bluuebunny/crossref_metadata_2025 huggingface dataset:
Offensive and Defensive Models of US Foreign Policy in the Middle East
Authors: Krylov Danila Sergeevich
Published: September 2022

The article is devoted to the analysis of the US foreign policy in the Middle East. The study analyzes the military-political, energy and information aspects of the offensive and defensive models of the Middle East policy of the United States at the present stage. The purpose of the study was to examine the results of the implementation of expansionist and exploitative geopolitical projects of the United States in the Middle East, taking into account the influence of the information factor and the Russian-American confrontation in the region. The methodological basis of the study is a systematic approach. The historical approach, statistical methods, event analysis, case-study method, analysis, comparison, induction and deduction were also applied. The novelty of the work lies in considering the offensive and defensive models of the US political course in the Middle East and the results of expansionist and exploitative geopolitical projects in specific regional situations. Attention is paid to the consequences of Washington's offensive foreign policy on the example of the invasion of Iraq and the occupation of Syria. The article considers the defensive model of US policy in the Persian Gulf with an emphasis on US-Saudi relations against the background of the visit of the US president to the region in July 2022. Examples of Russia's successful creative policy in the Middle East are given. The conclusion is made about the destructive nature and low effectiveness of both offensive and defensive models of the US geopolitical strategy in the Middle East. Against the background of Washington's weakening influence on regional processes, the sovereignty of states is gradually increasing, and it becomes possible for them to pursue an independent political course. The turn of a number of traditional Middle Eastern partners of the United States towards Russia and the system of multipolarity world order proposed by Moscow is becoming more and more noticeable. A change in the balance of power in the Middle East region in the future may lead to a gradual decrease in information influence and a deterioration in Washington's image, with a very likely continuation of conflict interaction between Russia and the United States.
Modelling of spall damage evolution and fragment distribution for melted metals under shock release
Authors: Zhang Feng-Guo , Liu Jun , He An-Min , Zhao Fu-Qi , Wang Pei ,   Institute of Applied Physics and Computational Mathematics, Beijing 100094, China
Published: September 2022

A strong shock-wave, produced by plate impact, explosive detonation or laser irradiation, can induce metal materials to melt. Reflection of the triangular pressure wave from the free surface generates a strong tensile stress in the liquid state, resulting in the creation of an expanding cloud of liquid debris. This phenomenon is called micro-spalling. The understanding of spall damage evolution and dynamic fragmentation of melted metal under shockwave loading and subsequent releasing is an issue of considerable importance for both basic and applied science, to predict the evolution of engineering structures subjected to explosive detonation in implosive dynamics or inertial confinement fusion, the latter involving high energy laser irradiation of thin metallic shells. For dynamic failure processes, spall fracture in solid material has been extensively studied for many years, while scarce data can be found about how such a phenomenon can evolve after being melted partially or fully when being compressed or released. In this paper, by studying the physical laws of void evolution in melted metals, we expect to reveal the mode and criterion of void coalescence, inertial and temperature effects on void distribution and evolution, and the relationship between fragment distribution and characteristics of breakup of damaged material. According to these physical laws, we can develop theoretical model to describe the damage evolution and fragment distribution of metal that melts when shock releases. This model is implemented as a failure criterion in a one-dimensional hydrocode. The experimental results and computational results are in fairly good agreement with each other. Some discrepancies are explained by using both experimental uncertainties and model limitations which are carefully pointed out and discussed. We believe that these results can deepen our physical understanding of the damage evolutions of metals and improve the credibility of numerical simulation on the damage and fragmentation of materials under implosive loading.
Ontogenetic, dietary, and environmental shifts in Mesosauridae
Authors: Verrière Antoine , Fröbisch Jörg
Published: September 2022

Mesosaurs are the first secondarily aquatic amniotes and one of the most enigmatic clades of reptiles from the early Permian. They have long puzzled paleontologists with their unique morphologies: possessing an elongated skull with thin needle-like teeth, a long neck, large webbed hindlimbs, banana-shaped pachyosteosclerotic ribs, and a long tail. Here, we look at a large dataset of morphometric measurements from 270 mesosaur specimens in collections around the world. These measurements characterize skull, tooth, and limb proportions and their variation with size. This data presents evidence of surprising ontogenetic changes in these animals as well as new insights into their taxonomy. Our results support the recent hypothesis thatMesosaurus tenuidensis the only valid species within Mesosauridae and suggest that “Stereosternum tumidum” and “Brazilosaurus sanpauloensis” represent immature stages or incomplete specimens ofMesosaurusby showing that all three species occupy an incomplete portion of the overall size range of mesosaurs. Under the single-species hypothesis, we highlight a number of ontogenetic trends: (1) a reduction in skull length accompanied by an elongation of the snout within the skull, (2) an elongation of teeth, (3) a reduction in hind limb length, and (4) a reduction in manus length. Concurrent with these changes, we hypothesize that mesosaurs went through a progressive ecological shift during their growth, with juveniles being more common in shallow water deposits, whereas large adults are more frequent in pelagic sediments. These parallel changes suggest that mesosaurs underwent a diet and lifestyle transition during ontogeny, from an active predatory lifestyle as juveniles to a more filter-feeding diet as adults. We propose that this change in lifestyle and environments may have been driven by the pursuit of different food sources, but a better understanding of the Irati Sea fauna will be necessary to obtain a more definitive answer to the question of young mesosaur diet.
Bayesian estimation of rainfall dispersion in Thailand using gamma distribution with excess zeros
Authors: Khooriphan Wansiri , Niwitpong Sa-Aat , Niwitpong Suparat
Published: September 2022

