bluuebunny/crossref_metadata_2025 huggingface dataset:
Social jet lag impairs exercise volume and attenuates physiological and metabolic adaptations to voluntary exercise training
Authors: Dial Michael B. , Malek Elias M. , Cooper Austin R. , Neblina Greco A. , Vasileva Nikoleta I. , Hines Dustin J. , McGinnis Graham R.
Published: March 2024

In mice, disrupting circadian rhythms with social jet lag for 6 wk caused significant weight gain, higher fasting blood glucose, and impaired glucose tolerance compared with control. Voluntary exercise in mice experiencing social jet lag prevented weight gain, though the mice still experienced increased fasting blood glucose and impaired exercise performance compared with trained mice not experiencing social jet lag. Social jet lag seems to be a potent circadian rhythm disruptor that impacts exercise-induced training adaptations.
The Disease Burden of Hereditary Angioedema: Insights from a Survey in French‐Canadians from Quebec
Authors: Boursiquot Jean-Nicolas , Chapdelaine Hugo , St-Pierre Charles , Hébert Jacques
Published: March 2024

Background. Limited data are available on the clinical profile and disease burden of hereditary angioedema (HAE) in Canadians. Objective. This study aimed to assess HAE disease characteristics and the burden of disease in Canadians with HAE types I, II, and normal levels of C1 inhibitor (nC1‐INH). Materials and Methods. A 46‐item patient survey evaluating clinical characteristics and burden of disease was developed and disseminated by the HAE patient organization Angio-oédeme héréditaire du Québec in Quebec, Canada, from May 2019 to February 2020. The survey received Research Review Board ethics approval. Results. In the 35 respondents, HAE type I was the most common (46%), followed by nC1‐INH (43%). Female participants were significantly younger at first symptom presentation than males (p = 0.04). Prior to diagnosis, 69% of participants underwent unnecessary treatments and procedures, with a 10‐year delay between first symptoms and diagnosis. Before starting the current treatment, 42% of participants experienced weekly HAE attacks. Most participants identified experiencing attacks in the abdomen (89%), followed by the larynx (66%), feet (66%), hands (63%), and face (63%). Most attacks were severe or moderate, yet almost half of patients waited >1 hr before getting medical attention at their last emergency department (ED) visit. HAE was associated with decreased health‐related quality of life, leading to significant functional impairment in personal and professional life. As compared to HAE type I/II, patients with HAE nC1‐INH were treated more often with tranexamic acid for long‐term prophylaxis, and their condition was less controlled, resulting in more attacks and ED visits. Conclusion. HAE manifests in this patient population as frequent moderate‐to‐severe attacks and a high disease burden; the HAE subtype may differentially affect care requirements. There is an urgent need for increased awareness and education on HAE among treating physicians.
A Simple and Rapid LC-MS/MS Method for the Quantification of Nirmatrelvir/Ritonavir in Plasma of Patients with COVID-19
Authors: Zhu Xiujing , Li Lin , Dai Bing , Liu Zhijun , Wang Zhipeng , Cui Lili , Gao Shouhong , Chen Wansheng , Tao Xia , Xu Deduo
Published: March 2024

The combined prescriptions of nirmatrelvir/ritonavir and other drugs are limited due to potential drug-drug interactions, so therapeutic drug monitoring (TDM) becomes particularly important. In this study, a liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was established for determination of the nirmatrelvir/ritonavir in plasma of patients with COVID-19, providing technical and theoretical support for the TDM. Plasma samples were processed by protein precipitation using acetonitrile, and analytes were separated on an Agilent Poroshell 120 SB-C18 (2.1 × 75 mm, 2.7 μm) column at 35°C. Acetonitrile and 0.1% formic acid in water (52 : 48) were utilized as the mobile phases at a flow rate of 0.3 mL/min. In the multiple reaction monitoring (MRM) mode, nirmatrelvir and ritonavir were monitored using precursor/product ions: m/z 500.2/110.1 and 721.3/296.1, respectively, with selinexor as the internal standard. The linear range of both analytes was 2.0 ng/mL to 5000 ng/mL with good inter- and intraday precision and accuracy, and the recovery was 92.0%–107% for nirmatrelvir and 85.7%–106% for ritonavir. Finally, this method was successfully applied to monitor the exposure levels of nirmatrelvir/ritonavir in plasma samples from hemodialysis patients.
On Partial Exact Controllability of Fractional Control Systems in Conformable Sense
Authors: Jneid Maher
Published: March 2024

In this work, we investigate the partial exact controllability of fractional semilinear control systems in the sense of conformable derivatives. Initially, we establish the existence and uniqueness of the mild solution for this type of fractional control systems. Then, by employing a contraction mapping principle, we obtain sufficient conditions for the conformable fractional semilinear system to be partially exactly controllable, assuming that its associated linear part is partially exactly controllable. To demonstrate the efficacy of the theoretical findings, a typical example is provided at the end.
Durability of Recycled Concrete after Reinforcing the Aggregates with Permeable Crystalline Materials
Authors: Liao Jinsong , Li Fuhai , Gong Jing , Zhao Lei , Tong Xi , Li Xinxin
Published: March 2024

