bluuebunny/crossref_metadata_2025 huggingface dataset:
CEEMDAN and adaptive distance embedding for fault diagnosis of train bogie bearing
Authors: Li Jiayi , He Deqiang , Wei Zexian , Zhao Ming , Xiang Zaiyu
Published: January 2025

As an essential part of the train, the health status of the bogie bearing is vital to its safety. In a complex working environment, the fault signal of the bearing is highly dimensional and nonlinear, which makes high-precision fault diagnosis difficult. Therefore, a fault diagnosis method based on improved complete ensemble empirical mode decomposition with adaptive noise (CEEMDAN) and adaptive weighted distance manifold learning (AWDU) is to address this issue. Firstly, an intrinsic modal component screening index is presented, which takes into account the advantages of the cross-correlation coefficient, mean square error, and kurtosis coefficient. It is embedded in CEEMDAN to improve further the algorithm’s signal decomposition and noise reduction ability. Secondly, the AWDU technique is proposed to reduce the dimensionality of raw data, which can accurately calculate the distance and adjacency relationship between high-dimensional data and better guide low-dimensional embedding. Eventually, a range of experiments was executed across two different benchmark cases, and the results indicated that the average accuracy of this method in each experiment was not less than 99.64%, and the performance was satisfactory in the comparison of similar methods, which verified the effectiveness, stability, and generalization of the proposed method.
Fault diagnosis in rotation motor bearings: novel interpretable indicator and improved snow ablation optimizer
Authors: Bai Xusong , Song Xiangjin , Wang Zhaowei , Chen Qian , Zhao Wenxiang , Fan Wei
Published: January 2025

Early bearing fault diagnosis is essential for stable operation and low-cost maintenance of rotation motors. A rolling bearing fault diagnosis method for rotation motors is proposed, leveraging a novel interpretable short-time kurtosis error (SKE) indicator and the improved snow ablation optimizer (ISAO). Initially, the Cauchy mutation mechanism is employed to bolster the global search capability of ISAO, thereby optimizing parameter settings. Subsequently, ISAO is utilized to adaptively configure key parameters within the adaptive feature mode decomposition (AFMD), reducing reliance on prior knowledge. The SKE indicator is then developed to enhance the efficacy of AFMD in extracting fault features. The proposed AFMD is validated using bearing single and composite fault data from two experimental platforms. The experimental results under various fault conditions show that AFMD can adaptively perform fault feature extraction and robust to noise interference. Meanwhile, the proposed method performs better than existing methods, such as traditional FMD and dung beetle optimizer-based variational mode decomposition. This study advances state-of-the-art bearing fault diagnosis and offers a more interpretable and adaptive rotation motor condition monitoring solution.
Robust and general reading recognition for pointer meters based on key point detection and large language model
Authors: Zhang Wenbiao , Li Peizhe , Bai Xiaojing
Published: January 2025

To meet the requirements of smart factories and intelligent industrial settings, it is of great significance to develop a reading recognition method for pointer meters. As existing methods lack the robustness necessary for complex environments and are overly specialized for specific meter types. In this paper, a robust and general method for pointer meter reading recognition is introduced. Our method demonstrates adaptability to a wide range of pointer meter types and maintains effectiveness under extreme conditions. Initially, a Tiny-YOLO object detection network is utilized to distinguish meters from the background. Subsequently, a multi-head key point detection network with a fusion strategy based on Swin Transformer is employed to identify four key points. The unique multi-head structure facilitates the key point detection of various image quality. The percentage indication is calculated using the angular method based on the key points. The numerical indication and the units come from the refined optical character recognition network by a large language model. Several extreme experiments have been conducted to demonstrate the robustness of our methods, with an average quoted error of less than 0.24%.
Octagonal nested CSRR sensor for improved liquid permittivity sensing
Authors: Borthakur Maitri , Buragohain Akash , Beria Yatish , Kalita Partha Protim , Doloi Trishna , Das Gouree Shankar
Published: January 2025

In this work, an octagonal shaped CSRR has been modified to form a nested structure for achieving a better field-material interaction. This modification results in an increase in the electrical length of the resonator providing higher sensitivity while accurately determining the complex permittivity of unknown samples. The resonator has been designed using high frequency structure simulator software with its structural dimensions chosen to operate at 2.4 GHz of the ISM band. It has been fabricated on a low-cost FR4 substrate where the nested CSRR structure is etched on the ground plane. A lumped equivalent circuit model of the proposed design is further developed using advanced design system software for the validation of the operating principle of the sensor. Some commonly available liquids covering a wider range of dielectric constants have been used to develop an equation between the permittivity parameters of the liquid and the transmission coefficients of the resonator. The sensor has effectively predicted both the real and imaginary parts of permittivity of toluene and aniline used as unknown samples with accuracy as high as 97%. The average and normalized sensitivity of the proposed sensor have been found to be 78.34 MHz/ϵ′ and 3.273% respectively. A comparison of this work with other recently reported works clearly indicates the superiority of this work and its potential to be used as a dielectric sensor.
Dislocation bow-out pair-mediated migration of boundaries in a TiAl alloy
Authors: Wen Daosheng , Qiao Yang , Kong Beibei , Wang Xinwei , Qian Chunguang , Sun Yongshuo , Zhang Minghao , Lv Qinghua
Published: January 2025

