Mere Volume Research Articles

Standards of Care for Peripheral Intravenous Catheters: Evidence-Based Expert Consensus

Highlights Abstract Background: The insertion of a peripheral intravenous catheter (PIVC) is the most commonly performed invasive procedure in healthcare. Despite its frequency in placement in hospitalized patients, PIVCs are generally perceived as being safe; however, the prevalence of failure ranges from 35%-50%. Additionally, complications are common and often deemed “acceptable” by clinicians. Healthcare provider and clinician foundational knowledge and competency is lacking nationally. Considering the mere volume of PIVCs placed, the failure and complication rates, the human impact is significant. Methods: The Association for Vascular Access (AVA) has led a collaborative effort with representatives from the Infusion Nurses Society (INS), the American Association of Critical Care Nurses (AACN), ECRI, and content experts representing nursing vascular access, infusion therapy, infection prevention, critical care, pediatrics, healthcare leadership, a physician, and a patient representative. Our aim is to provide concise guidance that will enhance and standardize practices related to peripheral intravenous catheters (PIVC). By consolidating current standards of practice into a comprehensive document, our framework seeks to advance the quality of care and improve patient safety. Results: This document has undergone meticulous scrutiny to ensure its quality; including incorporation of current standards, methodology for consensus from the expert panel, and input received from public comments. Conclusions: We anticipate that this work will have a significant impact on healthcare professionals, policymakers, and, most importantly, patients’ experiences by the promotion of consistent, high-quality treatment, safety, and comfort for patients receiving a PIVC.

Detection of Intrinsically Disordered Peptides by Biological Nanopore.

Intrinsically disordered protein regions (IDPRs) are pivotal in regulation of transcription and facilitation of signal transduction. Because of their multiple conformational states of structure, characterizing the highly flexible structures of IDPRs becomes challenging. Herein, we employed the wild-type (WT) aerolysin nanopore as a real-time biosensor for identification and monitoring of long peptides containing IDPRs. This sensor successfully identified three intrinsically disordered peptides, with the lengths up to 43 amino acids, by distinguishing the unique signatures of blockade current and duration time. The analysis of the binding constant revealed that interactions between the nanopore and peptides are critical for peptide translocation, which suggests that mechanisms beyond mere volume exclusion. Furthermore, we were able to compare the conformational stabilities of various IDPRs by examining the detailed current traces of blockade events. Our approach can detect the conformational changes of IDPR in a confined nanopore space. These insights broaden the understanding of peptide structural changes. The nanopore biosensor showed the potential to study the conformations change of IDPRs, IDPRs transmembrane interactions, and protein drug discovery.

Optimizing Bucking Decisions in Korean Red Pine: A Dynamic Programming Approach to Timber Profitability

Poor bucking decisions in forest stands can result in underestimating the profitability of timber sales. This study focuses on Pinus densiflora, commonly known as a red pine in Korea, which has often been underutilized as pulp and chips, leading to reduced profit margins. This study aimed to improve bucking decisions for red pine by analyzing the potential values in different log types and the profitability of manufacturing lumber products compared to pulp chips. A log sawing simulation model was developed using dynamic programming. This study optimized sawing patterns and estimated net profits for varying log sizes within the lumber market in Korea. The findings reveal that manufacturing lumber products from 3.6 m and 2.7 m logs can yield net profits 861% and 723% higher, respectively, than producing pulp chips from 1.8 m logs. Notably, sawing 3.6 m logs resulted in an average net profit 24% higher than from 2.7 m logs. These results advocate for more strategic bucking decisions based on potential timber sale profits and the end-uses of logs, especially in trees with large diameters at breast height (DBH), which can produce high-quality logs and should be bucked into long sawlogs whenever possible. Additionally, the study emphasizes the importance of practicing timber cruise to appraise the stumpage value of forest stands more accurately, moving beyond mere volume estimation to include tree type and expected volume. By implementing these practices, timber sale profits and the overall value of forest stands in Korea can be significantly enhanced. This approach not only benefits the economic aspect of forestry but also encourages sustainable and efficient resource management.

