Quality Measures Research Articles

Fentanyl may not be necessary for adequate endoscopic moderate sedation

BACKGROUND Although the majority of gastrointestinal (GI) endoscopies in the United States are now performed with propofol sedation, a substantial minority are performed with midazolam and fentanyl sedation. Despite the ubiquity of conscious sedation with midazolam and fentanyl in the United States, there is scant evidence specifically supporting the superiority of midazolam plus fentanyl over single agent midazolam sedation in GI endoscopy. We hypothesize that single agent sedation with midazolam is noninferior to sedation with midazolam plus fentanyl in GI endoscopy. AIM To investigate whether sedation with midazolam alone is noninferior to sedation with midazolam plus fentanyl in GI endoscopy. METHODS We conducted a randomized, single-blind study to compare the safety and effectiveness of single agent midazolam vs. standard fentanyl/midazolam moderate sedation in 300 outpatients presenting for upper endoscopy and/or colonoscopy at a tertiary care hospital. Primary outcomes were patient satisfaction as measured by the previously validated Procedural Sedation Assessment Survey. Secondary outcomes were procedure quality measures and adverse events. Statistical analysis was performed by a biomedical statistician using the χ 2 test, Fisher’s exact test, and Welch’s 2-sample t -test. RESULTS There was no difference in patient satisfaction between sedation groups, as measured by a less than 1 point difference between groups in Procedural Sedation Assessment Survey scores for discomfort during the procedure, and for preference for level of sedation with future procedures. There were no differences in adverse events or procedure quality measures. Cecal intubation time was 1 minute longer in the single agent midazolam group, and an average of 2.7 mg more midazolam was administered when fentanyl was not included in the sedation regimen. The recruitment goal of 772 patients was not reached. CONCLUSION It may be possible to minimize or avoid using fentanyl in endoscopist administered moderate sedation for GI endoscopy. We hope these findings spur further work in this under-researched area.

Melatonin for neuropathic pain: a double-blind, placebo-controlled, randomized, crossover trial.

Neuropathic pain (NP) is a common challenging problem, and there is a growing need to develop safe and effective nonopioid treatments. Sleep disturbance is commonly associated with NP because pain intensity of NP conditions is often worse at night. Some evidence suggests that the pineal hormone, melatonin, may reduce pain in clinical settings. We conducted a clinical trial to evaluate the efficacy of melatonin for NP. Using a double-blind, placebo-controlled, crossover design, 31 adults with NP were randomly allocated to 1 of 2 sequences of treatment with melatonin and placebo. During each of 2 treatment periods, participants took capsules containing melatonin or placebo for 4 weeks, followed by a 7-day washout period. The primary outcome was mean daily pain intensity (0-10) at maximally tolerated doses (MTD) during each period. Secondary outcomes, assessed at MTD, included adverse events, and measures of sleep, mood, and quality of life. Thirty-one participants were recruited, and 30 participants completed both treatment periods of the trial. The mean maximal tolerated dose of melatonin in this trial was 11.9 mg/day. Treatment-emergent adverse events with melatonin were infrequent and not statistically different from placebo. At MTD, mean daily pain (standard error) was 4.1 (0.3) for melatonin and 4.2 (0.3) for placebo (P = 0.8). There were no statistically significant differences between placebo and melatonin for any secondary outcomes. Overall, the results of this trial do not provide any evidence to suggest promise for melatonin as an effective treatment for NP.

Differences in Productivity and Clinical Care Between Permanent Staff, Employed Travel, and Locum Tenens Emergency Physicians.

Differences in Productivity and Clinical Care Between Permanent Staff, Employed Travel, and Locum Tenens Emergency Physicians.

