recognize different imaged objects. Subsequently, the optical field is recovered under the constraint of the object geometry, and then the luminous source is segmented by a learnable Laplace operator from the recovered optical field, which obtains stable and high-quality reconstruction results with extremely few parameters. This strategy enable 3DOL to better understand the relationship between the boundary optical measurement, optical field, and luminous source to improve 3DOL’s ability to work in a wide range of spectra. The results of numerical simulations, physical phantoms, and in vivo experiments demonstrate that 3DOL is a compatible deep-learning approach to tomographic imaging diverse objects. Moreover, the fully trained 3DOL under specific wavelengths can be generalized to other spectra in the 620–900 nm NIR-I window.
Athermal, fabrication-tolerant Si-SiN FIR filters for a silicon photonics foundry platform
Authors: Netherton Andrew M. , Gao Yun , Pestana Noah , Bovington Jock , Bowers John E.
Published: June 2023

A means of athermalizing unbalanced Mach-Zehnder interferometers on a 300 mm silicon photonics foundry platform utilizing Si and SiN layers to produce the path imbalance is demonstrated. This technique can be applied to all other forms of finite impulse response filters, such as arrayed waveguide gratings. Wafer scale performance of fabricated devices is analyzed for their expected performance in the target application: odd-even channel (de)-interleavers for dense wavelength division multiplexing links. Finally, a method is proposed to improve device performance to be more robust to fabrication variations while simultaneously maintaining athermality.
Linear polarization-separating metalens at long-wavelength infrared
Authors: Ishizuka Noe , Li Jie , Fuji Wataru , Ikezawa Satoshi , Iwami Kentaro
Published: June 2023

We designed and fabricated a linear polarization-separation metalens (PSM) made of single-crystal silicon (sc-Si) for long-wavelength infrared (LWIR) imaging. The PSM comprises sc-Si dielectric waveguide pillar meta-atoms with rectangular cross-sections, providing a full 2π phase delay range for two orthogonal linear polarization components with high transmittances (>70%). Electron beam lithography and deep reactive ion etching were used to fabricate the PSM. Polarization-separation imaging of elevated and ambient temperature objects was demonstrated with high extinction ratios of 21.8 dB and 12.8 dB for the x- and y-polarizations, respectively. Additionally, polarization-sensitive imaging was demonstrated by distinguishing the surfaces of a hand and toy windows. Our work enables the visualization of invisible information in the LWIR region and has widespread applications.
Investigations on diverse dynamics of soliton triplets in mode-locked fiber lasers
Authors: Xia Ran , Liu Yusong , Huang Siyun , Luo Yiyang , Sun Qizhen , Tang Xiahui , Xu Gang
Published: June 2023

Optical soliton molecules exhibiting behaviors analogous to matter molecules have been the hotspot in the dissipative system for decades. Based on the dispersion Fourier transformation technique, the real-time spectral interferometry has become the popular method to reveal the internal dynamics of soliton molecules. The rising degrees of freedom in pace with the increased constitutes of soliton molecules yield more intriguing sights into the internal motions. Yet the soliton molecules with three or more pulses are rarely investigated owing to the exponentially growing complexity. Here, we present both experimental and theoretical studies on the soliton molecules containing three solitons. Different assemblies of the constitutes are categorized as different types of soliton triplet akin to the geometric isomer, including equally-spaced triplet and unequally-spaced triplet. Typical soliton triplets with different dynamics including regular internal motions, hybrid phase dynamics and complex dynamics involving separation evolution are experimentally analyzed and theoretically simulated. Specifically, the energy difference which remains elusive in experiments are uncovered through the simulation of diverse triplets with plentiful dynamics. Moreover, the multi-dimensional interaction space is proposed to visualize the internal motions in connection with the energy exchange, which play significant roles in the interplays among the solitons. Both the experimental and numerical simulations on the isomeric soliton triplets would release a larger number of degrees of freedom and motivate the potentially artificial configuration of soliton molecules for various ultrafast applications, such as all-optical buffering and multiple encoding for telecommunications.
Temperature-tunable UV generation using an Alexandrite laser and PPLN waveguides
Authors: Tawy Goronwy , Palomar Davidson Noelia , Churchill Glenn , Damzen Michael J. , Smith Peter G. R. , Gates James C. , Gawith Corin B. E.
Published: June 2023

