bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health insurers' use of quality improvement expenses to achieve a minimum medical loss ratio requirement
Authors: Born Patricia H. , Tice Sirmans E. , Steinorth Petra 
Published: January 2023

AbstractHealth insurer medical loss ratios (MLRs) are the percentage of premium dollar spent on medical claims and healthcare quality improvement expenses (QIEs). QIEs include activities to improve patient health outcomes and safety, reduce medical errors, and prevent hospital readmissions. The Affordable Care Act mandates minimum MLRs in certain health insurance markets lest rebates be paid to policyholders. QIEs are reported in all markets regardless of whether that market is subject to minimum MLR requirements. Using health insurer statutory filings for a sample of group market insurers from 2010 to 2018, we employ a mixed regression discontinuity/regression kink approach to evaluate whether QIEs are used by insurers as a potential strategy for meeting the minimum MLR requirement. We show that health insurers' QIE increase in the loss ratio until meeting the minimum MLR requirement, have a significant discontinuous jump at the threshold, and decrease above the threshold after the introduction of the MLR mandate.
Transformer‐optimized generation, detection, and tracking network for images with drainage pipeline defects
Authors: Ma Duo , Fang Hongyuan , Wang Niannian , Lu Hongfang , Matthews John , Zhang Chao 
Published: January 2023

AbstractRegular detection of defects in drainage pipelines is crucial. However, some problems associated with pipeline defect detection, such as data scarcity and defect counting difficulty, need to be addressed. Therefore, a Transformer‐optimized generation, detection, and counting method for drainage‐pipeline defects was established in this paper. First, a generation network called Trans‐GAN‐Cla was developed for data augmentation. A classification network was trained to improve the quality of the generated images. Second, a detection and tracking model called Trans‐Det‐Tra was developed to track and count the number of defects. Third, the feature extraction capability of the proposed method was improved by leveraging Transformers. Compared with some well‐known convolutional neural network‐based methods, the proposed network achieved the best classification and detection accuracies of 87.2% and 87.57%, respectively. Furthermore, the F1 scores were 87.7% and 91.9%. Finally, two pieces of onsite videos were detected and tracked, and the numbers of misalignments and obstacles were accurately counted. The results indicate that the established Transformer‐optimized method can generate high‐quality images and realize the high‐accuracy detection and counting of drainage pipeline defects.
Measuring esophageal compliance using functional lumen imaging probe to assess remodeling in eosinophilic esophagitis
Authors: Moosavi Sarvee , Shehata Christina , Kou Wenjun , Hirano Ikuo , Gonsalves Nirmala , Peterson Stephanie , Pandolfino John E. , Carlson Dustin A. 
Published: January 2023

AbstractBackgroundEosinophilic esophagitis (EoE) is associated with fibrostenotic remodeling that can be objectively assessed using the functional lumen imaging probe (FLIP). This is typically done using a metric called distensibility plateau (DP). We aimed to describe a novel measure of compliance of the esophageal body and evaluate the associated clinical characteristics in EoE.MethodsOne hundred seventy‐one adult patients with EoE (mean (SD) age 38 (12) years), 31% female and 35 healthy, asymptomatic controls who completed 16‐cm functional luminal imaging probe (FLIP) during endoscopy, were evaluated in a cross‐sectional study. The esophageal body DP and compliance were measured using a customized analysis program, with compliance calculated as (Δ esophageal body volume)/(Δ pressure) between two FLIP‐filled volumes.ResultsIn controls, the median (5–95th percentile) DP was 19.8 mm (17.9–21) and esophageal body compliance was 0.37 ml/mmHg (0.18–1.1), which was greater than in EoE (DP 19 (11–21)), compliance 0.19 (0.02–0.71), p‐values <0.001. Among EoE patients, 70 (41%) had normal compliance (>0.2 ml/mmHg) and normal DP (>17 mm); 11 (6%) had normal compliance and reduced DP; 34 (20%) had reduced compliance and normal DP; and 56 (33%) had reduced compliance and reduce DP. Patients with both reduced compliance and DP had the greatest proportion of severe rings (61% with EREFS score 2–3) and stricture (100%).ConclusionFLIP provides an objective evaluation of biomechanical properties of the esophageal wall that appears enhanced by complementary application of metrics of DP and esophageal body compliance.
Xylan glucuronic acid side chains fix suberin‐like aliphatic compounds to wood cell walls
Authors: Derba‐Maceluch Marta , Mitra Madhusree , Hedenström Mattias , Liu Xiaokun , Gandla Madhavi L. , Barbut Félix R. , Abreu Ilka N. , Donev Evgeniy N. , Urbancsok János , Moritz Thomas , Jönsson Leif J. , Tsang Adrian , Powlowski Justin , Master Emma R. , Mellerowicz Ewa J. 
Published: January 2023