Hidden Markov model-based similarity measure (HMM-SM) for gait quality assessment of lower-limb prosthetic users using inertial sensor signals

BackgroundGait quality indices, such as the Gillette Gait Index or Gait Profile Score (GPS), can provide clinicians with objective, straightforward measures to quantify gait pathology and monitor changes over time. However, these methods often require motion capture or stationary gait analysis systems, limiting their accessibility. Inertial sensors offer a portable, cost-effective alternative for gait analysis. This study aimed to evaluate a novel hidden Markov model-based similarity measure (HMM-SM) for assessing gait quality directly from gyroscope and accelerometer data captured by inertial sensors.MethodsWalking trials were conducted with 26 lower-limb prosthetic users and 30 able-bodied individuals, using inertial sensors placed at various lower body locations. We computed the HMM-SM score along with other established inertial sensor-based methods, including the Movement Deviation Profile, Dynamic Time Warping, IMU-based Gait Normalcy Index, and Multifeature Gait Score. Spearman correlations with the GPS, a validated measure of gait quality, were assessed, as well as correlations among the inertial sensor methods. Welch’s t-tests were used to evaluate the ability to distinguish between prosthetic subgroups.ResultsThe HMM-SM and other inertial sensor-based methods demonstrated moderate-to-strong correlations with the GPS (0.49 <|r|< 0.77 for significant correlations). Comparisons between different measures highlighted key similarities and differences, both in correlations and in their ability to differentiate between subgroups. Overall, the pelvis and lower leg sensors achieved significant correlations and outperformed the upper leg sensors, which did not achieve significant correlations with the GPS for any of the signal-based measures.ConclusionResults suggest inertial sensors located at the pelvis and lower leg provide valid markers for monitoring overall gait quality, offering the potential to develop nonobtrusive, wearable systems to facilitate long-term monitoring. Such systems could enhance rehabilitation by enabling continuous gait assessment that can be easily integrated in clinical and everyday settings.

Low-Cost Monitoring of Airborne Heavy Metals Using Lichen Bioindicators: Insights from Opole, Southern Poland

The assessment of air pollution is an important and relevant issue that requires continuous monitoring and control, especially in urban spaces. However, using instrumental air quality measurement techniques and deploying meters throughout the city is extremely expensive, so a biological alternative can be used—a bioindicator, i.e., a species whose vital functions or morphological structure can reveal the qualitative state of the environment. In this work, the lichen Hypogymnia physodes L. was used to analyze air pollution in areas of the provincial city of Opole, southern Poland. Microscope and chemotaxonomy methods were used in the laboratory to confirm field identification of lichens (atlases and keys). The selected elements, Mn, Fe, Ni, Cu, Zn, Cd, and Pb, were determined using atomic absorption spectrometry, and direct mercury analyzer was used to analyzed Hg concentration. Factor analysis (FA) was performed to associate elements with possible sources of air pollution. The highest concentrations of analytes were found at measurement points close to railway roads (Fe = 5131 mg/kg) and streets with heavy traffic (Pb = 101 mg/kg). Statistically significant differences (p &lt; 0.001) were found between the concentrations of individual elements, which have positive correlation coefficients higher than 0.65. Based on the research carried out, different anthropogenic and traffic-related activities can be considered as one of the main sources of air pollution in Opole City based on the results of FA. Using an additional lichen scale, it can be concluded that the areas surveyed in the town of Opole can be classified as zone IV—characterized by an increase in the number of leaf lichens (additionally co-occurring lichens of the Polycauliona candelaria species), i.e., an area with an average level of air pollution (based also on contamination factor [CF] and pollution load index [PLI]). Accumulation concentrations of heavy metals in lichen were metal-specific and varied spatially, thus reflecting local differences in heavy metal deposition. The research presented here proves that low-cost passive biomonitoring can effectively support classical methods of assessing air pollution in urban spaces.

