Mixed Record Research Articles

Realizing the Full Potential of Clinical Decision Support: Translating Usability Testing into Routine Practice in healthcare operations.

Clinical Decision Support (CDS) tools have a mixed record of effectiveness, often due to inadequate alignment with clinical workflows and poor usability. While there's a consensus that usability testing methods address these issues, in practice, usability testing is generally only used for selected projects (such as funded research studies). There is a critical need for CDS operations to apply usability testing to all CDS implementations. In this State of the Art / Best Practice paper, we share challenges with scaling usability in healthcare operations and alternative methods and CDS governance structures to enable usability testing as a routine practice. We coalesce our experience and results of applying guerilla in-situ usability testing to over 20 projects in 1 year period with the proposed solution. We demonstrate the feasibility of adopting "guerilla in-situ usability testing" in operations and their effectiveness in incorporating user feedback and improving design. Although some methodological rigor was relaxed to accommodate operational speed, the benefits outweighed the limitations. Broader adoption of usability testing may transform CDS implementation and improve health outcomes.

Governing public sector use of external management consultancy—beyond client procurement and consultant professionalization

IMPACT Efforts to improve the governance of external management consulting have a mixed record. Attention has focused on either procurement (and insourcing) and/or raising standards through professionalization. The persistence of critiques and public scandals suggests that more is needed from the industry, policy-makers, clients/purchasers and other stakeholders. In this article, the authors highlight how systemic problems with consulting arise from the nature of its reward and value systems and the resulting lack of openness of consultants and their clients—none of which have been adequately addressed through traditional governance mechanisms. The authors explain why these neglected areas need attention. This can be done, in part, by drawing on new trends and classic dilemmas. Is the rise of purpose-led or alternative organizational forms, as well as moves to facilitate transparency and the speaking of ‘truth to power’, improving the governance and outcomes of external management consultancy?

Single-source zones detection using relative harmonic coefficients under diverse acoustic scenarios

Accurate detection of single-source zones, where only a single source is active or dominant within the mixed recordings, benefits many acoustic signal processing techniques, while with very little research focusing on this topic. This article uses a higher-order sensor array and proposes a spherical harmonics (SH) domain detector that is applicable under diverse acoustic scenarios. The detector utilizes multi-dimensional scaling (MDS) by projecting a recently introduced SH-domain feature denoted relative harmonic coefficients (RHC) into a low-dimensional space, where the single-source zones can be easily recognized as they locate at distinctive positions compared to the overlapped and source-absent zones. The method eases limitations suffered by the baseline detectors, such as direct-path wave propagation and far-field requirement, and is additionally capable of counting the unknown source number and automatically clustering the detected single-source zones into each source they originally belong. Extensive experimental results in both simulated and real-life environments have confirmed the proposed detector outperforms the baselines, especially in strongly noisy, reverberant and near-field soundfield.

Anthropocene North Western Pacific Oceanography Recorded as Seasonal‐Resolution Radiocarbon in Coral From Kikai Island, Japan

AbstractRadiocarbon (14C) in corals can be used as a relatively high‐sensitivity indicator of vertical and horizontal advection of water masses, which contributes to the understanding of ocean circulation. In this study, we reconstruct Kuroshio and Ryukyu current transport with a seasonal resolution Δ14C record spanning 1947–2009. This record covers the beginning of the atomic era and was obtained from a coral on Kikai Island in the south of Japan. The Kikai Δ14C curve features a newly discovered Δ14C spike in July 1955, a rapid increase after 1962, and a steady decrease after 1980. The spike in 1955 may directly reflect ocean current transport. The lack of periodicity in the Δ14C record suggests the existence of mesoscale eddies and the complexity of Kuroshio and Ryukyu current transport. In addition, comparing the high‐resolution Δ14C of Kikai and Ishigaki islands, both situated along the path of the Kuroshio, reveals the influence of Pacific Decadal Oscillation and El Niño‐Southern Oscillation on the Kuroshio and Ryukyu currents. This suggests that seasonally resolved Δ14C in corals along an ocean current can produce a long‐term record of ocean mixing that responds to climate variability.

