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Maraging steels are used in industries that require high precision due to their exceptional mechanical properties. This paper presents the impact of ten process parameters on the mechanical properties of maraging steel produced via electron beam melting (EBM). The parameters studied here include printing orientation, scanning speed, beam power, beam diameter, line offset, layer thickness, scan strategy, number of contours, preheating temperature, and post-processing. The mechanical properties evaluated are tensile strength, strain at fracture, elongation at failure, energy density, material hardness, porosity, and surface morphology. The results showed a significant correlation between these mechanical properties and the EBM parameters. The highest ultimate tensile stress, determined from the tensile test, was recorded at 1491.51 MPa, corresponding to an energy density of 64.28 J/mm3. The optimal parameters were identified as a line offset of 0.1 mm, a layer thickness of 50 μm, a scanning speed of 2800 mm/s, and a beam power of 15 mA. The energy density during EBM in turn affected microstructure, porosity, and mechanical properties. Furthermore, the study revealed that aging heat treatment had a considerable impact on the mechanical properties, with the highest tensile strength observed for a sample that had undergone aging at 460 °C for 8 h. The results show the critical role of process parameters and aging heat treatment in achieving optimal mechanical properties in EBM-produced maraging steel M789. These findings contribute to the optimization of this manufacturing technique for industrial applications. [ABSTRACT FROM AUTHOR]

Lattice structures are very interesting since they present good mechanical properties coupled with lightness. Today, the maturity reached by additive manufacturing technologies allows the production of such structures. However, the mechanical properties of the constituting material can be affected by the process itself, because of the particular geometry. In fact, in a previous work, the mechanical characteristics of the bulk‐printed material were used for modelling the bending behavior of lattice‐cored specimens made of Ti6Al4V and produced through electron beam melting (EBM) process, but a certain discrepancy with experimental results was found. Therefore, in this work, a procedure was proposed to determine the mechanical properties of the material the lattice specimen is made of, in order to reduce the gap between the numerical and the experimental results. By considering the redetermined yield strength, such mismatch was reduced. Moreover, the metallographic analysis of the material found that the α laths of the α + β microstructure, typical of the studied alloy, were thinner than those of bulk specimens, and the presence of α′ martensite was discovered too. The fracture surface analysis determined a ductile failure mode for the lattice core while a fragile mode for the skins. Highlights: A procedure to calculate the effective material properties was proposed.The numerical model for bending behavior resulted.A different microstructure for lattice material than bulk one was found.Damaging mechanisms were identified through SEM analysis. [ABSTRACT FROM AUTHOR]

Introduction: In this review, we aim to assess the categorical distribution of publications in 3 leading general OMS journals, British Journal of Oral and Maxillofacial Surgery (BJOMS), International Journal of Oral and Maxillofacial Surgery (IJOMS), Journal of Oral and Maxillofacial Surgery (JOMS) over the span of 21-years. Method: We examined all full-length publications between 1998 and 2018 in 3 OMS journals (IJOMS, BJOMS, JOMS) and categorised into 16 pre-determined categories. These included facial aesthetic, anatomical, craniofacial, implantology, pre-prosthetic, oncology, orthognathic, pathology, pharmacology, radiology, reconstruction, obstructive sleep apnoea (OSA), technical notes, third molar, temporomandibular joint, and trauma. Statistical analysis was conducted to analyse the proportional changes in these categories over 2 time periods. Results: A total of 14,324 articles were analysed. This included 3745 articles in IJOMS, 7229 from JOMS, and 3745 from BJOMS. The areas of greatest change were seen with a statistically significant increase in the field of orthodontics, OSA, and implantology in 2 of the 3 journals. There was a marked reduction proportion of case reports/series over this period. Conclusions: The subject areas where there has been a proportional increase in publications included orthognathics, implantology, and sleep-related studies. Most other subject areas remain unchanged with a decrease noted in pathology-related articles. [ABSTRACT FROM AUTHOR]

Purpose of Review: This document critically examines the role of cannabinoids in cancer care during an era marked by rapid advancements in oncology and changing perceptions on cannabis. It traces the historical context of cannabis in medicinal use, navigating its journey from widespread acceptance, subsequent criminalization, to its resurgence in modern therapeutic applications, particularly within the framework of Evidence-Based Medicine (EBM). Recent Findings: Anchored in EBM principles, this study synthesizes current research from clinical trials, systematic reviews, and meta-analyses to evaluate the efficacy and safety of cannabinoids in oncology. The focus is on their palliative effects, considering the nuances of effectiveness, risk assessment, and challenges inherent in translating these findings into clinical guidelines. Summary: The study seeks to bridge the gap between scientific research and clinical practice, offering insights to inform future oncological therapies and symptom management strategies involving cannabinoids. The potential benefits and risks of cannabinoid use in cancer treatment are assessed to guide clinicians and researchers in developing comprehensive, evidence-based approaches to patient care. [ABSTRACT FROM AUTHOR]

In recent years, additive technologies have become increasingly important for the production of parts with complex geometries, enabling the rapid and efficient creation of objects with different shapes and configurations in industrial sectors such as medicine, aerospace and construction. The focus of the study was the analysis of arc processes for additive manufacturing, particularly through non-consumable electrode welding in an inert gas environment (TIG) and its applications as a heat source. Modern methods of 3D printing metal products, such as SLM (Selective Laser Melting), EBM (Electron Beam Melting), and LMD (Laser Metal Deposition), allow the production of parts with good quality indicators: accuracy, surface roughness, mechanical properties, and others. However, these methods are expensive due to the technological complexity of the equipment, and a weakness of these methods is their low productivity compared to arc methods. The results presented in this article show that the productivity of arc methods in additive manufacturing is several times higher than that of SLM, EBM, and LMD, and arc methods are more cost-effective due to lower equipment costs and reduced energy consumption. The article presents the schemes of arc methods of additive manufacturing. One of the promising directions in the development of hybrid technology, namely the use of the TIG heat source for sintering metal powders, offers an effective way to reduce the cost of additive manufacturing by replacing the laser as a heat source, while allowing the continued use of various types of metal powders, reinforcing materials, and metal-ceramic blends.

