bluuebunny/crossref_metadata_2025 huggingface dataset:
The association between preoperative COVID-19-positivity and acute postoperative complication risk among patients undergoing orthopedic surgery
Authors: Mercier Michael R. , Koucheki Robert , Lex Johnathan R. , Khoshbin Amir , Park Sam S. , Daniels Timothy R. , Halai Mansur M.
Published: September 2023

Aims

This study aimed to investigate the risk of postoperative complications in COVID-19-positive patients undergoing common orthopaedic procedures.

Methods

Using the National Surgical Quality Improvement Programme (NSQIP) database, patients who underwent common orthopaedic surgery procedures from 1 January to 31 December 2021 were extracted. Patient preoperative COVID-19 status, demographics, comorbidities, type of surgery, and postoperative complications were analyzed. Propensity score matching was conducted between COVID-19-positive and -negative patients. Multivariable regression was then performed to identify both patient and provider risk factors independently associated with the occurrence of 30-day postoperative adverse events.

Results

Of 194,121 included patients, 740 (0.38%) were identified to be COVID-19-positive. Comparison of comorbidities demonstrated that COVID-19-positive patients had higher rates of diabetes, heart failure, and pulmonary disease. After propensity matching and controlling for all preoperative variables, multivariable analysis found that COVID-19-positive patients were at increased risk of several postoperative complications, including: any adverse event, major adverse event, minor adverse event, death, venous thromboembolism, and pneumonia. COVID-19-positive patients undergoing hip/knee arthroplasty and trauma surgery were at increased risk of 30-day adverse events.

Conclusion

COVID-19-positive patients undergoing orthopaedic surgery had increased odds of many 30-day postoperative complications, with hip/knee arthroplasty and trauma surgery being the most high-risk procedures. These data reinforce prior literature demonstrating increased risk of venous thromboembolic events in the acute postoperative period. Clinicians caring for patients undergoing orthopaedic procedures should be mindful of these increased risks, and attempt to improve patient care during the ongoing global pandemic.

Cite this article: Bone Jt Open 2023;4(9):704–712.
Variant Rebellions: Psychic Compromise in Obi; or, Three-Fingered Jack
Authors: Khan Yasser Shams
Published: September 2023

Abstract: This paper explores certain fundamental aspects of melodramatic theatricality used to depict the colonial world on the London stage at the turn of the century. As melodrama was a hybrid of comedy, tragedy, pantomime, and sentimentalism, the juxtaposition of a variety of these compositional strategies opens up the interpretation of John Fawcett's successful pantomime Obi; or Three-Fingered Jack (1800) and its later 1830 melodramatic adaptation by William Murray. As examples of racial melodramas, these plays disrupt the otherwise conventional moral polarity typical of melodramas by situating archetypal melodramatic characters in a morally ambiguous, theatrically conceptualized colonial space. Stage apparatus and performance were but two aspects of melodramatic theatricality that were deployed to recreate the colonial world. The basic argument in this paper explores the contrary pulls within these plays. On the one hand, the spectators' cathartic celebration of the rebels' expulsion at the end of the play entrenches their identification with British imperial ideology by arousing collective feelings of patriotism, thus consolidating the national identity of spectators as British imperialists. On the other hand, the visuals and the music that depict the colonial social order of a slave colony and the heroic feats of the rebel slave opened up a space of possible critique of British imperial ventures. These contrary drives within the melodramatic form are reformulated in terms of a "psychic compromise" in which the act of rebellion is endorsed for its dramatic potential to arouse fantasies of heroic revolt but is ultimately compromised in a larger ideological frame that celebrates the empire and the reconstitution of colonial order. This paper offers insights into the popular cultural perception of the empire, obliquely illuminating the larger historical processes of empire building during the late eighteenth and early nineteenth centuries.
Hermeneutics, the Hebrew Bible, and the Cosmopolitan Reader
Authors: Anderson Misty G.
Published: September 2023

Abstract: A review of Yael Almog's Secularism and Hermeneutics , a book examining how eighteenth-century German biblical hermeneutics shaped public interpretive practices in secularized, universalized forms and made the Bible, in both its "Judeo" and "Christian" components, a common cultural asset that produced a collective body of readers.
Feeling Profit at the Cusp of Modern Capitalism
Authors: Yahav Amit S.
Published: September 2023

Abstract: A review of Michael Genovese's The Problem of Profit: Finance and Feeling in Eighteenth-Century British Literature .
Paths Not Taken: How Did Nomadism Affect Border-Making during National Delimitation in Central Asia?
Authors: Rindlisbacher Stephan , Thomas Alun
Published: September 2023