We present a simple and novel technique for achieving ultra-violet (UV) wavelength-tunable laser operation in the continuous-wave regime. Wavelength tunable operation in the near infrared is obtained from a compact two-mirror Alexandrite laser cavity by temperature tuning of the laser crystal. Second-harmonic-generation to the UV is then achieved at 376-379 nm and 384-386 nm by temperature tuning of a periodically-poled lithium-niobate (PPLN) waveguide. A maximum UV power of 1.3 mW from 185 mW infra-red pump throughput is obtained from a third-order PPLN Λ=6.1μm grating. These results show promising potential for simple and wavelength tunable access to wavelengths at 360-400 nm.
Second harmonic generation in plasmonic metasurfaces enhanced by symmetry-protected dual bound states in the continuum
Authors: Liu Di , Ren Yingying , Huo Yanyan , Cai Yangjian , Ning Tingyin
Published: June 2023

We numerically investigate linear and nonlinear optical responses in metasurfaces consisting of Au double-gap split ring resonators (DSRRs). Symmetry-protected dual bound states in the continuum (BICs) in such plasmonic metasurfaces are observed at the near-infrared optical regime. Efficient second harmonic generation (SHG) is obtained at the quasi-BIC models due to the symmetry broken. The optimized SHG responses are obtained at the critical couplings between radiation and nonradiation processes at the linearly x- and y-polarized light, respectively. High conversion efficiency of SHG of a value 10−6 is arrived at the fundamental intensity of 10 GW/cm2 at the quasi-BIC wavelength under the y-polarized illumination. Large extrinsic and tunable chirality of linear and nonlinear optical responses empowered by quasi-BICs is acquired in asymmetry metasurfaces at oblique circularly polarized incidence. The results indicate that the plasmonic metasurfaces of symmetry-protected BICs at the near-infrared optical regime have great potential applications in the on-chip efficient frequency conversion, and the linear and nonlinear chiral manipulation.
Integrated lithium niobate optical phased array for two-dimensional beam steering
Authors: Yue Gongcheng , Li Yang
Published: June 2023

Optical phased arrays (OPAs) with high speed, low power consumption, and low insertion loss are appealing for various applications, including light detection and ranging, free-space communication, image projection, and imaging. These OPAs can be achieved by fully harnessing the advantages of integrated lithium niobate (LN) photonics, which include high electro-optical modulation speed, low driving voltage, and low optical loss. Here we present an integrated LN OPA that operates in the near-infrared regime. Our experimental results demonstrate 24 × 8° two-dimensional beam steering, a far-field beam spot with a full width at half maximum of 2 × 0.6°, and a sidelobe suppression level of 10 dB. Furthermore, the phase modulator of our OPA exhibits a half-wave voltage of 6 V. The low power consumption exhibited by our OPA makes it highly attractive for a wide range of applications. Beyond conventional applications, our OPA’s high speed opens up the possibility of novel applications such as high-density point cloud generation and tomographic holography.
Model-based large-dynamic iterative piston correction using extended objects
Authors: Zhang Zexia , Dong Bing
Published: June 2023

Cophasing is crucial for segmented or sparse aperture telescopes to achieve high resolution. In this Letter, we propose a novel, to the best of our knowledge, model-based piston correction method that can remove large-scale piston errors within a few iterations using extended objects. The relation between the piston error and a metric function is derived theoretically under broadband illumination. The metric function is based on the image’s power spectral density at the spatial frequency where the sidelobe peak of the modulation transfer function (MTF) appears. The piston error is iteratively estimated and corrected by introducing positive and negative piston biases. The dynamic range of piston correction can be as large as the coherence length of light. The correction accuracy in experiments is affected by the image noises and the accuracy of the introduced piston biases.
Dynamic dual-functional optical wave plate based on phase-change meta-molecules
Authors: Cai Ziru , Ding Yingtao , Chen Zhiming , Zheng Ziwei , Ding Fei
Published: June 2023

