bluuebunny/crossref_metadata_2025 huggingface dataset:
Estimating Market Growth for New Products: An Analogical Diffusion Model Approach
Authors: Thomas Robert J.
Published: September 2003

There has been a lot of interest in diffusion models as a basis for prelaunch estimates of the sales of new products, and indeed there have been several models developed that have achieved fairly good acceptance by new product managers. One of the limitations of such models, however, has been the requirement that a sales history for the new product, even a short one from a test market, for example, be available to derive the parameters of the model. For some types of products—consumer durables, services, industrial products, for example—a sales history isn't available. In this article, Professor Robert Thomas suggests some steps toward the development of models that incorporate the attractive features of diffusion models. His approach is to use, in a systematic way, the sales histories of products that can be considered to have analogous features from a buyer's point of view. He illustrates the approach by forecasting the sales of a new service.
Managing Research and Development for Results
Authors: Richardson Peter R.
Published: September 2003

Companies seeking excellence in R&D have discovered that the role of R&D has to be understood throughout the firm and that R&D has to be a fully integrated part of corporate strategy. In this article, Peter Richardson provides a framework for building a strategic view of R&D, using five conceptual building blocks that have to be cemented together to get good results.
From Experience: The Corporate Black Hole
Authors: Abend C. Joshua
Published: September 2003

There is a lot of creative potential lying dormant in corporations because too many managers fail to see innovation as a process to be deliberately managed. C. Joshua Abend sees innovation connected to virtually everything that happens—or doesn't happen—in an organization. He offers in this article ideas that managers can use to remove the impediments to increased innovation and productivity.
Phospholipid-Binding Protein Cts1 Controls Septation and Functions Coordinately with Calcineurin in
Cryptococcus neoformans
Authors: Fox Deborah S. , Cox Gary M. , Heitman Joseph
Published: October 2003

Cryptococcus neoformans
is an opportunistic fungal pathogen that causes life-threatening meningoencephalitis in immunocompromised patients. The Ca
2+
-calmodulin-activated protein phosphatase calcineurin is necessary for virulence of
C. neoformans
. Mutants lacking the calcineurin catalytic (Cna1) or regulatory (Cnb1) subunit fail to grow at elevated temperature and are defective in virulence and hyphal elongation. Here we isolated a multicopy suppressor gene,
CTS1
, which restores growth of a calcineurin mutant strain at 37°C. The
CTS1
gene (for calcineurin temperature suppressor 1) encodes a protein containing a C2 domain and a leucine zipper motif that may function as an effector of calcineurin. The
CTS1
gene was disrupted by homologous recombination, and
cts1
mutants were viable but exhibited defects in cell separation, growth, mating, and haploid fruiting. In addition,
cts1
mutants were inviable when calcineurin was mutated or inhibited. Taken together, these findings suggest that calcineurin and Cts1 function in parallel pathways that regulate growth, cell separation, and hyphal elongation.
Giant cell arteritis
Authors: Calvo-Romero J M
Published: September 2003

Giant cell arteritis (GCA), temporal arteritis or Horton’s arteritis, is a systemic vasculitis which involves large and medium sized vessels, especially the extracranial branches of the carotid arteries, in persons usually older than 50 years. Permanent visual loss, ischaemic strokes, and thoracic and abdominal aortic aneurysms are feared complications of GCA. The treatment consists of high dose steroids. Mortality, with a correct treatment, in patients with GCA seems to be similar that of controls.
Role of microbiological investigations in the management of non-perineal cutaneous abscesses
Authors: Garcea G , Lloyd T , Jacobs M , Cope A , Swann A , Berry D
Published: September 2003

Background

Pus samples for microbiological examination are routinely sent after incision and drainage of abscesses. There is no evidence that microbiology reports influence treatment for non-perineal cutaneous abscesses.

Aims

This study assessed (1) how often the microbiology report is used to manage patients’ treatment after incision and drainage of an abscess and (2) junior surgical trainees’ opinions on sending pus for microbiological examination.

Method

A retrospective analysis of the notes of all patients undergoing incision and drainage of abscesses from January 2001 to January 2002 was made. A telephone poll of junior surgical trainees was also undertaken.

Results

Most patients, 91%, had specimens referred for microbiology. Of these 43% yielded no growth. Staphylococcus aureus was the most common organism (55.9% of all positive cultures). Anaerobes were a frequent finding from axilla and groin abscesses. Mycobacterium tuberculosis was grown in two patients. Other less common organisms cultured were methicillin resistant S aureus (n=1) and Proteus sp (n=1). Follow up of microbiology reports was found to be inadequate.

Conclusion

The bacteria present in non-perineal cutaneous abscesses are, for the most part, predictable. However, a significant number grow less common organisms. It is concluded that pus specimens should be sent routinely for culture and sensitivity and there should be further emphasis on following up microbiology reports by junior medical staff.
Effects of diltiazem on platelet activation and cytosolic calcium during percutaneous transluminal coronary angioplasty
Authors: Dai H , Chen J , Tao Q , Zhu J , Zhang F , Zheng L , Qiu Y
Published: September 2003

Aims

To evaluate effects of diltiazem on platelet hyper-reactivity in situations associated with endothelial injury and their possible relationship to cytosolic calcium concentration.

