Quantitative Phase Research Articles

Implementing the Learning from Excellence approach to support continuous quality improvement in breast cancer care: a mixed-method study across Italian regions.

The aim of this study is to describe the application of the Learning from Excellence (LfE) approach in supporting a learning-oriented use of performance measures and continuous quality improvement in breast cancer (BC) care. Using a mix-method research, the BC pathway is evaluated among 12 Italian regions/autonomous provinces sharing the same Performance Measurement System. The study was conducted in three stages: (1) identification of the best performing geographical areas through quantitative evidence; (2) analysis of the best practices with qualitative methods; (3) professional engagement and quality improvement, and involvement of stakeholders. In the quantitative phase, the performances of 50 geographical areas were analyzed, leading to the identification of two best performing areas. After the characterization of the organizational determinants featuring the best performers' practices, the professionals were involved through on-site workshops, implementing a learning-oriented use of performance measures, benchmarking and team reflexivity on performance results. The intervention implied the modelling and assessment of the best performers' pathways, complementing performance measures with experience-based information. The models of the two areas were compared and hypothesis of care improvement were discussed. Feedback, reflexivity, networking and culture reinforcement were enacted among all the network professionals. In the last stage, the results were publicly presented allowing all stakeholders to recognize and appreciate the collaborative effort produced for the care of BC women and, leveraging on the logic of benchmarking, the stakeholders where able to identify generable performance improvements. This study provides evidence about the potential benefits of implementing LfE as a total quality management practice for care pathways.

Architectural order identification across label-free living cell imaging with a swin transformer-conditional GAN.

Quantitative Label-Free Imaging Phase and Polarization (QLIPP) technology enables non-invasive analysis and characterization of samples based on their intrinsic properties, without the need for exogenous labeling or contrast agents. However, QLIPP often involves dealing with complex tissue structures, such as overlapping or interconnected regions, making it challenging to accurately depict such intricate architectures. In order to elucidate the inherent ordered structures across spatial and temporal scales in living systems, we propose an efficient architecture based on the Swin Transformer Conditional Generative Adversarial Network (ST-cGAN). This model synergistically combines polarized light microscopy and the cooperative reconstruction of complementary optical properties. Leveraging complementary contrast information, the ST-cGAN achieves high-precision predictions of specific structures, addressing the difficulty of QLIPP in portraying complex tissue structures accurately. We demonstrate the efficacy of the model by predicting ordered structures within different components of kidney tissue morphology, including F-actin and cell nuclei. To enhance the accessibility and reproducibility of our proposed method, the open-source code used for neural network training is available on GitHub. This work marks a significant advancement in the field of label-free live cell imaging, particularly in the identification of ordered structures, contributing to a deeper understanding of dynamic biological processes.

Spatially-coded wavelength-scanning lensless on-chip microscopy for pixel-super-resolved quantitative phase imaging

Spatially-coded wavelength-scanning lensless on-chip microscopy for pixel-super-resolved quantitative phase imaging

Phase manipulating Fresnel lenses for wide-field quantitative phase imaging

Phase manipulating Fresnel lenses for wide-field quantitative phase imaging

Assessing Teacher Proficiency in Differentiated Instruction: Development and Validation of a Performance Appraisal Tool for Philippine Multigrade Classrooms

This study explores the implementation of Differentiated Instruction (DI) in Philippine multigrade classrooms and develops a tool to assess teacher proficiency in DI. Employing an exploratory sequential mixed-method design, the qualitative phase included focus group discussions with eight multigrade teachers, capturing their experiences and challenges in DI. These insights informed the creation of the Multigrade Differentiated Instruction Performance Appraisal Tool, which assesses DI proficiency across instructional planning, delivery, and classroom management. The tool underwent expert validation and reliability testing, with Cronbach’s Alpha of 0.91, indicating high internal consistency. The quantitative phase surveyed 163 multigrade teachers, revealing that DI implementation was generally effective, particularly in aligning lessons with curriculum standards (M = 4.09, SD = 0.73) and fostering a supportive learning environment. However, teachers faced challenges in utilizing technology, contextualized materials, and diverse assessment methods. Findings support the DI Assessment Checklist as a valuable tool for teachers and administrators to enhance instructional practices through reflective teaching. Recommendations include expanding training programs, improving access to instructional resources, and integrating DI-focused technology training. Further research should explore regional variations in DI implementation to inform more localized educational policies. This study provides practical insights to support teachers in effectively managing the complexities of multigrade education, ensuring equitable and inclusive learning experiences for diverse learners.