Optical metasurfaces have shown great potential for revolutionizing wave plates by enabling compact footprints and diversified functionalities. However, most metasurface wave plates (meta-WPs) are typically passive, featuring defined responses after fabrication, whereas dynamic meta-WPs have so far often been limited to ON and OFF states. Here, we design a dynamic dual-functional meta-WP based on judiciously designed low-loss Sb2Se3 meta-molecules at the telecom wavelength of 1.55 µm which enables reconfigurable linear-to-circular and linear-to-linear polarization conversion for orthogonal linear polarizations when Sb2Se3 transits between amorphous and crystalline states. In addition, a comprehensive electro-thermal simulation is carried out to verify the phase change process for realistic implementation. The designed dynamic dual-functional wave plate may open new avenues for developing integrated adaptive photonics with dynamic and multiplexed functionalities.
High-power lasing at ∼900  nm in Nd3+-doped fiber: a direct coordination engineering approach to enhance fluorescence
Authors: Chen Yinggang , Lin Zhiquan , Sun Hongtao , Wang Yafei , Dong Hehe , Wang Meng , Zhang Lei , Dong Guoping , Liu Xiaofeng , Yu Fei , Wang Shikai , Yu Chunlei , Hu Lili
Published: June 2023

Lasers at ∼900nm have been of vital importance in various fields, including material processing, underwater communications, and strong-field physics. Although Nd3+-doped materials have been employed for the ∼900nm laser, the ∼900nm emission is in strong competition with the often more dominating ∼1060nm emission, which strongly limits the output power and applications. This paper proposes a direct coordination engineering approach, which introduces halogen to the nearest coordination of Nd3+ in glass for increasing the bond covalency, leading to stronger emissions at ∼900nm than at ∼1060nm. Iodide-incorporated Nd3+-doped silica fibers show prevailing ∼900nm emission rarely observed in Nd3+-doped materials. Using the created fibers, a power (113.5 W) 50 times higher than the current record is accomplished based on an all-fiber structure. Our approach holds the potential for regulating the spectroscopic properties of other rare-earth-doped laser materials.
Characterizing biological responses to climate variability and extremes to improve biodiversity projections
Authors: Buckley Lauren B. , Carrington Emily , Dillon Michael E. , García-Robledo Carlos , Roberts Steven B. , Wegrzyn Jill L. , Urban Mark C.
Published: June 2023

Projecting ecological and evolutionary responses to variable and changing environments is central to anticipating and managing impacts to biodiversity and ecosystems. Current modeling approaches are largely phenomenological and often fail to accurately project responses due to numerous biological processes at multiple levels of biological organization responding to environmental variation at varied spatial and temporal scales. Limited mechanistic understanding of organismal responses to environmental variability and extremes also restricts predictive capacity. We outline a strategy for identifying and modeling the key organismal mechanisms across levels of biological organization that mediate ecological and evolutionary responses to environmental variation. A central component of this strategy is quantifying timescales and magnitudes of climatic variability and how organisms experience them. We highlight recent empirical research that builds this information and suggest how to design future experiments that can produce more generalizable principles. We discuss how to create biologically informed projections in a feasible way by combining statistical and mechanistic approaches. Predictions will inform both fundamental and practical questions at the interface of ecology, evolution, and Earth science such as how organisms experience, adapt to, and respond to environmental variation at multiple hierarchical spatial and temporal scales.
Impact of the WHO Safe Childbirth Checklist on safety culture among health workers: A randomized controlled trial in Aceh, Indonesia
Authors: Kaplan Lennart , Richert Katharina , Hülsen Vivien , Diba Farah , Marthoenis Marthoenis , Muhsin Muhsin , Samadi Samadi , Susanti Suryane , Sofyan Hizir , Ichsan Ichsan , Vollmer Sebastian
Published: June 2023