SUMMARY: The national delimitation of Soviet Central Asia in 1924 embedded a particular interpretation of nationhood into the constitutional structures of the Soviet Union. Pastoral nomadism was still common, and the dichotomy between sedentary and nonsedentary peoples became important in dividing nationalities: Uzbek versus Kyrgyz, Kazakh, and Turkmen. But the decision to build territorial national autonomies enhanced the importance of borders, and the logic of internal borders became insensitive to nomadic interests. The eventual project of national delimitation sidelined alternative viable scenarios for rearranging the region's populations and territories, such as a Central Asian Federation, economic raionirovanie , or embracing a nomadic perspective on space. Резюме: Понятие нации, положенное в основу конституционной структуры Советского Союза, сформировалось в ходе национального размежевания Средней Азии в 1924 г. Кочевое животноводство оставалось широко распространенным в регионе, и дихотомия между оседлыми и неоседлыми народами играла важную роль в дифференциации национальностей: узбеков и кыргызов, казахов и туркмен. Однако выбор в пользу создания территориальных национальных автономий повысил важность республиканских границ, а бюрократическая логика поддержания границ продемонстрировала нечувствительность к интересам кочевников. Окончательный проект национального размежевания заставил отказаться от альтернативных сценариев организации населения и территорий региона, таких как Среднеазиатская федерация, экономическое районирование или принятие кочевого восприятия пространства.
Theoretical study of graded-index fiber for beam quality improvement and SRS suppression
Authors: Jiang Mingrui , Zhang Entao , Wang Danfeng
Published: September 2023

A confined-doped graded-index fiber model was established with reference to Nufern’s
42C ytterbium-doped fiber. The core NA of the fiber is ∼0.06; the doping/core/cladding diameter is
30/42/250 µm; and the gain ion doping distribution is double
parabolic. Based on a forward tandem-pumped amplifier structure, the
numerical simulation was carried out on the physics characters of the
fiber model. The fourth-order Runge–Kutta method was used to solve the
boundary value problem during the numerical simulation. The
differences between the graded-index fiber (GIF) and the step-index
fiber (SIF) were studied theoretically, and the results illuminated
that the beam quality of the GIF was better than the SIF. The
stimulated Raman scattering (SRS) power in the GIF was lower than that
in the SIF. These results show that the GIF has great potential for
increasing the laser output power while maintaining good beam quality
and can provide theoretical guidance and reference to experimental
research of the high-power fiber laser.
Power equalization-based disaggregated optical network using switched gain equalization controlled amplifiers
Authors: Anchal Abhishek , Chatterjee Sumit , Sanghi Deepak , Maheshwari Praveen , Lichtman Eyal
Published: September 2023

Optical network disaggregation is an attractive agreement to avoid vendor lock-in in choosing desirable partners based on lead time of delivery and facilitates strong negotiations. Disaggregation of conventional coherent transceivers (XCVRs) with 400G ZR+ technologies (of similar bandwidth density and form factor QSFP-DD) allows operators to enjoy significant cost reduction and substantial power savings in high-capacity IP over a WDM transmission. However, interoperability between low power and high back-to-back required optical signal-to-noise ratio (OSNR) of ZR+ and high power with relatively lower back-to-back required OSNR of conventional coherent XCVRs limits the performance of the latter, which makes disaggregation more complex. This can be avoided by equalizing the power of ZR+ and conventional XCVRs, by wavelength-selective switches (WSSs) in re-configurable optical add/drop multiplexers. However, such power equalization can lead to lower link OSNR, originating from insertion loss and penalty caused by cascaded WSSs. In this Letter, we use a dynamic gain equalizer of a switched gain equalization controlled (SGEC) amplifier at each in-line amplifier site to equalize the powers, without introducing insertion loss or filter penalty. We report a field trial of a low power 400G-ZR+ QSFP-DD-DCO as an alien channel over ten high-power coherent host channels, interoperating with open forward error correction, between two different vendors. We obtain a similar Q-margin in the absence and presence of 400-ZR+ channel, suggesting the equalization by SGEC amplifiers. We further simulate the power and OSNR evolution of channels along the field trial link to verify the equalization. Simulation results are consistent with that of the field trial.
Serial synthesis of mid-infrared optical parametric amplifiers for enlarging a gain bandwidth
Authors: Gu Xingbin , Ding Yufang , Yuan Peng , Wang Jing , Qian Liejia , ma Jingui
Published: September 2023

Broadband optical parametric amplifiers (OPAs) require a group-velocity matching between the signal and the idler. For mid-infrared OPAs, however, the group-velocity matching is usually difficult to meet, rendering a limited gain bandwidth. Here, we report a serial synthesis of bandwidth-limited OPAs to provide a broad gain bandwidth. In a proof-of-principle experiment, two mid-IR OPAs based on KTA crystals with different phase-matching angles are sequentially employed to amplify different spectral regions of a broad seed pulse centered at 3.1 µm. Compared to the traditional two-stage OPA, here the gain bandwidth is nearly doubled, resulting in a much shorter compressed pulse. Such a serial synthesis approach, independent of a nonlinear crystal and an interaction wavelength, particularly suits for enlarging the gain bandwidth of OPAs when broadband amplification is impossible to achieve by a single crystal.
8.8 Gbps PAM-4 visible light communication link using an external modulator and a neural network equalizer
Authors: Shi Jianyang , Wei Yuan , Luo Zhiteng , Li Ziwei , Shen Chao , Zhang Junwen , Chi Nan
Published: September 2023