Electron Beam Melting (EBM) is typically used to produce high performance titanium parts, but it falls short in ensuring the high surface finishing always requested for aerospace applications, and this leads to the need of a post-building finishing resulting in additional resources and energy consumption. An optimization of the post-processing is necessary and the literature lacks guidelines in this regard. In this study, 18 cylindrical samples were produced by EBM and then postprocessed by wet and dry turning by using the same process parameters. Surface roughness, tool wear rate, specific cutting energy and energy consumption were investigated and compared to understand the best compromise to remove the same total depth of cut (2.4 mm). Results showed that dry turning can result in saving up 9% in total energy consumption. Also, feed rate and depth of cut can be varied by fixing the spindle speed without significantly affecting surface roughness by saving up to 73% in total energy consumption. [ABSTRACT FROM AUTHOR]

Background: Evidence-based medicine (EBM) is a term that has acquired different definitions in different settings and is considered as an ambiguous concept. However, it represents an empiricist mode of thinking in medicine. EBM is a patient-centered approach in medicine and bases clinical knowledge on evidence as well as having a huge impact on clinical practice during the past few decades. Aim: The study aimed to evaluate medical resident trainees’ attitude, knowledge, and practice of EBM and encountered barriers in clinical settings to determine the relationship between trainees at different levels and departments and implications on patient care. Methods: A cross sectional survey conducted between June 2022 till December 2022, utilizing face-to-face and online questionnaire. Our questionnaire consisted of 37 questions which include characteristics of the sample in addition to attitudes related to EBM and perceptions of barriers related to it. Inclusion criteria were residents working at Jordan University Hospital with a total of 175 residents who agreed to participate in this study, and exclusion criteria were other medical assistant members and fellows. Results: A survey was distributed to 175 residents, who completed it and provided information on their sociodemographic. Approximately 72.6 percent of the participants were females (n = 127), and the median age was 27 years and an interquartile range of 2 years. The majority of participants (n = 171, 97.7%) stated that they had heard the term "evidence-based medicine" before. When asked about the residents' knowledge of various research-related terms, their answers showed a positive trend, with the majority indicating that they had some understanding of the term. The remaining findings are covered below. Conclusion: Despite having received no formal training in this area during their years of training, JUH residents demonstrated positive views regarding EBM, supporting it, and believing in its conclusions. They also generally had good terminology knowledge. More than 85% utilize medical websites, more than 50% have papers published, and more than 50% endorse EBM. [ABSTRACT FROM AUTHOR]

JAMAevidence is an online resource available through McGraw Hill Medical for the teaching, learning, and application of evidence-based medicine. JAMAevidence helps students and clinicians identify, appraise, and use the best available evidence to assess health problems and the outcomes of health care. It also features books, calculators, educational guides, a glossary, and learning tools. [ABSTRACT FROM AUTHOR]

In a randomized study in a teaching context at the university of Lyon, France, we sought to measure the impact of scientific data interpretation on prescription intentions. Two different methodological approaches were used to interpret identical the same scientific data in the context of neuropathic pain treatment and influenced the prescription intentions of general practice residents. This example illustrates the evidence-based medicine approach with prescription of drugs even if the low level of evidence in the two presented vignettes. [ABSTRACT FROM AUTHOR]

Copyright of Hungarian Medical Journal / Orvosi Hetilap is the property of Akademiai Kiado and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Energy-environmental efficiency directly relates to global climate change and sustainable development. The research applies a staggered DiD design to estimate the effects of low-carbon governance on energy-environmental efficiency via panel data of 284 cities in China. Results show that low-carbon governance significantly improves both unified energy-environmental efficiency and pure energy-environmental efficiency. Heterogeneity analysis reveals that low-carbon governance in central cities has no significant effect on energy-environmental efficiency, while that in peripheral cities can improve energy-environmental efficiency, which indirectly confirms the law of decreasing returns to scale. At the same time, low-carbon governance in both resource-based and non-resource-based cities improves energyenvironmental efficiency. However, among resource-based cities, low-carbon governance in growth and mature cities facilitates energy-environmental efficiency, while this effect disappears in declining and regeneration cities. Mechanism tests suggest that low-carbon governance immediately improves energy-environmental efficiency through intensive energy use and carbon emission reduction channels. The intermediate effect channels are mainly driven by fiscal decentralization, industrial structure upgrading, industrial agglomeration, innovation, and marketization, where fiscal decentralization plays a dominant role. [ABSTRACT FROM AUTHOR]

