bluuebunny/crossref_metadata_2025 huggingface dataset:
Healthcare and economic cost burden of emergency medical services treated non-traumatic shock using a population-based cohort in Victoria, Australia
Authors: Bloom Jason E , Nehme Emily , Paratz Elizabeth Davida , Dawson Luke , Nelson Adam J , Ball Jocasta , Eliakundu Amminadab , Voskoboinik Aleksandr , Anderson David , Bernard Stephen , Burrell Aidan , Udy Andrew A , Pilcher David , Cox Shelley , Chan William , Mihalopoulos Cathrine , Kaye David , Nehme Ziad , Stub Dion
Published: April 2024

Objectives

We aimed to assess the healthcare costs and impact on the economy at large arising from emergency medical services (EMS) treated non-traumatic shock.

Design

We conducted a population-based cohort study, where EMS-treated patients were individually linked to hospital-wide and state-wide administrative datasets. Direct healthcare costs (Australian dollars, AUD) were estimated for each element of care using a casemix funding method. The impact on productivity was assessed using a Markov state-transition model with a 3-year horizon.

Setting

Patients older than 18 years of age with shock not related to trauma who received care by EMS (1 January 2015–30 June 2019) in Victoria, Australia were included in the analysis.

Primary and secondary outcome measures

The primary outcome assessed was the total healthcare expenditure. Secondary outcomes included healthcare expenditure stratified by shock aetiology, years of life lived (YLL), productivity-adjusted life-years (PALYs) and productivity losses.

Results

A total of 21 334 patients (mean age 65.9 (±19.1) years, and 9641 (45.2%) females were treated by EMS with non-traumatic shock with an average healthcare-related cost of $A11 031 per episode of care and total cost of $A280 million. Annual costs remained stable throughout the study period, but average costs per episode of care increased (Ptrend=0.05). Among patients who survived to hospital, the average cost per episode of care was stratified by aetiology with cardiogenic shock costing $A24 382, $A21 254 for septic shock, $A19 915 for hypovolaemic shock and $A28 057 for obstructive shock. Modelling demonstrated that over a 3-year horizon the cohort lost 24 355 YLLs and 5059 PALYs. Lost human capital due to premature mortality led to productivity-related losses of $A374 million. When extrapolated to the entire Australian population, productivity losses approached $A1.5 billion ($A326 million annually).

Conclusion

The direct healthcare costs and indirect loss of productivity among patients with non-traumatic shock are high. Targeted public health measures that seek to reduce the incidence of shock and improve systems of care are needed to reduce the financial burden of this syndrome.
Recovery duration and concussion severity in sport- and non-sport-related concussion among Pac-12 collegiate athletes: a retrospective cohort study
Authors: Konstantinides Niki , Geraghty Elisabeth , Harmon Kimberly , Whelan Bridget M , Poddar Sourav K , Bohr Adam
Published: April 2024

Objectives

To examine non-sport- and sport-related concussion severity, clinical care frequency and delayed reporting in relation to recovery duration among collegiate athletes.

Design

Retrospective cohort study.

Setting

Pac-12 varsity collegiate athletes.

Participants

461 collegiate male and female athletes

Primary and secondary outcome measures

The incidence of sport-related concussion (SRC) and non-sport-related concussion (NRC) were collected as well as times to recovery and return-to-play (RTP), symptom score and symptom severity and reported a loss of consciousness (LOC), retrograde amnesia (RGA) and post-traumatic amnesia (PTA) following concussion incidence.

Results

Among 461 concussions, 388 (84%) occurred within sport and 73 (16%) occurred outside of sport. NRC, on average, required 3.5 more days to become asymptomatic (HR: 0.73, 95%confidence interval: 0.56 to 0.96, p=0.02) and 7 more days to RTP (HR: 0.64, 95% confidence interval: 0.49 to 0.85, p<0.01) compared with SRC. NRC were associated with an increase of 1.83 (p=0.07) symptoms reported at the time of diagnosis, an increase of 6.95 (p=0.06) in symptom severity and a higher prevalence of reported LOC (22% NRC vs. 3% SRC, p<0.001), PTA (15% NRC vs. 5% SRC, p<0.01) and RGA (10% NRC vs. 4% SRC, p=0.06), compared with SRC. There was no significant difference in clinical care (p=0.28) or immediate reporting (p=0.35) between NRC and SRC.

Conclusion

NRC were associated with greater severity and longer recovery duration when compared with SRC in a cohort of collegiate athletes.
Inequalities in birth before arrival at hospital in South West England: a multimethods study of neonatal hypothermia and emergency medical services call-handler advice
Authors: Goodwin Laura , Kirby Kim , McClelland Graham , Beach Emily , Bedson Adam , Benger Jonathan Richard , Deave Toity , Osborne Ria , McAdam Helen , McKeon-Carter Roisin , Miller Nick , Taylor Hazel , Voss Sarah
Published: April 2024

Objectives

To examine inequalities in birth before arrival (BBA) at hospitals in South West England, understand which groups are most likely to experience BBA and how this relates to hypothermia and outcomes (phase A). To investigate opportunities to improve temperature management advice given by emergency medical services (EMS) call-handlers during emergency calls regarding BBA in the UK (phase B).