Biochemical investigation of LC3/GABARAP-ligand interaction as an important quality measure for LC3/GABARAP-targeting small molecules: addendum to the guidelines (4th edition)

ABSTRACT Targeted protein degradation (TPD) represents a new therapeutic modality that allows the targeting of proteins that are considered undruggable by conventional small molecules. While TPD approaches via the ubiquitin-proteasome system are well established and validated, additional degradation pathways still require rigorous characterization. Here, we focus on macroautophagy/autophagy tethering compounds, a class of small molecules, designed to recruit cargo to LC3/GABARAP proteins for subsequent autophagosome-dependent degradation. We provide guidance for the biophysical and structural characterization of small molecule modulators for studying LC3/GABARAP-ligand interactions. In addition, we discuss potential limitations of autophagy-based TPD systems and emphasize the need for rigorous quality control in the development of LC3/GABARAP-targeting small molecules. Abbreviations: DSF: differential scanning fluorimetry; FP: fluorescence polarization; FRET: Förster/fluorescence resonance energy transfer; HTRF: homogeneous time-resolved fluorescence; ITC: isothermal titration calorimetry; LIR: LC3-interacting region; MGs: molecular glues; NMR: nuclear magnetic resonance; PROTACs: PROteolysis-TArgeting Chimeras; SPR: surface plasmon resonance; TPD: targeted protein degradation; TR-FRET: time-resolved Förster/fluorescence resonance energy transfer; UPS: ubiquitin-proteasome system

The Use of EQ-5D in the Middle East and North Africa Region: A Systematic Literature Review.

The EQ-5D is the most commonly used preference-based measure of health-related quality of life. There is limited evidence about the use of the EQ-5D in the Middle East and North Africa (MENA) region. This study aimed to systematically identify, review, summarize, and synthesize the published literature on using the EQ-5D in this region. A systematic literature review was conducted, according to the PRISMA 2020 guidelines, using PubMed, Cochrane, PsycINFO, and CINAHL and covering the period up to 30 August 2024. Studies using any version of the EQ-5D in adults or youth in the MENA region were included. Pilot studies, guidelines, study protocols, and reviews were excluded. Key study characteristics and outcomes assessed included study design, clinical area, population, type of EQ-5D data reported, reference value set used, and mode of administration. Title/abstract screening was conducted independently by two reviewers to assess eligibility for inclusion. Two researchers completed full-text screening and extracted data using a standardized form. Disagreements were referred to a third reviewer if not resolved by discussion. Results were summarized in systematic evidence tables. After removing duplicates, 18,034 references were considered for title/abstract screening. In total, 184 studies were included with a total sample size of 128,164 subjects. Of the included single-country studies, 42% were reported in Iran, 20% in Saudi Arabia, and 11% in Jordan. Patient populations were investigated in 86% of the studies, 23% of which targeted endocrine diseases. Study design was observational in 57% and experimental in 14% of the studies. Only 10% of the included studies applied the EQ-5D in an economic evaluation. The EQ-5D-3L version was used in 40% of the studies. However, the trend is towards a greater use of the 5L version in more recent years. Twenty percent of the studies reported EQ-5D results using the index score, frequencies of severity levels per dimension, and visual analog scale scores. EQ-5D modes of administration and funding sources were not reported in 16% and 20% of the studies, respectively. There is an increased use of the EQ-5D in the MENA region, especially since 2020. In the region, the use of the EQ-5D is more prevalent in clinical studies than in economic evaluation studies. The reporting heterogeneity indicates the need for guidance in reporting EQ-5D study results in this region.

How to make service better? A review on developing service-oriented public transit systems

ABSTRACT Improving service quality of urban public transportation systems is essential for attracting travellers. Ideally, building a service-oriented transit system requires holistic approaches on the closed cycle of measuring travellers’ perception of transit service, relating perceptions with supply factors, and making optimisation or improvement decisions with the goal of better service and lower cost. Separate literature reviews on transit service quality measurement and transit system optimisation were conducted previously, while there is no review investigating the consistency of service quality perceptions and optimisation approaches in an integrated manner. To fill this gap, we systematically reviewed existing contributions and examined the connections among transit service quality measurement, influence of supply factors on service quality and transit system optimisation. Results revealed gaps on goals of subjective passenger perceptions in existing optimisation methods as well as the need for embedding interplays between perceived service quality indicators and supply factors. Our research findings provide directions to future studies in this field, and we posit the importance of integrating human factors considerations in transit policy, planning and operation practices.