The gamma distribution is commonly used to model environmental data. However, rainfall data often contain zero observations, which violates the assumption that all observations must be positive in a gamma distribution, and so a gamma model with excess zeros treated as a binary random variable is required. Rainfall dispersion is important and interesting, the confidence intervals for the variance of a gamma distribution with excess zeros help to examine rainfall intensity, which may be high or low risk. Herein, we propose confidence intervals for the variance of a gamma distribution with excess zeros by using fiducial quantities and parametric bootstrapping, as well as Bayesian credible intervals and highest posterior density intervals based on the Jeffreys’, uniform, or normal-gamma-beta prior. The performances of the proposed confidence interval were evaluated by establishing their coverage probabilities and average lengths via Monte Carlo simulations. The fiducial quantity confidence interval performed the best for a small probability of the sample containing zero observations (δ) whereas the Bayesian credible interval based on the normal-gamma-beta prior performed the best for large δ. Rainfall data from the Kiew Lom Dam in Lampang province, Thailand, are used to illustrate the efficacies of the proposed methods in practice.
The Importance of Estrogen Receptors in Aetiopathogenesis of Carpal Tunnel Syndrome in Postmenopausal Women
Authors: Deger Ayse Nur , Deger Hakki , Tayfur Mahir , Arik Ozlem , Ekici Mehmet Fatih , Balci Mecdi Gurhan
Published: September 2022

Introduction: Carpal Tunnel Syndrome (CTS) is a common peripheral neuropathy in postmenopausal women which is caused by compression of the median nerve in the carpal tunnel. Although mostly idiopathic, the aetiopathogenesis of CTS was not quite clear. Aim: To verify the possible role of the estrogen surges and the presence of Estrogen Receptor (ER) in tenosynovial tissue on postmenopausal period, in the pathogenesis of idiopathic CTS. Materials and Methods: The present study was a retrospective study conducted on, 16 patients with CTS in premenopausal group (group 1) and 18 patients with CTS in postmenopausal group (group 2). In the study, tenosynovial tissue samples of patients who had surgery due to CTS were used. Biopsy samples of 34 patients who were operated in the neurosurgery department of KSBU Medical Faculty Evliya Celebi Training and Research Hospital between January 2011 and January 2012 were included in the study. An examination was made by Haematoxylin and Eosin (H&E) in the tenosynovial tissue. ER was performed by immunohistochemistry on tissue samples. The non inflammatory fibrosis, vascular proliferation, oedema were observed. A nuclear staining for ER was observed in synovial lining cells and fibroblasts in the tenosynovial tissue. Results: The number of positive cells for ER in the tenosyvial tissue in postmenopausal patients with CTS was found higher according to premenopausal patients with CTS (p<0.01). A high association was found among patient age, severe EMG findings and ER positivity. Conclusion: There roles of hormonal surges in postmenopausal period and increased ER positivity in the tenosynovial tissue in the aetiopathogenesis of CTS.
Evaluation of Urinary Calcium, Creatinine and their Ratio in Preeclampsia: A Case-control Study
Authors: Jindal Sonia , Manhas Sunita , Rathee Monika
Published: September 2022

Introduction: Preeclampsia is a hypertensive disorder characterised by high blood pressure during pregnancy. It is the major cause of maternal and perinatal morbidity and mortality in females. Prediction of Pregnancy Induced Hypertension (PIH) can be done by using a valuable marker i.e. Urinary CalciumCreatinine ratio (UCa/Cr). Aim: To evaluate the urinary calcium, creatinine and UCa/Cr ratio in patients with preeclampsia and also to check the association of UCa/Cr ratio with the severity of the disease. Materials and Methods: The present case-control study was conducted in the Department of Biochemistry in collaboration with department of Obsteritics and Gynecology, Maharishi Markandeshwar University, Ambala, Haryana from January 2018 to January 2021. Total of 120 pregnant women with gestational age ≥20 weeks (60 normal and 60 preeclampsia) were evaluated for urinary calcium, urinary creatinine and UCa/ Cr ratio. For statistical analysis, Unpaired t-test and Chi-square test and was applied. Results: The mean age of control group was 27.51±5.05 years and for case group was 29.8±5.49 years. The level of urinary calcium and urinary creatinine was found to be significantly (p-value<0.001) lower in case group (3.54 mg/dL and 42.90 mg/dL respectively) as compared to control group (8.22 mg/dL and 80.40 mg/dL respectively). The level of UCa/Cr ratio was also significantly (p-value <0.001) lower in case group (0.08±0.04) than control group (0.11±0.04) (p<0.001). Conclusion: UCa/Cr ratio was significantly decreased in preeclampsia compared to normal pregnancy. UCa/Cr ratio in spot urine can be useful in identifying pregnant women at risk for preeclampsia.
What Drives Salespeople's Performance? the Role of Organizational Attributes and the Moderating Effect of Experience
Authors: Mustafi Mohitul Ameen Ahmed , Dolon Md. Shah Ali , Rashed Iftekhar , Rabbi Fazle
Published: September 2022

The mobile telecommunications services industry has a high level of instability as a result of shifting market conditions, persistent market problems, and changing market demand. As a result, marketers need to take their customers' preferences into account.