Development of a real-time dynamic inundation risk assessment approach on paddy fields during typhoons: Exploration of adaptation strategies and quantification of risks.

Development of a real-time dynamic inundation risk assessment approach on paddy fields during typhoons: Exploration of adaptation strategies and quantification of risks.

The cross-cultural adaptation and psychometric properties of the menstrual health instrument (MHI) among Iranian adolescent females

BackgroundMenstrual health encompasses a holistic state of physical, mental, and social well-being rather than simply the absence of illness associated with the menstrual cycle. It touches all aspects of human life. However, few tools are available to comprehensively examine the various areas of menstrual health. This study aimed to assess the psychometric properties of the menstrual health instrument (MHI).MethodThis study employed a cognitive method to psychometrically evaluate the English version of the Menstrual Health Questionnaire. This questionnaire consists of 29 items and 5 domains, including Affective symptoms, Somatic symptoms, school life, Daily habits for menstrual health, Menstrual cycle characteristics, Attitudes and perceptions on menstruation. It was conducted on 412 adolescent girls aged 13 to 18 from high schools in Babol City in 2023. Confirmatory and exploratory factor analyses were conducted in this study.ResultsA total of 412 adolescent girls from girls’ high schools in Babol City participated in this study. The mean age and mean age of menarche in participants were 14.20 ± 0.80 and 12.14 ± 0.99, respectively. The highest correlation among the 5 scales of the Menstrual Health Questionnaire was observed between emotional symptoms and physical symptoms and daily activities (r = 0.736, p < 0.001). In the content validity quantitative phase, all items of the original 29-question questionnaire had appropriate CVR and CVI and were retained in the study. The results of confirmatory factor analysis of the original questionnaire indicated that the hypothesized model has a reasonably good fit (Chi-square statistic = 846.09, CFI = 0.93, RMSEA = 0.057). The overall Cronbach’s alpha was 0.87. Finally, in the exploratory factor analysis within the same population for the initial 29 questions, 17 questions remained with 3 factors at the end of the structural validity phase, which explained 64.52% of the variance.ConclusionThe Persian version of the menstrual health questionnaire, with three extracted factors, demonstrates appropriate validity and reliability for use in studies related to menstrual health among Iranian girls.

The Indian Pregnant Women Quality of Life Index (IPW-QOLI): development and validation of scale to evaluate the quality of life of pregnant females across India—a mixed method study

BackgroundPregnancy is a transformative period in a woman’s life, deeply influenced by physical, emotional, social, and cultural factors. Despite its importance, there is limited research focused on evaluating the quality of life (QOL) of pregnant women in India, considering its unique socio-cultural diversity. The Indian Pregnant Women Quality of Life Index (IPW-QOLI) was developed to address this gap and provide a culturally sensitive, validated tool for assessing the QOL of pregnant women across India.MethodsA mixed-methods study was conducted. In the qualitative phase, in-depth interviews and focus group discussions with pregnant women, and healthcare providers. Themes related to physical health, mental well-being, social support, access to healthcare, and cultural practices were identified. These findings informed the development of a draft scale. The quantitative phase involved administering the scale to a diverse sample of 254 pregnant women across rural and urban settings. Psychometric testing included exploratory and confirmatory analyses to establish construct validity, while reliability was assessed through Cronbach’s alpha and test-retest reliability.ResultsThe IPW-QOLI comprises four domains: physical health, ADL, social, and psychological. The scale demonstrated excellent reliability (Cronbach’s alpha = 0.88). Along with acceptable face and content validity, it was found that the outcome measure is overall reliable and valid. The outcome measure consists of a significant correlation with SF-36 and GRAV-QOL with Pearson’s correlation coefficient value of > 0.7.ConclusionThe IPW-QOLI is a validated, culturally relevant tool for assessing the QOL of pregnant women in India. Its application can guide healthcare providers, policymakers, and researchers in identifying areas of intervention, eventually enhancing maternal health and well-being. Future research should focus on translating and adapting the scale for different regional languages and longitudinal validation across varying pregnancy trimesters.

