High-quality Outcomes Research Articles

Hyaluronidase for reducing perineal trauma.

Perineal trauma after vaginal birth is common and can be associated with short- and long-term health problems. Perineal hyaluronidase (HAase) injection has been widely used to reduce perineal trauma, perineal pain and the need for episiotomy since the 1950s. The administration of HAase is considered to be a simple, low risk, low cost and effective way to decrease perineal trauma without causing adverse effects. To assess the effectiveness and safety of perineal HAase injection for reducing perineal trauma, episiotomy and perineal pain during vaginal delivery. To identify studies for inclusion in this review, we searched the Cochrane Central Register of Controlled Trials, Ovid MEDLINE, Embase, CINAHL (EBSCOhost), ClinicalTrials.gov and WHO International Clinical Trials Registry Platform (ICTRP) in November 2023. Randomised and quasi-randomised controlled trials comparing women giving birth to their first baby receiving perineal HAase injection compared to placebo injection or no intervention during vaginal delivery of a single foetus with vertex foetal presentation (foetus with head engaging the maternal pelvis). We used standard methodological procedures expected by Cochrane. Two review authors independently assessed trials for inclusion, extracted and checked data, and evaluated the risk of bias in the studies. Our primary outcomes were perineal trauma (tears or episiotomy, or both), episiotomy and perineal pain. Our secondary outcomes were first and second degree perineal lacerations, third and fourth degree perineal lacerations, perineal oedema 1 hour after vaginal delivery, perineal oedema 24 hours after vaginal delivery and neonatal Apgar scores of less than 7 at five minutes after birth (Apgar score is a measure of the health status of a newborn). We assessed the certainty of the evidence using the GRADE approach. We included five randomised controlled trials involving a total of 747 women (data were available for 743 women). The dosage of HAase used in the perineal injection varied from 750 turbidity-reducing units to 5000 international units. The certainty of the evidence was largely low (ranging from very low to moderate). Perineal HAase injection versus placebo injection Data from three trials involving 426 women provided low-certainty evidence that there may be no difference between the HAase and placebo groups in the incidence of perineal trauma (tears or episiotomy, or both) (RR 0.94, 95% CI 0.87 to 1.03; 426 participants, 3 studies), episiotomy (RR 0.91, 95% CI 0.71 to 1.15; 427 participants, 3 studies), first and second degree perineal lacerations (RR 1.02, 95% CI 0.87 to 1.18; 341 participants, 3 studies), third and fourth degree perineal lacerations (RR 0.46, 95% CI 0.11 to 2.05; 426 participants, 3 studies), and perineal oedema one hour after vaginal delivery (RR 0.99, 95% CI 0.78 to 1.25; 303 participants, 2 studies). Moreover, perineal HAase injection during the second stage of labour likely resulted in a reduction in incidence of perineal oedema 24 hours after vaginal delivery compared with placebo injection (RR 0.42, 95% CI 0.26 to 0.70; 303 participants, 2 studies; moderate-certainty evidence). There may be no difference between groups in Apgar scores less than 7 at five minutes (RR 5.00, 95% CI 0.24 to 105.95; 148 participants, 1 study; low-certainty evidence). Perineal HAase injection versus no intervention Data from three trials involving 373 women suggested that perineal HAase injection during the second stage of labour may result in a lower incidence of perineal trauma (tears or episiotomy, or both) (RR 0.61, 95% CI 0.42 to 0.88; 373 participants, 3 studies; low-certainty evidence) compared with no intervention. The evidence is very uncertain for episiotomy (RR 0.79, 95% CI 0.44 to 1.42; 373 participants, 3 studies), first and second degree perineal lacerations (RR 0.59, 95% CI 0.30 to 1.18; 373 participants, 3 studies) and perineal oedema one hour after vaginal delivery (RR 0.32, 95% CI 0.01 to 7.71; 139 participants, 1 study), all very low certainty evidence. No third and fourth degree perineal lacerations, perineal oedema 24 hours after vaginal delivery or Apgar scores less than 7 at five minutes were reported in these three trials. No side effects were reported in the included trials. Perineal HAase injection during the second stage of labour may result in a lower incidence of perineal trauma (tears or episiotomy, or both) compared with no intervention, but not compared with placebo injection, in women having a vaginal delivery. Meanwhile, perineal HAase injection likely reduces the incidence of perineal oedema 24 hours after vaginal delivery compared with placebo injection. The potential use of perineal HAase injection as a method to reduce perineal trauma and perineal oedema remains to be determined as the number of high-quality trials and outcomes reported was too limited to draw conclusions on its effectiveness and safety. Further rigorous randomised controlled trials are required to evaluate the role of perineal HAase injection in vaginal deliveries, including evaluating whether there is any differential effect based on the dose, frequency and positioning of HAase injection.

