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The current research examines how the knowledge that a product is made using a traditional method influences perceptions of its quality. We propose that consumers believe that a brand using traditional methods is beneficial for society because it is concerned about cultural preservation and this belief has a positive effect on perceived quality. Six experimental studies show that consumers evaluate products produced with a method described as traditional to be higher in quality than similar products that are not described as traditionally made and this effect is mediated by the belief that the brand is beneficial for society. Consistent with this theory, the positive effect of traditional production on perceived quality is attenuated when consumers view the brand to be unconcerned about cultural preservation, such as when the use of a traditional method is framed as a follower strategy (i.e. it imitates the actions of other brands) or when the brand is a multinational company. By showing that the mere mention of a traditional method can be another subtle way to position a brand as a moral actor, these findings contribute to the understanding of the link between perceived social responsibility and product evaluations. [ABSTRACT FROM AUTHOR]

Introduction: Previous studies have shown that patients in the emergency department (ED) are frequently given incomplete discharge instructions that are written at least four grade levels above the recommended sixth-grade reading level, leading to poor understanding. Our aims in this study were to implement standardized discharge instructions containing six key components written at a more appropriate reading level for common emergency department (ED) diagnoses to improve patient understanding.Methods: We conducted this study in a 20-bed ED at an urban Veteran’s Administration hospital. Data was collected via in-person patient and clinician interviews. Patient interviews were conducted after patients received their discharge instructions. We compared patient responses to clinician responses and marked them as incorrect, partially correct, or correct with a score of 0, 0.5, or 1, respectively. The maximum possible score for each interview was six. Six key components of discharge instructions were asked about: diagnosis; new medications; at-home care; duration of illness; reasons to return; and follow-up. There were 25 patients in the pre-intervention group and 20 in the intervention group with the standardized set of instructions. We performed a Mann-Whitney U test on the total interview scores in the control and intervention groups and conducted a sub-analysis on the individual scores for each of the six key components.Results: The patients in the intervention demonstrated a statistically significant increase in patient-clinician correlation when compared to the patients in the pre-intervention group overall (P < 0.05), and two of the six key components of the discharge instructions individually showed statistically significant increase in patient-clinician correlation when standardized discharge instructions were used.Conclusion: Patients who received the standardized discharge instructions had improved understanding of their discharge instructions. Future opportunities extending off this pilot study include expanding the number of diagnoses for which standardized instructions are used and investigating patient-centered outcomes related to these instructions.

The advent of AI-generated news as a novel form of content demands renewed attention toward modes of understanding reader perceptions. This research sought to answer: What evaluative criteria do readers use to perceive automated news content? To answer this, the study employed a two-phase survey methodology designed to elicit reader perceptions of AI-generated news. Phase 1 yielded 26 dynamic descriptor words and reflected broad social perceptions of AI. In Phase 2, a series of exploratory factor analyses (EFA) was conducted on results of a survey using the 26 items obtained in phase 1 to uncover underlying factors contributing to differences in how readers ranked articles based on the aforementioned descriptor words. In both phases, readers were informed at the beginning of the survey that the articles were generated using AI. The first set of exploratory factor analysis results were obtained using varimax rotation, which revealed five salient factors underlying the 26 descriptors labeled Quality, Engagement, Alienation, Effort, and Coherence. The second exploratory factor analysis used oblimin rotation, which contrastingly revealed nine salient factors, which were labeled Credibility, Prolixity, Engagement, Substance, Clarity, Alienation, Complexity, Effort, and Neutrality. When compared with the results of factor analyses for human-generated news content, the findings offer new constellations of terms that reflect the dimensions that readers attend to in articles attributed to artificial intelligence.

The COVID-19 pandemic led to unprecedented challenges to healthcare quality in the emergency department, including directly impacting quality metrics and worsening barriers to the quality improvement process such as burnout, staff turnover, and boarding. We aimed to develop a blueprint for postpandemic quality improvement to address these specific barriers, focused on prioritizing frontline staff engagement from idea generation to implementation and assessment. Drawing from teamwork literature, we constructed a process that emphasized egalitarian conversations, psychological safety, and creating an environment where staff could feel heard at every step of the process. We applied this blueprint to improving rates of patients who leave without being seen and achieved a four percentage point reduction (9% vs. 5%, p

OBJECTIVE: To estimate and contrast the relationships between nurse staffing and health outcomes in nursing homes with low and high dementia census, to understand the association of staffing hours with dementia care quality. DATA SOURCES AND STUDY SETTING: A national sample of nursing homes during 2017-2019 (pre-COVID). Data included the Payroll-Based Journal, Medicare Claims, Nursing Home Care Compare, and Long-Term Care Focus. STUDY DESIGN: Retrospective, regression analyses. We estimated separate linear models predicting six long-term facility-level outcomes. Independent variables included staffing hours per resident-day (HPRD) interacted with the facility percentage of dementia residents, controlling for other resident and facility characteristics. DATA COLLECTION/EXTRACTION METHODS: Hospital-based nursing homes, those with fewer than 30% dementia residents, and missing data were excluded. PRINCIPAL FINDINGS: We found that registered nurses and certified nurse assistants HPRDs were likely to exhibit positive returns in terms of outcomes throughout most of the range of HPRD for both high and low-census dementia facilities, although, high- and low-dementia facilities differed in most outcome rates at all staffing levels. Average predicted antipsychotics and activities of daily living as functions of HPRD were worse in higher dementia facilities, independent movement, and hospitalizations did not differ significantly, and Emergency Rooms and pressure sores were worse in lower dementia facilities. Average marginal effects were not statistically different [CI included zero] between the high and low dementia facilities for any outcome. CONCLUSIONS: These findings suggest that increasing staffing will improve outcomes by similar increments in both low- and high-dementia facilities for all outcomes. However, at any given level of staffing, absolute differences in outcomes between low- and high-dementia facilities remain, suggesting that additional staffing alone will not suffice to close these gaps. Further studies are required to identify opportunities for improvement in performance for both low- and high-dementia census facilities.

