bluuebunny/crossref_metadata_2025 huggingface dataset:
Is economic inequality in maternal and child healthcare decreasing in India? Trends between 2005–2006, 2015–2016 and 2019–2021
Authors: Bajpai Rimjhim , Kumar Abhishek , Acharya Rajib , Saggurti Niranjan
Published: January 2025

Objective

This study examined economic inequality in coverage of selected maternal and child healthcare (MCH) indicators in India and its states over the last 15 years.

Design

The study analysed last three rounds of the National Family Health Survey data, conducted during 2005–2006, 2015–2016 and 2019–2021. Bivariate analyses, ratio of richest to poorest, slope index of inequality (SII) and multivariate binary logistic regression analyses were used to examine the coverage as well as inequalities in the outcome indicators for India and its states and at district level.

Primary outcomes

The outcome variables analysed in the study were full antenatal care, institutional delivery, postnatal care of mothers within 48 hours of delivery, and full immunisation among children.

Participants

Women aged 15–49 who had given a birth in the last 5 years before the surveys were unit of analysis for the maternal healthcare indicators, and children aged 12–23 months were unit of the analysis for childhood immunisation.

Results

Over the last 15 years, coverage of the MCH indicators has increased in India and across socioeconomic segment of the population, and the absolute increase was higher among the worse-off segments than the better-off. This led to decline in the inequality in coverage of all the MCH indicators. For instance, the value of SII for institutional births decreased from 0.76 in 2005–2006 to 0.45 in 2015–2016 and further to 0.37 in 2019–2021. Although inequality has decreased, geographic disparities persist across states and districts.

Conclusion

Though substantial improvement was observed, coverage of MCH indicators increased and the economic inequality declined; certain geographies are still characterised with the low coverage and persistent high inequality. This suggests that adding a spatial perspective to the inequality research and targeted strategies is essential for achieving universal access to reproductive healthcare services by 2030 in India.
Effects of transcranial magnetic stimulation combined with extracorporeal shockwave therapy for poststroke spasticity: study protocol for a randomised controlled trial
Authors: Liao Ling-Yi , Wang Peng-Yu , Zhu Yang , Peng Qiu-Yi , Yang Man , Liu Lu , Tao Yong , Liu Jin-Jing , Fang Xiang-Qin , Gao Shi-Hao , Gao Chang-Yue
Published: January 2025

Introduction

Spasticity is a common complication of stroke, which is related to poor motor recovery and limitations in the performance of activities. Both transcranial magnetic stimulation (TMS) and extracorporeal shockwave therapy (ESWT) are effective treatment methods for poststroke spasticity (PSS). However, there is no existing study exploring the safety and effectiveness of TMS combined with ESWT for PSS.

Methods and analysis

This study will be a prospective, single-centre, randomised, factorial, controlled clinical trial. In this trial, 136 patients with PSS will be randomly divided into 4 groups: experimental group 1 (TMS), experimental group 2 (ESWT), experimental group 3 (ESWT+TMS) and control group, 34 patients in each group; all patients received routine rehabilitation. Outcome measures will be assessed by 4 time points: baseline (T0), 2 weeks after initiation of treatment (T1), 4 weeks after initiation of treatment (T2) and follow-up (4 weeks after the end of treatment, T3). The primary outcome is the modified Ashworth scale at T2. The secondary outcomes include the modified Tardieu scale for the degree of spasticity, the Fugl-Meyer assessment scale and range of motion (ROM) for motor function, the stroke-specific quality of life scale (SS-QOL) and modified Barthel index for activities of life, cortical excitability measured by TMS–surface electromyography (EMG), cerebral cortex oxygen concentrations measured by functional near-infrared spectroscopy (fNIRS) and Hmax/Mmaxratio measured by EMG.

Ethics and dissemination

This study protocol was approved by the Ethics Committee of the Army Medical Center of PLA (Approval No. 2024-04) on 24 January 2024. The study will be disseminated through peer-reviewed publications and conference presentations.

Trial registration number

This study was registered in the Chinese Clinical Trial Registry (https://www.chictr.org.cn/; unique identifier: ChiCTR2400080862; data: 9 February 2024; study protocol V. 2.0).
Poly-skilling and advanced practice roles in perioperative care: protocol for a realist synthesis of evidence
Authors: Britton Carolina , Walker David , Griffin Ann , Freeth Della
Published: January 2025

Introduction

An ageing population and a workforce crisis have triggered an ambitious UK strategy for sustained delivery of healthcare. In perioperative care (the management of patients from contemplation of surgery until full recovery), it is recognised that interventions are needed to place the workforce on a more sustainable footing through cross-functionality and skill-shifting, namely with advanced practice roles. However, despite some reports and reviews in the literature, it is unclear how skills development efforts may potentially support workforce transformation for an effective and resilient perioperative care workforce. Thus, drawing causal inferences for policy-making that is both evidence based and rooted in theory is challenging. A scoping review, reported within this protocol, confirmed that ‘poly-skilling’ and ‘advanced practice roles’ are critical to this workforce transformation, but the mechanisms through which interventions in this area may work are not understood. A synthesis of evidence is, therefore, proposed in this protocol, to understand what works for whom and under what circumstances, in relation to poly-skilling and advanced practice roles in workforce transformation for sustained healthcare delivery.