With these considerations in mind, the goal of this study is to determine how the                         characteristics associated with the mobile communication services industry are presented to salesperson performance and how this influences sales personnel. Primary and secondary data sources were used in the investigation. In this study, we used a structured questionnaire, with 1 indicating strongly disagree and 5 indicating strongly agree. The data was analysed using both inferential and descriptive statistics. In Bangladesh, where the characteristics of mobile service providers are well documented, speculative data on elements influencing salespeople's performance was used. Structural Equation Modeling was utilised to identify impact factors connected to salesperson performance. Data was collected from active salesmen using a convenient sampling method. According to this study, just two parameters, external motivation and salespeople's political abilities, have a significant effect on predicting salespeople's effectiveness in mobile telecommunications in Bangladesh. As a result, business executives should take more initiative to improve their enterprises' performance, as this would benefit both salespeople and their organisations.
A Review on Genetic Analysis of Rice (Oryza sativa L.) Crop of Yield Contributing Traits
Authors: Pandey Abhay Kumar , Kumar Dharmendra , Shekhar Shivanshu , Singh Addya , Singh Divya , Yadav Neha , Singh Ruchi , Singh Sharad
Published: September 2022

Rice is the primary source of energy for the international population. In any crop breeding programme, the presence of genetic variability is vital for broadening the gene pool. An excessive magnitude of variability in the population is required for selecting a genotype with excessively applicable traits. The heritability estimates along with the amount of genetic variability provide us with an idea of genetic gain due to choose. Specific direct developments (number of panicles/plants, filled grains/plant, and test weight) and indirect tendencies (tiller number/plant, plant peak) determine the yield component of rice. In the present overview, we draw a clear picture of how variability affects the selection method and also how yield is related to distinct direct and indirect developments. Genotypes show high variability, and suitable characters can be used in a similar breeding programme. A glimpse of molecular advances in rice breeding has also been integrated into the gift overview.
Factors Contributing to Employee Retention in Banks: A Case of Iringa Municipality Tanzania
Authors: Bwana Yahaya , Kisawike Blandina , Golyama Bahati
Published: September 2022

This study sought to determine factors contributing to Employee Retention in Banks in Iringa Municipality Tanzania. The study specifically assessed the contribution promotion opportunities, financial incentives and work environment on employees’ retention. The researcher employed quantitative research approach, and research design was descriptive cross-sectional research. Data was obtained from 93 respondents. Data were collected using structured questionnaire and analyzed using descriptive (frequencies and percentages) and inferential statistics (regression analysis). Regarding promotion opportunities, the study found that there is positive and significant relationship between promotion opportunities and employees retention. Furthermore on financial incentives were found to have positive and significant relationship with employees’ retention and the study reveal banks provide bonuses and other benefits; however majority of the employees are not satisfied with salaried offered. Also the study also found there is positive and significant relationship between work environment and employees retention. As it was also revealed that work environment is very impressive as there are teamwork, support from management, and enough working tools but in terms of fair treatment the study there is a mixed opinion on this. All in all regression findings cemented that all the three determinants (work environment, promotion opportunities and financial incentives) have significant influence on employee retention. The study therefore concludes that there is significance influence between promotion opportunities, work environment and financial incentives on retention. Lastly the study recommends management of these banks to review salary and enhance fair treatment to all employees in the banks since most of employees had concerns on these two issues.
Chemical and Sensory Evaluation of Smoked Fish Treated with Ocimum gratissimum Extract
Authors: Chinasa Okorie-Humphrey , Nneoma E. Obasi , Chukwunwike U. Enyi , Emem O. Ukpong , Nmesomachi N. Amuzie , Bethel U. Udume
Published: September 2022

This work aims to the effect of three different concentrations (20%, 40%, and 60%) of Ocimum gratissimum extract on the proximate, mineral composition and sensory acceptability of smoked catfish and mackerel samples. Fresh fish samples were hot smoked in a locally fabricated smoking kiln at 1100C. Results showed that the moisture content of smoked catfish and mackerel was significantly different (P≤0.05) from the control sample. The percentage of crude protein content decreased in smoked catfish and increased in mackerel samples and also differed significantly (P≤0.05) compared with the control. Ash and fat content decreased in smoked fish and the crude fibre content was slightly increased in smoked mackerel. The minerals composition showed a significant difference (P≤0.05) was observed although there were decrease in iodine and potassium content of catfish. There was a significant difference (P≤0.05) in organoleptic scores among the fish samples treated with 20% and 40% Ocimum gratissimum which were significantly higher than the control. This study concluded that Ocimum gratissimum inclusion does not have any adverse effect on the chemical composition of smoked fish sample but could improve their sensory quality.
Effect of Exogenous Application of Auxin on Leaf Cuttings of Mexican Snow Ball (Echeveria elegans Rose)
Authors: Mourya Seema , Topno Samir E. , Kerketta Anita , Bahadur Vijay , Kashyap Sushil
Published: September 2022

Aims: Succulents are on the rising trend of popularity due to its compromising behaviour with watering and durability indoors, creating a peaceful and healthy living condition. Thus it is the need of the hour to find a suitable propagation method or use of exogenous substances with propagation to assist regenerating new plants.