This article examines the relation between internal audit function (IAF) quality and investment efficiency, a recurring value-added corporate activity critical to firm survival and profitability. We argue that an IAF, unlike other information intermediaries, is uniquely positioned to have access to firm-specific, private information—particularly related to localized, firm-specific risks. If a more competent IAF incrementally improves the information that is generated and communicated to management (while not participating directly in decision-making), we should observe more productive capital investment decisions from firms with higher quality IAFs relative to firms with lower quality IAFs. Through this enhanced information channel, we find that IAF quality is associated with investment efficiency. This result holds for both under- and overinvestment, although not in tests of all subsamples. We also document that this effect is more pronounced for firms with more complexity and for firms with greater investment opportunities. Our evidence indicates that IAF quality provides measurable and economically meaningful value to an organization. [ABSTRACT FROM AUTHOR]

This paper presents an evaluation of the usability, functionality, and usefulness of the Warehouse Error Prevention (WEP) tool that consists of seven modules. The WEP tool is framed in a simple yes/no form, which can be used to identify human factors related to sources of pick errors in a warehouse. Thirty-three participants in 27 organisations from three different countries participated in a trial application and evaluation of the tool. The evaluation included a survey study and semi-structured interviews. Survey results show that participants agreed on the usability and functionality of the WEP tool. In the interviews, participants generally reported the WEP tool as being both accurate and functional with the potential to support engineers, ergonomists, and warehouse managers to improve order picking quality. Further quantitative field testing of the WEP tool's potential to identify costly warehouse errors is needed. [ABSTRACT FROM AUTHOR]

Ensuring quality in healthcare calls for a coordinated, systematic, congruous, and sustained approach. Nevertheless, it demands defining what the quality of healthcare means in the local context. Presently, the Malaysian healthcare system utilizes various definitions of quality of healthcare across the different initiatives and levels of healthcare, which can lead to fragmented or ineffective quality improvement. The study aims to describe the process undertaken in developing an explicit definition of the quality of healthcare tailored to the Malaysian context, which is currently lacking. A pluralistic method was used to explore the different perspectives. Three distinct approaches were used to understand how quality is defined among the different stakeholder groups: (i) interactive policy-makers engagement sessions, (ii) a review of local quality-related documents, and (iii) an online survey engaging the public. The domains depicting quality of healthcare that emerged through these three approaches were mapped against a framework and synthesized to form the local definition of quality. A national quality-related technical working group convened on several sessions to achieve consensus and finalize the definition of quality of healthcare. Quality healthcare in Malaysia is defined as providing high-quality healthcare that is safe, timely, effective, equitable, efficient, people-centred, and accessible [STEEEPA] which is innovative and responsive to the needs of the people, and is delivered as a team, in a caring and professional manner in order to improve health outcomes and client experience. The consensus-driven local definition of healthcare quality will guide policies and ensure standardization in measuring quality, thereby steering efforts to improve the quality of healthcare services delivered in Malaysia.

This study documented three domains of journal research quality using metrics from six major publishers and two major database services for a large sample of kinesiology-related journals: Rigor/soundness, usage, and prestige. All journal metrics were highly skewed and variable. Median acceptance rates and initial review time were consistent with rigorous peer-review. Four variables were strongly interrelated (0.849 < r < 0.963) and indicate typical usage of 1 to 3 citations for articles in these journals. The 5-year Eigenfactor Score had a relatively weaker association (0.510 < r < 0.758) with the usage metrics, supporting it as an estimate of the prestige afforded these kinesiology journals in Scopus instead of usage. Care must be taken to interpret multiple journal metrics; taking into account the skew, large variability, and confounding factors such as journal size and subject. Differences across quality domains, metrics, and bias from numerous contextual factors refute the insidious misuse of any single journal metric as quality indictor for ranking journals. [ABSTRACT FROM AUTHOR]

U.S. equity exchanges have experienced a dramatic increase in competition from new entrants, resulting in the fragmentation of trading across venues. While market quality has generally improved over this period, we show most of the improvements have accrued to the largest stocks. We then show this bifurcation in market quality is related to the fragmentation of trading. Theoretically, more exchange competition should reduce trading costs, yet it may also increase adverse selection for liquidity providers, leading to higher spreads. We document evidence of both effects (fragmentation improves market quality for large stocks while small stocks experience relatively worse quality). [ABSTRACT FROM AUTHOR]

Changing customer requirements and turbulent markets require suitably adapted capabilities to proactively cope with rapid changes. Agile manufacturing emerged in the late 1990s as a competitive concept to respond to these business challenges. While several seminal research works address agility in terms of concept definition, drivers and strategic capabilities, there is a lack of implementation frameworks of agile manufacturing. The current paper is concerned with the question of how to improve the agility of manufacturing companies. To address this question, a framework is iteratively developed with the aim of supporting decision makers in planning and implementing agility improvement projects. To this end, Design Science Research (DSR) methodology is used in conjunction with CIMO-logic (Context, Intervention, Mechanism, Outcome). The iterative development of the framework relies heavily on insights from case studies and from practitioners in the broad manufacturing sector. The paper provides evidence of the validity of the framework as well as outlining further research perspectives. [ABSTRACT FROM AUTHOR]

PurposeTo develop and evaluate a deep learning (DL) model to assess fundus photograph quality, and quantitatively measure its impact on automated POAG detection in independent study populations.MethodsImage quality ground truth was determined by manual review of 2815 fundus photographs of healthy and POAG eyes from the Diagnostic Innovations in Glaucoma Study and African Descent and Glaucoma Evaluation Study (DIGS/ADAGES), as well as 11,350 from the Ocular Hypertension Treatment Study (OHTS). Human experts assessed a photograph as high quality if of sufficient quality to determine POAG status and poor quality if not. A DL quality model was trained on photographs from DIGS/ADAGES and tested on OHTS. The effect of DL quality assessment on DL POAG detection was measured using area under the receiver operating characteristic (AUROC).ResultsThe DL quality model yielded an AUROC of 0.97 for differentiating between high- and low-quality photographs; qualitative human review affirmed high model performance. Diagnostic accuracy of the DL POAG model was significantly greater (P < 0.001) in good (AUROC, 0.87; 95% CI, 0.80-0.92) compared with poor quality photographs (AUROC, 0.77; 95% CI, 0.67-0.88).ConclusionsThe DL quality model was able to accurately assess fundus photograph quality. Using automated quality assessment to filter out low-quality photographs increased the accuracy of a DL POAG detection model.Translational relevanceIncorporating DL quality assessment into automated review of fundus photographs can help to decrease the burden of manual review and improve accuracy for automated DL POAG detection.

