Quality Perspective Research Articles

A novel non-contrast agent-enhanced 3D whole-heart magnetic resonance sequence for congenital heart disease patients: the REACT Study.

The three-dimensional balanced-steady-state-free-precession (3D bSSFP) whole-heart (WH) technique has long been used to depict cardiac morphology in congenital heart disease (CHD) but is prone to banding artifacts. The Relaxation Enhanced Angiography without Contrast and Triggering (REACT) sequence is an alternative method that is resistant to off-resonance effects. To evaluate cardiac structures and great vessels in CHD patients using 3D WH REACT sequence and compare it to 3D WH bSSFP sequence. This study was approved by the Institutional Review Board. Thirty CHD patients were prospectively enrolled. Contrast-to-noise ratio (CNR), image quality, and cross-sectional area (CSA) were analyzed. Categorical data were compared with a Wilcoxon signed-rank test and normally distributed variables with a t-test. Thirty patients (16 females) participated in this study (median age 17, range 5months to 52years). REACT showed higher CNR in all pulmonary veins (all P<0.05), while 3D bSSFP had higher CNR in the right ventricle (P<0.001) and right pulmonary artery, (P=0.04). Image quality favored 3D bSSFP in the right atrium and ventricle (both P<0.001), main pulmonary artery (P=0.02), and coronary arteries (left: P<0.001, right: P=0.01). REACT outperformed 3D bSSFP for the pulmonary veins (all P<0.05) from image quality perspective. CSA measurements were not significantly different between REACT and 3D bSSFP (all P≥0.05). The REACT method is associated with improved image quality and CNR for pulmonary veins, with CSA measurements concordant with 3D bSSFP in CHD patients, while bSSFP shows better performance for imaging cardiac chambers and coronary arteries.

A systematic review of deep learning-based denoising for low-dose computed tomography from a perceptual quality perspective.

Low-dose computed tomography (LDCT) scans are essential in reducing radiation exposure but often suffer from significant image noise that can impair diagnostic accuracy. While deep learning approaches have enhanced LDCT denoising capabilities, the predominant reliance on objective metrics like PSNR and SSIM has resulted in over-smoothed images that lack critical detail. This paper explores advanced deep learning methods tailored specifically to improve perceptual quality in LDCT images, focusing on generating diagnostic-quality images preferred in clinical practice. We review and compare current methodologies, including perceptual loss functions and generative adversarial networks, addressing the significant limitations of current benchmarks and the subjective nature of perceptual quality evaluation. Through a systematic analysis, this study underscores the urgent need for developing methods that balance both perceptual and diagnostic quality, proposing new directions for future research in the field.

A toxicological assessment of Ganoderma lucidum and Cordyceps militaris mushroom powders

Gonoderma lucidum (G. lucidum) and Cordyceps militaris (C. militaris) are among the many mushrooms known for their long history of use in traditional medicine. Wildcrafted sources of mushrooms including G. lucidum and C. militaris can be limited from a scarcity and quality perspective, but solid fermentation processes in cultivation settings can provide an efficient way to deliver whole mushroom preparations of a consistent composition. Despite the historical use of these mushrooms, few published reports have explored their potential subchronic oral toxicity or genotoxicity, either from specific components or whole mushroom preparations. The purpose of this study was to assess the potential for acute toxicity, subchronic toxicity, and genotoxicity of powders produced from G. lucidum mycelial biomass and fruiting body (“Organic Reishi M2-102-02 powder”) cultured on oats, and C. militaris mycelial biomass, stroma, and fruiting body (“Organic Cordyceps M2-116-04 powder”) cultured on oats. Results of the testing demonstrate that both Organic Reishi M2-102-02 powder and Organic Cordyceps M2-116-04 powder were not acutely toxic, did not exhibit subchronic oral toxicity in rats at doses up to the highest dose tested of 2,000 mg/kg bw/day, and did not have genotoxic potential based on in vitro and in vivo genotoxicity assays.

Short-term postoperative recovery for patients after Thulium Laser Vapoenucleation of Prostate: evaluation of the impact of lower urinary tract symptoms on quality of life.