Nano-biosupercapacitors enable autarkic sensor operation in blood

Today’s smallest energy storage devices for in-vivo applications are larger than 3 mm3 and lack the ability to continuously drive the complex functions of smart dust electronic and microrobotic systems. Here, we create a tubular biosupercapacitor occupying a mere volume of 1/1000 mm3 (=1 nanoliter), yet delivering up to 1.6 V in blood. The tubular geometry of this nano-biosupercapacitor provides efficient self-protection against external forces from pulsating blood or muscle contraction. Redox enzymes and living cells, naturally present in blood boost the performance of the device by 40% and help to solve the self-discharging problem persistently encountered by miniaturized supercapacitors. At full capacity, the nano-biosupercapacitors drive a complex integrated sensor system to measure the pH-value in blood. This demonstration opens up opportunities for next generation intravascular implants and microrobotic systems operating in hard-to-reach small spaces deep inside the human body.

Not all clicks are equal: detecting engagement with digital content

ABSTRACT Clickstream data recording each click that each individual user makes on a media website has become the currency for evaluating digital platforms in order to maximise advertising and/or subscription revenue. There is a growing recognition, however, that the mere volume of clicks is not adequate for this purpose. We propose a new systematic approach to this problem based on an underlying theory of engagement. Engagement is construed theoretically as user experiences that connect to higher-order personal goals or social values. We show that such experiences can be described qualitatively using survey items that form engagement measurement scales and that these engagement scales, in fact, explain a willingness-to-pay outcome variable. Moreover, these experiences can be translated into surrogate decomposed clickstream variables. We analyse data from three news websites and show that these decomposed clickstream variables predict willingness-to-pay for the sites better than raw, undecomposed clickstream data. Our methodological framework thus provides a new way of using clickstream data to detect engagement with digital content, a method that provides a basis for improving engagement and ultimately outcomes such as the willingness to pay for content.

LIMES: A Framework for Link Discovery on the Semantic Web

The Linked Data paradigm builds upon the backbone of distributed knowledge bases connected by typed links. The mere volume of current knowledge bases as well as their sheer number pose two major challenges when aiming to support the computation of links across and within them. The first is that tools for link discovery have to be time-efficient when they compute links. Secondly, these tools have to produce links of high quality to serve the applications built upon Linked Data well. Solutions to the second problem build upon efficient computational approaches developed to solve the first and combine these with dedicated machine learning techniques. The current version of the Limes framework is the product of seven years of research on these two challenges. A series of machine learning techniques and efficient computation approaches were developed and integrated into this framework to address the link discovery problem. The framework combines these diverse algorithms within a generic and extensible architecture. In this article, we give an overview of version 1.7.4 of the open-source release of the framework. In particular, we focus on an overview of the architecture of the framework, an intuition of its inner workings and a brief overview of the approaches it contains. Some descriptions of the applications within which the framework was used complete the paper. Our framework is open-source and available under a GNU license at https://github.com/dice-group/LIMES together with a user manual and a developer manual.

Decomposing Acute Symptom Severity in Large Vessel Occlusion Stroke: Association With Multiparametric CT Imaging and Clinical Parameters.

Background and Purpose: Acute ischemic stroke of the anterior circulation due to large vessel occlusion (LVO) is a multifactorial process, which causes neurologic symptoms of different degree. Our aim was to examine the impact of neuromorphologic and vascular correlates as well as clinical factors on acute symptom severity in LVO stroke.Methods: We selected LVO stroke patients with known onset time from a consecutive cohort which underwent multiparametric CT including non-contrast CT, CT angiography and CT perfusion (CTP) before thrombectomy. Software-based quantification was used to calculate CTP total ischemic and ischemic core volume. Symptom severity was assessed using the National Institutes of Health Stroke Scale (NIHSS) upon admission. Multivariable regression analysis was performed to determine independent associations of admission NIHSS with imaging and clinical parameters. Receiver operating characteristics (ROC) analyses were used to examine performance of imaging parameters to classify symptom severity.Results: We included 142 patients. Linear and ordinal regression analyses for NIHSS and NIHSS severity groups identified significant associations for total ischemic volume [β = 0.31, p = 0.01; Odds ratio (OR) = 1.11, 95%-confidence-interval (CI): 1.02–1.19], clot burden score (β = −0.28, p = 0.01; OR = 0.76, 95%-CI: 0.64–0.90) and age (β = 0.17, p = 0.04). No association was found for ischemic core volume, stroke side, collaterals and time from onset. Stroke topography according to the Alberta Stroke Program CT Score template did not display significant influence after correction for multiple comparisons. AUC for classification of the NIHSS threshold ≥6 by total ischemic volume was 0.81 (p < 0.001).Conclusions: We determined total ischemic volume, clot burden and age as relevant drivers for baseline NIHSS in acute LVO stroke. This suggests that not only mere volume but also degree of occlusion influences symptom severity. Use of imaging parameters as surrogate for baseline NIHSS reached limited performance underlining the need for combined clinical and imaging assessment in acute stroke management.

