Variable Rate Research Articles

Enhancing assisted reproductive technology with AI: Addressing concerns and challenges

Assisted Reproductive Technology (ART) has revolutionized fertility treatments, yet it faces numerous challenges, including high costs, lengthy procedures, and variable success rates. Artificial Intelligence (AI) holds the potential to address these concerns by optimizing treatment protocols, improving embryo selection, and enhancing patient counseling. This paper explores the integration of AI into ART, highlighting its role in predictive modeling, image analysis, and personalized medicine. By leveraging AI algorithms, ART can become more efficient, cost-effective, and tailored to individual patient needs, ultimately advancing the field of reproductive medicine and offering hope to millions of couples struggling with infertility.

Comparative Analysis of GDP Per Capita, Logistic Performance, and Carbon Dioxide Emissions: A Case of SAARC Countries

This study investigated the association between economic growth, environmental sustainability, and social development in SAARC countries. The study uses robust and balanced panel data from 2008 to 2021. The advanced econometric techniques used for empirical analyses, specifically Dynamic Ordinary Least Squares (DOLS). It provided valuable observations on the relationships between economic and environmental factors. The independent variable logistic infrastructure, gross capital formation, labour force participation rate, and carbon dioxide emission significantly affect our dependent variable growth rate The study results showed that logistic infrastructure positively affected our GDP per capita. Similarly, LAB and GCF also directly impacted your GDP per capita while CO2 negatively impacted the GDP per capita of the projected economies. These findings suggest that policymakers must adopt holistic approaches that prioritize sustainable development goals, mitigate environmental degradation, and promote inclusive economic growth to ensure a prosperous and resilient future for all.

Dynamics of a Model of Coronavirus Disease with Fear Effect, Treatment Function, and Variable Recovery Rate

In this work, we developed, validated, and analysed the behaviour of a compartmental model of COVID-19 transmission in Saudi Arabia. The population was structured into four classes: susceptible (S), exposed (E), infectious (I), and removed (R) individuals. This SEIR model assumes a bilinear incidence rate and a nonlinear recovery rate that depends on the quality of health services. The model also considers a treatment function and incorporates the effect of fear due to the disease. We derived the expression of the basic reproduction number and the equilibrium points of the model and demonstrated that when the reproduction number is less than one, the disease-free equilibrium is stable, and the model predicts a backward bifurcation. We further found that when the reproduction number is larger than one, the model predicts stable periodic behaviour. Finally, we used numerical simulations with parameter values fitted to Saudi Arabia to analyse the effects of the model parameters on the model-predicted dynamic behaviours.

Bayesian prediction of the stock price rate in the Iraq stock market based on the symmetric heavy tails regression model

In this paper, we investigate the estimation of generalized modified Bessel regression model by using the Bayesian techniques under the assumption that the scale parameter and shape parameters are known. We use the informative priors for estimating of model. Then we derive a prediction distribution of the future response variable ▁Y_f by using informative priors for predictive future. Our work applied our results to real data which represent the Iraqi market for securities having taken monthly data for the services sector and of Baghdad sector of Iraq for public transport for the year 2018, as the stock variable rate response variables affecting it are closing price variable, the stock turnover variable. Through the study shows that the explanatory variables are the most important influence on the stock price rate variables through variance inflation factor, the estimated model was appropriate for the data studied.

Growth and Yield of Onion (<i>Allium cepa</i> L.) as Affected by Variable Rates of Poultry Manure and Mineral Nitrogen Fertilizer at Alage, Central Rift Valley Ethiopia