Relationships between self-efficacy and learning approaches as perceived by computer science students

Optimizing learning outcomes in university students necessitates an understanding of the processes that drive high-quality learning outcomes. This study investigates the motivational factors and learning methodologies perceived by computer science students during an introductory course. A cross-sectional study was conducted with 171 computer science students asked to complete a psychometric instrument (“Study Skills Inventory for Students”) during the first year of their university studies. Two major theoretical frameworks in educational psychology, namely students’ self-efficacy and learning approaches were tested relative to a factor structure obtained from learning situations. The findings supported self-efficacy and three learning approaches among computer science students. Models for deep, surface, and strategic learning approaches suggest that students with higher self-efficacy tend to adopt a deeper approach to learning. Conversely, students with lower self-efficacy were more inclined toward surface learning methods. Furthermore, a link was identified between strategic learning approaches and students’ experiences within their learning environments. The results substantiate earlier research and align with learning approach theories. The findings indicated that, in higher education settings, focus should be directed toward understanding the motivational factors influencing students and their learning approaches for educational outcomes.

2D animation comic character action generation technology based on biomechanics simulation and artificial intelligence

AI can greatly improve the process of creating 2D character animations, especially for platformer games. The objective is to enhance visual effects quality and streamline production by incorporating biomechanics and AI-driven technology into the animation process. The current state of study shows that conventional 2D animation production has several problems, such as lengthy procedures, complicated technical requirements, and the requirement for human involvement. Both efficiency and innovation are limited by these limitations. To solve this problem, we suggest generating 2D character animations using AI-driven generative methods and biomechanics simulation. Consistently high-quality outcomes can be achieved by automating aspects of animation design. Improving animation industry innovation, streamlining production workflows, and decreasing manual labor are crucial. The viability of 2D animations generated by AI has been demonstrated in preliminary studies. Artificial intelligence’s effects on animation’s expressiveness, realism, and aesthetics are covered in detail. Furthermore, it has presented challenges with training data, choosing the right model, and fine-tuning. Beyond the field of gaming, our research has wider implications. Several industries may benefit from the benefits of 2D animations enhanced with AI and biomechanics technology. These industries include advertising, entertainment, and education.

Manajemen Keuangan Madrasah dalam Pengadaan Sarana dan Prasarana Pendidikan

This study underscores the importance of effective financial management in the procurement of educational facilities and infrastructure at MA Al Washoya Ngoro Jombang, aiming to support optimal learning processes. Effective financial management is essential to ensure that the madrasah can provide adequate facilities in line with established educational standards. The objective of this research is to analyze how financial management is implemented at MA Al Washoya, focusing on planning, inventory, and evaluation related to the procurement of educational facilities and infrastructure.The research employs a qualitative descriptive approach, using data collection techniques such as observation, interviews, and documentation. The study examines the financial planning process involving the Waka Sarpras, fund allocation based on annual work meetings, and how inventory and financial evaluation are conducted to ensure proper and efficient use of funds.The findings reveal that financial management at MA Al Washoya is functioning reasonably well; however, there are areas requiring improvement, particularly in optimizing procurement and maintenance of existing facilities and infrastructure. The evaluation indicates that, although facilities and infrastructure have been planned and procured, better maintenance is needed to ensure their sustainability. The study recommends that the madrasah be more proactive in financial planning and asset maintenance strategies to ensure the achievement of high-quality and sustainable educational outcomes.

Best Evidence Summary for Management of Older People With Type 2 Diabetes Mellitus Using 'Internet Plus Nursing Services'.