Design

A two-phase multimethod study. Phase A analysed anonymised data from hospital neonatal records between January 2018 and January 2021. Phase B analysed anonymised EMS call transcripts, followed by focus groups with National Health Service (NHS) staff and patients.

Setting

Six Hospital Trusts in South West England and two EMS providers (ambulance services) in South West and North East England.

Participants

18 multidisciplinary NHS staff and 22 members of the public who had experienced BBA in the UK.

Results

35% (64/184) of babies conveyed to hospital were hypothermic on arrival. When compared with national data on all births in the South West, we found higher percentages of women with documented safeguarding concerns at booking, previous live births and ‘late bookers’ (booking their pregnancy >13 weeks gestation). These women may, therefore, be more likely to experience BBA. Preterm babies, babies to first-time mothers and babies born to mothers with disability or safeguarding concerns at booking were more likely to be hypothermic following BBA. Five main themes emerged from qualitative data on call-handler advice: (1) importance placed on neonatal temperature; (2) advice on where the baby should be placed following birth; (3) advice on how to keep the baby warm; (4) timing of temperature management advice and (5) clarity and priority of instructions.

Conclusions

Findings identified factors associated with BBA and neonatal hypothermia following BBA. Improvements to EMS call-handler advice could reduce the number of babies arriving at hospital hypothermic.
Liver fat as a dietary target by Chinese Medical Nutrition Therapy (CMNT) diet for treating type 2 diabetes with non-alcoholic fatty liver disease: study protocol for a randomised controlled trial
Authors: Luo Wu , Xiao Zhiyong , Yang Xiao , Wu Ruiyu , Li Jian , Yu Zhen , Guo Shengxiang , Nie Beibei , Liu Dongbo
Published: April 2024

Introduction

Type 2 diabetes and non-alcoholic fatty liver disease (NAFLD) often coexist and increase risk for developing liver fibrosis and diabetes complications if no effective measures are taken. Dietary intervention is known to be able to achieve diabetes remission, while evidence regarding the long-term effect on liver fat is limited for comorbidity management of type 2 diabetes and NAFLD. This study aims to investigate the long-term effect of a Chinese Medical Nutrition Therapy (CMNT) diet accompanied by intermittent energy restriction on reducing liver fat and glycated haemoglobin (HbA1c) in patients with type 2 diabetes and NAFLD.

Methods and analysis

This is a multicentre two-armed parallel randomised controlled trial study. 120 participants with type 2 diabetes and NAFLD will be recruited from the physical examination centres of multiple hospitals in China. Participants will be randomly allocated 1:1 to either the CMNT group or the usual care group. The CMNT group will be instructed to consume the provided specific meal replacement Chinese medicinal foods consisting of 6 cycles of 5 consecutive days followed by 10 days of regular food intake. The usual care group will be given standard dietary advice. Primary outcomes are changes in the controlled attenuation parameter value by transient elastography and HbA1c level. Secondary outcomes include differences in anthropometrics, clinical blood markers, questionnaires, gut microbiota and metabolomics. Further follow-up will be performed at 6 months, 1 year and 2 years.

Ethics and dissemination

The study protocol was approved by the Biomedical Research Ethics Committee of Hunan Agricultural University (BRECHAU20200235).

The results will be disseminated via relevant peer-reviewed publications and conference presentations.

Trial registration number

NCT05439226.
Clinician and parent views on urine collection in precontinent children in the UK: a qualitative interview study
Authors: Armengol Monica , Hayward Gail , Abbott Molly Grace , Bird Chris , Bergmann Jeroen H M , Glogowska Margaret
Published: April 2024

Objective

To explore the experiences of healthcare professionals (HCPs) and parents of urine collection methods, to identify barriers to successful sampling and what could improve the process.

Design

Qualitative research, using individual semistructured interviews with HCPs and parents. The interviews were audiorecorded, transcribed and thematically analysed.

Setting

UK-based HCPs from primary and secondary care settings and parents with experience with urine collection in primary and/or secondary care settings.

Participants

HCPs who were involved in aiding, supervising or ordering urine samples. Parents who had experience with urine collection in at least one precontinent child.

Results

13 HCPs and 16 parents were interviewed. 2 participating HCPs were general practitioners (GPs), 11 worked in paediatric secondary care settings (8 were nurses and 3 were doctors). Two parents had children with underlying conditions where frequent urine collection was required to rule out infections.

HCPs and parents reported that there were no straightforward methods of urine collection for precontinent children. Each method—‘clean catch’, urine bag and urine pad—had limitations and problems with usage. ‘Clean catch’, regarded as the gold standard by HCPs with a lower risk of contamination, often proved difficult for parents to achieve. Other methods had elevated risk of contamination but were more acceptable to parents because they were less challenging. Many of the parents expressed the need for more information about urine collection.

Conclusions

Current methods of urine collection are challenging to use and may be prone to contamination. A new device is required to assist with urine collection in precontinent children, to simplify and reduce the stress of the situation for those involved. Parents are key partners in the process of urine collection with young children. Meeting their expressed need for more information could be an important way to achieve better-quality samples while awaiting a new device.
Work engagement of psychiatric nurses: a scoping review
Authors: Mukaihata Tsuyoshi , Kato Yuichi , Swa Toshiyuki , Fujimoto Hirokazu
Published: April 2024

Objectives

Work engagement is an essential factor in improving employee performance. However, no reviews on the work engagement of psychiatric nurses have been conducted to date. This study aimed to examine the current status of research on the work engagement of psychiatric nurses and identify salient factors.

