bluuebunny/crossref_metadata_2025 huggingface dataset:
The Physiology of Heat Stress: A Shift in Metabolic Priorities at the Systemic and Cellular Levels
Authors: Rhoads Robert P. , Baumgard Lance H. , Zhao Lidan
Published: September 2016

At the onset of heat stress, cattle initiate a series of whole body adaptations in an effort to cope with and dissipate additional heat load. These include well-known physiological changes such as increased respiration rate and sweating rate and decreased feed intake. Environmentally induced hyperthermia in ruminants depresses production as a consequence of reduced feed intake but it is unclear how shifts in metabolism may further affect production performance and physiological acclimation. Our evidence indicates that cattle experiencing heat stress do not appear to engage metabolic and glucose-sparing adaptations consistent with their plane of nutrition. In this context, the liver is uniquely positioned to direct exogenously and endogenously derived nutrients for use by other metabolically active tissues such as the mammary gland and skeletal muscle. Despite the prominent role of the liver in whole-body metabolism, alterations in the molecular mechanisms leading to hepatic adaptation during heat challenge are unclear. We are using management tools and metabolic modifiers, such as bovine somatotropin, in an attempt to better understand and improve hepatic function during heat stress. Because a large proportion of an animal’s mass is comprised of skeletal muscle, alterations in skeletal muscle metabolism and function can have a profound impact on whole-animal energy metabolism and nutrient homeostasis especially during periods of stress.  We have initiated studies to understand how hyperthermia influences the set points of several metabolic pathways within skeletal muscle. It appears that during heat stress bovine skeletal muscle experiences mitochondrial dysfunction leading to impaired cellular energy status. Finally, investigations into adipose tissue metabolism demonstrate impaired lipolytic functions likely due to a refractory nature to adrenergic stimuli. Taken together, this may have broad implications for the reduced production and heat intolerance seen during heat stress especially if tissue(s) are not able to make necessary contributions to whole-body energy homeostasis. Accurately understanding the biological mechanism(s) by which thermal stress reduces animal performance is critical for developing novel approaches (i.e. genetic, managerial and nutritional) to preserve growth and lactation especially given the critical importance of nutrients, such as glucose, to animal production and well being in these situations.
Healthy Udders and Feet & Legs = Healthy Cows & Happy Dairy Producers
Authors: Timms Leo L.
Published: September 2016

Optimizing animal health and performance is critical for quality, safe dairy products and the economic vitality of dairy operations. Producing both high quality and quantities of milk is the main income side of dairies and crucial for economic success, so attention to optimizing animal nutrition and care and practicing proper milk harvesting practices is essential. Bovine mastitis is one of the most economically expensive diseases of dairy cattle. Proper and rapid identification of mastitis problems and cows (clinical and subclinical) is critical and programs for both prevention and appropriate therapy including culling of problem cows are important for maximizing udder health. Lameness is dairy cattle is another of the top 3 dairy health expenses that leads to decreased production and performance, and often premature culling from dairy herds. Like mastitis, proper and rapid lameness identification coupled with appropriate prevention programs and therapy strategies are critical for dairy economic success.
Explotación del Sector Forestal y su Aporte al Crecimiento Económico de Honduras en el Periodo 2000-2012
Authors: Hernández Israel E. , Velásquez Ingrid , Villatoro Dilma
Published: September 2016

La presente investigación tiene como finalidad detallar el comportamiento del sector forestal en la comercialización de bienes madereros en el periodo 2000-2012; de igual manera se pretende exponer el nivel de aporte que hace este sector al crecimiento económico del país, tomando estos datos del Instituto de Conservación y Desarrollo Forestal. La teoría que sustenta la investigación se basa en la teoría del desarrollo sostenible la cual ha sido desarrolladla por la Organización de las Naciones Unidas. El documento describe el comportamiento de las variables Crecimiento Económico, Silvicultura (dentro del sector primario) e Industria Forestal (dentro del sector secundario) en el que se expone cual ha sido su comportamiento durante el periodo, llegando a concluir que dicho sector aporta al crecimiento económico de Honduras un 0.87% presentando así un déficit en la balanza comercial de productos madereros durante los años en estudio; anudado a lo anterior en el país el aprovechamiento en cuanto al bosque se refleja a nivel privado con fines industriales utilizando la madera en rollo de pino en mayores proporciones, es decir el aprovechamiento ha sido únicamente de carácter de materia prima y pocos son los procesos tecnológicos que permiten a dichos productos obtener un mayor valor agregado. También se concluye que al ser este un sector poco significativo cuando se compara con otros de mayor desempeño un mayor crecimiento económico vendrá determinado por el desempeño de los diferentes sectores y además del sector forestal; sin embargo los niveles de aporte del sector son poco significativos al PIB por su carácter de ser una industria primaria en la que el proceso productivo sigue siendo débil y desfasado. Es entonces que al obtener los resultados podemos afirmar que la volatilidad del sector no necesariamente generará cambios significativos al crecimiento del país.Economía y Administración (E&A) Vol.6(1) 2015
IED en Centroamérica: Su efecto en la Inversión Domestica
Authors: López María Auxiliadora , Osorto Tito Anibal
Published: September 2016