INTRODUCTION: Olive oil is a widely recognized and appreciated food commodity, its quality and health benefits can be compromised when the oil goes through oxidative processes that may occur during production and storage. This study aimed to investigate the effects of the olive genotype on polar phenolic content after seven months of storage. METHODS: Oil produced from eight different olive cultivars (Leccino, Leccio del Corno, Moraiolo, Frantoio, Bianchera, Pendolino, Maurino, and Caninese) grown in southern Tuscany, Italy, were subjected to chemical analysis such as free fatty acids, peroxide value, K232 and K268, phenolics and UPLC-DAD at the beginning of the trial (Control) and seven months later (Stored). RESULTS AND CONCLUSIONS: Free fatty acids, peroxide values, K232 and K268, significantly increased, suggesting heightened hydrolysis and oxidation after storage. A cultivar effect was observed, with Leccino, Moraiolo, and Pendolino showing less susceptibility to oxidation (low differences between Control and Stored). In contrast, others (Bianchera and Caninese) are more affected (higher differences between Control and Stored). Phenolics analysis supports this observation, revealing that samples with higher resistance to oxidation exhibit elevated levels of hydroxytyrosol, tyrosol, vanillic acid, caffeic acid, p-coumaric acid, and ferulic acid. Principal Component Analysis highlights that Bianchera and Caninese cultivars correlate with rutin, tyrosol, and pinoresinol. As this research delves into the intricate relationship between genotype diversity, phenolic composition, and oxidative stability, a nuanced understanding emerges, shedding light on how different cultivars may present varying compositions and concentrations of phenols, ultimately influencing the oils resistance to the oxidation that occurred during storage.

Wire Arc Additive Manufacturing (WAAM) is a metal arc welding additive process that allows the production of large parts. Managing the quality of produced parts is a key challenge to the adoption of this technology in the industry. A particular case of this is the production of aluminum thin walls and the management of their thicknesses. Literature supports that the use of a near-infrared camera is a good way to monitor the meltpool shape to predict the manufactured thickness. Nevertheless, the post-processing applied to the image has a big influence on the accuracy of the measure. That is why, this article proposes a method to qualify image post-processing for thin wall thickness prediction from near-infrared camera images of aluminum WAAM process. A dataset from the literature is used to evaluate the accuracy of different post-processes. First, a method is proposed to evaluate the accuracy of a given post-process. Secondly, two types of post-processing are presented: post-processing based on conventional image processing and post-processing based on neural networks. Their accuracy is evaluated with the proposed method. The article concludes that the proposed method is adapted to qualify post-processes and that the proposed post-processing based on neural networks gives significant results in terms of accuracy. [ABSTRACT FROM AUTHOR]

The green fodder deficit is the biggest bottleneck for livestock productivity in semi-arid regions, especially for resource-poor farmers. Low-cost climate-smart hydroponic chamber (CSHC) based hydroponic fodder production provides a viable solution under such an environment. A CSHC equipped with a fan pad-based evaporative cooling system, controlled drip watering system and smart air exhaust system was designed and developed at ICAR-IGFRI, Jhansi, India with the aim of modifying the inside growth environment of the chamber for improved production of quality fodder. The developed CSHC was capable of maintaining daily average temperature and relative humidity in the range of 23-280C and 87-90%, respectively, with an average cooling efficiency of 78.3%. This efficient cooling was an outcome of specialized CSHC designed with an effective covering material (UV stabilized 200 µm LDPE), shade net with 70% shading efficiency, fan pad-based evaporative cooling system, controlled drip watering system, and smart air exhaust system; which enabled ambient environment conducive for optimum plant growth. Among the different treatment combinations of seed loading rates and soaking hours, the highest maize biomass yield of 2.58 kg/ft2 was achieved after seven days with a seed loading rate of 300 g/ft2 when the seed was soaked for 12 h. At the highest productivity of biomass, the values of dry matter, crude protein, and crude fiber contents were found as 13.51%, 13.71%, and 15.12% respectively. The benefit-cost ratio of the developed CSHC was 1.32 with a payback period of 3.12 years. The developed CSHC was found productive and profitable; hence, it can create a great impact in achieving feed security under resource deficit conditions of climate-change-affected semi-arid regions across the globe. [ABSTRACT FROM AUTHOR]

Statistical Process Control (SPC) is employed to support the effective quality performance of production and manufacturing processes. The control chart is a type of SPC utilized to reduce variability in key quality parameters, leading to the production of quality conforming products. Control charts, such as the Exponentially Weighted Moving Average (EWMA) are widely used to reduce variation, improve productivity, and ensure quality. However, small manufacturers face challenges that may prevent their effective use of quality control charts. One such challenge relates to resource constraints. These constraints tend to inhibit the conduct of quality inspections at high rates. With this in mind, the present study sets out to develop and present an improved EWMA control chart for effective quality control that takes into consideration significant resource constraints in a small aluminium manufacturing firm. The findings suggest that adopting the improved EWMA chart can enhance the detection of any increase in defectives without the need for additional resources. The improved EWMA control chart provides small manufacturers with an enhanced quality conforming tool developed based on practical realities. Implications for both practice and theory are also highlighted. [ABSTRACT FROM AUTHOR]

Copyright of GeSec: Revista de Gestao e Secretariado is the property of Sindicato das Secretarias e Secretarios do Estado de Sao Paulo (SINSESP) 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.)