Methods

Blood samples were collected at seven time points from 35 patients undergoing percutaneous transluminal coronary angioplasty (PTCA) who received combined diltiazem and aspirin/ticlopidine therapy or aspirin/ticlopidine therapy alone. Platelet expression of glycoprotein IIb/IIIa and P-selectin, production of thromboxane B2, and cytosolic calcium concentration were measured, respectively, by whole blood flow cytometry, radioimmunoassay, and fluorospectrophotometry. The effects of diltiazem of different concentrations on expression of glycoprotein IIb/IIIa and P-selectin were also studied in vitro in blood samples from patients with chronic stable angina.

Results

Of the two treatments, aspirin/ticlopidine therapy did not prevent an acute increase of expression of glycoprotein IIb/IIIa and P-selectin and plasma thromboxane B2 five minutes and 10 minutes after first inflation and 10 minutes after PTCA, whereas combined diltiazem and aspirin/ticlopidine therapy had a significant inhibitory effect. In the group receiving aspirin/ticlopidine therapy, there was a short term increase of platelet [Ca2+]i immediately after PTCA which was significantly reduced by diltiazem treatment. Expression of glycoprotein IIb/IIIa and P-selectin was significantly inhibited in vitro by diltiazem in the concentration of 200 ng/ml or higher, but not 50 ng/ml.

Conclusions

Combined diltiazem and aspirin/ticlopidine therapy significantly inhibited platelet activation that continued in the presence of conventional aspirin/ticlopidine treatment. Antiplatelet effects of diltiazem were probably a consequence of reduction of platelet [Ca2+]i and may only be achieved in higher than therapeutic concentrations.
QUANTUM DOT INFRARED DETECTORS AND SOURCES
Authors: BHATTACHARYA P. , STIFF-ROBERTS A. D. , KRISHNA SANJAY , KENNERLY S.
Published: September 2003

InAs/GaAs quantum dot devices have the potential to be the leading technology for infrared detection and emission, which are necessary for many military and domestic applications. Quantum dot infrared photodetectors yield higher operating temperatures, lower dark currents, and more wavelength tunability. They also permit the detection of normal-incidence light. Quantum dot infrared sources are also expected to yield higher operating temperatures, in addition to lower threshold currents and higher modulation bandwidths. After a brief review of the history of infrared detection and emission, the optical and electrical characteristics of self-organized In(Ga)As/GaAs quantum dots grown by molecular beam epitaxy are discussed, followed by results for the quantum dot detectors and emitters that have been developed at the University of Michigan, Ann Arbor.
MID-INFRARED GaSb-BASED LASERS WITH TYPE-I HETEROINTERFACES
Authors: DONETSKY D. V. , MARTINELLI R. U. , BELENKY G. L.
Published: September 2003

The design of room-temperature, InGaAsSb/AlGaAsSb diode lasers has evolved from the first double-heterojunction lasers described in 1980 that operated in the pulsed-current mode to present-day continuous–wave (CW), high-power, quantum–well diode lasers. We discuss in detail recent results from type-I-heterostructure, GaSb-based CW room-temperature diode lasers. The devices operate within the wavelength range of 1.8 to 2.7 μm, providing output powers up to several Watts. We analyze the factors limiting device performance.
HIGH-FIELD ELECTRON TRANSPORT CONTROLLED BY OPTICAL PHONON EMISSION IN NITRIDES
Authors: KOMIRENKO S. M. , KIM K. W. , KOCHELAP V. A. , STROSCIO M. A.
Published: September 2003

We have investigated the problem of electron runaway at strong electric fields in polar semiconductors focusing on the nanoscale nitride-based heterostructures. A transport model which takes into account the main features of electrons injected in short devices under high electric fields is developed. The electron distribution as a function of the electron momenta and coordinate is analyzed. We have determined the critical field for the runaway regime and investigated this regime in detail. The electron velocity distribution over the device is studied at different fields. We have applied the model to the group-III nitrides: InN, GaN and AlN. For these materials, the basic parameters and characteristics of the high-field electron transport are obtained. We have found that the transport in the nitrides is always dissipative. However, in the runaway regime, energies and velocities of electrons increase with distance which results in average velocities higher than the peak velocity in bulk-like samples. We demonstrated that the runaway electrons are characterized by the extreme distribution function with the population inversion. A three-terminal heterostructure where the runaway effect can be detected and measured is proposed. We also have considered briefly different nitride-based small-feature-size devices where this effect can have an impact on the device performance.
THWARTED METAPHORS: COMPLICATING THE LANGUAGE OF DESIRE IN THE TARGUM OF THE SONG OF SONGS
Authors: Menn Esther
Published: September 2003

Contrary to what might be expected, the allegorical interpretation of the Song of Songs set forth in the Targum of the Song of Songs does not consistently portray God and Israel as male lover and female beloved. Instead, the Targum presents a multiplicity of additional metaphors suggesting the intimacy between divine and human counterparts throughout their history together, including the affective relationships between male friends and scholarly colleagues, siblings, infant and nurse, father and son, gardener and plants, and farmer and animals. Ambivalence towards sexual love and marriage as appropriate theological metaphors, sensitivity to the rich symbolic language of the Song of Songs and other scriptural passages, and celebration of the primacy of Torah study with male colleagues in rabbinic culture all contribute to this diversification of imagery, which builds on the emotive intensity of the Song of Songs even as it complicates the language of desire.
PHOTO MAGIC: PHOTOGRAPHS IN PRACTICES OF HEALING AND HARMING IN EAST AFRICA
Authors: Behrend Heike
Published: September 2003