The utilization of recycled aggregate can significantly mitigate the extraction of natural sand and gravel. However, the practical application of recycled aggregate in engineering is impeded by its inherent characteristics, encompassing high water absorption, high crushing, and low apparent density. This study employed a soaking and air‐drying method to enhance the strength of three types of aggregates with varying initial strengths by utilizing permeated crystalline materials. The durability of recycled aggregate concrete (RAC) was studied with three different aggregate replacement rates (0%, 50%, and 100%). The test results demonstrate that the slump, compressive strength, freeze resistance, and carbonation resistance of RAC exhibit a decreasing trend as the aggregate replacement rate increases. The freeze resistance and carbonation resistance of RAC are notably enhanced after incorporating permeated crystalline material. This study contributes to a sustainable and efficient solution for the treatment of construction waste, thereby enhancing the utilization rate of recycled concrete.
EI efecto de la socialización cultural en la teoría del propósito
Authors: Barrientos Oradini Nicolás , Álvarez-Maldonado David , Araneda Reyes Mauricio , Aparicio Puentes Carlos
Published: March 2024

EI presente articulo cuestiona la teoría del propósito, que sostiene que los individuos están motivados por objetivos de orden superior subjetivos e independientes del contexto social, como explicación de los fenómenos motivacionales y de los rasgos de personalidad en el ámbito laboral. Se propone una perspectiva interaccionista, que considera que los objetivos de orden superior son el resultado de la internalización de significados culturales que se socializan en el contexto de intercambio social, y que influyen en la activación de los rasgos de personalidad y en los procesos motivacionales que determinan el desempeño y el comportamiento organizacional. Se discuten las implicaciones teóricas y prácticas de esta propuesta, que permite explicar la variabilidad del comportamiento en función de las características de la situación y de los atributos individuales, así como ofrecer una alternativa a la interpretación esencialista y patológica de los rasgos de personalidad asociados a la triada oscura o a los cinco grandes rasgos de personalidad.
Recursos y capacidades organizacionales
Authors: Muñoz-Cisternas Victor , Geldes Cristian , Castillo-Vergara Mauricio
Published: March 2024

EI artículo discute la importancia de los recursos y capacidades organizacionales en la gestión estratégica de empresas, Desde la visión basada en recursos y capacidades de la firma (Resource-Based View o RBV), el trabajo analiza cómo las empresas logran y mantienen ventajas competitivas a través de sus recursos y capacidades únicas. Se enfatiza la diferencia entre recursos y capacidades destacando cómo influyen en la creación de valor y la ventaja competitiva. EI artículo también aborda las capacidades operacionales y dinámicas, distinguiendo entre procesos actuales y la adaptación a cambios en el entorno de negocios. Se incluyen ejemplos prácticos, para ilustrar la aplicación de estos conceptos en eI mundo real, Este estudio es un aporte a la comprensión de cómo las empresas pueden desarrollar estrategias efectivas basadas en sus recursos y capacidades únicas.
Figure S6 from Combined CDK4/6 and ERK1/2 Inhibition Enhances Antitumor Activity in NF1-Associated Plexiform Neurofibroma
Authors: Flint Alyssa C. , Mitchell Dana K. , Angus Steven P. , Smith Abbi E. , Bessler Waylan , Jiang Li , Mang Henry , Li Xiaohong , Lu Qingbo , Rodriguez Brooke , Sandusky George E. , Masters Andi R. , Zhang Chi , Dang Pengtao , Koenig Jenna , Johnson Gary L. , Shen Weihua , Liu Jiangang , Aggarwal Amit , Donoho Gregory P. , Willard Melinda D. , Bhagwat Shripad V. , Clapp D. Wade , Rhodes Steven D.
Published: March 2024

Caspase Glo 3/7 Assay
Targeting CCL2/CCR2 Signaling Overcomes MEK Inhibitor Resistance in Acute Myeloid Leukemia
Authors: Modak Rucha V. , de Oliveira Rebola Katia G. , McClatchy John , Mohammadhosseini Mona , Damnernsawad Alisa , Kurtz Stephen E. , Eide Christopher A. , Wu Guanming , Laderas Ted , Nechiporuk Tamilla , Gritsenko Marina A. , Hansen Joshua R. , Hutchinson Chelsea , Gosline Sara J.C. , Piehowski Paul , Bottomly Daniel , Short Nicholas , Rodland Karin , McWeeney Shannon K. , Tyner Jeffrey W. , Agarwal Anupriya
Published: March 2024

Purpose:

Emerging evidence underscores the critical role of extrinsic factors within the microenvironment in protecting leukemia cells from therapeutic interventions, driving disease progression, and promoting drug resistance in acute myeloid leukemia (AML). This finding emphasizes the need for the identification of targeted therapies that inhibit intrinsic and extrinsic signaling to overcome drug resistance in AML.

Experimental Design:

We performed a comprehensive analysis utilizing a cohort of ∼300 AML patient samples. This analysis encompassed the evaluation of secreted cytokines/growth factors, gene expression, and ex vivo drug sensitivity to small molecules. Our investigation pinpointed a notable association between elevated levels of CCL2 and diminished sensitivity to the MEK inhibitors (MEKi). We validated this association through loss-of-function and pharmacologic inhibition studies. Further, we deployed global phosphoproteomics and CRISPR/Cas9 screening to identify the mechanism of CCR2-mediated MEKi resistance in AML.