Osmotic processes play a crucial role in developing high-quality intermediate moisture food products. This study investigates the role of osmotic dehydration focusing on using natural sweeteners to reduce health risks from refined sugar. Jaggery and honey were used for osmosis of papaya cubes, with a Box-Behnken design to determine optimal conditions: osmosis temperature (30, 40, 50 °C), osmotic solution concentration (40, 50, 60°Brix), and osmosis time (3, 4, 5 h). Simultaneous optimization of these parameters considered responses such as water loss, solid gain, weight reduction, colour change, ascorbic acid content, lycopene content, and phenolic content. The optimized conditions were identified as 49.46 °C, 40°Brix, and 5 h for jaggery osmosed samples and 39.64 °C, 60°Brix, and 4.92 h for honey osmosed samples. Drying the osmosed samples using advanced domestic solar dryer revealed superior quality (total phenolic content and lycopene content) in jaggery osmosed papaya compared to honey osmosed papaya. The study suggests that introducing a new osmotic agent, jaggery, can enhance the nutritional value of osmosed papaya cubes. [ABSTRACT FROM AUTHOR]

Background: Preprints are scientific articles that have not undergone the peer-review process. They allow the latest evidence to be rapidly shared, however it is unclear whether they can be confidently used for decision-making during a public health emergency. This study aimed to compare the data and quality of preprints released during the first four months of the 2022 mpox outbreak to their published versions. Methods: Eligible preprints (n = 76) posted between May to August 2022 were identified through an established mpox literature database and followed to July 2024 for changes in publication status. Quality of preprints and published studies was assessed by two independent reviewers to evaluate changes in quality, using validated tools that were available for the study design (n = 33). Tools included the Newcastle-Ottawa Scale; Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2); and JBI Critical Appraisal Checklists. The questions in each tool led to an overall quality assessment of high quality (no concerns with study design, conduct, and/or analysis), moderate quality (minor concerns) or low quality (several concerns). Changes in data (e.g. methods, outcomes, results) for preprint-published pairs (n = 60) were assessed by one reviewer and verified by a second. Results: Preprints and published versions that could be evaluated for quality (n = 25 pairs) were mostly assessed as low quality. Minimal to no change in quality from preprint to published was identified: all observational studies (10/10), most case series (6/7) and all surveillance data analyses (3/3) had no change in overall quality, while some diagnostic test accuracy studies (3/5) improved or worsened their quality assessment scores. Among all pairs (n = 60), outcomes were often added in the published version (58%) and less commonly removed (18%). Numerical results changed from preprint to published in 53% of studies, however most of these studies (22/32) had changes that were minor and did not impact main conclusions of the study. Conclusions: This study suggests the minimal changes in quality, results and main conclusions from preprint to published versions supports the use of preprints, and the use of the same critical evaluation tools on preprints as applied to published studies, in decision-making during a public health emergency. [ABSTRACT FROM AUTHOR]

Aim Method Results Conclusion Optimal care for patients with kidney failure reduces the risks of adverse health outcomes, including cardiovascular events and death. We evaluated data from the third iteration of the International Society of Nephrology Global Kidney Health Atlas (ISN‐GKHA) to assess the capacity for quality service delivery for kidney failure care across countries and regions.We explored the quality of kidney failure care delivery and the monitoring of quality indicators from data provided by an international survey of stakeholders from countries affiliated with the ISN from July to September 2022.One hundred and sixty seven countries participated in the survey, representing about 97.4% of the world's population. In countries where haemodialysis (HD) was available, 81% (n = 134) provided standard HD sessions (three times weekly for 3–4 h per session) to patients. Among countries with peritoneal dialysis (PD) services, 61% (n = 101) were able to provide standard PD care (3–4 exchanges per day). In high‐income countries, 98% (n = 62) reported that >75% of centers regularly monitored dialysis water quality for bacteria compared to 28% (n = 5) of low‐income countries (LICs). Capacity to monitor the administration of immunosuppression drugs was generally available in 21% (n = 4) of LICs, compared to 90% (n = 57) of high‐income countries. There was significant variability between and within regions and country income groups in reporting the quality of services utilized for kidney replacement therapies.Quality assurance standards on diagnostic and treatment tools were variable and particularly infrequent in LICs. Standardization of delivered care is essential for improving outcomes for people with kidney failure. [ABSTRACT FROM AUTHOR]

This article discusses the importance of preparing graduate nursing students to address environmental health issues and lead nursing green teams. It emphasizes the need to integrate environmental health concepts into nursing school curricula and highlights the role of nurses in addressing climate change and pollution in healthcare settings. The article provides information on the impact of health services on climate change and the formation of nursing green teams to implement sustainability initiatives. It also discusses opportunities and solutions for greening healthcare workplaces, waste management, chemical use, and improving environmental sustainability in healthcare settings. The document includes a list of references and sources for further research on the topic. [Extracted from the article]

We report on a quality improvement initiative to facilitate biopsychosocial approaches for medical patients in an acute hospital setting through a hybrid integrated psychology care model. The expectation was to improve patient outcomes by increasing provider satisfaction and reducing average length of stay (ALOS). Psychologists in the adult consultation–liaison (CL) service were embedded with two service lines: hematology–oncology and medical trauma teams to comanage medical patients in their daily care through an interdisciplinary integrated approach. After 6 months, we compared differences in the ALOS between the traditional CL and hybrid integrated models. Satisfaction with the psychology services among providers was evident with 97% noting that integrated psychologists would reduce their own burnout. ALOS for patients evaluated by psychologists in the CL service was not statistically significantly different from the hybrid integrated model (CL service ALOS = 28 days vs. hybrid integrated pilot model ALOS = 20 days, p =.603). Earlier psychology evaluations (i.e., conducted within 5 days of admission) resulted in statistically significantly lower LOS in both models (p ≤.002). An integrated approach to patient care showed the potential to reduce LOS especially when psychological evaluation occurred within 5 days of admission. Additionally, the integrated model resulted in improved staff satisfaction. This collaboration can be of significant clinical and potential monetary value for the medical field as a whole. Public Significance Statement: This study advances the notion that integrating a psychologist within a medical team in an acute care medical setting can improve overall hospital outcomes for both patients and physicians. Additionally, it highlights how to maximize efficiencies of health care services being utilized, which has significant clinical and potential monetary value for the medical field. Hence, this approach aligns with the quadruple aim of health care. [ABSTRACT FROM AUTHOR]