The migration of twin boundaries plays a crucial role in the formability of TiAl alloys at low temperatures. In this study, the dislocation bow-out pair-mediated migration of boundaries in TiAl alloys was systematically investigated. A model describing the interaction of Shockley dislocation bow-out pairs was developed based on the theory of dislocations. The thermodynamics of dislocation bowing were thoroughly examined, revealing the formation mechanisms of two types of dislocation bow-outs in terms of their formation energy and stress field interactions. A critical bow-out angle, φ
c, was proposed as a criterion for the transition from a triangular to a trapezoidal bow-out. Additionally, the relationship among the critical bow-out angle, maximum bow-out height, and the spacing of bow-out pairs was derived.
Effect of ultra-violet (UV) degradation on polyvinyl fluoride (PVF) films: investigating structural, thermal, surface, and mechanical properties
Authors: Chehat N , Doulache N , Sali S
Published: January 2025

This paper investigates the effect of UVC irradiation on the structural, thermal, mechanical, and surface properties of polyvinyl fluoride (PVF) films. To achieve this, PVF films were characterized using Raman and FTIR spectroscopy, x-ray diffraction (XRD), Differential Scanning Calorimetry (DSC), Nano-indentation, optical profilometer, and x-ray Photoelectron Spectroscopy (XPS). Raman and FTIR spectroscopy revealed significant changes in band intensities, indicating alterations in the chemical structure, such as crosslinking and chain scission and oxidation. XRD analysis confirmed these findings, showing changes in microstrain consistent with the shifts observed in Raman bands. FTIR spectra also showed the formation of carbonyl (C=O) and C=C stretching groups, indicative of oxidation and photodegradation processes. DSC analysis revealed that crystallinity and Tg increased up to 72 h of exposure, after which both decreased. These changes in crystallinity indicate a complex interplay between chain scission and cross-linking mechanisms. Mechanical testing demonstrated corresponding trends in hardness and Young’s modulus, aligning with changes in crystallinity. Surface roughness increased, while the contact angle decreased, indicating enhanced hydrophilicity with prolonged UVC exposure, attributed to photo-oxidation. XPS analysis highlighted significant surface chemical changes, including an increased O/C ratio due to photo-oxidation, which correlated with contact angle and FTIR findings.
Informing grassland ecosystem modeling with in-situ and remote sensing observations
Authors: Arteaga Johny , Hartman Melannie D , Parton William J , Chen Maosi , Gao Wei
Published: January 2025

We simulated historical grassland aboveground plant productivity (ANPP) across the midwestern and western contiguous United States using the DayCent-UV ecosystem model. For this study we developed new methods for informing DayCent-UV of growing season length and validating its plant productivity estimates for grasslands by utilizing a wide range of data sources at multiple scales, from field observations to remotely sensed satellite data. The model’s phenology was informed by the MODIS MCD12Q2 product, which showed good agreement with in-situ observations of growing season commencement and duration across different grassland ecosystems, and with observed historical trends. Model results from each simulated grid cell were compared to a remote-sensing estimate of grassland plant productivity offered by the Rangeland Analysis Platform (RAP). We determined that a modified RAP ANPP calculation that incorporated total annual precipitation instead of mean annual temperature to estimate the fraction of total productivity allocated to roots improved temporal correlations between RAP and field measurements and between RAP and DayCent-UV, We found that RAP provides a valuable data set for evaluating grassland ANPP predictions from ecosystem and other types of models because it provides estimates of grassland plant productivity over large spatial regions and a long historical period and captures temporal variablilty in plant production. This work provides the foundation for using the DayCent-UV model to predict climate change impacts on grassland cecosystem dynamics in the contiguous US.
A Darcy–Forchheimer fluid model with fuzzy norms in variable exponent sequence spaces
Authors: Díaz Palencia José Luis
Published: January 2025

The Darcy–Forchheimer model extends Darcy’s law to account for nonlinear inertial effects in fluid dynamics. This paper integrates fuzzy logic and variable exponent sequence spaces into the model to address the inherent uncertainties and heterogeneities in porous media. Through Fredholm operator theory and fixed-point theorems, we establish the existence and uniqueness of solutions to the nonlinear system. Numerical investigations highlight the impact of varying porous media conditions on fluid behavior. As a main outcome, we observe that solutions exhibit a smooth behavior for moderate levels of permeability and porosity in the media, while for increased fuzzy norms in both media properties, the fluid velocity profile exhibits fluctuations due to the influence of the fuzzy terms.
Optimization of silver/graphene composite coating for GIL touch spring based on cyanide-free electroplating technology
Authors: Yan Jiahao , Wang Qian , Zhang Zichen , Chen Miaomiao , Yang Hao
Published: January 2025