In this work, we demonstrate a novel device structure with a dual‐electron blocking layer (2EBL) configuration to improve the capacitance‐voltage (CV) behavior without compromising other critical performances of bottom‐emission red organic light‐emitting diode (OLED). We started the work from studying the influence of electron blocking materials (EBMs) on various device characteristics including capacitance behavior. It is found that with conventional single EBL configuration, EBM with a deep highest occupied molecular orbital (HOMO) level tends to have high voltage yet low capacitance, while EBM with a shallow HOMO has the opposite behavior. To combine the advantages of low voltage and low capacitance, we investigate the employment of 2EBL configuration. 2 EBMs were developed, where EBM1 has a HOMO of ‐5.17 eV and a faster hole mobility of 21×10‐5 cm2/Vs, while EBM2 has a deeper HOMO level of ‐5.22 eV and a slower mobility of 14×10‐5 cm2 /Vs. Bottom emission red OLEDs A‐D with single EBM1, single EBM2, EBM1/EBM2, and EBM2/EBM1 were fabricated, respectively. The characterization of OLEDs A‐D reveals that OLED C reaches a balanced performance, at 10 mA/cm2 achieving a low voltage of 3.5 V, a low maximum capacitance per unit area (u‐Cmax) of 36 nF/cm2 and an accumulated charges per unit area (u‐Q) of 8 nC/cm2, while maintaining a high EQE of 30.6% and a long lifetime LT95 of 11,300 h. Moreover, Electrochemical Impedance Spectroscopy (EIS) measurements highlight the differences in bulk resistance among the OLED configurations, emphasizing the importance of EBL composition and arrangement in optimizing OLED performance. Low capacitance of OLED ensures a quick signal response and hence quick refresh rate, especially at low gray scale scenarios. Reduction of capacitance through EBL optimization is believed to be the best strategy, comparing to tuning emitter and hosts which is more likely to affect other key performances of OLED. Although this work is based on study of red OLED, the same scheme can be extended to other colors. [ABSTRACT FROM AUTHOR]

Abstract Background Primary care depends upon a good information flow across professional and structural boundaries to provide the best care for patients. Previous research has mainly focused on Evidence-Based Practice (EBP) within specific professions. Mapping of pan-professional experiences of and attitudes to EBP in publicly funded clinical practice is necessary to deepen the understanding of EBP and its implementation. Thus, this study aimed to investigate healthcare professionals’ experiences of and attitudes towards working in accordance with EBP in primary care. Methods The study used a convergent mixed methods design divided into two strands: a quantitative enquiry tool (Evidence-Based Practice Attitude Scale, EBPAS) and a set of qualitative interviews analysed by means of qualitative content analysis. Both strands included all primary care employees with patient interaction in the studied county (n = 625), including doctors, nurses, physiotherapists, psychologists and assistant nurses. Out of the original 625 healthcare professionals, 191 finished the first strand and 8 volunteered for the second strand (2 nurses, 2 physiotherapists, 1 psychiatrist and 3 doctors). Results The EBPAS value of 2.8 (max 4) indicated a generally positive attitude towards EBP amongst the population, which was also evident in the interviews. However, there were additional experiences of not having the ability or resources to engage in EBP. This was illustrated by the theme that emerged from the qualitative content analysis: “The dilemma of the split between theory and reality”. Due to the organisational and managerial focus on efficiency rather than quality of care, there were few or no incentives for promoting individual educational or research development. Conclusions Although the general attitude towards EBP is positive, experiences of practising it differ. There is a need to increase knowledge of EBP concepts, requirements and implementation in the clinical setting. The absence of opportunities to do research and collegial debate about new ways of finding and implementing research-based evidence results might influence the quality of care.

The activity of part orientation is of crucial importance in terms of impact on the quality of parts in powder bed additive manufacturing. To support the decision-making of computer aided manufacturing (CAM) operators, several knowledge and software models are proposed. Even if they seem to help operators in orientation process, their operational effectiveness still needs to be scientifically assessed. This paper proposes to evaluate the efficiency of a part orientation software in assisting CAM engineers in part orientation choice. The related software is based on the mathematization of action rules issued from a knowledge model. The knowledge involved in carrying out the orientation activity is analyzed based on the users' expertise. To do this, an empirical approach based on a case study is made with participants of different levels of skills. Several design scenarios including various part typologies to be oriented are submitted to engineers, before their manufacturing with electron beam melting (EBM) technology. Two means of orientation are thus used for comparison, namely, a manual orientation and a computer-aided orientation software. Based on the orientation results, an analysis of the software usage is undertaken. As an underlying result of our study, we have come up with an evaluation approach that can be reused in other contexts and with other software. [ABSTRACT FROM AUTHOR]

With the growth of global population and economic development, people are facing the problem of increasing scarcity of renewable energy and unsustainable energy use. To achieve the sustainable development goals (SDGs) proposed by the United Nations, research on energy consumption efficiency has become particularly important. This research evaluates the energy consumption efficiency of 270 cities in China through an improved EBM model and finds a common phenomenon of low energy consumption efficiency in the cities, with the highest efficiency in northeast China and the lowest efficiency in eastern China. In addition, the efficiency of industrial exhaust emissions most significantly positively correlates with the efficiency of employed population and total energy consumption efficiency, while the efficiency of regional GDP does not significantly correlate with the efficiency of the two input variables. Using the LMDI method to decompose the driving factors of energy consumption efficiency in the cities, we find that the most important factor affecting energy consumption efficiency is their own energy endowment. Therefore, to improve the energy consumption efficiency of its cities, the China government should comprehensively consider factors such as regional economic development level, industrial structure, and technological level differences, formulate relevant energy-saving and emission-reduction policies, focus on optimizing the energy consumption structure, encourage technological progress and innovation, and help increase investment in science and technology. [ABSTRACT FROM AUTHOR]