Agricultural systems strongly impact ecosystems by driving terrestrial degradation, water depletion, and climate change. The Life Cycle Assessment allows for comprehensive analyses of the environmental impacts of food production. Nonetheless, its application still faces challenges due to cropping systems' increased complexity and multifunctionality. Past research has emphasized the need for more holistic approaches to consider dynamic crop interactions and diverse functions of cropping systems, beyond just meeting the demand for foods and feeds. In this context, this study applied an alternative combined and multifunctional modelling approach to compare the environmental performances of two durum wheat cropping systems. The latter differed in crop rotation schedules, farming methods, tillage techniques, and genotypes grown (including both modern and old ones). Novel methodological choices were adopted in this study, aiming at best representing the complexity and peculiarities of these systems, by considering crop rotation effects and reflecting the main durum wheat stakeholders' perspectives. The results showed that the organic low-input landrace-growing system (Case 1) had considerably lower environmental impacts than the conventional high-input one (Case 2), regardless of the functional unit. The environmental hotspots were the increased land occupation and the bare fallow for Case 1 and Case 2, respectively. At the endpoint level, the most affected impact categories for both the systems of analysis were land use, fine particulate matter formation, global warming (human health), and human non-carcinogenic toxicity. Also, the midpoint analysis pointed out important differences in terms of other assessed impact categories, with Case 1 better performing for the majority of them. The identified improvement solutions include the following: the enhancement of the yield performances and the optimization of nitrogen provision from the leguminous crop for Case1, the shift toward a more efficient rotational scheme, the reduction of the use of external inputs, and the avoidance of unnecessary soil tillage operations for Case 2. [ABSTRACT FROM AUTHOR]

We analysed the full text of all journal articles returned to the education subpanel of the 2021 Research Excellence Framework (REF2021). Using a latent Dirichlet allocation topic model, we identified 35 topics that collectively summarise the journal articles that research units, typically schools of education, selected for submission. We found that the topics which units wrote about in their submitted articles collectively explained a large proportion (84.1%) of the variance in the quality assessments they received from the REF's expert peer review process. Further, with the important caveat that we cannot attribute causality, we found that there were strong associations between what the subpanel perceived to be excellent research and the adoption of particular methods or approaches. Most notably, units that returned more interview‐based work typically received lower scores, and those which returned more analyses of large‐scale data and meta‐analyses typically received higher scores. Finally, we applied our 2021 model to articles submitted to the previous exercise, REF2014. We found that education research seems to have become less qualitative and more quantitative over time, and that our 2021 model could successfully predict the scores assigned by the REF2014 subpanel, suggesting a reasonable degree of between‐exercise consistency. [ABSTRACT FROM AUTHOR]

In this study, the effect of maltodextrin, powdered sugar, and corn starch carrier agents used at different ratios (5% and 10%) in the convective dryer at 65 ºC and hybrid dryer (microwave + convective) at 350 W + 65 ºC to produce blackberry powder was investigated. Drying kinetics, energy analyses, physical, flow properties, and biochemical analyses of blackberry powder production processes were investigated. Drying rates in drying processes varied between 0.0052–0.0477 g moisture/g dry matter minute. Effective moisture diffusion values were determined between 3.36 × 10–8-2.57 × 10–7 m2/s. Specific moisture absorption rate and specific energy consumption values were found to vary between 0.0019–0.0034 kg/kWh and 237.15–530.00 kWh/kg, respectively. Tapped density was determined in the range of 1.666–2.765 g/ml, while bulk density was determined in the range of 1.319–1.937 g/ml. The wettability values of blackberry powders were found to vary between 2.00–27.67 s. Drying processes did not preserve the color values of fresh blackberry puree (p < 0.05). In bioactive findings, total phenol content values were 16.756–25.876 µg GAE/g−1 dw, total monomeric anthocyanin values were 229–1.469 µg cy−3-glu/g−1 dw, total flavonoid values 3.958–5.080 mg KE/kg dw and total antioxidant activity values 406–500 µmol TE/g−1 dw. [ABSTRACT FROM AUTHOR]

Satisfaction of 81 patients was evaluated before and after receiving occupational therapy services. There was a statistically significant difference between patients' scores before and after receiving occupational therapy services (p <.05). Over 85% indicated a high satisfaction in relation to quality and health outcomes attributed to occupational therapy services, 44% reported barriers related to limited availability, accessibility, and knowledge of occupational therapy services, and 35% made suggestions for improvements. Patient-therapist communication and easy access to occupational therapy services can enhance occupational therapy knowledge, lead to positive patient experience and quality health outcomes, and higher patient satisfaction. [ABSTRACT FROM AUTHOR]