Agrobiodiversity threats amid expanding woody monocultures and hopes nourished through farmer and food movements in the Mediterranean

The high biodiversity of food and agriculture (agrobiodiversity) in the Mediterranean exists in rapidly changing landscapes and food systems. The first goal of this Commentary is to explain how agrobiodiverse Mediterranean food cereals and legumes are threatened by the accelerating expansion and intensification of monocultures of woody crops—principally olive, nut, grape, and citrus monocrops—in landscapes of the western Mediterranean (Spain, Morocco, and France). Its second goal is to explain the key countervailing force of specific food and farmer movements, organizations, and practices supporting agrobiodiversity. We argue this food agrobiodiversity support is timely and vital because of growing threats. Intensive woody monocultures have been promoted for climate change adaptation and policies, while the proposed agroecological alternatives to woody monocultures show a mixed record regarding the support of food agrobiodiversity. The Mediterranean’s boom of woody monocultures relies on increased irrigation, including groundwater extraction, that undermines water sustainability. We engage with policy to explain how the timely support of food agrobiodiversity by farmer and food movements and practices demonstrates the production–consumption linkages that can strengthen sustainability, biodiversity conservation, and climate change adaptation/mitigation. Our policy arguments focus on the promising bridge of agrobiodiversity’s production–consumption linkages to agroecology as an increasingly influential approach in these policy sectors. Finally, as a key complementary goal, we reflect on current agrobiodiversity-monoculture challenges by engaging the broad themes of rural–urban networks and urbanization in the Mediterranean, the land sparing versus land sharing debate, and the Plantationocene concept. Each thematic reflection enhances the understanding of food agrobiodiversity threats and support, landscapes of mixed agrobiodiversity and intensified woody monocultures (monoculture-agrobiodiversity landscapes), and relevant policy insight.

Simulating the Effects of Partial Neural Conduction Delays in the Visual Evoked Potential.

The purpose of this study was to understand the double peaks or broadening of P100 observed in some cases of optic neuritis by inducing conduction delays in healthy eyes through stimulus luminance manipulation in analogy to the perceptual Pulfrich effect. Checkerboard pattern reversal visual evoked potentials (VEPs) with check sizes of 0.8degrees, 0.4degrees, and 0.2degrees were recorded in healthy participants using two experiment variants. Variant (1) involved binocular stimulation with inter-ocular luminance difference achieved by a 1.8 neutral density (ND) filter, along with monocular control conditions. Variant (2) included monocular stimulation with hemifields having a luminance difference (half of monitor with ND filter), along with single-hemifield control conditions. In both variants, VEP curves under mixed stimulation were compared to synthesized VEPs computed from offline summation of curves from the relevant control conditions, followed by assessing P100 characteristics. Despite considerable variability between participants, the binocular variant demonstrated marked differences between VEPs from mixed recordings and synthesized curves, whereas in the hemifield variant, agreement was strong. The anticipated double peak or broadened deflection pattern was observed to varying extents in participants, often contingent on check size, with nominal peak time frequently failing to indicate partial conduction delays. The present findings corroborate the hypothesis that nominal peak time does not always reflect conduction delays if only a subset of fiber bundles is affected. Peak shape might provide additional diagnostic evidence of a partial conduction delay. Enhancing the understanding of VEP waveform changes associated with partial conduction delays could offer diagnostic insights for optic neuritis.

Towards a Coherent Trade-Environment Nexus? The EU’s Critical Raw Materials Policy