Methods and analysis

This protocol sets out the plan to undertake a realist synthesis of the related literature, with theory elicitation (step 1), search for empirical evidence (step 2), selection and appraisal of evidence (step 3) and programme theory refinement (step 4). Exploratory reviews of the literature and key informants’ inputs will produce initial hypotheses as to what it is about interventions in poly-skilling and advanced practice roles that work and why. Data from the literature will then be collected based on relevance, rigour and richness. The iterative analysis and synthesis of these data will produce causal links between contexts, mechanisms and outcomes. The results will inform a realist evaluation, to be undertaken as part of doctoral research, to better understand the mechanisms that support workforce transformation through poly-skilling and advanced practice roles.

Ethics and dissemination

As a review of previously published literature, the evidence synthesis proposed in this protocol does not require formal ethical approval. Recommended ethical considerations regarding the involvement of key informants, who are not study participants but a consultative group, are presented in this protocol. A formal ethics approval will be sought ahead of the later empirical stage of the research. The results of the realist synthesis proposed in this protocol will be fed back to the local National Health Service organisation and Integrated Care Board and disseminated to the research community via presentations at conferences and a peer-reviewed journal article.

PROSPERO registration number

CRD42024512164.
Impact of bone quality on surgical decision-making in total hip arthroplasty: a qualitative analysis in the UK
Authors: Karia Monil , Abouharb Alex , Sabharwal Sanjeeve , Mavroveli Stella , Cobb Justin
Published: January 2025

Introduction

For total hip arthroplasty (THA) to be successful, surgeons need to make several decisions ranging from implant choice to impaction force. It is unclear, however, whether and how bone quality affects surgeon’s decision-making and how surgeons evaluate bone quality.

Objectives

This inductive/deductive qualitative hybrid study aims to explore the impact of bone quality on the decision-making of surgeons performing elective primary THA. This study will evaluate: (1) whether surgeons consider bone quality as an important factor for surgical decision-making; (2) how bone quality influences surgical decision-making; and (3) how surgeons assess bone quality preoperatively and intraoperatively.

Design

This is a qualitative study, involving inductive/deductive hybrid thematic analysis.

Setting

Semistructured interviews were conducted virtually via Microsoft Teams and on hospital premises.

Participants

Purposive and snowball sampling methods were used to recruit consultant orthopaedic surgeons specialised in elective lower limb arthroplasty.

Results

10 surgeons from eight centres in the UK were interviewed. Thematic saturation was achieved after eight interviews. 5 main themes and 13 subthemes were identified. Bone quality impacted decisions around preoperative planning, surgical procedure, implant choice, concerns of iatrogenic injury and hip biomechanics. Many surgeons (7/10) described changing surgical procedure based on their intraoperative assessment of bone quality. There was consensus that cemented femoral fixation is superior in patients with poor bone quality and on the importance of assessing radiographs preoperatively. There was, however, a lack of consensus on optimal acetabular fixation method, the radiographs metrics used to measure bone quality and attitudes towards current guidelines.

Conclusions

Bone quality has a significant impact on the decision-making of experienced arthroplasty surgeons, though there are significant limitations and divergence in current methods of assessing bone quality. Further work to identify intraoperative and preoperative imaging metrics that correlate with bone mechanical properties could enhance surgical decision-making.
Readiness of adults with type 1 diabetes and diabetes caregivers for diabetes distress monitoring using a voice-based digital health solution: insights from the PsyVoice mixed methods study
Authors: Aguirre Vergara Franchesca , Pinker India , Fischer Aurélie , Seuring Till , Tichomirowa Maria A , de Beaufort Carine , Kamp Siri-Maria , Fagherazzi Guy , Aguayo Gloria A
Published: January 2025

Objectives

Diabetes distress can negatively affect the well-being of individuals with type 1 diabetes (T1D). Voice-based (VB) technology can be used to develop inexpensive and ecological tools for managing diabetes distress. This study explored the competencies to engage with digital health services, needs and preferences of individuals with T1D or caring for a child with this condition regarding VB technology to inform the tailoring of a co-designed tool for supporting diabetes distress management.

Design

We used a mixed methods design. We performed a qualitative reflexive thematic analysis of semistructured interviews of people living with T1D or caring for a child with T1D, complemented by quantitative analysis (descriptive statistics).

Setting

12 adults living with T1D who attended diabetes centres or cared for a child with this condition participated in semistructured interviews to collect opinions about voice technology. They also responded to three questionnaires on sociodemographics and diabetes management, diabetes distress and e-health literacy.

Outcome measures

Main: Patient experiences and perceptions derived from the coded transcriptions of interview data. Secondary: Quantitative data generated from Socio-Demographic and Diabetes Management questionnaire; Problem Areas in Diabetes Scale and e-Health Literacy Questionnaire.