Background: Neonatal health is one of the targets for the sustainable development goals (SDGs) that aim to reduce neonatal mortality to at least as low as 12 per 1 000 live births in 2030. However, the world is not on track to achieve this target. The problem has worsened in many low-income countries, including Ethiopia, due to a fragile health system, as well as health crises such as the COVID-19 pandemic, conflict, food insecurity and climate change. According to the Mini Ethiopian Demographic Health Survey, neonatal mortality is unacceptably high in Ethiopia in general, and in Amhara region in particular. Despite these facts, there is a paucity of information on the quality of neonatal health service provision in comprehensive specialized hospitals in Amhara region. Therefore, this study is aimed at assessing the quality of neonatal health services in terms of outcome (neonatal mortality) and its causes in comprehensive specialized hospitals in Amhara region. Methods: A multi-center retrospective study was conducted (from September 1–30/2022) on 315 neonates in four comprehensive hospitals with chart review. Data were collected through death audit with standardized neonatal death audit tool. Data were entered into Epi-data 3.1 and exported to SPSS 20 for analysis. Descriptive analysis was used to describe and summarize the data in an informative manner. Results: From 315 neonatal deaths, about two-thirds, 205 (65.1%), were from rural areas. Nearly half, 151 (48%), of the mothers had complications and delivered outside a health facility. About 36 (11.4%), 45 (14.3%), and 21 (6.7%) neonates' mothers had 1st, 2nd, and 3rd delays, respectively. About 59 (19%) of mothers had membrane rupture before the onset of labor and 23 (7.3%) had meconium-stained liquor. Almost three-fourths, 226 (71.7%), of the deaths were low birth weight (< 2500 gram). About 25 (8%) of neonates had congenital anomalies, 65% of them had fast breathing and 54.6% were preterm. Conclusion: Higher proportions of neonatal deaths were observed among neonates with rural residence, low birth weight, mothers' complications and neonates admitted for fast breathing. Histories of abortion, complications, congenital anomalies, and the 3 delays contributed to neonatal deaths. [ABSTRACT FROM AUTHOR]

Summary: In this study, sesame hull oil (SHO) was extracted to characterise its composition. SHO was heated to determine the volatiles and their effect on the quality of cold‐pressed dehulled sesame oil (SO). Seventeen fatty acids, four lignans (1088.65 mg/100 g), tocopherols (284.17 mg/100 g) mainly in the γ‐form, and sterol (1722.16 mg/100 g, 4.67 times more than in sesame kernel oil) were detected in SHO. After heating, the volatiles found in SHO were mainly aldehydes and acids, represented by hexanal (fatty, green aroma) and 3‐methyl‐butanoic acid (fatty, rancid aroma), respectively. The acid value, peroxide value, anisidine value, and turbidity of SO increased significantly after adding SHO, and the scavenging ability of 2,2‐diphenyl‐1‐picrylhydrazyl (DPPH) was enhanced. The oxidation induction times of SO with the addition of SHO ranged from 8.93 to 9.53 h. The present study provides information about SHO and a new direction for the utilisation of sesame hulls. [ABSTRACT FROM AUTHOR]

Summary: The application of edible films can be an alternative solution for maintaining the quality of post‐harvest horticultural commodities. This study aimed to determine the effect of adding a stabiliser, cellulose nanocrystals (CNCs), on the functional characteristics of citrus peel pectin and limonene essential oil (LEO)‐based coatings. A formulation comprising pectin (0.5%), CNC (0.075%) and LEO (0.5%) was prepared. The CNC morphology (nanometre scale) was nanorods with pointed ends on both sides, revealed with atomic force microscopy. Gas chromatography–mass‐spectrometry verified the main component of LEO, d‐limonene. All prepared film‐forming solution showed good stability with zeta potential values ranging from −76.34 to −35.33 mV. The developed film had a rougher surface due to the presence of oil aggregates and CNC agglomeration during film preparation. The addition of Pickering emulsion showed improvements in terms of mechanical properties (tensile strength 23.61 MPa, and elongation 65.87%), water barrier and the film clarity compared with regular emulsions with synthetic surfactants. It effectively inhibited the growth of harmful microbes that cause the rotting of fresh fruits, i.e., Penicilium digitatum, by 3.87% and 14.83% compared to the conventional emulsion and pectin‐based film, respectively, through the well diffusion test method. Thus, the combination of pectin/CNC/LEO can be used as an alternative active coating for fresh fruit commodities. [ABSTRACT FROM AUTHOR]

High quality laboratory results are critical for patient management. However, poor sample quality can impact these results and patient safety. To ensure reliable and accurate results laboratories must be aware of each analyte's stability under various storage conditions and matrices to guarantee correct and dependable outcomes. This knowledge allows laboratories to define the allowable delay between sample collection and centrifugation/analysis for all analytes to guarantee appropriate results quality and interpretation. The EFLM Working Group for the Preanalytical Phase (WG-PRE) therefore established a 4-step plan to tackle this issue, aiming to standardize and harmonize stability studies for improved comparison and meta-analysis. The plan included the development of checklists and how-to guides for performing and reporting stability studies as well as a central resource of stability data. This manuscript deals with the issue of evaluating publications and incorporating them into a central resource. To evaluate stability studies, the CRESS checklist was used to structure 20 sections used to judge the quality of studies. Each section has 4 levels of quality, with scores converted to numerical values and weighted based on expert opinion. Based on this, a final score ranging from A to D was determined. The procedure was then tested on six manuscripts and checked for agreement between expert judgements. The results demonstrated that the proposed evaluation process is a useful tool to distinguish between best in class manuscripts and those of lower quality. The EFLM WG-PRE strongly believes that the provided recommendations and checklists will help improving stability studies both in quality and standardisation. [ABSTRACT FROM AUTHOR]

This chapter was based on a case study of a selected University in Zimbabwe. It was particularly concerned with modes of blended learning during the COVID-19 era and assessing if these modes were effective. The World health Organisation (WHO) declared a global health emergency based on the virus. The COVID-19 pandemic brought with it a national lockdown which compelled universities to blend their teaching instruction. Universities were no longer able to congregate students all at once; hence learning had to be sustained through online means when students were not physically on campus. Although universities invested in ICTs, and insisted on blended learning to ensure that teaching and learning took place amidst COVID-19, they were beset with many challenges. This chapter covers the study period from March 2020 to April 2021. The study assumed a qualitative approach and case study design. Data was collected through interviews and questionnaires. The same was presented and analysed in a thematic approach. The findings of the study revealed that although learning did take place through blended learning, the effectiveness of learning through this mode was questionable as the quality of learning was compromised. The most widely used online learning modes which were blended with face- to-face interaction were Google Classroom, Zoom and WhatsApp. [ABSTRACT FROM AUTHOR]