The Gas Insulated Line (GIL) spring contact finger, a critical component connecting GIL units, undergoes displacement over time due to factors such as equipment vibration. This displacement induces friction and wear between the contact finger and the current-carrying conductor, altering the contact state, increasing contact resistance, and adversely affecting electrical power transmission. Moreover, metal debris generated from friction can cause partial discharges within GIL equipment, potentially leading to insulation breakdown and significant equipment damage. To address these challenges, this study proposes the incorporation of graphene into the existing silver-plated layer of the contact finger to enhance wear resistance and optimize overall performance. A silver/graphene composite coating was fabricated using a cyanide-free silver-plating technique based on a thiosulfate system. The coating performance was optimized by varying both the coating thickness and graphene content. Performance evaluation using radar charts identified the optimal coating parameters. Results indicated that at a cathodic current density of 0.4–0.6 A dm−2, the coating surface was smooth, graphene was uniformly distributed, and adhesion was strong. Specifically, a coating thickness of 10 μm with 8.23% graphene content maintained a stable friction coefficient around 1, reduced contact resistance by approximately 100 μΩ compared to pure silver, increased hardness by 7.08 HV, and preserved thermal conductivity and corrosion resistance. In conclusion, the addition of graphene to the silver coating significantly enhances wear resistance, and an appropriate coating thickness effectively improves overall performance. The optimal coating parameters of 10 μm thickness and 8.23% graphene content meet the requirements for performance optimization.
Static and dynamic assessments of park accessibility and equity across different living circles in shenzhen’s core area
Authors: Huang Zhongshan , Jia Qiyue , Luo Shixian , Tu Zhigang , Zhao Lei , Li Siyuan , Lu Zhengyan
Published: January 2025

With the rapid expansion of cities, the demand for park green spaces within urban living circles is increasing. Enhancing park accessibility and distributional equity has become an important avenue for improving urban residents’ quality of life. However, existing studies mainly rely on static population data, neglecting the impact of residents’ dynamic location changes on park accessibility, and lack a systematic analysis across different living circles. To fill this research gap, this paper takes the urban core area of Shenzhen as a case study. By combining static and dynamic population data and employing the improved dynamic two-step floating catchment area (D2SFCA) and the traditional two-step floating catchment area (2SFCA) methods, we systematically evaluate the walkability and equity of parks within different living circles (5-, 15-, and 30 min). The results show significant differences between static and dynamic population distributions, with overall park accessibility being lower for the dynamic population than for the static population. Within the 5 min living circle, the Gini coefficient for the static population is 0.952 but reaches as high as 0.971 for the dynamic population, indicating extreme inequity in park distribution within short walking distances. In the 15- and 30 min living circles, the Gini coefficients for the static population are 0.813 and 0.731, respectively, while those for the dynamic population are 0.882 and 0.785, indicating that the degree of inequitable park resource distribution decreases with increased walking time. Overall, the study reveals that park accessibility for the static population is significantly higher than that for the dynamic population across different living circles, especially within short-time living circles where the difference is most pronounced.
A graph neural network simulation of dispersed systems
Authors: Hashemi Aref , Izadkhah Aliakbar
Published: January 2025

We present a graph neural network (GNN) that accurately simulates a multidisperse suspension of interacting spherical particles. Our machine learning framework is built upon the recent work of Sanchez-Gonzalez et al (2020 ICML vol 119 (PMLR) pp 8459–68) on graph network simulators, and efficiently learns the intricate dynamics of the interacting particles. Nodes and edges of the GNN correspond, respectively, to the particles with their individual properties/data (e.g. radius, position, velocity) and the pairwise interactions between the particles (e.g. electrostatics, hydrodynamics). A key contribution of our work is to account for the finite dimensions of the particles and their impact on the system dynamics. We test our GNN against a representative case study of a multidisperse mixture of two-dimensional spheres sedimenting under gravity in a liquid and interacting with each other by a Lennard–Jones potential. The present GNN framework offers a fast and accurate method for the theoretical study of complex physical systems such as field-induced behavior of colloidal suspensions and ionic liquids. Our implementation of the GNN is available on GitHub at github.com/rfjd/GNS-DispersedSystems.
From Parental Morality to Political Morality
Authors: Clayton Matthew
Published: January 2025

This chapter addresses the implications of independence for children as a conception of parental morality for how governments ought to regulate education and the upbringing of children. It begins by distinguishing between the concepts of justice and legitimacy, and itemizing different ways of regulating society. The central argument of the chapter is that, because they would wrong their child if they enrolled her into a particular religion, parents lack a moral claim to the legal right to enrol their children. The chapter proceeds to examine the implications of independence for children for the political community’s regulation of upbringing in both ideal and non-ideal circumstances. The particular focus is education policy, and an argument is offered for the phased abolition of religious schools.
Storage
Authors: Leachman Jacob W , Wilhelmsen Øivind , Matveev Konstantin I
Published: January 2025