We evaluated short-term postoperative recovery in patients with benign prostatic hyperplasia (BPH), especially focusing on symptoms reduction and life quality enhancement. We prospectively enrolled 160 BPH patients who underwent surgery and were followed up regularly for 12 weeks, collecting the International Prostate Symptom Score (IPSS), Quality of Life (QoL), and Qmax. Regression analysis and mixed effect models were used to evaluate the tendency of symptoms on recovery from the perspective of quality of life. At 12 weeks, all patients recovered well with conspicuous change in IPSS, QoL and Qmax, that were 4.80 ± 4.59, 1.34 ± 1.14,20.02 ± 8.61 mL/s respectively. Voiding symptoms were significantly reduced by 79.4% at 2 weeks, whereas storage symptoms recovered slowly until 12 weeks with residual lower urinary tract symptoms (LUTS), predominantly urinary frequency and nocturia. Improvements in incomplete emptying urination and urinary frequency were significantly associated with QoL. With regards to the comprehensive full-cycle treatment of LUTS patients, in addition to the objective results, more attention should also be focused on the change in following symptoms, that is, incomplete emptying urination, urine frequency and urination difficulty, which play key roles in the enhancement of patients' quality of life.

Nature-Based Solution for Climate Change Adaptation: Coastal Habitats Restoration in Xiamen Bay, China

Nature-based solutions (NbSs) of biodiversity conservation and ecosystem restoration have been paid increasing attention as an essential approach to slow down climate change. However, to what degree an NbS approach will contribute to the combined effects of human intervention and climate change has not been well studied. From a habitat quality perspective, we set four NbS scenarios to analyze whether the NbS—mangrove restoration in particular—will be enough for climate change in Xiamen Bay of Fujian Province, China. The habitat quality module of the InVEST model (InVEST-HQ) and the Sea Level Affecting Marshes Model (SLAMM) were used to simulate the spatial-temporal changes in habitat types and habitat quality. Results show that (1) rising sea levels will cause coastal squeeze effects, impacting habitat quality due to erosion and inundation in the study area; (2) mangrove restoration is an effective way to mitigate climate change effects and to increase habitat quality; and (3) further analysis of the effectiveness of mangrove restoration shows that the consideration of mangrove fragmentation effects and sea-use impacts are necessary. The findings in this study will enrich the international discussion of NbSs to climate change in coastal areas.

Have a Good Travel Time in Routing: Bibliometric Analysis, Literature Review, and Future Directions

ABSTRACTTravel time serves as a critical factor in routing problems, affecting routing decisions, congestion avoidance, and environmental sustainability. In this study, a thorough bibliometric and network analysis is presented based on 1752 documents collected from Web of Science published in the past three decades. CiteSpace is adopted to generate research clusters for topological analysis that graphically illustrate the publications' evolution over time and identify the current state and the emerging trends of routing problems with travel time focus. The collaboration network explores the cooperation patterns between countries and institutions. Attention toward the time‐dependency, uncertainty, dynamic characteristics of travel time, and the influence of travel speed on emissions, is uncovered through document co‐citation analysis. Furthermore, a comprehensive review of the literature has been conducted from an information quality and evolution perspective. Realistic scenarios such as fuel consumption and traffic conditions are eliciting more attention. Significant emphasis is increasingly placed on the time dependency, reliability, uncertainty, and dynamics of travel time. This study systematically reviews and analyzes relevant research on routing problems with travel time focus, identifying key emerging trends and knowledge gaps, and offering valuable insights for future research.