Confocal Laser Scanning Platform Combined With InSitu High-Resolution Quantitative Phase Imaging.

This paper introduces an advanced dual-modality imaging platform by integrating a confocal laser scanning/imaging module with flat-fielding quantitative phase contrast microscopy (FF-QPCM). The platform enables phase/fluorescence dual-modality imaging of the same samples with high resolution and contrast. Using this platform, we observed that confocal fluorescence excitation causes minimal damage to cells, whereas wide-field fluorescence excitation (WFE) results in significant damage, particularly mitochondrial fragmentation and notable alterations in phase values. Additionally, insitu quantitative phase imaging was conducted on live COS7 cells with a specific region irradiated by a confocal laser. The results demonstrated that 5-min continuous confocal laser irradiation affects only COS7 cells with fluorescently labeled mitochondria, causing mitochondrial dysfunction throughout the cell. These findings suggest that integrating FF-QPCM with a confocal laser scanning/imaging module offers a highly efficient, sensitive, and information-rich tool for cell biology research, with broad application potential.

Understanding Self-Care Patterns in Adults With Type 1 Diabetes: Insights From a Mixed Methods Study.

The aim of this study was to explore self-care among adults with type 1 diabetes (T1D) to (1) characterise possible self-care profiles in adults with T1D; (2) explain self-care maintenance, monitoring and management within the self-care profiles; and (3) develop a typology of self-care in adults with T1D. Mixed-methods study with explanatory sequential design. Participants (n = 200) completed a validated self-care survey. Cluster analysis of survey data was performed to identify self-care profiles. Then, semi-structured individual interviews were performed with a nested sample (n = 20) stratified by these profiles. Directed content analysis was applied to transcript data to describe self-care within profiles. Findings were integrated via joint display to develop a typology of self-care in adults with T1D. A total of 200 adults with T1D were recruited from a diabetes centre in a large, urban US city from 6/2022 to 11/2022 (quantitative phase) and a nested sample (n = 20) from 12/2022 to 4/2023 (qualitative phase). We identified three self-care profiles: Expert, Inconsistent and Novice. Expert self-care was characterised by a steadfast and holistic approach to maintaining health, the use of internal and external cues to monitor for health changes and informed management decision-making when health changes were detected. Inconsistent self-care was characterised by the capability to maintain health, often limited by low health prioritisation, a lack of perceived need for greater effort and compulsive management decision-making. Novice self-care was characterised by difficulty maintaining health and limited skill development in more advanced self-care processes, including monitoring for and managing health changes. This study identified an Expert-Inconsistent-Novice typology of self-care in adults with T1D, aligning with previous research and suggesting a stable typology across conditions. Characterising self-care among adults with T1D may facilitate aligning support with individual needs. Progression towards Expert self-care may offer clinically meaningful improvements in glycaemic control and reduced risk for diabetes complications. Good Reporting of A Mixed Methods Study (GRAMMS) Checklist. No patient or public contribution.