The chapter covers modeling of processes inside liquid hydrogen storage tanks, such as autogenous pressurization and venting of boil-off gas to keep pressure within specified limits, as well as materials commonly used for thermal insulation of tank walls. Reduced-order modeling is based on fundamental mass and energy conservation equations, whereas different heat- and mass transfer-mechanisms are evaluated using theoretical or empirical correlations. Examples are presented for several operational scenarios with tanks of different shapes, sizes, and insulations. Passive and active cooling techniques are considered, such as vapor-cooled shielding, para–orthohydrogen conversion of vented gas, and application of cryocoolers. The calculated trends for boil-off losses in tanks with venting and pressure rise in closed tanks are presented for variable system parameters, including a validation case for a zero-boil-off cycle in a large-scale tank and a techno-economic example for different storage techniques.
2672 Exploring stakeholders’ experiences implementing a navigation program for people living with dementia and their carers
Authors: MacNeil L , Doucet S , Luke A , Faig K , Jarrett P
Published: January 2025

Introduction

Navigating dementia care is challenging, but patient navigation (PN) offers valuable support for this population. The ‘Navigating Dementia NB/Naviguer la démence NB’ program piloted a PN program in New Brunswick, Canada, targeting people living with dementia (PLWD) and their carers. The program aimed to assist participants in navigating health and social care systems, matching their needs with available services.

Methods

Navigating Dementia NB was co-developed by researchers, patient partners, and clinicians. This pilot program embedded six PNs in primary care clinics/centres across the province between July 2022 and July 2023. Using a mixed methods approach, participant surveys and interviews were used to explore program benefits and recommendations for improvement. Focus groups were used to explore facilitators and barriers to program development and implementation.

Results

There were 150 participants (PLWD and carer dyads) enrolled in the PN program who provided informed consent. Interviews were conducted with 36 PLWD and their carers. Focus groups were conducted with nine members of the research team and five patient navigators. Program benefits included: emotional support from navigators, provision of relevant information, and facilitating connections to appropriate services. Recommendations for improvement included: the need for PLWD and their carers to have access earlier in the patient journey and the need to reassess provincial policies related to home care support. Facilitators for implementing a PN program included: providing appropriate staff training and leveraging established connections within the health and social systems. Barriers included a compressed timeline and existing systemic issues to service access.

Conclusions

The findings suggest that embedding PN for PLWD in community based primary care can be done. The program was beneficial for PWLD and their caregivers/care partners. Future plans involve partnering with government to support the implementation and evaluation of a province-wide scale-up of the PN program for this population.
2773 Co-designing an intervention for older adults with multiple conditions, using changes in physical activities to predict decline
Authors: Henderson I , Sheppard JP , Barnes R , McManus RJ
Published: January 2025

Introduction

Multiple long-term conditions (MLTCs) are common in the population, which increase with age and are associated with increased hospital admissions. Identifying early signs of decline, such as restricted physical activity, could help reduce avoidable hospitalisations, however it is not clear how best to do this.

Aim

To co-design with patients, caregivers and primary care professionals (PCPs), an intervention aimed at identifying changes in activity in order to recognise decline in older adults with MLTCs.

Methods

The Person-Based Approach was followed to plan and develop this intervention. Qualitative interviews were conducted with older patients with MLTCs, caregivers, and PCPs to examine perspectives on an intervention measuring changes in physical activity. A prototype app was developed, using these results and patient and public involvement. This was further optimised through iterative think-aloud interviews with patients, caregivers, and PCPs.

Results

Thirty-six interviews were conducted comprising of 17 patients (mean age 79-years, 23% female), eight caregivers and 11 PCPs (GPs, nurses, occupational therapists, and pharmacists). Interviews were recorded, transcribed, and thematically analysed. Findings highlighted the importance of restricted activity as an indicator of decline. Patients often described their experiences of decline through non-specific symptoms, including changes in physical activity. PCPs emphasised the value of knowing about such changes to clinical decision-making. Different technology options for measuring activity were explored, considering data quality, and acceptability of passive/active data collection. The initial prototype intervention was designed for iterative testing and think-aloud interviews will be completed by November and presented.

Conclusion

This study highlights the utility of measuring changes in activity in older patients, and some benefits and lessons learned from co-design. A proactive approach to detecting early decline within community settings may provide opportunities to unplanned hospital admissions.
2772 Poor appetite predicts worse health in community dwelling older adults
Authors: Cox NJ , Lim SER , Sayer AA , Robinson SM
Published: January 2025

Introduction

Poor appetite affects 15–20% of community dwelling older adults. Studies link poor appetite with frailty and sarcopenia; however, lack of longitudinal evidence exists to inform potential causality. We aimed to determine if poor appetite predicts frailty or sarcopenia-related factors in community dwelling older adults.

Methods

Secondary data analysis on adults aged >60 years recruited from, syncope, fragility fracture and comprehensive geriatric assessment clinics with 2.5 year follow up. Appetite was assessed by Simplified Nutritional Appetite Questionnaire (SNAQ); a score of <14/20 defining poor appetite. Hand grip strength (HGS) was measured using a dynamometer, low HGS was defined by European criteria (<27 kg for males and < 16 kg for females). Frailty was measured using self-report of Fried phenotype.