Ontology in Dance Domain - A Survey

This article presents a literature review on the domain of dance research that exploits ontology artifacts to manage their domain knowledge. Any dance form around the world is rich in knowledge because of its historical and geographical diversity, movement rules, and interpretive aspects. Researchers found various approaches to manage this knowledge base, among which the ontology development process is preferred by most people owing to its superficial and easy-to-manage characteristics. However, the heterogenic use of ontology in different dance research aspects demands an organized study to understand its contributions to the domain. Our survey approach towards this objective starts with a systematic literature selection and further grouping them into four categories based on ontology involvement. Second, we discuss each group of articles by their contributions and the level of ontology involvement. Third, a novel evaluation framework is proposed, which assesses each selected article based on nineteen attributes from ontology quality, development, and applications perspectives. We rank each article into three qualitative measures, i.e., High(H), Medium(M), and Low(L), for our attribute set based on our understanding. Finally, We comprehensively analyze the outcomes of our qualitative assessment to present the current research status and their limitations in the candidate domain. This review aspires to be a cornerstone resource, enlightening researchers about the current landscape and future prospects of ontological involvement in dance research.

Effects of TMIn Flow Rate During Quantum Barrier Growth on Multi-quantum Well Material Properties and Device Performance in GaN-Based Laser Diodes

Abstract Multidimensional influence of indium composition in barrier layers on GaN-based blue laser diodes (LDs) are discussed through both material quality and device physics perspectives. LDs with higher indium content in the barriers demonstrate a notably lower threshold current and shorter lasing wavelength compared to those with lower indium content. Our experiments reveal that higher indium content in the barrier layers can partially reduce indium composition in the quantum wells, a novel discovery. Employing higher indium content barrier layers leads to improved luminescence properties of MQW region. Detailed analysis reveals that this improvement can be attributed to better homogeneity in the indium composition of the well layers along the epitaxy direction. InGaN barrier layers suppressed lattice mismatch between barrier and well layers, thus mitigating the indium content pulling effect in well layers. In supplement to experimental analysis, theoretical computations are performed, showing that InGaN barrier structures can effectively enhance carrier recombination efficiency and optical confinement of LD structure, thus improving output efficiency of GaN-based blue LDs. Combining these theoretical insights with our experimental data, we propose that higher indium content barriers effectively enhance carrier recombination efficiency and indium content homogeneity in quantum well layers, thereby improving the output performance of GaN-based blue LDs.

Creating airlines’ innovation: linking employees’ perspective of service quality, intellectual capital and innovation performance

ABSTRACT This study investigates various dimensions, including service quality, absorptive capacity, innovation performance, and intellectual capital (specifically organisational capital, social capital, and human capital), within the context of the airline industry. A survey questionnaire was administered to airline employees during the COVID-19 pandemic. The findings indicate that service quality has the potential to generate favourable innovation outcomes, such as increased absorptive capacity, thereby further enhancing employee innovation performance. Service quality is also found to have a simultaneous positive impact on human capital, leading to increased innovation performance and absorptive capacity. Therefore, organisations should prioritise the development of absorptive capacity to enhance both human capital and the accumulation of intellectual capital. Furthermore, both organisational capital and human capital play a vital role in these intricate strategy decision procedures. These factors play a crucial role in strengthening the connections between service quality and innovation performance.

Sleep quality in secure psychiatric healthcare: Inpatient & staff perspectives

The lived experiences of psychiatric inpatients are not well represented in the literature, especially when these experiences pertain to health. Reports regarding sleep health are particularly sparse, despite the increasing prevalence of sleep disorders in this population. The current study aimed to explore inpatient and staff perspectives of inpatient sleep quality to aid the future development of a sleep quality intervention. Fourteen inpatients (average age 43 years, 36 % female) were recruited for individual interviews and eleven staff members were recruited for three focus groups, from a secure psychiatric hospital (England). A semi-structured interview guide facilitated discussions regarding the prevalence and type of inpatient sleep problems, existing support for inpatient sleep problems including medication, and the bidirectional relationships between nighttime sleep and daytime behaviours, such as napping and physical activity. Using reflexive thematic analysis, four themes were developed: Irregular Sleep Schedules, Nighttime Disruptions, The Patient's Bedroom, and Keeping a Routine & Staying Physically Active. Study results can be utilised when developing inpatient sleep interventions, which were identified within the study as being sorely needed. Such interventions could focus on managing daytime sleeping, sedentary behaviour, and physical activity, in order to support good sleep hygiene, foster regular sleep/wake cycles, and improve overall health.