To evaluate and summarise the evidence for the management of older people with Type 2 diabetes mellitus (T2DM) using 'Internet Plus nursing services (IPNS)'. This study was conducted as an evidence summary, adhering strictly to the evidence summary reporting standards established by Fudan University Center for Evidence-based Nursing. We systematically searched for the best available evidence pertaining to the management of older people with T2DM using the IPNS. The literature types encompassed clinical guidelines, expert consensuses, systematic reviews, evidence summaries and original research studies. In order to gather pertinent information, we conducted a comprehensive search across various databases, including UpToDate, BMJ Best Practice, Joanna Briggs Institute, Guidelines International Network, National Institute for Health and Care Excellence, Registered Nurses Association of Ontario, Scottish Intercollegiate Guidelines Network, the Cochrane Library, PubMed, Web of Science, Yi Maitong Guidelines Network, SinoMed, CNKI, WanFang database, Chinese Biomedical Literature Database and China Science and Technology Journal Database. The search spanned from the inception of each database up to July 2023, ensuring an extensive coverage of relevant resources. After rigorous screening and evaluation, our study ultimately identified 19 articles with high-quality research outcomes. These articles consisted of three guidelines, two expert consensus documents, three systematic reviews and eleven original research studies. Through collaborative and in-depth discussions, we extracted and synthesised 27 pieces of evidence related to the application of the IPNS to enhance the T2DM management for older people. We categorised the evidence into five primary themes: mobile terminal design, team building, health education design, interaction and social support, and information feedback. In designing the IPNS for older people with T2DM, utmost attention should be paid to the intricacies of Internet module development preceded by comprehensive guidance. It is imperative to establish multidisciplinary teams to oversee the curation of patient educational content, ensuring its relevance and effectiveness. Leveraging Internet-based information feedback mechanisms is crucial for fostering peer support, assisting in blood glucose control, enhancing self-management capabilities and ultimately improving overall quality of life. Healthcare professionals are supposed to customise the IPNS for this vulnerable population, taking into account institutional resources and local contextual realities. It is highly recommended that clinical medical personnel worldwide adhere to the evidence-based recommendations for better care of older people with T2DM using the IPNS. No patient or public contribution was incorporated in this study. Our study provides structured ideas for the application of IPNS in T2DM management, provides practicable new ways for IPNS to improve self-management of older people with T2DM, and encourages the provision of Internet-based nursing services based on the needs and characteristics of older people, and jointly solves the challenges of T2DM management in order to enhance the effectiveness of nursing services.

Prediction of feed force with machine learning algorithms in boring of AISI P20 plastic mold steel

Feed force plays a critical role in machining performance, including efficiency, hole quality, energy consumption, and tool life. While feed force is typically measured using dynamometers, these devices are often impractical in real-world experiments due to their complexity and cost. In particular, boring operations, which are essential for enlarging holes within tight tolerances, depend on precise feed force control to maintain high-quality hole outcomes. Achieving this precision requires reliable pre-process feed force estimation. However, traditional analytical methods for calculating feed force in boring operations often fall short, largely due to factors such as in-hole dynamics, the inclination of the rake surface, and the slenderness of the boring bar. This study aims to apply single and hybrid machine learning methods to accurately model and predict feed force in the boring process. Unlike previous research, which focused on feature selection, we propose the use of all possible combinations of input feature subsets to determine the optimal input features. The results indicate that feed force can be predicted effectively using these optimized feature combinations. Such accurate feed force prediction is crucial for effective process optimization, material selection, and process planning.

Temperature measurement in laser–metal processing using optical sensing: Radiometric calibration and validation of a multispectral camera

In laser–metal processing such as Laser-based Powder Bed Fusion of Metals (PBF-LB/M), the quality of the final product is significantly influenced by the thermal behaviour of the melt pool. Accurate temperature measurements are challenging due to high temperature gradients and rapid cooling. This study introduces Multispectral Imaging (MSI) as a highly effective thermometry technique to address these demanding conditions. MSI captures multiple bands of radiation, enabling the simultaneous determination of absolute temperature and surface emissivity. This capability is crucial for ensuring high-quality outcomes in laser–metal processing such as PBF-LB/M, contingent upon robust radiometric calibration.To enhance reliability, two radiometric calibration models were developed: an empirical model based on linear sensor data correlations and an analytical model leveraging sensor behaviour. An efficient calibration was found for both models across a range of signal-to-noise ratios in the black body calibrator, where the analytical model even performs robust under a high noise level.Additionally, the temperature accuracy in the solid-state case was tested with a thermo-mechanical simulator. Results showed that the empirical and analytical models achieved mean relative errors of 2.0% and 1.6%, respectively, outperforming the state-of-the-art. Further, laser irradiation experiments highlighted the analytical model’s ability to accurately determine the emissivity decrease during the solid-to-liquid transition, allowing for accurate melt pool temperature estimations. Conversely, the empirical model struggled to estimate temperature effectively in the liquid phase.This study not only proposed a robust methodology of MSI in temperature measurement but also confirmed the accuracy and reliability of the system, broadening the scope for further investigation into the intricate thermal dynamics involved in laser–metal interactions.