El propósito de la siguiente investigación fue determinar si la inversión extranjera directa que recibieron los países de Centroamérica, en el período 1980-2013, tuvo un efecto crowding in o crowding out sobre la inversión doméstica. Además, se describe la evolución de los flujos de IED en el mundo y en la región, así como los patrones de distribución de la misma, también se analiza el vínculo entre violencia-IED y Corrupción-IED. Para estimar dicho efecto, se utilizó un modelo econométrico de series de tiempo, y se aplicó el test de Wald a los coeficientes del modelo según la metodología de Agosín y Mayer (2000) Para realizar los cálculos se dividió la serie en dos periodos, 1980-1994 y 1995-2013 dado que hubo cambios importantes en algunas economías de la región. Los resultados de la investigación revelaron que la IED tuvo un efecto crowding in en Costa Rica y Honduras entre 1980-1994, en los demás países de la región se observó lo contrario. Sin embargo, en el siguiente período el efecto crowding in se observó únicamente en Nicaragua y en los demás países fue crowding out, a excepción de Costa Rica donde tuvo un efecto neutral.Economía y Administración (E&A) Vol.6(1) 2015
Proceso de producción de las cooperativas asociadas a PRODECOOP para la exportación de café orgánico a mercados preferenciales. 2014-2015
Authors: Chavarría Espinoza Zeyra , Ruiz Gutiérrez Marycruz , Valdivia Gutiérrez Yessenia Lisbeth , Castillo Herrera Beverly
Published: September 2016

El presente trabajo se enfoca en analizar el proceso de producción del café orgánico de los productores socios de la cooperativa PRODECOOP R, L. para el diseño de una estrategia que mejore los niveles de producción de café orgánico de calidad para la exportación. Según el nivel de conocimiento de esta investigación es aplicada y según el enfoque filosófico es cualitativa. La muestra la constituye el centro de cooperativas base PRODECOOP con sede en la ciudad de Estelí y su beneficio ubicado en el municipio de palacaguina. Las técnicas de recolección de datos fueron: investigación documental, observación y entrevistas. Las entrevistas se aplicaron a informantes claves de la empresa con experiencia en el proceso de producción a productores con varios años de conocimientos y exportación con la responsable. Los principales resultados obtuvimos que la relación de los productores asociados a PRODECOOP es pertinente ya que la mayoría son fundadores y laboran desde que inicio la empresa y les brinda una oportunidad de mantenerse y mejorar su calidad de vida. La certificación de las fincas es de gran importancia para la exportación porque le da seguridad al cliente del producto, ya que es un café orgánico y mediante el comercio justo se beneficia el productor. La mayoría de los productores cumplen con los parámetros de calidad que les exige PRODECOOP para obtener café en cantidad y calidad teniendo mejor rentabilidad en sus tierras. Los productores están satisfechos por formar parte de la cooperativa porque obtienen beneficios que apoya a mejorar su calidad de vida y esto también le favorece a PRODECOOP por que eleva su nivel de exportación y a la vez ayuda a la certificación de las fincas y así cumplir con los parámetros de calidad.
La economía global en crisis: Un repaso sobre las causas, las respuestas y los aprendizajes
Authors: Delgado Elvir Rafael Antonio
Published: September 2016

Este artículo hace un repaso de las diversas interpretaciones sobre las causas de la crisis financiera en 2008. Se explican los argumentos que apuntan hacia los cambios de actitud de los principales actores en el mercado y del contagio; se explican además las fallas del mercado como las causantes de la crisis.  La creación de la crisis fue un proceso largo que fue precedido de un período donde la banca lanzó las innovaciones financieras para diversificar el riesgo de la cartera hipotecaria. La caída en los precios de las viviendas tuvo efectos sobre otros mercados. Llegó la crisis financiera y con ello la caída en el crédito y la quiebra de importantes instituciones financieras.  El artículo hace un esbozo de las principales reacciones de la política económica frente a la crisis para concluir en los aprendizajes que resultan de la misma. En especial, se requiere que el sistema financiero vuelva a financiar la producción, mejorar el análisis del riesgo crediticio, aumentar la sensibilización del público sobre los instrumentos financieros, crear incentivos internos que también generen macro-resultados deseables; volver a la regulación de productos riesgosos.
Modelo para reducción de mora quirúrgica en cirugías selectivas del Hospital El Progreso, Yoro
Authors: Sánchez Mario José , Enamorado Luis Fernando
Published: September 2016

La presente investigación se desarrolló en el Hospital de El Progreso, Yoro, Honduras. Datos estadísticos han arrojado que en la actualidad la mora quirúrgica de cirugía selectiva es de 120 días, lo que contrasta con los 30 días usados como indicador meta por parte del Ministerio de Salud de Honduras y recomendado por la Organización Mundial de la Salud (OMS). En vista de esta problemática se propone un modelo a través de simulación, que evalúe formas de disminuir dicha mora quirúrgica. Para el diseño de la investigación se usó un enfoque mixto dominante cuantitativo. Para alimentar el software de simulación Flexsim y corroborar el modelo actual de forma simulada, se construyó una bitácora de cirugías del 2012, gráficos de caja y bigote, pruebas de ANOVA y de hipótesis para cada cirujano (A, B y C) en las seis intervenciones quirúrgicas más frecuentes según diagrama de Pareto. Al tener el modelo actual validado, se recrearon cinco tipos de escenarios. Se eligió el primero, ya que es el que implica menor costo con alto impacto, obteniendo una disminución de la mora quirúrgica a solo 38 días. Por lo que se recomienda implementar el escenario número uno para reducir la mora y cumplir con el presupuesto del hospital.
Aanpassing afstammings- en gezagsrecht gewenst voor ongehuwd samenwonende ouders
Authors: Schrama W.M.
Published: September 2016