Results

86 participants, mean age of 78 years, 62% female. Sixty-two (72%) were followed up, of those 9 had died. Baseline mean SNAQ score was 15.2 (SD 8.1); 14 (16.3%) scored <14. Mean SNAQ score for the 53 participants at 2.5 year follow up was 14.9, 12 (14%) scored <14. Baseline and follow up SNAQ scores correlated moderately (Pearson’s r = 0.5; P = <.001). Fifteen (28%) individuals had low HGS at follow up, 12 had frailty (22%). Baseline SNAQ score < 14 was associated with increased odds of frailty (OR 18.00; 95% CI 2.92–111.00) and low HGS (OR 7.76; 95% CI 1.62–37.30) after 2.5 years. The association of baseline SNAQ <14 with presence of frailty was robust to adjustment for age and comorbidities (OR 13.50; 95% CI 1.14–160.03), while association with low HGS was attenuated (OR 2.29; 95% CI 0.27–19.39).

Conclusion

Poor appetite is predictive of presence of frailty and low HGS after 2.5 years in community dwelling older adults. This suggests poor appetite as causative in the development of poor health outcomes in older people and so a key intervention target to optimise healthy ageing.
2784 Respiratory syncytial virus hospitalisation burden in older adults in Europe: preliminary results from a systematic analysis
Authors: Ashraf S ,   on behalf of the authors: T Zhang, Ma S , Miao Y , Sun S , Nair H , Fonseca M , Reeves R , Marijam A , Wang X , Li Y
Published: January 2025

Introduction

The disease burden of respiratory syncytial virus (RSV) in older adults is substantial but not well quantified previously. We aimed to estimate country-specific hospitalisation burden of RSV-associated acute respiratory infection in older adults (>60 years) in Europe.

Methods

We collected published data (through a systematic review) and unpublished data (from GSK-sponsored studies and international collaborators) on RSV hospitalisation burden. We used multiple imputation for missing age bands. We applied stepwise statistical adjustment to account for case under ascertainment related to the variations in case definitions, clinical specimens and RSV diagnostic tests in individual studies. We reported country-level RSV hospitalisation rates for countries with ≥1 eligible study reporting point estimate and 95% confidence interval (CI) of the rates (a random-effects meta-analysis was conducted when ≥2 studies were available). As an alternative method, we additionally included studies not reporting 95% CI and calculated the median of the rate point estimates.

Results

Seven studies were included from five countries: Denmark (1), Finland (1), Netherlands (1), Spain (1) and UK (3). Denmark and Spain had the highest and lowest adjusted RSV-associated hospitalisation rate (408/100000, 95% CI: 319–516; and 176/100000, 137–226) in >60 years, which was about 2.4 times the unadjusted estimate. The alternative method with 5 more studies added had similar estimates for the five countries; another country (Norway) was added and it had the highest adjusted hospitalisation rate (742/100000). RSV-associated hospitalisation rate increased with increasing age across all countries.

Conclusions

With RSV vaccines now approved for use in older adults, our findings help inform the need for country-level RSV prevention.
2783 Addressing depression and loneliness in older adults: findings from the BASIL+ randomised control trial
Authors: Littlewood E , Atha L , Bailey D , Ryde E , Shearsmith L , Baker H , Heeley J , McMillan D , Chew-Graham C , Baird K , Fairhurst C , Hollingsworth K , Brady S , Burke L , Agnew E , Coventry P , Traviss-Turner G , Newbronner E , Bosanquet K , Woodhouse R , Crosland S , Wang H , Webster J , Hill A , Clegg A , Gentry T , Lovell K , Ekers D , Gilbody S
Published: January 2025

Background

Older adults were more likely to be socially isolated during the COVID-19 pandemic, with increased risk of depression and loneliness. The Behavioural Activation in Social Isolation (BASIL+) trial investigated whether a Behavioural Activation (BA) intervention delivered remotely could mitigate depression and loneliness in at-risk older people during the COVID-19 pandemic.

Methods

We undertook a multicentre randomised controlled trial [ISRCTN63034289] of BA to mitigate depression and loneliness among older adults (65+) with multiple long-term health conditions, including low mood or depression. BA was delivered remotely (telephone or video call) with intervention participants (n = 218). Control participants received usual care, with existing COVID wellbeing resources (n = 217).

Results

Participants engaged with an average of 5.2 (SD 2.9) of 8 remote BA sessions. Adjusted mean difference (AMD) for depression (Patient Health Questionnaire-9, PHQ-9) at 3 months [primary outcome] was −1.65 (95% CI -2.54 to −0.75, p < 0.001). There was an effect for BA on emotional loneliness at 3 months (AMD -0.37, 95% CI -0.68 to −0.06, p = 0.02), but not social loneliness (AMD -0.05, 95% CI -0.33 to 0.23, p = 0.72). For participants with lower severity depression symptoms (5–9 on the PHQ-9) at baseline, there was an effect AMD PHQ9 1.13 (95% CI –2.26 to 0.01, p = 0.051), though this was less pronounced than for those scoring 10 or more at baseline (−2.48, 95% CI -3.81 to 1.16, p = 0.0002).

Conclusion

Behavioural activation is an effective and potentially scalable intervention that can reduce symptoms of depression and emotional loneliness in at-risk groups in the short term. The findings of this trial add to the range of strategies to improve the mental health of older adults with multiple long-term conditions. These results can be helpful to policy makers beyond the pandemic in reducing the global burden of depression and addressing the health impacts of loneliness, particularly in at-risk groups.
Centralization of prior authorization services at a community health system’s infusion clinics
Authors: Taylor Preston , Kulwicki Benjamin D , Farwig Lindy M , Cynova Rachel , Cannon Maureen , Hu Yueyue
Published: January 2025

Disclaimer

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.