Randomized controlled trials (RCTs) are considered to produce the highest level of evidence in the original studies that informs the practice of evidence-based medicine (EBM). By manipulating an independent variable to study its impact on the outcome, RCTs establish causal relationships and provide valuable insights into clinical treatment. To improve patient outcomes and optimize the use of clinical resources, the practice of EBM plays a crucial role in designing and conducting RCTs to evaluate the effectiveness of clinical interventions. This review aims to explore the essential steps involved in conducting a rigorous and reliable RCT, ensuring the generation of highquality evidence. [ABSTRACT FROM AUTHOR]

India is the most populous in the world. Its healthcare ecosystem and the spectrum of diseases seen make it the ideal place to carry out research. It also demands that practices are evidence-based to conserve precious healthcare resources. There are, however, challenges encountered in practicing evidence-based medicine in India. These include a lack of researchers trained in the practice of EBM, a paucity of funds in the research field as well as lack of familiarity among physicians with EBM. Training in the 5 steps of EBM, acronymized as the 5 As (Ask, Acquire, Appraise, Apply, and Assess) is essential for all healthcare professionals, It is critical to identify research gaps before undertaking any form of research to avoid unnecessary duplication. A systematic search of literature is useful in generating evidence maps which can help in identifying areas requiring further studies. The task before us is also to build an army of astute health care professionals armed with skills of EBM, who can separate the grain from the chaff and be the torchbearers of evidence-based practices. There is a need to encourage a culture of EBM, where it is the responsibility of every clinician to calibrate the most evidence-based solution to their setting and administer it taking into account the values and beliefs of the patient. That would be the point of the union of the science and art of evidence-based medicine.

Subject of the study Clinical practice guidelines are an effective strategy for optimizing health care by promoting evidence-based recommendations. Appropriate methodology and a rigorous strategy when formulating the recommendations of clinical guidelines has a significant impact on their quality, reliability and ability to be effectively implemented in practice. Purpose of the study The purpose of our study was to assess the quality of clinical practice guidelines for asthma management using the AGREE II tool. The analysis compared the quality of Polish clinical guidelines with those from other countries and international organizations. Nine guidelines were evaluated: Management of Asthma Exacerbations in Adults - Guidelines for General Practitioners (author: Supreme Medical Council, Poland), Global Strategy for Asthma Management and Prevention (author: The Global Initiative for Asthma (GINA)), Asthma and Respiratory Foundation NZ Adolescent and Adult Asthma Guidelines 2020: a quick reference guide (author: Asthma and Respiratory Foundation New Zealand), Australian Asthma Handbook V2.0 (author: National Asthma Council Australia), National Clinical Guideline: The Diagnosis and Management of Asthma in Adults V2. 1 (author: Ministry of Public Health Qatar), SIGN 158 British guideline on the management of asthma (author: Scottish Intercollegiate Guidelines Network (SIGN) British Thoracic Society), Management of Asthma in Adults (author: Malaysian Health Technology Assessment Section (MaHTAS)), Asthma: diagnosis, monitoring and chronic asthma management (author: National Institute for Health and Care Excellence (NICE)), and The Spanish Guideline on the Management of Asthma (author: Guía Española para el Manejo del Asma (GEMA)). Results The highest scored domains were transparency and presentation of recommendations (all guidelines scored 100% or close to 100%), guideline scope and purpose, and editorial independence. The domains that scored lowest were in the areas of stakeholder engagement and applicability (79.3% and 69.2%, respectively). The largest differences were observed in the area of editorial independence, ranging from 100% (the maximum possible score) to 16.7%. The guidelines developed by the National Institute for Health and Care Excellence and the Scottish Intercollegiate Guidelines Network received the highest overall score. The Polish guidelines received the maximum number of points in areas related to scope and purpose, transparency and presentation, and editorial independence. Conclusions A properly conducted guideline development process, including the involvement of experts and adherence to methodological standards, results in high-quality clinical practice guidelines. High-quality clinical practice guidelines can be used as tools to support clinical decision-making, however, guideline authors should pay special attention to the applicability of guidelines in practice and the involvement of all stakeholders. To improve the process of guideline development and patient access to the newest therapies, it is also important to consider the synergies between the recommendations in clinical practice guidelines and health technology assessment reports.

Obesity has been a global health problem since the twentieth century. Despite the intensive research, there is no scientific consensus on the onset of obesity. The energy balance model (EBM) and the carbohydrate-insulin model (CIM) are two competing obesity theories, each with supporting and conflicting evidence. In this essay, I propose a new model, the energy-rush and insulin model (ERIM) which integrates not only the energy intake and expenditure, but also the food composition and digestibility, to explain how the high energy-rush and insulin secretion contribute to the development of obesity. The ERIM offers a novel framework to explain how obesity occurs and proposes new recommendations which may reverse the obesity epidemic in the future.