Design

A scoping review.

Methods

This review adhered to the established scoping review methodological guidelines and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews checklist. The inclusion criteria were based on nurses, work engagement and psychiatric settings without language or date restrictions. Regardless of the methodology or study design, research studies related to the work engagement of psychiatric nurses have been included. A systematic search was conducted in MEDLINE, CINAHL and PsycINFO from the inception of each database, with the search strategies being set by an information specialist. The deadline for the search was 15 February 2023.

Results

The study included 12 studies. All studies have been published since 2013. The study designs included cross-sectional (n=10), longitudinal (n=1) and intervention (n=1) studies. The impacts of work engagement were classified into (1) attitudes towards patients, (2) attitudes towards work, (3) mental health and (4) quality of care. Factors influencing work engagement were classified into (1) demographics, (2) workplace factors, (3) individual factors and (4) patient factors.

Conclusion

Work engagement of psychiatric nurses has lately gained attention, although data are limited because most studies used a cross-sectional design. Psychiatric nurses with higher work engagement showed positive outcomes. Workplace and individual factors can potentially improve their work engagement. The findings can assist nursing managers in enhancing psychiatric nurses’ work engagement and, consequently, their performance.
SUPRAMAX-study: supramaximal resection versus maximal resection for glioblastoma patients: study protocol for an international multicentre prospective cohort study (ENCRAM 2201)
Authors: Gerritsen Jasper Kees Wim , Young Jacob S , Chang Susan M , Krieg Sandro M , Jungk Christine , van den Bent Martin J , Satoer Djaina D , Ille Sebastian , Schucht Philippe , Nahed Brian V , Broekman Marike Lianne Daphne , Berger Mitchel , De Vleeschouwer Steven , Vincent Arnaud J P E
Published: April 2024

Introduction

A greater extent of resection of the contrast-enhancing (CE) tumour part has been associated with improved outcomes in glioblastoma. Recent results suggest that resection of the non-contrast-enhancing (NCE) part might yield even better survival outcomes (supramaximal resection, SMR). Therefore, this study evaluates the efficacy and safety of SMR with and without mapping techniques in high-grade glioma (HGG) patients in terms of survival, functional, neurological, cognitive and quality of life outcomes. Furthermore, it evaluates which patients benefit the most from SMR, and how they could be identified preoperatively.

Methods and analysis

This study is an international, multicentre, prospective, two-arm cohort study of observational nature. Consecutive glioblastoma patients will be operated with SMR or maximal resection at a 1:1 ratio. Primary endpoints are (1) overall survival and (2) proportion of patients with National Institute of Health Stroke Scale deterioration at 6 weeks, 3 months and 6 months postoperatively. Secondary endpoints are (1) residual CE and NCE tumour volume on postoperative T1-contrast and FLAIR (Fluid-attenuated inversion recovery) MRI scans; (2) progression-free survival; (3) receipt of adjuvant therapy with chemotherapy and radiotherapy; and (4) quality of life at 6 weeks, 3 months and 6 months postoperatively. The total duration of the study is 5 years. Patient inclusion is 4 years, follow-up is 1 year.

Ethics and dissemination

The study has been approved by the Medical Ethics Committee (METC Zuid-West Holland/Erasmus Medical Center; MEC-2020-0812). The results will be published in peer-reviewed academic journals and disseminated to patient organisations and media.
Impact of lens autofluorescence and opacification on retinal imaging
Authors: von der Emde Leon , Rennen Geena C , Vaisband Marc , Hasenauer Jan , Liegl Raffael , Fleckenstein Monika , Pfau Maximilian , Holz Frank G , Ach Thomas
Published: April 2024

Background

Retinal imaging, including fundus autofluorescence (FAF), strongly depends on the clearness of the optical media. Lens status is crucial since the ageing lens has both light-blocking and autofluorescence (AF) properties that distort image analysis. Here, we report both lens opacification and AF metrics and the effect on automated image quality assessment.

Methods

227 subjects (range: 19–89 years old) received quantitative AF of the lens (LQAF), Scheimpflug, anterior chamber optical coherence tomography as well as blue/green FAF (BAF/GAF), and infrared (IR) imaging. LQAF values, the Pentacam Nucleus Staging score and the relative lens reflectivity were extracted to estimate lens opacification. Mean opinion scores of FAF and IR image quality were compiled by medical readers. A regression model for predicting image quality was developed using a convolutional neural network (CNN). Correlation analysis was conducted to assess the association of lens scores, with retinal image quality derived from human or CNN annotations.

Results

Retinal image quality was generally high across all imaging modalities (IR (8.25±1.99) >GAF >BAF (6.6±3.13)). CNN image quality prediction was excellent (average mean absolute error (MAE) 0.9). Predictions were comparable to human grading. Overall, LQAF showed the highest correlation with image quality grading criteria for all imaging modalities (eg, Pearson correlation±CI −0.35 (−0.50 to 0.18) for BAF/LQAF). BAF image quality was most vulnerable to an increase in lenticular metrics, while IR (−0.19 (−0.38 to 0.01)) demonstrated the highest resilience.