Onion is one of the important vegetable crops produced in many home gardens and in some extent commercially in different parts of Ethiopia. Therefore, this experiment was conducted at Alage Central Rift Valley of Ethiopia with the objectives of assessing the growth, yield, and quality response of onion to the variable rates of poultry manure and mineral nitrogen fertilizer. The experiment comprising of three nitrogen levels (0, 46, and 92 kg ha<sup>-1</sup>) and four levels of poultry manure (0, 5, 10, and 15 t ha<sup>-1</sup>) were laid out in a randomized complete block design with three replications. The result indicated that leaf length, leaf number, days to maturity, bulb length, and bulb dry matter content were significantly influenced by main factors. Application of poultry manure at the rate of 15 t ha<sup>-1</sup> recorded the highest total bulb yield (63.33 t ha<sup>-1</sup>) and marketable bulb yield (62.52 t ha<sup>-1</sup>), but statistically, there was no significant difference between 15t ha<sup>-1</sup> and 10t ha<sup>-1</sup> poultry manure application. The results of the partial budget analysis showed that 15 t ha<sup>-1</sup> poultry manure application gave the highest marginal rate of returns. Since the highest bulb yield and maximum marginal rate of returns are obtained at 15 t ha<sup>-1</sup> poultry manure application, this rate can be recommended for onion production in the researched area, and areas having similar agro-ecologies. However, as the research is conducted for a single season and location, repeating the experiment over location and year will be required to give a conclusive recommendation.

State- and frequency-dependence in autonomic rebalance mediated by intradermal auricular electroacupuncture stimulation

BackgroundVagus nerve stimulation (VNS) improves diseases such as refractory epilepsy and treatment-resistant depression, likely by rebalancing the autonomic nervous system (ANS). Intradermal auricular electro-acupuncture stimulation (iaES) produces similar effects. The aim of this study was to determine the effects of different iaES frequencies on the parasympathetic and sympathetic divisions in different states of ANS imbalance.MethodsWe measured heart rate variability (HRV) and heart rate (HR) of non-modeled (normal) rats with the treatment of various frequencies to determine the optimal iaES frequency. The optimized iaES frequency was then applied to ANS imbalance model rats to elucidate its effects.Results30 Hz and 100 Hz iaES clearly affected HRV and HR in normal rats. 30 Hz iaES increased HRV, and decreased HR. 100 Hz iaES decreased HRV, and increased HR. In sympathetic excited state rats, 30 Hz iaES increased HRV. 100 Hz iaES increased HRV, and decreased HR. In parasympathetic excited state rats, 30 Hz and 100 Hz iaES decreased HRV. In sympathetic inhibited state rats, 30 Hz iaES decreased HRV, while 100 Hz iaES decreased HR. In parasympathetic inhibited rats, 30 Hz iaES decreased HR and 100 Hz iaES increased HRV.Conclusion30 Hz and 100 Hz iaES contribute to ANS rebalance by increasing vagal and sympathetic activity with different amplifications. The 30 Hz iaES exhibited positive effects in all the imbalanced states. 100 Hz iaES suppressed the sympathetic arm in sympathetic excitation and sympathetic/parasympathetic inhibition and suppressed the vagal arm and promoted the sympathetic arm in parasympathetic excitation and normal states.

Phenotypic and genotypic analysis of antimicrobial resistance and population structure of gastroenteritis-related Aeromonas isolates

BackgroundThe population structure and the correlation between antimicrobial resistance (AMR) phenotypes and genotypes in Aeromonas species isolated from patients with gastroenteritis are not well understood. The aims of the study were to: (1) investigate the antimicrobial susceptibility profiles of Aeromonas species isolated from patients with gastroenteritis; (2) explore the relationship between AMR genes and resistance phenotypes; and (3) describe the population structure of these isolates and provide evidence of transmission events among them.MethodsThis microbiological survey was performed at the Microbiology Laboratory of the Emek Medical Center in Afula, Israel. Cultivation of Aeromonas was attempted from stool samples that tested positive by PCR. Antimicrobial susceptibility testing (AST) was performed using the Sensititre GN3F microdilution panel. Whole genome sequencing (WGS) was done using the Illumina NextSeq500/550 system. Phylogenetic studies involved multi-locus sequence typing (MLST) and core genome (cg) MLST. Resistance mechanisms were identified using the Comprehensive Antibiotic Resistance Database and compared with the AST results.ResultsThe study included 67 patient-unique isolates. The species that were identified included A. caviae (n = 58), A. dhakensis (n = 3), A. media (n = 2), A. veronii (n = 2) and A. hydrophila (n = 2). Isolates were almost uniformly susceptible to amikacin, gentamicin, aztreonam, cefepime, ceftazidime, ciprofloxacin and meropenem. All isolates with the exception of 1–2 isolates were resistant to ampicillin, cefazolin and ampicillin-sulbactam which was compatible with the presence of the blaOXA genes. Variable resistance rates were observed to cefuroxime, cefoxitin, ceftriaxone, piperacillin-tazobactam that were not correlated with the presence of other β-lactamase genes. Resistance to tetracycline and trimethoprim-sulfamethoxazole correlated with the presence of tetA and sul1, respectively. The population structure of A. caviae was highly diverse with the minority of the isolates (16/57) clustering into six defined sequence types. A cgMLST-based distance of four genes was found in one pair of isolates, suggesting common source transmission.ConclusionsA. caviae is the dominant species related to gastroenteritis and is characterized by a diverse population structure, with almost no evidence for common-source transmission. Resistance rates to most antimicrobial agents were low and partially matched with the presence of resistance genes.

