Consecutive Order Research Articles

Correlation of the Transfusion Camp knowledge assessment test with clinical transfusion practice.

It is uncertain how transfusion knowledge translates to practice. The purpose of the study was to determine if higher scores on a validated Transfusion Camp knowledge assessment test were associated with transfusion order appropriateness. Eligible participants included postgraduate trainees and faculty physicians who had prescribed at least four transfusion orders in the preceding 6 months at two hospitals. Participant data and knowledge were collected using a web-based questionnaire with a validated Transfusion Camp knowledge assessment tool. The most recent 4-10 consecutive transfusion orders per prescriber were independently dually adjudicated for appropriateness based on published criteria. The primary outcome was the correlation between the score on six questions on red blood cells (RBCs), platelets (PLTs), and plasma from the validated test and the percentage order appropriateness. Generalized linear regression was conducted to determine if factors (sex, specialty, participation in Transfusion Camp, previous transfusion education, self-rated knowledge) were associated with appropriate orders. Seventy-four participants (45 trainees, 29 faculty; 31 females, 43 males) completed the test. Median score was 66.7% (interquartile range [IQR]: 50.0, 83.3) for six questions on RBCs, PLTs, and plasma transfusions. Of 546 transfusion orders adjudicated, appropriateness was 90.7% (95% confidence interval [CI]: 87.9%-93.0%). The correlation between prescriber test scores and order appropriateness was very weak (r = -.08). In multivariable analysis, female prescribers (p = .02) and beginner (vs. intermediate) self-rated knowledge (p = .01) were associated with higher transfusion appropriateness. Transfusion knowledge test scores did not correlate with order appropriateness. Factors other than knowledge are key to understanding how to improve appropriate blood use.

Improving the OncotypeDX ordering process in patients with ER+ HER2- early-stage breast cancer: A longitudinal QI project.

292 Background: Use of the 21-gene recurrence score assay, OncotypeDX, is an NCCN category 1 recommendation to define adjuvant treatment planning for patients with hormone receptor positive (HR+), HER2 negative (HER2-) early-stage breast cancer. The assay is a key part of the decision-making process to define who may benefit from adjuvant chemotherapy with delays in testing that may impact patient care and loss of trust between oncologists and patients. Methods: We first created a comprehensive process map of the system in place to order OncotypeDX and met with an interdisciplinary team to determine the best area of intervention. A nurse coordinator from medical oncology took over OncotypeDX ordering in September 2023. To determine impact, we obtained data on OncotypeDX orders (N=473) sent by medical oncologists at Washington University in St. Louis between 9/2022 and 4/2024. We determined the delay between specimen collection and OncotypeDX order and the time from order to delivery of the report in the electronic medical record system. We then assessed our outcome measure, the date of the first office visit after surgery and whether patients had an OncotypeDX test result at that visit for 270 consecutive orders spanning pre- and post-intervention (6/2023 – 4/2024). Results: We used a p-chart to assess our outcome measure of OncotypeDX availability at the time of office visit with medical oncology, a key metric for both treatment planning and patient trust. We observed a positive trend of seven data points in the most recent data when mapping the 270 patients by consecutive groups of 10. In our most recent data pull from April 2024, 85% (22/26) of patients who required an OncotypeDX had one completed at the time of office visit, in comparison to 50% (20/40) in August 2023, the month prior to the intervention. We used XmR and S charts to determine impact on delay from specimen collection to OncotypeDX order, which showed increased precision and a trend of decreased delay after implementing the nurse coordinator. The overall delay decreased from an average of 28 days pre-intervention (9/2022-9/2023) to 24 days in the most recent post-intervention data (3/2024). Average time between order and delivery, our balancing measure, decreased during these time periods from 16 days to 13 days. Conclusions: Implementing a nurse coordinator improved delays in specimen collection to order and order to receipt. This intervention increased the percentage of patients who had an OncotypeDX result at the time of office visit with medical oncology after surgery.

