Quality Measures Research Articles

Star Ratings in Long-Term Care Facilities in Australia: Facility Characteristics Associated With High Ratings and Changes in Ratings Over Time

ObjectivesA Star Rating system (1 to 5 stars) of long-term care facilities in Australia is based on 4 sub-categories: compliance, quality measures, residents’ experience, and staffing. The objectives were to examine associations between facility characteristics and the odds of receiving a 4- or 5-star rating, and changes in ratings between the earliest reporting period (October–December 2022) to the most recent (April–June 2023). DesignCross-sectional, ecological study, with an additional longitudinal component. SettingLong-term care facilities in Australia. MethodsAssociations between facility characteristics and the odds of receiving a 4- or 5-star rating were examined using a multiple logistic regression model. Average changes in overall star rating and each sub-category weighted by fractional contribution to overall star rating were estimated. ResultsOf 2476 facilities, 53.7% received a 4- or 5-star rating, 44.1% a 3-star rating, and 2.1% a 1- or 2-star rating in the April–June 2023 reporting period. Facility characteristics associated with higher odds of 4- or 5-star ratings included small (≤60 residents) and medium-size (61–100 residents) (odds ratios, 3.16; 95% CI, 2.51–3.98 and 1.72; 05% CI, 1.38–2.13, respectively), and Queensland location compared with New South Wales (2.42; 95% CI, 1.87–3.14). Facilities in socioeconomically disadvantaged areas (0.45; 95% CI, 0.33–0.62) and for-profit (0.12; 95% CI, 0.07–0.22) or not-for-profit facilities (0.16; 95% CI, 0.09–0.29) compared with government-operated were associated with lower odds of 4- or 5-star ratings. Between the 2 reporting periods, 25.1% of facilities' star ratings increased and 10.2% decreased (average change 0.156). Residents’ experience, compliance, and staffing had the largest weighted average sub-category rating changes (0.051, 0.042, and 0.042, respectively). ConclusionsSmaller size, government ownership, and location in socioeconomically advantaged areas were associated with higher odds of 4- or 5-star ratings in long-term care facilities. Average star ratings increased over time but increases and decreases in overall and sub-category ratings were observed.

An Innovative New Approach to Light Pollution Measurement by Drone

The study of light pollution is a relatively new and specific field of measurement. The current literature is dominated by articles that describe the use of ground and satellite data as a source of information on light pollution. However, there is a need to study the phenomenon on a microscale, i.e., locally within small locations such as housing estates, parks, buildings, or even inside buildings. Therefore, there is an important need to measure light pollution at a lower level, at the low level of the skyline. In this paper, the authors present a new drone design for light pollution measurement. A completely new original design for an unmanned platform for light pollution measurement is presented, which is adapted to mount custom sensors (not originally designed to be mounted on a unmanned aerial vehicles) allowing registration in the nadir and zenith directions. The application and use of traditional photometric sensors in the new configuration, such as the spectrometer and the sky quality meter (SQM), is presented. A multispectral camera for nighttime measurements, a calibrated visible-light camera, is used. The results of the unmanned aerial vehicle (UAV) are generated products that allow the visualisation of multimodal photometric data together with the presence of a geographic coordinate system. This paper also presents the results from field experiments during which the light spectrum is measured with the installed sensors. As the results show, measurements at night, especially with multispectral cameras, allow the assessment of the spectrum emitted by street lamps, while the measurement of the sky quality depends on the flight height only up to a 10 m above ground level.

Work-related stress and sleep quality—the mediating role of rumination: a longitudinal analysis

Abstract Objective This study investigates the mediating role of rumination in the relationship between work-related stress and sleep quality. Sleep quality is a critical component of mental health and wellbeing. Work-related stress is a potential risk factor for poor sleep quality, and this research focuses on how the constructs of rumination—affective rumination, detachment, and problem-solving rumination—may mediate this association. Methods Data from the Dresden Burnout Study were analyzed cross-sectionally and longitudinally over three timepoints. The sample included 360 full- and parttime employees. Work-related stress was assessed using the effort–reward Imbalance Questionnaire, sleep quality using the Pittsburgh Sleep Quality Index, and rumination using the Work-Related Rumination Questionnaire. Results The study found that work-related stress was positively correlated with reduced sleep quality, both cross-sectionally and longitudinally. In addition, work-related stress predicted increased levels of affective rumination and detachment but not of problem-solving rumination. Affective rumination and detachment partially mediated the relationship between work-related stress and sleep quality, suggesting that individuals who experience higher levels of work-related stress are more likely to engage in ruminative thoughts about their work experiences, which, in turn, leads to reduced sleep quality. Conclusion These findings highlight the importance of considering cognitive processes such as rumination when addressing sleep disturbance related to work stress. Future research should include objective measures of sleep quality and consider shorter intervals to capture immediate changes in stress and sleep patterns. By addressing these factors, healthcare professionals can better support those suffering from sleep disturbance due to work-related stress. Ultimately, this may have a positive impact on their overall wellbeing and productivity at work.