Hybrid manufacturing (HM) is a process that combines additive manufacturing (AM) and subtractive manufacturing (SM). It is becoming increasingly recognized as a solution capable of producing components of high geometric complexity, while at the same time ensuring the quality of the surface finish, rigour and geometric tolerance on functional surfaces. This work aims to study the surface finish quality of an orthopaedic hip resurfacing prosthesis obtained by HM. For this purpose, test samples of titanium alloy Ti-6Al-4V using two Power Bed Fusion (PBF) processes were manufactured, which were finished by turning and 5-axis milling. It was verified that, upon the machining tests, no differences in Ra and Rt were found between the various types of AM. Regarding the type of SM used, 5-axis milling provided lower roughness results with a consistent value of Ra = 0.6 µm. The use of segmented circle mills in 5-axis milling proved to be an asset in achieving a good surface finish. This work successfully validated the concept of HM to produce a medical device, namely, an orthopaedic hip prosthesis. As far as surface quality is concerned, it could be concluded that the optimal solution for this case study is 5-axis milling. [ABSTRACT FROM AUTHOR]

Background: To reduce their decisional uncertainty, health policy decision‐makers rely more often on experts or their intuition than on evidence‐based knowledge, especially in times of urgency. However, this practice is unacceptable from an evidence‐based medicine (EbM) perspective. Therefore, in fast‐changing and complex situations, we need an approach that delivers recommendations that serve decision‐makers' needs for urgent, sound and uncertainty‐reducing decisions based on the principles of EbM. Aims: The aim of this paper is to propose an approach that serves this need by enriching EbM with theory. Materials and Methods: We call this the EbM+theory approach, which integrates empirical and theoretical evidence in a context‐sensitive way to reduce intervention and implementation uncertainty. Results: Within this framework, we propose two distinct roadmaps to decrease intervention and implementation uncertainty: one for simple and the other for complex interventions. As part of the roadmap, we present a three‐step approach: applying theory (step 1), conducting mechanistic studies (EbM+; step 2) and conducting experiments (EbM; step 3). Discussion: This paper is a plea for integrating empirical and theoretical knowledge by combining EbM, EbM+ and theoretical knowledge in a common procedural framework that allows flexibility even in dynamic times. A further aim is to stimulate a discussion on using theories in health sciences, health policy, and implementation. Conclusion: The main implications are that scientists and health politicians – the two main target groups of this paper—should receive more training in theoretical thinking; moreover, regulatory agencies like NICE may think about the usefulness of integrating elements of the EbM+theory approach into their considerations. [ABSTRACT FROM AUTHOR]

Copyright of Arthroskopie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Artificial Intelligence (AI) has become increasingly integral to healthcare, aiding medical professionals in disease diagnosis. However, a critical challenge faced by practitioners lies in the trustworthiness of diagnosed results, as machine learning models often lack transparent explanations for their predictions. Explainable AI (XAI) addresses this, allowing practitioners and patients to comprehend and trust outcomes. This study employs the liver disease patient dataset to predict liver disease, vital in India where yearly, 10 lakh people face new liver cirrhosis diagnoses with high mortality. Early detection difficulties underscore the need for transparent predictions. Using Kaggle data, Random Forest, XGBoost, and Explainable Boosting Machine (EBM) classifiers are compared, with EBM outshining, achieving a 99.8% accuracy score. The study concludes that the EBM classifier is a superior and transparent liver disease predictor. [ABSTRACT FROM AUTHOR]

Abstract Objectives Decision aids (DAs) are promising tools to foster evidence‐based shared decision‐making between practitioners and service users. Nevertheless, it is still obscure how an evidence‐based DA for people with severe mental illness, especially psychosis, should look in an inpatient treatment setting to be useful and feasible. Therefore, we conducted focus groups with psychiatrists and service users to collect and assess their expectations and wishes regarding an evidence‐based DA. From these findings, we derived immediate recommendations for the future development of DAs. Methods We held two group interviews with service users (n = 8) and three group interviews with psychiatrists (n = 10). We used an open, large‐scale topic guide. First, we presented data from a current meta‐analysis on antipsychotics to the interviewees and, in a second step, asked for their expectations and wishes towards a DA that integrates these data. Results Our thematic analysis revealed six key themes addressed by the respondents: (1) general considerations on the importance and usefulness of such a DA, (2) critical comments on psychiatry and psychopharmacotherapy, (3) communicative prerequisites for the use of a DA, (4) form and content of the DA, (5) data input, data processing and output as well as (6) application of the DA and possible obstacles. Conclusions Participants identified several important features for the development of DAs for selecting antipsychotics in inpatient psychiatric treatment. The digital format was met with the greatest approval. Especially the adaptability to different needs, users and psychopathologies and the possibility to outsource information dissemination via app seemed to be a decisive convincing argument. Further research is required to test specific features of DAs to be developed in clinical settings.

Like many surgical subspecialties, there have been frequent advancements and discoveries in the field of hand and upper extremity surgery. With a rapidly growing literature base, it can be difficult to remain updated on the latest recommendations. A comprehensive literature search was completed on PubMed using MeSH terms. Topics included nutrition management, anticoagulation, immunosuppressive medication management, antibiotic use, skin preparation, splinting, tourniquet use, and suture choice. Data from articles with a level of evidence 1A-3 C were included. A total of 42 articles were identified and reviewed to provide evidence for recommendations regarding various aspects of pre-, intra-, and post-operative care. The objective of this manuscript is to serve as a resource for evidence-based recommendations by the findings of recent evidence related to perioperative care in elective hand surgery. Additional studies are required in certain areas of the literature in order to provide stronger recommendations. [ABSTRACT FROM AUTHOR]