SummaryWood is the most important repository of assimilated carbon in the biosphere, in the form of large polymers (cellulose, hemicelluloses including glucuronoxylan, and lignin) that interactively form a composite, together with soluble extractives including phenolic and aliphatic compounds. Molecular interactions among these compounds are not fully understood.We have targeted the expression of a fungal α‐glucuronidase to the wood cell wall of aspen (Populus tremulaL. × tremuloidesMichx.) and Arabidopsis (Arabidopsis thaliana(L.) Heynh), to decrease contents of the 4‐O‐methyl glucuronopyranose acid (mGlcA) substituent of xylan, to elucidate mGlcA's functions.The enzyme affected the content of aliphatic insoluble cell wall components having composition similar to suberin, which required mGlcA for binding to cell walls. Such suberin‐like compounds have been previously identified in decayed wood, but here, we show their presence in healthy wood of both hardwood and softwood species. By contrast, γ‐ester bonds between mGlcA and lignin were insensitive to cell wall‐localized α‐glucuronidase, supporting the intracellular formation of these bonds.These findings challenge the current view of the wood cell wall composition and reveal a novel function of mGlcA substituent of xylan in fastening of suberin‐like compounds to cell wall. They also suggest an intracellular initiation of lignin–carbohydrate complex assembly.
Improving safety in anesthetized patients undergoing magnetic resonance imaging—Concept of time‐out in the MRI suite and measures to improve adherence to time‐out protocol
Authors: Joselyn Anita Shirley , Teddy Dan Anna , Jose Riya , Shanthini Sharon , Joseph Lallu , Rai Ekta , Williams Aparna 
Published: January 2023

AbstractBackgroundThe time‐out protocol introduced by the Joint Commission is an important tool to prevent adverse events and improve safety in various health‐care environments. However, its implementation and utilization involve human, social, behavioral as well as system issues.AimsThe SMART aim of the current project was to increase the utilization of the time‐out protocol to more than 80% from baseline of 13%, over 6‐month period in all the magnetic resonance imaging (MRI) procedures performed at a tertiary care, teaching institute in South India.MethodsThe Plan, Do, Study, Act (PDSA) cycle and root cause analysis strategies were utilized in this quality improvement initiative. The time‐out protocol was modified for MRI environment and put into practice to improve safety. Six months after the initiation of this safety protocol, our audit showed only a 13% compliance to the time‐out protocol. A multimodal strategy was utilized by involving all the stakeholders, educational interventions, and placing reminders for following the time‐out protocol, to affect change and achieve improvement in safety.ResultsThe compliance to time‐out protocol increased from 13% to 86% and the run chart showed that a special cause variation indicated by six points above the centerline at 86%. When analyzing individual components of the time‐out, the greatest improvement was noted in the ferromagnetic check of the personnel involved, namely, the Anesthesiologist, radiographer, and anesthesia technician. There were no delays in the list because of adherence to the time‐out protocol.ConclusionTime‐out protocol in an MRI suite provides a final check to the anesthesia team before the anesthetized patient is wheeled into MR gantry. Using quality improvement methodology, we increased the compliance of time‐out protocol in the magnetic resonance imaging environment. Our study is an example how other institutions in India and elsewhere can adapt similar improvement strategies to enhance patient safety.
Chemokine receptors on human regulatory T cells during cutaneous leishmaniasis
Authors: Brelaz de Castro Maria Carolina Accioly , de Freitas e Silva Rafael , de Andrade Cavalcante Marton Kaique , Silva Larissa Layne Soares Bezerra , Santos dos Gomes Fabiana Oliveira , de Brito Maria Edileuza Felinto , Pereira Valéria Rêgo Alves 
Published: January 2023