Results:

Our multifaceted analysis unveiled that CCL2 activates multiple prosurvival pathways, including MAPK and cell-cycle regulation in MEKi-resistant cells. Employing combination strategies to simultaneously target these pathways heightened growth inhibition in AML cells. Both genetic and pharmacologic inhibition of CCR2 sensitized AML cells to trametinib, suppressing proliferation while enhancing apoptosis. These findings underscore a new role for CCL2 in MEKi resistance, offering combination therapies as an avenue to circumvent this resistance.

Conclusions:

Our study demonstrates a compelling rationale for translating CCL2/CCR2 axis inhibitors in combination with MEK pathway-targeting therapies, as a potent strategy for combating drug resistance in AML. This approach has the potential to enhance the efficacy of treatments to improve AML patient outcomes.
Supplementary Figure 1 from CALGB 80802 (Alliance): Impact of Sorafenib with and without Doxorubicin on Hepatitis C Infection in Patients with Advanced Hepatocellular Carcinoma
Authors: Abou-Alfa Ghassan K. , Geyer Susan M. , Nixon Andrew B. , Innocenti Federico , Shi Qian , Kumthekar Priya , Jacobson Sawyer , El Dika Imane , Yaqubie Amin , Lopez Juan , Huang Binhui , Tang Yi-Wei , Wen Yujia , Schwartz Lawrence H. , El-Khoueiry Anthony B. , Knox Jennifer J. , Rajdev Lakshmi , Bertagnolli Monica M. , Meyerhardt Jeffrey A. , O'Reilly Eileen M. , Venook Alan P.
Published: March 2024

Supplementary Figure 1. CONSORT diagram of those with evaluable sample for the HCV-based analyses for this manuscript
Development and Validation of a Scale to Measure Person-Centered Care in Fetal Care Centers
Authors: Wilpers Abigail , White Marney , Austin Mary T. , Bahtiyar Mert Ozan , Francis Katie , Emery Stephen P. , Wall Diane , Somers Lonnie , Wool Charlotte
Published: March 2024

Introduction: Fetal care centers (FCCs) in the USA lack a standardized instrument to measure person-centered care. This study aimed to develop and validate the Person-Centered Care in Fetal Care Centers (PCC-FCC) Scale. Methods: Initial items were developed based on literature and input from clinicians and former patients. A Delphi study involving 16 experts was conducted to validate the content and construct. Through three rounds of online questionnaires using open-ended questions and Likert scales, consensus on item clarity and relevancy was established. The resulting items were then piloted with former fetal care center patients via a web-based survey. The instrument’s reliability and validity were validated using Cronbach’s α and exploratory factor analysis, respectively. Concurrent validity was assessed by comparing scores with the Revised Patient Perception of Patient-Centeredness (PPPC-R) Questionnaire. Results: 258 participants completed the 48-item pilot PCC-FCC survey, categorized into six domains. Factor analysis yielded a 2-factor, 28-item scale. Internal consistency of the final scale had good reliability (α = 0.969). Data supported content, construct, and concurrent validity. Conclusion: The PCC-FCC Scale is a reliable and valid measure of person-centered care in U.S. FCCs. It can be used to enhance services and begin connecting person-centered care to maternal-child health outcomes.
Deprogramming Implicit Bias: The Case for Public Interest
Technology
Authors: Walker Darren
Published: March 2024

New technologies have fundamentally transformed the systems that govern modern life, from criminal justice to health care, housing, and beyond. Algorithmic advancements promise greater efficiency and purported objectivity, but they risk perpetuating dangerous biases. In response, the field of public interest technology has emerged to offer an interdisciplinary, human-centered, and equity-focused approach to technological innovation. This essay argues for the widespread adoption of public interest technology principles, including thinking critically about how and when technological solutions are deployed, adopting rigorous training to educate technologists on ethical and social context, and prioritizing the knowledge and experiences of communities facing the disproportionate harms or uneven benefits of technology. Tools being designed and deployed today will shape our collective future, and collaboration between philanthropy, government, storytellers, activists, and private-sector technologists is essential in ensuring that these new systems are as just as they are innovative.
Hegemony Approach and Political Struggles over a New Political Order: The Case of Turkey
Authors: Kutay Acar
Published: March 2024

This paper proposes an analytical framework that employs a hegemony approach to political transformations, which bring about significant changes in the fundamental norms and values of a political community, as well as in the organizing principles of the social and economic system. The hegemony approach, drawing inspiration from the works of Ernesto Laclau and Chantal Mouffe, provides political theorists and social scientists with conceptual tools for analyzing struggles over political power. The paper argues that attempts at hegemonic formations, when extended to political transformations, involve articulations around social antagonisms, the construction of the people, establishment of political frontiers, and mobilization of the demands of excluded and oppressed groups. The Justice and Development Party, led by Recep Tayyip Erdogan in Turkey, serves as a unique case study to illustrate this approach.
Toward an Integrated Model of Healthy Food Purchase via the Impact of Online Nutrition Information Seeking
Authors: Pan Po-Lin , Bhandari Manu , Meng Juan
Published: March 2024