Study Design: The experiment was laid out in randomized block design (RBD) with three replications.

Place and Duration of Study: The present investigation entitled Effect of IAA and IBA Application on leaf cuttings of Mexican Snow Ball (Echeveria elegans). Was conducted in Research Field, Department of Horticulture, Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj, during February, 2021 to April, 2021.

Methodology: The experiment was laid out in randomized block design (RBD) with three (IAA 100 ppm, IAA 300 ppm, IAA 500 ppm, IBA 100 ppm, IBA 300, IBA 500 ppm, IAA + IBA (100 ppm + 500 ppm), IAA + IBA (500 ppm  + 100 ppm) and Control replications. The treatment in each replication was allotted randomly. Nine treatments having one variety were tried in the experimental design.

Results: The results revealed that among all the treatments, application of IAA + IBA (100 ppm + 500 ppm)  in treatment (T8) took minimum days to rooting (9.00), number of leaves (16.56), number of shoots (2.56), shoot height (15.56 mm), shoot diameter (16.44 mm), root length (29.00 mm)  and  in economic point of view treatment T8 IAA + IBA (100 ppm + 500 ppm) was found to be most economically viable in terms of gross return (Rs. 17,000), net return (Rs. 11,100) and benefit cost ratio (2.88).

Conclusion: According to the present investigation it is concluded that treatment IAA + IBA (100 ppm + 500 ppm) was found most effective in terms of growth of Echevaria (Echevaria elegan).
Studies on Management of Fruit and Shoot Borer [Leucinodes orbonalis (Guenee)] Using Chemicals and Neem Oil in Brinjal Solanum melongena L.
Authors: Poornachander Maloth , Tayde Anoorag R.
Published: September 2022

The experiment was conducted at the research plot of the Department of Agricultural Entomology and Central Research Farm, Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj, during Rabi from November to February 2021-22 in Randomized Block Design (RBD) with three replications. Eight treatments were evaluated against , Leucinodes orbonalis i.e., Chlorantraniliprole 18.5% EC, Spinosad 45% SC, Flubendiamide 20 WG, Indoxicarb 14.5% SC, Emamectin benzoate 5 SG, Lambda cyhalothrin 4.9% CS, Neem oil 0.15% EC and control in RBD with three replication. The best and most economical treatment was Chlorantraniliprole (1:10.06) which was par with Spinosad (1:8.51) followed by Flubendiamide (1:8.44), Indoxacarb (1:8.04), followed by Emamectin benzoate (1:7.12) and Lambda cyhalothrin (1:6.85), Neem oil (1:6.36) as compared to control (1:4.63).The data on the percent infestation of shoot and fruit borer on brinjal 3rd, 7th and 14th day after first spray reveal that all the chemical treatments were significantly superior over control. Ratio was Chlorantraniliprole 18.5% EC (10.85%, 7.29%), Spinosad 45% SC (11.95%, 9.12%), Flubendiamide 20 WG (13.76%, 9.79%), Indoxacarb 14.5% SC (14.05%, 10.47%), Emamectin benzoate 5 SG (15.59%, 13.46%), Lambda cyhalothrin 4.9% CS (17.09%, 13.46%), Neem oil 0.15% EC (19.97%, 17.43%). The yields among the treatment were significant.The highest yield was recorded in Chlorantraniliprole 18.5% EC (222.50 q/ha), followed by Spinosad 45% SC (198.33 q/ha).
Immuno-Protective Effect of Aqueous Extract of Ocimum gratissimum Leaf in Cyclophosphamide-Induced Myelotoxicity in Wistar Rat
Authors: Egwuatu Ifeanyi Anthony , Anyanwu Emeka Godson , Ozoemena Chiadikobi Lawrence , Ozor Christian Chiemeka , Ozoemena Osinachi Francis , Obikili Emmanuel N.
Published: September 2022

The bone marrow is the manufacturing center of blood cells; the suppression of its activity causes a deficiency of blood cells. This condition can rapidly lead to life-threatening infections. Ocimum gratissimum plays a vital role in preventing some disease conditions, but its hematological effects on the bone marrow have not been documented much. This study is designed to investigate the immuno-protective activity of the aqueous leaf extract of Ocimum gratissimum in cyclophosphamide-induced myelotoxicity. Twenty-four Wistar rats aged two to three months, weighing 170-200 g were used for the study. The rats were divided into six groups of four rats each, labeled A to F. The rats in the control group (group A) were given feed and water. Group B was administered with 3 mg/kg of cyclophosphamide intraperitoneally daily for seven days to induce myelotoxicity. Groups C and D were treated daily with 100 mg/kg and 200 mg/kg of the extract for fourteen (14) days respectively. Groups E and F were treated with the extract for seven (7) days and then induced and treated with myelotoxicity and extract simultaneously for the next seven (7) days. On the 15th day, blood samples (3.0 ml) were collected from each rat through the retro-orbital plexus. Also, the bone marrow was harvested and analyzed using a standard histological procedure. Data were analyzed with Pearson’s correlation test and multivariate analysis of variance using Statistical Package for Social Sciences (SPSS) version 21 and results were expressed as mean ± SD. Myelotoxicity was achieved in Group B rats. Group E and F rats showed a significant increase in hemoglobin (Hb), hematocrit (Hct), and total white blood cell count (TWBC) compared with Group B. The Group C and D rats revealed a significant increase in Hb, Hct, and TWBC when compared with group A. Aqueous leaf extract of Ocimum gratissimum may possess immuno-protective properties when orally administered in cyclophosphamide-induced bone marrow suppression.
Hypokalemia in Hospitalized COVID-19 Patients: Prevalence and Correlates
Authors: Ogunkoya John Omotola , Bamidele Emmanuel Fikayo , Uduagbamen Peter Kehinde , Ladele Akindele Emmanuel , Ngubor Taamaka Davis , Eigbe Solomon Olubunmi , Adeboye Boluwatife Adetoyin
Published: September 2022