This study investigates the elasticity of specific lattice structures made from titanium alloy (Ti6Al4V), namely, anatomically shaped lattice scaffolds (ASLS) aimed for reinforcement of the bone tissue graft that substitute a missing piece of the previously injured bone during its recovery. ASLSs that were used for testing were fabricated using the Electron Beam Melting (EBM) method. The mechanical properties of the ASLS were examined through uniaxial compression tests. Compression testing revealed the complex non-linear behavior of the scaffold structure's elasticity, with distinct compression stages and deformation dependencies. The ASLS structures exhibited quasi-elastic deformation followed by the rupture of individual struts. Results demonstrate that the ASLSs can be stiffened by applying appropriate compression load and accordingly achieve the target elasticity of the structure for the specific load range. The modulus of elasticity was determined for different compression stages of ASLS, allowing interpolation of the functional relation between the modulus of elasticity and compressive force that is used for stiffening the ASLS. This study enhances the understanding of the mechanical behavior of the specific lattice structures made of Ti6Al4V and provides insights for the development of mechanically optimized anatomically shaped lattice scaffolds. [ABSTRACT FROM AUTHOR]

Objective To train and test a model predicting chronic kidney disease (CKD) using the Generalized Additive2 Model (GA2M), and compare it with other models being obtained with traditional or machine learning approaches. Materials We adopted the Health Search Database (HSD) which is a representative longitudinal database containing electronic healthcare records of approximately 2 million adults. Methods We selected all patients aged 15 years or older being active in HSD between January 1, 2018 and December 31, 2020 with no prior diagnosis of CKD. The following models were trained and tested using 20 candidate determinants for incident CKD: logistic regression, Random Forest, Gradient Boosting Machines (GBMs), GAM, and GA2M. Their prediction performances were compared by calculating Area Under Curve (AUC) and Average Precision (AP). Results Comparing the predictive performances of the 7 models, the AUC and AP for GBM and GA2M showed the highest values which were equal to 88.9%, 88.8% and 21.8%, 21.1%, respectively. These 2 models outperformed the others including logistic regression. In contrast to GBMs, GA2M kept the interpretability of variable combinations, including interactions and nonlinearities assessment. Discussion Although GA2M is slightly less performant than light GBM, it is not "black-box" algorithm, so being simply interpretable using shape and heatmap functions. This evidence supports the fact machine learning techniques should be adopted in case of complex algorithms such as those predicting the risk of CKD. Conclusion The GA2M was reliably performant in predicting CKD in primary care. A related decision support system might be therefore implemented. [ABSTRACT FROM AUTHOR]

Titanium alloys additively manufactured by electron beam melting (EBM) inevitably obtained some pore defects, which significantly reduced the very high cycle fatigue performance. An ultrasonic fatigue test was carried out on an EBM TC21 titanium alloy with hot isostatic pressing (HIP) and non-HIP treatment, and the effect of pore defects on the very high cycle fatigue (VHCF) behavior were investigated for the EBM TC21 titanium alloy. The results showed that the S-N curve of non-HIP specimens clearly had a tendency to decrease in very high cycle regimes, and HIP treatment significantly improved fatigue properties. Fatigue limits increased from 250 MPa for non-HIP specimens to 430 MPa for HIP ones. Very high cycle fatigue crack mainly initiated from the internal pore for EBM specimens, and a fine granular area (FGA) was observed at the crack initiation site in a very high cycle regime for both non-HIP and HIP specimens. ΔKFGA had a constant trend in the range from 2.7 MPa m to 3.5 MPa m , corresponding to the threshold stress intensity factor range for stable crack propagation. The effect of pore defects on the very high cycle fatigue limit was investigated based on the Murakami model. Furthermore, a fatigue indicator parameter (FIP) model based on pore defects was established to predict fatigue life for non-HIP and HIP specimens, which agreed with the experimental data. [ABSTRACT FROM AUTHOR]

The concept of »evidence-based medicine« (EBM) is actually a very good proposal to keep a sufficient overview with respect to the abundance of research literature – also in the field of psychotherapy – and thus to be able to make better decisions for the benefit of patients. It is shown that this good concept is now predominantly misused. Instead of taking into account the breadth of relevant information on an issue, EBM in Germany has been substantially converted into an instrument for selection and regulation. Only studies that follow the logic of pharmaceutical trials – RCTs – are taken into account, although this approach is inadequate for a wide range of psychotherapy. Moreover, these results are then summarized by means of »effect sizes« using the methods of meta-analysis – although »effect size« does not (only) measure treatment success. [ABSTRACT FROM AUTHOR]

Objectives: Decision aids (DAs) are promising tools to foster evidence‐based shared decision‐making between practitioners and service users. Nevertheless, it is still obscure how an evidence‐based DA for people with severe mental illness, especially psychosis, should look in an inpatient treatment setting to be useful and feasible. Therefore, we conducted focus groups with psychiatrists and service users to collect and assess their expectations and wishes regarding an evidence‐based DA. From these findings, we derived immediate recommendations for the future development of DAs. Methods: We held two group interviews with service users (n = 8) and three group interviews with psychiatrists (n = 10). We used an open, large‐scale topic guide. First, we presented data from a current meta‐analysis on antipsychotics to the interviewees and, in a second step, asked for their expectations and wishes towards a DA that integrates these data. Results: Our thematic analysis revealed six key themes addressed by the respondents: (1) general considerations on the importance and usefulness of such a DA, (2) critical comments on psychiatry and psychopharmacotherapy, (3) communicative prerequisites for the use of a DA, (4) form and content of the DA, (5) data input, data processing and output as well as (6) application of the DA and possible obstacles. Conclusions: Participants identified several important features for the development of DAs for selecting antipsychotics in inpatient psychiatric treatment. The digital format was met with the greatest approval. Especially the adaptability to different needs, users and psychopathologies and the possibility to outsource information dissemination via app seemed to be a decisive convincing argument. Further research is required to test specific features of DAs to be developed in clinical settings. Patient or Public Contribution: The entire project is supported by an advisory board, including also experienced users. The members are regularly updated about the process and give important feedback. [ABSTRACT FROM AUTHOR]