Equity in Heart Failure Care: A Get With the Guidelines Analysis of Between- and Within-Hospital Differences in Care by Sex, Race, Ethnicity, and Insurance.

Disparities in guideline-based quality measures likely contribute to differences in heart failure (HF) outcomes. We evaluated between- and within-hospital differences in the quality of care across sex, race, ethnicity, and insurance for patients hospitalized for HF. This retrospective analysis included patients hospitalized for HF across 596 hospitals in the Get With the Guidelines-HF registry between 2016 and 2021. We evaluated performance across 7 measures stratified by patient sex, race, ethnicity, and insurance. We evaluated differences in performance with and without adjustment for the treating hospital. We also measured variation in hospital-specific disparities. Among 685 227 patients, the median patient age was 72 (interquartile range, 61-82) and 47.2% were women. Measure performance was significantly lower (worse) for women compared with men for all 7 measures before adjustment. For 4 of 7 measures, there were no significant sex-related differences after patient-level adjustment. For 20 of 25 other comparisons, racial and ethnic minorities and Medicaid/uninsured patients had similar or higher (better) adjusted measure performance compared with White and Medicare/privately insured patients, respectively. Angiotensin receptor neprilysin inhibitor measure performance was significantly lower for Asian, Hispanic, and Medicaid/uninsured patients, and cardiac resynchronization therapy implant/prescription was lower among women and Black patients after hospital adjustment, indicating within-hospital differences. There was hospital-level variation in these differences. For cardiac resynchronization therapy implantation/prescription, 278 hospitals (46.6%) had ≥2% lower implant/prescription for Black versus White patients compared with 109 hospitals (18.3%) with the same or higher cardiac resynchronization therapy implantation/prescription for Black patients. HF quality measure performance was equitable for most measures. There were within-hospital differences in angiotensin receptor neprilysin inhibitor and cardiac resynchronization therapy implant/prescription for historically marginalized groups. The magnitude of hospital-specific disparities varied across hospitals.

SEASONAL VARIATIONS IN SOMATIC CELL COUNT AND THEIR IMPACT ON THE PHYSICOCHEMICAL COMPOSITION OF RAW COW MILK

Understanding milk quality is essential for ensuring dairy products meet required standards. Somatic cell count (SCC) serves as a commonly used measure of milk quality within the dairy sector. While it offers valuable insights into the udder health of dairy cows, its reliability is influenced by various non-infectious factors, notably seasonal variations. This study aimed to investigate the impact of seasonal variations on SCC in raw cow milk, and subsequently, how these variations may lead to changes in its physicochemical composition. Over a year, 4,287 samples were collected from three dairies in Bitola, Macedonia. Standard accredited methodologies were employed, adhering to ISO 21187:2011 for total bacteria count (TBC), ISO 13366-2:2010 for SCC determination, ISO 9622:201 for analyzing fat, protein, and lactose content, and ISO 5764:2010 for determining freezing point. Statistical analysis using SPSS 15.0 was conducted on the acquired data. Significant differences were observed in the lactose content (p<0.05), but not in the milk fat content (p>0.05), while for the other parameters (proteins, freezing point, and solids-non-fat) seasonal variations were observed with the increase in SCC in summer and autumn. TBC in summer is the highest (1,992 x 103 CFU/ml) while in winter is the lowest (1,168 x 103 CFU/ml), which is not the case for SCC where the highest values are also in summer (537 x 103 SCC/ml), but the lowest values were determined in spring (449 x 103 SCC/ml). These findings underscore the importance of considering seasonal variations when evaluating milk quality and suggest potential implications for dairy industry practices and regulations.

Real-Time and Wireless Transmission of a Nitrogen-Doped Ti3C2Tx Wearable Gas Sensor for Efficient Detection of Food Spoilage and Ammonia Leakage.