The World Health Organization (WHO) developed the Safe Childbirth Checklist (SCC) to increase the application of essential birth practices to ultimately reduce perinatal and maternal deaths. We study the effects of the SCC on health workers safety culture, in the framework of a cluster-randomized controlled trial (16 treatment facilities/16 control facilities). We introduced the SCC in combination with a medium intensity coaching in health facilities which already offered at minimum basic emergency obstetric and newborn care (BEMonC). We assess the effects of using the SCC on 14 outcome variables measuring self-perceived information access, information transmission, frequency of errors, workload and access to resources at the facility level. We apply Ordinary Least Square regressions to identify an Intention to Treat Effect (ITT) and Instrumental Variable regressions to determine a Complier Average Causal Effect (CACE). The results suggest that the treatment significantly improved self-assessed attitudes regarding the probability of calling attention to problems with patient care (ITT 0.6945 standard deviations) and the frequency of errors in times of excessive workload (ITT -0.6318 standard deviations). Moreover, self-assessed resource access increased (ITT 0.6150 standard deviations). The other eleven outcomes were unaffected. The findings suggest that checklists can contribute to an improvement in some dimensions of safety culture among health workers. However, the complier analysis also highlights that achieving adherence remains a key challenge to make checklists effective.
Cluster randomized trial of influenza vaccination in patients with acute heart failure in China: A mixed-methods feasibility study
Authors: Liu Rong , Du Xin , Patel Anushka , Di Tanna Gian Luca , Zhao Yangyang , Wang Zhiyan , Fan Yihang , Zhang Hao , Yi Yang , Dong Jianzeng , Anderson Craig , Liu Hueiming
Published: June 2023

Uncertainties about the efficacy of influenza vaccination for populations with heart failure (HF) in preventing cardiovascular outcomes, as well as lack of effective vaccination strategies, may contribute to low vaccine coverage rate (VCR) in China and globally. We assessed the feasibility of a strategy to promote influenza vaccines in patients hospitalized with acute HF in China and to inform the design of a hybrid effectiveness-implementation cluster randomized trial to evaluate this strategy on mortality and hospital re-admission. We conducted a cluster randomized pilot trial involving 11 hospitals in Henan Province in China, with mixed-methods evaluation between December 2020 and April 2021. A process evaluation involved interviews with 51 key informants (patients, health professionals, policy makers). The intervention included education about influenza vaccination and availability of free vaccines administered prior to hospital discharge for HF patients, while usual care included attending community-based points of vaccination (PoV) for screening and vaccination. Implementation outcomes focused on reach, fidelity, adoption, and acceptability. Recruitment rates were assessed for trial feasibility. Effectiveness outcomes were influenza VCR, HF-specific rehospitalizations and mortality at 90 days. A total of 518 HF patients were recruited from 7 intervention and 4 usual care hospitals (mean of 45 participants per hospital per month). VCR was 89.9% (311/346, 86.1–92.8%) in the intervention group and 0.6% (1/172, 0.0–3.7%) in the control group. The process evaluation demonstrated reach to patients with lower socioeconomic and education status. There was good fidelity of the intervention components, with education and PoV set up processes being adapted to local hospital workflow and workforce capacity. Intervention was acceptable and adopted by patients and health professionals. However, outside of a trial setting, concerns were raised around vaccination reimbursement costs, workforce accountability and capacity. The intervention strategy appears feasible and acceptable for improving VCR in HF patients at county-level hospitals in China.

Trial registration: This pilot trial is registered with the acronym PANDA II Pilot (Population Assessment of Influenza and Disease Activity) at ChiCTR.org.cn (ChiCTR2000039081).
Transmission-blocking activity of antimalarials for Plasmodium vivax malaria in Anopheles darlingi
Authors: Andrade Alice O. , Santos Najara A. C. , Bastos Alessandra S. , Pontual José D. C. , Araújo Jéssica E. , Silva Alexia M. V. , Martinez Leandro N. , Lima Alzemar A. , Aguiar Anna Caroline C. , G. Teles Carolina B. , Medeiros Jansen F. , Pereira Dhelio B. , Vinetz Joseph M. , Gazzinelli Ricardo T. , Araújo Maisa S.
Published: June 2023