Conclusion

The use of CNN-based retinal image quality assessment achieved excellent results. The study highlights the vulnerability of BAF to lenticular remodelling. These results can aid in the development of cut-off values for clinical studies, ensuring reliable data collection for the monitoring of retinal diseases.
Relation between pre-existing quality management measures and prevention and containment of COVID-19 outbreaks in 159 nursing homes in Tuscany: a mixed methods study
Authors: Poldrugovac Mircha , Barsanti Sara , Pardini Emiliano , Klazinga Niek S , Kringos Dionne S
Published: April 2024

Background

Nursing homes were often the focus of COVID-19 outbreaks. Many factors are known to influence the ability of a nursing home to prevent and contain a COVID-19 outbreak. The role of an organisation’s quality management prior to the pandemic is not yet clear. In the Italian region of Tuscany nursing home performance indicators have been regularly collected since before the pandemic, providing the opportunity to better understand this relationship.

Objectives

To test if there is a difference in the results achieved by nursing homes in Tuscany on 13 quality management indicators, when grouped by severity of COVID-19 outbreaks; and to better understand how these indicators may be related to the ability to control COVID-19 outbreaks, from the perspective of nursing homes.

Methods

We used a mixed methods sequential explanatory design. Based on regional and national databases, 159 nursing homes in Tuscany were divided into four groups by outbreak severity. We tested the significance of the differences between the groups with respect to 13 quality management indicators. The potential relation of these indicators to COVID-19 outbreaks was discussed with 29 managers and other nursing homes’ staff through four group interviews.

Results

The quantitative analysis showed significant differences between the groups of nursing homes for 3 of the 13 indicators. From the perspective of nursing homes, the indicators might not be good at capturing important aspects of the ability to control COVID-19 outbreaks. For example, while staffing availability is seen as essential, the staff-to-bed ratio does not capture the turn-over of staff and temporary absences due to positive COVID-19 testing of staff.

Conclusions

Though currently collected indicators are key for overall performance monitoring and improvement, further refinement of the set of quality management indicators is needed to clarify the relationship with nursing homes’ ability to control COVID-19 outbreaks.
Randomised trial of ‘hybrid’ water-assisted colonoscopy (modified water immersion) versus water exchange colonoscopy: WAVE study
Authors: Ahmad Ahmir , Buenaventura Anna , Motes Belma , Misra Ravi , Man Ripple , Dhillon Angad , Bassett Paul , Thiruvilangam Kowshika , Saunders Brian P
Published: April 2024

Background and aims

Colonoscopy practice has evolved with a trend towards water-assisted insertion. A recent national survey suggests a hybrid approach to colonic distension during insertion, with water used predominately to the splenic flexure and carbon dioxide (CO2) with water used thereafter to the caecum, is commonly used. This contrasts with the water exchange technique where no CO2is used. This study aimed to evaluate whether a hybrid or water exchange technique allows more efficient colonoscopy.

Methods

This prospective, randomised controlled trial was conducted between March 2021 and June 2022. Participants were randomised 1:1 to hybrid or water exchange colonoscopy, performed by four experienced colonoscopists. The primary outcome was total procedure time with secondary outcomes of caecal intubation time, caecal intubation rate, polyp detection, loop formation, number of ancillary manoeuvres, sedation use and patient comfort.

Results

256 patients were invited, and 246 were randomised to either hybrid or water exchange colonoscopy. 122 patients were included in each arm of the primary analysis. Total procedure time was greater in the water exchange group compared with hybrid (29 vs 25 min, p=0.009). Patient reposition episodes occurred more frequently in the water exchange group vs hybrid group (5.5 vs 5, p=0.003) and left colon Boston Bowel Preparation Scale (BBPS) score was improved. No difference was seen in all other outcomes.

Conclusion

A hybrid technique, compared with water exchange, enabled faster colonoscopy without adversely impacting sedation requirement, caecal intubation, overall bowel cleansing and patient comfort. This technique appears to maximise the advantages of both water and CO2to enable more efficient colonoscopy.

Trial registration number

NCT04710706.
Placental circulating T cells: a novel, allogeneic CAR-T cell platform with preserved T-cell stemness, more favorable cytokine profile, and durable efficacy compared to adult PBMC-derived CAR-T
Authors: Ruggeri Barbaro Natalia , Drashansky Theodore , Tess Kristina , Djedaini Mansour , Hariri Robert , He Shuyang , van der Touw William , Karasiewicz Kathy
Published: April 2024

Background

Chimeric antigen receptor (CAR)-T cell quality and stemness are associated with responsiveness, durability, and memory formation, which benefit clinical responses. Autologous T cell starting material across patients with cancer is variable and CAR-T expansion or potency can fail during manufacture. Thus, strategies to develop allogeneic CAR-T platforms including the identification and expansion of T cell subpopulations that correspond with CAR-T potency are an active area of investigation. Here, we compared CAR-T cells generated from healthy adult peripheral blood T cells versus placental circulating T (P-T) cells.

Methods

CAR-T cells from healthy adult peripheral blood mononuclear cells (PBMCs) and P-T cells were generated using the same protocol. CAR-T cells were characterized in detail by a combination of multiparameter flow cytometry, functional assays, and RNA sequencing. In vivo antitumor efficacy and persistence of CAR-T cells were evaluated in a Daudi lymphoma xenograft model.