Outcome Quality Beyond the Mean - An Analysis of 43,231 Pancreatic Surgical Procedures Related to Hospital Volume.

The aim of this study was to examine whether elevated in-hospital mortality rates in lower volume hospitals are only valid on average or also apply for individual hospitals. Various studies demonstrated a volume-outcome relationship in pancreatic surgery with increased mortality in low volume hospitals. However, almost all studies assessed quality indicators only for groups of hospitals by averaged measures, neglecting variability of hospital performance. The German nationwide hospital discharge data (diagnosis-related groups-statistics) was used to determine risk-adjusted in-hospital mortality for all distal pancreatectomies (DP), pancreatoduodenectomies (Whipple-proce-dure, PD), and pylorus-preserving pancreatoduodenectomies (PPD) performed between 2011 and 2015. Hospitals were stratified according to annual and 5-year total procedure volume and examined in relation to average in-hospital mortality of the highest volume quintile. Lowest adjusted mortality rates were observed in highest volume quintiles for each pancreatic resection procedure, with 6.2% for DP, 8.3% for PD, and 5.7% for PPD in the 5-year observation period. With these mortality rates as reference values the analysis revealed that a non-negligible proportion of hospitals performed equal or better (DP: 430/784, 54.5%; PD: 269/611, 44.0%; PPD: 255/565, 45.1%) than the hospitals of the highest volume quintile. High quality of care, with in-hospital mortality rates less or equal to high-volume hospitals, is also achieved in hospitals with lesser procedure volume. Therefore, mere volume seems not suitable as proximal measure for assessing individual hospital quality. instead, more sophisticated certification systems, that allow accurate quality assessment and better reflect clinical variability, should preferred to fixed minimum volume thresholds.

Physical Activity Promotion for Apprentices in Nursing Care and Automotive Mechatronics-Competence Counts More than Volume.

Apprentices in the area of nursing care and automotive mechatronics are exposed to increased health risks. In this context, the promotion of physical activity (PA) is considered an effective strategy for the assurance of work ability. The goal of the PArC-AVE study was therefore to better understand the role of PA for apprentices employed in these two sectors. In an exploratory study, 55 apprentices wore an ActiGraph accelerometer over seven consecutive days and were subject to activity analysis. The objective accelerometer data (18,979 ± 3780 steps/day; 471.00 ± 159.75 min of moderate-to-vigorous PA/week), complemented by questionnaire data, indicated that most met the volume-based PA recommendations. Subsequently, we conducted a multicenter study comprising 745 apprentices from six vocational education institutions. Path analyses showed that competencies for health-enhancing PA were significantly related to indicators of work ability (0.180 ≤ b ≤ 0.452) and psychophysical health (0.139 ≤ b ≤ 0.347), whereas mere volume of PA was not (−0.048 ≤ b ≤ 0.080). In summary, apprentices of nursing care and automotive mechatronics showed high levels of PA. However, the results highlight the importance of competencies for health-enhancing PA. The PAHCO model could provide a useful framework for the conceptualization of effective interventions.

The Future of Facial Fat Grafting.