In this contribution, I present a few examples of practices in present-day African Christian Churches in which photographs 'do magic' and are used to heal or harm. To counter a tendency, inherent in this topic, of exoticizing and othering, I not only give examples of African 'photo magic' but also include European ones, examples that in the 'standard' or 'official' histories of Western photography are missing. In addition, I try to work out the interdependence and the mutual mirroring of Western and African practices and discourses, i.e., aspects of their interculturality, against the background of the Christian Eucharist and cult of relics. For it is in the Eucharist and relics that the paradoxes of simultaneous presence and absence as well as substance and representation are dealt with, paradoxes that will reappear in the photographic practices in Kenya and Uganda. Thus, I attempt to interpret Ugandan and Kenyan photo magic in Christian churches as variations of the Eucharist.
Prospective study of risk factors for early and persistent wheezing in childhood
Authors: Lewis S , Richards D , Bynner J , Butler N , Britton J
Published: September 2003

The object of this study was to determine the relative importance of low birth weight, preterm birth, low maternal age, household size, exposure to maternal smoking, personal smoking at 16 yrs of age, early termination of breastfeeding and socioeconomic status in the aetiology of wheezing illness in the first 5 yrs of life, and on the persistence of this illness at 16 yrs of age. In 15,712 children born in Britain during one week of April 1970, the occurrence of wheezing by 5 yrs of age, and of wheezing in the past year at 16 yrs of age within this group were analysed in multivariate logistic regression against each potential risk factor. The independent determinants of wheezing by 5 yrs of age were male sex, maternal smoking during pregnancy (odds ratio (OR) for 15+ cigarettes.day-1 = 1.39; 95% confidence interval (95% CI) 1.22-1.58) and low birthweight (OR for birthweight < 2.5 kg = 1.26; 95% Cl 1.07-1.50). Of children who had wheezed by 5 yrs of age, 15% reported wheezing in the past 12 months at 16 yrs of age. The persistence of symptoms at 16 yrs of age was independently related to low maternal age (OR for 20 vs 40 yrs of age = 1.96; 95% CI 1.08-3.45) and to high social status (OR for most vs least advantaged = 1.95; 95% CI 1.13-3.38). We conclude that low birth weight and maternal smoking in pregnancy are independent risk factors for early childhood wheezing, but in 85% of children with early wheezing it resolves by 16 yrs of age.(ABSTRACT TRUNCATED AT 250 WORDS)
Effect of altitude on urinary leukotriene (LT) E4 excretion and airway responsiveness to histamine in children with atopic asthma
Authors: Christie PE , Yntema JL , Tagari P , Ysselstijn H , Ford-Hutchinson AW , Lee TH
Published: September 2003

Asthmatic subjects who are resident at altitude may experience a deterioration in lung function following a stay at sea level. To determine whether measurement of urinary leukotriene E4 (LTE4) reflects changes in asthma severity and airway responsiveness, 14 allergic asthmatic subjects resident at altitude (1560 m, Davos, Switzerland) were studied. Subjects were randomly divided into two groups. Measurements of baseline forced expiratory volume in one second (FEV1), the concentration of histamine producing a 20% decrease in FEV1, (PC20 FEV1), serum total immunoglobulin E (IgE), eosinophil count, and urinary LTE4 concentration were determined prior to and following a 2 week stay in The Netherlands (sea level) in eight subjects (4 males and 4 females, aged 14 +/- 0.5 yrs) (mean +/- SEM) and over a similar time period in six subjects (4 males and 2 females, aged 15 +/- 0.3 yrs) resident in Davos, Switzerland. There was no significant difference in total IgE and eosinophil count, and no significant correlation between urinary LTE4 and PC20FEV1 histamine, FEV1, total IgE, and eosinophil count. In subjects returning to Davos from The Netherlands there was a significant increase in urinary LTE4 from a baseline value of 16.9 pg.mg-1 creatinine (GM, range 0.3-101.7 pg.mg-1 creatinine) to 52.3 pg.mg-1 creatinine (GM, range 8.8-301.6 pg.mg-1 creatinine), a significant decrease in PC20FEV1 from 1.7 mg.ml-1 (GM, range 0.3-16.4 mg.ml-1) to 0.9 mg.ml-1 (GM, range 0.1-->32 mg.ml-1), and a significant fall in FEV1 from 3.0 +/- 0.3 to 2.8 +/- 0.3 l (mean +/- SEM).(ABSTRACT TRUNCATED AT 250 WORDS)
The effect of 1 ppm nitrogen dioxide on bronchoalveolar lavage cells and inflammatory mediators in normal and asthmatic subjects
Authors: Jorres R , Nowak D , Grimminger F , Seeger W , Oldigs M , Magnussen H
Published: September 2003

Several studies have suggested that patients with bronchial asthma are more susceptible to the potential effects of nitrogen dioxide (NO2) than healthy subjects, with respect to airway responsiveness and lung function. We investigated whether these differences are paralleled by differences in the cellular and biochemical response within the airway lumen. Twelve subjects with mild extrinsic asthma and eight normal subjects breathed either filtered air or 1 ppm NO2 in a single-blind manner during intermittent exercise for 3 h. Bronchoscopy with bronchoalveolar lavage (BAL) was performed one hour after each exposure, and on a third day without exposure (baseline day). Prostanoids, leukotrienes and histamine were analysed in BAL fluid, and the cellular composition of BAL fluid was assessed. In the asthmatic subjects, NO2 induced a small mean drop in forced expiratory volume in one second (FEV1). Differential cell counts in BAL fluid did not reveal significant effects of NO2. Levels of 6-keto-prostaglandin1 alpha (6-keto-PGF1 alpha) were decreased, and levels of thromboxane B2 (TxB2) and prostaglandin D2 (PGD2) in BAL fluid were increased after NO2 compared to filtered air exposure; whereas, prostaglandin E2 (PGE2), prostaglandin F2 alpha (PGF2 alpha), histamine and leukotriene levels did not change significantly. The normal subjects showed no change in lung function parameters and a small increase in TxB2 after breathing NO2. We conclude that in subjects with mild asthma NO2 is capable of inducing an activation of cells, which is compatible with enhancement of airway inflammation, even if lung function parameters and cellular composition of BAL fluid are not markedly affected.(ABSTRACT TRUNCATED AT 250 WORDS)
Effect of protriptyline, 10 mg daily, on chronic hypoxaemia in chronic obstructive pulmonary disease
Authors: Strom K , Boman G , Pehrsson K , Alton M , Singer J , Rydstrom PO , Uddenfeldt M , Ericsson CH , Ostholm B , Morlin C
Published: September 2003