Results

P-T cells possess stemness advantages compared with T cells from adult PBMCs. P-T cells are uniformly naïve prior to culture initiation, maintain longer telomeres, resist immune checkpoint upregulation, and resist further differentiation compared with PBMC T cells during CD19 CAR-T manufacture. P-T CD19 CAR-T cells are equally cytotoxic as PBMC-CD19 CAR-T cells but produce less interferon gamma in response to lymphoma. Transcriptome analysis shows P-T CD19 CAR-T cells retain a stem-like gene signature, strongly associate with naïve T cells, an early memory phenotype, and a unique CD4 T cell signature compared with PBMC-CD19 CAR-T cells, which enrich for exhaustion and stimulated memory T cell signatures. Consistent with functional data, P-T CD19 CAR-T cells exhibit attenuated inflammatory cytokine and chemokine gene signatures. In a murine in vivo model, P-T CD19 CAR-T cells eliminate lymphoma beyond 90 days. PBMC-CD19 CAR-T cells provide a non-durable benefit, which only delays disease onset.

Conclusion

We identified characteristics of T cell stemness enriched in P-T CD19 CAR-T which are deficient in PBMC-derived products and translate into response durability in vivo. Our findings demonstrate that placental circulating T cells are a valuable cell source for allogeneic CAR-T products. Stemness advantages inherent to P-T cells translate to in vivo persistence advantages and long-term durable activity.
Interpreting hydroxychloroquine blood levels for medication non-adherence: a pharmacokinetic study
Authors: Balevic Stephen , Sun Kai , Rogers Jennifer L , Eudy Amanda , Sadun Rebecca Eli , Maheswaranathan Mithu , Doss Jayanth , Criscione-Schreiber Lisa , O'Malley Tyler , Clowse Megan , Weiner Daniel
Published: April 2024

Objective

Characterise the relationship between hydroxychloroquine (HCQ) blood levels and the number of missed doses, accounting for dosage, dose timing and the large variability in pharmacokinetics (PK) between patients.

Methods

We externally validated a published PK model and then conducted dosing simulations. We developed a virtual population of 1000 patients for each dosage across a range of body weights and PK variability. Using the model, 10 Monte Carlo simulations for each patient were conducted to derive predicted whole blood concentrations every hour over 24 hours (240 000 HCQ levels at steady state). To determine the impact of missed doses on levels, we randomly deleted a fixed proportion of doses.

Results

For patients receiving HCQ 400 mg daily, simulated random blood levels <200 ng/mL were exceedingly uncommon in fully adherent patients (<0.1%). In comparison, with 80% of doses missed, approximately 60% of concentrations were <200 ng/mL. However, this cut-off was highly insensitive and would miss many instances of severe non-adherence. Average levels quickly dropped to <200 ng/mL after 2–4 days of missed doses. Additionally, mean levels decreased by 29.9% between peak and trough measurements.

Conclusions

We propose an algorithm to optimally interpret HCQ blood levels and approximate the number of missed doses, incorporating the impact of dosage, dose timing and pharmacokinetic variability. No single cut-off has adequate combinations of both sensitivity and specificity, and cut-offs are dependent on the degree of targeted non-adherence. Future studies should measure trough concentrations to better identify target HCQ levels for non-adherence and efficacy.
Computable phenotype for real-world, data-driven retrospective identification of relapse in ANCA-associated vasculitis
Authors: Scott Jennifer , White Arthur , Walsh Cathal , Aslett Louis , Rutherford Matthew A , Ng James , Judge Conor , Sebastian Kuruvilla , O’Brien Sorcha , Kelleher John , Power Julie , Conlon Niall , Moran Sarah M , Luqmani Raashid Ahmed , Merkel Peter A , Tesar Vladimir , Hruskova Zdenka , Little Mark A
Published: April 2024

Objective

ANCA-associated vasculitis (AAV) is a relapsing-remitting disease, resulting in incremental tissue injury. The gold-standard relapse definition (Birmingham Vasculitis Activity Score, BVAS>0) is often missing or inaccurate in registry settings, leading to errors in ascertainment of this key outcome. We sought to create a computable phenotype (CP) to automate retrospective identification of relapse using real-world data in the research setting.

Methods

We studied 536 patients with AAV and >6 months follow-up recruited to the Rare Kidney Disease registry (a national longitudinal, multicentre cohort study). We followed five steps: (1) independent encounter adjudication using primary medical records to assign the ground truth, (2) selection of data elements (DEs), (3) CP development using multilevel regression modelling, (4) internal validation and (5) development of additional models to handle missingness. Cut-points were determined by maximising the F1-score. We developed a web application for CP implementation, which outputs an individualised probability of relapse.

Results

Development and validation datasets comprised 1209 and 377 encounters, respectively. After classifying encounters with diagnostic histopathology as relapse, we identified five key DEs; DE1: change in ANCA level, DE2: suggestive blood/urine tests, DE3: suggestive imaging, DE4: immunosuppression status, DE5: immunosuppression change. F1-score, sensitivity and specificity were 0.85 (95% CI 0.77 to 0.92), 0.89 (95% CI 0.80 to 0.99) and 0.96 (95% CI 0.93 to 0.99), respectively. Where DE5 was missing, DE2 plus either DE1/DE3 were required to match the accuracy of BVAS.