The new generation of manufacturing methods that extends over subtractive type is introduced by additive manufacturing. The benefit of additive manufacturing is that it directly uses 3D CAD models to create three-dimensional objects by adding more layers of material and joining them together. It is commonly utilized in the motor sector, aerospace industry, biomedical applications, prototyping, fashion such as creation of custom-made jewellery, accessories, and even clothing and many more. Additive manufacturing technology is extensively employed because of its numerous benefits, which include multimaterial goods, improved product ergonomics, on-demand manufacturing, short production runs, and so on. Various fabricating methods, which include rapid prototyping, stereolithography, electron-beam melting, fused-deposition modelling, 3D printing (3DP), selective laser sintering, etc. Understanding the complex relationships between fundamental process parameters, flaws, and the finished product of the AM process depends heavily on mechanical testing. Because of the growing use of additive manufacturing in a variety of industries, it is critical to evaluate the mechanical performance of the components created. [ABSTRACT FROM AUTHOR]

Nonlinear oscillations are an essential fact in physical science, mechanical structures, and other engineering problems. Some of the popular analytical solutions to analyze nonlinear differential equations governing the behavior of strongly nonlinear oscillators are the Energy Balance Method (EBM), and He's Amplitude Frequency Formulation (HAFF). The lack of precision and accuracy despite needing several computational steps to resolve the system frequency is the main demerit of these methods. This research creates a novel analytical approximation approach with a very efficient algorithm that can perform the calculation procedure much easier and with much higher accuracy than classic EBM and HAFF. The presented method's steps rely on Hamiltonian relations described in EBM and the defined relationship between frequency and amplitude in HAFF. This paper demonstrates the substantial precision of the presented method compared to common EBM and HAFF applied in different and well-known engineering phenomena. For instance, the approximate solutions of the equations govern some strongly nonlinear oscillators, including the two-massspring systems, buckling of a column, and duffing relativistic oscillators are presented here. Subsequently, their results are compared with the Runge-Kutta method and exact solutions obtained from the previous research. The proposed novel approach resultant error percentages show an excellent agreement with the numerical solutions and illustrate a very quickly convergent and more precise than mentioned typical methods. [ABSTRACT FROM AUTHOR]

Innovative carbon reduction and sustainability solutions are needed to combat climate change. One promising approach towards cleaner air involves the utilization of lithium-ion batteries (LIB) and electric power vehicles, showcasing their potential as innovative tools for cleaner air. However, we must focus on the entire battery life cycle, starting with production. By prioritizing the efficiency and sustainability of lithium-ion battery manufacturing, we can take an essential step toward mitigating climate change and creating a healthier planet for future generations. A comprehensive case study of the leading LIB manufacturers demonstrates the usefulness of the suggested hybrid methodology. Initially, we utilized the Malmquist model to evaluate these firms' total efficiency while dissecting their development into technical and technological efficiency change components. We employed the Epsilon-Based Measure (EBM) model to determine each organization's efficiency and inefficiency scores. The findings show that the EBM approach successfully bridged the gap in the LIB industry landscape. Combined with the Malmquist model, the resulting framework offers a powerful and equitable evaluation paradigm that is easily applicable to any domain. Furthermore, it accurately identifies the top-performing organizations in specific aspects across the research period of 2018–2021. The EBM model demonstrates that most organizations have attained their top level, except for A10, which has superior technology adoption but poor management. A1, A2, A4, A6, A8, A9, and A10 were unable to meet their targets because of the COVID-19 pandemic, despite productivity improvements. A12 leads the three highest-scoring enterprises in efficiency and total productivity changes, while A3 and A5 should focus on innovative production techniques and improved management. The managerial implications provide vital direction for green energy practitioners, enhancing their operational effectiveness. Concurrently, consumers can identify the best LIB manufacturers, allowing them to invest in long-term green energy solutions confidently. [ABSTRACT FROM AUTHOR]

This study illustrates the utility and effectiveness of machine learning algorithms in identifying dependencies in data transmitted in industrial networks. The analysis was performed for two different algorithms. The study was carried out for the XGBoost (Extreme Gradient Boosting) algorithm based on a set of decision tree model classifiers, and the second algorithm tested was the EBM (Explainable Boosting Machines), which belongs to the class of Generalized Additive Models (GAM). Tests were conducted for several test scenarios. Simulated data from static equations were used, as were data from a simulator described by dynamic differential equations, and the final one used data from an actual physical laboratory bench connected via Modbus TCP/IP. Experimental results of both techniques are presented, thus demonstrating the effectiveness of the algorithms. The results show the strength of the algorithms studied, especially against static data. For dynamic data, the results are worse, but still at a level that allows using the researched methods to identify dependencies. The algorithms presented in this paper were used as a passive protection layer of a commercial IDS (Intrusion Detection System). [ABSTRACT FROM AUTHOR]