Purpose

The centralization of prior authorization services to prevent denials and improve reimbursement measures at 2 community hospital–based infusion clinics is described.

Current process gaps at 2 hospital-based infusion clinics within the health system were leading to a significant denial burden and high out-of-pocket expenses to patients. As a result, authorization and benefit verification processes were centralized by deploying financial coordinators (FCs) at the beginning of fiscal year 2023. A retrospective cohort data review of participating payer claims from adult patients treated at the infusion clinics compared the pre- and postcentralization financial impact. The primary endpoint was the change in the number and cost of denials related to FC workflow. Secondary endpoints included the change in the number and cost of all initial denials, denial type, and success of local denial recovery efforts. Denials related to FC workflow decreased by 68% in the postcentralization period, with a cost reduction of approximately $1.4 million. Total initial denials decreased by 50%, resulting in a cost savings of $3.8 million. Among the top 10 most common denials, 4 were deemed related to FC workflow and declined dramatically after centralization. Local denial recovery efforts resulted in an organizational savings of $0.2 million and a patient savings of $0.19 million.

Conclusion

Centralization of prior authorization services via utilization of FCs significantly reduced the number and cost of preventable denials and positively impacted denial recovery efforts.
The TDQ-60 Tr—a Picture-Naming Test to Assess Anomia in Turkish Adults and the Elderly: Normative Data and Validation Study in Alzheimer’s Disease and Mild Cognitive Impairment
Authors: Karalı Fenise Selin , Tosun Samet , Eskioğlu Elif İkbal , Çınar Nilgün , Macoir Joël
Published: January 2025

Objective

Anomia is defined by difficulty in retrieving content words like nouns and verbs from long-term memory, independent of any impairments related to articulatory movements or motor speech execution. The tools for measuring picture naming, the conventional method for assessing anomia, are very limited in Turkey. The aim of this study was to adapt the Test de Dénomination de Québec—60 images/Quebec picture-naming test—60 pictures (TDQ-60), a color picture-naming test for adults and the elderly into Turkish, establish its validity, and develop normative data adapted to the Turkish population to address this gap.

Method

We conducted three separate studies. The objective of Study 1 was to culturally adapt the Test de Dénomination de Québec—60 images. In Study 2, we developed normative data for the TDQ-60 Tr adapted to the adult and elderly population in Turkey based on the performance of 414 community residents aged 18 years and older. In Study 3, the known-group validity, the convergent validity, and the test–retest validity of the TDQ-60 Tr were determined.

Results

The results show that the TDQ-60 Tr is reliable in distinguishing participants with Alzheimer’s disease and mild cognitive impairment from healthy participants. The TDQ-60 Tr measures the same cognitive construct as the Boston Naming Test and also has a high test–retest reliability.

Conclusions

In summary, the TDQ-60 Tr is a valid and reliable instrument for assessing naming abilities in adults and the elderly. The results of this study have significant implications for the assessment of naming ability in Turkish-speaking patients. Our work serves as a crucial connection to address the lack of tools for diagnosing anomia in Turkey.
Attention-aware differential learning for predicting peptide-MHC class I binding and T cell receptor recognition
Authors: Niu Rui , Wang Jingwei , Li Yanli , Zhou Jiren , Guo Yang , Shang Xuequn
Published: January 2025

The identification of neoantigens is crucial for advancing vaccines, diagnostics, and immunotherapies. Despite this importance, a fundamental question remains: how to model the presentation of neoantigens by major histocompatibility complex class I molecules and the recognition of the peptide-MHC-I (pMHC-I) complex by T cell receptors (TCRs). Accurate prediction of pMHC-I binding and TCR recognition remains a significant computational challenge in immunology due to intricate binding motifs and the long-tail distribution of known binding pairs in public databases. Here, we propose an attention-aware framework comprising TranspMHC for pMHC-I binding prediction and TransTCR for TCR-pMHC-I recognition prediction. Leveraging the attention mechanism, TranspMHC surpasses existing algorithms on independent datasets at both pan-specific and allele-specific levels. For TCR-pMHC-I recognition, TransTCR incorporates transfer learning and a differential learning strategy, demonstrating superior performance and enhanced generalization on independent datasets compared to existing methods. Furthermore, we identify key amino acids associated with binding motifs of peptides and TCRs that facilitate pMHC-I and TCR-pMHC-I binding, indicating the potential interpretability of our proposed framework.
CRAmed: a conditional randomization test for high-dimensional mediation analysis in sparse microbiome data
Authors: Liu Tiantian , Xu Xiangnan , Wang Tao , Xu Peirong
Published: January 2025

Motivation

Numerous microbiome studies have revealed significant associations between the microbiome and human health and disease. These findings have motivated researchers to explore the causal role of the microbiome in human complex traits and diseases. However, the complexities of microbiome data pose challenges for statistical analysis and interpretation of causal effects.