Ultra-high-speed non-interferometric quantitative phase and multi-plane imaging

The existing non-interferometric phase imaging methods are unable to retrieve quantitative phase up to microsecond temporal resolution due to the lack of a suitable parallel recording strategy. Therefore, we propose an ultra-high-speed non-interferometric method for phase and multi-plane imaging using partially coherent light sources. The method uses space division multiplexing to record two or more intensity images in parallel. Due to its ability to acquire images at desired distances, high-speed non-interferometric quantitative phase retrieval can be performed. Furthermore, due to its phase retrieval capability, numerical focusing can be achieved, allowing multiple axial plane images to be obtained from parallelly recorded images. The applicability of the proposed method is confirmed by imaging high-speed gas flow, where both the initial stage and the evolution of cavity formation can be visualized, as well as by imaging electric discharge, where the blocking of light by afterglow plasma can be observed. The developed imaging method can be applied to study phenomena with a wide range of speeds, from static to very fast, in various fields such as physics and life sciences, without the need for coherent light illumination.

From inequalities to solutions: an explanatory sequential study on type 2 diabetes health services utilization

BackgroundHealth inequities are a significant issue. This study aimed to measure and decompose socioeconomic inequality in the utilization of type 2 diabetes (T2D) services and propose solutions to mitigate these inequalities.MethodsThis explanatory sequential mixed-method study was conducted in two phases: quantitative and qualitative. A total of 2000 T2D patients from health centers, hospitals, and diabetes clinics in Isfahan and Khuzestan provinces, Iran, were selected. In the quantitative phase, the existence of inequality in the utilization of T2D services was examined using the Concentration Index (CI) approach. To determine the contribution of each explanatory variable to T2D inequality, we used concentration index decomposition analysis. In the qualitative phase, based on the main contributors identified in the quantitative phase, we conducted semi-structured interviews with purposefully selected key experts to identify solutions for reducing inequality in the utilization of T2D services.ResultsThe sample consisted of 65.3% men, with 40% of T2D patients being over 60 years old. The CI values were 0.31 (p < 0.05) for outpatient services, -0.10 (p > 0.05) for inpatient services, and 0.11 (p < 0.05) for pharmaceutical services. This indicates an inequality in the utilization of outpatient and pharmaceutical services among T2D patients, while the inequality in inpatient services was not significant. The main variables contributing to inequality in outpatient services were health status (33.54%), basic insurance (27.43%), and socioeconomic status (24.08%). For pharmaceutical services, the contributing variables were health status (22.20%), basic insurance (13.63%), and socioeconomic status (34.35%). Experts’ solutions to reduce socioeconomic inequalities in Iran were classified into three main themes: socioeconomic status, health status, and basic insurance, with 29 sub-themes.ConclusionThe results suggest that targeted health interventions for poor T2D patients are recommended. Efforts towards universal coverage in outpatient care and commonly used pharmaceutical items, such as: Antidiabetic Drugs, Triglyceride Control Drugs, Cardiovascular Drugs, Neuropathy Drugs, and Nephropathy Drugs, should be considered.

Use of Natural Areas among Latinxs Living in South Carolina

The Latinx population in the United States (US) is growing. While Latinxs have historically been present in US cities and southwestern states, there is a notable surge in migration to new destination states, including South Carolina (SC). As the Latinx population grows and extends to new geographies, there is a need to examine the evolution of Latinxs’ outdoor recreation patterns. Exploring their changing preferences regarding public spaces can inform park management planning and policy. This study examines outdoor recreation use among SC-based Latinxs, exploring three central questions: 1. What are the outdoor recreation preferences among Latinxs living in SC? 2. What constraints do Latinxs face while engaging in outdoor recreation? 3. What are Latinxs’ primary motivations in visiting natural areas? This study employs a convergent parallel mixed method design. The quantitative phase consists of a cross-sectional sampling approach via online surveys, while the qualitative phase utilizes focus groups. Analyses of survey results include descriptive statistics and ANOVA and Chi-square tests for select variables. Qualitative analyses are based on a priori open coding with thematic development. Quantitative and qualitative data were first examined separately and later compared. Results suggest that walking/hiking is the primary outdoor recreation activity in which Latinxs engage. Focus-group participants also mentioned a variety of land and water-based outdoor recreation activities. The most prevalent motivations for recreation experiences included relaxation, escape, and improved health. The top five factors preventing survey respondents from visiting natural areas were tiredness after work, insufficient time off work, insufficient time and money to visit natural areas, and proximity to natural areas. Focus group participants also reported various constraints hindering their visits to natural areas, including time, cost, safety, inadequate on-site amenities, weather, and Latinx-specific constraints. The findings indicate that natural resource agencies wanting to improve Latinx outdoor recreation experiences should have bilingual front-line staff and provide communicative media, such as website information or on-site signage, in Spanish. Our findings also underscore the importance of Latinx-focused social media groups as useful tools for disseminating information.