AbstractThe aim of this work was to define the population of regulatory T cells (Tregs) which are circulating in the blood of Leishmania infected individuals clinically displaying a lesion (active disease–AD) and sub‐clinical (SC) ones. We have individually collected blood samples, processed the PBMC and stained with fluorochrome‐conjugated antibodies against CD3, CD4, Foxp3, CD25, CTLA‐4, Ki‐67, CCR4, CCR5, and CCR7. Cells were analyzed by flow cytometry. Our results suggest that CD25 and CTLA‐4 are upregulated in Tregs of AD patients when compared to SC and uninfected (UN) controls. Moreover, Tregs proliferate upon infection based on Ki‐67 nuclear antigen staining. Finally, we have observed that these Tregs of SC and AD patients upregulate CCR4, but not CCR5 and CCR7. There is an increase in the number of circulating Tregs in the blood of Leishmania infected individuals. These cells are potentially more suppressive based on the increased upregulation of CD25 and CTLA‐4 during clinical infection (AD) when compared to SC infection. Tregs of both SC and AD cohorts are proliferating and express CCR4, which potentially guide them to the skin, but do not upregulate CCR5 and CCR7.
Long‐term service agreement in electricity supply chain with renewable energy penetration
Authors: Kouvelis Panos , Matsuo Hirofumi , Xiao Yixuan , Yuan Quan 
Published: January 2023

We study a long‐term service agreement (LTSA) between an original equipment manufacturer (OEM) of a conventional power generator and a utility firm in the electricity supply chain. The OEM offers the LTSA to the utility firm, which specifies the service fee and the maintenance interval. The utility firm dynamically chooses among different resources (conventional, renewable, or emergency) to meet energy demand. An LTSA contracts on a generator's long‐term production schedule (i.e., the usage time and number of starts). We first characterize that the conventional generator's optimal operating mode (i.e., on or off) follows a two‐threshold policy, which shows a hysteresis phenomenon. Then, the optimal production from different resources can be obtained by minimizing the utility firm's cost of the current period. We prove that the OEM's optimal LTSA design on the maintenance interval and service fee can be solved sequentially, and capture the trade‐off between the service margin and the usage of conventional generator. Our numerical results show that the utility firm starts the conventional generator less often as the maintenance service fee of a start increases and the minimum conventional output decreases. The OEM has incentives to reduce the minimum output to make the conventional generator more flexible, but such improvement may not benefit the utility firm. Finally, increasing renewable penetration leads to more frequent cycling of the conventional generator and less conventional output. With more renewable generation and less conventional and emergency generation, higher renewable penetration reduces the utility firm's cost, the OEM's profit, and the total emission.
Bridging the gap: Applying analytics to address gender pay inequity
Authors: Anderson David , Bjarnadóttir Margrét Vilborg , Ross David Gaddis 
Published: January 2023

Employers are under increasing pressure from regulators, investors, and their own employees to address gender pay inequity in their compensation structure. However, managers tasked with measuring and closing gender and other pay gaps have few helpful quantitative tools at their disposal. We design and implement an algorithm that measures whether an employer has a pay gap and suggests salary adjustments to close it, all while supporting the employer's goals with respect to equity, culture, and incentives in its pay structure. We present our approach through a case study of one of the first firms we worked with. We also discuss the application of the approach at other organizations ranging from 75 to 130,000 employees. Our work not only provides management personnel with an accessible solution to a problem of growing social and practical importance but also demonstrates how the operations management toolkit may be applied to improve human resources management and address an important social problem.
Isolation and identification of Epicoccum nigrum as the causal agent of brown spot disease in Solanum tuberosum in China
Authors: Jin Mengjun , Yang Chengde , Wang Yidan , Wei Lijuan , Osei Richard 
Published: January 2023