The Influence of Financial and Environmental Performance on Stock Prices: Evidence from Indonesian Manufacturing Firms

This study examines the influence of financial and environmental performance on stock prices among manufacturing companies listed on the Indonesia Stock Exchange during the period 2015–2024. Using panel data regression with the Random Effect Model (REM), the results show that Return on Assets (ROA), Net Profit, and Greenhouse Gas (GHG) Emissions have significant positive effects on stock prices, while Return on Equity (ROE) does not have a significant impact. These findings highlight those financial fundamentals remain the primary determinants of stock price movements, while environmental performance is beginning to serve as an indirect indicator of firm size and strength. The study suggests that investors in emerging markets continue to prioritize profitability and operational efficiency, although sustainability considerations are gradually gaining relevance. Future research is recommended to incorporate firm size controls and ESG quality measures to deepen the understanding of sustainability’s role in market valuation.

Impact of Institutional Quality on the Effectiveness of Monetary and Fiscal Policies in Peru Between 2005 and 2020

This study examines how institutional quality (measured by the ICRG and POLCON indices) impacts the effectiveness of monetary and fiscal policies in Peru between 2005 and 2020. Specifically, a Taylor-style monetary policy rule and a fiscal reaction function are jointly estimated, each augmented with an interaction between the output gap and the institutional quality measures. Moreover, the models incorporate inflation, exchange rate, and terms-of-trade gaps, alongside instrument lags and dummy variables. Monthly financial data come from the Central Reserve Bank of Peru, whereas ICRG and POLCON are annualized via Ecotrim. The equations are then estimated using the Generalized Method of Moments (GMM) to address potential endogeneity through lagged instruments. As a result, critical quality thresholds emerge (POLCON ≈ 0.86 for both rules, ICRG ≈ 72 in the Taylor framework, and ICRG ≈ 68 in the fiscal model) that distinguish procyclical from countercyclical regimes. Additionally, the interest-rate gap exhibits high persistence (exceeding 0.93), while the real-expenditure gap persists around 0.30. Furthermore, inflation, exchange rate, and terms-of-trade gaps significantly influence both policy instruments, and dummy variables capture the structural impacts of banking and fiscal reforms. In conclusion, strong institutional quality enhances the autonomy and credibility of both the Central Bank and fiscal authorities, thereby enabling countercyclical measures that stabilize economic fluctuations; conversely, periods of weak institutional frameworks in the 1980s and 1990s constrained such policy effectiveness. Finally, deepening institutional independence, transparency, and oversight is recommended to strengthen countercyclical policy, reduce macroeconomic volatility, and bolster economic agents’ confidence.

Surveying Family Caregivers to Assess Quality of End-of-Life Care in Medicare Advantage.

Objectives: As Medicare Advantage (MA) enrollment increases, measures are needed to monitor end-of-life care quality across settings. We aimed to use MA data to identify respondents for a survey of end-of-life care and derive quality measures from survey responses. Study Design: Cross-sectional study. Methods: We developed a survey that assesses end-of-life care experiences across settings and field-tested it among family caregivers of Kaiser Permanente members who died from July to November 2021. We used factor analysis to assess survey item performance and calculate composite measures, examined validity by regressing overall ratings on composites, and described care experiences across settings and care patterns through multivariable regression. Results: The response rate was 30%; 33% of decedents had cancer, 49% died at home, 24% in a hospital, and 5% in a nursing home. Confirmatory factor analyses supported five composite quality measures, assessing timeliness, communication, consistency of care with patient preferences, respect, and symptom palliation. Cronbach's alpha indicated adequate internal consistency reliability of composites (range: 0.72-0.82). Care experiences were better for those who died at home with hospice compared with those who died in a nursing home and for those who received care from one setting compared with those who transitioned across settings. Conclusion: It is possible to sample family caregivers for a survey of end-of-life care experiences using administrative data from an MA organization. Survey-based quality measures can be used to assess and compare the quality of end-of-life care in MA.