This Letter presents an experimental demonstration of a visible light communication system utilizing a LiNbO3 external modulator to support the transmission of pulse amplitude modulation (PAM)-4 signals. To solve the problem of the low-frequency fluctuations and inter-symbol interference (ISI) introduced by the external modulator-based system, a neural network with a low-frequency signal as the second label (LFNN) is proposed. A data rate of 8.8 Gbps using PAM-4 is experimentally achieved under the 7% hard-decision forward error correction (HD-FEC) bit-error-ratio (BER) limit of 3.8 × 10−3. To the best of our knowledge, this work represents the highest transmission data rate achieved thus far using external modulation in visible light communication systems.
Deep-learning-enabled electromagnetic near-field prediction and inverse design of metasurfaces
Authors: Kanmaz Tevfik Bulent , Ozturk Efe , Demir Hilmi Volkan , Gunduz-Demir Cigdem
Published: September 2023

Metasurfaces generate desired electromagnetic wavefronts using sub-wavelength structures that are much thinner than conventional optical tools. However, their typical design method is based on trial and error, which is adversely inefficient in terms of the consumed time and computational power. This paper proposes and demonstrates deep-learning-enabled rapid prediction of the full electromagnetic near-field response and inverse prediction of the metasurfaces from desired wavefronts to obtain direct and rapid designs. The proposed encoder–decoder neural network was tested for different metasurface design configurations. This approach overcomes the common issue of predicting only the transmission spectra, a critical limitation of the previous reports of deep-learning-based solutions. Our deep-learning-empowered near-field model can conveniently be used as a rapid simulation tool for metasurface analyses as well as for their direct rapid design.
Mixtures of strategies underlie rodent behavior during reversal learning
Authors: Le Nhat Minh , Yildirim Murat , Wang Yizhi , Sugihara Hiroki , Jazayeri Mehrdad , Sur Mriganka
Published: September 2023

In reversal learning tasks, the behavior of humans and animals is often assumed to be uniform within single experimental sessions to facilitate data analysis and model fitting. However, behavior of agents can display substantial variability in single experimental sessions, as they execute different blocks of trials with different transition dynamics. Here, we observed that in a deterministic reversal learning task, mice display noisy and sub-optimal choice transitions even at the expert stages of learning. We investigated two sources of the sub-optimality in the behavior. First, we found that mice exhibit a high lapse rate during task execution, as they reverted to unrewarded directions after choice transitions. Second, we unexpectedly found that a majority of mice did not execute a uniform strategy, but rather mixed between several behavioral modes with different transition dynamics. We quantified the use of such mixtures with a state-space model, block Hidden Markov Model (block HMM), to dissociate the mixtures of dynamic choice transitions in individual blocks of trials. Additionally, we found that blockHMM transition modes in rodent behavior can be accounted for by two different types of behavioral algorithms, model-free or inference-based learning, that might be used to solve the task. Combining these approaches, we found that mice used a mixture of both exploratory, model-free strategies and deterministic, inference-based behavior in the task, explaining their overall noisy choice sequences. Together, our combined computational approach highlights intrinsic sources of noise in rodent reversal learning behavior and provides a richer description of behavior than conventional techniques, while uncovering the hidden states that underlie the block-by-block transitions.
Estimating the proportion of clinically suspected cholera cases that are true Vibrio cholerae infections: A systematic review and meta-analysis
Authors: Wiens Kirsten E. , Xu Hanmeng , Zou Kaiyue , Mwaba John , Lessler Justin , Malembaka Espoir Bwenge , Demby Maya N. , Bwire Godfrey , Qadri Firdausi , Lee Elizabeth C. , Azman Andrew S.
Published: September 2023

Background

Cholera surveillance relies on clinical diagnosis of acute watery diarrhea. Suspected cholera case definitions have high sensitivity but low specificity, challenging our ability to characterize cholera burden and epidemiology. Our objective was to estimate the proportion of clinically suspected cholera that are trueVibrio choleraeinfections and identify factors that explain variation in positivity.

Methods and findings

We conducted a systematic review of studies that tested ≥10 suspected cholera cases forV.choleraeO1/O139 using culture, PCR, and/or a rapid diagnostic test. We searched PubMed, Embase, Scopus, and Google Scholar for studies that sampled at least one suspected case between January 1, 2000 and April 19, 2023, to reflect contemporary patterns inV.choleraepositivity. We estimated diagnostic test sensitivity and specificity using a latent class meta-analysis. We estimatedV.choleraepositivity using a random-effects meta-analysis, adjusting for test performance. We included 119 studies from 30 countries.V.choleraepositivity was lower in studies with representative sampling and in studies that set minimum ages in suspected case definitions. After adjusting for test performance, on average, 52% (95% credible interval (CrI): 24%, 80%) of suspected cases represented trueV.choleraeinfections. After adjusting for test performance and study methodology, the odds of a suspected case having a true infection were 5.71 (odds ratio 95% CrI: 1.53, 15.43) times higher when surveillance was initiated in response to an outbreak than in non-outbreak settings. Variation across studies was high, and a limitation of our approach was that we were unable to explain all the heterogeneity with study-level attributes, including diagnostic test used, setting, and case definitions.