This article contributes to the debate on the policy coherence of the trade-environment nexus by analysing the recent critical raw materials (CRM) policy of the European Union (EU). Critical raw materials are crucial for the green and digital transitions but face significant risks in their supply. This raises the question to what extent the EU can ensure a coherent approach in an era of geopolitics. The analysis proceeds in three steps: what does coherence mean (problem definition), how coherent are the EU’s policy objectives, and how coherent are its policy instruments designed for CRMs? The article finds that the EU’s problem definition of the trade-environment nexus has over the past two decades become more coherent. However, the rise of geopolitics has added foreign policy considerations to the understanding of this nexus. As the case of CRMs shows, open strategic autonomy, which aims to reduce strategic dependencies, generates incoherence among the policy objectives. The many existing or proposed EU policy instruments can, so far, be assessed as being relatively more coherent yet also with a mixed record. Future research will have to confirm this preliminary finding and also address the coherence of the policy implementation and outcomes of the EU’s CRMs policy. critical raw materials, European Union, geopolitics, Green Deal, open strategic autonomy, policy coherence, sustainability, trade-environment nexus, trade policy, twin transition

The chimera of new forms of worker organisation: why trade unions matter in rebuilding national and global labour movements

The decline in union representation is occurring globally even as the working class has been growing, especially in the Global South. The decline in the global organised workforce contradicts expectations that trade unions would grow in response to growing levels of exploitation prevailing especially in poor countries integrated into global production chains. However, trade unions are not growing stronger but are weaker as industrial and service workers are growing in number. This article reprises the concept of new forms of worker organisation (NFWO), advocated and advanced over the past 25 years and rooted in independent labour entities, including worker centres, syndicalist organisations, and autonomous, unaffiliated unions, and even NGOs. The record of these entities thus far demonstrates that new forms of worker organisation are expanding in response to rank-and-file activism but are ineffective as a replacement for traditional union models in building and consolidating labour power to challenge the rise of precarious and contract labour. This article examines the mixed record of new labour organisations and their failure to confront neoliberal capitalism. To remedy this structural defect, this article contends that existing unions must engage in activism rooted in the precarious working class of the Global South to build trade union power.

Clinical decision support and electronic interventions to improve care quality in chronic liver diseases and cirrhosis.

Significant quality gaps exist in the management of chronic liver diseases and cirrhosis. Clinical decision support systems-information-driven tools based in and launched from the electronic health record-are attractive and potentially scalable prospective interventions that could help standardize clinical care in hepatology. Yet, clinical decision support systems have had a mixed record in clinical medicine due to issues with interoperability and compatibility with clinical workflows. In this review, we discuss the conceptual origins of clinical decision support systems, existing applications in liver diseases, issues and challenges with implementation, and emerging strategies to improve their integration in hepatology care.

The Role of International Criminal Court in Prosecuting Crimes against Humanity

Crimes against humanity are grave offenses that shock the conscience of humanity, and demand a strong international response. The International Criminal Court (ICC), established in 2002, plays an important role in prosecuting individuals responsible for such heinous crimes, including genocide, war crimes, and crimes against humanity. This research explores the role of the ICC in prosecuting crimes against humanity in Indonesia, a country with a complex history of human rights violations. Through a qualitative research design, including case studies, legal analysis, and content analysis, it assesses the effectiveness of the ICC's interventions, analyzes the international legal framework guiding its actions, explores the challenges faced, and evaluates Indonesia's cooperation with the court. The findings show a mixed record of effectiveness, with challenges in evidence collection, witness protection, and limited cooperation hampering some cases. Despite these obstacles, the ICC's involvement has shed light on past atrocities and provided an opportunity for victims to seek justice. The study concludes with recommendations to improve the effectiveness of the ICC in addressing crimes against humanity in Indonesia and underscores the importance of continued efforts to promote accountability and justice on a global scale.

Of Crimes and Crowns

Abstract This article explains variation in state cooperation with International Criminal Court (ICC)’s investigations and prosecutions across cases and over time. The idea motivating this study stems from the observation of the mixed record of state cooperation with ICC operations. For legal professionals and scholars this observation is puzzling, since states falling within the ICC’s territorial jurisdiction are legally bound to provide full judicial assistance to the Court. Thus, why do some countries entertain collaborative relations with the ICC while others display hostility towards it? I argue that state leaders’ perceptions of potential ICC indictment best explain variation in state behaviour. This article aims to contribute to a better understanding of how state attitudes form and of the extent to which external actors, spearheaded by the ICC Prosecutor’s Office (OTP), can change them. The research findings suggest that: 1) neither formal state consent (ratification) nor regime type are reliable predictors of state cooperation; 2) state leaders’ perception of potential ICC indictment appears better suited to correctly predict state behaviour in all the situations investigated by the OTP; 3) the OTP’s signalling strategy — including the timing of its intervention — affects state leaders’ perception of future ICC indictment and, in turn, the prospects of state cooperation; 4) when state authorities deny cooperation, regime change provides a one-time opportunity to start ICC–state relations anew.