With the rising popularity of smart homes, there is an urgent need for devices that can perform real-time online detection of ammonia (NH3) concentrations for food quality measurement. In addition, timely warning is crucial to preventing individual deaths from NH3. However, few studies can realize continuous monitoring of NH3 with high stability and subsequent application validation. Herein, we report on an integrated device equipped with a nitrogen-doped Ti3C2Tx gas sensor that shows great potential in detecting food spoilage and NH3 leakage. The nitrogen doping results in the lattice misalignment of Ti3C2Tx, subsequently realizing effective barrier height modulation and enhanced charge transfer efficiency of nitrogen-doped Ti3C2Tx. Density functional theory calculations confirm the greatly enhanced adsorption of NH3 on nitrogen-doped Ti3C2Tx. Our work can inspire the design of efficient gas sensors for real-time and wireless detection of food spoilage and NH3 leakage.

The quality of home-based primary care delivered by nurse practitioners: A national Medicare claims analysis.

As the US population ages, there is an increasing demand for home-based primary care (HBPC) by those with Alzheimer's/dementia, multiple chronic conditions, severe physical limitations, or those facing end-of life. Nurse practitioners (NPs) are increasingly providing HBPC, yet little is known about their quality of care in this unique setting. This observational study uses Medicare claims data from 2018 to assess the quality of care for high-intensity HBPC users (5 or more visits/year) based on provider type (NP-only, physician (MD)-only, or both NP and MDs). We employ 12 quality measures from 3 care domains: access and prevention, acute care utilization, and end-of-life. Analysis includes bivariate comparisons and logistic regression models that adjust for demographic, clinical, and geographic characteristics. Among the 574,567 beneficiaries with 5 or more HBPC visits, 37% saw an NP, 37% saw a MD, and 27% saw both NPs and MDs. In multivariate models, those receiving HBPC from an NP or both NP-MD are significantly more likely to receive a flu shot than the MD-only group, but less likely to access preventive care. NP-only care is associated with more acute care hospitalizations, avoidable ED visits, and fall-related injuries, but significantly fewer avoidable admissions. For end-of-life care, those with NP-only or both NP-MD care are significantly more likely to have an advanced directive, be in hospice in the last 3 days of life, and more likely to die in hospice. The NP group is also more likely to die in the next year. HBPC patients are complex, with both palliative and curative needs. NPs provide almost half of HBPC in the Medicare program, to patients who are possibly sicker than those treated by physicians, with similar quality to MDs.

Electronic Health Record Nudges and Health Care Quality and Outcomes in Primary Care

Nudges have been increasingly studied as a tool for facilitating behavior change and may represent a novel way to modify the electronic health record (EHR) to encourage evidence-based care. To evaluate the association between EHR nudges and health care outcomes in primary care settings and describe implementation facilitators and barriers. On June 9, 2023, an electronic search was performed in PubMed, Embase, PsycINFO, CINAHL, and Web of Science for all articles about clinician-facing EHR nudges. After reviewing titles, abstracts, and full texts, the present review was restricted to articles that used a randomized clinical trial (RCT) design, focused on primary care settings, and evaluated the association between EHR nudges and health care quality and patient outcome measures. Two reviewers abstracted the following elements: country, targeted clinician types, medical conditions studied, length of evaluation period, study design, sample size, intervention conditions, nudge mechanisms, implementation facilitators and barriers encountered, and major findings. The findings were qualitatively reported by type of health care quality and patient outcome and type of primary care condition targeted. The Risk of Bias 2.0 tool was adapted to evaluate the studies based on RCT design (cluster, parallel, crossover). Studies were scored from 0 to 5 points, with higher scores indicating lower risk of bias. Fifty-four studies met the inclusion criteria. Overall, most studies (79.6%) were assessed to have a moderate risk of bias. Most or all descriptive (eg, documentation patterns) (30 of 38) or patient-centeredness measures (4 of 4) had positive associations with EHR nudges. As for other measures of health care quality and patient outcomes, few had positive associations between EHR nudges and patient safety (4 of 12), effectiveness (19 of 48), efficiency (0 of 4), patient-reported outcomes (0 of 3), patient adherence (1 of 2), or clinical outcome measures (1 of 7). This systematic review found low- and moderate-quality evidence that suggested that EHR nudges were associated with improved descriptive measures (eg, documentation patterns). Meanwhile, it was unclear whether EHR nudges were associated with improvements in other areas of health care quality, such as effectiveness and patient safety outcomes. Future research is needed using longer evaluation periods, a broader range of primary care conditions, and in deimplementation contexts.