Conclusions

In this study, we found that burden estimates based on suspected cases alone may overestimate the incidence of medically attended cholera by 2-fold. However, accounting for cases missed by traditional clinical surveillance is key to unbiased cholera burden estimates. Given the substantial variability in positivity between settings, extrapolations from suspected to confirmed cases, which is necessary to estimate cholera incidence rates without exhaustive testing, should be based on local data.
Implementing physical activity calorie equivalent (PACE) food labelling: Views of a nationally representative sample of adults in the United Kingdom
Authors: Daley Amanda J. , Kettle Victoria E. , Roalfe Andrea K.
Published: September 2023

Background

Nutritional labels aim to support people to make informed healthy food choices, but many people do not understand the meaning of calories on food labels. Another approach is to provide calorie information with an interpretation of what the calorie content of food means for energy expenditure, known as physical activity calorie equivalent (PACE) labelling. PACE aims to illustrate how many minutes of physical activity are equivalent to the calories contained in food/drinks. This study investigated the views of the public about the possible implementation of PACE labelling.

Methods

Data was obtained from a nationally representative sample of adults in the United Kingdom and collected by UK Ipsos KnowledgePanel. Panellists are recruited via a random probability unclustered address-based sampling method. 4,000 panellists were randomly invited to participate and asked to compare their views about traffic light and PACE labelling preferences and behaviour parameters.

Results

Data were analysed descriptively and using logistic and multinomial regression analyses. 2,668/4,000 (67%) of those invited participated. More participants preferred traffic light (43%vs33%) than PACE labelling, but more reported PACE was easier to understand (41%vs27%) and more likely to catch their attention (49%vs31%). More participants thought PACE was more likely to help them avoid high calorie food than traffic light labelling (44%vs28%). Physically active (3–4 or 5+ days/week) respondents were more likely to report PACE would catch their attention than traffic light labelling, compared with less active participants (weighted adjusted relative risk ratio = 1.42 (1.00–2.00) and 1.45 (1.03–2.05 respectively)). Perceived overweight was the most predictive factor (weighted adjusted OR = 2.24 (1.19 to 4.20)) in whether PACE was considered useful in helping people decide what to eat/buy.

Conclusion

The public identified value to their health in labelling food with PACE information. PACE labelling may be a useful approach to complement current approaches to food labelling.
Rapid, high-throughput phenotypic profiling of endosymbiotic dinoflagellates (Symbiodiniaceae) using benchtop flow cytometry
Authors: Anthony Colin Jeffrey , Lock Colin , Bentlage Bastian
Published: September 2023

Endosymbiotic dinoflagellates (Family Symbiodiniaceae) are the primary producer of energy for many cnidarians, including corals. The intricate coral-dinoflagellate symbiotic relationship is becoming increasingly important under climate change, as its breakdown leads to mass coral bleaching and often mortality. Despite methodological progress, assessing the phenotypic traits of Symbiodiniaceae in-hospite remains a complex task. Bio-optics, biochemistry, or “-omics” techniques are expensive, often inaccessible to investigators, or lack the resolution required to understand single-cell phenotypic states within endosymbiotic dinoflagellate assemblages. To help address this issue, we developed a protocol that collects information on cell autofluorescence, shape, and size to simultaneously generate phenotypic profiles for thousands of Symbiodiniaceae cells, thus revealing phenotypic variance of the Symbiodiniaceae assemblage to the resolution of single cells. As flow cytometry is adopted as a robust and efficient method for cell counting, integration of our protocol into existing workflows allows researchers to acquire a new level of resolution for studies examining the acclimation and adaptation strategies of Symbiodiniaceae assemblages.
The development of Dutch COVID-19 ICU triage guidelines from an institutional work perspective
Authors: Broughton Tamara Christina , Weggelaar-Jansen Anne Marie , de Graaff Bert
Published: September 2023

Introduction

Throughout the COVID-19 pandemic, two ICU triage guidelines were developed in the Netherlands—the Pandemic Guideline and the Guideline Code Black—ostensibly to tackle the threat of absolute care scarcity. Healthcare guidelines are generally based on evidence and prescribe what healthcare professionals should do in certain situations. We used the institutional work perspective, focusing on the human agency to create, maintain, and/or disrupt institutional structures, to study the development of these guidelines and observed that they did a lot more than just offering guidance to healthcare professionals. By including the Actor Network Theory (ANT) perspective on materiality’s agency in our theoretical lens, we show how guidelines, as a materiality—a non-human artefact—interact with human actors and as such shape and are shaped by the social context.

Methods

17 online documents were analyzed. This analysis resulted in a timeline of events, which was used to identify key actors in the guideline development process. We included 12 purposely sampled respondents for semi-structured interviews. Interview transcripts were thematically coded.

Results

During their development, the guidelines played a role in diverse forms of institutional work performed by a variety of stakeholders to: 1) strengthen the medical profession of intensivists; 2) control the medical profession; 3) gain support for the actions needed; and 4) protect the medical profession. In turn, institutional work performed by these stakeholders also shaped the guidelines, indicating the two-sidedness of the interaction between human actors and materiality in the healthcare context.