Healthy eating is critical to consumers’ overall health. The purpose of this study was to examine body mass index (BMI), obesity knowledge, and self-efficacy, along with online nutrition information seeking (ONIS), as antecedents to healthy food purchase (HFP) in a moderated mediation model. An online survey was conducted using Amazon Mechanical Turk to recruit 897 participants, with 484 women and 380 men. A moderated mediation analysis was then used to explore the mediating effect of ONIS, and the moderating effects of obesity knowledge and self-efficacy. Results found the impact of ONIS on HFP was significantly generated by obesity knowledge but not by BMI. Both ONIS and self-efficacy yielded individual and interactive effects on HFP, and ONIS did not only generate a direct effect on HFP but also interacted with self-efficacy for HFP. Practically, it was suggested that online health information should be strategically crafted to promote healthy eating behavior, given that consumers in various health conditions were activated to purchase heathier foods via ONIS. Through the ONIS’s mediation of the relationship between obesity knowledge and HFP, consumers with poor obesity knowledge would be cultivated well to further develop their better eating habits.
Prevalence and Associated Factors of Atherosclerotic Plaque and Stenosis in Renal Arteries: A Community-Based Study
Authors: Wang Dongxue , Pan Yuesong , Cai Xueli , Jing Jing , Yan Hongyi , Wang Suying , Meng Xia , Mei Lerong , Zhang Yanli , Li Shan , Wei Tiemin , Zhou Yilun , Wang Yongjun
Published: March 2024

The epidemiology of renal artery atherosclerosis in community populations is poorly documented. This study aimed to determine the prevalence of renal artery plaque (RAP) and atherosclerotic renal artery stenosis (ARAS), and the association of plaque and stenosis with vascular risk factors and kidney disease markers among community-dwelling adults. We conducted a cross-sectional analysis of the Polyvascular Evaluation for Cognitive Impairment and Vascular Events (PRECISE) study. RAP and ARAS were evaluated by thoracoabdominal computed tomography angiography. A total of 3045 adults aged 50–75 years were included. The prevalence of RAP and ARAS was 28.7% and 4.8%, respectively. The prevalence of RAP and ARAS was 41.3% and 7.7% in individuals aged ≥60 years, 42.9% and 8.7% in hypertensives, and 45.4% and 8.5% in individuals with chronic kidney disease. Older age, hypertension, higher total cholesterol level, and lower high-density lipoprotein cholesterol level were independently associated with RAP and ARAS. A higher urinary albumin-creatinine ratio was independently associated with RAP, whereas a reduced estimated glomerular filtration rate was independently associated with ARAS. In conclusion, there was a non-negligible prevalence of RAP and ARAS among the older, community population in China.
Place and Land in Anglican Theology: Intercultural Theology in a Global World
Authors: Zink Jesse
Published: March 2024

Aspects of Anglican theology have in the recent past emphasized the importance of place. Indigenous knowledge and worldviews speak of the centrality of land. Tessayshis places place-based thinking alongside land-based thinking to argue that these distinct ways of thinking can be mutually enriching and challenging. The essay limits itself primarily to Anglican-related authors while also contextualizing this theology within a broader scope of thinking about place. The paper concludes with suggestions for ways in which place- and land-based thinking can enrich Anglican approaches to ministry and mission, particularly in relation to the Doctrine of Discovery and ownership of property.
Polysomnographic Characteristics of Sleep Architecture in Children With Obstructive Sleep Apnea
Authors: Don Debra M. , Osterbauer Beth , Gowthaman Divya , Fisher Laurel , Gillett Emily S.
Published: March 2024

Background:

The conventional measure of sleep fragmentation is via polysomnographic evaluation of sleep architecture. Adults with OSA have disruption in their sleep cycles and spend less time in deep sleep stages. However, there is no available evidence to suggest that this is also true for children and published results have been inconclusive.

Objective:

To determine polysomnographic characteristics of sleep architecture in children with OSA and investigate effects relative to OSA severity.

Methods:

Overnight polysomnograms (PSG) of children referred for suspected OSA were reviewed. Subjects were classified by apnea hypopnea index (AHI). PSG parameters of sleep architecture were recorded and analyzed according to OSA severity.

Results:

Two hundred and eleven children were studied (median age of 7.0 years, range 4-10 years) Stage N1 sleep was longer while stage N2 sleep and REM sleep was reduced in the OSA group when compared to those without OSA (6.10 vs 2.9, P < .001; 42.0 vs 49.7, P < .001; 14.0 vs 15.9, P = .05). The arousal index was also higher in the OSA group (12.9 vs 8.2, P < .001). There was a reduction in sleep efficiency and total sleep time and an increase in wake after sleep onset noted in the OSA group (83.90 vs 89.40, P = .003; 368.50 vs 387.25, P = .001; 40.1 ± 35.59 vs 28.66 ± 24.14, P = .007; 29.00 vs 20.50; P = .011). No significant difference was found in N3 sleep stage (33.60 vs 30.60, P = .14).