A Bibliometric Analysis of Public Business School Scientific Productivity and Impact in South-East Europe (2017-2021)

Abstract In this paper, we analyze the scientific productivity and impact of selected public business schools in South East Europe (SEE) in the 2017-2021 period by using the scientific output indexed in the Elsevier Scopus reference database. The region’s most productive and influential authors, institutions, and publication outlets are identified in the field of business research. Empirical results are discussed from the viewpoints of two research questions related to regional business school research patterns and the research cooperation outcomes. Selected public business schools in the SEE region have been found to have a mixed record regarding research productivity and impact. International collaboration is valuable in increasing the research impact, while institutional collaboration seems more effective in raising impact than national one. Recommendations for business school administrators are identified and discussed.

On a Scientific Approach for Deep Time Investigations

AbstractI came to geology through a metaphoric back door and was gifted a series of visionary mentors who imbued me with an outside‐the‐box view of Earth history. Coupled with remarkable advances in microscale analytical capabilities that arose just as I was graduating into the field, that unorthodox view permitted my research group to explore an alternate conception of the longstanding paradigm of earliest Earth history. As I look back on how the field has evolved in my 40 year career, I see a mixed record of significant advances in our understanding alongside a persistent groupthink that discourages creativity and individual responsibility. I've come to understand this as reflecting different intellectual requirements of deep time geology relative to the study of modern processes. This difference between the general understanding of the scientific method and our needs has given cover to an unconstructive habit. My field is ripe for a fundamental change in the way we address the meager and almost certainly biased geologic record. This disruption could lead younger scientists and future generations away from poorly justified consensus models toward a more complete understanding of the darkest age of our planet's history.

Great Green Walls: Hype, Myth, and Science

Visions of planting walls of trees to block the expansion of the desert have long been promoted but never realized. The green wall myth persists today even though it is premised on outdated understandings of desertification. We review the history of the idea of green walls and focus on two sets of contemporary initiatives to assess their outcomes: peri-Saharan programs (Algeria's Green Dam and Great Green Wall in sub-Saharan Africa) and China's Three Norths Shelterbelt Program. This review reveals a mixed record of technical success with low rates of the establishment of monocultures of fast-growing trees vulnerable to disease. While there is evidence for reduced wind erosion in some areas, afforestation is also associated with reduced soil moisture and lowering of water tables. Social impacts include increased water scarcity for people and livestock in some cases, and resource enclosures that particularly work against pastoralist livelihoods.

Immunisation used for offensive and defensive purposes during the Second World War.

The best defence against natural or intentional biological agents during armed conflict is usually immunisation, as with typhoid fever, but exceptional circumstances are informative. A large iatrogenic epidemic of hepatitis B occurred in 1942 due to contaminated lots of yellow fever (YF) vaccine used in the US military, even though there was no natural risk of infection. YF vaccine was intended to protect against Japanese Army's use of YF as a biowarfare agent, which did not eventuate. Salmonella typhi was used to infect German soldiers in a Paris café during Christmas 1941 in the knowledge that the café staff but not the soldiers were likely to be immunised against typhoid fever. German Army use of the Weil-Felix reaction to eliminate civilians likely to be typhus infected was subverted by Polish medical officers. They immunised civilians with locally produced Proteus antigens to create false-positive Weil-Felix reactions in order to exempt men from forced labour schemes. Immunisation against biowarfare agents has a mixed record, indicating that vaccines rarely cover well for intelligence gaps.