AbstractBrown spots occurring on potato leaves affect the normal growth of host plants. Recently, a new brown spot disease with some black dots was discovered on potato leaves in Dingxi, China. To confirm the causal agents of potato brown spots, the diseased lesions were collected and disinfected, and only one type of isolate, with football‐shaped conidia, was obtained from disinfected diseased leaves in three experimental fields. Pathogenicity tests of four representative isolates revealed that they can cause disease symptoms on 50%–75% of wounded and non‐wounded potato leaves. In addition, a typical isolate, DXPH, was identified based on morphological and molecular characteristics, and the colony and conidial characteristics were similar to those of Epicoccum sp. Multilocus sequence analysis showed that the internal transcribed spacer (ITS), RNA polymerase II second largest subunit (RPB2) and β‐tubulin (Tub2) genes of DXPH were 100%, 100% and 99% identical to the sequences of Epicoccum nigrum (CBS 140523), respectively. Additionally, antagonistic evaluation confirmed that the representative pathogenic strain DXPH showed greatest inhibition of the mycelial growth of Colletotrichum coccodes and Fusarium chlamydosporum in vitro, with antagonistic effects of 66.67% and 61.56%, respectively. Our findings provide evidence that E. nigrum can be pathogenic to potatoes in vivo in China, while retaining a biocontrol capacity on C. coccodes, Fusarium spp. and Botrytis cinerea in vitro, which will be helpful for the effective control of potato brown spot disease and management of the use of E. nigrum as a biological control agent.
Is Colour incompatibility analytic?
Authors: Knowles William Bondi 
Published: January 2023

AbstractIt is widely believed that some a priori necessary truths are not analytic in the sense of transformable by substitution of synonyms into logical truths. One much‐cited example comes from the supposed incompatibility between colour predicates. The idea is that sentences like “Nothing is both blue all over (or uniformly or at a point) and also red” are not transformable into a logical truth in the same way as “Nothing is both a bachelor and married” because the requisite conceptual link between “bachelor” and “not married” is absent between “blue” and “not red”. This paper examines whether colour exclusion may be more like the bachelor case than it initially appears. It transpires that the most promising line of thought is not, however, as has been argued at length in the literature, that “blue” in some more or less convoluted way manages to mean “not red”. Instead it is suggested that the requisite conceptual link may reside in the oft‐ignored qualifications (“all over”, “uniformly”, etc.), without which there is no incompatibility in the first place.
Education as social policy: New tensions in maturing knowledge economies
Authors: Carstensen Martin B. , Emmenegger Patrick 
Published: January 2023

AbstractEducation has long played an important role in social policy as a means for strengthening labour market integration and increasing social mobility. The shift towards a knowledge economy has placed education policy even more centrally in efforts to provide the institutional preconditions for making economic efficiency compatible with social inclusion. To provide conceptual and theoretical context to the special issue, this paper first explores the key tension in the role of education in modern economies between serving concerns for efficiency and inclusion. Second, it argues that it remains possible for education policy to balance between efficiency and inclusion, but that the capacity of advanced economies to do so is politically mediated. Finally, the paper reviews the four main arenas in which such mediation processes take place—the parliamentary arena, the corporatist arena, the state, and public opinion—and how the contributions to the special issue study these.
Grass xylan structural variation suggests functional specialization and distinctive interaction with cellulose and lignin
Authors: Tryfona Theodora , Bourdon Matthieu , Delgado Marques Rita , Busse‐Wicher Marta , Vilaplana Francisco , Stott Katherine , Dupree Paul 
Published: January 2023

SUMMARYXylan is the most abundant non‐cellulosic polysaccharide in grass cell walls, and it has important structural roles. The name glucuronoarabinoxylan (GAX) is used to describe this variable hemicellulose. It has a linear backbone of β‐1,4‐xylose (Xyl) residues that may be substituted with α‐1,2‐linked (4‐O‐methyl)‐glucuronic acid (GlcA), α‐1,3‐linked arabinofuranose (Araf), and sometimes acetylation at the O‐2 and/or O‐3 positions. The role of these substitutions remains unclear, although there is increasing evidence that they affect the way xylan interacts with other cell wall components, particularly cellulose and lignin. Here, we used substitution‐dependent endo‐xylanase enzymes to investigate the variability of xylan substitution in grass culm cell walls. We show that there are at least three different types of xylan: (i) an arabinoxylan with evenly distributed Araf substitutions without GlcA (AXe); (ii) a glucuronoarabinoxylan with clustered GlcA modifications (GAXc); and (iii) a highly substituted glucuronoarabinoxylan (hsGAX). Immunolocalization of AXe and GAXc in Brachypodium distachyon culms revealed that these xylan types are not restricted to a few cell types but are instead widely detected in Brachypodium cell walls. We hypothesize that there are functionally specialized xylan types within the grass cell wall. The even substitutions of AXe may permit folding and binding on the surface of cellulose fibrils, whereas the more complex substitutions of the other xylans may support a role in the matrix and interaction with other cell wall components.
Leaf anatomy does not explain the large variability of mesophyll conductance across C3 crop species
Authors: Xiong Dongliang 
Published: January 2023