Private entrepreneurs’ technical background and innovation output: The perspective of innovation quantity and quality

This study investigates the impact of entrepreneurs' technical backgrounds on innovation output from the perspective of innovation quantity and quality, using data from A-share listed private companies in China between 2009 and 2018. Our analysis reveals that CEOs with technical expertise significantly enhance both the quantity and quality of firm innovation. We identify three key mechanisms through which technical backgrounds promote innovation: increased management attention to innovation, reduced information asymmetry, and enhanced long-term investment. These findings contribute to the literature on Upper Echelons Theory and corporate innovation, offering practical insights for private enterprises aiming to achieve talent-driven technological innovation and foster high-quality development.

Case Studies on Changes and Proposed Process Development Approaches reflecting applicability of PDA Technical Report No. 89 Strategies for Vaccine Development and Lifecycle Management.

Vaccines are complex and a very diverse group of products with relatively long product lifecycles. The manufacturing programs for these vaccines need to be continually updated to comply with evolving regulatory expectations. Members of the Parenteral Drug Association (PDA) Vaccines Interest Group (VIG) authored and published PDA Technical Report No. 89 Strategies for Vaccine Development and Lifecycle Management (TR 89) which seeks to provide context to vaccine developers and manufacturers regarding key aspects of new or legacy vaccines such as control strategy from process development to vaccine lifecycle management, comparability and lifecycle management including technical, validation, quality and regulatory perspectives. To further explain and illustrate the concepts and topics discussed, seven relevant situations were selected as either case studies associated with changes implemented or proposed process development strategies, which are discussed in this article. The situations described are: working cell bank, modification or update of externally supplied product contact components for vaccine manufacturing, raw material change, new product at an existing site, vaccine development acceleration by leveraging existing platforms, selection and implementation of potency method, and modeling for stability forecast prediction. For each situation, the applicable key concepts from TR#89 are discussed as follows: Control Strategy, Prior Knowledge, Relying on PQS, Classification of Parameters, Validation Approach, Use of a Risk-based Approach, Comparability, Use of ICHQ12 and Additional Regulatory Considerations.

Reverse mixed-ownership reform and earnings quality of Chinese private enterprises: from the perspective of state-owned capital participation

ABSTRACT This paper employs a multiple regression model to empirically investigate the economic effects of Chinese private enterprises’ reverse mixed-ownership reform from the perspective of earnings quality. The results indicate that state-owned capital participation primarily enhances private enterprises’ earnings quality by augmenting its resource support effect in obtaining government subsidies. Meanwhile, a certain degree of checks and balances is required for state-owned capital to participate in the process to mitigate the second type of principal-agent problem to exert a governance supervision effect. Furthermore, state-owned capital participation does not contribute to the value appreciation of private enterprises solely through improving earnings quality.

Measurement and Evaluation of the Development Level of Health and Wellness Tourism from the Perspective of High-Quality Development

In recent years, with the dramatic surge in the demand for health and elderly care services, the emergence of the health dividend has presented good development opportunities for health and wellness tourism. However, as a sector of the economy, health and wellness tourism still faces numerous challenges in achieving high-quality development. Therefore, this paper focuses on 31 provinces in China and constructs a multidimensional evaluation index system for the high-quality development of health and wellness tourism. The global entropy-weighted TOPSIS method and cluster analysis are used to conduct in-depth measurements, regional comparisons, and classification evaluations of the high-quality development of health and wellness tourism in each province. The research results indicate that: (1) From a quality perspective, the level of health and wellness tourism development in 11 provinces in China has exceeded the national average, while the remaining 20 provinces are below the national average. (2) From a regional perspective, the current level of high-quality development in health and wellness tourism decreases sequentially from the eastern to the central to the western regions, with significant regional differences. (3) Overall, the development in the 31 provinces can be categorized into five types: the High-Quality Benchmark Type, the High-Quality Stable Type, the High-Quality Progressive Type, the General-Quality Potential Type, and the General-Quality Lagging Type. (4) From a single-dimension analysis perspective, there are significant differences in the rankings of each province across different dimensions. Finally, this paper enriches and expands the theoretical foundation on the high-quality development of health and wellness tourism; on the other hand, it puts forward targeted countermeasures and suggestions to help promote the comprehensive enhancement of health and wellness tourism.