Rules for parentage and parental authority in informal cohabitation need to be adapted

In this article attention will be paid to the radical societal changes in respect of informal cohabitation. The rate of extramarital child birth has increased to over 50% of all first-born children. Family law is traditionally focused on marriage, which was for a long time the only acceptable relationship type. The question addressed in this article is whether the law of parentage and the law of parental responsibilities should be reformed in order to meet the needs of modern families.
Development and Validation of an ERCC1 Immunohistochemistry Assay for Solid Tumors
Authors: Bahamon Brittany N. , Gao Feng , Danaee Hadi
Published: September 2016

Context.—

Excision repair cross-complementation 1 (ERCC1) is a key enzyme in nuclear excision repair pathway and has a critical role in helping remove DNA adducts caused by cross-linking agents, such as platinum-containing cancer chemotherapies and other DNA-damaging therapeutic modalities. ERCC1 expression, evaluated by techniques such as immunohistochemistry, has been associated with clinical response; ERCC1+ tumors are more resistant to cisplatin treatment than are ERCC1− tumors. Although several immunohistochemistry, anti-ERCC1 antibodies are available, the 8F1 clone, in particular, has been used in many studies. Recent evidence has suggested that the 8F1 antibody cross-reacts with at least one other protein, raising concerns about the specificity of this clone.

Objective.—

To design an immunohistochemistry assay to detect ERCC1 levels that show dynamic range and consistent analytic performance.

Design.—

Two different primary antibodies to ERCC1, clones 4F9 and D6G6, were evaluated on formalin-fixed, paraffin-embedded tissue. We then performed a fit-for-purpose assay validation with the 4F9 clone, which included sensitivity assessment across several solid tumor types and evaluation of analytic parameters, such as precision and reproducibility.

Results.—

The 4F9 clone was consistently superior to the D6G6 clone in the optimization phase. A range of expression was seen in ovarian, head and neck, non–small cell lung, and esophageal cancer samples when tested with the 4F9 clone. The antibody showed acceptable reproducibility (31.02%) and precision (16.06%).

Conclusions.—

This assay can be used to assess ERCC1 levels during clinical studies of patient tumors from a variety of tumor types.
Interobserver Agreement of Usual Interstitial Pneumonia Diagnosis Correlated With Patient Outcome
Authors: Hashisako Mikiko , Tanaka Tomonori , Terasaki Yasuhiro , Uekusa Toshimasa , Achcar Rosane D. , Aswad Bassam I. , Bamefleh Hanaa S. , Capelozzi Vera L. , English John C. , Fabro Alexandre T. , Kataoka Kensuke , Hayashi Tomayoshi , Kondoh Yasuhiro , Taniguchi Hiroyuki , Fukuoka Junya
Published: September 2016

Context.—

The histopathologic criteria for idiopathic pulmonary fibrosis were revised in the American Thoracic Society/European Respiratory Society/Japan Respiratory Society/Latin American Thoracic Association guidelines in 2011. However, the evidence of diagnosis based on the guidelines needs further investigation.

Objective.—

To examine whether the revised histopathologic criteria for idiopathic pulmonary fibrosis improved interobserver agreement among pathologists and the predicted prognosis in patients with interstitial pneumonia.

Design.—

Twenty, consecutive, surgical lung-biopsy specimens from cases of interstitial pneumonia were examined for histologic patterns by 11 pathologists without knowledge of clinical and radiologic data. Diagnosis was based on American Thoracic Society/European Respiratory Society guidelines of 2002 and 2011. Pathologists were grouped by cluster analysis, and interobserver agreement and association to the patient prognosis were compared with the diagnoses for each cluster.

Results.—

The generalized κ coefficient of diagnosis for all pathologists was 0.23. If the diagnoses were divided into 2 groups: usual interstitial pneumonia (UIP)/probable UIP (the UIP group) or possible/not UIP (the non-UIP group), according to the 2011 guidelines, the κ improved to 0.37. The pathologists were subdivided into 2 clusters in which 1 showed an association between UIP group diagnosis and patient prognosis (P < .05).

Conclusions.—

Agreement about pathologic diagnosis of interstitial pneumonia is low; however, results after division into UIP and non-UIP groups provided favorable agreement. The cluster analysis revealed 1 of the 2 clusters providing high interobserver agreement and prediction of patient prognosis.
Do More With Less: Tips and Techniques for Maximizing Small Biopsy and Cytology Specimens for Molecular and Ancillary Testing: The University of Colorado Experience
Authors: Aisner Dara L. , Rumery Mathew D. , Merrick Daniel T. , Kondo Kimi L. , Nijmeh Hala , Linderman Derek J. , Doebele Robert C. , Thomas Natalie , Chesnut Patrick C. , Varella-Garcia Marileila , Franklin Wilbur A. , Camidge D. Ross
Published: September 2016

Context.—

In an era in which testing of patient tumor material for molecular and other ancillary studies is of increasing clinical importance for selection of therapy, the ability to test on small samplings becomes critical. Often, small samplings are rapidly depleted in the diagnostic workup or are insufficient for multiple ancillary testing approaches.