Malaria is caused by parasite of the genus Plasmodium and is still one of the most important infectious diseases in the world. Several biological characteristics of Plasmodium vivax contribute to the resilience of this species, including early gametocyte production, both of which lead to efficient malaria transmission to mosquitoes. This study evaluated the impact of currently used drugs on the transmission of P. vivax. Participants received one of the following treatments for malaria: i) chloroquine [10 mg/kg on day 1 and 7.5 mg/kg on day 2 and 3] co-administered with Primaquine [0.5 mg/kg/day for 7 days]; ii) Chloroquine [10 mg/kg on day 1 and 7.5 mg/kg on day 2 and 3] co-administered with one-dose of Tafenoquine [300 mg on day 1]; and iii) Artesunate and Mefloquine [100 mg and 200 mg on day 1, 2 and 3] co-administered with Primaquine [0.5 mg/kg/day for 14 days]. Patient blood was collected before treatment and 4 h, 24 h, 48 h and 72 h after treatment. The blood was used to perform a direct membrane feeding assay (DMFA) using Anopheles darlingi mosquitoes. The results showed 100% inhibition of the mosquito infection after 4 h using ASMQ+PQ, after 24 h for the combination of CQ+PQ and 48 h using CQ+TQ. The density of gametocytes declined over time in all treatment groups, although the decline was more rapid in the ASMQ+PQ group. In conclusion, it was possible to demonstrate the transmission-blocking efficacy of the malaria vivax treatment and that ASMQ+PQ acts faster than the two other treatments.
Psychometric properties of novel instrument for evaluating ambient air pollution health literacy in adults
Authors: Chen I-Chen , Li Chung-Yi , Lu Chien-Yeh , Huang Yi-Chin , Lee Pei-Chen , Lin Ming-Yeng , Wang Yu-Chen , Chen Long-Sheng , Kuo Chia-Lun , Hou Wen-Hsuan
Published: June 2023

We aimed to develop and validate a comprehensive ambient air pollution health literacy instrument. We developed items covering 12 constructs, four information competencies within three health domains. In this population-based telephone interview study, probability proportional to size sampling and random digit dialing were used to determine participants. We conducted confirmatory factor analysis to analyze model fits and used content validity indices and Cronbach’s alpha to measure content validity and internal consistency reliability. Twenty-four items were generated, and a total of 1,297 participants were recruited. A theoretically conceived 12-factor model was supported (root mean square error of approximation [RMSEA] = 0.068, comparative fit index [CFI] = 0.039, standardized root mean square residual [SRMR] = 0.934, normed fit index [NFI] = 0.914, Tucker–Lewis index [TLI] = 0.902). Content validity indices for relevance, importance, and unambiguity were 0.97, 0.99, and 0.94, respectively. Internal consistency reliability assessed by Cronbach’s alpha was 0.93. The ambient air pollution health literacy instrument is valid and reliable and can be used in community residents. The novel instrument can guide the stakeholders and the authority to tailor and implement effective and appropriate interventions and actions, empowering the public to manage hazardous exposure and improving AAPHL of the public.
Free-oscillation technique: The effect of the magnitude of the impulse applied on muscle and tendon stiffness around the ankle
Authors: Faria Aurélio , Gabriel Ronaldo , Brás Rui , Moreira Helena , Soares Márcio , Ditroilo Massimiliano
Published: June 2023

The importance of the muscle-tendon complex in sport and for activities of everyday living is well recognised. The free oscillation technique is frequently used to determine the musculo-articular “apparent” stiffness (obtained from vertical ground reaction force) and other parameters. However, an in-depth understanding of the muscle-tendon complex can be gained by separating the muscle (soleus) and the tendon (Achilles tendon) components and studying the “true” stiffness for each of these components (by considering the ankle joint moment arms), which can be valuable in improving our understanding of training, injury prevention, and recovery programs. Hence, this study aimed to investigate if muscle and tendon stiffness (i.e., “true” stiffness) are similarly affected by different impulse magnitudes when using the free-oscillation technique. Three impulse magnitudes (impulse 1, 2 and 3), corresponding to peak forces of 100, 150 and 200 N, were used to estimate the stiffness of the ankle joint in 27 males, using multiple loads (10, 15, 20, 25, 30, 35, and 40 kg). A significant decrease (p < 0.0005) was found in musculo-articular “apparent” stiffness (29224 ± 5087 N.m-1; 27839 ± 4914 N.m-1; 26835 ± 4880 N.m-1) between impulses 1, 2 and 3 respectively, when loads were collapsed across groups. However, significant differences (p < 0.001) were only found between the median (Mdn) of impulse 1 (Mdn = 564.31 (kN/m)/kN) and 2 (Mdn = 468.88 (kN/m)/kN) and between impulse 1 (Mdn = 564.31 (kN/m)/kN) and 3 (Mdn = 422.19 (kN/m)/kN), for “true” muscle stiffness, but not for “true” tendon stiffness (Mdn = 197.35 kN/m; Mdn = 210.26 kN/m; Mdn = 201.60 kN/m). The results suggest that the musculo-articular “apparent” stiffness around the ankle joint is influenced by the magnitude of the impulse applied. Interestingly, this is driven by muscle stiffness, whereas tendon stiffness appears to be unaffected.
Health workforce capacity of intensive care units in the Eastern Mediterranean Region
Authors: Jalal Arooj , Iwamoto Kazuyo , Gedik Gulin , Ravaghi Hamid , Kodama Chiori
Published: June 2023