Results

Five major themes were generated from the participants’ interview responses: (1) Experience of T1D, (2) Barriers to VB technology use, (3) Facilitators of VB technology, (4) Expectations of VB technology management in T1D, (5) Role of healthcare professionals in implementing VB technology for T1D. Most participants expressed a favourable view of voice technology for diabetes distress management. Trust in technology and healthcare professionals emerged as the predominant sentiment, with participants’ current device type impacting anticipated barriers to adopting new technologies.

Conclusion

The results highlighted positive participant views towards VB technology. Device use, previous experience and health professional endorsement were influential facilitators of novel VB digital health solutions. Further research involving younger people with T1D could further contribute to the successful development of these tools.

Trial registration number

ClinicalTrials.gov,NCT05517772.
Geographical equity in Ethiopian infant feeding practices: a secondary analysis of a birth cohort study
Authors: Tariku Amare , Persson Lars , Schellenberg Joanna , Marchant Tanya , Berhanu Della , Lemma Seblewengel , Defar Atkure , Zemedu Theodros Getachew , Denu Zewditu Abdissa , Delele Tadesse Guadu , Shiferaw Solomon , Zeleke Girum Taye , Zelalem Meseret , Gelaye Kassahun Alemu
Published: January 2025

Objectives

To assess the geographical equity in Ethiopian infants’ exclusive breastfeeding at 5 months and dietary diversity at 12 months and whether social factors explained the spatial inequities.

Design

Secondary analysis of a birth cohort study.

Setting

Analysis of data from the Ethiopian Performance Monitoring for Action panel study conducted from July 2020 to August 2021 in five regions (ie, Oromia, Amhara, Afar and Southern Nations, Nationalities and Peoples regions and the Addis Ababa City administration). We analysed geographical autocorrelation to assess geographical variations in exclusive breastfeeding and dietary diversity. Areas with higher and lower coverage of appropriate infant feeding outcomes were analysed using hotspot analyses. We performed geographically weighted regression to investigate whether sociodemographic factors explained the geographical feeding differences.

Participants

1850 infants were prospectively followed from birth to 12 months.

Outcome measures

Exclusive breastfeeding at 5 months and minimum-level dietary diversity at 12 months.

Results

Sixty-nine percent (95% CI 67 to 71) of infants were exclusively breastfed at 5 months, while at 12 months, only 16% (95% CI 13 to 19) had complementary feeding from five or more food groups. There were geographical variations in the coverage of exclusive breastfeeding and minimum dietary diversity. Higher proportions of infants were exclusively breastfed at 5 months in northern areas, and more 12-month-old infants in central parts of the country had complementary feeding from at least five food groups. Sociodemographic factors explained a quarter of the geographical variation in dietary diversity.

Conclusion

Most Ethiopian infants were exclusively breastfed, which was in line with global recommendations but with some geographical differences. There was prominent geographical variation in dietary diversity, partly explained by social factors, but overall, very few 12-month-old infants were fed from at least five food groups. This low dietary quality could impair Ethiopian children’s physical growth, development and health.
How sufficient economy philosophy contributes to sustainable resilience: a qualitative study on the COVID-19 pandemic response in Thailand
Authors: Samutachak Bhubate , Ford Kathleen , Tangcharoensathien Viroj , Satararuji Kullatip
Published: January 2025

Objective

This qualitative study sought to understand how sufficient economy philosophy (SEP) was applied to cope with and recover from the COVID-19 pandemic.

Design

A qualitative study conducted through focus group discussions.

Participants

19 focus groups, with 161 participants, selected for the diverse backgrounds in gender, profession, education and region (urban/rural) and different levels of impact from the pandemic.

Setting

Bangkok, the capital city, and the four regions of Thailand: north, northeast, south and central.

Findings

Participants highlighted the moderation, reasonableness and prudence as key themes that mitigated adverse economic impacts during the pandemic. Communities practising the SEP reported resilience through balanced consumption, prudent planning and social cooperation. Many participants mentioned that the SEP was crucial to their survival and should have been better practised. Though the market structure failed during the pandemic, they still could secure the essential items to maintain livelihood.

Conclusion

In a society where changes are complicated by multiple factors, crises may occur more frequently, unsuspectedly and in various forms. Tools and a mechanism for resilience are increasingly needed. This study highlights the importance of the SEP, which incorporates five key concepts: moderation, reasonableness, prudence, knowledge and morality. These concepts help affected communities survive and become resilient, which is crucial for achieving several Sustainable Development Goals, such as poverty and hunger reduction, enhanced health and well-being and the sustainability of cities and communities.
Providing medically tailored groceries and food resource coaching through the charitable food system to patients of a safety-net clinic in Dallas, Texas: a randomised controlled trial protocol
Authors: Albin Jaclyn , Leonard Tammy , Wong Willis , Siler Milette , Haskins Carolyn , Turcios Jessica , Pruitt Sandi L , Bowen Michael , Pezzia Carla , Ford Alisha , Schinzer Bianca , Hollis-Hansen Kelseanna
Published: January 2025

Introduction

Linking patients living with chronic, diet-related diseases and food insecurity to charitable food assistance, medically tailored groceries (MTGs) and food resource coaching may empower patients to better manage their health in a way that is economically sustainable. This protocol paper describes the implementation of a study evaluating MTGs and food resource coaching in a food pantry setting.