The Quality of Blume and Vasicek Betas for forecasting systematic risk: Evidence from a German stock portfolio

Abstract In both practical applications and empirical capital market research the beta factor is often estimated for the future period using an OLS regression analysis based on historical data. However, these betas are often not reliable for the future. For this reason, methods have been developed to correct or adjust the (raw) beta. The aim of this study is to find out to what extent the forecasting quality of a stock beta can be improved by Blume Beta, Vasicek Beta and a simple variant of Blume Beta ("Adjusted Beta"). For this purpose, an empirical analysis is carried out on the basis of 10 stocks included in the German stock index DAX. For the entire period under review, it can be observed that all three adjustment methods tend to improve the forecast quality compared to the raw beta, with the simple “Adjusted beta” leading to the best values. The examination of two subperiods, one covering the financial and economic crisis of 2008/2009 and the other the Corona pandemic, shows that the forecasting quality tends to be lower when looking at individual stocks compared with the overall period. However, according to the values (i.e. averages of all stocks) of the forecasting quality measures used in this paper, the adjustment procedures mostly produce better values than raw beta in both subperiods. JEL classification numbers: G11. Keywords: Adjusted beta, Blume beta, Vasicek beta, Mean Squared Error.

Response of Integrated Nutrient Management (INM) Practice on Growth, Yield and Quality Parameters of Fenugreek (Trigonella corniculate L.)

Integrated nutrient management methods assist improve fenugreek (Trigonella corniculate L.) development and yield by integrating the use of organic and inorganic fertilizers. These methods enhance soil fertility, increase nutrient availability, and improve plant health, all of which lead to increased crop yield, growth and quality. Future policies must place a high priority on the economical, sustainable, and efficient use of nutrient resources for the purpose to increase agricultural output. Thus, proper crop, water, soil, and land management along with integrated nutrient management are necessary for sustainable agriculture. Improved soil qualities and increased nutrient availability for agricultural plants come from the use of organic manures in conjunction with inorganic fertilizers. This enhances fenugreek growth, yield, and quality measures. The synthesis of carbohydrates, phytohormones, and even biofertilizers is enhanced by a nutritious diet. It also builds up the soil's organic status, which raises the availability of other nutrients and contributes to the maximum growth of crops. Vermicompost, farmyard manure, rhizobium, phosphorus- and potassium-soluble bacteria (PSB) are among the materials used in methi cultivation that support sustainable agriculture by enhancing soil fertility, nutrient availability, and general crop health, all of which lead to higher methi yields and quality. Organic matter is a storehouse of nutrients; applying both organic and inorganic fertilizer together can boost yields, improve soil fertility, raise crop input-use efficiency, and reduce the need for expensive fertilizers. This crop responds effectively to N provided through a combination of organic and inorganic sources. Majority of the nitrogen applied from different sources is not used by the first crop and is always reflected in the crop that follows. Therefore, it is necessary to assess how integrated nutrition management affected fenugreek's yield and nutrient uptake.

Impact of Disease Factors of Patients with Psoriasis and Psoriatic Arthritis on Biologic Therapy Switching: Real-World Evidence from the CorEvitas Psoriasis Registry.

Patients with psoriasis (PSO) and psoriatic arthritis (PsA) may frequently switch biologic therapies over the course of treatment because of symptom variability and individual responses. Real-world studies analyzing patient characteristics and clinical factors associated with biologic switching are limited. This longitudinal cohort study used real-world data from the CorEvitas Psoriasis Registry to evaluate the relationship between associated disease factors and biologic switching among patients with PSO and PsA in the United States (US) and Canada following initiation of a biologic. Patients were evaluated between April 2015-August 2022. Combinations of disease severity (as measured by Psoriasis Area Severity Index [PASI]) and Dermatology Life Quality Index (DLQI) as a measure of health-related quality of life (HRQoL) were assessed, and the association with time to switching was calculated using Cox proportional hazards regression modeling. Among 2580 patient-initiations (instances of patients initiating a biologic), 504 (19.5%) switched biologics within 30months of initiation. Switching was more frequent when either PASI > 10 or DLQI > 5 compared with PASI ≤ 10 or DLQI ≤ 5 at follow-up. Patients with higher skin involvement (PASI > 10) and impact on HRQoL (DLQI > 5) were 14 times more likely to switch (hazard ratio = 14.2, 95% confidence interval: 10.7, 18.9) than those with lower skin involvement (PASI ≤ 10) and HRQoL (DLQI ≤ 5). Patients with PSO and PsA treated in a real-world dermatology setting with substantial disease factors following biologic initiation were more likely to switch therapies. Those with PASI > 10 and DLQI > 5 switched more frequently than those with PASI ≤ 10 and DLQI ≤ 5.