Objective

The onset of COVID-19 pandemic increased the need for functioning and equipped intensive care units (ICUs) with staff trained in operating them. In the Eastern Mediterranean Region, this also triggered the need for assessing the available capacities of ICUs and health workforce so that appropriate strategies can be developed to address emerging challenges of staff shortages in the wake of COVID-19. To address this need, a scoping review on the health workforce capacity of intensive care units in the Eastern Mediterranean Region was conducted.

Methods

A scoping review methodology as outlined by Cochrane was followed. Available literature and different data sources were reviewed. Database includes Pubmed (medline,Plos included), IMEMR, Google Scholar for peer-reviewed literature, and Google for grey literature such as relevant website of ministries, national and international organization. The search was performed for publications on intensive care unit health workers for each of the EMR countries in the past 10 years (2011–2021). Data from included studies was charted, analysed and reported in a narrative format. A brief country survey was also conducted to supplement the findings of the review. It included quantitative and qualitative questions about number of ICU beds, physicians and nurses, training programs as well as challenges faced by ICU health workforce.

Results

Despite limited data availability, this scoping review was able to capture information important for the Eastern Mediterranean Region. Following major themes appeared in findings and results were synthesized for each category: facility and staffing, training and qualification, working conditions/environment and performance appraisal. Shortage of intensive care specialist physicians and nurses were in majority of countries. Some countries offer training programmes, mostly for physicians, at post-graduate level and through short courses. High level of workload, emotional and physical burnout and stress were a consistent finding across all countries. Gaps in knowledge were found regarding procedures common for managing critically ill patients as well as lack of compliance with guidelines and recommendations.

Conclusion

The literature on ICU capacities in EMR is limited, however, our study identified valuable information on health workforce capacity of ICUs in the region. While well-structured, up-to-date, comprehensive and national representative data is still lacking in literature and in countries, there is a clearly emerging need for scaling up the health workforce capacities of ICUs in EMR. Further research is necessary to understand the situation of ICU capacity in EMR. Plans and efforts should be made to build current and future health workforce.
Supporting SURgery with GEriatric Co-Management and AI (SURGE-Ahead): A study protocol for the development of a digital geriatrician
Authors: Leinert Christoph , Fotteler Marina , Kocar Thomas Derya , Dallmeier Dhayana , Kestler Hans A. , Wolf Dennis , Gebhard Florian , Uihlein Adriane , Steger Florian , Kilian Reinhold , Mueller-Stierlin Annabel S. , Michalski Christoph W. , Mihaljevic André , Bolenz Christian , Zengerling Friedemann , Leinert Elena , Schütze Sabine , Hoffmann Thomas K. , Onder Graziano , Andersen-Ranberg Karen , O’Neill Desmond , Wehling Martin , Schobel Johannes , Swoboda Walter , Denkinger Michael ,   for the SURGE-Ahead Study Group
Published: June 2023

Introduction

Geriatric co-management is known to improve treatment of older adults in various clinical settings, however, widespread application of the concept is limited due to restricted resources. Digitalization may offer options to overcome these shortages by providing structured, relevant information and decision support tools for medical professionals. We present the SURGE-Ahead project (Supporting SURgery with GEriatric co-management and Artificial Intelligence) addressing this challenge.