High Rates of Honey Bee Colony Losses and Regional Variability in Ethiopia Based on the Standardised COLOSS 2023 Survey

High Rates of Honey Bee Colony Losses and Regional Variability in Ethiopia Based on the Standardised COLOSS 2023 Survey

Contemporary Insights into Hepatitis C Virus: A Comprehensive Review

Hepatitis C virus (HCV) remains a significant global health challenge. Approximately 50 million people were living with chronic hepatitis C based on the World Health Organization as of 2024, contributing extensively to global morbidity and mortality. The advent and approval of several direct-acting antiviral (DAA) regimens significantly improved HCV treatment, offering potentially high rates of cure for chronic hepatitis C. However, the promising aim of eventual HCV eradication remains challenging. Key challenges include the variability in DAA access across different regions, slightly variable response rates to DAAs across diverse patient populations and HCV genotypes/subtypes, and the emergence of resistance-associated substitutions (RASs), potentially conferring resistance to DAAs. Therefore, periodic reassessment of current HCV knowledge is needed. An up-to-date review on HCV is also necessitated based on the observed shifts in HCV epidemiological trends, continuous development and approval of therapeutic strategies, and changes in public health policies. Thus, the current comprehensive review aimed to integrate the latest knowledge on the epidemiology, pathophysiology, diagnostic approaches, treatment options and preventive strategies for HCV, with a particular focus on the current challenges associated with RASs and ongoing efforts in vaccine development. This review sought to provide healthcare professionals, researchers, and policymakers with the necessary insights to address the HCV burden more effectively. We aimed to highlight the progress made in managing and preventing HCV infection and to highlight the persistent barriers challenging the prevention of HCV infection. The overarching goal was to align with global health objectives towards reducing the burden of chronic hepatitis, aiming for its eventual elimination as a public health threat by 2030.

Unraveling tuberculosis patient cluster transmission chains: integrating WGS-based network with clinical and epidemiological insights

BackgroundTuberculosis remains a global health threat, and the World Health Organization reports a limited reduction in disease incidence rates, including both new and relapse cases. Therefore, studies targeting tuberculosis transmission chains and recurrent episodes are crucial for developing the most effective control measures. Herein, multiple tuberculosis clusters were retrospectively investigated by integrating patients’ epidemiological and clinical information with median-joining networks recreated based on whole genome sequencing (WGS) data of Mycobacterium tuberculosis isolates.MethodsEpidemiologically linked tuberculosis patient clusters were identified during the source case investigation for pediatric tuberculosis patients. Only M. tuberculosis isolate DNA samples with previously determined spoligotypes identical within clusters were subjected to WGS and further median-joining network recreation. Relevant clinical and epidemiological data were obtained from patient medical records.ResultsWe investigated 18 clusters comprising 100 active tuberculosis patients 29 of whom were children at the time of diagnosis; nine patients experienced recurrent episodes. M. tuberculosis isolates of studied clusters belonged to Lineages 2 (sub-lineage 2.2.1) and 4 (sub-lineages 4.3.3, 4.1.2.1, 4.8, and 4.2.1), while sub-lineage 4.3.3 (LAM) was the most abundant. Isolates of six clusters were drug-resistant. Within clusters, the maximum genetic distance between closely related isolates was only 5–11 single nucleotide variants (SNVs). Recreated median-joining networks, integrated with patients’ diagnoses, specimen collection dates, sputum smear microscopy, and epidemiological investigation results indicated transmission directions within clusters and long periods of latent infection. It also facilitated the identification of potential infection sources for pediatric patients and recurrent active tuberculosis episodes refuting the reactivation possibility despite the small genetic distance of ≤5 SNVs between isolates. However, unidentified active tuberculosis cases within the cluster, the variable mycobacterial mutation rate in dormant and active states, and low M. tuberculosis genetic variability inferred precise transmission chain delineation. In some cases, heterozygous SNVs with an allelic frequency of 10–73% proved valuable in identifying direct transmission events.ConclusionThe complex approach of integrating tuberculosis cluster WGS-data-based median-joining networks with relevant epidemiological and clinical data proved valuable in delineating epidemiologically linked patient transmission chains and deciphering causes of recurrent tuberculosis episodes within clusters.