Disparities in the utilization of supportive care medications among older adults with metastatic pancreatic ductal adenocarcinoma.

51 Background: Inequities in cancer care delivery can profoundly affect access to high-quality treatments and patient outcomes. Supportive care medication use is important for preserving quality of life in older adults with metastatic pancreatic ductal adenocarcinoma (PDAC). Whether there are differences in supportive care medication use by race and sex is unknown. Our objectives were to assess the racial/ethnic and biological sex inequities in use of treatments for pain, depression, and pancreatic insufficiency-related treatments (PERT) among older adults with PDAC. Methods: We used the Surveillance, Epidemiology, and End Results-Medicare linked database, to identify Medicare beneficiaries aged 65 and older diagnosed with metastatic PDAC from January 2008 to December 2019. We included those continuously enrolled in Medicare prescription drug benefits in the 6 months before and month of diagnosis. Any use of opioid pain medications, antidepressants, and PERT was identified from diagnosis to the end of the study period (at death, disenrollment, or 12 months). Multivariable regression was used to compare supportive care medications use by racial/ethnic and biological sex groups. Results: There were 29,509 individuals in our sample, with12.9% Black patients, 3.9% Hispanic patients, and 83.2% White patients. The mean age was 76.5 (SD: 7.4) years. Mean follow-up time was 135.4 (SD:117.7) days overall, with the shortest follow-up among Black patients 124 (SD:111.1) days and longest for White patients 137.5 (SD: 118.8) days. Antidepressants were used by 23.8%, opioids by 60.3%, and PERT by 12.4% overall. Within race groups there were limited differences in medication use by sex. However, we observed differences in supportive care treatment use by race and ethnicity. Specifically, relative to White individuals, those who identified as Black were 20% less likely (adjusted risk ratio [aRR]: 0.8, 95% CI:0.74-0.85) to receive antidepressants, 14% less likely to receive opioids (aRR: 0.86, 95% CI:0.84-0.89), and 41% less likely to receive PERT (aRR: 0.59, 95% CI:0.53-0.65). Similar patterns were observed for patients of Hispanic ethnicity, with those individuals being 12% less likely (adjusted risk ratio[aRR]: 0.88, 95% CI:0.89-0.98) to receive antidepressants, 9% less likely to receive opioids (aRR: 0.91, 95% CI:0.87-0.96), and 42% less likely to receive PERT (aRR: 0.58, 95% CI:0.47-0.70). Conclusions: Our preliminary data showed differences in the uptake of supportive care drugs among Black and Hispanic patients relative to White patients. Specifically, these individuals were less likely to start opioid pain medications, antidepressants, and pancreatic enzyme replacement therapy compared to their White counterparts. These findings highlight potential gaps in treatment use that may better support patients facing life-limiting illnesses.

Achievement of international benchmark outcomes for robotic pancreaticoduodenectomy in a low volume country

BackgroundRecently, there has been an increase in the utilisation of the robotic platform to perform minimally invasive pancreaticoduodenectomy in high volume centres, with the goal of reducing morbidity and improving patient outcomes. This study reports the successful implementation of a robotic pancreaticoduodenectomy (RPD) programme in the relatively low volume setting of Australia, measured against established, internationally accepted benchmarks for low-risk open pancreaticoduodenectomy (OPD). MethodsRetrospective review of a prospectively maintained database for consecutive RPD at two Brisbane hospitals was performed, comparing data to internationally established benchmarks for low-risk OPD. A structured RPD programme was implemented by two surgeons across a study period spanning May 2017 to December 2023. ResultsOver the study period, seventy-two consecutive RPDs were performed, with 79 % for malignancy. Perioperative outcomes for transfusions, conversion rate, postoperative fistula rate, morbidity, mortality and oncological outcomes were all within established benchmark cutoffs for low-risk open pancreaticoduodenectomy (OPD), although operative time exceeded the benchmark value by 0.7hrs. ConclusionA carefully implemented RPD programme in the low volume Australian setting is feasible, with high quality outcomes achievable when compared to established benchmarks for low-risk OPD and to reported RPD series published by high volume pioneering centres.