Methods and analysis

A randomised controlled trial whereby patients of a safety-net health centre will be screened for The Emergency Food Assistance Program (TEFAP) and study eligibility. Eligible patients will be randomised to receive 4 months of usual pantry services (control), MTGs (intervention 1) or MTGs and food resource coaching (intervention 2) from a colocated food pantry. Measures collected monthly include adherence, fidelity and food selections from the pantry. Measures collected at baseline and follow-up include food and nutrition security, diet quality, household resiliency, loneliness and overall well-being. Qualitative interviews (n=60) will be conducted preintervention and postintervention. Analyses will include multiple regression models to analyse changes from baseline to follow-up as well as changes between groups over time. Deductive thematic analysis of qualitative data will be conducted.

Ethics and dissemination

This study was approved by the UT Southwestern Medical Center Institutional Review Board (STU-2023-1166) and the Parkland Health Office of Research Administration. This is protocol version two, modification approved on 3 June 2024. Findings will be disseminated through academic conferences, journals and to the public.

Trial registration number

NCT06242808.
Effect of providing at-home opioid disposal kits at discharge after an orthopaedic surgery
Authors: Shan Eric , Xiong Ruiying , Katzman Michael , Ali Zarina , Lee Daniel , Delgado M Kit , Agarwal Anish
Published: January 2025

Prescription opioids after surgery may pose a risk if left unused. However, prescribers rely on their best judgement in determining how much their patients need, often resulting in over-prescription of these medications. Opioid disposal is a strategy to reduce the risk of persistent use or misuse of opioids. At-home disposal kits allow patients to safely dispose of leftover opioids. In this study, we assess the impact of opioid disposal kits on disposal rates after orthopedic surgery. In a difference-in-differences study of 1,321 eligible patients, disposal kits were associated with a 10.6 percentage point increase (95% CI: -3.5% to 24.7%) in disposal rates as well as a 10.5 percentage point increase (95% CI: 0.2% to 20.9%) in the fraction of opioids disposed. We build on prior research and identify that providing surgery patients with an opioid disposal kit at the time of discharge increases their self-disposal rates.
Development of a Preliminary Patient Safety Classification System for Generative AI
Authors: Hose Bat-Zion , Handley Jessica L , Biro Joshua , Reddy Sahithi , Krevat Seth , Hettinger Aaron Zachary , Ratwani Raj M
Published: January 2025

Generative artificial intelligence (AI) technologies have the potential to revolutionise healthcare delivery but require classification and monitoring of patient safety risks. To address this need, we developed and evaluated a preliminary classification system for categorising generative AI patient safety errors. Our classification system is organised around two AI system stages (input and output) with specific error types by stage. We applied our classification system to two generative AI applications to assess its effectiveness in categorising safety issues: patient-facing conversational large language models (LLMs) and an ambient digital scribe (ADS) system for clinical documentation. In the LLM analysis, we identified 45 errors across 27 patient medical queries, with omission being the most common (42% of errors). Of the identified errors, 50% were categorised as low clinical significance, 25% as moderate clinical significance and 25% as high clinical significance. Similarly, in the ADS simulation, we identified 66 errors across 11 patient visits, with omission being the most common (83% of errors). Of the identified errors, 55% were categorised as low clinical significance and 45% were categorised as moderate clinical significance. These findings demonstrate the classification system’s utility in categorising output errors from two different AI healthcare applications, providing a starting point for developing a robust process to better understand AI-enabled errors.
Knowledge GAPPS: a case report of a rare inherited gastric cancer syndrome
Authors: McGowan Aiden , Hoque Sami
Published: January 2025

A 66-year-old patient presented to a clinic to be investigated for a diagnosis of gastric adenocarcinoma and proximal polyposis of the stomach (GAPPS). GAPPS is a rare, autosomal-dominant syndrome manifesting with extensive polyposis of the stomach and predisposes patients to gastric adenocarcinoma. Gastroscopy and biopsy confirmed a diagnosis of GAPPS, showing polyposis in a typical antrum-sparing distribution. Due to the rarity of GAPPS, accepted management pathways remain contentious, especially regarding if and when to advise gastrectomy to minimise the risk of malignant polyp transformation. Moreover, the similarity in presentation of GAPPS and other stomach polyposis syndromes raises concerns about missed cases and lack of follow-up.
Comparative analysis of injuries related to self-harm, assault, and intimate partner violence: insights from U.S. Emergency Departments (2005–2021)
Authors: Khurana Bharti , Bayne Haley Nicole , Temple Jeff , Andover Peggy , Loder Randall
Published: January 2025

Background

Emergency departments are on the front lines of non-fatal self-harm injury (SHI). This study identifies patterns in patients presenting to emergency departments with SHI compared with patients presenting with assault and intimate partner violence.

Methods

Using the National Electronic Injury Surveillance System All Injury Program database, we analyzed SHI cases in the emergency department from 2005 to 2021 and examined demographic characteristics, injury mechanism and anatomic location, emergency department disposition and temporal patterns relative to cases involving assault and intimate partner violence.