The effect of health facility ownership on perceived healthcare quality: evidence from Ghana.

Whether private healthcare providers should be encouraged over public providers remains unclear. On the one hand, because private providers are profit-driven, they are more motivated to compete for demand by enhancing quality if demand is elastic. However, because they are more motivated to maximize revenue, they may sacrifice quality to maximize profit. A crucial factor in determining whether private providers should be encouraged is the extent to which their quality exceeds or falls short of that of the public provider. This study, therefore, investigates whether the public and private differ in providing quality healthcare services using the 2014 Ghana Demographic and Health Survey. Our measure of healthcare quality is based on patient satisfaction level with nine healthcare services (cleanliness, waiting time, comfort and safety, consultation time, privacy, listening, explanation, treatment advice and confidentiality) provided by public and private healthcare facilities. We applied an instrumental variable approach to account for endogeneity issues related to the patient's choice of healthcare provider. We find that private facility users have a higher probability of being very satisfied with "waiting time", "consultation time", "listening", "cleanliness", "comfort and safety", "confidentiality", and "privacy" than public users, thus suggesting that private facilities provide better service than public. We thus recommend encouraging the private sector to enter the healthcare market. We also find that failing to account for endogeneity in provider choice when estimating the effect of healthcare facility ownership on healthcare service quality underestimates the effects.

The effects of age on associations between pre-school children's eating behaviour traits and diet quality

Child eating behaviour traits are associated with several aspects of dietary intake of pre-school children, however the associations between child eating behaviour traits and overall dietary quality in pre-school children has not been examined. Additionally, it is unknown how these relationships vary by age. This study examines the associations between child eating behaviour traits and pre-school children's dietary quality and whether children's age moderates these associations. This study utilises cross-sectional online survey data collected from mothers (n = 1367) of pre-school aged children (2–5 years) from across Australia. The survey included a validated measure of four child eating behaviour traits and a validated measure of diet quality. Multiple linear regression assessed associations between child eating behaviour traits and dietary quality, including interactions between child eating behaviour traits and child age. The average age of the children was 3.3 years, with 50.2% reported as males. Enjoyment of food was positively associated with dietary quality (B coefficient: 2.51, p < 0.001). Food fussiness and satiety responsiveness were inversely associated with dietary quality (B coefficients: 2.59 and −2.25, respectively, p < 0.001), while food responsiveness was not related to diet quality. Child age moderated associations between food fussiness and dietary quality (B coefficient: 0.38, p = 0.025). The difference in dietary quality between lower and higher food fussiness is most pronounced among 5-year-old children. In conclusion, this study demonstrates that it is important for future interventions aiming to improve dietary quality of pre-school children to target children with lower food enjoyment, higher food fussiness or satiety responsiveness as possible ways to improve child dietary quality. Future interventions should also have a particular focus on strategies to reduce food fussiness for older preschoolers.

Teknik Pendederan Udang Galah (Macrobrachium Rosenbergii) di Instalasi Budidaya Air Payau (IBAP) Probolinggo, Jawa Timur

Giant Freshwater Prawn (Macrobrachium rosenbergii) or also known as Giant Freshwater Prawn is a type of crustacean that has the largest size compared to other freshwater prawns. Giant prawns are a freshwater fisheries commodity that has great potential to be developed because it has a high selling value. This Field Work Practice (PKL) activity was carried out at the Brackish Water Cultivation Installation (IBAP) in Probolinggo City, East Java. The results of Field Work Practices (PKL) regarding giant prawn nursery techniques start from preparing nursery ponds, preparing water for rearing media, stocking juveniles, managing water tanks for rearing media, water quality management, feed management, controlling pests and diseases, as well as harvesting and packaging. Water quality measurements include DO with values obtained at 5.1-5.6 mg/L, pH 7.1-8.7, temperature reaching 24-28°C, and salinity ranging from 0-5 ppt. The feed given is Artemia salina, corn bran mixed with flakes in a ratio of 3:1, and commercial feed is in the form of pellets with a frequency of administration twice a day, namely in the morning and evening.