Conclusions

This case study shows how guidelines as a materiality and human actors interact and influence each other in multiple ways, resulting in institutional work and thus shaping two institutions: the guidelines and healthcare professions. We found that a materiality does not stand on its own but influences and shapes institutional work in relation to human actors. By studying the development, implementation, and use of the guidelines, we gained more empirical insights into the impact materiality can have on the social context of healthcare and how this can influence existing institutional environments.
Women’s awareness, knowledge, attitudes, and behaviours towards nutrition and health in Pakistan: Evaluation of kitchen gardens nutrition program
Authors: Shah Nadia , Zaheer Sidra , Safdar Nilofer Fatimi , Turk Tahir , Hashmi Shahkamal
Published: September 2023

Introduction

Vulnerability to malnutrition is very high with low-income women and their children in rural Balochistan with contributing factors including lack of awareness about proper nutrition, low literacy, scarcity of vegetables and fruit, and low purchasing power of households. The Food and Agriculture Organization’s kitchen garden program provides resources to improve nutrition and health knowledge and promote healthy eating practices. The objective of this study was to assess nutrition and health awareness, knowledge, attitudes, behavioural intentions/behaviours (AKAB) of women who attended the kitchen garden program and trainings.

Materials and methods

A community based cross-sectional survey (N = 209) using a two-stage cluster sampling method was used to select households with survey participants being mothers with children under five years of age. A pretested questionnaire was administered via face-to-face surveys by trained enumerators in two districts of Balochistan province of Pakistan. Nutrition and health AKAB were constructed indices. Chi-square tests compared statistical differences in AKAB by women attending against a control group who did not-attend kitchen garden interventions. Binary logistic regression analyses were performed to assess kitchen garden program outcomes against key AKAB indicators, while adjusting for covariates.

Results

Significant differences (p<0.001) were identified between intervention and control groups with women attending kitchen garden being more aware of the components of kitchen garden (65.8% vs 36.8%), and more knowledgeable about causes of illnesses caused by poor nutrition including, iron deficiency anemia, pregnancy, and unborn child health complications, compared to women not attending kitchen gardens program. Logistic regression analysis identified women attending kitchen gardens also had higher odds of being more knowledgeable (OR = 1.59, 95%CI 1.27–1.99, p<0.001), having improved attitudes (OR = 4.86, 95%CI 2.77–8.53, p <0.001), and behavioural intentions/behaviours (OR = 1.98, 95%CI 1.26–3.12, p = 0.003) towards improved nutrition and health.

Conclusions

Substantial opportunities exist for achieving improved nutrition and health outcomes with vulnerable groups in Balochistan, through greater participation in kitchen gardens behavioural change programs and interventions. As part of scaling-up efforts, academically rigorous project evaluations should be institutionalized for continuous improvement of nutrition programs to address micronutrient deficiencies in rural communities.
Assessment of positive selection across SARS-CoV-2 variants via maximum likelihood
Authors: Middleton Carly , Kubatko Laura
Published: September 2023

Study of the genome of the SARS-CoV-2 virus, particularly with regard to understanding evolution of the virus, is crucial for managing the COVID-19 pandemic. To this end, we sample viral genomes from the GISAID repository and use several of the maximum likelihood approaches implemented in PAML, a collection of open source programs for phylogenetic analyses of DNA and protein sequences, to assess evidence for positive selection in the protein-coding regions of the SARS-CoV-2 genome. Across all major variants identified by June 2021, we find limited evidence for positive selection. In particular, we identify positive selection in a small proportion of sites (5-15%) in the protein-coding region of the spike protein across variants. Most other variants did not show a strong signal for positive selection overall, though there were indications of positive selection in the Delta and Kappa variants for the nucleocapsid protein. We additionally use a forward selection procedure to fit a model that allows branch-specific estimates of selection along a phylogeny relating the variants, and find that there is variation in the selective pressure across variants for the spike protein. Our results highlight the utility of computational approaches for identifying genomic regions under selection.
The battle to achieve Sustainable Development Goal Two: The role of environmental sustainability and government institutions
Authors: Gyimah Justice , Saalidong Benjamin M. , Nibonmua Louis K. M.
Published: September 2023

The current period marked by addressing environmental sustainability challenges and the instability of government institutions has heightened the issue of food security, especially in developing countries as they work towards achieving Zero Hunger as highlighted in the Sustainable Development Goals. To assess the effect of environmental sustainability and government institutions on food security in West Africa with data from 1990 to 2021, two models have been deployed. The Generalized Method of Moments was deployed as the main model and while Two-Stage Least Squares was used as the robustness check. The findings of the study reveal that carbon emissions which represent environmental sustainability has no direct significant effect on food security, while government institutions has negative effect on food security. The study also reveals that income and urbanization promote food security, while renewable energy and population growth reduce food security. The findings of the study could be a reflection of the current political instability and attitude towards tackling carbon emissions mitigation in the region. Government institutions are encouraged to exercise authority without fear to implement policies that would encourage food security and restrict the use of high-emission technologies.
A hierarchical model for strategic and operational planning in blood transportation with drones
Authors: Amirsahami Amirali , Barzinpour Farnaz , Pishvaee Mir Saman
Published: September 2023