Results

Of all injury-related emergency department visits, 1.5% (7 774 900) were due to SHI, 4.8% (24 165 696) due to assault and 0.6% (3 188 790) due to intimate partner violence. SHI peaked in ages 15–19 (18.3%), assault in ages 20–24 (17.3%) and intimate partner violence in ages 25–29 (19.2%). Patients with SHI were 41.0% males, compared with assault (66.3%) and intimate partner violence (19.3%) groups (p<0.0001). Most SHIs involved white patients (75.2%), compared with assaults (46.2%) and intimate partner violence (40.4%) (p<0.0001). Lacerations (20.6%) were the most common injury for SHI, while contusions/abrasions were the most common injuries for both assaults (27.8%) and intimate partner violence (39.1%) (p<0.0001). The upper extremity was the most common injury location in SHI (71.11%), while the head/neck was the most injured area in assaults (58.4%) and intimate partner violence (59.7%). Of adolescents sustaining SHI, 76.7% were women, compared with 59.0% of emerging adults and 53.2% of adults (p<0.0001). Among adolescents, the prevalence of SHI was lowest on weekends and during the summer.

Conclusions

Our findings highlight distinct demographic, injury and temporal patterns observed in patients with SHI.
Estimated exposure to endotoxin and circulating immunological markers among male farmers in the Biomarkers of Exposure and Effect in Agriculture study
Authors: Ezennia Somayina C , Beane Freeman Laura E , Chang Vicky C , Xie Shuai , Sandler Dale P , Andreotti Gabriella , Parks Christine G , Friesen Melissa C , Hofmann Jonathan N
Published: January 2025

Background

Occupational exposure to endotoxin has been associated with reduced lung cancer risk. The mechanisms underlying this association are unclear, though immunological alterations likely play a role. Farmers who perform certain tasks (eg, raising hogs) can be highly exposed to endotoxin. We, therefore, leveraged measurements of circulating immune markers from a prior investigation among male farmers in the Biomarkers of Exposure and Effect in Agriculture study to evaluate associations with newly developed estimates of endotoxin exposure.

Methods

Our investigation included 122 non-smoking farmers from Iowa, oversampling those raising hogs. Serum levels of 60 markers were measured using multiplex bead-based assays and ELISA. Based on an algorithm linking measurement-based task intensity estimates with self-reported task frequency, we estimated cumulative endotoxin exposure in the 30 days up to sample collection. We used multivariable linear regression to estimate geometric mean ratios of immune markers across exposure quartiles.

Results

Higher endotoxin exposure in the last 30 days was associated with increased levels of fibroblast growth factor-2, macrophage inflammatory protein-3 alpha/CCL20 and sIL-4R (P
trend
≤0.02) and decreased levels of macrophage-derived chemokine/CCL22 (P
trend
=0.02). We also identified novel associations with several additional markers; those with the highest (vs lowest) exposure to endotoxin had decreased levels of TARC/CCL17, sCD27 and IL-1B.

Conclusions

Several circulating immune markers were associated with endotoxin levels in an exposure–response manner. Our findings are consistent with prior work on hog farming and suggest possible biological mechanisms through which endotoxin may confer a reduced risk of lung cancer.
Reliability of the OMERACT Giant cell arteritis Ultrasonography Score (OGUS): results of a patient-based exercise involving experts and non-experts in vascular ultrasonography
Authors: Duftner Christina , Redlinger Norbert , Bruyn George A , Chadachan Veerendra , Chrysidis Stavros , Correyero Maria , D’Agostino Maria Antonietta , Dalsgaard Nielsen Berit , Dasgupta Bhaskar , De Miguel Eugenio , Diamantopoulos Andreas P , Fulvio Giovanni , Gkikopoulos Nikitas , Hartung Wolfgang , Hocevar Alojzija , Keen Helen , Kurteva Vesselina , Mandl Peter , Manger Eva , Mercatelli Paolo , Midtgard Irina , Monti Sara , Muller Raili , Mykkänen Kati , Pineda Carlos , Ponte Cristina , Reffat Duriad , Sarbu Adela-Cristina , Seitz Luca , Terslev Lene , Schmidt Wolfgang , Dejaco Christian
Published: January 2025

Objective

To test the reliability of the Outcome Measures in Rheumatology Giant cell arteritis (GCA) Ultrasonography Score (OGUS) and other composite scores in a patient-based exercise involving experts and non-experts in vascular ultrasonography.

Methods

Six GCA patients were scanned twice (two rounds separated ≥3 hours) by 12 experts and 12 non-experts. Non-experts received 90 min of theoretical and 240 min of practical training between rounds 1 and 2. Ultrasonography was conducted on temporal arteries (common superficial, frontal and parietal branches) and axillary arteries bilaterally to calculate the OGUS, the Southend score and the Halo count. Inter-reader and intra-reader reliability were assessed by intraclass correlation coefficient (ICC).

Results

Mean age of GCA patients was 78±5.1 years, 2 (33.3%) were women, and all were in clinical remission. Expert inter-reader ICC of the OGUS was 0.60 in both rounds, 0.40 in round 1 and 0.51 in round 2 for the Southend score and 0.45 and 0.52, respectively, for the Halo count. Median ICCs for intra-reader reliability were 0.86, 0.73 and 0.65 for the OGUS, Southend score and Halo count, respectively.