Buoyancy glitches in pulsating stars revisited

Sharp structural variations induce specific signatures on stellar pulsations that can be studied to infer localised information on the stratification of the star. This information is key to improve our understanding of the physical processes that lead to the structural variations and how to model them. Here we revisit and extend the analysis of the signature of different types of buoyancy glitches in gravity-mode and mixed-mode pulsators presented in earlier works, including glitches with step-like, Gaussian-like, and Dirac-δ-like shapes. In particular, we provide analytical expressions for the perturbations to the periods and show that these can be reliably used in place of the expressions provided for the period spacings, with the advantage that the use of the new expressions does not require modes with consecutive radial orders to be observed. Based on a comparison with two limit cases and on simulated data, we further tested the accuracy of the expression for the Gaussian-like glitch signature whose derivation in an earlier work involved a significant approximation. We find that the least reliable glitch parameter inferred from fitting that expression is the amplitude, which can be up to a factor of two larger than the true amplitude, reaching this limit when the glitch is small. We further discuss the impact on the glitch signature of considering a glitch in the inner and outer half of the g-mode cavity, emphasising the break of symmetry that takes place in the case of mixed-mode pulsators.

Assessing the Readability of Patient Education Materials on Cardiac Catheterization From Artificial Intelligence Chatbots: An Observational Cross-Sectional Study.

Artificial intelligence (AI) is a burgeoning new field that has increased in popularity over the past couple of years, coinciding with the public release of large language model (LLM)-driven chatbots. These chatbots, such as ChatGPT, can be engaged directly in conversation, allowing users to ask them questions or issue other commands. Since LLMs are trained on large amounts of text data, they can also answer questions reliably and factually, an ability that has allowed them to serve as a source for medical inquiries. This study seeks to assess the readability of patient education materials on cardiac catheterization across four of the most common chatbots: ChatGPT, Microsoft Copilot, Google Gemini, and Meta AI. A set of 10 questions regarding cardiac catheterization was developed using website-based patient education materials on the topic. We then asked these questions in consecutive order tofour of the most common chatbots: ChatGPT, Microsoft Copilot, Google Gemini, and Meta AI. The Flesch Reading Ease Score (FRES) was used to assess the readability score. Readability grade levels were assessed using six tools: Flesch-Kincaid Grade Level (FKGL), Gunning Fog Index (GFI), Coleman-Liau Index (CLI), Simple Measure of Gobbledygook (SMOG) Index, Automated Readability Index (ARI), and FORCAST Grade Level. The mean FRES across all four chatbots was 40.2, while overall mean grade levels for the four chatbots were 11.2, 13.7, 13.7, 13.3, 11.2, and 11.6 across the FKGL, GFI, CLI, SMOG, ARI, and FORCAST indices, respectively. Mean reading grade levels across the six tools were 14.8 for ChatGPT, 12.3 for Microsoft Copilot, 13.1 for Google Gemini, and 9.6 for Meta AI. Further, FRES values for the four chatbots were 31, 35.8, 36.4, and 57.7, respectively. This study shows that AI chatbots are capable of providing answers to medical questions regarding cardiac catheterization. However, the responses across the four chatbots had overall mean reading grade levels at the 11th-13th-grade level, depending on the tool used. This means that the materials were at the high school and even college reading level, which far exceeds the recommended sixth-grade level for patient education materials. Further, there is significant variability in the readability levels provided by different chatbots as, across all six grade-level assessments, Meta AI had the lowest scores andChatGPT generally had the highest.

Appropriateness and imaging outcomes of ultrasound, CT, and MR in the emergency department: a retrospective analysis from an urban academic center.