Dupilumab Efficacy in Children with Atopic Dermatitis with Different Phenotypes and Endotypes: A Case Series.

Atopic dermatitis (AD) is a prevalent disease in infants and young children worldwide. Dupilumab has been shown to rapidly and significantly improve AD signs, symptoms, and quality of life in pediatric patients with moderate-to-severe AD. In LIBERTY AD PRESCHOOL, a randomized, double-blind, placebo-controlled, phase 3 clinical trial, patients aged 6months to 5years with moderate-to-severe AD received subcutaneous dupilumab or matched placebo every 4weeks for 16weeks. All patients received concomitant low-potency topical corticosteroids. Here, we present 12 photographic cases of patients with different phenotypes and endotypes in the dupilumab group, representative of the study population, before and after treatment. Each case is presented with clinical outcome measures of AD severity and quality of life, as well as relevant biomarkers, with percent improvement from baseline. Treatment with dupilumab led to visible improvements in signs of lichenification, erythema, excoriations, skin dryness, and oozing/crusting. Clinically meaningful improvements in the measured outcomes were observed in most of the patients, including AD extent and severity, clinical lesions, itch, sleep loss, frequency of symptoms, and quality of life. These improvements were associated with substantial reductions in AD-related biomarkers. Treatment with dupilumab improved signs, symptoms, and quality of life, and reduced AD-related serum biomarkers in young children with moderate-to-severe AD with different phenotypes and endotypes. The trial was registered with ClinicalTrials.gov with ID number NCT03346434 on November 17, 2017. Video abstract available for this article. Video abstract (MP4 1,02,609 KB).

Translation, cultural adaptation and validation of the Stapesplasty Outcome Test 25 (SPOT-25) for measurement of disease-specific health-related quality of life in Dutch otosclerosis patients: a prospective study.

To translate and culturally adapt the SPOT-25 to the Dutch language and validate the Dutch SPOT-25 in a Dutch population of otosclerosis patients undergoing primary stapes surgery. A multicenter prospective validation study was performed between November 2018 and May 2024. The translation into Dutch and validation process of the SPOT-25 was performed according to the COSMIN guidelines. Patients were asked to complete the SPOT-25 and Glasgow Health Status Questionnaire (GHSQ) preoperatively, the SPOT-25, GHSQ and Glasgow Benefit Inventory six to eight weeks postoperatively and the SPOT-25 eight to ten weeks postoperatively. Healthy controls were asked to complete the translated SPOT-25 once. Preoperative and postoperative audiometric results were also obtained. The evaluated measurement properties included construct validity, measurement invariance, discriminative validity, reliability and responsiveness of the translated SPOT-25. Hundred and fifteen patients and 50 healthy controls were analyzed. Analyses of the translated SPOT-25 showed adequate construct validity, discriminative validity, reliability and responsiveness. The SPOT-25 scores were strongly correlated with the GHSQ score. The internal consistency and test-retest reliability were good as Cronbach's alpha and intraclass correlation coefficients were higher than 0.70. The four-factor model fitted best in our population of otosclerosis patients; however the results indicated a mediocre fit between the model and the data. The Dutch SPOT-25 showed good validity, reliability and responsiveness and can be implemented as an additional outcome measure to improve otosclerosis research and clinical practice.

Towards a Better Understanding of the Lived Experience of Carers of People With Bipolar Disorder: A Mixed-Methods Study.