For non-experts, inter-reader ICCs in round 1 were 0.20 for the OGUS, 0.20 for a normalised Southend score (=score divided by available segments) and 0.35 for a normalised Halo count. After training, inter-reader reliability ICCs improved to 0.52, 0.29 and 0.54, respectively.

Conclusion

Inter-reader reliability was fair to moderate, and intra-reader reliability was good for OGUS, Southend score and Halo count among experts. Inter-reader reliability of non-experts in vascular ultrasonography improved after the training.
A hitchhiker’s guide to active motion
Authors: Plasczyk Tobias , Monderkamp Paul A. , Löwen Hartmut , Wittmann René
Published: January 2025

Intelligent decisions in response to external informative input can allow organisms to achieve their biological goals while spending very little of their own resources. In this paper, we develop and study a minimal model for a navigational task, performed by an otherwise completely motorless particle that possesses the ability of hitchhiking in a bath of active Brownian particles (ABPs). Hitchhiking refers to identifying and attaching to suitable surrounding bath particles. Using a reinforcement learning algorithm, such an agent, which we refer to as intelligent hitchhiking particle (IHP), is enabled to persistently navigate in the desired direction. This relatively simple IHP can also anticipate and react to characteristic motion patterns of their hosts, which we exemplify for a bath of chiral ABPs (cABPs). To demonstrate that the persistent motion of the IHP will outperform that of the bath particles in view of long-time ballistic motion, we calculate the mean-squared displacement and discuss its dependence on the density and persistence time of the bath ABPs by means of an analytic model.

Graphical abstract

Illustration of an intelligent hitchhiking particle (IHP) in a bath of active Brownian particles (ABPs). The IHP fulfills a navigational task by holding on to an ABP only if its orientation points upwards, enabling persistent motion.
Frequency-Assisted Local Attention in Lower Layers of Visual Transformers
Authors: Zhou Xin , Jiang Zeyu , Zhou Shihua , Ren Zhaohui , Zhang Yongchao , Yu Tianzhuang , Liu Yulin
Published: January 2025

Since vision transformers excel at establishing global relationships between features, they play an important role in current vision tasks. However, the global attention mechanism restricts the capture of local features, making convolutional assistance necessary. This paper indicates that transformer-based models can attend to local information without using convolutional blocks, similar to convolutional kernels, by employing a special initialization method. Therefore, this paper proposes a novel hybrid multi-scale model called Frequency-Assisted Local Attention Transformer (FALAT). FALAT introduces a Frequency-Assisted Window-based Positional Self-Attention (FWPSA) module that limits the attention distance of query tokens, enabling the capture of local contents in the early stage. The information from value tokens in the frequency domain enhances information diversity during self-attention computation. Additionally, the traditional convolutional method is replaced with a depth-wise separable convolution to downsample in the spatial reduction attention module for long-distance contents in the later stages. Experimental results demonstrate that FALAT-S achieves 83.0% accuracy on IN-1k with an input size of [Formula: see text] using 29.9[Formula: see text]M parameters and 5.6[Formula: see text]G FLOPs. This model outperforms the Next-ViT-S by 0.9[Formula: see text]APb/0.8[Formula: see text]APm with Mask-R-CNN [Formula: see text] on COCO and surpasses the recent FastViT-SA36 by 3.1% mIoU with FPN on ADE20k.
Pricing Strategy for Crowdsourced Delivery Service Platform Considering Demand Heterogeneity: Subscription or Pay-Per-Transaction
Authors: Yang Yafei , Zhang Yi , Zhao Shouting , Liu Samuel Shuai
Published: January 2025

Subscription pricing strategies are increasingly adopted by crowdsourcing delivery platforms, allowing subscribers to pay a fixed upfront fee for unlimited future services. This paper explores the impact of demand heterogeneity and transaction costs on the comparison between subscription pricing and pay-per-transaction pricing. We construct and solve models to obtain optimal service prices, delivery commissions, and profits under both strategies. Our findings indicate that the subscription strategy is more effective at attracting consumers compared to the pay-per-transaction strategy. Specifically, the subscription strategy can lower commission rates and reduce the number of deliverers required, while generating higher surplus for both consumers and deliverers when transaction costs are high. Moreover, the subscription strategy maintains a profit advantage when demand heterogeneity is low and transaction costs are high. This study offers valuable insights into pricing decisions, strategy selection, and operational performance optimization, aiding delivery service platforms in better targeting consumers and products.
Design of Multiple Quasi-Zero Stiffness Isolators Based on a Shallow Arch
Authors: Liang Da , Liu Furong , Zhang He , Zheng Hao , Nie Peng
Published: January 2025