Fat grafting was first described in the early 20th century but for many years remained a relatively underused technique due to the unreliability of long-term volume expansion. Significant improvements in reliability have been made in the last 2 decades and there is a large body of literature pertaining to extraction, processing and injection methods to obtain more lasting effects. However, volume loss and graft resorption remain a major challenge in the long term and lead to unpredictability in results. Enriching adipose graft with stromal vascular fraction, ex vivo cultured adipose stem cells and platelet-derived growth factor among others is one method under active investigation which may assist graft survival through a range of mechanisms including increased angiogenesis. Breaking adipose graft into smaller fragments such that engrafted cells have greater access to donor-site oxygenation and nutrition is another method which in theory may promote survival. Presently, adipose grafting in the face is usually for the addition of volume to fill defects. However, the stem-cell containing fraction of adipose grafting (stromal vascular fraction) appears to exert a rejuvenating effect on overlying skin and soft tissue when administered alone. The application of these low-volume injections represents a significant shift in thinking away from mere volume expansion. These techniques have been tested in a range of animal models and some human studies. In this review, the authors provide a broad overview of present research and highlight both limitations in previous research and current areas of investigation.

Shock Etiologies and Fluid Management in Liver Failure.

Liver failure can occur in patients with or without underlying chronic liver disease (mainly cirrhosis) and is, respectively, termed acute on chronic liver failure or acute liver failure (ALF). In both cases, it is associated with marked systemic inflammation and profound hemodynamic disturbances, that is, increased cardiac output, peripheral vasodilation, and decreased systemic vascular resistance, on top of several superimposed etiologies of shock. In patients with cirrhosis, sepsis is the main cause of intensive care unit admission but portal hypertension-related gastrointestinal hemorrhage is also common. Septic shock is also particularly frequent in patients with ALF and can complicate the initial hypovolemic shock related to poor oral intake, vomiting, and encephalopathy prior to admission. Given the susceptibility of the liver to hypoxia and also the potential deleterious effects of fluid on liver function, the assessment of hemodynamic status and volume responsiveness is especially important in these patients. However, one should keep in mind that the hyperdynamic state and low systemic vascular resistance in liver failure may bias the accuracy of some hemodynamic monitoring devices. Fluid therapy should use crystalloids, and balanced salt solutions may limit the risk of hyperchloremic acidosis and subsequent adverse kidney events. Nevertheless, the beneficial effects of albumin resuscitation have been demonstrated in patients with cirrhosis and may reflect more than mere volume expansion.

Effects of Contributor Experience on the Quality of Health-Related Wikipedia Articles.

BackgroundConsulting the Internet for health-related information is a common and widespread phenomenon, and Wikipedia is arguably one of the most important resources for health-related information. Therefore, it is relevant to identify factors that have an impact on the quality of health-related Wikipedia articles.ObjectiveIn our study we have hypothesized a positive effect of contributor experience on the quality of health-related Wikipedia articles.MethodsWe mined the edit history of all (as of February 2017) 18,805 articles that were listed in the categories on the portal health & fitness in the English language version of Wikipedia. We identified tags within the articles’ edit histories, which indicated potential issues with regard to the respective article’s quality or neutrality. Of all of the sampled articles, 99 (99/18,805, 0.53%) articles had at some point received at least one such tag. In our analysis we only considered those articles with a minimum of 10 edits (10,265 articles in total; 96 tagged articles, 0.94%). Additionally, to test our hypothesis, we constructed contributor profiles, where a profile consisted of all the articles edited by a contributor and the corresponding number of edits contributed. We did not differentiate between rollbacks and edits with novel content.ResultsNonparametric Mann-Whitney U-tests indicated a higher number of previously edited articles for editors of the nontagged articles (mean rank tagged 2348.23, mean rank nontagged 5159.29; U=9.25, P<.001). However, we did not find a significant difference for the contributors’ total number of edits (mean rank tagged 4872.85, mean rank nontagged 5135.48; U=0.87, P=.39). Using logistic regression analysis with the respective article’s number of edits and number of editors as covariates, only the number of edited articles yielded a significant effect on the article’s status as tagged versus nontagged (dummy-coded; Nagelkerke R2 for the full model=.17; B [SE B]=-0.001 [0.00]; Wald c2 [1]=19.70; P<.001), whereas we again found no significant effect for the mere number of edits (Nagelkerke R2 for the full model=.15; B [SE B]=0.000 [0.01]; Wald c2 [1]=0.01; P=.94).ConclusionsOur findings indicate an effect of contributor experience on the quality of health-related Wikipedia articles. However, only the number of previously edited articles was a predictor of the articles’ quality but not the mere volume of edits. More research is needed to disentangle the different aspects of contributor experience. We have discussed the implications of our findings with respect to ensuring the quality of health-related information in collaborative knowledge-building platforms.