Infective endocarditis is rare in patients with hematologic malignancy and neutropenia.

Infective endocarditis (IE) is a serious complication of bloodstream infections (BSIs) that occurs at variable rates depending on the pathogen and clinical setting. There is a paucity of data describing the risk of IE in patients with hematologic malignancy who develop bacteremia while neutropenic. Adult patients on the hematology ward from January 2018 to December 2020 with hematologic malignancy and bacteremia were evaluated retrospectively for endocarditis by applying the 2023 Duke-ISCVID criteria. Charts of possible cases were evaluated 90 days after the initial BSI for new infectious complications that could indicate missed IE. Descriptive statistics compared patients admitted for hematopoietic stem cell transplantation (HSCT) to those admitted for alternative reasons (non-HSCT). Among the 1005 positive blood cultures initially identified, there were 66 episodes in 65 patients with hematologic malignancy and at least grade 3 neutropenia for a mean duration of 11.4 days during their admission. Transthoracic echocardiography (TTE) was performed in 34.8% of BSIs, and transesophageal echocardiography (TEE) in 6.1%. There were no new infectious complications in possible cases 90 days after their initial BSI. No cases of endocarditis were identified. Endocarditis is rare amongst patients with hematologic malignancy, bacteremia, and neutropenia, and no cases were identified in this cohort. The use of routine TTE in this setting seems unwarranted, and the addition of TEE is unlikely to improve patient-centered outcomes.

HOW PASSENGER TRANSPORT IS DEVELOPING IN BULGARIA IN THE CONDITIONS OF A DYNAMIC CHANGING ENVIRONMENT?

The current study seeks to establish the preferences of Bulgarians through exploring how passenger transport in Bulgaria developed from 2012 to 2022. On a theoretical level, the characteristics of this sector are described, such as types of passenger transport vehicles. The research interest is aimed at tracking the dynamics behind all the options for passenger carriage forming the supply of the transport market in Bulgaria: by rail, bus, air, water, and urban electric transport. To achieve this objective, the parameters of activity in the passenger transport segment are used as the main measures – number of passengers, passenger-kilometres and average distance travelled. During the studied period, passenger transport in Bulgaria developed at variable rates and was influenced by environmental factors. The mode of transport most affected by the pandemic in 2020–2021 was by air. A decrease in the total number of passengers and overall performance for 2022 compared to 2012 can be observed. This decline is due to a decrease in bus and rail transport indicators. The study has established that Bulgarians prefer traveling by bus to other public transport alternatives. Although the absolute number of vehicles has decreased in this segment, it has the largest relative share according to the indicators of transported passengers and performed work as part of the total transport activity in the country. In a practical respect, attention is focused on modern solutions related to information and communication technologies, as well as some opportunities to attract more public transport passengers. The author also draws attention to some EU initiatives in the field of air and maritime transport concerning Union-wide energy policy.