Results

We introduced a novel statistical framework, CRAmed, for inferring the mediating role of the microbiome between treatment and outcome. CRAmed improved the interpretability of the mediation analysis by decomposing the natural indirect effect into two parts, corresponding to the presence–absence and abundance of a microbe, respectively. Comprehensive simulations demonstrated the superior performance of CRAmed in Recall, precision, and F1 score, with a notable level of robustness, compared to existing mediation analysis methods. Furthermore, two real data applications illustrated the effectiveness and interpretability of CRAmed. Our research revealed that CRAmed holds promise for uncovering the mediating role of the microbiome and understanding of the factors influencing host health.

Availability and implementation

The R package CRAmed implementing the proposed methods is available online at https://github.com/liudoubletian/CRAmed.
A Pilot, Randomized Controlled Trial of Dual Daily HIV and Sexually Transmitted Infection Pre-exposure Prophylaxis Using Tenofovir Disoproxil Fumarate/Emtricitabine and Doxycycline in Gay, Bisexual, and Other Men Who Have Sex With Men and Transgender Women: The DuDHS Study
Authors: Grennan Troy , Mohammed Saira , Edward Joshua , Tattersall Tessa , Gupta Amit K , Seto Joyce , Dennehy Michelle , Romney Marc G , Zhang Wendy , Li Jenny , Trigg Jason , Lima Viviane D , Juwono Stephen , Wong Jason , Zhang Guijun , Montaner Julio S G , Hull Mark W
Published: January 2025

Background

Men who have sex with men (MSM) and transgender women experience high sexually transmitted infection (STI) rates. This study evaluated the feasibility of doxycycline pre-exposure prophylaxis (doxyPrEP) for STI prevention in these key populations.

Methods

Sexually-active MSM and transgender women without human immunodeficiency virus (HIV) with prior syphilis were recruited. Participants initiated HIV PrEP with tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) daily for 48 weeks and were randomized 1:1 to daily doxyPrEP for 48 weeks (immediate arm), or doxyPrEP initiated at 24 weeks (deferred arm). Primary outcomes included adherence, measured using questionnaires, along with tolerability; STI incidence (chlamydia, gonorrhea, syphilis) was a secondary outcome. Nasal carriage of Staphylococccus aureus was assessed serially for doxycycline resistance.

Results

Fifty-two participants were enrolled into the immediate (n = 26) and deferred (n = 26) arms. At 48 weeks, self-reported adherence (≥95%) was 75.0% versus 66.7% (P = .538) for TDF/FTC, and 70.8% versus 61.9% (P = .526) for doxycycline in the immediate versus deferred arms, respectively. No doxyPrEP-related serious adverse events occurred. Incidence of any STI at 24 weeks was reduced in the immediate versus deferred arms, and over 48 weeks, being on doxycycline (vs being off; ie, first 24 weeks of deferred arm) was associated with STI reduction (adjusted odds ratio [aOR] 0.36; 95% confidence interval [CI]: .15–.89). Emergent doxycycline-resistant S. aureus was identified in six individuals, with five in the immediate arm (P = .077).

Conclusions

Dual HIV/doxyPrEP is feasible and associated with a significant reduction in incident STI. Further evaluation of dosing strategies, efficacy and impact on antimicrobial resistance is warranted.
Glucose-dependent insulinotropic polypeptide/glucagon-like peptide 1 receptor agonist tirzepatide promotes branched chain amino acid catabolism to prevent myocardial infarction in non-diabetic mice
Authors: Chen Mengya , Zhao Nan , Shi Wenke , Xing Yun , Liu Shiqiang , Meng Xianxian , Li Lanlan , Zhang Heng , Meng Yanyan , Xie Saiyang , Deng Wei
Published: January 2025

Aims

A novel dual glucose-dependent insulinotropic polypeptide and glucagon-like peptide 1 receptor agonist, tirzepatide (LY3298176, TZP), has been developed to treat Type 2 diabetes mellitus (T2DM). In ischaemic heart diseases, TZP is involved in cardiac metabolic processes. However, its efficacy and safety in treating heart failure (HF) following myocardial infarction (MI) remain uncertain.

Methods and results

Herein, 12 week C57BL/6J mice were subjected to MI surgery, followed by administration of TZP. The effects of TZP on cardiac function and metabolism were thoroughly assessed by physiological, histological, and cellular analyses. Downstream effectors of TZP were screened through untargeted metabolomics analysis and molecular docking. Construct a lower branched chain amino acid (BCAA) diet model to determine whether TZP’s cardioprotective effect is associated with reducing BCAA levels. Our results demonstrated that TZP reduced mortality following MI, decreased the infarct area, and attenuated cardiomyocyte necrosis. Pathological evaluation of cardiac tissues demonstrated increased fibrosis repair and decreased inflammatory infiltration. Mechanistically, untargeted metabolomics analysis uncovered a positive correlation between TZP and the BCAA catabolism pathway. The molecular docking verified that TZP could bind with branched-chain keto acid dehydrogenase E1 subunit α (BCKDHA). TZP reduced BCKDHA phosphorylation at S293, enhanced BCAA catabolism, and inhibited the activation of metabolism by activating rapamycin (mTOR) signalling pathway. Furthermore, mice fed a low-BCAA diet post-MI demonstrated reduced cardiomyocyte necrosis, increased fibrosis repair, and decreased inflammatory infiltration. These cardioprotective effects were further enhanced when used synergistically with TZP.