Maximum contrast projection: A powerful tool for biomedical image stack analysis.

Maximum intensity projection is a simple post-hoc dimension reduction approach that yields sharp 2-dimensional images from image stacks but is limited by low signal or high background. Herein, we demonstrated improvement in image contrast using maximum contrast versus maximum intensity projection in 3-dimensional phase-contrast and quantitative phase imaging of frozen cross-sections of murine peripheral nerve. Fresh frozen murine sciatic nerve sections were imaged using 3-dimensional fluorescence, phase-contrast, and quantitative phase microscopy. Images were processed using maximum intensity and maximum contrast projection. Higher image contrast of nerve morphology was obtained when the images were processed with maximum contrast projection. Enhanced image contrast in quantitative phase imaging facilitated label-free multicolor imaging of murine peripheral nerves. Herein, we demonstrate the utility of maximum contrast projection in enhancing image contrast over intensity projection approaches in fluorescence phase-contrast and quantitative phase imaging of nerve histological samples. A user-friendly, open-source Python-based maximum contrast projection algorithm to facilitate the adoption of this technique is provided.

Education Research: A Mixed-Methods Analysis of Journal Club Formats to Enhance Evidence-Based Practice Through Social Cognitive Learning Theory.

In an era of rapid advances in research, it is imperative for residents to develop the skills for evidence-based practice. Alternative journal club formats grounded in active learning strategies may be better suited to address this need, although evidence is lacking. A theoretical framework of social cognitive learning theory (SCLT) may provide insight into how journal clubs can be better designed to teach residents how to evaluate research. Using a sequential, explanatory mixed-methods design and SCLT framework, we compared 2 different journal club formats for teaching methodology and clinical application. We also explored neurology resident experiences with both formats using a qualitative approach. We conducted 4 alternating journal clubs: 2 active learning and 2 traditional. In the quantitative phase, we compared resident performance on presession and postsession assessments for the 2 different journal club formats. We designed parallel pretest and posttest forms and analyzed the change in scores using a linear mixed-effects model with fixed effects for the test type and pretest score. In the qualitative phase, we explored neurology resident experiences with both formats through the lens of SCLT. We observed the journal club sessions through an ethnographic lens and conducted semistructured one-on-one interviews with residents. The data were mixed during analysis of interview data. Resident participants (n = 18 active learning, 18 traditional) of each journal club completed pretests (n = 16 active learning, 11 traditional) and posttests (n = 8 active learning, 5 traditional). There were statistically significant increases in total (estimate = 18.03%, SD = 6.9, p = 0.028) and clinical application (estimate = 48.40%, SD = 6.6, p < 0.0001) pretest and posttest scores with the active learning format. There was no difference in methodology subscores (estimate = 5.84%, SD = 11.8, p = 0.63). Regarding the active learning format, observations noted more demonstrations of retention, reproduction, and motivation during the sessions than a traditional format. Interviews highlighted 4 main themes: the burden of preparation, the importance of clinical relevance, preference for organic discussion, and the value of faculty expertise. These results highlight the strengths and disadvantages of a more discussion-based journal club format. Further altering the design to a "no-prep" approach and emphasizing the faculty facilitator's role may further optimize teaching of evidence-based practice.