Nile red staining for rapid screening of plastic-suspect particles in edible seafood tissues

Concerns regarding microplastic (MP) contamination in aquatic ecosystems and its impact on seafood require a better understanding of human dietary MP exposure including extensive monitoring. While conventional techniques for MP analysis like infrared or Raman microspectroscopy provide detailed particle information, they are limited by low sample throughput, particularly when dealing with high particle numbers in seafood due to matrix-related residues. Consequently, more rapid techniques need to be developed to meet the requirements of large-scale monitoring. This study focused on semi-automated fluorescence imaging analysis after Nile red staining for rapid MP screening in seafood. By implementing RGB-based fluorescence threshold values, the need for high operator expertise to prevent misclassification was addressed. Food-relevant MP was identified with over 95% probability and differentiated from natural polymers with a 1% error rate. Comparison with laser direct infrared imaging (LDIR), a state-of-the-art method for rapid MP analysis, showed similar particle counts, indicating plausible results. However, highly variable recovery rates attributed to inhomogeneous particle spiking experiments highlight the need for future development of certified reference material including sample preparation. The proposed method demonstrated suitability of high throughput analysis for seafood samples, requiring 0.02–0.06 h/cm2 filter surface compared to 4.5–14.7 h/cm with LDIR analysis. Overall, the method holds promise as a screening tool for more accurate yet resource-intensive MP analysis methods such as spectroscopic or thermoanalytical techniques.Graphical

Imaging CAR-NK cells targeted to HER2 ovarian cancer with human sodium-iodide symporter-based positron emission tomography.

Chimeric antigen receptor (CAR) cell therapies utilize CARs to redirect immune cells towards cancer cells expressing specific antigens like human epidermal growth factor receptor 2 (HER2). Despite their potential, CAR T cell therapies exhibit variable response rates and adverse effects in some patients. Non-invasive molecular imaging can aid in predicting patient outcomes by tracking infused cells post-administration. CAR-T cells are typically autologous, increasing manufacturing complexity and costs. An alternative approach involves developing CAR natural killer (CAR-NK) cells as an off-the-shelf allogeneic product. In this study, we engineered HER2-targeted CAR-NK cells co-expressing the positron emission tomography (PET) reporter gene human sodium-iodide symporter (NIS) and assessed their therapeutic efficacy and PET imaging capability in a HER2 ovarian cancer mouse model.NK-92 cells were genetically modified to express a HER2-targeted CAR, the bioluminescence imaging reporter Antares, and NIS. HER2-expressing ovarian cancer cells were engineered to express the bioluminescence reporter Firefly luciferase (Fluc). Co-culture experiments demonstrated significantly enhanced cytotoxicity of CAR-NK cells compared to naive NK cells. In vivo studies involving mice with Fluc-expressing tumors revealed that those treated with CAR-NK cells exhibited reduced tumor burden and prolonged survival compared to controls. Longitudinal bioluminescence imaging demonstrated stable signals from CAR-NK cells over time. PET imaging using the NIS-targeted tracer 18F-tetrafluoroborate ([18F]TFB) showed significantly higher PET signals in mice treated with NIS-expressing CAR-NK cells.Overall, our study showcases the therapeutic potential of HER2-targeted CAR-NK cells in an aggressive ovarian cancer model and underscores the feasibility of using human-derived PET reporter gene imaging to monitor these cells non-invasively in patients.

Long term results of punctoplasty with canalicular triangular flap in punctal stenosis.

The aim was to describe the punctoplasty technique with canalicular triangular flap, and present the long-term results of the technique in patients with inferior punctal stenosis. The files of the patients who were diagnosed with punctal stenosis grade 0, 1, and 2 and underwent a canalicular triangular flap were evaluated retrospectively. The study was approved by the local ethical committee of the University of Health Sciences, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul. The demographic data, symptoms, prior interventions, punctal stenosis grading, associated eye pathologies, fluorescein clearance test, Munk score, and follow-up time were recorded. The puncta were evaluated biomicroscopically, and photographs were taken at each visit. The patients with at least 6 months of follow-up were included in the study. The loss of epiphora symptom, positive dye disappearance, and puncti ≥grade 3 opening were accepted as a success. A hundred and nine inferior puncti of 64 patients with symptoms of epiphora and punctal stenosis diagnosis were included in the study. Thirteen eyes were excluded as they were diagnosed to have punctal atresia or canalicular stenosis of a variable degree beyond punctum. The rest 96 eyes of 55 patients-65 eyes of 36 females and 31 eyes of 19 males-were included in the study as having pure punctal stenosis. The mean age of the patients was 64.3 ± 9.01 years (40-88 years). Forty-one patients had bilateral and 14 patients had unilateral punctal stenosis. Sixty-six were grade 1, and 30 were grade 2. Epiphora was the most commonly reported symptom.The mean follow-up time was 21.17 ± 10.5 months (6-46 months). In 76 (79.1%) eyes of 96, Munk score was 0 and in 15 (15.6%) eyes, Munk score was 1. Anatomical success as having puncta larger than grade 2 was recorded in 97.9%, and functional success was recorded in 94.6% of anatomically successful eyes. No restenosis was recorded in any punctum. Although the techniques of 1-snip, 2-snip, 3-snip, and 4-snip punctoplasty are performed with variable success rates in punctal stenosis patients, there is always a risk of restenosis due to the incision of the flap and unpredictability of the way the tissues will epithelize. In the canalicular triangular flap technique, the canalicular mucosal flap is preserved, and the continuity of the lacrimal mucosa with conjunctiva is provided, which utilizes appropriate re-epithelization of the wound edges, resulting in a wide punctal opening for the upper lacrimal system in the long term.