To evaluate the appropriateness and outcomes of ultrasound (US), computed tomography (CT), and magnetic resonance (MR) orders in the ED. We retrospectively reviewed consecutive US, CT, and MR orders for adult ED patients at a tertiary care urban academic center from January to March 2019. The American College of Radiology Appropriateness Criteria (ACRAC) guidelines were primarily used to classify imaging orders as "appropriate" or "inappropriate". Two radiologists in consensus judged specific clinical scenarios that were unavailable in the ACRAC. Final imaging reports were compared with the initial clinical suspicion for imaging and categorized into "normal", "compatible with initial diagnosis", "alternative diagnosis", or "inconclusive". The sample was powered to show a prevalence of inappropriate orders of 30% with a margin of error of 5%. The rate of inappropriate orders was 59.4% for US, 29.1% for CT, and 33.3% for MR. The most commonly imaged systems for each modality were neuro (130/330) and gastrointestinal (95/330) for CT, genitourinary (132/330) and gastrointestinal (121/330) for US, neuro (273/330) and gastrointestinal (37/330) for MR. Compared to inappropriately ordered tests, the final reports of appropriate orders were nearly three times more likely to demonstrate findings compatible with the initial diagnosis for all modalities: US (45.5 vs. 14.3%, p < 0.001), CT (46.6 vs. 14.6%, p < 0.001), and MR (56.3 vs. 21.8%, p < 0.001). Inappropriate orders were more likely to show no abnormalities compared to appropriate orders: US (65.8 vs. 38.8%, p < 0.001), CT (62.5 vs. 34.2%, p < 0.001), and MR (61.8 vs. 38.7%, p < 0.001). The prevalence of inappropriate imaging orders in the ED was 59.4% for US, 29.1% for CT, and 33.3% for MR. Appropriately ordered imaging was three times more likely to yield findings compatible with the initial diagnosis across all modalities.

A tensor renormalization group analysis of an evolutionary game of competing Ising and Potts subgames

The temperature-induced phase transitions of an evolutionary game of competing Ising- and Potts-type coordination subgames are studied using the tensor renormalization group method proposed by Michael Levin and Cody P. Nave. Depending on the relative strength of the subgames, a continuous Ising order to disorder or a continuous Potts order to disorder or consecutive first-order Potts order to Ising order and continuous Ising order to disorder phase transitions are observed. In the game-theoretic interpretation of the model, these results imply that while both types of coordination can spread in the population at low noise levels, one of them will always be dominant in equilibrium. Under a relatively narrow set of circumstances, a small increase in noise can cause the population to suddenly switch from Ising-type coordination to Potts-type coordination. The results are in general qualitative and quantitative agreement with previous Monte Carlo simulation findings.

The GARD Prebiotic Reproduction Model Described in Order and Complexity.

Early steps in the origin of life were necessarily connected to the unlikely formation of self-reproducing structures from chaotic chemistry. Simulations of chemical kinetics based on the graded autocatalysis replication domain (GARD) model demonstrate the ability of a micellar system to become self-reproducing units away from equilibrium. Even though they may be very rare in the initial state of the system, the property of their endogenous mutually catalytic networks being dynamic attractors greatly enhanced reproduction propensity, revealing their potential for selection and Darwinian evolution processes. In parallel, order and complexity have been shown to be crucial parameters in successful evolution. Here, we probe these parameters in the dynamics of GARD-governed entities in an attempt to identify characteristic mechanisms of their development in non-covalent molecular assemblies. Using a virtual random walk perspective, a value for consecutive order is defined based on statistical thermodynamics. The complexity, on the other hand, is determined by the size of a minimal algorithm fully describing the statistical properties of the random walk. By referring to a previously published diagonal line in an order/complexity diagram that represents the progression of evolution, it is shown that the GARD model has the potential to advance in this direction. These results can serve as a solid foundation for identifying general criteria for future analyses of evolving systems.

P935 Remission rates of biologics and small molecules in extension studies of moderate to severe Ulcerative Colitis; A systematic review and Network Meta-analysis