Employment Quality and Migration Intentions: A New Perspective from China’s New-Generation Migrant Workers

This study explores the factors influencing the migration intentions of the new generation of migrant workers from the perspective of employment quality. Utilizing differential analysis, correlation analysis, and the Partial Least Squares Structural Equation Modeling (PLS-SEM) model, this study analyzes data on hukou transfer intention obtained through an exploratory questionnaire survey. The results indicate significant differences in migration intentions among new-generation migrant workers differentiated by job industry, job position, gender, household registration type, and housing type. Additionally, age, the number of local family members, and housing satisfaction are strongly correlated with migration intentions. Path analysis reveals that employment stability, income–expenditure match, and social integration significantly positively affect migration intentions. This research provides a unique perspective on employment quality and offers theoretical foundations for policies related to migrant workers’ hukou transfer intention.

Air Pollution and Corporate Innovation: Does Top Management Quality Mediate and Government Talent Policy Moderate?

Air pollution not only poses significant threats to the physical and mental well-being of individuals, but it also has the potential to trigger a regional brain drain, thus inhibiting corporate innovation performance. This study explores the impact of air pollution on corporate innovation from the perspective of top management quality. We find that lower air quality significantly reduces the quality of corporate top management, thereby reducing their innovation output. However, local government talent attention alleviates the negative impact of air pollution on corporate innovation. Further analysis reveals that the local government’s environmental attention aggravates the negative effects of air pollution on corporate innovation. Finally, executive compensation alleviates the negative impact of air pollution on corporate innovation.

Rubinstein-Taybi Syndrome Clinical Characteristics from the Perspective of Quality of Life and the Impact of the Disease on Family Functioning.

Background/Objectives: Rubinstein-Taybi Syndrome (RSTS-OMIM, #180849) is a rare genetic disorder associated with distinctive clinical features, including a typical craniofacial appearance, global developmental delay, intellectual disability and broad, angular thumbs and fingers. The main aim of the study was to evaluate the health problems of children with RTST, their quality of life and the impact of the disease on family functioning. In addition, we investigate whether comorbidities, autistic behavior and eating problems affect the children's overall QOL. Methods: A cross-sectional study was performed, including a total of 13 caregivers of children diagnosed with RSTS. A self-reported questionnaire [SRQ], medical records and the Pediatric Impact Module PedsQLTM 2.0, the Pediatric Quality of Life PedsQLTM 4.0 were used to obtain data on QOL and the impact of the disease on family functioning. Results: The overall QOL score for children with RSTS was x = 52.40; SD 13.01. The highest QOL was in emotional functioning (EF; x = 59.23; SD 18.69), while the lowest QOL was in physical functioning (PF; x = 48.56; SD 16.32) and social functioning (SF; x = 48.85; SD 18.84). There was a statistically significant negative correlation (p < 0.03; r = -2.01) between the age of the child and their QOL, indicating that older children had lower QOL scores. The mean overall rating for the impact of RSTS on family functioning was x = 50.00; SD 10.91. Caregivers reported the highest scores for cognitive functioning (CF; x = 64.23; SD 23.70) and family relationships (FR; x = 60.00; SD 17.17). The lowest scores were for daily activities (DA; x = 41.03; SD 17.17) and worry (W; x = 37.69; SD 18.55). Conclusions: This study provides the first comprehensive exploration of the QOL of children with RSTS) and its impact on family functioning.