Precision agriculture in the United States: A comprehensive meta-review inspiring further research, innovation, and adoption

Precision agriculture has emerged as a dominant force in the United States, with widespread adoption of advanced technologies and decision support systems (DSS) since the 1980s. Key tools such as variable rate application (VRA), autopilot systems, and remote sensing have become integral for U.S. farmers, offering invaluable insights from crop, soil, and weather information to optimize agricultural production while minimizing environmental impact. To synthesize and categorize the extensive research available on precision agriculture, a systematic review protocol has been designed. Our objective is to offer clear and authoritative insights into the nature, scope, and volume of this field. Implementing a rigorous search strategy, we utilized renowned databases such as Scopus® and Web of ScienceTM to gather relevant and significant materiality. The retrieval process involved the use of indexing terms and Boolean operators, with a focus on ’precision agriculture’ and ’precision farming’, striking a balance between specificity and comprehensiveness. To ensure the credibility of our findings, only peer-reviewed papers authored by individuals affiliated with U.S. institutions have been included. Expert reviewers with deep knowledge in the field independently assessed the selected papers, thoroughly evaluating titles, abstracts, keywords, methods, conclusions, and declarations. Consistency and eligibility were paramount in determining which papers met the criteria for inclusion. Any discrepancies or disagreements were resolved through rigorous consensus-building discussions among the reviewers. Through this comprehensive meta-review, we provide a scientific contribution that enhances our understanding of precision agriculture, highlighting focus areas for further research and development (R&D). By synthesizing and categorizing the existing literature, we offer authoritative insights into the research landscape, informing future investigations and fostering innovation. Focusing specifically on the U.S., we shed light on the unique aspects and pioneering advancements in precision agriculture within the country. Ultimately, our findings have the potential to drive progress, contributing to sustainable development, increased productivity, enhanced environmental sustainability, and responsible agricultural practices.

A quantization-coding scheme with variable data rates for cyber-physical systems under DoS attacks

This paper considers Cyber-Physical Systems (CPSs) in the presence of Denial-of-Service (DoS) attacks, and investigates the networked control problem under data rate limitations. We develop a framework for CPSs in the presence of DoS attacks, and present a state-estimate control scheme for CPSs under DoS attacks. For the different communication status, the information on the plant state is transmitted to the controller by employing a different data rate in order to mitigate the influence of DoS attacks. Sufficient conditions on the data rate for mean square observability and stabilization of CPSs are derived by applying information theoretic tools of source coding. Our result is less conservative than some existing results. An illustrative example is given to demonstrate the effectiveness of the proposed quantization-coding scheme.