The quasi-zero stiffness (QZS) structure is capable of achieving a satisfactory low-frequency vibration isolation effect. However, the majority of current QZS structure designs are complex, comprising a single working load and a relatively limited QZS zone. This paper presents the development of a multi-quasi-zero (MQZS) stiffness vibration structure based on a circular shallow arch structure. The static compression of the unit structure was studied in detail using the theoretical derivation, and finite element simulation, which can achieve multiple loads and a big QZS zone using the symmetrical and orthogonal connections, respectively. An analytical solution for the transfer rate was derived by solving the nonlinear dynamic equations of the system using the Harmonic Balance Method (HBM). In comparison to the conventional QZS system and the linear system, the vibration isolation frequency of the MQZS system is reduced by 75%, and the vibration transmissibility is reduced by 22[Formula: see text]dB at the same frequency. Furthermore, the findings based on 3D printing demonstrate that the designed MQZS isolator exhibits an effective low-frequency vibration isolation effect and has promising potential for meeting the requirements of integration and lightweight design.
n-cotorsion pairs and recollements of extriangulated categories
Authors: He Jian , He Jing
Published: January 2025

In this paper, we prove that if [Formula: see text] is a recollement of extriangulated categories, then n-cotorsion pairs in [Formula: see text] and [Formula: see text] can induce n-cotorsion pairs in [Formula: see text]. Conversely, this holds true under natural assumptions. Besides, we give mild conditions on a pseudo cluster tilting subcategory on the middle category of a recollement of extriangulated categories such that the corresponding additive quotients become a recollement of semi-abelian categories.
OVERLAPPING COMMUNITY DETECTION ALGORITHMS USING MODULARITY AND THE COSINE
Authors: DO DUY HIEU , PHAN THI HA DUONG
Published: January 2025

The issue of network community detection has been extensively studied across many fields. Most community detection methods assume that nodes belong to only one community. However, in many cases, nodes can belong to multiple communities simultaneously. This paper presents two overlapping network community detection algorithms that build on the two-step approach, using the extended modularity and cosine function. The applicability of our algorithms extends to both undirected and directed graph structures. To demonstrate the feasibility and effectiveness of these algorithms, we conducted experiments using real data.
A Multiplicity Analysis of Value Leakage in Telecom Infrastructure Projects: Emerging Insights from an Exploratory Sequential Mixed Method
Authors: Asiedu Ernest Marfo , Mkansi Marcia
Published: January 2025

The purpose of this study was to thoroughly examine the value leakage, both qualitatively and quantitatively, in telecom infrastructure projects using Ghana as the case study. The study used an exploratory sequential mixed-methods approach. A semi-structured interview was utilized in the qualitative study to investigate and generate relevant practical insights from the four case studies. The quantitative study used a structured questionnaire survey in which 81% of the 230 questionnaires distributed were returned to test and validate the qualitative study’s findings using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The researchers analyzed the data using Atlas TI, SPSS, and AMOSS version 25.0. The findings indicate that value leakage has tolerable and intolerable points. The intolerable point has two key impacts on telecom infrastructure projects, namely “financial impact” and “brand image impact”, with standardized regression weights of 0.791 and 0.910, respectively. These findings contribute to the development of value in the contemporary literature in the field of telecommunication. Again, these findings would edify the understanding of the practicing managers about project value leakage that may conventionally be seen as a mistake in their effort to achieve the project’s value.
Synthesis and Multifunctional Applications of Calcium Magnesium Pyrophosphate (CMP) Nanoparticles: Photocatalysis, Electrochemical Sensing and Energy Storage
Authors: Indumukhi B. C. , Tejashwini D. M. , Nagaswarupa H. P. , Naik Ramachandra , Sukrutha S. K.
Published: January 2025

For the first time, calcium magnesium pyrophosphate (CMP) nanoparticles were synthesized using the solution–combustion method, with urea serving as the fuel. The successful formation of CMP was confirmed through powder X-ray diffraction (XRD) analysis. Fourier transform infrared spectroscopy (FT-IR) verified the presence of phosphate groups, while UV-diffuse reflectance spectroscopy (UV-DRS) determined the bandgap energy of CMP to be 4.7[Formula: see text]eV. Morphological studies were conducted using scanning electron microscopy (SEM). In photocatalytic degradation tests, CMP nanoparticles exhibited an outstanding 90% degradation efficiency of Acid Red-88 dye under UV light, confirming their effectiveness as photocatalysts. Furthermore, post-treatment testing of the degraded dye sample on Eleusine coracana seeds revealed a positive impact on plant growth. A modified carbon-paste CMP electrode was also employed for cyclic voltammetry (CV) and linear sweep voltammetry (LSV), demonstrating high selectivity in detecting heavy metals such as mercury and chromium, as well as biomolecules like creatinine in the sensitivity range of 1–5 mM. Additionally, electrochemical impedance spectroscopy (EIS) and galvanostatic charge–discharge (GCD) measurements confirmed the stability of CMP electrodes for applications in batteries and supercapacitors.
Thermal Conductivity Properties of Ti–V–Cr–Fe–M (M =Mn, Co, Sc and Ni) High Entropy Alloys
Authors: Li Zhe , Li Lirong , Luo Long
Published: January 2025