Psychological distress, work environment quality, and motivation levels among nurses working in Saudi Arabia.

A favorable clinical environment and nurse motivation are both essential for achieving high-quality patient outcomes and organizational performance in healthcare systems, which can be highly distressing for nurses. The purpose of this study was thus to determine the associations among and influences of psychological distress, work environment quality, and motivation on one another. This was a cross-sectional, descriptive-correlational study conducted with a total sample of 204 nurses in two public tertiary hospitals. We used an online survey to collect nurses' responses, which comprised the Kessler Psychological Distress Scale-6, Brief Nurses' Practice Environment Scale, and Multidimensional Work Motivation Scale. We ran the necessary statistical analyses in SPSS version 28. We found that nurses' psychological distress, work environment quality, and motivation were moderate. A significant, positive, and moderate relationship existed between psychological distress and work environment quality, while nurses' educational level was statistically different with their motivation level. In the regression, only the nationality, current position, and work environment variables significantly influenced psychological distress. The hospital type also significantly influenced work environment quality. No variable was found to influence nurses' motivation level, though. We concluded that nurses' work environment quality and motivation are interconnected with the psychological stress they experience at work. Monitoring nurses' work environment quality, motivation levels, and psychological distress is thus vital to ensure better patient care.

Longitudinal Study of Changes in Ammonia, Carbon Dioxide, Humidity and Temperature in Individually Ventilated Cages Housing Female and Male C57BL/6N Mice during Consecutive Cycles of Weekly and Bi-Weekly Cage Changes.

Housing conditions are essential for ensuring animal welfare and high-quality research outcomes. In this study, we continuously monitored air quality-specifically ammonia, carbon dioxide, relative humidity, and temperature-in Individually Ventilated Cages (IVCs) housing five female or male C57BL/6N mice. The cages were cleaned either weekly or bi-weekly, and the data were collected as the mice aged from 100 to 348 days. The survival rate remained above 96%, with body weight increasing by 35-52% during the study period. The ammonia levels rose throughout the cleaning cycle, but averaged below 25 ppm. However, in the older, heavier mice with bi-weekly cage cleaning, the ammonia levels reached between 25 and 75 ppm, particularly in the males. While circadian rhythms influenced the ammonia concentration only to a small extent, the carbon dioxide levels varied between 800 and 3000 ppm, increasing by 30-50% at night and by 1000 ppm with body weight. Humidity also correlated primarily with the circadian rhythms (10% higher at night) and, to a lesser extent, with body weight, reaching ≥70% in the middle-aged mice. The temperature variations remained minimal, within a 1 °C range. We conclude that air quality assessments in IVCs should be conducted during animals' active periods, and both housing density and biomass must be considered to optimise welfare.

Linkability measures to assess the data characteristics for record linkage.

Accurate record linkage (RL) enables consolidation and de-duplication of data from disparate datasets, resulting in more comprehensive and complete patient data. However, conducting RL with low quality or unfit data can waste institutional resources on poor linkage results. We aim to evaluate data linkability to enhance the effectiveness of record linkage. We describe a systematic approach using data fitness ("linkability") measures, defined as metrics that characterize the availability, discriminatory power, and distribution of potential variables for RL. We used the isolation forest algorithm to detect abnormal linkability values from 188 sites in Indiana and Colorado, and manually reviewed the data to understand the cause of anomalies. We calculated 10 linkability metrics for 11 potential linkage variables (LVs) across 188 sites for a total of 20680 linkability metrics. Potential LVs such as first name, last name, date of birth, and sex have low missing data rates, while Social Security Number vary widely in completeness among all sites. We investigated anomalous linkability values to identify the cause of many records having identical values in certain LVs, issues with placeholder values disguising data missingness, and orphan records. The fitness of a variable for RL is determined by its availability and its discriminatory power to uniquely identify individuals. These results highlight the need for awareness of placeholder values, which inform the selection of variables and methods to optimize RL performance. Evaluating linkability measures using the isolation forest algorithm to highlight anomalous findings can help identify fitness-for-use issues that must be addressed before initiating the RL process to ensure high-quality linkage outcomes.