Blood transportation is a critical aspect of the healthcare systems, ensuring whole blood and blood products are delivered to patients in a timely and efficient manner. However, transportation of blood and other medical supplies can be challenging, especially in urban areas with limited infrastructure and heavy traffic. Drones have become increasingly important in recent years as a means of delivering medical supplies, including blood, due to their ability to provide fast, reliable, and cost-effective transportation. This study proposes two mathematical programming models in the hierarchical structure to improve decision-making for strategic and operational planning in the blood supply chain network. The limited information available in strategic planning presents risks to the blood supply chain, making it imperative to address uncertainties. To tackle this challenge, a novel approach called Scenario-based Robust Bi-objective Optimization has been proposed. The first model employs this approach to efficiently handle demand uncertainty by simultaneously maximizing the covered demand and minimizing costs. The model is subsequently solved using the augmented ε-constraint method. The second model is a routing-scheduling operational model that aims to minimize the sum of operations time, taking into account time windows for blood collection centers and hospitals. The developed hierarchical model is implemented in a three-level supply chain of Tehran province under three crisis scenarios in different parts. The findings and analysis of this implementation suggest that it is beneficial to set up drone stations in cost-effective and central locations to avoid costly network design. Furthermore, utilizing the minimum number of feasible drones enhances operational time and results in cost savings and increased efficiency. Overall, this study highlights the potential of using drones for blood transportation in urban settings, which can have significant implications for improving the quality of healthcare delivery.
Optionality in Australian Football League draftee contracts
Authors: Chandrakumaran Jemuel , Larkin Paul , McIntosh Sam , Robertson Sam
Published: September 2023

Though player drafts have commonly been utilised to equitably disperse amateur talent and avoid bidding wars, often they have also been accused of creating a monopsony labour market which restricts player movement. Within the Australian Football League (AFL) some have called for the increase of the initial draftee contract from two to three seasons, which further pushes the envelope on monopsony power. Instead of increasing the contract length, this paper suggests a call option to be purchased by the teams allowing them to add a further season to the draftee contract at a predetermined compensation package should they choose to do so at the end of the initial contract. The call prices per pick were calculated using the Black-Scholes model and were valued between 1% and 1.5% of the pick value. However, it failed to follow a monotonic function similar to pick value, owing to managerial overconfidence and sunk investment plays. Overall, the findings allow teams to procure the option of increasing initial draftee contracts and not impede further on a player’s ability to move.
Burnout and fatigue amongst internal medicine residents: A cross-sectional study on the impact of alternative scheduling models on resident wellness
Authors: Yuan Jack H. , Huang Yiming , Rosgen Brianna K. , Donnelly Sarah , Lan Xiaoyang , Katz Steven J.
Published: September 2023

Background

Fatigue and burnout are prevalent among resident physicians across Canada. Shifts exceeding 24 hours are commonly purported as detrimental to resident health and performance. Residency training programs have employed strategies towards understanding and intervening upon the complex issue of resident fatigue, where alternative resident scheduling models have been an area of active investigation. This study sought to characterize drivers and outcomes of fatigue and burnout amongst internal medicine residents across different scheduling models.

Methods

We conducted cross-sectional surveys were among internal medicine resident physicians at the University of Alberta. We collected anonymized socioeconomic demographics and medical education background, and estimated associations between demographic or work characteristics and fatigue and burnout outcomes.

Results

Sixty-nine participants competed burnout questionnaires, and 165 fatigue questionnaires were completed (response rate of 48%). The overall prevalence of burnout was 58%. Lower burnout prevalence was noted among respondents with dependent(s) (p = 0.048), who identified as a racial minority (p = 0.018), or completed their medical degree internationally (p = 0.006). The 1-in-4 model was associated with the highest levels of fatigue, reported increased risk towards personal health (OR 4.98, 95%CI 1.77–13.99) and occupational or household harm (OR 5.69, 95%CI 1.87–17.3). Alternative scheduling models were not associated with these hazards.

Conclusions

The 1-in-4 scheduling model was associated with high rates of resident physician fatigue, and alternative scheduling models were associated with less fatigue. Protective factors against fatigue are best characterized as strong social supports outside the workplace. Further studies are needed to characterize the impacts of alternative scheduling models on resident education and patient safety.
A hybrid adaptive large neighborhood search for time-dependent open electric vehicle routing problem with hybrid energy replenishment strategies
Authors: Fan Lijun
Published: September 2023

As competition intensifies, an increasing number of companies opt to outsource their package distribution operations to professional Third-Party Logistics (3PL) fleets. In response to the growing concern over urban pollution, 3PL fleets have begun to deploy Electric Vehicles (EVs) to perform transportation tasks. This paper aims to address the Time-Dependent Open Electric Vehicle Routing Problem with Hybrid Energy Replenishment Strategies (TDOEVRP-HERS) in the context of urban distribution. The study considers the effect of dynamic urban transport networks on EV energy drain and develops an approach for estimating energy consumption. Meanwhile, the research further empowers 3PL fleets to judiciously oscillate between an array of energy replenishment techniques, encompassing both charging and battery swapping. Based on these insights, a Mixed-Integer Programming (MIP) model with the objective of minimizing total distribution costs incurred by the 3PL fleet is formulated. Given the characteristics of the model, a Hybrid Adaptive Large Neighborhood Search (HALNS) is designed, synergistically integrating the explorative prowess of Ant Colony Optimization (ACO) with the localized search potency of Adaptive Large Neighborhood Search (ALNS). The strategic blend leverages the broad-based solution initiation of ACO as a foundational layer for ALNS’s deeper, nuanced refinements. Numerical experiments on a spectrum of test sets corroborate the efficacy of the HALNS: it proficiently designs vehicular itineraries, trims down EV energy requisites, astutely chooses appropriate energy replenishment avenues, and slashes logistics-related outlays. Therefore, this work not only introduces a new hybrid heuristic technique within the EVRP field, providing high-quality solutions but also accentuates its pivotal role in fostering a sustainable trajectory for urban logistics transportation.
Analysis of left-turn behaviors of non-motorized vehicles and vehicle-bicycle conflicts
Authors: Feng Tianjun , Liu Jingyao , Liang Chunyan , Tian Xiujuan , Chen Chun , Liu Keke
Published: September 2023