A daily dose of 20 mg of protriptyline can improve daytime arterial blood gas tensions in chronic obstructive pulmonary disease (COPD). Its usefulness is limited by anticholinergic side-effects. This study examined whether a daily dose of 10 mg of protriptyline improved daytime arterial oxygen tension (PaO2) and quality of life in patients with stable mild or moderate hypoxaemia caused by COPD. Twenty six patients were randomized to receive protriptyline or placebo in a double-blind parallel-group trial for 12 weeks, following a run-in period of 4 weeks, in order to assess the stability of hypoxaemia. Patients with a change in PaO2 of > 0.7 kPa during the run-in were excluded. Spirometry, quality of life and dyspnoea score were measured at randomization and after 12 weeks, whilst arterial blood gas tensions were also measured 2 and 6 weeks after randomization. No improvement in arterial blood gas tensions, spirometry values, dyspnoea score, or quality of life was found in either the protriptyline or the placebo group. The majority of patients receiving protriptyline experienced anticholinergic side-effects, which necessitated the withdrawal of the drug in one patient. We conclude that there was no evidence that a daily dose of 10 mg of protriptyline had a significant effect on daytime arterial oxygen tension in stable mild and moderate hypoxaemia caused by COPD. Despite the low dose, anticholinergic side-effects occurred in most patients.
Activity of latissimus dorsi muscle during inspiratory threshold loads
Authors: Orozco-Levi M , Gea J , Monells J , Aran X , Aguar MC , Broquetas JM
Published: September 2003

The ability of the latissimus dorsi muscle (LD) to participate as an accessory inspiratory muscle has been the subject of controversy. Electromyographic (EGM) activity of LD was evaluated in 11 healthy subjects (aged 30 +/- 2 yrs; forced expiratory volume in one second (FEV1) 106 +/- 5% predicted; maximal inspiratory pressure (Pmax), 120 +/- 6 cmH2O) under different breathing conditions. The ipsilateral biceps brachii was chosen as the control muscle. The EMG was recorded from surface electrodes, but needle electrodes were also used for LD evaluation in a subset of three subjects. The EMG signal from both muscles was recorded simultaneously, rectified and integrated, with subtraction of the electrocardiographic signal. Situations evaluated were: 1) maximal voluntary contraction (MVC); 2) apnoea; and 3) breathing under progressive inspiratory threshold loads (20-100% Pmax, at 20% intervals). A close relationship was evident between LD recordings from surface and needle electrodes (r = 0.975). Activity of LD at baseline was 1.8 +/- 0.4% MVC, and showed a phasic increase during inspiration under loads. This change had a linear tendency and was significant for loads corresponding to 40, 60, 80 and 100% of Pmax when compared to the control muscle. At this latter level, LD activity was equivalent to 32 +/- 5% MVC (range 11-61%), whereas mean activity of the control muscle was less than 7.5% MVC.(ABSTRACT TRUNCATED AT 250 WORDS)
A threshold loading device for testing of inspiratory muscle performance
Authors: Eastwood PR , Hillman DR
Published: September 2003

Threshold loading is a method of incrementally loading the inspiratory muscles, which requires development of an adjustable threshold pressure (Pth) before air will flow. In the ideal device, flow is independent of pressure once Pth is exceeded. A "weighted plunger" apparatus is commonly used, but devices described previously perform unreliably at high inspiratory load. We have modified this apparatus using the diaphragm and valve seating from a threshold valve used to deliver positive airway pressure (AMBU 10, AMBU International, Denmark) to yield improved pressure-flow characteristics. With this device, there was a linear relationship between Pth and weight on the plunger (r = 0.998), and flow was largely independent of pressure once Pth was exceeded: pressure developed at an inspiratory flow of 1.3 +/- 0.1 l.s-1 was 13.6 +/- 7.0% below Pth. Our modified weighted plunger apparatus allows consistent and reliable threshold loading of inspiratory muscles, even at high inspiratory loads.
Cation-Exchange Properties of CrPO4
Authors: Mustafa S. , Murtaza S. , Naeem A. , Dilara B. , Farina K.
Published: September 2003

Alkali metal ion exchange (Li+, Na+ and K+) on chromium phosphate (CrPO4) was studied potentiometrically as a function of temperature and metal ion concentration. The shift in the potentiometric titration curves corresponding to the exchange of alkali metal cations increased with increasing pH and concentration of the metal ions, while the opposite results were obtained by increasing the temperature of the system. The affinity of the exchanger for alkali metal ions was also found to be in the order Li+ > Na+ > K+. The data were employed to evaluate the apparent deprotonation constants of CrPO4 and the corresponding thermodynamic parameters ΔH0, ΔS0 and ΔG0.
Interactive Behaviour of Structures Equipped with Combined Seismic Dampers and Unbounded Foundations
Authors: Tsai C. S. , Chen Bo-Jen , Pong W. S.
Published: September 2003