Objective.—

To describe technical methodologies that can be implemented to preserve and maximize tissue for molecular and other ancillary testing.

Data Sources.—

Retrospective analysis of a case cohort from the University of Colorado, description of techniques used at the University of Colorado, and published literature.

Conclusions.—

Numerous techniques can be deployed to maximize molecular and other ancillary testing, even when specimens are from small samplings. A dedicated process for molecular prioritization has a high success rate, but also increases workload, which must be factored into establishing such a process. Additionally, establishing high-fidelity communication strings is critical for success of dedicated molecular prioritization of samples. Numerous approaches can be deployed for alternative specimen types, and several technical approaches can also aid in maximizing small specimens.
Design and Function of Lowe and Sawmill Points from the Preceramic Period of Belize
Authors: James Stemp W. , Awe Jaime J. , Prufer Keith M. , Helmke Christophe G.B.
Published: September 2016

To date, 81 stemmed and barbed preceramic (Archaic) points (8000–900 B.C.) have been identified in Belize. Fifty-four are Lowe points; 21 are Sawmill points. Four more are provisionally classified as Allspice and two as Ya’axche’ points. These stemmed bifaces are frequently beveled on alternate-opposite edges and demonstrate variable degrees of resharpening and reworking, which affects blade shape and tool size. Numerous functions have been attributed to these artifacts; specifically, they have been called spear points, dart points, harpoons, and knives. Metric data from these bifaces, limited macrowear and microwear analyses, and design features, such as barbs and alternate-opposite edge beveling, have been used to interpret likely tool functions. Results suggest that Lowe points were affixed to throwing/thrusting spears and also served as knives, whereas the Sawmill points were used as spear-thrower dart points and as knives. New dating information suggests that alternate-opposite edge beveling and consequently beveled bifaces may be much older than 2500–1900 B.C., which is the date currently assigned to these specimens.
L’évaluation par les pairs en musique contemporaine en France et aux États-Unis
Authors: Fryberger Annelies
Published: September 2016

Cet article a pour objet l’évaluation par les pairs en musique contemporaine, notamment au sein de deux institutions : le ministère de la Culture (France) et New Music usa (États-Unis). Nous nous arrêtons longuement sur une figure d’évaluateur que nous appelons « l’intermédiaire » (d’après le travail du sociologue Ronald S. Burt), typifiée par ses liens avec plusieurs réseaux de créateurs plutôt que par son ancrage dans un seul réseau cohésif. Cela nous mène à discuter de l’art sonore, un genre qui demande aux créateurs de nourrir des liens avec des réseaux divers, et du succès institutionnel étonnant des compositrices dans ce domaine. S’ensuit une comparaison des différents systèmes de vote utilisés par les deux institutions étudiées, avec une conclusion sur le travail de gatekeeping en musique contemporaine et sur les façons dont ce travail peut influer sur le travail créateur des compositeurs.
A functional genomics screen in planarians reveals regulators of whole-brain regeneration
Authors: Roberts-Galbraith Rachel H , Brubacher John L , Newmark Phillip A
Published: September 2016

Planarians regenerate all body parts after injury, including the central nervous system (CNS). We capitalized on this distinctive trait and completed a gene expression-guided functional screen to identify factors that regulate diverse aspects of neural regeneration in Schmidtea mediterranea. Our screen revealed molecules that influence neural cell fates, support the formation of a major connective hub, and promote reestablishment of chemosensory behavior. We also identified genes that encode signaling molecules with roles in head regeneration, including some that are produced in a previously uncharacterized parenchymal population of cells. Finally, we explored genes downregulated during planarian regeneration and characterized, for the first time, glial cells in the planarian CNS that respond to injury by repressing several transcripts. Collectively, our studies revealed diverse molecules and cell types that underlie an animal’s ability to regenerate its brain.
Relationships among Service Quality, Value, and Student Athlete Satisfaction at Taiwan’s National Tug of War Competition
Authors: Lee De-Jen , Hsieh Li-Wen , Cheng Eva (Hui-Ping)
Published: September 2016

Service quality has been extensively used to improve corporate performance in business; however, few studies have applied this concept to the sports field. In Taiwan, students’ sporting events play an important role in national sports development as they are the main channels in which to incubate elite athletes and a way to develop professional experiences related to holding mega-sports events. Therefore, the main purpose of this study is the application of the service quality concept to sports events. Specifically, a model was proposed to examine the relationships among service quality, perceived value, and satisfaction. Self-administered questionnaire surveys were completed by 356 student athletes recruited from the 2013 National Tug of War Competition in Taiwan. The data were analyzed using structural equation modeling with LISREL 8.52. Results of this study indicated that the research model fit the data well. Participants’ overall satisfaction was directly influenced primarily by perception of event value, followed by staff service quality and interaction service quality; finally, the perceived event value served as a mediator, and significant indirect effects on participants’ satisfaction were found in administrative service quality and facility service quality. The study established a model including service quality, value, and satisfaction for tug of war competitions. Suggestions for sports organizers and implications for future studies are provided.

Keywords: Service Quality; Perceived Event Value, Satisfaction, Tug of War Competitions

To cite this document: De-Jen Lee, Li-Wen Hsieh, and Eva (Hui-Ping) Cheng, "Relationships among Service Quality, Value, and Student Athlete Satisfaction at Taiwan’s National Tug of War Competition", Contemporary Management Research, Vol.12, No.3, pp. 275-288, 2016.