Parent-adolescent emotional communication patterns and adolescent depressive symptoms: A dyadic, mixed methods study.

This study aimed to explore the characteristics of parent-adolescent emotional communication patterns from the perspectives of both parents and adolescents and to further examine their relationships with adolescent depressive symptoms. A mixed methods exploratory sequential design was used. In the qualitative phase, 21 parent-adolescent dyads (adolescents aged 15.1 years, with 11 reporting high depressive symptoms and 10 reporting low depressive symptoms) were interviewed, and the data were analyzed via inductive thematic analysis. The quantitative phase surveyed 369 parent-adolescent dyads (adolescents aged 13.5, 48.5% female). Emotional communication patterns were identified via latent profile analyses, and adolescent depressive symptoms were compared across patterns. The qualitative phase identified six parent-adolescent emotional communication patterns depending on parental behaviors, adolescents' needs, and family arrangements. Different patterns were observed between groups with high and low depressive symptoms. In the quantitative phase, five patterns emerged from both adolescent and parent reports. Adolescents' depressive symptoms significantly differed across patterns regardless of the data source, with the lowest in the adaptive communication pattern and the highest in maladaptive or limited communication patterns. Reporting concordance/discordance was also associated with adolescent depressive symptoms. Parent-adolescent emotional communication patterns differ in frequency and quality. Adolescent depressive symptoms varied across patterns. Concordance/discordance in reporting was associated with depressive symptoms in adolescents.

A protocol for validation of the Handover Evaluation Scale in multicultural ICUs.

Effective handover communication by nurses is essential to ensuring care continuity, care quality and patient safety and minimizing the risk of adverse events. Notably, the increasing globalization of the nursing profession and the resulting rise of multicultural workplaces in health care can affect handover communication. However, no tools have yet been developed to evaluate the current practices and factors contributing to effective handover in multicultural care settings, even though such instruments are deemed necessary to identify communication challenges and opportunities for improvement. This paper describes the protocol that will be used in a proposed study that aims to adapt and validate an existing instrument for measuring handover quality-namely the Handover Evaluation Scale. The proposed study will also examine the factors contributing to effective handovers in a multicultural critical care context using a sequential exploratory mixed-method and will involve a qualitative and a quantitative phase. The first phase will explore Saudi Arabian ICU nurses' perceptions of effective shift handovers and the factors influencing handover quality. Data will be collected by recruiting 20 nurses through purposive sampling for semi-structured interviews. Interpretive description will be used to analyse the data to identify items useful for modifying the tool. Next, the tool will be modified based on the qualitative findings. Lastly, a quantitative study will be conducted based on the results of the first phase to assess the instrument's reliability and content validity and determine its internal dimensional structure. This paper describes the study protocol that will be applied to adapt and validate an existing tool to measure the quality of handover in multicultural ICUs, using an exploratory sequential mixed-methods design. The protocol described in this paper provides a framework for an adaptation of the Handover Evaluation Scale to measure handover effectiveness and to identify current challenges and factors affecting handover effectiveness in the multicultural critical care context. This version of the scale can be applied in clinical practice to determine best practices for improving handover.

Half-pixel sliding window processing for fourfold resolution improvement on single-shot quantitative phase imaging with polarization cameras

Half-pixel sliding window processing for fourfold resolution improvement on single-shot quantitative phase imaging with polarization cameras

Saccharomyces cerevisiae recovery from various mild abiotic stresses: Viability, fitness, and high resolution three-dimensional morphology imaging

Saccharomyces cerevisiae recovery from various mild abiotic stresses: Viability, fitness, and high resolution three-dimensional morphology imaging

Modeling of solid-air dendrite growth solidification in liquid hydrogen by using isotropic quantitative phase field method

Modeling of solid-air dendrite growth solidification in liquid hydrogen by using isotropic quantitative phase field method