SUMMARYIncreasing mesophyll conductance of CO2 (gm) is a strategy to improve photosynthesis in C3 crops. However, the relative importance of different anatomical traits in determining gm in crops is unclear. Mesophyll conductance measurements were performed on 10 crops using the online carbon isotope discrimination method and the ‘variable J’ method in parallel. The influences of crucial leaf anatomical traits on gm were evaluated using a one‐dimensional anatomical CO2 diffusion model. The gm values measured using two independent methods were compatible, although significant differences were observed in their absolute values. Quantitative analysis showed that cell wall thickness and chloroplast stroma thickness are the most important elements along the diffusion pathway. Unexpectedly, the large variability of gm across crops was not associated with any investigated leaf anatomical traits except chloroplast thickness. The gm values estimated using the anatomical model differed remarkably from the values measured in vivo in most species. However, when the species‐specific effective porosity of the cell wall and the species‐specific facilitation effect of CO2 diffusion across the membrane and chloroplast stoma were taken into account, the model could output gm values very similar to those measured in vivo. These results indicate that gm variation across crops is probably also driven by the effective porosity of the cell wall and effects of facilitation of CO2 transport across the membrane and chloroplast stroma in addition to the thicknesses of the elements.
Feminist Sensory Ethnography
Authors: Guzman Elena H. , Hong Emily 
Published: January 2023

ABSTRACTIn this article, we call for a feminist sensory ethnography that centers relations of care, subjectivity, and power between filmmakers, film "subjects," and audiences. Through in‐depth discussion of two films, Smile4Kime (Guzman 2023) and Nobel Nok Dah (Hong, Lai, and Mihai 2015) we explore three techniques of feminist sensory ethnography—a multisensorial theory of the flesh, sensory accompaniment, and narrative intimacy—that draw on feminist and non‐Western genealogies of sensory knowledge production. We see this move away from observational filmmaking as a “politic of necessity” (Moraga and Anzaldúa 2015) through which the sensory is imbued with embodied knowledge.
Can volume‐reduced plasma products prevent transfusion‐associated circulatory overload in a two‐hit animal model?
Authors: Bulle Esther B. , Klanderman Robert B. , de Wissel Marit B. , Roelofs Joris J. T. H. , Veelo Denise P. , van den Brom Charissa E. , Kapur Rick , Vlaar Alexander P. J. 
Published: January 2023

AbstractBackground and ObjectivesTransfusion‐associated circulatory overload (TACO) is a pulmonary transfusion complication and a leading cause of transfusion‐related morbidity and mortality. Volume overload and rising hydrostatic pressure as a consequence of transfusion are seen as the central pathway leading to TACO. A possible preventative measure for TACO could be the use of low‐volume blood products like volume‐reduced lyophilized plasma. We hypothesize that volume‐reduced lyophilized plasma decreases circulatory overload leading to a reduced pulmonary capillary pressure and can therefore be an effective strategy to prevent TACO.Materials and MethodsA validated two‐hit animal model in rats with heart failure was used. Animals were randomized to receive 4 units of either solvent‐detergent pooled plasma (SDP) as control, standard volume lyophilized plasma (LP‐S) or hyperoncotic volume‐reduced lyophilized plasma (LP‐VR). The primary outcome was the difference between pre‐transfusion and post‐transfusion left ventricular end‐diastolic pressure (ΔLVEDP). Secondary outcomes included markers for acute lung injury.ResultsLVEDP increased in all randomization groups following transfusion. The greatest elevation was seen in the group receiving LP‐VR (+11.9 mmHg [5.9–15.6]), but there were no significant differences when compared to groups receiving either LP‐S (+6.3 mmHg [2.9–13.4], p = 0.29) or SDP (+7.7 mmHg [4.5–10.5], p = 0.55). There were no significant differences in markers for acute lung injury, such as pulmonary wet/dry weight ratios, lung histopathology scores or PaO2/FiO2 ratio between the three groups.ConclusionTransfusion with hyperoncotic volume‐reduced plasma did not attenuate circulatory overload compared to standard volume plasma and was therefore not an effective preventative strategy for TACO in this rat model.