Macronutrient quality and its association with micronutrient adequacy in children

The double burden of malnutrition compels us to reconsider macronutrients from a diet quality perspective. The Macronutrient Quality Index (MQI) has been designed to reflect overall macronutrient quality and is based on three sub-indexes: the carbohydrate quality index (CQI), the healthy plate protein quality index (HPPQI) and the fat quality index (FQI). Nutritional adequacy is an essential aspect of diet quality that should be captured by reliable dietary indexes. We analyzed the association between the Macronutrient Quality Index (MQI) and micronutrient adequacy. Participants were children aged 4 and 5 years, recruited in the SENDO cohort. Baseline information was collected through a self-administered online questionnaire, which included information on sociodemographic, dietary, and lifestyle variables. Dietary information was obtained using a 147-item validated semi-quantitative food frequency questionnaire. Participants were categorized into tertiles based on their MQI score. We evaluated the intake of 20 micronutrients and assessed the probability of micronutrient adequacy using the Estimated Average Requirement cut-off point. Children in the highest tertile of MQI had 0.33-fold lower odds (95%CI 0.17-0.66) of having ≥3 inadequate micronutrient intakes than their peers in the lowest tertile, after adjusting for potential confounders. The adjusted proportions of children with inadequate intake of ≥3 micronutrients were 18%, 14% and 11% in the first, second, and third tertiles of MQI respectively. The MQI appears to be capable of capturing nutrient adequacy in children, although our results suggest that a modified MQI, with eggs and dairy products weighted positively, might be more adequate for the pediatric population.

Harmonics mitigation in distribution networks comprising smart online electric vehicles chargers based on equal sharing algorithm

This study focuses on analyzing the distribution network's performance due to the scheduled integration of electric vehicles (EVs). In this context, an online equal sharing scheduled algorithm is utilized to monitor and manage the charging process of EVs inside the charging stations (CSs). By this way, the planned charging demand may aid in minimizing the power stresses at the point of common coupling (PCC). Afterwards, the penetration of CSs into practical distribution networks is investigated and resolved from power quality perspectives. Meanwhile, voltage and current harmonic distortions of 3.3 % and 8.3 %, respectively resulted at the PCC due to installing these harmonic injection sources. It is worth mentioning that diverse topologies of passive filters are interrogated in this research for harmonics mitigation purposes. Single tuned passive filters demonstrate their superiority over other architectures in harmonics suppression with the simplest and most cost-effective solution. Additionally, the overloading stresses over the installed package substation of about 7 % are also alleviated permitting the CS to charge with full capacity. Finally, this work presents a forward step in the fields of EVs smart charging and harmonics mitigation in practical distribution gids.

Physicians' perspectives on clinical indicators: systematic review and thematic synthesis.

Clinical indicators are increasingly used to improve the quality of care, particularly with the emergence of 'big data', but physicians' views regarding their utility in practice is unclear. We reviewed the published literature investigating physicians' perspectives, focusing on the following objectives in relation to quality improvement: (1) the role of clinical indicators, (2) what is needed to strengthen them, (3) their key attributes, and (4) the best tool(s) for assessing their quality. A systematic literature search (up to November 2022) was carried out using: Medline, EMBASE, Scopus, CINAHL, PsycInfo, and Web of Science. Articles that metall of the following inclusion criteria were included: reported on physicians' perspectives on clinical indicators and/or tools for assessing the quality of clinical indicators, addressing at least one of the four review objectives; the clinical indicators related to care at least partially delivered by physicians; and published in a peer-reviewed journal. Data extracted from eligible studies were appraised using the Critical Appraisal Skills Programme tool. A thematic synthesis of data was conducted using NVivo software. Descriptive themes were inductively derived from codes, which were grouped into analytical themes answering each objective. A total of 14 studies were included, with 17 analytical themes identified for objectives 1-3 and no data identified for objective 4. Results showed that indicators can play an important motivating role for physicians to improve the quality of care and show where changes need to be made. For indicators to be effective, physicians should be involved in indicator development, recording relevant data should be straightforward, indicator feedback must be meaningful to physicians, and clinical teams need to be adequately resourced to act on findings. Effective indicators need to focus on the most important areas for quality improvement, be consistent with good medical care, and measure aspects of care within the control of physicians. Studies cautioned against using indicators primarily as punitive measures, and there were concerns that an overreliance on indicators can lead to narrowed perspective of quality of care. This review identifies facilitators and barriers to meaningfully engaging physicians in developing and using clinical indicators to improve the quality of healthcare.