The use of supplemental damping to dissipate seismic energy is one of the most economical and effective ways to mitigate the effects of earthquakes on structures. Both displacement-dependent and velocity-dependent devices dissipate earthquake-induced energy effectively. Combining displacement-dependent and velocity-dependent devices for seismic mitigation of structures minimizes the shortcomings of individual dampers, and is the most economical solution. Previous studies have focused on reducing seismic responses of a damped structure without considering the consequence of the unbounded foundation. To better understand the seismic response of structures, it is necessary to anticipate the interaction of damped structures and the unbounded foundations during earthquakes. This paper focuses on the flexibility and radiation effects on a time-domain procedure based on the finite element method for damped structures. The infinitesimal finite-element cell method for unbounded media addresses the interactive behaviour of a damped structure and the foundation with an unbounded far field. In this study, significant differences between the system with and without the radiation damping are observed. To obtain better accuracy, the radiation damping needs to be properly taken into account. Quantitative results also reveal that interaction effects between damped structures and unbounded media are important.
Buckling and Vibration of Stiffened Panels or Single Plates with Clamped Ends
Authors: Watson A. , Kennedy D. , Williams F. W. , Featherston C. A.
Published: September 2003

An efficient method for the buckling and vibration analysis of plates or stiffened panels with clamped ends is presented. The method uses Lagrangian multipliers to couple sinusoidal modes with appropriate half-wavelengths of response, thereby enforcing the end conditions at discrete point supports. Clamped ends can usually be modelled accurately using only a few point supports, while arguments from symmetry often enable some of the required end conditions to be satisfied without explicitly applying constraints. In such cases few half-wavelengths are needed to obtain excellent accuracy. Solutions obtained for the simple limiting case of single plates are exact or within 1% of the classical or other reported solutions. Solutions obtained for stiffened panels are in close agreement with those obtained using finite element analysis.
Trends in Fills, Spending, and Prices of Doxepin for Insomnia
Authors: Cai Christopher L. , Kesselheim Aaron S. , Rome Benjamin N.
Published: February 2025

This cross-sectional study explores US prescription fills, retail spending, and prices of low-dose doxepin for insomnia and the possible cost savings to patients had they used liquid doxepin, a less expensive formulation.
Supporting Primary Care for Medically and Socially Complex Patients in Medicaid Managed Care
Authors: Ash Arlene S. , Alcusky Matthew J. , Ellis Randall P. , Sabatino Meagan J. , Eanet Frances E. , Mick Eric O.
Published: February 2025

Importance

In 2023, the Massachusetts Medicaid and Children’s Health Insurance Program (MassHealth) required accountable care organizations (ACOs) to increase payments to primary care practices and shift to monthly payments, currently calibrated to historical revenues and enhanced practice capabilities, such as being staffed to address behavioral health needs. To prevent rewarding practices for avoiding difficult patients, future payments to primary care practices should reflect their patients’ apparent need.

Objective

To describe MassHealth’s initiative and a complexity-adjusted payment model.

Design, Setting, and Participants

This cross-sectional study of payment model development and performance was conducted between February 2022 and November 2024. Participants included all 2019 Massachusetts Medicaid managed-care eligible members who were enrolled for 183 days or longer.

Exposures

Medical and social complexity.

Main Outcomes and Measures

For each member, the primary care activity level (PCAL) outcome proxies the resources that primary care clinicians need to provide comprehensive, coordinated care. Models were evaluated via R2 and through ratios of observed-to-expected (ie, estimated by the model) outcomes for selected subgroups, which will be approximately 1.0 when payments and expected costs are well matched. The implications of paying practices using PCAL (vs a model based only on age and sex) were explored by examining financial and practice-level characteristics in high and low deciles of practice-level estimated mean.

Results

Among 1 092 742 MassHealth members enrolled in 3602 primary care practices (1 014 252 person-years; mean [SD] age, 25.9 [18.4] years; 538 065 [53.1%] female), the PCAL model achieved R2 = 69.6% and estimates within 10% of observed PCAL spending for high-risk populations (mental health disorders, substance use disorders, complex chronic conditions, and disabilities) and across racial and ethnic groups. Age-adjusted and sex-adjusted payments would overpay practices in the lowest-need decile by 10% and underpay those in the highest-need decile by 34%, while the PCAL model would match payment to estimated need almost exactly in the lowest decile and underpay by just 6% in the highest decile.

Conclusions and Relevance

MassHealth’s 2023 reform invests in primary care. This cross-sectional study developed a risk model that can adjust primary care payments to patient needs. Neither age and sex adjustments nor inflated historical payments would provide adequate resources to primary care practices caring for the most complex patients.
Research Priorities in Neuropalliative Care
Authors: Lau Winnie K. , Fehnel Corey R. , Macchi Zachary A. , Mehta Ambereen K. , Auffret Manon , Bogetz Jori F. , Fleisher Jori E. , Graber Jerome J. , Leeper Heather E. , Manglani-Terranova Heena R. , Muehlschlegel Susanne , Mroz Emily L. , Pedowitz Elizabeth J. , Ramanathan Usha , Sarmet Max , Shlobin Nathan A. , Sokol Leonard , Weeks Susan Allyson , Xu Jiayun , Bundy Medsger Helen , Creutzfeldt Claire J. , Vranceanu Ana-Maria , Zahuranec Darin B. , Hwang David Y.
Published: February 2025

Importance

The integration of palliative care in neurology, or neuropalliative care, is an emerging area of practice focused on holistically improving quality of life and reducing the burden of suffering for people living with serious neurologic disease and their care partners. Major neurology and palliative care societies have recognized the need to advance primary and specialty palliative care services for people with neurologic disease. However, research to support this work is in its early stages.