Conclusions

This CP accurately quantifies the individualised probability of relapse in AAV retrospectively, using objective, readily accessible registry data. This framework could be leveraged for other outcomes and relapsing diseases.
The effect of scalar hair on the charged black hole with the images from accretions disk
Authors: Sui Tao-Tao , Wang Zi-Liang , Guo Wen-Di
Published: April 2024

In this paper, we investigate the optical properties of a charged black hole with scalar hair (CSH) within the context of four-dimensional Einstein–Maxwell–Dilaton gravity. To achieve this, we consider three distinct toy models of thin accretion disks. The presence of dilaton coupling allows us to express both the solutions of CSH and the Reissner–Nordström (RN) black hole in terms of their mass (M) and charge (Q). Our findings reveal differences in the effective potentials $$V_{eff}$$

V

eff

, photon sphere radii $$r_{ph}$$

r

ph

, and innermost stable circular orbit $$r_{isco}$$

r

isco

between the CSH and RN black hole cases, which become increasingly pronounced as the charge parameter Q increases. However, no noticeable distinctions are observed concerning the critical impact parameter $$b_{ph}$$

b

ph

. When the ratio of the photon ring band and the lensed ring band exceeds 0.1, it may suggest the presence of a charged black hole with scalar hair. Furthermore, our results underscore the significant influence of the charge parameter Q on the brightness distributions of the direct, lensed ring, and photon ring for three standard emission functions. These findings emphasize the potential for distinguishing between CSH and RN black holes through an analysis of direct intensity and peak brightness in specific accretion disk models.
Scalar field perturbation around a rotating hairy black hole: quasinormal modes, quasibound states and superradiant instability
Authors: Lei Yun-He , Yang Zhen-Hao , Kuang Xiao-Mei
Published: April 2024

We consider the quasinormal modes, quasibound states and superradiant instability of a rotating hairy black hole, which possesses a Horndeski hair as deviation from Kerr black hole, under the perturbation of massive scalar field. With the use of the matrix method, we mainly calculate the eigenfrequencies related to those modes of the perturbation. Under the perturbation of the massless scalar field, the Horndeski hair and spin parameter have significant influences on the quasinormal frequency, but its imaginary part is always finite negative and no unstable mode is found. Under the perturbation of the massive scalar field, we focus on the eigenfrequencies of quasibound states and find the modes of which the imaginary part of eigenfrequencies is positive, indicating that the black hole undergoes superradiant instability. Then we scan the parameters and figure out a diagram in the space of Horndeski hair and spin parameters to distinguish the rotating hairy black hole with superradiant instability from the stable one.
BIFURCATION ANALYSIS AND CHAOS CONTROL OF THE DISSOLVED OXYGEN-PHYTOPLANKTON DYNAMICAL MODEL
Authors: PRIYANKA M. , MUTHUKUMAR P.
Published: April 2024

The production of oxygen through phytoplankton photosynthesis is a crucial phenomenon in the dynamics of marine ecosystems. A generic oxygen-phytoplankton interaction model is considered to comprehend its underlying mechanism. This paper investigates the discrete-time dynamics of oxygen and phytoplankton in aquatic ecosystems, incorporating factors that cause phytoplankton mortality due to external influences. We explore the conditions for the local stability of steady states concerning the oxygen content in dissolved water and phytoplankton density. The analysis reveals that the model undergoes a co-dimension one bifurcation, encompassing flip and Neimark–Sacker bifurcations, utilizing the center manifold theorem and bifurcation theory. To manage the chaos resulting from the Neimark–Sacker bifurcation, we apply the OGY feedback control method and a hybrid control methodology. Finally, we present numerical simulations to validate the theoretical discussion.
THE FRACTAL ZAKHAROV–KUZNETSOV–BENJAMIN–BONA–MAHONY EQUATION: GENERALIZED VARIATIONAL PRINCIPLE AND THE SEMI-DOMAIN SOLUTIONS
Authors: WANG KANG-JIA , SHI FENG , LI SHUAI , XU PENG
Published: April 2024

By means of He’s fractal derivative, a new fractal (2 + 1)-dimensional Zakharov–Kuznetsov–Benjamin–Bona–Mahony equation is extracted in this paper. The semi-inverse method is employed to establish the generalized fractal variational principle. The generalized fractal variational principle can show the conservation laws through the energy form in the fractal space. Moreover, some semi-domain solutions are also explored by applying the variational approach and the one-step method namely Wang’s direct mapping method-II. The dynamics of the extracted solutions on the Cantor set are unveiled graphically. The findings of this study are expected to provide some new insights into the exploration of the fractal PDEs.
An Improved Algebraic Structure of Nonlinear Dynamical Systems
Authors: Farwa Shabieh , Noor Farwa , Nawaz Bushra
Published: April 2024

A substitution box is regarded as an eminent source of nonlinearity and perplexity in most of the block ciphers. In this work, we propose that the involvement of a local ring has a favorable influence on the highly desirable features of this nonlinear cryptographic system. We deploy the unit group of a local ring by considering its correspondence with the Galois field and design an algorithm that utilizes the algebraic properties of the local ring [Formula: see text], to synthesize a highly efficient S-box.
Does Residents’ Perception of Information Influence the Implementation Effect of Increasing-Block Water Pricing Policy?
Authors: Zhang Guoji , Wu Huaqing , Liu Yezheng , Chen Xin , Song Pingfan
Published: April 2024