In order to further study the expansion characteristics of left-turning non-motorized vehicles at intersections and the relationship between expansion characteristics and vehicle-bicycle conflicts, the trajectory point data of left-turning non-motorized vehicles are extracted using video trajectory tracking technology, and construct the cubic curve expansion envelope equation with the highest fitting degree. For the purpose of quantifying the expansion degree of non-motor vehicles after starting, two intersections in Guangxi Zhuang Autonomous Region were selected for case analysis, and the numerical range of expansion degree of the intersection with a left-turn waiting area and the intersection without a left-turn waiting area was obtained. Study the mathematical relationship between the expansion degree and its influencing factors, and establish the multivariate nonlinear regression equation between the expansion degree and the left-turn non-motorized vehicle flow, the number of parallel non-motorized vehicles, and the left-turn green light time. Analyze the vehicle-bicycle conflicts caused by the expansion of left-turning non-motorized vehicles, determine the essential factors affecting the number of non-motorized vehicles, and establish the multiple linear regression equation between the number of non-motorized vehicles and the number of left-turning non-motorized vehicles, the expansion degree, and the number of parallel non-motorized vehicles, the results show that the model has high accuracy. By analyzing the expansion characteristics of left-turning non-motorized vehicles at intersections, the relationship between different influencing factors and the expansion degree is obtained. Then the vehicle-bicycle conflicts under the influence of expansion characteristics is analyzed, providing theoretical ideas for improving traffic efficiency and optimizing traffic organization at intersections.
Monitoring the appropriate prescription of low molecular weight heparins and Fondaparinux through administrative data. A retrospective observational study in the Tuscany region
Authors: Moretti Giaele , Vinci Bruna , Zito Simona , Caputo Alessia , Attanasio Francesco , Vainieri Milena
Published: September 2023

Introduction

Low Molecular Weight Heparins (LMWHs) and Fondaparinux have been widely used as anticoagulants. Mass prescription may lead to prescriptive inappropriateness, which causes Heparin-induced thrombocytopenia and other side effects.

Objectives

The study investigates the appropriate prescription of LMWHs and Fondaparinux in Tuscany. We aim to validate the crude measure of prescription appropriateness of the Key Performance Indicator (KPI) “Patients treated with LMWHs and Fondaparinux every hundred residents in Tuscany” as a proxy for monitoring prescription appropriateness.

Methods

To compare a crude KPI based only on drug consumption with a refined KPI based on exclusions listed in the clinical guidelines, a retrospective observational cohort study was carried out, using the RECORD guidelines for the year 2019. The refined indicator is computed via record linkage of different datasets regarding (a) pharmaceutical services; (b) hospital discharge records; (c) outpatient services; and (d) birth certificates. We apply exclusion criteria to identify the cohort of patients. Values of the KPI are compared, by ranking, with those obtained from its refined version. A Spearman test was performed to validate the use of the crude KPI as a proxy.

Results

208,717 LMWH and Fondaparinux users are identified, of which 103,299 fall within the study’s inclusion criteria. 16,817 (16%) of LMWHs and Fondaparinux users are classified as high consumption. The refined version of the KPI produces the same ranking results in terms of local health districts (rho = 0.98 p<0.01).

Conclusions

Although the crude KPI is less refined and detailed than the adjusted indicator computed by our study, it has proven capable to provide an accurate snapshot of the use of these drugs across the region. This analysis is useful to enable regional and local managers to run rapid and simple indicators to monitor the appropriateness of LMWHs and Fondaparinux. This analysis should be reviewed periodically to confirm its accuracy.
Phenotypic and genotypic resistance to antibiotics in Staphylococcus aureus strains isolated from cattle milk in Northern Kazakhstan
Authors: Baymenov Bakhit Muratovich , Bulashev Aitbay Kabykeshovich , Сhuzhebayeva Gulzhagan Dzhambulovna , Aliyeva Gulnur Kozyevna , Beishova Indira Saltanovna , Kokanov Sabit Kabdyshevich , Raketsky Vitaly Anatolevich
Published: September 2023

Background and Aim: Staphylococcus aureus is the most frequent and ubiquitous cause of mastitis in cows. In recent decades, antibiotic resistance has rapidly spread among infectious disease pathogens in Kazakhstan and globally. This study examined the phenotypic and genotypic resistance of S. aureus strains obtained from cattle milk to antibiotics.