Comparing Inference Methods for Non‐probability Samples

SummarySocial and economic scientists are tempted to use emerging data sources like big data to compile information about finite populations as an alternative for traditional survey samples. These data sources generally cover an unknown part of the population of interest. Simply assuming that analyses made on these data are applicable to larger populations is wrong. The mere volume of data provides no guarantee for valid inference. Tackling this problem with methods originally developed for probability sampling is possible but shown here to be limited. A wider range of model‐based predictive inference methods proposed in the literature are reviewed and evaluated in a simulation study using real‐world data on annual mileages by vehicles. We propose to extend this predictive inference framework with machine learning methods for inference from samples that are generated through mechanisms other than random sampling from a target population. Describing economies and societies using sensor data, internet search data, social media and voluntary opt‐in panels is cost‐effective and timely compared with traditional surveys but requires an extended inference framework as proposed in this article.

Do environmental-related disclosures help enhance investment recommendations?

PurposeUsing a sample of UK FTSE 350 companies continuously listed in the period 2007-2011, this paper aims to investigate the impact of the quality and quantity of corporate environmental disclosure on analysts’ recommendations.Design/methodology/approachThe study adopted a method based on that developed by Beck et al. (2010). The “CONI” approach measures information diversity, content and volume. It involves dual qualitative and quantitative measurement, which is suitable for the purpose of this paper.FindingsThe findings suggest that the quality of environmental disclosure is associated with more favourable buy recommendations. Mere volume of disclosure is insufficient for effective signalling about environmental strategies. Further tests show that only discretionary quality disclosure that is influenced by managerial intervention receives optimistic recommendation, suggesting that analysts are more likely to give better recommendation when managers have a higher level of discretion in their disclosures.Originality/valueThis paper contributes to the academic literature by empirically examining the association between sell-side analyst recommendations on both innate and discretionary components of environmental disclosures (quality and volume) within the UK context. This is a significant extension of the existing literature, which has focused on the related association between analyst recommendations and corporate social responsibility, mainly measured by corporate social responsibility ratings or a dummy variable reflecting the existence of supplementary corporate social responsibility reports in different international setting. The topic is of interest to contemporary accounting scholars and responds to calls for more research into how analysts use nonfinancial data such as environmental data in making recommendations.

Brute force effects of mass media presence and social media activity on electoral outcome

ABSTRACTIn this study, we analyze whether the mere volume of presence in mass media and the mere volume of activity on social media convey advantages to candidates in parliamentary elections. Based on the theoretical model of bounded rationality, we call these potential effects brute force effects. During the last month of the election campaign of the Swiss federal election of 2015, we tracked the presence of all 873 candidates in the canton of Zurich, the most populous canton, in a broad sample of mass media. Additionally, we tracked those candidates’ activity on Facebook and Twitter. The results of our multilevel Bayesian estimates show that mass media presence has a consistent nontrivial impact on different aspects of electoral outcome. Furthermore, social media activity also has a nontrivial impact, but only in terms of resonance (reactions to candidates’ social media activity). Overall, our results suggest that brute force effects of of mass media presence and social media activity can have substantial impact on voting behavior.

Do Financial Analysts Care About Environmental Disclosures in Corporate Annual Reports?

The paper examines the role of environmental disclosures and their effect on the accuracy of financial analysts’ forecasts. Specifically it examines and compares the effects of the volume and quality of disclosure. In doing so, it distinguishes between ‘greenwash’ and more specific, quantified and comparable disclosures that have the potential to provide more effective market signals. The paper demonstrates that there is a significant negative relationship between the quality of disclosure and analyst forecast error. The mere volume of disclosure meanwhile only adds to forecast accuracy in the absence of quality, and to a lesser degree. Disclosure quality therefore is valuable for investment decision makers when evaluating the financial consequences of firm level environmental policies, and potentially in wider contexts.