Objectives: This study was designed to evaluate the prevalence, and the severity of hypokalemia, and the factors associated with hypokalemia among patients hospitalized with COVID-19.

Methods: Random sampling technique was employed in this study. Socio-demographic data such as age, gender, weight (kg), height (meters) and BMI (kg/m2) as well as presenting symptoms (pulmonary and extra-pulmonary), duration of admission, the need for mechanical ventilation and treatment outcomes (discharged or died) as well as the plasma level of potassium (mmol/l) were extracted from the medical records of RT-PCR confirmed hospitalized cases of COVID-19 patients. Data collected were analyzed with IBM/ SPSS version 25.0 software. Discrete variables were presented as percentages and frequencies and the associations between qualitative variables tested using the Chi-square test at a level of significance of p < 0.05.

Results: Hypokalaemia was detected in 61 out of 117 COVID-19 positive subjects used for this study during hospitalization. The mean serum potassium was 3.45±0.633 mmol/L. The majority of hypokalemic patients (n=35, 29.9%) patients experienced a mild decrease in serum potassium level (3–3.4 mmol/L). Risk factors for hypokalaemia were female sex and patients presenting with sneezing or/and sore throat. There was no relationship between the plasma potassium level and comorbid factors. There was no increasing trend of 30-day mortality associated with lower plasma potassium level.

Conclusion: Plasma potassium levels should be monitored routinely and maintained within appropriate ranges in patients with COVID-19 especially in female patients as well as patient with significant upper respiratory symptoms such as sore throat and sneezing.
Hydroxychloroquine Dose per Ophthalmology Guidelines and the Risk of Systemic Lupus Erythematosus Flares
Authors: Jorge April M. , Mancini Christian , Zhou Baijun , Ho Gary , Zhang Yuqing , Costenbader Karen , Choi Hyon K.
Published: September 2022

This study of an academic medical center patient cohort with systemic lupus erythematosus (SLE) investigates the association between hydroxychloroquine dose based on current guidelines and risk of lupus flares.
Receipt of Out-of-State Telemedicine Visits Among Medicare Beneficiaries During the COVID-19 Pandemic
Authors: Mehrotra Ateev , Huskamp Haiden A. , Nimgaonkar Alok , Chaiyachati Krisda H. , Bressman Eric , Richman Barak
Published: September 2022

Importance

Early in the COVID-19 pandemic, states implemented temporary changes allowing physicians without a license in their state to provide care to their residents. There is an ongoing debate at both the federal and state levels on whether to change licensure rules permanently to facilitate out-of-state telemedicine use.

Objective

To describe out-of-state telemedicine use during the pandemic.

Design, Setting, and Participants

This cross-sectional study of telemedicine visits included all patients with traditional Medicare from January through June 2021.

Main Outcomes and Measures

Telemedicine visits from January through June 2021 where the patient’s home address and the physician’s practice address were in different states.

Results

In describing which patients and specialties were using out-of-state telemedicine, we focused on the period between January to June 2021. We chose this period because it was after the turmoil of the early pandemic, when vaccines became widely available and the health care system had stabilized, but before many of the temporary licensing regulations began to lapse by mid-2021. In the first half of 2021, there were 8 392 092 patients with a telemedicine visit and, of these, 422 547 (5.0%) had 1 or more out-of-state telemedicine visits. Those who lived in a county close to a state border (within 15 miles) accounted for 57.2% of all out-of-state telemedicine visits. Among the out-of-state visits in this time period, 64.3% were with a primary care or mental health clinician. For 62.6% of all out-of-state visits, a prior in-person visit occurred between the same patient and clinician between March 2019 and the visit. The demographics and conditions treated were similar for within-state and out-of-state telemedicine visits, with several notable exceptions. Among those with a telemedicine visit, people in rural communities were more likely to receive out-of-state telemedicine care (33.8% vs 21.0%), and there was high of out-of-state telemedicine use for cancer care (9.8% of all telemedicine visits for cancer care).

Conclusions and Relevance

The findings of this cross-sectional study suggest that licensure restrictions of out-of-state telemedicine would have had the largest effect on patients who lived near a state border, those in rural locales, and those who received primary care or mental health treatment.
Comparison of 1-Year Health Care Expenditures and Utilization Following Minimally Invasive vs Open Nephrectomy
Authors: Okhawere Kennedy E. , Milky Gediwon , Shih I-Fan , Li Yanli , Badani Ketan K.
Published: September 2022

Importance

Given the widespread adoption and clinical benefits of minimally invasive surgery approaches (MIS) in partial nephrectomy (PN) and radical nephrectomy (RN), assessment of long-term cost implications is relevant.