Surface Topography Analysis of BK7 with Different Roughness Nozzles Using an Abrasive Water Jet.

This study investigated the effect of abrasive water jet (AWJ) kinematic parameters, such as jet traverse speed and water pressure, abrasive mass flow rate, and standoff distance on the surface of BK7. Nozzle A reinforced with a 100 nm particle-sized coating of titanium alloy has more wear resistance compared to Nozzle B coated with nothing. Through analysis of variance and measurement of BK7 surface quality, it is concluded that the grooving and plowing caused by abrasive particles and irregularities in the abrasive water jet machined surface with respect to traverse speed (3, 7.2, 7.8, and 9 mm/min), abrasive flow rate (7 L/min and 10 L/min, 80 mesh) and water pressure (2 and 3 MPa) were investigated using surface topography measurements. The surface roughness (15.734 nm) of BK7 results show that a nozzle coated with titanium alloy has more hardness, which protects BK7 undamaged and super-smooth. The values of selected surface roughness profile parameters-average roughness (Ra) and maximum height of PV (maximum depth of peak and valleys)-reveal a comparatively smooth BK7 surface in composites reinforced with 2% titanium alloy in the nozzle weight at a traverse speed of 7.8 mm/min. Moreover, abrasive water jet machining at high water pressure (3 MPa) produced better surface quality due to material removal and effective cleaning of lens fragmentation and abrasive particles from the polishing zone compared to a lower water pressure (2 MPa), low traverse speed (5 mm/min), and low abrasive mass flow rate (200 g/min).

4D flow MRI velocity uncertainty quantification.

An automatic method is presented for estimating 4D flow MRI velocity measurement uncertainty in each voxel. The velocity distance (VD) metric, a statistical distance between the measured velocity and local error distribution, is introduced as a novel measure of 4D flow MRI velocity measurement quality. The method uses mass conservation to assess the local velocity error variance and the standardized difference of means (SDM) velocity to estimate the velocity error correlations. VD is evaluated as the Mahalanobis distance between the local velocity measurement and the local error distribution. The uncertainty model is validated synthetically and tested in vitro under different flow resolutions and noise levels. The VD's application is demonstrated on two in vivo thoracic vasculature 4D flow datasets. Synthetic results show the proposed uncertainty quantification method is sensitive to aliased regions across various velocity-to-noise ratios and assesses velocity error correlations in four- and six-point acquisitions with correlation errors at or under 3.2%. In vitro results demonstrate the method's sensitivity to spatial resolution, venc settings, partial volume effects, and phase wrapping error sources. Applying VD to assess in vivo 4D flow MRI in the aorta demonstrates the expected increase in measured velocity quality with contrast administration and systolic flow. The proposed 4D flow MRI uncertainty quantification method assesses velocity measurement error owing to sources including noise, intravoxel phase dispersion, and velocity aliasing. This method enables rigorous comparison of 4D flow MRI datasets obtained in longitudinal studies, across patient populations, and with different MRI systems.

Adherence to Clinical Practice Guidelines on the Management of Acute Infectious Gastroenteritis in Children as a Measure of Quality of Care Delivered by a Primary Care Facility in Rural Philippines: A Descriptive Retrospective Study.

This study aimed to describe the pattern of prescription and laboratory use in the management of infectious acute gastroenteritis (AGE) in children seen in a rural service delivery network (SDN) and to determine their adherence to the 2019 Clinical Practice Guidelines on the Management of Acute Infectious Diarrhea in Children and Adults from the Department of Health (DOH). A descriptive retrospective study was done using the electronic medical records (EMR) of patients less than 19 years old seen by the rural SDN from April 2019-2021 and diagnosed with infectious AGE. Data were extracted on diagnostic and therapeutic management. Adherence to strong CPG recommendations focusing on rehydration, zinc supplementation, rational laboratory use, and antibiotic prescription was chosen as indicator of quality of care. Adherence of less than 70% was defined as low. There were 227 infectious AGE cases, with 72% diagnosed under non-specific infectious AGE. Fifty two percent (52%) were prescribed with low-osmolarity oral rehydration solutions (ORS), while 74% were given zinc. Stool analysis was done in 25% of cases while CBC was done in 20%. Top antibiotics given were metronidazole at 44% and cotrimoxazole at 33%. There was low adherence to prescribing low-osmolarity ORS for rehydration (52%) and to deferring routine antibiotic prescription for non-specific infectious AGE cases (24%). Adherence to deferring routine stool analysis and CBC were relatively high at 73% and 70%, respectively while adherence to antibiotic use for indicated cases was high at 95%. Frequency of diagnostics ordered were low resulting to high adherence rates to recommendations concerning judicious laboratory use. Prescription frequency of appropriate antibiotics and interventions for AGE were low, leading to low adherence rates to recommendations concerning rational antibiotic use and prescription of cornerstone therapies for infectious AGE.