Permanent link to this document:
http://dx.doi.org/10.7903/cmr.15852
Chronic Illness and Quality of Life 5 Years After Displacement Among Rohingya Refugees in Bangladesh
Authors: Hossain Ahmed , Baten Redwan Bin Abdul , Saadi Altaf , Rana Juwel , Rahman Taifur , Reza Hasan Mahmud , Alameddine Mohamad
Published: September 2024

Importance

Rohingya refugees, forcibly displaced from Myanmar, face challenges adapting to Bangladesh. Examining their quality of life (QOL) is vital to identifying nuanced factors associated with their well-being, informing targeted interventions for an improved QOL.

Objectives

To identify the QOL among Rohingya refugees 5 years after migration to Bangladesh, with a particular emphasis on understanding the complex interplay between sociodemographic factors and chronic illnesses.

Design, Setting, and Participants

A cross-sectional study involving resettled Rohingya adults was conducted between May 18 and July 7, 2021, approximately 5 years after their resettlement in Bangladesh. Of the participants, 500 individuals were healthy, whereas 558 individuals were undergoing treatment for at least 1 chronic disease. Data were analyzed from January to February 2024.

Main Outcomes and Measures

The study assessed QOL using the short version of the World Health Organization’s QOL Questionnaire, covering 4 domains: physical, psychological, social, and environmental. Scores were transformed to a maximum of 100. Tobit linear regression, adjusted for potential confounders, was employed for analysis.

Results

The study included a total of 1058 respondents, who were predominantly female (630 participants [59.5%]) and had a mean (SD) age of 42.5 (16.1) years. Despite being healthy, individuals without chronic illnesses had median QOL scores ranging from 44 to 56 out of 100, indicating a relatively poor QOL. A total of 260 participants (46.6%) with chronic diseases reported very poor or poor QOL, in contrast to 58 healthy individuals (11.6%) in the fifth year after displacement. Specifically, patients with cancer and those who had multimorbidity exhibited the lowest QOL scores across all domains, with significant reductions in the physical health (10.57 decrease; 95% CI, −12.97 to −8.17) and psychological domain scores (7.20 decrease; 95% CI, −9.71 to −5.93) according to Tobit regression analysis.

Conclusions and Relevance

This study found that chronic illnesses were associated with all domains of QOL among Rohingya refugees, particularly those with musculoskeletal disorders, cancer, and multimorbid conditions. This heightened vulnerability may contribute to poor QOL in this population. By uncovering these disparities, the study lays the groundwork for targeted interventions and policies aligned with the United Nations’ goal of leaving no one behind in sustainable development efforts.
Outcomes by Race and Ethnicity Following a Medicare Bundled Payment Program for Joint Replacement
Authors: Kim Narae , Jacobson Mireille
Published: September 2024

Importance

The Comprehensive Care for Joint Replacement (CJR) model, a traditional Medicare bundled payment program for lower-extremity joint replacement, is associated with care for patients outside traditional Medicare. Whether CJR model outcomes have differed by patient race or ethnicity outside of traditional Medicare is unclear.

Objective

To evaluate outcomes associated with the CJR model among Hispanic patients not enrolled in traditional Medicare.

Design, Setting, and Participants

This cohort study used hospitalization data from California’s Patient Discharge Dataset for all patients who underwent lower-extremity joint replacement in California between January 1, 2014, and December 31, 2017. In California, 3 metropolitan statistical areas (MSAs) were randomly selected to participate in CJR in April 2016. Hospitals not participating in other Medicare Alternative Payment Models were included in the treated group if they were in these 3 MSAs and in the control group if they were in the remaining 23 MSAs. The data analysis was performed between October 1 and December 31, 2023.

Exposure

Comprehensive Care for Joint Replacement program implementation.

Main Outcomes and Measures

The main outcomes were hospital length of stay and home discharge rates by race and ethnicity. Home discharge status included self-care, the use of home health services, and hospice care at home. Event study, difference-in-differences, and triple differences models were used to estimate differential changes in health care service use by race and ethnicity for patients in the treated MSAs compared with the control MSAs before vs after CJR implementation.

Results

Of 309 834 hospitalizations (patient mean [SD] age, 68.3 [11.3] years; 60.6% women; 14.8% Hispanic; 72.4% non-Hispanic White), 48.0% were in treated MSAs and 52.0% in control MSAs. The CJR program was associated with an increase in home discharge rates for patients without traditional Medicare coverage; however, the increase differed by patient race and ethnicity. The increase was 0.05 (95% CI, 0.02-0.08) percentage points higher for Hispanic patients with Medicare Advantage and 0.03 (95% CI, 0.01-0.04) percentage points higher for Hispanic patients without Medicare compared with their non-Hispanic White counterparts.