Conclusion:

We found evidence that children with OSA have a disturbance in their sleep architecture. The changes indicate greater sleep fragmentation and more time spent in lighter stages of sleep. Future research is needed and should focus on more effective methods to measure alterations in sleep architecture.
Essential Capabilities for Successful Digital Service Innovation at the Bottom of the Pyramid
Authors: Sunder M Vijaya , Modukuri Siddhartha
Published: March 2024

Several firms worldwide that attempted to penetrate the bottom of the pyramid (BOP) with digital service innovations have encountered disappointing returns. This article explores what capabilities firms should develop and how they should nourish them for value creation at the BOP. Using the multiple-case method, this study inductively derives persuasion, co-creation, adaptation, and self-sustainability as essential capabilities. Cumulative maneuvering of these capabilities resulted in a sand cone model. Both established incumbents and digital natives benefit from this model, which enables them to safeguard their digital offerings while penetrating or expanding within BOP markets.
The Power of a Star Rating: Differential Effects of Customer Rating Formats on Magnitude Perceptions and Consumer Reactions
Authors: Abell Annika , Morgan Carter , Romero Marisabel
Published: March 2024

Average product ratings are displayed on many major websites, including online retailers, search engines, and social media sites. Research in both academia and industry has shown that consumers rely heavily on product ratings when making purchase decisions. Websites may show customer ratings in different shapes, colors, or formats. For example, some websites present their rating in a numerical format (e.g., 4.0/5) while others utilize an analog format (e.g., [Formula: see text]). The present research investigates how a website's rating presentation may influence magnitude perceptions of the rating, which subsequently affect choices and purchase intentions. The authors propose and find that when the average customer rating is at or above the midpoint (i.e., .5–.9) of each rating level (i.e., 1–5 on a five-point scale), the numerical (vs. analog) rating format is perceived to be lower in magnitude due to left-digit anchoring, leading to differences in choice likelihood, purchase intent, and ad click likelihood for products and services. Across nine experiments, including an eye-tracking study and a multiple-ad study without holdout, the findings show robust evidence for the proposed effect.
Effect of a Ten-week Sensorimotor Exercise Program on the Side-to-Side LAM Asymmetry of Adolescent Football Players: A Randomized Control Trial
Authors: Sikora Damian , Linek Paweł
Published: March 2024

In this study we, evaluated the effects of a 10-week sensorimotor exercise program on the thickness and side-to-side asymmetry of the lateral abdominal muscles in adolescent soccer players. From among 120 initially recruited participants, we included 90 athletes (aged 10–17 years old) in our final analysis. Healthy athletes who met our inclusion criteria were randomly divided into comparative experimental and control groups. Sensorimotor exercises were conducted twice weekly for 10-weeks in the experimental group, and the control group received no intervention. We took ultrasound measurements when participants were in supine and standing rest positions. In the supine position, the experimental group (a) reduced the asymmetry of the internal oblique (IO) muscle by 0.4 mm (MD: 0.7; 95% CI 0.6–1.1); (b) increased the thickness of the external oblique (EO) muscle on the right by 0.7 mm (MD: 0.2; 95% CI 0.1–0.6) and on the left by 0.9 mm (MD: 0.2, 95% CI 0.2–0.7); and (c) increased the muscle on the IO right by 0.8 mm (MD: 0.3; 95% CI 0.2–0.9) and on the, left by 1.2 mm (MD: 0.4 95% CI 0.3–1.1). In a standing position the experimental group increased the thickness of the EO on the right by 1.5 mm (MD: 0.6; 95% CI 0.03–1.2) and on the left by 2.1 mm (MD: 0.6; 95% CI 0.1–1.3) and increased the IO on the right by 1.2 mm (MD: 0.7; 95% CI 0.2–1.7) and on the left by 1.1 mm (MD: 0.9; 95%CI 0.1–2.0). Thus, this 10-week program of additional sensorimotor exercises reduced the (side-to-side) asymmetry of the internal oblique muscle and increased the thickness of the EO and IO muscles in young football players.
Cross-Age Peer Tutoring to Improve Literacy Outcomes for Students With Disabilities
Authors: Mauer Emily , Swanson Elizabeth
Published: March 2024

Learning to read is of primary focus in the early grades. Reading can be a challenge for many students, especially those with disabilities. With rising class sizes, and more students with disabilities included in the general education setting, the need for more individualized support in literacy instruction is vital. Innovative approaches are needed to increase learning opportunities in ways that are both practical to implement and cost-effective for schools. Cross age peer tutoring presents a promising approach to support students, both academically and socially. This involves pairing an older student, the tutor, with a younger student, the tutee, for tutoring sessions. This article provides elementary general and special education teachers with a step-by-step plan for implementing a cross age tutoring program to increase literacy outcomes for all students, specifically those with disabilities.
Fostering Flexibility: How Medicare Advantage Potentially Accelerated Telehealth Benefits
Authors: Grabert Lisa M. , McCormack Grace , Trish Erin , Wagner Kathryn L.
Published: March 2024