Abstract Background Ulcerative colitis is a relapsing and remitting inflammatory bowel disease characterised by symptoms of bloody diarrhoea and abdominal pain. In recent years, newer therapies have emerged such as biologics and small molecule therapies. However, these therapies have not been compared head-to-head in the longer term, and the choice in clinical practice is often at the discretion of the clinician. In this study we aim to compare these biologics and small molecule therapies across outcomes such as remission (as defined by the Mayo score) as well as histological, endoscopic and corticosteroid free remission in data beyond 52 weeks of medication administration. Methods Medical databases including MEDLINE, EMBASE and Cochrane were searched for phase III and IV randomised control trials examining efficacy of biologic and small molecule therapies in adults with moderate to severe ulcerative colitis beyond 52 weeks. A network meta-analysis was performed using the frequentist model to compare the aforementioned outcomes with pooled relative risk, heterogeneity and P values used to rank treatments. Results 13 randomised control trials (RCT) were included for analysis from a screen of 2516 abstracts. Of these 13 RCTs, there were 8 treatments directly compared to placebo beyond week 52. In terms of remission as defined by the Mayo score, Upadacitinib 30mg was found to be the best treatment for moderate-severe ulcerative colitis when compared to Upadacitnib 15mg, Vedolizumab and Etrolizumab in consecutive order. In achieving histological remission, Upadacitinib 30mg was superior to Upadacitinib 15mg, Filgotinib (200mg and 100mg) and Etrolizumab. For endoscopic remission, Upadacitinib 30mg was superior to Upadacitinib 15mg, Filgotinib (200mg and 100mg), Vedolizumab, Etrolizumab and Golimumab. For corticosteroid free remission, Filgotinib 200mg was superior to Golimumab, Upadacitinib (30mg and 15mg), Vedolizumab and Etrolizumab. Conclusion Large head-to-head trials of biologic and small molecule therapies in the treatment of moderate to severe ulcerative colitis beyond 52 weeks have not been performed. However, our results show Upadacitinib 30mg to be efficacious in terms of remission defined by the Mayo score as well as histologic, endoscopic and corticosteroid free remission when compared to other biologics and small molecule therapies. Whilst these newer therapies show promise, their overall performance over an extended period remains unclear and their use often precludes the efficacy of subsequent biologic or small molecule therapies. As such, the first choice of therapy must be made carefully to increase the probability of remission whilst also balancing the burden of adverse events.

Contextual Meanings of Similarities in Âşık Veysel’s Poems

Analysis of the signs used in the language of poetry means bringing what the poet wants to say from the deep structure to the surface structure. Poetry is the art of bringing signs together accurately and artistically. What this means is that the desired emotion of the poem is conveyed by bringing the chosen language elements together harmoniously. These language elements which come together form the framework of the poetic language with the semantic bonds they create with each other. The concept of "context" determines how all the words that make up the poem will come together. The language used in poetry is a tool for the poet. While using language as a tool, the poet will want to convey their thoughts and feelings to the reader through context. However, it’s not possible for them to go out of context while doing this. The concept of word, which corresponds to a sign in language, cannot be separated from the context. Words must be in a consecutive order to form a meaningful text sequence because the signs in language are linear. When using language, sounds and words are placed one after the other. When the words connect to each other, a meaningful relationship will arise between them. As a result of this meaningful relationship, contextual meanings emerge. In this study, the contextual meanings of the metaphors identified in Âşık Veysel's poems are explained through tables. Before moving on to the review section, brief information and examples are given about the concepts of sign/referent/context.

Machine-learning applications for differentiation across states/stages of creative thinking based on time-series and time-frequency features of EEG/ERP signals

BACKGROUND: The study presents machine-learning (ML) classification approaches for the state/stage differentiation of creative tasks using the “test-control” approach. The control tasks were considered as the initial stages of the creative activity. Time-series and time-frequency electroencephalography (EEG) data analyses were employed in three divergent thinking tasks: 1) creating endings to well-known proverbs (“PROVERBS”, event-related potential [ERP] paradigm); 2) creating stories (“STORIES”, continuous EEG); 3) free creative painting (“viART”, continuous EEG). AIM: To compare and select effective ML classification approaches for EEG signal separation at different stages or states of creative task performance. METHODS: In this study, 22 individuals participated in the “PROVERBS” (ERP paradigm), 15 in the “STORIES”, and 1 (a longitudinal case study) in the “viART” tasks. Linear and convolutional neural network (CNN) classifiers were used. EEG data were previous artifacts corrected and converted to current source density (CSD). Continuous EEGs were divided into 4-s intervals and 1500 ms after stimulus presentation, were used in ERPs. The EEG/ERP time-frequency maps (Morlet wavelet transformation) for 3–30 Hz were generated for 4-s intervals with 100 ms shift (continuous EEGs in “STORIES” and “viART”) or for 1500 ms after stimulus presentation (ERPs in “PROVERBS”) and consisted of combined images (224×224 px) for frontal (Fz) and parietal (Pz) brain zones. Image classification was carried out using the modified CNN (ResNet50, ResNet18 architectures). RESULTS: The offline classification accuracy of the four-class system (description of a picture, inventing a story plot, continuation of story’s plot, and background with open eyes) in the “STORY” creation task was up to 96.4% [±8.3 SD] with ResNet architectures (ResNet50 and ResNet18). The accuracy of the three states discrimination of the artists’ creative painting (resting state with open eyes, painting on canvas, and viewing the painting) was 86.94% for kernel naive bayes and 98.2% for CNN. For the trained and tested samples given for the CNN in consecutive order (neurointerface mode), the accuracy diminished to 70.0% [11% SD] on average. In the ERP paradigm “PROVERBS”, the classification accuracy of the three-class system (creation of “new” ending, naming of semantic synonym, and remembering of the known ending) was 80.5% [±8.7 SD] for the common spatial pattern, followed by rSVM (radial kernel basis support vector machine), compared with 43.2% [±8.8 SD] for CNN. CONCLUSION: The use of CNNs allowed better classifying of “continuous” long-term states of creative activity. In fast “transient processes” such as ERP, time-series classifiers with spatial filtering proved to be more efficient.