Conclusions and Relevance

This cohort study shows that CJR program outcomes differed by race and ethnicity for patients covered outside traditional Medicare, with home discharge rates increasing more for Hispanic compared with non-Hispanic White patients. These findings suggest the importance of considering differential outcomes of Medicare payment policies for racial and ethnic minority patient populations beyond the initially targeted groups.
Transcriptional changes impact hepatic proteome in autophagy‐impaired liver
Authors: Baral Kamal , Joshi Spandan , Lopez Adriana , Mugon Gavisha , Chanda Aroma , Chandrasheker Arya A. , Hinton Cameron , Thapa Kapil , Mercer Arissa , Spade Leah , Liu Gang , Bhetwal Bhupal Prasad , Fang Jia , Khambu Bilon
Published: September 2024

Hepatic proteomes are intricately controlled through biosynthesis, extracellular secretion, and intrahepatic degradation. Autophagy governs lysosome‐mediated intrahepatic degradation and the hepatic proteome. When autophagy is impaired, it leads to the accumulation of intrahepatic proteins, causing proteinopathy. This study investigates whether autophagy can modulate the hepatic proteome non‐degradatively. Utilizing conditional, inducible, and hepatotoxin models of hepatic autophagy impairment, we assessed the overall hepatic proteome expression using Coomassie brilliant blue (CBB) staining and liquid chromatography–tandem mass spectrometry (LC/MS). We pinpointed and confirmed four specific hepatic proteins—Cps1, Ahcy, Ca3, and Gstm1—that were selectively modified in autophagy‐deficient livers. Expression of Cps1, Ahcy, and Ca3 were significantly reduced, while Gstm1 expression increased in livers with autophagy impairment. Interestingly, these changes in hepatic protein levels were not due to defective autophagic degradation but were associated with alterations in mRNA transcript levels. Moreover, as a result of autophagic dysfunction, sustained activation of the nuclear erythroid‐derived 2‐like 2 (Nrf2) transcription factor, transcriptionally regulated the mRNA levels of these proteins. Our findings indicate that autophagy can influence hepatic proteins not solely via traditional degradative routes but also through non‐degradative transcriptional processes by modulating Nrf2.
New findings on clinical experience on surface‐guided radiotherapy for frameless non‐coplanar stereotactic radiosurgery treatments
Authors: Sánchez‐Rubio Patricia , Rodríguez‐Romero Ruth , Pinto‐Monedero María , Alejo‐Luque Luis , Martínez‐Ortega Jaime
Published: September 2024

Purpose

The aim of this study was to assess the accuracy of a surface‐guided radiotherapy (SGRT) system for setup and intra‐fraction motion control in frameless non‐coplanar stereotactic radiosurgery (fSRS) using actual patient data immobilized with two different types of open‐faced masks and employing a novel SGRT systems settings.

Methods and materials

Forty‐four SRS patients were immobilized with two types of open‐faced masks. Sixty lesions were treated, involving the analysis of 68 cone‐beam scans (CBCT), 157 megavoltage (MV) images, and 521 SGRT monitoring sessions. The average SGRT translations/rotations and 3D vectors (MAG‐Trasl and MAG‐Rot) were compared with CBCT or antero‐posterior MV images for 0° table or non‐coplanar beams, respectively. The intrafraction control was evaluated based on the average shifts obtained from each monitoring session. To assess the association between the SGRT system and the CBCT, the two types of masks and the 3D vectors, a generalized estimating equations (GEE) regression analysis was performed. The Wilcoxon singed‐rank test for paired samples was performed to detect differences in couch rotation with longitudinal (LNG) and lateral (LAT) translations and/or yaw.

Results

The average SGRT corrections were smaller than those detected by CBCT (≤0.5 mm and 0.1°), with largest differences in LNG and yaw. The GEE analysis indicated that the average MAG‐Trasl, obtained by the SGRT system, was not statistically different (p = 0.09) for both mask types, while, the MAG‐Rot was different (p = 0.01). For non‐coplanar beams, the Wilcoxon singed‐rank test demonstrated no significantly differences for the corrections (LNG, LAT, and yaw) for any table rotation except for LNG corrections at 65° (p = 0.04) and 75° (p = 0.03) table angle position; LAT shifts at 65° (p = 0.03) and 270° (p < 0.001) table angle position, and yaw rotation at 30° (p = 0.02) table angle position. The average intrafraction motion was < 0.1 mm and 0.1° for any table angle.

Conclusion

The SGRT system used, along with the novel workflow performed, can achieve the setup and intra‐fraction motion control accuracy required to perform non‐coplanar fSRS treatments. Both masks ensure the accuracy required for fSRS while providing a suitable surface for monitoring.
Identifying dose constraints for the parotid ducts to minimize patient‐reported xerostomia: Is conventional mean dose sparing of the parotid glands sufficient?
Authors: Ahmidouch Manal , Das Shiva K. , Zhu Tong , Shen Colette , Marks Lawrence B. , Chera Bhishamjit S. , Fried David V.
Published: September 2024

Background and purpose

The aim of this study was to identify dose constraints for the parotid ducts that limit patient‐reported xerostomia and estimate whether these constraints are achieved during conventional parotid gland sparing radiation therapy (PGS‐RT).

Methods and materials

Thirty‐eight oropharyngeal squamous cell carcinoma patients were treated prospectively on trial with MRI sialography‐guided parotid duct sparing radiation therapy (PDS‐RT). PDS‐RT explicitly minimizes dose to the parotid ducts in addition to PGS‐RT. Parotid duct dose constraints were identified that distinguished patients reporting high and low rates of xerostomia. Atlas‐based parotid duct contours were generated on a retrospective cohort of similar patients where the parotid ducts were not contoured nor explicitly spared to estimate the dose received by the parotid ducts during PGS‐RT.