Objective

To compare health care utilization and expenditures within 1 year after MIS and open surgery (OS).

Design, Setting, and Participants

This cohort study was conducted using a US commercial claims database between 2013 and 2018. A total of 5104 patients aged 18 to 64 years who underwent PN or RN for kidney cancer and were continuously insured for 180 days before and 365 days after surgery were identified. An inverse probability of treatment weighting analysis was performed to examine differences in costs and use of health care services.

Exposures

Surgical approach (MIS or OS).

Main Outcomes and Measures

Outcomes assessed included 1-year total health care expenditure, health care utilizations, and estimated days missed from work.

Results

Of the 5104 patients, 2639 had PN (2008 MIS vs 631 OS) and 2465 had RN (1816 MIS vs 649 OS) and most were male (PN: 1657 [62.8%]; RN: 399 [63.1%]) and between 55 and 64 years of age (PN: 1034 [51.3%]; RN: 320 [55.7%]). Patients who underwent MIS had lower index hospital length of stay compared with OS (mean [95% CI] for PN: 2.45 [2.37-2.53] vs 3.78 [3.60-3.97] days; P < .001; for RN: 2.82 [2.73-2.91] vs 4.62 [4.41-4.83] days; P < .001), and lower index expenditure for RN ($28 999 [$28 243-$29 796] vs $31 977 [$30 729-$33 329]; P < .001). For PN, index expenditure was lower for OS than MIS (mean [95% CI], $27 480 [$26 263-$28 753] vs $30 380 [$29614-$31 167]; P < .001). Patients with MIS had lower 1-year postdischarge readmission rate (PN: 15.1% vs 21.5%; odds ratio [OR], 0.65; 95% CI, 0.52-0.82; P < .001; RN: 15.6% vs 18.9%; OR, 0.79; 95% CI, 0.63-1.00; P = .05), and fewer hospital outpatient visits (mean [95% CI] for PN: 4.69 [4.48-4.90] vs 5.25 [4.84-5.66]; P = .01; RN: 5.50 [5.21-5.80] vs 6.71 [6.12-7.30]; P < .001) than those with OS. For RN, MIS was associated with 1.47 fewer missed workdays (95% CI, 0.57-2.38 days; P = .001). The reduction in health care use in MIS was associated with lower or similar total cumulative expenditures compared with OS (mean difference [95% CI] for PN: $331 [–$3250 to $3912]; P = .85; for RN: –$11 265 [–$17 065 to –$5465]; P < .001).

Conclusions and Relevance

In this cohort study, MIS was associated with lower or similar total cumulative expenditure than OS in the period 1 year after discharge from the index surgery. These findings suggest that downstream expenditures and resource utilization should be considered when evaluating surgical approach for nephrectomy.
Evaluation of Systemwide Improvement Programs to Optimize Time to Surgery for Patients With Hip Fractures
Authors: Tewari Pariswi , Sweeney Brian F. , Lemos Jacie L. , Shapiro Lauren , Gardner Michael J. , Morris Arden M. , Baker Laurence C. , Harris Alex S. , Kamal Robin N.
Published: September 2022

Importance

Longer time to surgery (TTS) for hip fractures has been associated with higher rates of postoperative complications and mortality. Given that more than 300 000 adults are hospitalized for hip fractures in the United States each year, various improvement programs have been implemented to reduce TTS with variable results, attributed to contextual patient- and system-level factors.

Objective

To catalog TTS improvement programs, identify their results, and categorize program strategies according to Expert Recommendations for Implementing Change (ERIC), highlighting components of successful improvement programs within their associated contexts and seeking to guide health care systems in implementing programs designed to reduce TTS.

Evidence Review

A systematic review was conducted per the Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline. Three databases (MEDLINE/PubMed, EMBASE, and Cochrane Trials) were searched for studies published between 2000 and 2021 that reported on improvement programs for hip fracture TTS. Observational studies in high-income country settings, including patients with surgical, low-impact, nonpathological hip fractures aged 50 years or older, were considered for review. Improvement programs were assessed for their association with decreased TTS, and ERIC strategies were matched to improvement program components.

Findings

Preliminary literature searches yielded 1683 articles, of which 69 articles were included for final analysis. Among the 69 improvement programs, 49 were associated with significantly decreased TTS, and 20 programs did not report significant decreases in TTS. Among 49 successful improvement programs, the 5 most common ERIC strategies were (1) assess for readiness and identify barriers and facilitators, (2) develop a formal implementation blueprint, (3) identify and prepare champions, (4) promote network weaving, and (5) develop resource-sharing agreements.

Conclusions and Relevance

In this systematic review, certain components (eg, identifying barriers and facilitators to program implementation, developing a formal implementation blueprint, preparing intervention champions) are common among improvement programs that were associated with reducing TTS and may inform the approach of hospital systems developing similar programs. Other strategies had mixed results, suggesting local contextual factors (eg, operating room availability) may affect their success. To contextualize the success of a given improvement program across different clinical settings, subsequent investigation must elucidate the association between interventional success and facility-level factors influencing TTS, such as hospital census and type, teaching status, annual surgical volume, and other factors.
Building Metal‐Molecule Interface towards Stable and Reversible Zn Metal Anodes for Aqueous Rechargeable Zinc Batteries
Authors: Qin Hongyu , Kuang Wei , Hu Nan , Zhong Xiaomin , Huang Dan , Shen Fang , Wei Zongwu , Huang Yanping , Xu Jing , He Huibing
Published: September 2022