Caring for someone with Bipolar disorder (BD) is unique, and the severity and complexity of symptoms can overwhelm informal carers such as family, friends, and partners. This study employed a concurrent mixed-methods model to investigate the lived experience of informal carers caring for those with BD in Australia. Participants (n = 46) answered an online survey containing standardised measures of quality of life and coping mechanisms as well as open-ended questions about their caring role challenges and support. Carers reported mental health problems as the highest care-related burden and reported low perceived social support. However, a one-way MANOVA indicated no difference in these dimensions between carers of people with BD I and II. Reflexive thematic analysis revealed five superordinate themes relating to informal caregivers' challenges, coping strategies, and the support they need. The themes were: like a roller-coaster; carer mental health; complexities of the carer role and diagnosis; how to cope; and multifaceted support. The oscillation of symptoms and complexities of the caring role increased the burden on carers and created mental health challenges, requiring carers to use various coping strategies. Findings highlight the need for individualised, multimodal support for carers. Carers need adequate and accessible support through strong partnerships with healthcare providers to improve their own quality of life and mental health and, in turn, those in their care.

Regional Only Anesthesia is a Safe Alternative to Perform Arthroplasty for Femoral Neck Fracture.

To examine the efficacy of regional only anesthesia for arthroplasty surgery following displaced femoral neck fractures. Design: Retrospective study. A single academic medical center and Level 1 Trauma Center. Patients with displaced femoral neck fracture (AO/OTA 31B1.3) treated with either hemi- or total hip arthroplasty were identified. Patients who had general (GA) and Spinal (SA) anesthesia were each matched 2:1 to those who underwent Lateral Femoral Cutaneous and Over the Hip (LOH),based on the Score for Trauma Triage in the Geriatric and Middle Aged (STTGMA) risk score and arthroplasty type. Patient demographics, injury characteristics, and surgical history were compared. Outcomes included postoperative complications, 90-day readmission rates, 1-year mortality and discharge location. Significance was p>0.05. 145 patients were analyzed: 58 GA, 58 SA, and 29 Regional. Cohorts were similar in demographics: mean age was 79.9 +9.9 for LOH, 79.8+11.00 for GA and 82.2+8.6 for SA (p=0.3), with 72% female patients in the LOH, 67% female in the GA and 76% female in SA (p=0.585). GA patients had the highest BMI (25.3±5.3 kg/m2, p=0.004). SA patients had the highest ASA score (2.9±0.7, p=0.036). GA patients had the longest anesthesia (2:55 hours, p=0.013) and operating room time (3:35, p=0.009). Regional anesthesia had the shortest anesthesia (2:26, p=0.013) and operating room time (2:54, p=0.009). GA had a higher complication rate (56.9%, p=0.039), including major complications (20.7%, p=0.025) and post-operative anemia (34.5%, p=0.049). GA had a longer length of stay (6.4±2.9 days, p=0.022). Patients operated on under regional only were discharged to home (62%, p=0.003) while more GA (79%) and SA (71%) patients were discharged to SNF (p<0.001). LOH patients ambulated sooner following surgery (1.03±0.2 days, p=0.001). No post-operative complications, blood transfusions (p=0.321), mortality (p=0.089), 30-day readmission (p=0.819), and post-operative delirium (p=0.514) were significantly different. Regional only anesthesia (LOH Block) was safe and effective for hemi and total hip arthroplasty for a displaced femoral neck fracture as compared to spinal and general anesthesia. This anesthetic approach allowed for successful procedures and yielded lower associated rates of post-operative complications and operative time in addition to improved quality measures. Prognostic Level III.

Aggregating single nucleotide polymorphisms improves filtering for false-positive associations postimputation.

Imputation causes bias in P-values in downstream genome-wide association studies. Imputation quality measures such as IMPUTE info are used to discriminate between false and true associations. However, implementing a high threshold often discards true associations, while a low threshold preserves false associations. This poses a challenge, especially for studies genotyped with SNP arrays. In practice, association signals register as spikes of low P-values for SNPs in close proximity owing to linkage disequilibrium, but postimputation filtering is conducted on SNPs independently. We simulated 1536 small case-control studies on the human chromosome 19 both to quantify the introduced bias and to evaluate postimputation filtering. The established IMPUTE info thresholds 0.3 and 0.8 were compared on individual SNPs and aggregated spikes in the formats "best guess genotype" and "dosage." Furthermore, we applied 2 recently published methods, Iam hiQ and MagicalRsq, to assess their effect on filtering. We found differences in false signals and imputation quality between the genotype formats, especially in the midrange between thresholds. In this midrange, 51 and 60% of associated SNPs for best guess and dosage format, respectively, are true associations. For aggregated SNPs, the majority of spikes in the midrange are true associations. We propose a new method, the Midrange Filter, which uses both thresholds and formats to classify spikes instead of SNPs. This method discards up to the same number of false signals as the upper threshold, while preserving all true associations in most simulation settings. The PsyCourse study is included as a real-data application.