Observations

The International Neuropalliative Care Society Research Committee convened an interdisciplinary panel of experts, including clinicians, scientists, people with neurologic disease, and care partners, to identify priority research areas for the advancement of neuropalliative care as a field. Three priority areas highlighted in this review include (1) patient- and care partner–centered symptoms and outcomes specific to neurologic illness and tools for their assessment, (2) development of effective neuropalliative care interventions and delivery models, and (3) methods to support the ability to foster, deliver, and measure goal-concordant care over time.

Conclusions and Relevance

This Special Communication outlines some of the most pressing neuropalliative care research needs, the advancement of which will best serve patients of all ages living with serious neurologic diseases and their care partners. Research funding mechanisms are needed to support and sustain impactful work in this field.
HDAC4 regulates apoptosis in Acan‐CreERT2;HDAC4d/d mice with osteoarthritis by downregulating ATF4
Authors: Huang Jingrui , Xu Yukun , Li Yujia , Pang Yiming , Ding Xueting , Zhou Raorao , Liang Dan , Che Xianda , Zhang Yuanyu , Wang Chunfang , Li Wenjin , Li Pengcui
Published: February 2025

Several studies have previously shown that histone deacetylase 4 (HDAC4) can regulate endoplasmic reticulum stress‐induced apoptosis through the activating transcription factor 4 (ATF4)/CAAT/enhancer binding protein homologous (CHOP) signaling pathway, thereby affecting the progression of osteoarthritis (OA). The present study investigated the regulatory mechanism of HDAC4 in chondrocyte apoptosis in OA using Acan‐CreERT2;HDAC4fl/fl gene knockout mice. Forty mice were divided into four groups: TM‐DMM group [tamoxifen (TM) injection at 2 months of age and destabilization of the medial meniscus (DMM) surgery at 3 months], TM‐sham group (TM injection at 2 months of age and sham surgery at 3 months), no TM‐DMM group (corn oil injection at 2 months of age and DMM surgery at 3 months) and no TM‐sham group (corn oil injection at 2 months of age and sham surgery at 3 months). Apoptosis and cartilage damage were assessed through imaging, histological analysis, immunohistochemistry, reverse transcriptase‐PCR and terminal deoxynucleotidyl transferase‐mediated dUTP nick end labeling staining. HDAC4 knockdown resulted in increased osteophyte formation, significant narrowing of the joint space and increased articular cartilage damage. Furthermore, expression levels of key apoptosis‐related markers, ATF4, CHOP, caspase‐3 and caspase‐9, were significantly higher in the TM groups than in their respective control groups. Taken together, our results suggest that HDAC4 deficiency leads to increased apoptosis induced by the ATF4/CHOP signaling pathway in the pathogenesis of OA. Therefore, upregulation of HDAC4 may represent a potential therapeutic strategy.
Wearable Body Temperature Sensing with Autonomous Self‐regulated Joule Heating and Passive Cooling for Healthcare Applications
Authors: Guo Hongxu , Lu Lichang , Hatton Fiona L. , Xu Lulu , Yu Eileen , Peijs Ton , Bilotti Emiliano , Zhang Han , Liu Yi
Published: February 2025

The positive temperature coefficient (PTC) effect observed in conductive polymer composites (CPCs) holds significant promise due to its wide materials selection and ability to offer enhanced sensitivity. However, traditional CPCs have relatively high PTC switching temperatures (typically above 100 °C) and are often unsuitable for bodily healthcare devices. This study introduces a novel approach leveraging the synergistic effect of an eco‐friendly fatty acid, namely lauric acid (LA), with flexible styrene‐ethylene‐butylene‐styrene (SEBS) thermoplastic elastomer (TPE) as a matrix and graphene nanoplatelets (GNPs) as a conductive filler. The composite film demonstrates exceptional temperature responsiveness at body‐relevant temperatures (35–40 °C) with a PTC intensity reaching an unprecedented 4 orders of magnitude, set apart by its fine‐tuning ability across a remarkable detecting temperature interval (Maximum temperature coefficient of resistance (TCR): 471.4% °C−1). This advancement is facilitated through a carefully engineered morphology, wherein the distribution of LA significantly influences the conductive network's reformation within the composite, with the in‐situ optical microscope used to reveal the reformation of the conductive network structure. The flexible composite demonstrates significant potential for body temperature sensing, self‐regulating heating, and passive cooling, paving the way for future developments in eco‐friendly, highly sensitive, and flexible sensors in wearable health monitoring and thermotherapy.
Molecular Bridge in Wide‐Bandgap Perovskites for Efficient and Stable Perovskite/ Silicon Tandem Solar Cells
Authors: Ye Tianshi , Qiao Liang , Wang Tao , Wang Pengshuai , Zhang Lin , Sun Ruitian , Kong Weiyu , Xu Menglei , Yan Xunlei , Yang Jie , Zhang Xinyu , Yang Xudong
Published: February 2025