TREATMENT OF PAEDIATRIC ARTHROGRYPOTIC CLUBFOOT: 20 YEARS OF CLINICAL EXPERIENCE

BackgroundTreatment of arthrogrypotic clubfoot (AC) presents a challenging problem. Over time many different methods have been proposed, with variable rates of success, recurrence and other complications. In this study we describe our 20-year experience in treatment of AC.Materials and methodsBetween 1996 and 2016, 165 AC in 90 children (51 males and 39 females) were treated in our department. Their mean age was 7.6 years (3 months-16 years). Ponseti casting and Achilles tendon release (PCATR) was performed on 38 children (68 feet) and soft tissue release and casting (STRC) on 35 children (67 feet). The remaining 17 children (30 feet) underwent wide soft tissue release and correction using the Ilizarov method (STRIL). The results of each subgroup were graded according to clinical (pain, foot appearance, residual deformities, walking and standing status and shoe modifications) and radiological (anteroposterior and lateral talocalcanear angles, the angle between longitudinal axes of talus and the first metatarsal and the position of talus in the lateral view) criteria.ResultsThe average follow up was 6.4 (2–10) years. Results were excellent (plantigrade, painless, properly loaded feet, without deformities, adapted to common shoes) in 56 PCATR group feet, 59 STRC group feet and 23 STRIL group feet. Good results (required orthopaedic shoes) were obtained in 10 PCATR group feet, 6 STRC group feet and 7 STRIL group feet. Fair results (residual temporary pain and/or mild deformity) presented 2 PCATR group feet and 1 STRC group foot, while bad results (reoccurrence of clubfoot) were found in 1 STRC group foot.ConclusionsOn the basis of our 20-year clinical experience we believe that pediatric AC can be successfully treated with PCATR in the age of less than 1 year old (y.o), with STRC between 1–5 y.o. and with STRIL in children over the age of 5 y.o.

EXPRESS: Paying with Money or Paying with Points: How Variable vs. Fixed Exchange Rates Influence Loyalty Point Redemption

Although research examining loyalty point redemption has focused almost exclusively on fixed exchange rates between points and money (e.g., 100 points = $1), we frequently observe variable exchange rates in practice (e.g., 100 points might equate to more or less than $1, depending on the monetary price and the required points for a flight redemption within the continental U.S.). Such variable rates are particularly common in loyalty programs in the hospitality industry. In this research, we show that the stability of the exchange rate – whether the exchange rate is fixed or variable across offers – systematically influences point redemption. Consumers are less likely to redeem loyalty points and instead spend money when they observe a variable exchange rate between money and points than when they observe a fixed exchange rate, even when the average value of points is the same. We demonstrate this effect in a series of studies across contexts, including an incentive compatible retail loyalty program and a hotel loyalty program. We show that a variable point exchange rate induces more optimism than a fixed exchange rate, reducing point redemption. This effect is moderated by individual differences in optimism and by point expiration date. We conclude by discussing the implications for managers of loyalty programs and consumers.

Implementation of the International Consortium of Health Outcomes Measurement CHD standard set in patients undergoing pulmonary valve replacement.

Despite the burden of CHD, a high cost and utilization condition, an implementation of long-term outcome measures is lacking. The objective of this study is to pilot the implementation of the International Consortium of Health Outcomes Measurement CHD standard set in patients undergoing pulmonary valve replacement, a procedure performed in mostly well patients with diverse CHD. Patients ≥ 8 years old undergoing catheterization-based pulmonary valve replacement were approached via various approaches for patient-reported outcomes, with a follow-up assessment at 3 months post-procedure. Implementation strategy analysis was performed via a hybrid type 2 design. Of the 74 patients undergoing pulmonary valve replacement, 32 completed initial patient-reported outcomes with variable response rates by strategy (email and in-person explanation 100%, email only 54%, and email followed by text/call 64%). Ages ranged 8-67 years (mean 30). Pre-procedurally, 34% had symptomatic arrhythmias, which improved post-procedure. For those in school, 43% missed ≥ 6 days per year, and over half had work absenteeism. Financial concerns were reported in 34%. Patients reported high satisfaction with life (50% [n = 16]) and health-related quality of life (90% [n = 26]). Depression symptoms were reported in 84% (n = 27) and anxiety in 62.5% (n = 18), with tendency towards improvement post-procedurally. Pilot implementation of the International Consortium of Health Outcomes Measurement CHD standard set in pulmonary valve replacement patients reveals a significant burden of disease not previously reported. Barriers to the implementation include a sustainable, automated system for patient-reported outcome collection and infrastructure to assess in real time. This provides an example of implementing cardiac outcomes set in clinical practice.