Expected spacing

The expected spacing, or average difference between consecutive order statistics, is known for uniform and exponential random variates. For other distributions, we can estimate it using the derivative of the inverse cumulative density (quantile) function, since passing a uniformly drawn value, whose spacing we know, through this function generates a random value from the distribution, and the difference between two such uniform values approximates the derivative. We calculate the spacing for two new distributions, the logistic and Gumbel, and show the estimator is exact for the first and approximate for the second. Comparing the estimators for six other distributions to numeric simulations shows they are also approximations, best in the middle of the order statistics with an error that goes inversely with the square of the sample size, but degrading in the tails.

Two-dimensional silver nanonetwork on Ag4Ti5O12 film as highly efficient SERS substrate

Surface Enhanced Raman Spectroscopy (SERS) is a powerful technique to study and detect single molecules adsorbed onto a surface. In this work, molar concentrations were varied over three consecutive orders of magnitude (10-3 M, 10-6 M, 10-9 M) of Methylene Blue (MB) to study SERS on different thicknesses of silver (6, 8, 10, 12 nm) coated on Ag4Ti5O12 deposited onto glass substrates as the base material. The Ag4Ti5O12 thin films were prepared by a unique ion-exchange method where Li4Ti5O12 thin films were initially deposited by the sol–gel method followed by the exchange of Li+ ion with Ag+ ion. The varied thicknesses of thermally deposited Ag-thin films were grown with unaltered Ag+ ions nucleation sites atop the Ag4Ti5O12 layer to create the two-dimensional (2D) nanonetwork. The structure and morphology of the as-prepared thin-film samples were characterized using X-ray diffraction, Scanning Electron Microscopy (SEM), and Atomic Force Microscopy (AFM) techniques. The SERS enhancement factor (EF), calculated using Raman spectroscopy, showed the systematic changes in the Raman signal enhancement as a function of Ag-thickness. The 10 nm thick as-deposited Ag sample showed the highest signal enhancement in Raman spectra than the other Ag thickness films. The successive signal enhancement was obtained due to forming the critical nuclei size of Ag on top of Ag4Ti5O12, which was further bolstered with film surface roughness and surface energy measurements. The as-prepared Ag-10 nm sample showed the lowest film roughness of ∼2.07 nm, in tune with the maximum enhancement factor (EF). We believe this work could open wide opportunities for developing efficient SERS substrates with sensing capabilities for ultra-low analyte concentration coupled with low cost and high enhancement factors.

Technological disparity and its impact on market quality

Technological investments made by speed-sensitive market participants are increasingly frequent and have thus been a focal point of recent research. We examine an important, but unexplored facet of this trend: the technological disparity between the fastest market participants and the exchange itself. Using a proprietary dataset of a high-frequency market maker's limit orders and order acknowledgments timestamped to the nanosecond, we explore the consistency and reliability of an exchange's ability to discern the correct sequence of orders when messages are submitted in rapid (sub-microsecond) succession. We find a high degree of variability in acknowledgement times, and the proportion of times in which the first order entered is also first to be acknowledged is surprisingly low when consecutive orders are placed at very high frequencies. Furthermore, we provide evidence of impaired market quality as a result. These issues remain pertinent even following substantial technological improvements made by the exchange, because of the ongoing technological disparity between the exchange and the fastest market participants, who continue to competitively invest in technological improvements.