Hyperspectral characterization of wastewater in the Tijuana River Estuary using laboratory, field, and EMIT satellite spectroscopy.

Hundreds of millions of liters of untreated wastewater are discharged into the Tijuana River annually, impacting communities on both sides of the US-Mexico border. Current monitoring methods are resource-intensive and limited in coverage. Optical satellite imaging may enable broader spatiotemporal monitoring, yet retrievals of bacterial concentrations and other key water quality indicators remain challenging. Here we investigate the utility of spectroscopic sensors to monitor the presence of wastewater in this estuarine-coastal system, as a proxy for bacterial concentrations and other water quality parameters. We prepared dilutions of untreated wastewater and uncontaminated seawater, measuring visible through shortwave infrared (VSWIR; 350-2500nm) reflectance spectra of each sample. At high wastewater concentrations, a distinct spectral feature centered near 620nm strongly correlated with paired water quality measurements (R2≥0.97, p-value<0.01). This feature is additionally observed in multispectral resolution, in field observations, and in hyperspectral satellite imagery. An example application of plume mapping with this feature is presented, representing one of the earliest adoptions of EMIT hyperspectral satellite imagery for water quality monitoring. These results are promising for the use of spectroscopic sensors to map and monitor wastewater pollution in the Tijuana River Estuary and potentially, similarly polluted coastal and estuarine systems.

Impact of rail grinder vibration characteristics on grinding quality and alleviation measures

Periodic grinding marks generated during rail grinding can readily serve as excitation for the initiation of rail corrugation. To improve the rail surface roughness after rail grinding, an improvement of the grinding carriage frame was conducted based on the analysis of resonance characteristic. Vibration tests revealed that the vibrations were dominated by the grinding motor’s rotation at the frequency of 60 Hz, and there were significant vibration responses ranging from 59 to 63 Hz in the grinding carriage frame. Modal analysis further revealed that the longitudinal expansion and contraction of the primary longitudinal beams of the grinding carriage frame with natural frequency of 57.6 Hz and the rolling motion of the crossbeams with natural frequency of 60.3 Hz were exacerbated by the motor rotation at 60 Hz. From the perspective of avoiding resonance, a structural improvement of the frame was conducted, resulting in a notable reduction in motor vibration. The vibration jump-up of the improved structure from idle condition to grinding condition decreased by 66% compared to that before structural improvement. The rail roughness at the wavelength corresponding to the resonant frequency decreased from 19.8 dB before grinding to 15.3 dB after grinding, representing a reduction of 22.6%, and this enhanced grinding effect was 1.9 times that of the original structure. Therefore, the improved grinding carriage frame can significantly alleviate the impact of resonance, thereby reducing the fluctuations in grinding force during the process, and substantially enhancing the quality of rail grinding.

A long-term high-resolution air quality reanalysis with a public-facing air quality dashboard over the Contiguous United States (CONUS)