Aqueous zinc ion batteries (AZIBs) are receiving increasing attention for large‐scale energy storage systems owing to their appealing features with intrinsic safety, low cost, and scalability. Unfortunately, the water‐induced parasitic reactions and dendrite growth on the Zn anode severely impede the further development of AZIBs. Herein, a thiourea additive is introduced into ZnSO4 electrolyte to construct unique metal‐molecule interface for simultaneously regulating the Zn anode interface chemistry and the bulk electrolyte environment. Experimental results and theoretical calculations reveal that the formed metal‐molecule interface can not only serve as a corrosion inhibitor for alleviating the water‐induced side reactions, but also act as a Zn2+ ion regulator for promoting the homogenous Zn deposition, thus achieving a corrosion‐free and dendrite‐free Zn anode. Consequently, the Zn|Zn symmetric cell exhibits an extended lifespan of 1200 h at 1 mA cm–2, 1mAh cm–2, and a high cumulative capacity of 3000 mAh cm–2 at 10 mA cm–2. When paired with V2O5 cathode, the Zn|V2O5 full cell delivers a high capacity retention of 76.0% after 1000 cycles at 1 A g–1. This study paves a new way to modulate Zn electrode interface chemistry by the novel design of metal‐molecule interface for advanced rechargeable Zn metal batteries and beyond.
Programmable Photo‐Induced Doping in 2D Materials
Authors: Aftab Sikandar , Iqbal Muhammad Zahir , Iqbal Muhammad Waqas
Published: September 2022

Over the past few decades, certain features of the bulk and surface properties of nanoscale two‐dimensional (2D) layered materials have been exploited to improve the performance and efficiency of optoelectronics functional devices. These findings include the role of surface modifications, including dopant engineering with chemical modifications, structural control through physical modifications, and bandgap modification through electrostatic control, but to enable n‐ or p‐type behavior in the same nanoflakes without photoresist and environmental stability in traded devices is challenging. In this state‐of‐the‐art focused review article, the most up‐to‐date and promising strategies to develop nanodevices with photoresist‐free possibilities of controlling the conduction type in 2D nanostructures based on the mechanical exfoliation of ultrathin nanomaterials are attempted to summarize. This article demonstrates how carrier type band modulation in transition metal dichalcogenides is generated by the charge storage interface or defect engineering such as optical‐electronic excitation of donor‐like states (or point defects) in BN upon illumination to configure opposite polarities, n, or the p‐type field‐effect transistor from an intrinsic semiconductor. It is believed that this brief overview of recent research on nanomaterials for application in various types of functional electronic devices may contribute in the development of future optoelectronic devices.
Ceramic‐Polymer Nanocomposites Design for Energy Storage Capacitor Applications
Authors: Li Wei , Liang Riran , Wu Chunran , Yang Lingni , Wang Fenglin , Liu Zhuofeng , Chen Xingyu , Mao Haijun , Zhang Weijun
Published: September 2022

Given the remarkable advantages of high power density, fast charge–discharge speed, good stability, and low cost, the dielectric capacitors have sparked tremendous research interest in recent years for their unique applications in electrical systems and modern electronics. As for satisfying the future demands of the miniaturization and integration of the electrical devices, novel dielectric material with high energy storage density should be developed urgently. Importantly, ceramic‐polymer nanocomposites, which combine the high permittivity of the ceramic fillers and the excellent breakdown strength of the polymer matrix, are regarded as promising candidates. In this review, the various designs of the emerging nanocomposites are introduced from three aspects. First, the diverse design of the nanofillers, including tailoring the size, engineering the dimension, and selecting the species is focused. In addition, the design of the interfaces between the two phases by organic surface coating and inorganic surface coating is demonstrated. Furthermore, the spatial structure design of the nanocomposites, such as sandwich structure, gradient structure, and array structure, is presented as well. Finally, the bottlenecks along with opportunities of this booming field at present are concluded and outlined.
Enhanced Carrier Transport in X‐Ray Detector Based on Cs3Bi2I9/MXene Composite Wafers
Authors: Wei Shunyong , Tie Shujie , Shen Kai , Sun Hui , Zheng Xiaojia , Wang Hao , Liang Wenqing , Zou Jihua , Huang Yixuan , Luo Lingzhi , Zhou Xiangyu , Zeng Tixian , Ren Aobo , Zhao Dewei , Wu Jiang
Published: September 2022