Perovskite/silicon tandem solar cells (TSCs) attract intensive attention because of their potential to deliver power conversion efficiencies (PCE) beyond those of their single‐junction counterparts. However, the performance and stability of tandem devices are limited by defect‐assisted non‐radiative recombination and light‐induced halide segregation in wide‐bandgap (WBG) perovskite sub‐cells. Here, 2‐aminoethanesulfonamide hydrochloride (AESCl), with multi‐point chelation sites and bridging capability, is incorporated into a 1.68 eV WBG perovskite to comprehensively passivate defects at grain boundaries and surfaces. As a result, AESCl‐treated perovskite films show suppressed halide segregation and a champion WBG single‐junction solar cell achieves an impressive efficiency of 22.80% with an open‐circuit voltage of 1.286 V due to reduced non‐radiative recombination. The efficient WBG perovskite sub‐cells enable perovskite/silicon TSCs to reach a champion PCE of 30.36% over 1 cm2. Moreover, the tandem devices retain over 96% of their initial efficiency after operation for 1068 h under continuous AM 1.5G illumination at 25 °C in ambient air.
Metastability‐Induced Atom Coordination and Electron Relocalization Toward Dendrite Free All‐Solid‐State Lithium Batteries
Authors: Ke Junmin , Xu Guofeng , Liu Furong , Wang Changhong , Zhao Jinling , Wu Mengru , Zulfiqar Ali , Wang Jiantao , Sun Xueliang
Published: February 2025

Li‐argyrodite electrolytes have attracted special attention as the promising candidate for all‐solid‐state batteries considering its high ionic conductivity and relative stability. However, the interfacial compatibility issues associated with PS43− tetrahedra decomposition led to dendrite growth and rapid battery failure in integrating the lithium metal anode. Herein, in situ electrochemical (de)lithiation of Li6PS5Cl coated with Mg(ClO4)2 (LPSC‐MCO) induced by metastable decomposition is proposed to mitigate undesirable reactions at lithium anode through atomic coordination and electron relocalization. The inhibition of electrochemical decomposition for PS₄3⁻ tetrahedra is due to the formation of PS3O3− and the components regulation from Li2S and Li3P to Li2O, LiCl in solid electrolyte interphase. Additionally, the ab initio molecular dynamics (AIMD) and density functional theory (DFT) analysis are utilized to uncover the fundamental mechanism behind the interactions of Li‐O and Li‐Cl and electron redistribution around O, Cl, and Mg. A high critical current density of 1.9 mA cm−2 and stable lithium plating/stripping behaviors over 2300 h are presented to verify the suppression for lithium dendrite and the NCM/LPSC‐MCO/Li cell consequently exhibits excellent performance. It inspires new pathways of probing into atom coordination and electron relocalization to address (electro)chemical decomposition and dendrite issues in all‐solid‐state batteries.
Construction of Lignin‐Assisted Nitrogen Defective Engineering Graphitic Carbon Nitride for HMF Selective Conversion to Maleic Acid Through Photo‐Thermal Processes
Authors: Zhao Yue , Wang Zhen , Wang Xinrui , Sun Pingli , Meng Fanyao , Yang Guihua , Zhou Xiaomeng , Wang Jianing , Zhang Xinjian , Lyu Gaojin
Published: February 2025

Design engineering for the preparation of green and inexpensive catalysts assisted by lignocellulosic biomass or biomass‐based derivatives has garnered significant attention. Herein, alkali lignin (AL) is utilized as a carbon precursor to prepare porous coral‐like g‐C3N4 (x% PLCN) with nitrogen defects and biochar persistent free radicals (biochar‐PFRs). This catalyst is applied for photo‐thermal catalysis of HMF to produce maleic acid (MA). The optimal yield of MA (50.43%) is achieved using 1.5% PLCN in a GVL/FAc (1:1, V/V) solution at 90 °C for 4 h under visible light irradiation. Results show alkali lignin plays a key role in forming biochar components and introducing nitrogen defects into the catalysts, which significantly boosts H2O2 generation (156.68 µmol L−1 h−1). Under photocatalytic conditions, biochar‐PFRs induce the generation of ·OH through a metal‐free Fenton‐like reaction and provide active sites for the recombination of ·OH and ·O2− to form 1O2. The presence of 1O2 greatly enhances the selective generation of MA. Additionally, the increased Lewis acidity of x% PLCN activates the C─C bond in HMF under thermal catalytic conditions, further facilitating HMF conversion. This work presents a new approach for biomass‐based material refinement through thermal‐photo catalysis.
Automated Fabrication of 3D Printed Magnetic Soft Robots With Programmable 3D Magnetizations
Authors: Sholdice Jackson , Clancy Kaitlyn , Teresinska Karolina , Castro Carl , Watson Lauren , Onaizah Onaizah
Published: February 2025

Magnetic soft robots (MSRs) are a viable tool for many biomedical applications, such as targeted drug delivery and minimally invasive surgery, since they can be actuated remotely using external magnetic fields. These robots are developed by programming ferromagnetic domains with specific magnetizations using magnetic particles embedded in a flexible substrate. Existing fabrication methods rely on partially automated or manual processes, which limit production rates and realistic design iterations. To address these challenges, a fully automated workflow that translates robot simulations into an instruction set for a stereolithography 3D printer is presented. In this process, a rotating permanent magnet is used to program 3D magnetizations by reorienting hard magnetic particles within a photosensitive resin. Geometric resolutions of 1.6 mm are achieved with a layer height of 0.1 mm, enabling the creation of structures 14 layers thick. Beam bending tests identify an optimal 6:1 resin‐to‐magnetic particle mass ratio, yielding a maximum deflection angle of 80°. Demonstrated applications include rolling and climbing locomotion in a maze and independent control of each arm in a multiarmed robot. By enabling fast, repeatable production of MSRs within 30 min, this automated system shortens the feedback loop from design to application, advancing their potential as a biomedical tool.
Understanding the Stability of Poorly Covered Pickering Emulsions Using on‐Chip Microfluidics
Authors: Shen Xuefeng , Chen Chang , van der Meer Berend , Kodger Thomas E. , Sen Uddalok , Deshpande Siddharth , van der Gucht Jasper
Published: February 2025