Forming process control of powder bed fusion (PBF) additive manufacturing (AM) is the key to produce high-quality qualified parts. In this paper, spreading powder process and electron-beam melting (EBM) of Ti6Al4V powder were simulated based on simulation technology, and the state of powder bed powder and melting trajectory characteristics were characterized. Firstly, the particle size distribution of Ti6Al4V powder was tested, and the particle diameter of normal distribution for simulation was determined. Then, the simulation models of spreading powder and EBM model were established. Finally, based on the simulation results, the effect of processing parameters on the quality of powder laying is analyzed, and the morphology of EBM melting trajectory is characterized. [ABSTRACT FROM AUTHOR]

Featured Application: This article deals with a method for directly determining the volume loss during a pin-on-disc test. The results can provide a reliable basis for an in-depth study of the performance of prosthetic joints, including a tribo-pair consisting of a Ti6Al4V pin produced by EBM and a UHMWPE sheet. Debris formation is a crucial aspect that determines the lifespan of prosthetic joints. The wearing contact between ultra-high molecular weight polyethylene (UHMWPE) and a Ti alloy surface has been studied in the literature. However, when measuring mass loss, potential errors can arise due to the very small values involved (on the order of some units of 0.1 mg in experiments lasting several hours) and be caused by the absorption of humidity in the specimen, in addition to the lack of accuracy typical of weight scales. These errors can hardly be avoided, but accurate cleaning and drying processes can minimize them. With these premises, the present work aims to determine, by pin-on-disc test, the wear effect in the UHMWPE rotating sheet and Ti6Al4V pin produced by Electron Beam Melting (EBM) under dry and lubricated conditions. The morphology of the worn surface was documented by optical microscopy, and the volume loss of both the rotating specimens and the pin was accurately calculated through the detection of the wear track observed by optical microscopy. In particular, the present work proposes a method for directly determining the volume loss of the polymer to compare it with that obtained with the weight measurement. For both procedures, the uncertainty in evaluating the specific wear rate was analyzed, demonstrating that volume measurement allows for avoiding any possible error associated with weighing the polymeric specimens. [ABSTRACT FROM AUTHOR]

With the growth of global population and economic development, people are facing the problem of increasing scarcity of renewable energy and unsustainable energy use. To achieve the sustainable development goals (SDGs) proposed by the United Nations, research on energy consumption efficiency has become particularly important. This research evaluates the energy consumption efficiency of 270 cities in China through an improved EBM model and finds a common phenomenon of low energy consumption efficiency in the cities, with the highest efficiency in northeast China and the lowest efficiency in eastern China. In addition, the efficiency of industrial exhaust emissions most significantly positively correlates with the efficiency of employed population and total energy consumption efficiency, while the efficiency of regional GDP does not significantly correlate with the efficiency of the two input variables. Using the LMDI method to decompose the driving factors of energy consumption efficiency in the cities, we find that the most important factor affecting energy consumption efficiency is their own energy endowment. Therefore, to improve the energy consumption efficiency of its cities, the China government should comprehensively consider factors such as regional economic development level, industrial structure, and technological level differences, formulate relevant energy-saving and emission-reduction policies, focus on optimizing the energy consumption structure, encourage technological progress and innovation, and help increase investment in science and technology.

Significant contributions to debates in the philosophy of evidence-based medicine (EBM) have come from a variety of different philosophical quarters, yet mainstream discourse in the field has been largely devoid of contributions from scholars working in the pragmatist tradition. This is a particularly conspicuous omission, given pragmatism's commitment to the melioristic view that philosophy both can, and should, be about the business of concretely bettering the human estate. Two exceptions to this oversight come from Brian Walsh and Maya Goldenberg. Unfortunately, in both cases, the misapplication of pragmatist thinking leads to the mistaken view that EBM is committed to some form of pernicious objectivism. This article aims to revise these pragmatist critiques in order to bring them more consistently in line with pragmatist values and commitments. Doing so shows that EBM is defensible on pragmatist grounds against objectivist attacks. [ABSTRACT FROM AUTHOR]

Despite the significant potential advantages of processing Ti-5Al-5Mo-5V-1Cr-1Fe alloy (Ti-55511) using Electron Beam Melting (PBF-EB/M), when compared to conventional manufacturing technologies, the resulting internal defects are an important characteristic of such additive technologies and can highly decrease mechanical properties. One of the most dangerous defects formed during metal additive manufacturing processes are material discontinuities such as a lack of fusion. Defects of this type, due to their "flat" nature, are difficult to characterize. For cycle-loaded specimens, where the loading force acts perpendicular to the lack-of-fusion plane, defects of this type can significantly reduce fatigue properties. This paper presents the results of research aimed at improving the fatigue properties of Ti55511 alloy by reducing the influence of the lack-of-fusion defect on fatigue damage. The static and fatigue properties of specimens in the as-built state, as well as after hot isostatic pressing (HIP) treatment, were analyzed. The effect of HIP on both the reduction of pores and the degree of sphericity when using the X-ray computed tomography (XCT) system was presented. The change in the microstructure after HIP was analyzed in terms of the change in the size of individual phases, as well as the change in the phase ratio. This paper also contains a fractographic analysis of the samples after tensile and fatigue tests. [ABSTRACT FROM AUTHOR]