Metal-hydride solid state hydrogen storage (H-storage) has the advantages of high bulk density, good safety, easy operation and low operating cost, and is considered to be the most ideal H-storage method. High entropy alloys (HEAs), which contain at least five principal elements and each with an atomic percentage in the range of 5–35%, have gained continuous increasing attention in the material science community. Since large entropy encourages the generation of single-phase solid solutions with severe lattice distortions and more suitable reaction sites, HEAs have become a research hotspot for better performance in hydrogen storage. Body-centered cubic (BCC) alloy systems can theoretically store double amounts of hydrogen compared with commercial metal hydrides at room temperature, and BCC structural HEAs have shown the potential to reach this theoretic limit. The thermal conductivity of HEAs seriously affects its hydrogen storage performance, but little research has been conducted on the thermal conductivity of HEAs. In this study, as-cast [Formula: see text]Ti[Formula: see text]Cr[Formula: see text]Fe[Formula: see text]M[Formula: see text] (M [Formula: see text] Mn, Co, Sc and Ni) HEAs were fabricated by arc-melting. The microstructure and thermal conductivity behavior of the HEAs were systematically investigated. It is found that the main phase of the HEAs is a BCC-structured solid solution. The alloys also have high thermal diffusivity, specific heat capacity and thermal conductivity. The [Formula: see text]Ti[Formula: see text]Cr[Formula: see text]Fe[Formula: see text]Sc[Formula: see text] sample exhibit the highest thermal conductivity of [Formula: see text] at [Formula: see text]C. The factors affecting the thermal conductivity of HEAs were systematically analyzed. This study provides a new perspective on alloys applied to solid-state hydrogen storage.
Development of a Centralized Conflict Free Greedy Assignment Learning Spiking Neural Network for Solving a Perimeter Defense Problem
Authors: Thousif Mohammed , Velhal Shridhar , Sundaram Suresh , Sundararajan Narasimhan
Published: January 2025

In this paper, a Centralized Conflict-free Assignment Learning Spiking neural network (C2ALS) is formulated for solving a Perimeter Defense Problem (PDP). Here, the region between the perimeter and the sensing range of the defender is divided into two layers. The outermost layer, in which the defender can only sense the intruders, is termed the sensing layer. The layer closest to the perimeter in which the defenders can sense and capture the intruders is termed the capture layer. Both layers are further divided into angular segments with respect to the center of the area to be protected. The spatiotemporal movements of both the defenders and intruders in these segments are converted into spikes and given as input to a Spiking Neural Network (SNN). The SNN is trained in a supervised manner to learn the intruder capture assignments of a defender in terms of these segments. Here, the desired assignments required for training a defender are referred to as greedy assignments because while generating them, priority is given to those segments that are relatively closer to the defender’s actual location. Inhibitory connections are used in the SNN architecture to obtain assignments without conflicts. Detailed performance study results show that the proposed C2ALS approach outperforms the other existing centralized optimization-based solutions for PDP by a 17% increase in the success rates of capturing the intruders. Also, C2ALS is the first centralized spike-based learning solution for PDP, capable of generating conflict-free assignments while ensuring robust intruder assignments with minimal defender movement.
Partiality of China’s Foreign Aid Policy Reform: A Cognitive Approach
Authors: Yue Wu
Published: January 2025

This paper examines the partiality of the Xi administration’s foreign aid policy (FAP) reform. China has established the China International Development Cooperation Agency (CIDCA) to reform its foreign aid management system while continuing the loan-for-oil model within the framework of South–South Cooperation. By applying the cognitive theory of international regimes, this paper explores the reform and continuity of China’s FAP. It finds that although national interests drive China’s foreign aid, the reform of China’s FAP is the result of idea learning. China’s learning of ideas from developed donor countries explains its FAP reform, as evidenced by the establishment of CIDCA. In contrast, its adherence to domestic ideas explains the continuity of the loan-for-oil model. The ideas of recipient countries serve as secondary learning sources for China, but China only made appropriate policy adjustments based on their feedback.
The value of biostratigraphy in site investigation and its application to the development of ‘ground models’ (
sensu
Peter Fookes)
Authors: Hart Malcolm B.
Published: January 2025

Micropalaeontology is a core component of biostratigraphy and, as a subject, is constantly in use for the solution of stratigraphical and palaeoenvironmental problems. The application to the field of engineering geology, and specifically site investigation, is probably less well appreciated despite its role in the construction of two major infrastructure projects in South-East England: viz. the Channel Tunnel and the Thames Barrier.
Immune Regulation of Goblet Cell and Mucus Functions in Health and Disease
Authors: Gustafsson Jenny K. , Hansson Gunnar C.
Published: January 2025

The mucosal surfaces of the body are the most vulnerable points for infection because they are lined by single or multiple layers of very active epithelial cells. The main protector of these cells is the mucus system generated by the specialized goblet cells secreting its main components, the gel-forming mucins. The organization of the mucus varies from an attached mucus that is impenetrable to bacteria in the large intestine to a nonattached, more penetrable mucus in the small intestine and airways. The respiratory tract mucus system clears particles and microorganisms from healthy lungs but causes disease if reorganized to an attached mucus that cannot be efficiently transported. Similarly, transformation of large intestine mucus from impenetrable to penetrable causes chronic inflammation directed toward the intestinal microbiota. Mucus-producing goblet cells are regulated by and responsive to signals from immune cells and at the same time signal back to the immune system. In this review we focus on the relationship of immune cells with intestinal goblet cells and mucus, making parallels to the respiratory tract.