Hydrogen absorption in RE2T2In compounds

• Hydrogenation on selected RE 2 T 2 X was performed. • Nd 2 Ni 2 In is unique among “221” compounds, exhibiting a very high H absorption. • The behavior found in RE 2 Ni 2 In changes when replacing Ni for Pd. • The amorphization of La 2 Pd 2 In allows to go up to 4.6 H/f.u. • RE 2 Pd 2 In with heavy RE can absorb 2 H/f.u. without structure distortion. RE 2 T 2 In compounds (RE = rare earth, T is a late transition metal) were found, depending on the composition, absorbing different amounts of H. Several types of reaction of crystal structure have been found. Mere volume expansion, analogous to U 2 T 2 X compounds, was found e.g. in Tb 2 Pd 2 In, allowing to accommodate up to 2 H atoms/f.u. (one formula unit comprises 2 RE atoms). More dramatic structure modifications are required, to keep the H–H spacing higher than 2.1 Å, for higher H absorption. One type of reaction is amorphization, observed in La 2 Pd 2 In. Other type was observed in Nd 2 Ni 2 In, undergoing an orthorhombic distortion and forming four different H sites. The volume expansion exceeds 23%.

Pharmacotherapy of urolithiasis: evidence from clinical trials

Urolithiasis is a worldwide problem with significant health and economic burdens. Medical therapy that alters the course of stone disease has enormous medical and financial impact. Urolithiasis is a final manifestation of a broad range of etiologies and pathogenesis. The modest progress in understanding the pathophysiology has hampered successful development of targeted therapy. Current regimens are based mostly on rational alteration of urinary biochemistry and physical chemistry to lower the risk of precipitation. In terms of pharmacotherapy, there are drugs to successfully improve hypercalciuria, hypocitraturia, aciduria, hyperuricosuria, and hypercystinuria. These agents have been proven to be effective in randomized controlled trials in improving urinary biochemical and physicochemical risk factors, as well as clinical outcomes. Although our current regimens have clearly improved the management and lives of stone formers, there are still clearly identifiable immense voids in the knowledge of pathophysiology of stone disease that can be filled with combined basic science and clinical studies.

Iron porphyrin-based cathode catalysts for polymer electrolyte membrane fuel cells: Effect of NH 3 and Ar mixtures as pyrolysis gases on catalytic activity and stability

Ten different catalysts were prepared by loading 66 wt% ClFeTMPP on N330, a furnace grade carbon black, and pyrolyzing this catalyst precursor for 10 min at 950 °C in a NH 3/Ar gas mixture with various NH 3 volume fractions (from 0% to 100%). The activity and stability of these catalysts were measured in a fuel cell and compared. The only stable catalyst, although the least active, among these was the one pyrolyzed in pure Ar. A notable leap in catalytic activity, but drop in stability, was observed for all catalysts pyrolyzed in gas mixtures containing NH 3, even with a mere volume fraction of 1.3% NH 3 in the pyrolysis gas mixture. Catalytic activities increased, while stability decreased with increasing volume fraction of NH 3. The physicochemical properties of these catalysts were correlated with their electrochemical behaviour observed in fuel cell tests. It was found that a volume fraction of only 1.3% NH 3 was enough to double the micropore surface area, the surface nitrogen and iron concentrations in the resulting catalyst. Since the active sites are believed to be of the Fe/N/C type, the sharp increase in catalytic activity with as little as 1.3% NH 3 is attributed to the concurrent increase in microporous surface area, N and Fe surface contents in these catalysts. The only property that apparently correlates with stability is the degree of graphitization of the catalyst, which was estimated either from either X-ray diffraction and Raman spectroscopy measurements. Lastly, it was found that the catalysts’ peroxide yield, resulting from the partial reduction of O 2, does not correlate with their degree of stability.

Garment exports from Vietnam: changes in supplier strategies

This paper looks at Vietnam's changes in export performance and supplier strategies in the global garment value chains as a result of shift in international trade arrangements. Trade and competitive theories are used to analyse supplier reactions to the shifts. After the changes the Vietnamese garment industry has sustained its high level of export growth and gained import market share at its main US market although not as much as China. However, the growth export performance appears to be a mere volume expansion. There is little evidence that the suppliers are pursuing functional upgrading strategies besides the fact that they are flexible serving several customers at different markets.