Social networks have become a widely used and accessible source of health-related information for patients, but this material is not always accurate or appropriate. The purpose of this study was to evaluate the quality of orthodontic information available on 2 of the most popular social media platforms. The authors conducted a systematic search of the literature that analyzed the quality of information regarding orthodontics on social networks and used recognized quality-evaluation methods, such as DISCERN, modified DISCERN, and the Quality Global Scale or the Video Information Quality Index, in the electronic databases of PubMed, Embase, and Scopus and through a manual search of gray literature. The authors identified a total of 534 potentially eligible articles, of which 22 eventually were included in the qualitative analysis. The application of the scales revealed that most of the content was of insufficient quality and lacked scientific rigor, precision, and support from reliable sources. The authors observed marked heterogeneity in the nature of the publications analyzed, with the most recurrent topics being general orthodontic treatment and the use of clear aligners. Social media platforms provide low-quality information to patients, which potentially can be harmful. These findings underscore the need to offer alternative ways to resolve patient queries before and during treatment and highlight the importance of promoting informed and responsible education regarding online information on orthodontic treatments. [ABSTRACT FROM AUTHOR]

After decades of bilateral "subtotal" and later "total" thyroidectomy, the extent of resection is now determined individually depending on the dominant thyroid condition. The leading indication by far in the study, documentation and quality center (StuDoQ) register of the Surgical Working Group Endocrinology (CAEK) is currently the suspicion of malignancy, which is followed by benign symptomatic nodular goiter, functional disorders and confirmed malignancy. The decision for an intervention as well as the extent of resection must be rigorously established. Aids for intraoperative nerve monitoring, vessel-sealing and parathyroid autofluorescence increase the safety of thyroid resections but also the complexity. The surgical technique of lobectomy using modern devices for vessel sealing is an intricate process in which the positioning, access to the neck and a modified sequence of dissection steps are equally important. While the usefulness of neuromonitoring is nowadays no longer in doubt, this is not yet so clear for other technologies. Above all, however, modern thyroid surgery is characterized by the knowledge of one's own results and a clear positioning to follow-ups. The selection of any surgical aid should be based on this knowledge. [ABSTRACT FROM AUTHOR]

Efficacy and safety of sugammadex for the reversal of neuromuscular blocking agents (NMBAs) in patients with neuromuscular diseases remains unclear. We summarised the available evidence and evaluated the quality of data reporting and the validity of published reports. We searched for reports (any design) on the usage of sugammadex (any regimen) for the reversal of an NMBA in patients (any age) with any neuromuscular disease. We used a modified CARE checklist (maximum score 23) to assess the quality of data reporting and an original specific validity checklist (maximum score 41) that was developed through a Delphi process. We retrieved 126 observational reports (386 patients). Most dealt with myasthenia gravis patients receiving rocuronium. The train-of-four ratio returned to ≥0.9 in 258 of 265 (97.4%) patients in whom neuromonitoring was used. Adverse events occurred in 14 of 332 (4.2%) patients in whom adverse events were reported as present or absent. In 90 case reports, the median score of the 23-point CARE checklist was 13.5 (inter-quartile range [IQR] 11–16). In all 126 reports, the median score of the 41-point validity checklist was 23 (IQR 20–27). Scores were positively correlated. These uncontrolled observations (of mainly low to moderate quality and validity) do not allow confident assessment of the efficacy and safety of sugammadex for the reversal of NMBAs in patients with neuromuscular diseases. Reporting of observational data should follow established guidelines, include specific information to ensure validity, and emphasise what the new data add to current knowledge. PROSPERO 2019 (CRD42019119924). [ABSTRACT FROM AUTHOR]

This work summarizes the application of gas fumigation technology in postharvest fruit quality management and related biochemical mechanisms in recent years. Gas fumigants mainly include SO2, ClO2, ozone, NO, CO, 1-MCP, essential oils, H2S and ethanol. This work indicated that gas fumigation preservatives can effectively improve postharvest fruit quality, which is mainly manifested in delaying senescence, inhibiting browning, controlling disease and alleviating chilling injury. Gas preservatives are mainly involved in postharvest fruit quality control in the roles of antifungal agent, anti-browning agent, redox agent, ethylene inhibitors, elicitor and pesticide remover. Different gas preservatives have different roles, but most of them have multiple roles at the same time in postharvest fruit quality management. In addition, the role of some gas preservatives with direct antifungal activity in the control of postharvest fruit diseases can also activate defense systems to improve fruit resistance. It should be noted that some gas fumigation treatments with slow-release effects have been developed recently, which may allow gas fumigation gases to perform better. Moreover, some gas fumigants can cause irrational side effects on the fruit and some combined treatments need to be found to counteract such side effects. [ABSTRACT FROM AUTHOR]

Background: Despite increasing use of minimally invasive surgical (MIS) techniques for trauma, limited large-scale studies have evaluated trends, outcomes, and resource utilization at centers that utilize MIS modalities for blunt abdominal trauma. Methods: Operative adult admissions after blunt assault, falls, or vehicular collisions were tabulated from the 2016-2020 National Inpatient Sample. Patients who received diagnostic laparoscopy or other laparoscopic and robotic intervention were classified as MIS. Institutions with at least one MIS trauma operation in a year were defined as an MIS Performing Institution (MPI; rest: non-MPI). The primary endpoint was mortality, with secondary outcomes of reoperation, complication, postoperative length of stay (LOS), and hospitalization costs. Mixed regression models were used to determine the association of MPI status on the outcomes of interest. Results: Throughout the study period, the proportion of MIS operations and MPI significantly increased from 22.6 to 29.8% and 45.9 to 58.8%, respectively. Of an estimated 77,480 patients, 66.7% underwent care at MPI. After adjustment, MPI status was not associated with increased odds of mortality (adjusted odds ratio [AOR] 1.09, 95% confidence interval [CI] [.96,1.24]), reoperation (AOR 1.02, CI [.87,1.19]), or any of the tabulated complications. There was additionally no difference in adjusted LOS (β-.18, CI [-.85, +.49]) or costs (β+$1600, CI [-1600, +4800]), between MPI and non-MPI. Discussion: The use of MIS operations in blunt abdominal trauma has significantly increased, with performing centers experiencing no difference in mortality or resource utilization. Prospectively collected data on outcomes following MIS trauma surgery is necessary to elucidate appropriate applications. [ABSTRACT FROM AUTHOR]