Influence of Chinese National Centralized Drug Procurement policy on pharmaceutical corporate R&D investment

ABSTRACT The Chinese National Centralized Drug Procurement (CNCDP) policy has dramatically changed the Chinese drug market and influenced the production and R&D behaviour of pharmaceutical companies. This study empirically examined the impact of the CNCDP policy on pharmaceutical enterprises’ R&D investment and its mechanism using the difference-in-differences (DID) estimation. The findings demonstrate that this policy has a significant positive impact on corporate R&D investment. Moreover, selling expenses and accounts receivable play a crucial mediating role between them. However, there is no corresponding increase in the patent output of pharmaceutical enterprises. Heterogeneity analysis reveals that the policy exerts a more substantial influence on non-state-owned enterprises (non-SOEs) and chemical drug manufacturers than on state-owned enterprises (SOEs) and comprehensive firms. Therefore, it is recommended that the government continue to implement procurement policies, combat medical corruption, urge hospitals to pay promptly for medicines, broaden the scope of procured medicines, and promote the conversion of companies’ R&D investment into high-quality outcomes. These findings offer valuable guidance for developing countries in formulating policies to bolster the R&D competitiveness of their pharmaceutical industries and secure the supply of medicines.

Identifying emergent roles and their relationship with learning outcomes and collaborative problem-solving skills

Collaborative problem-solving (CPS) has become essential in today's society because it provides opportunities for deep learning and critical thinking. During CPS, students tend to spontaneously adopt different roles that facilitate the interactive process. Previous studies have focused on the influence of emergent roles on learning outcomes and CPS skills, but have rarely used procedural approaches to analyze the diversity of and changes in emergent roles during CPS. The availability of naturally occurring educational discourse data provides the opportunity to identify emergent roles at a fine-grained level. Therefore, this study identified emergent roles based on fine-grained coding and used hierarchical regression and epistemic network analysis to explore the influence of emergent roles on learning outcomes through CPS activities and their co-occurrence with CPS skills. The identification of emergent roles was based on observations of 54 undergraduates and postgraduates. The results showed that the participants played different, flexible roles during the CPS process. Roles focused on content and performance appeared more frequently, while those related to social emotion and evaluation were relatively less frequent. Furthermore, knowledge seeker and distractor significantly impeded the success of CPS activities, and harmonizer was conducive to high-quality learning outcomes. In addition, information giver always co-occurred with the skills of maintaining team function. Content- and performance-focused roles usually appeared together with negotiation and coordination. These findings highlight the importance of emergent roles during the CPS process, and provide some practical suggestions for improving learning outcomes and CPS skills.

Timely Quality Problem Resolution in Peer-Production Systems: The Impact of Bots, Policy Citations, and Contributor Experience

Online peer-production systems create value by enabling people to participate in the production of a common good such as an open encyclopedia by building freely on each other’s work. Fixing quality problems in peer production in a timely manner is critical because millions of people rely on peer-produced content for learning and decision making. The longer low-quality content remains in place, the more it can harm the reputation of a peer-production system and diminish the capability of the system to maintain its contributor base. We study different mechanism affecting the timeliness of quality problem resolution in Wikipedia and find that the speedy resolution of quality problems depends on the successful integration of software robots (bots) and the careful calibration of policy citations to the different levels of experience among contributors. Most control mechanisms found in firm-based production do not apply to peer production, and instead, quality control in peer production must leverage the strengths of different contributors and harness the benefits of technological support and adaptive policy frameworks to improve productivity and achieve high-quality outcomes.

Advanced petrographic thin section segmentation through deep learning-integrated adaptive GLFIF