Abstract. We present a 14-year, 12 km, hourly air quality dataset (https://doi.org/10.5065/cfya-4g50, Kumar and He, 2023) created by assimilating satellite observations of aerosol optical depth (AOD) and carbon monoxide (CO) in an air quality model to fill gaps in the contiguous United States (CONUS) air quality monitoring network and help air quality managers understand long-term changes in county-level air quality. Specifically, we assimilate the Moderate Resolution Imaging Spectroradiometer (MODIS) AOD and the Measurement of Pollution in the Troposphere (MOPITT) CO observations in the Community Multiscale Air Quality Model (CMAQ) every day from 1 January 2005 to 31 December 2018 to produce this dataset. Meteorological fields simulated with the Weather Research and Forecasting (WRF) model are used to drive CMAQ offline and to generate meteorology-dependent anthropogenic emissions. Both the weather and air quality (surface fine particulate matter (PM2.5) and ozone) simulations are subjected to a comprehensive evaluation against multi-platform observations to establish the credibility of our dataset and characterize its uncertainties. We show that our dataset captures regional hourly, seasonal, and interannual variability in meteorology very well across the CONUS. The correlation coefficient between the observed and simulated surface ozone and PM2.5 concentrations for different regions defined by the Environmental Protection Agency (EPA) across the CONUS are 0.77–0.91 and 0.49–0.79, respectively. The mean bias and root-mean-square error for modeled ozone are 3.7–6.8 and 7–9 ppbv, respectively, while the corresponding values for PM2.5 are −0.9–5.6 and 3.0–8.3 µg m−3, respectively. We estimate that the annual CONUS-averaged maximum daily 8 h average (MDA8) ozone and PM2.5 trends are −0.30 ppb yr−1 and −0.24 µg m−3 yr−1, respectively. Wintertime MDA8 ozone shows an increasing but statistically insignificant trend at several sites. We also found a decreasing trend in the 95th percentile of MDA8 ozone but an increasing trend in the 5th percentile. Most of the sites in the Pacific Northwest show an increasing but statistically insignificant trend during summer. An ArcGIS air quality dashboard has been developed to enable easy visualization and interpretation of county-level air quality measures and trends by stakeholders, and a Python-based Streamlit application has been developed to allow the download of the air quality data in simplified text and graphic formats.

DEVELOPMENT OF HYDROGEL FORMULATIONS OF SELECTED ANTIFUNGAL DRUGS USING CYCLODEXTRIN BASED NANOSPONGES AS A CARRIER

Objective: This project will construct a Cyclodextrin-Based Nanosponge (CDNS) gel and test its topical skin application to improve Posaconazole's (PO) therapeutic impact, distribution, and preservation. Methods: Using convection heating, Cyclodextrin (CDs) (β-CD, 2-HP-β-CD, and SBE-β-CD) were employed to crosslink diphenylcarbonate Nanosponge (NS). Make Posaconazole-Loaded Nanosponges (PONS) by freeze-drying. Box–Behnken Experimental Design (BBD) was used to formulate Carbopol 974 (1–3%, w/w), Propylene glycol (5–10%), and ethanol (10–20%, w/w). The relationship between procedural parameters and quality factors was examined using statistical screening. Analysis of Variance (ANOVA) was used for pilot studies. Key techniques affect contour, Response Surface Methodology (RSM), and perturbation graph quality measures. Results: The average particle size of plain NS was 120–220 nm, while PO loaded ones were 48–51 nm with low Polydispersity Index (PDI). High Zeta Potential (ZP) suggests stable, low-agglomeration chemicals. The formulation demonstrated strong encapsulation efficiency (85.78±4.13%) with a viscosity range of 3476.34±213.12 to 3538.28±164.24 and showed 14% degradation over three months. All test formulations exhibited significantly higher PO skin penetration 12 h post-application (range: 41.64±1.72 μg/cm² to 54.12±1.89 μg/cm²) compared to the control group (5.68±0.23 μg/cm²). In vitro release tests indicated NS complexes released medicines faster than pure medications. PONS3, PONS7, and PONS12 with controlled release were chosen for topical hydrogel research due to their effective PO release regulation. NS resisted photodegradation and chemical degradation of PO for 6 mo. Model carbopol gel with NS compositions tested skin permeability, antifungal efficacy, and stability. PONS steadily permeated rat skin for 12 h. Conclusion: The slow drug release, greater skin penetration, and superior storage stability of the gel formulation based on CDNS of PO imply that it has great potential as a topical delivery system.