Conclusion

Taken together, our findings provide new perspectives on the unrecognized role of TZP in cardiac protection. TZP enhanced BCAA catabolism and attenuated BCAA/mTOR signalling pathway in MI mice. Consequently, this study may present novel therapeutic options for patients with HF.
Personalized app-based coaching for improving physical activity in heart failure with preserved ejection fraction patients compared with standard care: rationale and design of the MyoMobile Study
Authors: Zeid Silav , Prochaska Jürgen H , Schuch Alexander , Tröbs Sven Oliver , Schulz Andreas , Münzel Thomas , Pies Tanja , Dinh Wilfried , Michal Matthias , Simon Perikles , Wild Philipp Sebastian
Published: January 2025

Aims

Patients suffering from heart failure with preserved ejection fraction (HFpEF) often exhibit a sedentary lifestyle, contributing to the worsening of their condition. Although there is an inverse relationship between physical activity (PA) and adverse cardiovascular outcomes, the implementation of Class Ia PA guidelines is hindered by low participation in supervised and structured programmes, which are not suitable for a diverse population of HFpEF patients. The MyoMobile study has been designed to assess the effect of a 12-week, app-based coaching programme on promoting PA in patients with HFpEF.

Methods and results

The MyoMobile study was a single-centre, randomized, controlled three-armed parallel group clinical trial with prospective data collection to investigate the effect of a personalized mobile app health intervention compared with usual care on PA levels in patients with HFpEF. Major inclusion criteria were age ≥ 45 years, a diagnosis of HFpEF, LVEF > 40%, and current HF symptoms (NYHA Class I–III). Major exclusion criteria included acute decompensated HF, non-ambulatory status, recent acute coronary syndrome or cardiac surgery, alternative diagnoses for HF symptoms, active cancer treatment, and physical or medical conditions affecting mobility. Participants were recruited from hospitals, general practices, and practices specialized in internal medicine and cardiology in the Rhine-Main area, Germany. Participants underwent an objective 7-day PA measurement with a 3D accelerometer (Dynaport, McRoberts) at screening and after the 12-week intervention period. Following the screening, eligible participants were randomized into one of three groups: standard care (PA consulting), the intervention arm with app-based PA tracking and coaching, or the intervention arm with tracking but without coaching. The primary efficacy endpoint was the change in average daily step count between the average step count at baseline and at the end of the intervention, comparing standard care to a 12-week app-based PA coaching intervention.

Conclusion

Exercise intolerance is a primary symptom in HFpEF patients, leading to poor quality of life and HF-related adverse outcomes due to physical inactivity. The MyoMobile study was designed to investigate the use of app-based coaching to improve PA in patients with HFpEF with a personalized, home-based intervention, focusing on simple step counts for flexibility and ease of integration into daily routines.

Clinical trial registration

URL: https://clinicaltrials.gov/ct2/show/NCT04940312.

Unique identifier

NCT04940312.
Polygenic risk score, dietary inflammatory potential, and incident coronary heart disease
Authors: Liu Bangquan , Li Yun , Han Minghui , Yuan Chenxi , Liu Bisen , Ren Xiyun , Liu Tianyu , Huang Keyong , Li Jianxin , Liu Fangchao , Lu Xiangfeng , Tian Wenjing
Published: January 2025

Aims

Dietary inflammatory potential and genetic factors are reported as being linked to coronary heart disease (CHD). We aimed to investigate their joint association with CHD incidence.

Methods and results

We included 51 889 British participants from the UK Biobank who completed the 24-h dietary assessment at baseline. We used reduced rank regression and stepwise linear regression analyses to generate an empirical dietary inflammatory pattern (EDIP) score to assess dietary inflammatory potential. A polygenic risk score (PRS) for CHD was constructed based on 1.7 million genetic variants. During a median follow-up of 11 years, 1346 incident cases of CHD were observed. High EDIP scores significantly increased the risk of CHD with the hazard ratio (HR) [95% confidence interval (CI)] of 1.26 (1.10–1.45) for high EDIP scores (T3) compared with low EDIP scores (T1). Interestingly, we observed a gradient in the risk of CHD across PRS categories, with the HRs of 1.12 (95% CI: 0.73–1.71), 1.20 (95% CI: 1.01–1.43), and 1.42 (95% CI: 1.10–1.83) in low (Q1), intermediate (Q2–4), and high (Q5) PRS categories, respectively. When the joint effect was examined, individuals with high PRS (Q5) and high EDIP scores (T3) would have the highest risk of CHD with a HR of 3.87 (95% CI: 2.74–5.46) compared with individuals with both low PRS (Q1) and low EDIP scores.

Conclusion

High dietary inflammatory potential was associated with a higher CHD risk, especially in those with high PRS, suggesting that a comprehensive assessment of inflammatory diet and genetic factors may be beneficial in the prevention of CHD.