Results

Patients whose intraglandular parotid ducts or total parotid ducts were planned for a mean dose < 14 Gy and < 12 Gy, respectively, reported significantly (p < 0.01) lower rates of xerostomia at 6 and 12 months post‐RT. Patients receiving PDS‐RT had average total and intraglandular duct doses of 11.6  and 13.6 Gy, respectively, compared to an estimated 23.8  and 22.1 Gy, for those receiving PGS‐RT (p < 0.01). Only 6% (6/108) and 20% (22/108) of patients receiving PGS‐RT were estimated to meet the dose constraints for the total ducts and intraglandular ducts, respectively.

Conclusion

Parotid duct dose thresholds exist that appear to distinguish patients with and without xerostomia. The identified dose thresholds are frequently not met in PGS‐RT plans. In addition to reducing the dose to the parotid gland(s), parotid duct sparing may also further reduce xerostomia.
Improving access in medical physics residency programs for physicists with disabilities
Authors: Fagerstrom Jessica M. , Eliason Grace , Al‐Hallaq Hania , Taylor Brian A. , Ashraf Muhammad Ramish , Viscariello Natalie
Published: September 2024

Within the landscape of medical physics education, residency programs are instrumental in imparting hands‐on training and experiential knowledge to early‐career physicists. Ensuring access to educational opportunities for physicists with disabilities is a legal, ethical, and pragmatic requirement for programs, considering that a significant proportion of the United States population has a disability. Grounded in conceptual frameworks of competency‐based medical education and the social model of disability, this work provides an introduction to some practical recommendations for medical physics residency programs. Strategies include embracing universal design principles, fostering partnerships with disability service offices, using inclusive language, developing and publicizing clear procedures for disclosing disabilities and requesting accommodations, and maintaining an overall commitment to equitable access to education. This work urges medical physics residency leadership to proactively move towards training environments that support the needs of residents across the spectrum of disability, highlighting why disability inclusion fundamentally enriches diversity.
Explore the feasibility of using spot‐scanning proton arc therapy for a synchrotron accelerator‐based proton therapy system – A simulation study
Authors: Cong Xiaoda , Liu Gang , Liu Peilin , Zhao Lewei , Chen Shupeng , Li Xiaoqiang , Shen Jiajian , Ding Xuanfeng
Published: September 2024

Objective

The aim of this study was to evaluate the feasibility and plan quality of spot‐scanning proton arc therapy (SPArc) using a synchrotron‐accelerator‐based proton therapy system compared to intensity‐modulated proton therapy (IMPT).

Approach

Five representative disease sites, including head and neck, lung, liver, brain chordoma, and prostate cancers, were retrospectively selected. Both IMPT and SPArc plans are generated with the HITACHI ProBEAT PBS system's minimum MU constraints and physics beam model. The SPArc plans are generated with 2.5° sampling frequency. The static delivery time was simulated based on the previously published synchrotron delivery sequence model, and the dynamic delivery time was simulated using a proton arc gantry mechanical model integrated with the synchrotron delivery sequence. Both dosimetric plan quality and delivery efficiency are evaluated.

Main results

A superior plan quality is reached compared with the IMPT plans generated for the same disease site. However, a relatively prolonged static and dynamic delivery time post new challenge, as static time increased by 49.22% and dynamic time 59.10% on average.

Significance

This study presents the first simulation results of delivering the SPArc plans using a synchrotron‐accelerated proton therapy system. The result shows its feasibility and limitations, which could guide future development.
Anti Wind‐Up and Robust Data‐Driven Model‐Free Adaptive Control for MIMO Nonlinear Discrete‐Time Systems
Authors: Heydari Mohsen , Novinzadeh Alireza B. , Tayefi Morteza
Published: September 2024

This article addresses a solution to one of the main challenges of online data‐driven control (DDC) methods: reducing the sensitivity of the model‐free adaptive control (MFAC) method to initial conditions and control parameters with the new control cost function and added the output error rate and integral along with a new anti‐wind up strategy for multi‐input multi‐output (MIMO) systems. The parameters introduced to the new control law have been validated using the boundary‐input boundary‐output (BIBO) approach to design and converge the controller. The simulation findings on a nonlinear auto‐regressive moving average model with exogenous inputs (NARMAX) system with triangular control input demonstrate that the proposed control rule will outperform to prototype MFAC. Furthermore, to analyze the sensitivity of the controller to the initial conditions and the uncertainties of the control parameters, 30 Monte Carlo simulations were performed with random initial conditions in the presence of disturbance in the control input, and output noise, and the results were compared with the prototype MFAC and conventional PID controller using standard criteria such as integral time absolute error, standard deviation, steady‐state error, and mean maximum error, which shows a noticeable superiority of proposed controller relative to the prototype MFAC.
Magnetron Sputtering Dual‐Ion Sequential Release Coating on PET Artificial Ligament Promotes Vascular Nerve Regeneration and Graft‐Bone Integration
Authors: Wu Wei , Xia Yuhao , Huang Ye , Wei Wenying , Wu Xiaopei , Tu Rong , Chen Tianwu , Dai Honglian
Published: September 2024