In 2018, the US Congress enacted a policy permitting Medicare Advantage (MA) plans to cover telehealth services in a beneficiary’s home and through audio-only means as part of the basic benefit package of services, where prior to the policy change such benefits were only allowed to be covered as a supplemental benefit. MA plans were afforded 2 years of lead time for strategizing, negotiating, and capital investment prior to the start date (January 1, 2020) of the new coverage option. Our data analysis found basic benefit telehealth was offered by plans comprising 71% of enrollment in 2020 and increased to 95% in 2021. At the same time, remote access telehealth was offered as a supplemental benefit for 69% of enrollees in 2020, a decrease of 23% compared to 2019. These efforts by MA plans may have enabled traditional Medicare (TM) to leverage an existing telehealth infrastructure as a solution to the access issues created by public health policies requiring sheltering in place and social distancing during the COVID-19 pandemic. The success of this MA policy prompts consideration of additional flexibility beyond the standard basic benefit package, and whether such benefits reduce costs while improving access and/or outcomes in the context of a managed care environment like MA. Subject to oversight, such flexibility could potentially improve value in MA, and facilitate future changes in TM, as appropriate.
Constrained Power Expansion: China’s Procuratorial Reforms within and beyond Criminal Justice
Authors: Wu Wanqiang , Lin Xifen
Published: March 2024

This article employs the ecological theory of “boundary work and exchange” to elucidate the latest reforms in China’s procuratorial system, delineating the expanding remits of the procuratorates both within and beyond their traditional domain of criminal justice. Following the national supervision system pilot reform in 2016, which stripped the procuratorial bodies of their authority to investigate official crimes, China’s procuratorates have endeavored to expand their jurisdictions in areas such as criminal, civil, administrative, and public interest litigation. By examining how China’s procuratorates leverage their respective institutional advantages to broaden their functions, we find that they have not only strengthened their role in criminal proceedings but have also continuously expanded their functions beyond criminal litigation. These reforms follow a well-defined trajectory shaped by boundary work and exchange. However, in contrast to boundary work and exchange as usually theorized, which usually starts in ambiguous and elastic areas, China’s procuratorial reforms are notably confined to a fixed sphere. This can be attributed to the procuratorate’s pursuit of state support, which has, in turn, led to its constrained expansion. This enhanced theoretical framework sheds light on the evolving role of China’s procuratorates and underscores the potential significance of ecological theory for understanding broader institutional reforms in China.
Head teacher leadership behavior, class collective efficacy and school adjustment of junior high school students: A 2-2-1 multilevel mediation analysis
Authors: Shi Leishan , Wu Yuping , Zhou Yanfang
Published: March 2024

Based on Bass' leadership theory and Bandura's social cognitive theory, we tested the direct relationship between head teacher transformational leadership behavior, head teacher transactional leadership behavior, and junior high school students’ school adjustment as well as explored the role of class collective efficacy in mediating this relationship. Surveying 5,083 junior high school students in 168 classes and controlling for grade, head teacher gender, and class size, the hypothesized relationships were tested through a 2-2-1 mediation model using multilevel structural equation modeling. The results indicated that there was not only a direct relationship between head teacher transformational leadership behavior and school adjustment ( b = .326, 95% confidence interval [CI] [.218, .434]), but also an indirect relationship through class collective efficacy (.047, 95% CI [.007, .087]), although the direct link was stronger. Moreover, there was only an indirect relationship between head teacher transactional leadership behavior and school adjustment through class collective efficacy (.051, 95% CI [.007, .096]), and the link between head teacher transformational leadership behavior and school adjustment was stronger than the link between head teacher transactional leadership behavior and school adjustment (diff = .351, 95% CI [.126, .577]). This study extended Bass' leadership theory to a class organization, and the relationship between head teacher leadership behavior and school adjustment was explored at the class level in a junior high school.
Challenges in Acceptance of Smartphone-Based Assistive Technologies: Extending the UTAUT Model for People With Visual Impairments
Authors: Theodorou Paraskevi , Tsiligkos Kleomenis , Meliones Apostolos
Published: March 2024

Introduction: Despite the plethora of sensor-based assistive technology solutions, there is still no widespread acceptance and adoption by people who are blind or have low vision (i.e., visually impaired). Many reasons prevent reducing abandonment levels with a prominent one being a lack of focus on the dimension of training, which, from our standpoint, is integral to the acceptance of assistive technologies. To prove the importance of training, we extend and validate a new version of the Unified Theory of Acceptance and Use of Technology (UTAUT) model incorporating training as a factor. Methods: Closed- and open-ended questionnaires were given online and offline to 231 participants with visual impairments after conducting training sessions with an application for outdoor navigation by people with visual impairments developed by our research team. To assess the UTAUT extension exploratory factor analysis, confirmatory factor analysis, and structural equation model were employed to explore the relationships between the factors. A usability and user experience qualitative analysis supplemented the previous. Results: We uncovered that no factor besides performance expectancy (standardized regression weight = 0.264, p < .001) and training (standardized regression weight = 0.538, p < .001) significantly predict behavioral intention. Furthermore, the analysis demonstrated a significant interaction ( p < .007) strengthening the positive relationship between training and behavioral intention (standardized regression weight = 0.142). The qualitative analysis showed an overall positive evaluation highlighting the application's usefulness and dependability. Discussion: An application's adoption increases if individuals who are visually impaired are properly trained and acquainted with the features in real-life scenarios and recognize the application's utility for their daily lives. Implications for Practitioners: Training plays an important role in technology acceptance. It can be leveraged to make solutions more appealing to people who are visually impaired.
Can dynamical systems theory be applied to second language acquisition? The issues of reductionism and intentionality
Authors: Pienemann Manfred , Lenzing Anke , Nicholas Howard
Published: March 2024