INNV-02. USAGE TRENDS OF COLLAGEN TILE BRACHYTHERAPY FOR THE FIRST 1000 ORDERS

Abstract INTRODUCTION Collagen tile brachytherapy (CTBT) was cleared by the FDA in 2018 for all recurrent intracranial neoplasms and in 2020 for newly diagnosed intracranial neoplasms. We sought to describe usage trends of CTBT by evaluating the first 1000 consecutive orders since CTBT became commercially available in 2019 with respect to tumor type (glioma, brain metastasis, meningioma) and CTBT treatment setting (newly diagnosed, recurrence with prior radiation, recurrence without prior radiation). METHODS Commercial data was accessed using Salesforce, Inc. Coefficient of correlation (r2) was estimated as a measure of orders over time. 1000 orders were divided into 4 time cohorts (Cohort 1 for 1st 250 orders, Cohort 2 for 2nd 250 orders, Cohort 3 for 3rd for 250 orders and Cohort 4 for 4th 250 orders). Order proportions were compared among time cohorts using X2 tests. RESULTS Time period for 1000 orders among 93 centers was 1/23/19–5/11/23. Over these 17 completed yearly quarters there was a positive trend in ordering frequency (r2=0.97). Tumor type was known for 917 orders, of which 52.2% were glioma, 37.4% metastases, and 10.4% meningioma. Proportions of orders for tumor type did not change over time cohorts (p=0.26). Treatment setting was known for 816 orders, of which 80.3% were in recurrence with previous radiation, 14.3% newly diagnosed, and 5.4% recurrence without previous radiation. For glioma and meningioma, treatment setting did not change over time cohorts (p=0.5, p=0.3, respectively). However, for metastases, the proportion of orders for use in the newly diagnosed setting increased over time: 6.4% in Cohort 1, 19.2% in Cohort 2, 21.6% in Cohort 3, 34.7% in Cohort 4 (p&amp;lt; 0.001). CONCLUSION CTBT usage is increasing over time. Proportions of orders among tumor types (glioma, meningioma, metastases) has not changed. However, use of CTBT is increasing in the newly diagnosed setting for brain metastases.

Metabolic dysfunction-associated steatotic liver disease increases the risk of incident cardiovascular disease: a nationwide cohort study

The various subcategories under the overarching term of steatotic liver disease (SLD) have been recently proposed by the nomenclature consensus group and endorsed by international academic liver societies. Our aim was to investigate the association between each subtype of SLD and incident cardiovascular disease (CVD) in a nationwide Korean cohort. From a nationwide health screening database from Korea, 351,068 individuals aged 47-86 years between January 1, 2009 and December 31, 2010 were included and followed until December 31, 2019 for a median of 9.0 years. Individuals were categorised into no SLD, metabolic dysfunction-associated steatotic liver disease (MASLD), MASLD with increased alcohol intake (MetALD), and alcohol-related liver disease (ALD). Hepatic steatosis was defined as fatty liver index ≥60. The primary outcome was a composite CVD, which includes non-fatal and fatal myocardial infarction and stroke. The subdistribution hazard ratio (SHR) was calculated using the Fine-Gray model with treating non-CVD-related death as a competing risk. There were 199,817 male (56.9%) and 151,251 female (43.1%) with a median age of 55 years (interquartile range, 50-61). The prevalence of no SLD, MASLD, MetALD, and ALD was 44.3%, 47.2%, 6.4%, and 2.1%, respectively; and the incidence rate of CVD in each subcategory was 6.2, 8.5, 8.5, and 9.6 per 1000 person-years, respectively. MASLD (SHR, 1.19; 95% confidence interval [CI], 1.15-1.24), MetALD (SHR, 1.28; 95% CI, 1.20-1.36), and ALD (SHR, 1.29; 95% CI, 1.18-1.41) increased the risk of CVD compared to no SLD, which increment was in consecutive order (Ptrend < 0.001). Individuals with MASLD, MetALD, or ALD are at an increased risk of developing incident CVD. Higher risk of CVD observed in MetALD compared to MASLD suggests the additive impact of alcohol consumption in conjunction with cardiometabolic risk factors on CVD development. These findings support and validate the utility of the new consensus criteria for SLD in predicting CVD. The National Research Foundation of Korea and the Korea Centers for Disease Control and Prevention.