Anterior cruciate ligament (ACL) injuries in sports have become increasingly prevalent, leading to the widespread adoption of polyethylene terephthalate (PET) artificial ligaments for ACL reconstruction due to their superior mechanical properties. However, the bio‐inertness of PET presents a significant challenge to graft‐bone integration, necessitating the enhancement of PET surface bioactivity. This study employed magnetron sputtering and hydrogel coating techniques to introduce strontium calcium‐phosphorus, and magnesium ions onto the surface of PET ligaments, achieving the sequential release of Mg, and Sr ions. The scanning electron microscopy analysis confirmed the uniformity and stability of the modified PET ligament surface material. The synergistic effect of sequential release from Mg/Sr‐PET has effectively promoted osteogenesis, angiogenesis, and neuronal differentiation in vitro. Moreover, in the reconstructed ACL model using Sprague‐Dawley rats, the histological staining, micro‐computed tomography, and biomechanical test results indicated that the Mg/Sr‐PET group notably stimulated blood vessel and nerve formation, demonstrating remarkable bone regrowth promotion. In conclusion, the sequential release and synergistic effect of magnesium and strontium ions significantly enhanced graft‐bone integration and accelerated rapid healing, offering valuable insights for improving clinical ACL reconstruction outcomes.
In Situ Photoelectrodeposited Polyaniline on Ti‐Doping Hematite For Highly Selective Photoelectrochemical Oxygen Demand Determination
Authors: Li Jieyu , Tang Tongxin , Xiao Yushen , Zou Wenhao , Chen Junwei , Ge Sitong , Wu Beibei , Li Lei , Li Meng , Lin Zhan , Ye Kai‐Hang , Zhang Shanqing
Published: September 2024

Chemical Oxygen Demand (COD), as a detection indicator of water pollution, is of particular importance in assessing organic pollution in water. Furthermore, accurate and simple measuring COD methods are essential for water quality assessment and pollution control. However, the photoelectrochemical oxygen demand (PECOD) measurement, as one of the measuring COD methods, is affected by the reaction of water splitting, which is one of the hindrances to the commercialization of the analytical method of the PeCOD measurement. Hence, to overcome this challenge, a new PANI/Ti:Fe2O3 photoanode is constructed by hydrothermal and photoelectrochemical (PEC) deposition methods and investigated their optical properties and photoactivity. Under optimization conditions, it is discovered that the oxidation of organic compounds produces a net steady‐state current (inet) is directly proportional to COD concentration, with a detection limit of 1 mM glucose solution and a wide linear detection range of 1–78.125 mM, which is suitable for high concentration of glucose detection. As has been noted, PANI/Ti:Fe2O3 photoanode overcomes the obstacles to the practical application and eventual commercialization of the PECOD technology.
Programmable Merged‐Net Porphyrinic Metal–Organic Frameworks for Water Sorption
Authors: Lee Junghye , Park Dajin , Jin Eunji , Lee Soochan , Lee Jinhyu , Oh Hyunchul , Choe Wonyoung
Published: September 2024

Porous materials have attracted considerable interest as water sorbents due to their potential in a broad range of water sorption‐related applications. Metal–organic frameworks (MOFs) are particularly notable for their high porosity and tunability. However, their limited hydrolytic stability often results in pore collapse, which significantly hinders their water sorption performance. To address this issue, an innovative design strategy based on reticular chemistry is essential to enhance structural stability and ensure efficient water sorption. Herein, a novel synthetic approach for constructing a merged‐net MOF structure using metallolinkers is introduced. Specifically, a porphyrin linker is employed to successfully synthesize a porphyrin‐based merged‐net MOF, UPF‐5. This MOF demonstrates significantly enhanced hydrolytic stability and improved water sorption performance while maintaining high pore volume. Additionally, the structure of UPF‐5 allows for the modification of accessible Zr6 nodes, enabling control over the pore environments and fine‐tuning the water sorption properties. This programmable synthetic strategy for porphyrin‐based merged‐net MOFs not only significantly enhances the structural stability for practical applications, including water sorption, but also advances reticular chemistry by discovering unprecedented topologies in MOF chemistry.
Continuous Homogeneous Thin Liquid Film on a Single Cross‐Shaped Profiled Fiber with High Off‐Circularity: Toward Quick‐Drying Fabrics
Authors: Xu Bojie , Shi Zhongyu , Lu Cong , Hu Zexu , Cheng Yanhua , Zhu Meifang , Jiang Lei , Liu Huan
Published: September 2024

Quick‐drying fabrics, renowned for their rapid sweat evaporation, have witnessed various applications in strenuous exercise. Profiled fiber textiles exhibit enhanced quick‐drying performance, which is attributed to the excellent wicking effect within fibrous bundles, facilitating the rapid transport of sweat. However, the evaporation process is not solely influenced by macroscopic liquid transport but also by microscopic liquid spreading on the fibers where periodic liquid knots induced by spontaneous fluidic instability significantly reduce the evaporation area. Here, a cross‐shaped profiled fiber with high off‐circularity, featured as multiple concavities along the fibrous longitude‐axis, which enables the formation of a homogeneous thin liquid film on a single fiber without any periodic liquid knots, is developed. The high off‐circularity cross‐sections help overcoming Plateau–Rayleigh instability by tuning the Laplace pressure difference, further facilitated by capillary flow along the concave surface. The homogeneous thin liquid film on a single fiber is responsible for maximizing the evaporation area, resulting in excellent overall evaporation capacity. Consequently, fabrics made from such fibers exhibit rapid evaporation behavior, with evaporation rates ≈50% higher than those of cylindrical fabrics. It is envisioned that profiled fibers may provide inspiration for the manipulating homogeneous liquid films for applications in fluid coatings and functional textiles.