Since the 1990s, China has gradually implemented price reform. The increasing-block pricing policy (referred to as “IBP”) began to be applied in different kinds of household resource-based products so as to produce resource-saving effect. However, when evaluating policy effects, the information factors are often ignored. This paper concentrates on evaluating the residential increasing-block water pricing policy (referred to as “IBWP”) and divides the information into two categories: policy information and bill information. Among them, policy information is divided into implementation information and rule information, and bill information is subdivided into three aspects: price, volume and fee. Based on the household data of the Chinese Household Water Use Behavior Survey 2019, this paper uses the propensity score matching (PSM) method to investigate the impact of households’ information cognition on water consumption. The results show that residents with policy information will increase their water consumption, while the availability of rule information will reduce the increase in water consumption; bill information encourages households to take behavioral water-saving measures more frequently, and among different types of bill information, residents are the most sensitive to water fee information. Through further analysis, the shadow price of household water is much higher than the current water price. Hence it can be considered that the current water price is distorted to a large extent, which leads to the deviation of the policy information received by consumers. Therefore, the water-saving effect of IBWP at the present stage is very limited. The policy implication shows that IBWP needs to further optimize its structure, the government should gradually increase the current residential water price; relevant departments ought to strengthen the policy publicity, and improve the acquisition rate of previous bills for residents.
3DPFIX: Improving Remote Novices' 3D Printing Troubleshooting through Human-AI Collaboration Design
Authors: Kwon Nahyun , Sun Tong Steven , Gao Yuyang , Zhao Liang , Wang Xu , Kim Jeeeun , Hong Sungsoo Ray
Published: April 2024

The widespread consumer-grade 3D printers and learning resources online enable novices to self-train in remote settings. While troubleshooting plays an essential part of 3D printing, the process remains challenging for many remote novices even with the help of well-developed online sources, such as online troubleshooting archives and online community help. We conducted a formative study with 76 active 3D printing users to learn how remote novices leverage online resources in troubleshooting and their challenges. We found that remote novices cannot fully utilize online resources. For example, the online archives statically provide general information, making it hard to search and relate their unique cases with existing descriptions. Online communities can potentially ease their struggles by providing more targeted suggestions, but a helper who can provide custom help is rather scarce, making it hard to obtain timely assistance. We propose 3DPFIX, an interactive 3D troubleshooting system powered by the pipeline to facilitate Human-AI Collaboration, designed to improve novices' 3D printing experiences and thus help them easily accumulate their domain knowledge. We built 3DPFIX that supports automated diagnosis and solution-seeking. 3DPFIX was built upon shared dialogues about failure cases from Q&A discourses accumulated in online communities. We leverage social annotations (i.e., comments) to build an annotated failure image dataset for AI classifiers and extract a solution pool. Our summative study revealed that using 3DPFIX helped participants spend significantly less effort in diagnosing failures and finding a more accurate solution than relying on their common practice. We also found that 3DPFIX users learn about 3D printing domain-specific knowledge. We discuss the implications of leveraging community-driven data in developing future Human-AI Collaboration designs.
Advocating Values through Meaningful Participation: Introducing a Method to Elicit and Analyze Values for Enriching Data Donation Practices in Healthcare
Authors: Sörries Peter , Leimstädtner David , Müller-Birn Claudia
Published: April 2024

The secondary use of routinely collected patient data made possible by the broad consent form is seen as a prerequisite for developing data-driven health technologies. In Germany, relevant stakeholder groups (e.g., ethics committees and data protection authorities) specified the broad consent form; however, only one group of patient representatives was consulted, which may indicate asymmetries in engagement. This situation informed our research on medical data donation and emphasized foregrounding patient values. Drawing on participatory design, value sensitive design, and emerging research on value-led participation, we propose a method consisting of (1) a workshop concept for participatory value elicitation composed of four carefully coordinated phases and (2) an analysis procedure to examine the empirical data collected. This analysis allowed us to derive design requirements for medical data donation user interfaces. We conducted three workshops with patient advocates of vulnerable groups and patients in residential care of a psychosomatic unit. Our findings provide new directions to improve user interfaces for medical data donation: First, user interfaces need to enhance patients' reflective thinking about the potential consequences of their data donation; second, a decision facilitator supporting patients' value-based decision-making (e.g., by providing simple language or tailoring descriptions to patient needs); and finally, a data intermediary relieving patients' decision-making and giving them control over their data after donation. Moreover, we emphasize the need to increase the use of participatory approaches in health technology development.
An Intersectional Lifecourse Lens and Participatory Methods as the Foundations for Co-Designing with and for Minoritised Older Adults
Authors: Willatt Alice , Gray Stuart Iain , Manchester Helen , Foster Tot , Cater Kirsten
Published: April 2024