Particle‐stabilized emulsions, also known as Pickering emulsions, have shown promise in areas that require long‐term stability with minimum use of surfactants. While most work has focused on densely covered Pickering emulsions, such emulsions are known to retain stability even when the interfaces are sparsely covered with particles. Here, the formation, dynamics, and stability of poorly covered model Pickering emulsions are studied in a controlled manner by utilizing a microfluidic platform. The formed Pickering emulsions remain highly stable, over at least 12 h, even with a surface area coverage below 3%. By directly visualizing the droplet interface at various stages, the exceptional stability is attributed to the highly spatially heterogeneous distribution of adsorbed particles which exclusively form particle bridges at the contact point between the droplets. Remarkably, these bridges are assembled in the form of crowns between the droplet interfaces, as visualized by confocal microscopy. The assembly behavior of the adsorbed particles in response to hydrodynamic forces and the formation of non‐uniform particle distribution are discussed by analyzing the different forces present during emulsification, corroborated by numerical simulations. In conclusion, using a lab‐on‐a‐chip approach, this work provides further understanding toward the fabrication of Pickering emulsions via preferential interfacial localization of particles.
Legged Robot with Tensegrity Feature Bionic Knee Joint
Authors: Wen Qi , Zhang Meiling , Sun Jianwei , Li Weijia , Chu Jinkui , Wang Zhenyu , Zhang Songyu , Ren Luquan
Published: February 2025

Legged robots, designed to emulate human functions, have greatly influenced numerous sectors. However, the focus on continuously improving the joint motors and control systems of existing legged robots not only increases costs and complicates maintenance but also results in failure to accurately mimic the functionality of the human skeletal‒muscular system. This study introduces a bionic legged robot structure that leverages the tensegrity principle, drawing inspiration from the human leg's structural morphology and kinematic mechanisms. By designing a system that distinguishes between rolling and sliding movements, the human knee's variable instantaneous center of rotation (ICR), is successfully replicated showcasing its capabilities in achieving gait resemblance and vibration absorption. The tensegrity unit's features, including remarkable deformability, self‐recovery, and the four‐bar mechanism's singular position characteristic, alongside a rope unlocking mechanism reminiscent of human muscles, facilitate in situ compliance–rigid–compliance transitions of the knee joint without the need for knee joint motors, relying solely on ground contact through the foot. This innovation overcomes the conventional dependency of legged robots on joint motors, as the system requires only a single DC motor positioned at the hip joint and a straightforward control program to seamlessly execute a complete cycle of a single leg's movement.
Effect of Extracellular Vesicles Derived From Tumor Cells on Immune Evasion
Authors: Liu Xuanfan , To Kenneth K.W. , Zeng Qinsong , Fu Liwu
Published: February 2025

The crosstalk between immunity and cancer in the regulation of tumor growth is considered a hallmark of cancer. Antitumor immunity refers to the innate and adaptive immune responses that regulate cancer development and proliferation. Tumor immune evasion represents a major hindrance to effective anticancer treatment. Extracellular vesicles (EVs) are nano‐sized and lipid‐bilayer‐enclosed particles that are secreted to the extracellular space by all cell types. They are critically involved in numerous biological functions including intercellular communication. Tumor‐derived extracellular vesicles (TEVs) can transport a variety of cargo to modulate immune cells in the tumor microenvironment (TME). This review provides the latest update about how tumor cells evade immune surveillance by exploiting TEVs. First, the biogenesis of EVs and the cargo‐sorting machinery are discussed. Second, how tumor cells modulate immune cell differentiation, activation, and function via TEVs to evade immune surveillance is illustrated. Last but not least, the novel antitumor strategies that can reverse immune escape are summarized.
Tunable Emissions in Zero‐Dimensional (C6H5CH2NH3)3InBr6 Enabled by Controlled Structural Amorphization
Authors: Li Qian , Xu Bin , Xu Xiaofan , Wang Yayun , Quan Zewei
Published: February 2025

Zero‐dimensional (0D) hybrid metal halides (HMHs) hold great promise as multifunctional emitters. However, precise functionalization of organic moieties and controlled modulation of self‐trapped exciton (STE) emission from inorganic polyhedra remain challenging. This study introduces 0D (PMA)3InBr6 (PMA+ = C6H5CH2NH3+) as a multifunctional emitter, leveraging pressure‐induced structural regulation to control photoluminescence properties. Increasing pressure leads to simultaneous contraction and distortion of InBr63− octahedra, shifting the STE emission color from orange to green. At high compression, structural amorphization quenches STE emission, but upon pressure release, a bright cyan emission from the PMA+ cation emerges, with intensity approximately 21 times stronger than that of the initial STE emission. The enhanced emission is attributed to altered molecular configurations, disrupted intermolecular contacts, and reduced lattice vibrations, collectively suppressing excimeric coupling and minimizing nonradiative losses in the recovered amorphous phase. Furthermore, emission conversion is also achieved via laser‐induced structural amorphization, expanding the potential of (PMA)3InBr6 for direct laser writing and sensitive laser detection applications.