Materials and Methods: In 2021 and 2022, 675 cow milk samples were collected from 16 dairy farms in Northern Kazakhstan. Staphylococcus aureus was identified using culture and biochemical methods. The nature of antibiotic resistance was determined by the disk diffusion (DD) method. The distribution of antibiotic resistance genes was determined by polymerase chain reaction.

Results: Among the obtained S. aureus isolates, high levels of resistance to β-lactam antibiotics (100%), tetracyclines (95.4%), fluoroquinolones (95.4%), and macrolides (60.92%) were observed. Meanwhile, the lowest levels of resistance were identified for sulfonamides (21.84%) and aminoglycosides (27.59%). All the obtained isolates were positive for the nuc gene encoding thermonuclease. The blaZ, ermC, and tetK genes were detected in 45.9%, 77%, and 83.9% of the studied S. aureus isolates, respectively.

Conclusion: The results indicate a high prevalence of antibiotic resistance in S. aureus isolated from cows with clinical and subclinical forms of mastitis in Northern Kazakhstan. In addition, the prevalence of resistance was higher when evaluated by the DD method than when detecting the specific antibiotic resistance genes blaZ, tetK, and ermC, indicating the need for deeper analysis of the phenotypic and genetic determinants of antibiotic resistance.

Keywords: antibiotic resistance genes, cow milk, polymerase chain reaction, Staphylococcus aureus strains.
Within-site adaptation: Growth and mortality of Norway spruce, Scots pine and Silver birch seedlings in different planting positions across a soil moisture gradient
Authors: Nordin Per , Olofsson Erika , Hjelm Karin
Published: September 2023

Adapting to site conditions is a central part of forest regeneration and can be done through selection of different planting positions. Requirements are tree species specific, and the use of soil moisture maps could be a way to support decision making in forest regeneration planning. At two experimental sites with varying soil moisture conditions in southern Sweden Norway spruce (Picea abies (L.) Karst.), Scots pine (Pinus sylvestris L.), and silver birch (Betula pendula Roth) seedlings were planted in four different planting positions following mounding site preparation; Depression, Hinge, Mound and Unscarified. Soil moisture estimates were obtained from a high-resolution depth-to-water raster for each planting spot. The effect of soil moisture, planting position and their interactions on mortality, height and diameter was evaluated for each tree species. In wet conditions mounds proved to be the best option to minimize seedling mortality for conifers, but with decreasing soil moisture, differences between the planting positions decreased. Birch on the other hand had the greatest survival in the hinge. The coniferous species displayed increased height and diameter when planted in mounds independent of the soil moisture conditions, whereas silver birch was less dependent on a specific planting position. Results from this study shows that a soil moisture map can explain mortality, height and diameter and thus can be a useful tool when choosing planting position in different soil moisture conditions.
The Unification of Sensibility and the Transcendental Unity of Apperception
Authors:   The T. S. Eliot Society Of Korea, KIM Younghee
Published: September 2023

Immanuel Kant argued that the object does not represent the state of the thing-in-itself, but becomes a phenomenon constructed by human subjectivity in general, and this is called the Copernican revolution. Kant is a philosopher representing German Idealism, followed by Bradley and Bergson. In the meantime, it has been assumed that Eliot’s core poetics developed from the cognitive framework of Bergson or Bradley: the concept of flux that grasps the time of the past, present, and future as an indivisible continuum in mutually organic relationships, immediate experience, historical consciousness, Impersonality, and unification of sensitivity, etc. in “Tradition and Individual Talent,” “Hamlet,” and “Metaphysical Poets.” However, in the “Report on Kant’s Categories” submitted by Eliot to a philosophy class at Harvard University in Mar. 2013, it can be confirmed that Eliot was already aware of Kant’s transcendental philosophy. Eliot’s unification of sensibility, which represents an experience in which, intellect and sensibility are unified, is nothing other than Kant’s transcendental unity of apperception.
Visión cristiana de la ciencia y la técnica en Teilhard de Chardin
Authors: Udías Vallina Agustín
Published: September 2023

La ciencia y la técnica tienen hoy una gran influencia en la vida humana, proporcionando la ciencia la visión del universo y condicionando la técnica el progreso de las condiciones de vida en un mundo globalizado. Teilhard de Chardin reconoce estas funciones de la ciencia y la técnica y trata de dar una visión cristiana de ellas. Propone que la visión del mundo de la ciencia no solo es compatible con la fe, sino que debe ayudarnos a conocer mejor a Dios creador. Por otro lado, es en este mundo conocido por la ciencia que Dios se ha encarnado en Cristo y, de esta forma, la investigación científica se convierte en una forma de adoración. Para Teilhard la visión evolutiva del mundo que nos da la ciencia encuentra en Cristo su último fin, de forma que la cosmogénesis se convierte en una Cristogénesis. La técnica se ha de ver dentro de este proceso evolutivo del mundo como elemento importante de la evolución humana. Esta evolución llevará a la llegada del ultra-humano y finalmente a la unión del mundo con Cristo-Omega. Para Teilhard, ciencia y técnica tienen de esta forma finalmente una dimensión cristológica.