Compression of room impulse responses for compact storage and fast low-latency convolution

Room impulse responses (RIRs) are used in several applications, such as augmented reality and virtual reality. These applications require a large number of RIRs to be convolved with audio, under strict latency constraints. In this paper, we consider the compression of RIRs, in conjunction with fast time-domain convolution. We consider three different methods of RIR approximation for the purpose of RIR compression and compare them to state-of-the-art compression. The methods are evaluated using several standard objective quality measures, both channel-based and signal-based. We also propose a novel low-rank-based algorithm for fast time-domain convolution and show how the convolution can be carried out without the need to decompress the RIR. Numerical simulations are performed using RIRs of different lengths, recorded in three different rooms. It is shown that compression using low-rank approximation is a very compelling option to the state-of-the-art Opus compression, as it performs as well or better than on all but one considered measure, with the added benefit of being amenable to fast time-domain convolution.

Assembly and annotation of a chromosome-level reference genome for the endangered Colorado pikeminnow Ptychocheilus lucius.

Advancements in genome sequencing technology have brought unprecedented accessibility of high-throughput sequencing to species of conservation interest. The potential knowledge gained from application of these techniques is maximized by availability of high-quality, annotated reference genomes for endangered species. However, these vital resources are often lacking for endangered minnows of North America (Cypriniformes: Leuciscidae). One such endangered species, Colorado pikeminnow (Ptychocheilus lucius) is the largest North American minnow and the top-level native aquatic predator in the Colorado River Basin of the southwestern United States and northwestern Mexico. Over the past century Colorado pikeminnow has suffered habitat loss and population declines due to anthropogenic habitat modifications and invasive species introductions. The lack of genetic resources for Colorado pikeminnow has hindered conservation genomic study of this unique organism. This study seeks to remedy this issue by presenting a high-quality reference genome for Colorado pikeminnow developed from Pacific Biosciences HiFi sequencing and Hi-C scaffolding. The final assembly was a 1.1 Gb genome comprised of 305 contigs including 25 chromosome-sized scaffolds. Measures of quality, contiguity, and completeness met or exceeded those observed for Danio rerio (Danionidae) and two other Colorado River Basin leuciscids (Meda fulgida and Tiaroga cobitis). Comparative genomic analyses identified enrichment of gene families for growth, development, immune activity, and gene transcription; all of which are important for a large-bodied piscivorous fish living in a dynamic environment. This reference genome will provide a basis for important conservation genomic study of Colorado pikeminnow and help efforts to better understand the evolution of desert fishes.

Green credit’s impact on pollution and economic development: A study from Vietnam

Vietnam is actively pursuing sustainable economic development while transitioning to a greener economy, facing challenges in balancing economic growth with environmental sustainability. The evaluation of current sustainable development efforts and the identification of effective green financial tools are critical for Vietnam's progress. This study introduces the Sustainable Economic Development (SED) Index, a comprehensive measure of sustainable economic development quality across Vietnam's 63 provinces from 2015 to 2022. Using a range of analytical techniques, we explore the relationships between green credit, environmental pollution, and sustainable economic development during this period. Our findings indicate rapid growth in sustainable economic development until 2019, followed by a deceleration due to the COVID-19 pandemic and the Ukraine war. Green credit emerges as a pivotal factor in supporting sustainable economic growth, managing climate risks, and mitigating environmental pollution, particularly during times of uncertainty. Additionally, we observe spatial spillover effects, where the benefits of green credit and the challenges of environmental pollution transcend provincial boundaries. The study recommends promoting green credit policies, fostering regional cooperation, and enhancing local competitiveness, digital transformation, and social equality to advance Vietnam's journey toward sustainable economic development.