Intrinsically high attenuation of X‐rays and excellent optoelectronic properties endow Cs3Bi2I9 with great promise for high‐performance X‐ray detectors. However, preparation of high quality Cs3Bi2I9 single crystal with large area and millimeter‐thick remains challenging and time‐consuming. A size scalable growth technology, a mechanical sintering process, which is applicable for the integration in image detectors is proposed in this work. Compared with the Cs3Bi2I9 wafer, the Cs3Bi2I9/MXene composite wafer exhibits higher carrier transfer efficiency and mobility‐lifetime product through incorporation of Ti3C2Tx MXene multilayer nanoflakes (MXene nanoflakes). The Cs3Bi2I9/MXene composite wafer X‐ray detector shows an excellent linearity of X‐ray response, a fast response speed, and a low limit of detection of 231 nGyair s−1. The sensitivity of 368 µC Gyair−1 cm−2 under 120 V mm−1 is achieved, which is 15.4% enhanced over the Cs3Bi2I9 wafer detector. The sensitivity of Cs3Bi2I9/MXene wafer device enhances ≈20–40% at low applied voltage regime. In addition, the Cs3Bi2I9/MXene wafer detector exhibits excellent operational stability after storage for 12 months in ambient air. This work provides an alternative approach for realization of next‐generation high‐performance perovskite X‐ray detectors.
Oxidation States Regulation of Cobalt Active Sites through Crystal Surface Engineering for Enhanced Polysulfide Conversion in Lithium–Sulfur Batteries
Authors: Xiao Rujian , Luo Dan , Wang Jiayi , Lu Han , Ma Heng , Akinoglu Eser Metin , Jin Mingliang , Wang Xin , Zhang Yongguang , Chen Zhongwei
Published: September 2022

In this work, unique Co3O4/N‐doped reduced graphene oxide (Co3O4/N‐rGO) composites as favorable sulfur immobilizers and promoters for lithium–sulfur (Li–S) batteries are developed. The prepared Co3O4 nanopolyhedrons (Co3O4‐NP) and Co3O4 nanocubes mainly expose (112) and (001) surfaces, respectively, with different atomic configurations of Co2+/Co3+ sites. Experiments and theoretical calculations confirm that the octahedral coordination Co3+ (Co3+Oh) sites with different oxidation states from tetrahedral coordination Co2+ sites optimize the adsorption and catalytic conversion of lithium polysulfides. Specially, the Co3O4‐NP crystals loaded on N‐rGO expose (112) planes with ample Co3+Oh active sites, exhibiting stronger adsorbability and superior catalytic activity for polysulfides, thus inhibiting the shuttle effect. Therefore, the S@Co3O4‐NP/N‐rGO cathodes deliver excellent electrochemical properties, for example, stable cyclability at 1 C with a low capacity decay rate of 0.058% over 500 cycles, superb rate capability up to 3 C, and high areal capacity of 4.1 mAh cm−2. This catalyst's design incorporating crystal surface engineering and oxidation state regulation strategies also provides new approaches for addressing the complicated issues of Li–S batteries.
Photoluminescence Intensity Enhancement in Tin Halide Perovskites
Authors: Poli Isabella , Ambrosio Francesco , Treglia Antonella , Berger Felix J. , Prato Mirko , Albaqami Munirah D. , De Angelis Filippo , Petrozza Annamaria
Published: September 2022

The prevalence of background hole doping in tin halide perovskites usually dominates their recombination dynamics. The addition of excess Sn halide source to the precursor solution is the most frequently used approach to reduce the hole doping and reveals photo‐carrier dynamics related to defects activity. This study presents an experimental and theoretical investigation on defects under light irradiation in tin halide perovskites by combining measurements of photoluminescence with first principles computational modeling. It finds that tin perovskite thin films prepared with an excess of Sn halide sources exhibit an enhancement of the photoluminescence intensity over time under continuous excitation in inert atmosphere. The authors propose a model in which light irradiation promotes the annihilation of VSn2−/Sni2+ Frenkel pairs, reducing the deep carrier trapping centers associated with such defect and increasing the radiative recombination. Importantly, these observations can be traced in the open‐circuit voltage dynamics of tin‐based halide perovskite solar cells, implying the relevance of controlling the Sn photochemistry to stabilize tin perovskite devices.
Cropping system diversity and tillage intensity affects wheat productivity in Texas
Authors: Bekewe Perejitei E. , Foster Jamie L. , Neely Clark B. , Neely Haly L. , Lewis Katie L. , Tomlin Lauren E. , Schnell Ronnie W. , Smith A. Peyton , Boutton Thomas W. , Gerrish Brandon
Published: September 2022

Wheat (Triticum aestivum L.) production in Texas depends heavily on conventional tillage (CT) and a long summer fallow period, which contributes to soil degradation. This study compared the impact of reducing tillage intensity (CT, no‐tillage, and strip‐tillage) combined with summer cropping to CT–summer fallow on wheat establishment, grain production, and herbage mass from 2016 to 2020 in three Texas ecoregions (Coastal Plains, Southern High Plains, and Blackland Prairie). Tillage and summer cropping resulted in variable impacts on wheat stand establishment, grain yield, and herbage mass across years and locations. At Beeville, in the Coastal Plains, wheat grain and herbage mass yields were not impacted by tillage. Sorghum (Sorghum bicolor [L.] Moench) cropping resulted in less wheat grain yield in 2020. In 1 yr at Lubbock in the Southern High Plains, wheat grain yield was greater with CT than reduced tillage. Sorghum summer cropping resulted in lower wheat grain yield than cover crop mixture or cowpea (Vigna unguiculata [L.] Walp.) in 2017, but yield was greater in 2020. At Thrall, in the Blackland Prairie, wheat stand establishment and yield with reduced tillage were greater than CT in 2016, whereas CT was greater in 2017 and 2020. Sorghum or cover cropping resulted in reduced wheat grain yield compared with fallow in 2018, but sorghum and sesame (Sesamum indicum L.) resulted in increased yield compared with fallow in 2019 and 2020. Summer cropping in wheat production systems rarely had a negative impact on wheat production compared with summer fallow in all three ecoregions.