In geological research, precise segmentation of sandstone thin sections is crucial for detailed subsurface material analysis. Traditional methods often fall short in accurately capturing the complexities of these samples. This study presents an innovative segmentation approach that integrates an adaptive Global and Local Fuzzy Image Fitting (GLFIF) algorithm with Otsu's thresholding, significantly enhancing segmentation accuracy and efficiency. Our method combines deep learning and traditional image processing techniques. The adaptive GLFIF algorithm, powered by deep learning, automates parameter tuning, thereby reducing manual intervention and improving precision. Unlike conventional methods that learn fixed parameters, our model dynamically adjusts the segmentation process to achieve accurate results. The dual-phase segmentation strategy effectively isolates small features and handles intricate boundaries, ensuring high-quality outcomes. Experimental results demonstrate that our approach improves segmentation accuracy by 11.2% (from 82.6% to 93.8%), the Jaccard index by 15.4% (from 76.8% to 92.2%), and the Dice coefficient by 9% (from 86.9% to 95.9%) compared to traditional methods. This technique bridges the gap between conventional image analysis and deep learning, combining precise segmentation with the automation and computational power of advanced algorithms. Our segmentation algorithm represents a significant advancement in automated petrographic thin section analysis. Traditional image processing methods, such as thresholding and level sets, excel in handling small objects and complex boundaries but require significant manual intervention and cannot achieve full automation. Recent deep learning methods, particularly semantic segmentation, offer end-to-end automation but struggle with small targets and intricate boundaries. Our approach effectively combines the strengths of both methodologies, providing a comprehensive and efficient solution for geological image analysis that ensures both high accuracy and full automation.

<p>How to Promote Honest Learning Outcomes in Online Education: Understanding Achievement Goal Orientation and Self-Efficacy</p>

Introduction. This study aimed to investigate the relationship between Achievement Goal Orientation, Self-Efficacy, and Academic Dishonesty among college students during online learning. Method. A total of 238 students from students colleges in Indonesia completed an online questionnaire consisting of scales measuring Achievement Goal Orientation, Self-Efficacy, and Academic Dishonesty. The data were then analyzed using hierarchical regression analysis. Results. The results showed a significant relationship between Mastery goal orientation (approach-avoidance) Performance avoidance orientation and Academic Dishonesty. Additionally, a significant relationship was found between Self-Efficacy and Academic Dishonesty, with students who had lower Self-Efficacy being more likely to engage in Academic Dishonesty compared to those with higher Self-Efficacy. Hierarchical regression analysis also revealed that Mastery goal orientation, Performance goal orientation, and Self-Efficacy together predicted Academic Dishonesty in college students during online learning. Discussion and Conclusion. This study concludes that Achievement Goal Orientation and Self-Efficacy are important factors that influence Academic Dishonesty in college students during online learning. These findings may contribute to the development of more effective online learning programs that encourage students to achieve honest and high-quality learning outcomes.

192: Go Big AND Go Home: How to drive high-quality outcomes in an awake ECMO Program

192: Go Big AND Go Home: How to drive high-quality outcomes in an awake ECMO Program

Omalizumab Implementation in Practice: Lessons Learned From the OUtMATCH Study

In February 2024, omalizumab was approved by the Food and Drug Administration for the treatment of food allergy, based on data from the landmark Phase 3 clinical trial “Omalizumab as Monotherapy and as Adjunct Therapy in Children and Adults (OUtMATCH).” In this Rostrum, OUtMATCH investigators share their perspectives on the trial results, the implications for translation into daily practice, and on remaining gaps in the field. The study met its primary and key secondary endpoints, demonstrating a large effect size in multi-allergen desensitization compared to placebo; yet there were some participants who did not respond, and the percentage of responders tolerating all 3 food allergens was lower than that for single foods. . Clinicians are likely to have many questions about appropriate patient selection, monitoring for treatment responsiveness, and how to manage off-label considerations such as dietary incorporation or co-treatment with oral immunotherapy. Additional research is needed to answer these remaining questions and ensure that the translation of omalizumab in real-world practice leads to high-quality outcomes.

Energy-Efficient Application of CrN Coating on Low-Alloy Tool Steel: Comparative Analysis of Technological Processes

Abstract This research examines the technological processes of applying CrN coating on low-alloy tool steel, focusing on the comparison between hardening-tempering-coating (HTC) and hardening-coating (HC) processes, with an emphasis on energy savings. The study investigates the chemical composition, microstructure, mechanical properties, fractography, residual stress, and corrosion resistance of the coated tool steel. Notably, the results indicate no significant differences in the microstructural, mechanical, and corrosion properties between the HTC and HC processes, suggesting that tempering may be excluded without compromising the quality. This study introduces a novel approach to tool steel coating, which improves energy efficiency while maintaining high-quality outcomes. The findings highlight potential improvements in industrial applications, offering an energy-efficient alternative that does not sacrifice the performance or durability of the tool steel. This advancement could lead to significant improvements in manufacturing efficiency and sustainability.