Hybrid multi-objective evolutionary meta-heuristics for a parallel machine scheduling problem with setup times and preferences

Fabric dyeing is a vital production process of textile products. In the dyeing process, orders are scheduled to machines, and the sequence of jobs on a machine is crucial since the machines require washing out that depends on the type of consecutive orders. This washing out process is a significant cost factor of the dyeing process because of the chemicals used, which causes sequence dependent setup times. Also, the order of the products to be processed is important in terms of quality that depends on color and shade of the jobs. In this paper, two metaheuristics, namely a non-dominated sorting genetic algorithm (NSGA-II) and multi-objective evolutionary algorithm based on decomposition (MOEA/D) are presented to solve the multi-objective scheduling problem for the dyeing process with sequence dependent setup times, in which the objectives are makespan, tardiness, total number of setups, color preference, and shade difference. Two different gene designs and corresponding feasible schedule generation methods — one heuristic based and one integer programming based, which are integrated within the metaheuristic framework, are proposed. Finally, proposed algorithms are compared based on single and multiple objective analysis. From the tests conducted, we observed that the use of hybrid-optimal approaches integrated within the meta-heuristic frameworks provide higher quality solutions but suffer from longer computation times.

Coverage error and shade-match accuracy in three ceramic gingival systems

Research into the coverage error (CE) of gingival systems that have been expanded by using ceramic specimens created by mixing basic colors is lacking. The purpose of this in vitro study was to compare the CEs of 3 ceramic gingival color systems that have been expanded with basic-color mixtures from a sample of 360 White participants and to classify the participants according to the accuracy of the shade match achieved with each system. L*a*b* color coordinates were recorded in 3 zones of attached gingiva for 360 White participants with healthy gingival tissue (187 men and 173 women). The CEs were calculated for 3 ceramic gingival systems that had been expanded with specimens obtained by mixing the basic colors in consecutive order, the color percentages in each mixture having been altered by 10% increments. The systems were Heraceram (Kulzer GmbH) (n=51); Vita VM9 (Vita-Zahnfabrik) (n=41); and IPS Style (Ivoclar AG) (n=41). The participants were classified into 3 groups according to how well the selected shade matched their gingival color (excellent, acceptable, or poor). The data were analyzed using a 1-way ANOVA with a randomized block design and the homogeneity of proportions test (α=.05). Statistically significant differences were found between the CEs of the 3 expanded gingival systems in the 3 zones where gingival color was measured (P<.001). The expanded Heraceram system had the smallest CE (ΔE00: minimum 2.66 in the middle zone and maximum 2.95 at the mucogingival line). In the 3 gingival zones, the expanded IPS Style system produced the largest percentage of participants with a poor shade match (ΔE00: minimum 71.4% at the mucogingival line and maximum 75.8% at the free gingival margin), while the expanded Heraceram system had the lowest percentage of participants with a poor shade match (ΔE00: minimum 33.3% in the middle zone and maximum 41.7% at the mucogingival line). The CEs calculated for the expanded Vita VM9 and IPS Style ceramic gingival color systems exceeded the clinical acceptability thresholds in the 3 zones examined. According to the ΔE00 formula, the gingival color of at least 33% of participants matched poorly with the expanded systems studied.

Formant change and individual variation in male-to-female transgender speakers during voice therapy

Increased fundamental frequency (F0), resonance frequency (F2), and vowel formant frequency (F1, F2, F3) are linked to be perceived as feminine, making them desired outcomes of successful gender-affirmative voice therapy for male-to-female transwomen (MTF). However, treatment often only targets pitch, reporting F0 as an acoustic outcome measure. Vowel formants are measured less often and show inconsistent results. We retrospectively explored the effect of voice therapy on formants of Australian English /i:/. 44 MTF speakers were treated with Sob Voice Therapy using the Optimal Phonation Task, Sob Voice Quality, and Sob Variant therapy components in consecutive order. Speakers were recorded at baseline and after mastering each therapy component. F1, F2, and F3 were extracted at /i:/ target in maximally three words per component. Formant values were analyzed using linear mixed models with therapy component and therapy length as fixed effects and patient as random effect. We found no statistically significant effect of therapy component nor session on formant values at p = 0.05. Graphic inspection of the data suggests between-speaker variation, indicating that some patients may respond to treatment despite the lack of group effect. Future research may explore other acoustic outcome measures for the efficacy of gender-affirmative voice therapy.