To seek the optimal combination of water–air for drip irrigation processing tomatoes in Northern Xinjiang, China, field experiments consisted of four irrigation levels, and two types of gas-filling methods were proposed. Throughout the whole growth period, the water consumption by physical aeration and chemical aeration increased by 13.65% and 9.27%, respectively compared with the nonaerated treatment. Under the conditions of physical aeration, the processing tomato fruit yield and irrigation water use efficiency (IWUE) increased by 8.14% and 4.74%; while by chemical aeration, they increased by 7.91% and 4.61%, respectively. Physical aeration had the most prominent role in increasing the contents of organic acid, soluble solids, soluble sugar, lycopene, and VC in processing tomatoes. The presented indicators show that the effect of physical aeration was better than that of chemical aeration. Physical aeration in combination with different irrigation levels, the 4,950 m3·hm−2 irrigation level gave the highest yield of processing tomato, whereas the highest IWUE was obtained in the 4,500 m3·hm−2 irrigation treatment, and the quality parameters of processing tomatoes at the 4,500 m3·hm−2 irrigation level performed better than those at the 4,950 m3·hm−2 irrigation level. To take into account the requirements of processing tomatoes for maximum IWUE and fruit yield and quality, the entropy weight method was used to determine that the irrigation water volume of 4,500 m3·hm−2 under the conditions of physical aeration can be used as a suitable water and air combination pattern for processing tomatoes in drip irrigation in Northern Xinjiang. [ABSTRACT FROM AUTHOR]

Peach production in China uses large inputs of mineral fertilizers but lower inputs of organic fertilizers, resulting in decreased peach quality and increased environmental risks. This study investigated the effects of formula fertilizers (combined organic and inorganic fertilizers) on peach yield, quality, and carbon and nitrogen footprints using three peach cultivars in two consecutive years. Two types of formula fertilizers had positive effects on improving the peach yield (5.6–13.6%), single fruit weight (9.0–32.5%), transverse diameter (3.6–13%) and longitudinal diameter (5.4–21.6%). Also, these fertilizers increased soluble solids (7.2–36.6%) and vitamin C (7.1–78%). In addition, the carbon footprint of peach decreased by 37–49%. This study demonstrates the potential of formula fertilizers to achieve balance between peach quality and environmental health. [ABSTRACT FROM AUTHOR]

Background: Child care quality rating and improvement systems exist to inform child care decisions and improve the quality of care. While previous research has shown QRIS have effects on quality, less is known about how child care providers vary in engagement and improvement within QRIS. In a voluntary QRIS, it is important to understand how providers vary in motivation, engagement, and progress within the system. Objective: Identify provider characteristics and attitudes that predict QRIS quality advancement. Identify and describe provider subgroups whose rates of quality improvement were different. Method: A random sample of providers (N = 179) and their coaches were interviewed five times over 2 years. The outcome was change in QRIS levels. Predictors were type of care, personal/professional characteristics, QRIS motivation, and coach perceptions of provider motivation and likelihood to advance. Linear regression was used to model change in QRIS level over five time points. Latent profile analysis was used to sort providers into classes. Results: Significant overall predictors of QRIS change were providers' education level and fewer years of experience, and coach's perception of the provider's likelihood to advance. Four subgroups in the latent profile analysis varied by rate of advancement, type of care, education, experience, professional engagement, QRIS motivation, and general readiness to change. Conclusions: Results point to the importance of assessing early and continuing attitudes, engagement, professionalization, and education of participating child care providers. The incentives and needs of providers in most QRIS will vary widely. Technical support geared to provider characteristics will be more effective in improving within QRIS. [ABSTRACT FROM AUTHOR]

Background: The Clinical Nurse Leader (CNL) is a skilled clinician qualified in outcomes-based practice and quality improvement. Publications describe the CNL training, integration, and outcomes. However, CNL practice development and its impact has not been fully explored. Purpose: This review aimed to synthesize existing literature related to CNL practice development and identify what influences on the care environment and nursing care outcomes. Methods: An integrative literature review was conducted in 5 bibliographic databases for sources published in English from January 2012 to March 2023. Results: Fifteen publications identified 3 interrelated themes of CNL practice, outcomes, and practice development. Staff development needs were identified across various levels of expertise. Conclusion: There is a need to further explore CNL practice development and how it can impact the care environment and care outcomes. [ABSTRACT FROM AUTHOR]

The impact of hot air drying temperature on instant dough sheets' qualities was investigated based on water migration and gluten network structure changes. The results revealed that the drying process redistributed the hydrogen proton, with deeply bound water accounting for more than 90%. The T2 value decreased as the drying temperature increased, effectively restricting moisture mobility. Meanwhile, microstructural analysis indicated that instant dough sheets presented porous structures, which significantly reduced the rehydration time of instant dough sheets (p < 0.05). In addition, elevated drying temperatures contributed to the cross-linking of proteins, as evidenced by increased GMP and disulfide bond content (reaching a maximum at 80 °C), which improved the texture and cooking properties. Hence, the water mobility was effectively reduced by controlling the drying temperature. The temperature had a facilitating impact on promoting the aggregation of the gluten network structure, which improved the quality of the instant dough sheets. [ABSTRACT FROM AUTHOR]

The study looks at the impact that the three dimensions of financial inclusion (FI) (i.e., access, usage, quality) may have on poverty alleviation. In doing so, the study relies on demand and supply-side data to measure Nigeria's FI. The demand-side data were derived from the 2021 Global Findex data, and the supply side data were sourced from the IMF Access survey database (2004–2021). The supply-side data were analysed using the ordinary least squares regression (OLS), while the demand-side data were analysed using the probit regression model. The study outcomes revealed a negative and significant relationship between financial access and poverty rate, further indicating that those who use financial services are less likely to experience poverty. The study recommends that financial service providers tailor their financial products to align with the educational level of the target population to encourage savings. [ABSTRACT FROM AUTHOR]