Methods

A digital application with a dashboard-style user interface will be developed, displaying 1) evidence-based recommendations for geriatric co-management and 2) artificial intelligence-enhanced suggestions for continuity of care (COC) decisions. The development and implementation of the SURGE-Ahead application (SAA) will follow the Medical research council framework for complex medical interventions. In the development phase a minimum geriatric data set (MGDS) will be defined that combines parametrized information from the hospital information system with a concise assessment battery and sensor data. Two literature reviews will be conducted to create an evidence base for co-management and COC suggestions that will be used to display guideline-compliant recommendations. Principles of machine learning will be used for further data processing and COC proposals for the postoperative course. In an observational and AI-development study, data will be collected in three surgical departments of a University Hospital (trauma surgery, general and visceral surgery, urology) for AI-training, feasibility testing of the MGDS and identification of co-management needs. Usability will be tested in a workshop with potential users. During a subsequent project phase, the SAA will be tested and evaluated in clinical routine, allowing its further improvement through an iterative process.

Discussion

The outline offers insights into a novel and comprehensive project that combines geriatric co-management with digital support tools to improve inpatient surgical care and continuity of care of older adults.

Trial registration

German clinical trials registry (Deutsches Register für klinische Studien, DRKS00030684), registered on 21st November 2022.
Multivariate epidemic count time series model
Authors: Koyama Shinsuke
Published: June 2023

An infectious disease spreads not only over a single population or community but also across multiple and heterogeneous communities. Moreover, its transmissibility varies over time because of various factors such as seasonality and epidemic control, which results in strongly nonstationary behavior. In conventional methods for assessing transmissibility trends or changes, univariate time-varying reproduction numbers are calculated without taking into account transmission across multiple communities. In this paper, we propose a multivariate-count time series model for epidemics. We also propose a statistical method for estimating the transmission of infections across multiple communities and the time-varying reproduction numbers of each community simultaneously from a multivariate time series of case counts. We apply our method to incidence data for the novel coronavirus disease 2019 (COVID-19) pandemic to reveal the spatiotemporal heterogeneity of the epidemic process.
Frequent gamblers’ perceptions of the role of gambling marketing in their behaviour: An interpretative phenomenological analysis
Authors: Houghton Scott , Punton Georgia , Casey Emma , McNeill Andrew , Moss Mark
Published: June 2023

This study explored how frequent gamblers perceive gambling marketing and the role they feel it has in their gambling behaviour. Ten frequent gamblers participated in semi-structured interviews oriented around their experiences of gambling marketing. An interpretative phenomenological analysis of the data led to three overarching themes: exploiting gambling marketing for personal gain; gambling marketing as a test of self-control; and safer gambling messages marketing perceived as ineffective. These themes encapsulated participants’ views of gambling marketing as something they could take advantage of to increase their own gambling success. Marketing was also perceived as a test of self-control among self-identified experienced gamblers, although identified as a risk to those who are considered more vulnerable. Finally, safer gambling messages included within marketing was considered ineffective due to perceived insincerity and being seen as an ‘afterthought’ by marketers. In support of previous research, the current investigation highlights concerning narratives around self-control and perceived risk, as encapsulated within gambling marketing, and these are evident in the perceptions of frequent gamblers. Given gamblers’ perceived lack of effectiveness of current safer gambling messages within marketing, future research should explore new avenues for safer gambling promotion.
Does financial innovation foster financial inclusion in Arab world? examining the nexus between financial innovation, FDI, remittances, trade openness, and gross capital formation
Authors: Qamruzzaman Md.
Published: June 2023

The present paper aims to study the impacts of financial innovation on financial inclusion for selected 22 Arab countries from 2004 to 2020. It considers financial inclusion as a dependent variable. It describes ATMs and the number of commercial banks’ depositors as proxy variables. In contrast, financial inclusion is considered an independent variable. We used the ratio between broad and narrow money to describe it. We employ several statistical tests such as lm, Pesaran, and shin W-stat, a- tests for cross-section dependence, and unit root and panel granger causality with NARDL and system GMM approaches. The empirical results reveal the significant nexus between these two variables. The outcomes suggest that adaptation and diffusion of financial innovation play catalyst roles in bringing unbanked people into the financial network. In comparison, the inflows of FDI establish mixed positive and negative effects, which vary with model estimation following different econometrical tools. It is also revealed that FDI inflow can augment the financial inclusion process, and trade openness can play a directive role and enhance the financial inclusion process. These findings suggest that financial innovation, trade openness, and institutional quality should continue in the selected countries to enhance financial inclusion and promote capital formation in the selected countries.