In this article we address two key questions in the application of dynamical systems theory (DST) to second language acquisition (SLA) that have not been resolved in recent debates about this issue. The first question relates to reductionism. Is an antireductionist position a necessary element of DST? We show that the radical antireductionist stance put forward by key movers of the application of DST to SLA neither follows from the mathematics of DST nor from the application of DST to science and that radical antireductionism results in an impasse for empirical research. In contrast, we argue that reductionism offers ways in which theory-derived hypotheses can be formed about subsystems that can be studied empirically using DST mathematics. The second question relates to intentionality. Are physical systems and mental systems similar enough to justify applying DST principles based in the physical sciences to processes in the human mind? Following Tschacher, we argue that current evidence suggests that there is a limited class of mental phenomena that can arise from physical phenomena. It is only this class of mental phenomena that can currently be modeled using DST mathematics. We offer a discussion of these perspectives to indicate how important it is to resolve these fundamental questions. In our view, these fundamental issues need resolution to put the application of DST to SLA on a solid conceptual and empirical footing.
Vascular contributions to cognitive decline: Beyond amyloid and tau in the Harvard Aging Brain Study
Authors: Shirzadi Zahra , Boyle Rory , Yau Wai-Ying W , Coughlan Gillian , Fu Jessie Fanglu , Properzi Michael J , Buckley Rachel F , Yang Hyun-Sik , Scanlon Catherine E , Hsieh Stephanie , Amariglio Rebecca E , Papp Kathryn , Rentz Dorene , Price Julie C , Johnson Keith A , Sperling Reisa A , Chhatwal Jasmeer P , Schultz Aaron P
Published: March 2024

In addition to amyloid and tau pathology, elevated systemic vascular risk, white matter injury, and reduced cerebral blood flow contribute to late-life cognitive decline. Given the strong collinearity among these parameters, we proposed a framework to extract the independent latent features underlying cognitive decline using the Harvard Aging Brain Study (N = 166 cognitively unimpaired older adults at baseline). We used the following measures from the baseline visit: cortical amyloid, inferior temporal cortex tau, relative cerebral blood flow, white matter hyperintensities, peak width of skeletonized mean diffusivity, and Framingham Heart Study cardiovascular disease risk. We used exploratory factor analysis to extract orthogonal factors from these variables and their interactions. These factors were used in a regression model to explain longitudinal Preclinical Alzheimer Cognitive Composite-5 (PACC) decline (follow-up = 8.5 ±2.7 years). We next examined whether gray matter volume atrophy acts as a mediator of factors and PACC decline. Latent factors of systemic vascular risk, white matter injury, and relative cerebral blood flow independently explain cognitive decline beyond amyloid and tau. Gray matter volume atrophy mediates these associations with the strongest effect on white matter injury. These results suggest that systemic vascular risk contributes to cognitive decline beyond current markers of cerebrovascular injury, amyloid, and tau.
A metric for quantitative evaluation of glioma margin changes in magnetic resonance imaging
Authors: Hu Binwu , Zhang Zhiqiang , Chen Suting , Xu Qiang , Li Jianrui
Published: March 2024

Background

Gliomas differ from meningiomas in their margins, most of which are not separated from the surrounding tissue by a distinct interface.

Purpose

To characterize the margins of gliomas quantitatively based on the margin sharpness coefficient (MSC) is significant for clinical judgment and invasive analysis of gliomas.

Material and Methods

The data for this study used magnetic resonance image (MRI) data from 67 local patients and 15 open patients to quantify the intensity of changes in the glioma margins of the brain using MSC. The accuracy of MSC was assessed by consistency analysis and Bland–Altman test analysis, as well as invasive correlations using receiver operating characteristic (ROC) and Spearman correlation coefficients for subjects.

Results

In grading the tumors, the mean MSC values were significantly lower for high-grade gliomas (HGG) than for low-grade gliomas (LGG). The concordance correlation between the measured gradient and the actual gradient was high (HGG: 0.981; LGG: 0.993), and the Bland–Altman mean difference at the 95% confidence interval (HGG: −0.576; LGG: 0.254) and the limits of concordance (HGG: 5.580; LGG: 5.436) indicated no statistical difference. The correlation between MSC and invasion based on the margins of gliomas showed an AUC of 0.903 and 0.911 for HGG and LGG, respectively. The mean Spearman correlation coefficient of the MSC versus the actual distance of invasion was −0.631 in gliomas.

Conclusion

The relatively low MSC on the blurred margins and irregular shape of gliomas may help in benign-malignant differentiation and invasion prediction of gliomas and has potential application for clinical judgment.
Teaching Fifth-Grade Students With Specific Learning Disabilities to Explain Their Mathematical Reasoning Through Written Expression
Authors: Riccomini Paul J. , Hughes Elizabeth E. , Deshpande Divya , Lee Joo Young , Fiveash Laura , Lin Tzu-Hsing
Published: March 2024