The design of digital technologies for older adults is often premised on deficit models of ageing that position older people as a homogenous group and as passive users of technology, with an overwhelming focus on meeting practical needs in older age. In response, a growing number of scholars in HCI and Science and Technology Studies (STS) are engaging with processes of co-design that situate older adults as experts in their own lives and as central to the design process. These scholars highlight how an essential first phase of co-design is understanding and foregrounding the lifeworlds, experiences and expertise of older adults. This paper responds to these calls, alongside the lack of consideration of minoritised older adults in co-design. It draws on the empirical findings from the first phase of the Connecting Through Culture As We Age project, which places twenty minoritised older adults who identify as disabled, and/or racially and/or socio-economically minoritised, at the centre of a digital innovation process. Through a case study approach, we focus on two of the minoritised older adults involved, to demonstrate the value of bringing together participatory methods with an interdisciplinary lifecourse lens. We highlight the power of this approach for understanding minoritised older adults' relationships with technology, as shaped by experiences across the lifecourse, for building relationships, and ensuring their agency and voice underpin the co-design process.
CodeTree: A System for Learnersourcing Subgoal Hierarchies in Code Examples
Authors: Jin Hyoungwook , Kim Juho
Published: April 2024

Subgoal-labeled code examples help learners understand code patterns and apply them to different problem contexts. Subgoal labels are multi-level in nature and based on goal structures that define the hierarchical functional units in code. Data-driven methods and experts can supply the goal structures, but they do not work in environments with scarce data and limited availability of experts. Previous research has shown that learnersourcing is effective for sourcing high-quality subgoal labels of given goal structures. We extend this research by learnersourcing goal structures themselves, thereby making the generation of subgoal-labeled materials fully learner-driven. We introduce CodeTree, a system that generates multi-level goal structures by aggregating learner-generated subgoals from two subgoal learning activities---Generation and Selection. In a between-subjects study, 45 novices studied three code examples with either CodeTree or code explanations alone. The results showed that CodeTree could learnersource high-quality goal structures and subgoal labels for all three examples with just five learners. Learners reported a significantly higher learning gain and satisfaction compared to the baseline.
Meeting Bridges: Designing Information Artifacts that Bridge from Synchronous Meetings to Asynchronous Collaboration
Authors: Wang Ruotong , Qiu Lin , Cranshaw Justin , Zhang Amy X.
Published: April 2024

A recent surge in remote meetings has led to complaints of Zoom fatigue" and collaboration overload," negatively impacting worker productivity and well-being. One way to alleviate the burden of meetings is to de-emphasize their synchronous participation by shifting work to and enabling sensemaking during post-meeting asynchronous activities. Towards this goal, we propose the design concept of meeting bridges, or information artifacts that can encapsulate meeting information towards bridging to and facilitating post-meeting activities. Through 13 interviews and a survey of 198 information workers, we learn how people use online meeting information after meetings are over, finding five main uses: as an archive, as task reminders, to onboard or support inclusion, for group sensemaking, and as a launching point for follow-on collaboration. However, we also find that current common meeting artifacts, such as notes and recordings, present challenges in serving as meeting bridges. After conducting co-design sessions with 16 participants, we distill key principles for the design of meeting bridges to optimally support asynchronous collaboration goals. Overall, our findings point to the opportunity of designing information artifacts that not only support users to access but also continue to transform and engage in meeting information post-meeting.
Cooperation in the Gig Economy: Insights from Upwork Freelancers
Authors: Fulker Zachary , Riedl Christoph
Published: April 2024

Existing literature on online labor markets predominantly focuses on how freelancers individually complete tasks and projects. Our study examines freelancers' willingness to work collaboratively. We report results from a survey of 122 freelancers on a leading online labor market platform (Upwork) that examine freelancers' preferences for collaborative work arrangements, and that explore several antecedents of cooperative behaviors. We then test if actual cooperative behavior matches with freelancers' stated preferences through an incentivized social dilemma experiment. We find that respondents cooperate at a higher rate (85%) than reported in previous comparable studies (between 50-75%). This high rate of cooperation may be explained by an ingroup bias. Using a sequential mediation model, we demonstrate the importance of a sense of shared expectations and accountability for cooperation. We contribute to a better understanding of the potential for collaborative work on online labor market platforms by assessing if and what social factors and collective culture exist among freelancers. We discuss the implications of our results for platform designers by highlighting the importance of platform features that promote shared expectations and improve accountability. Overall, contrary to existing literature and predictions, our results suggest that freelancers in our sample display traits that are more consistent with belonging to a coherent group with a shared collective culture, rather than being anonymous actors in a transaction-based market.
Creative ML Assemblages: The Interactive Politics of People, Processes, and Products
Authors: Shelby Renee , Srinivasan Ramya , Burgdorf Katharina , Lena Jennifer C. , Rostamzadeh Negar
Published: April 2024

Creative ML tools are collaborative systems that afford artistic creativity through their myriad interactive relationships. We propose using "assemblage thinking" to support analyses of creative ML by approaching it as a system in which the elements of people, organizations, culture, practices, and technology constantly influence each other. We model these interactions as "coordinating elements" that give rise to the social and political characteristics of a particular creative ML context, and call attention to three dynamic elements of creative ML whose interactions provide unique context for the social impact a particular system has: people, creative processes, and products. As creative assemblages are highly contextual, we present these as analytical concepts that computing researchers can adapt to better understand the functioning of a particular system or phenomena and identify intervention points to foster desired change. This paper contributes to theorizing interactions with AI in the context of art, and how these interactions shape the production of algorithmic art.