Higher order Morita approximation and its validity for random copolymer adsorption onto homogeneous and periodic heterogeneous surfaces

Adsorption of a single AB random copolymer (RC) chain onto homogeneous and inhomogeneous ab surfaces with a regular periodic pattern is studied theoretically. For the averaging over disorder in the RC sequence, the constrained annealed approximation, known as the Morita approximation is employed. A general scheme for constructing the Morita approximation of an arbitrary order m is proposed; it is based on representation of the RC monomer sequence as a Markov chain of overlapping –1)-ads. The problem is solved within the framework of the generating functions approach for the two-dimensional partially directed walk model of the polymer on a square lattice. Temperature dependences of various adsorption characteristics are obtained. The accuracy of the Morita approximation is assessed by comparison with the numerical results for RC with quenched sequences obtained by the transfer matrix approach. It is shown that for RC adsorption on a homogeneous surface for AB-copolymers with adsorbing A and neutral B blocks, it is sufficient to use the Morita approximation of second or third order. If the non-adsorbing B block is repelled from the surface, then a higher order of the approximation (5th–6th) is required. An important indicator of validity of the Morita approximation is the entropy: if the order of the approximation is not high enough, the entropy becomes negative in the low-temperature regime which means that the Morita approximation is wrong in this order. In the case when the surface is periodically inhomogeneous, the Morita approximation works worse and very high orders are required, which can be beyond the computational capabilities. Moreover, the Morita approximations become degenerate: approximations of two or more consecutive orders give the same result.

Courier Dispatch in On-Demand Delivery

We study a courier dispatching problem in an on-demand delivery system in which customers are sensitive to delay. Specifically, we evaluate the effect of temporal pooling by comparing systems using the dedicated strategy, with which only one order is delivered per trip, versus the pooling strategy, with which a batch of consecutive orders is delivered on each trip. We capture the courier delivery system’s spatial dimension by assuming that, following a Poisson process, demand arises at a uniformly generated point within a service region. With the same objective of revenue maximization, we find that the dispatching strategy depends critically on customers’ patience level, the size of the service region, and whether the firm can endogenize the demand. We obtain concise but informative results with a single courier and assuming that customers’ underlying arrival rate is large enough, meaning a crowded market, such as rush hour delivery. In particular, when the firm has a growth target and needs to achieve an exogenously given demand rate, using the pooling strategy is optimal if the service area is large enough to fully exploit the pooling efficiency in delivery. Otherwise, using the dedicated strategy is optimal. In contrast, if the firm can endogenize the demand rate by varying the delivery fee, using the dedicated strategy is optimal for a large service area. The reason is that it is optimal for the firm to sustain a relatively low demand rate by charging a high fee for a large service radius: within this large area, the pooling strategy leads to a long wait because it takes a long time for multiple orders to accumulate. Moreover, with an exogenous demand rate to meet, customers’ patience level has no impact on the dispatch strategy. However, when the demand rate can be endogenized, the dedicated strategy is preferable if customers are impatient. Furthermore, we extend our model to account for social welfare maximization, a hybrid contingent delivery policy, a general arrival rate that does not have to be large, a nonuniform distribution of orders in the service region, and multiple couriers. We also conduct numerical analysis and simulations to complement our main results and find that most insights in our base model still hold in these extensions and numerical studies. This paper was accepted by Jeannette Song, operations management. Funding: This work was supported by the Natural Sciences and Engineering Research Council of Canada [Grants RGPIN-2015-06757 and RGPIN-2021-04295]. Supplemental Material: The online appendix and data are available at https://doi.org/10.1287/mnsc.2023.4858 .