The current study investigated the effectiveness of an intensive writing intervention focusing on mathematical reasoning through written expression. A group pretest–intervention–posttest comparison experimental design was used to implement a 12-lesson intervention, delivered through a combination of Google Classroom and in-person classroom teacher support, to fifth-grade students with specific learning disabilities ( n = 19). Although underpowered, our results indicated the intensive writing intervention led to all students in the intervention group ( n = 11) significantly outperforming the students in the control group ( n = 8) on subtraction and division word problems requiring an explanation of their solution in written form. Additionally, student treatment interviews revealed the strategy was both enjoyable and helpful in solving and explaining their word problem solutions and the teacher provided insight into potential additional scaffolds to support the most intensive students. Lessons learned and implications for research and practice are presented.
Early Beta-Blocker Utilization in Critically Ill Patients With Moderate-Severe Traumatic Brain Injury: A Retrospective Cohort Study
Authors: Kelly-Hedrick Margot , Liu Sunny Yang , Komisarow Jordan , Hatfield Jordan , Ohnuma Tetsu , Treggiari Miriam M. , Colton Katharine , Arulraja Evangeline , Vavilala Monica S. , Laskowitz Daniel T. , Mathew Joseph P. , Hernandez Adrian , James Michael L. , Raghunathan Karthik , Krishnamoorthy Vijay
Published: March 2024

Background

There is limited evidence that beta-blockers may provide benefit for patients with moderate-severe traumatic brain injury (TBI) during the acute injury period. Larger studies on utilization patterns and impact on outcomes in clinical practice are lacking.

Objective

The present study uses a large, national hospital claims-based dataset to examine early beta-blocker utilization patterns and its association with clinical outcomes among critically ill patients with moderate-severe TBI.

Methods

We conducted a retrospective cohort study of the administrative claims Premier Healthcare Database of adults (≥17 years) with moderate-severe TBI admitted to the intensive care unit (ICU) from 2016 to 2020. The exposure was receipt of a beta-blocker during day 1 or 2 of ICU stay (BB+). The primary outcome was hospital mortality, and secondary outcomes were: hospital length of stay (LOS), ICU LOS, discharge to home, and vasopressor utilization. In a sensitivity analysis, we explored the association of beta-blocker class (cardioselective and noncardioselective) with hospital mortality. We used propensity weighting methods to address possible confounding by treatment indication.

Results

A total of 109 665 participants met inclusion criteria and 39% (n = 42 489) were exposed to beta-blockers during the first 2 days of hospitalization. Of those, 42% received cardioselective only, 43% received noncardioselective only, and 14% received both. After adjustment, there was no association with hospital mortality in the BB+ group compared to the BB− group (adjusted odds ratio [OR] = 0.99, 95% confidence interval [CI] = 0.94, 1.04). The BB+ group had longer hospital stays, lower chance of discharged home, and lower risk of vasopressor utilization, although these difference were clinically small. Beta-blocker class was not associated with hospital mortality.

Conclusion

In this retrospective cohort study, we found variation in use of beta-blockers and early exposure was not associated with hospital mortality. Further research is necessary to understand the optimal type, dose, and timing of beta-blockers for this population.
Numerical simulation and multi-objective optimization of thin-walled aluminum/carbon fiber reinforced plastic hybrid tubes under axial crushing
Authors: Zhang Chao , Sun Yunyun , Curiel-Sosa Jose L , Qiao Kai
Published: March 2024

Crushing behavior analysis and energy absorption optimization are crucial for lightweight structures in automotive applications. The present paper aims to investigate the crushing behavior of thin-walled aluminum/CFRP hybrid tubes under axial loading using an explicit finite element (FE) simulation. The damage constitutive models of aluminum and CFRP are implemented by coding the user-defined subroutine VUMAT in ABAQUS/Explicit, which includes the damage initiation and evolution laws and element deletion scheme. Parametric studies are conducted to assess the effects of radius and aluminum layer thickness on the crushing performance of hybrid tubes. Additionally, a multi-objective optimization is performed on the Isight platform using a non-dominant sorting genetic algorithm (NSGA-II) and technique for order preference by similarity to ideal solution (TOPSIS) with entropy weight method. The optimization aims to maximize crashworthiness and increase energy absorption capacity, enabling designers to select an optimum size ratio.
Height-posture and load coupling control methodology of URAPM and its application in active suspension control of multi-axle vehicles
Authors: Wu Zhenhua , Zhang Fan , Cai Jintian , Gang Xianyue , Li Chu , Yang Jiguo
Published: March 2024

Unidirectional redundant actuated parallel mechanism (URAPM) is the physical prototype of active suspension system, truck crane outrigger system, etc. As the number of adjustment mechanisms (AMs) increases to more than three, the difficulty of height-posture control of the upper component (UC) increases considerably. The AMs load control is also tough but highly underappreciated, which in turn causes height-posture disturbance. In this work, a convenient height-posture and bearing load coupling control methodology and its application in the active suspension system are presented. Firstly, by characterizing the force-deformation coupling relationship of the URAPM, a basic geometry and load coupling control model is proposed. And for the desired bearing load control, different optimal load allocation algorithms are developed and evaluated. Secondly, coupling control models for the flexible load control under stationary height-posture, and the flexible height-posture control under balancing load are constructed respectively. Finally, bench tests based on a six-legged URAPM (equivalent to a three-axle active suspension vehicle) validate the proposed method can achieve high precision, high convergence, and most attractively, the height-posture and load coupling adjustment with few iterations, thus demonstrating its good application prospect in low-speed off-road maneuvering of multi-axle vehicles and other related fields.