Integrating Citizen Science into the Work of United States Environmental Agencies

Citizen scientists in the United States (US) gather data on a wide range of environmental conditions. Environmental agencies, however, have a mixed record when it comes to capitalizing on the resource that this information represents. In 2020, the Environmental Law Institute (ELI), on behalf of the US Environmental Protection Agency, examined how citizen science was being used or supported by environmental agencies in states, tribes, and local governments in the US. This article summarizes and builds on that research to assess progress to date. It concludes that there is significant use by agencies of citizen-generated data on water quality, but much more limited use in other fields. This is particularly true for air quality data, where the technology for private data collection is much more recent. ELI called on agencies to be more proactive in exploring the value of citizen science data, and in providing leadership to help agencies build on each other’s experiences. It is of interest that these recommendations are similar to recommendations also made in 2020 by the staff of the European Commission. Another important conclusion in ELI’s recommendations is that agencies should see citizen science as an important tool in addressing environmental justice concerns.

Local Binary Pattern Histogram Based Web Facial Authentication System

The objective of the project is to Detect and Recognize Human Facial Features via a Camera. The basic concept of this project is:- To convert the input image to HSV format to extract the binary image and additionally remove the noise from binary image using morphological operations and finally then contours are used to segment out the region of interest and further the region is analyzed to get the final result. While biometric data is generally considered one of the most reliable authentication methods, it also carries significant risk. That’s because if someone’s credit card details are hacked, that person has the option to freeze their credit and take steps to change the personal information that was breached. What do you do if you lose your digital ‘face’? Around the world, biometric information is being captured, stored, and analyzed in increasing quantities, often by organizations and governments, with a mixed record on cybersecurity. A question increasingly being asked is, how safe is the infrastructure that holds and processes all this data? As facial recognition software is still in its relative infancy, the laws governing this area are evolving (and sometimes non-existent).

Pakistan at 75: a mixed record

Pakistan at 75: a mixed record

All the President's men. Leadership style, advisory system and Donald Trump's mixed record in foreign policy

AbstractDonald Trump was expected to dismantle the internationalist approach that has dominated US foreign policy since the end of the Second World War. However, his impact is narrower than is commonly supposed. In some areas, he was able to generate some significant change, while in many others he failed to pursue his revisionist agenda. This article explores the reasons for this surprising result by investigating the relationship between Trump's leadership style and his advisory system. Building on the model of Preston and t'Hart it elaborates a new framework for presidents with leadership traits similar to Trump's, namely, a high need for power, low conceptual complexity, and low experience. The model presents two opposite ideal‐types of interaction between the President and their advisory system – ‘presidential predominance’ vs. ‘presidential permissiveness’ – that help us better understand how Trump failed in certain issue areas and succeeded in others. The model is then tested on two case studies, one in which the president failed and the other in which he achieved his goals. These are respectively the cases of NATO and the World Health Organization (WHO).

A record of post-accretion asteroid surface mixing preserved in the Aguas Zarcas meteorite

Particle ejection and redeposition events on the surface of asteroid 101955 Bennu, which led to transport, mixing and loss of material, have been observed frequently by NASA’s OSIRIS-REx mission. Besides large-scale impacts, this may be one of the most important post-accretional processes on small carbonaceous asteroids. Here we looked for relics of such activity in a Bennu analogue, the carbonaceous chondrite Aguas Zarcas. We discovered compact fragments that were strongly shocked, redistributed and deposited onto an unshocked lithology, consistent with surficial re-accretion on Aguas Zarcas’s parent body. Such re-accretion could be driven by large-scale impacts or by frequent pebble transport from endogenous asteroidal activity such as observed at Bennu. The latter hypothesis is supported by the matching size distribution of the Aguas Zarcas compact fragments with that of the Bennu ejecta. Such mixing has hitherto been unexplored in other regolith breccias, and further analysis will determine how common such processes are. Some fragments of the Aguas Zarcas carbonaceous meteorite have been shocked before being redeposited over an unshocked lithology. As their size distribution is similar to that of the ejecta observed at Bennu, they might be the signature of activity of the Aguas Zarcas parent body. Alternatively, they might be the result of a large-scale impact.