Complimentary Return-Freight Insurance Serves as Quality Signal or Noise?

Most information system (IS) theories arise from Western research and the transferability of these _theories to other cultures is under-researched. Business intelligence (BI) has topped CIOs’ _technology priority list for years and BI is the largest IT spend at present. Chinese BI software _markets have great potential because Chinese economy supports its technological development. _China adopts a different culture and a different management philosophy to the Western _organizations. Guanxi and constructs from the unified theory of acceptance and use of technology __(UTAUT) are applied in two large Chinese organizations, where UTAUT constructs cannot explain _managerial BI system use. A model of Chinese BI use (MCBIU) is proposed to fill this gap, and this _model is the major theoretical contribution of the research paper. This research also contributes to _practice by improving Chinese managers’, BI consultants’ and developers’ understanding of the _topic.

Patient Dropout Prediction in Virtual Health: A Multimodal Dynamic Knowledge Graph and Text Mining Approach

Virtual health has been acclaimed as a transformative force in healthcare delivery. Yet, its dropout issue is critical that leads to poor health outcomes, increased health, societal, and economic costs. Timely prediction of patient dropout enables stakeholders to take proactive steps to address patients' concerns, potentially improving retention rates. In virtual health, the information asymmetries inherent in its delivery format, between different stakeholders, and across different healthcare delivery systems hinder the performance of existing predictive methods. To resolve those information asymmetries, we propose a Multimodal Dynamic Knowledge-driven Dropout Prediction (MDKDP) framework that learns implicit and explicit knowledge from doctor-patient dialogues and the dynamic and complex networks of various stakeholders in both online and offline healthcare delivery systems. We evaluate MDKDP by partnering with one of the largest virtual health platforms in China. MDKDP improves the F1-score by 3.26 percentage points relative to the best benchmark. Comprehensive robustness analyses show that integrating stakeholder attributes, knowledge dynamics, and compact bilinear pooling significantly improves the performance. Our work provides significant implications for healthcare IT by revealing the value of mining relations and knowledge across different service modalities. Practically, MDKDP offers a novel design artifact for virtual health platforms in patient dropout management

Predicting Consultation Success in Online Health Platforms Using Dynamic Knowledge Graphs and Multimodal Data Fusion

In virtual or online health platforms, accurately predicting the success of online consultations is paramount in the face of fierce competition. The scarcity of patient data poses a significant challenge to predicting online healthcare consultation success rate. To address this challenge, we introduce MDKSP, which harnesses advanced language models, a novel Knowledge Graph Attention Network, and a new multi-modal data fusion technique. MDKSP enhances predictive accuracy by capturing explicit (patient-doctor communication) and implicit (digital traces in patients\u27 healthcare journeys, both online and offline) knowledge. MDKSP significantly enhances the predictive capability of healthcare consultation success in virtual health. MDKSP\u27s utility extends to diverse virtual or hybrid models, such as online education (predicting student retention at the onset of a course), hybrid sales (forecasting purchase intent through online information provision and offline testing and real-world experiences), and more

A prospective single-arm study on surgical treatment of pulmonary nodules located beneath the interlobar pleura and adjacent to the pulmonary hilum

Background and purpose: Accurately locating pulmonary nodules is the key to the success of thoracoscopic surgery. This study aimed to investigate the strategy and evaluate the feasibility, safety, and clinical value of thoracoscopic surgical treatment for pulmonary nodules located beneath the interlobar pleura and close to the pulmonary hilum. Methods: The patients who underwent pulmonary nodule surgery at Liaocheng Tumor Hospital from May 2023 to November 2024 were enrolled, and the patients who did not meet the inclusion criteria were excluded. This study was approved by the Ethics Committee of Liaocheng Tumor Hospital (EC-20240112-1020) and informed consent was obtained from the patients. The research was designed as a prospective single-arm study. The patients were treated with wedge resection, which was performed following CT-guided localization, where the location needle was inserted through the interlobar pleura. The feasibility of the procedure was evaluated by analyzing the success rate of preoperative localization and perioperative complications. Results: A total of 28 patients who met the inclusion criteria were included in this study. There were 5 male and 23 female patients with an average age of (56.0±8.5) years (range 38-69 years). In all, 28 patients with 28 nodules underwent thoracoscopic wedge resection, and the preoperative CT-guided localization was successfully performed in all patients, without urgent complications. The mean operation time of thoracoscopic surgery was (15.6±4.0) min, intraoperative bleeding was (20.9±14.3) mL, and postoperative drainage was (214.3±62.2) mL. No cases of postoperative air leaks or conversion to thoracotomy were observed. The average length of hospital stay was (5.4±0.9) days. The postoperative histological diagnosis revealed 3 benign lesions (pulmonary fibrosis in 2 cases, atypical adenomatous hyperplasia in 1 case) and 25 malignant lesions (adenocarcinoma in situ in 5 cases, minimally invasive adenocarcinoma in 16 cases, and invasive adenocarcinoma in 4 cases). Conclusion: Thoracoscopic wedge resection following CT-guided nodule localization through the interlobar pleura is a feasible approach for nodules located beneath the interlobar pleura and close to the pulmonary hilum. The method ensures precise tumor localization, adequate margin, and minimal loss of normal lung tissue, with a low incidence of postoperative complication, which has important guiding significance for the surgical treatment of pulmonary nodules in such special locations

Inducing drop to bubble transformation via resonance in ultrasound

Bubble formation plays an important role in industries concerned with mineral flotation, food, cosmetics, and materials, which requires additional energy to produce the liquid–gas interfaces. A naturally observed fact is, owing to the effect of surface tension, a bubble film tends to retract to reduce its surface area. Here we show a “reverse” phenomenon whereby a drop is transformed into a bubble using acoustic levitation via acoustic resonance. Once the volume of the cavity encapsulated by the buckled film reaches a critical value V*, resonance occurs and an abrupt inflation is triggered, leading to the formation of a closed bubble. Experiments and simulations both reveal that V* decreases with increasing acoustic frequency, which agrees well with acoustic resonance theory. The results afford enlightening insights into acoustic resonance and highlight its role in manipulating buckled fluid–fluid interfaces, providing a reference for fabricating unique core–shell-like materials

Atrial Fibrillation Follow-up Investigation to Recover Memory and Learning Trial (AFFIRMING): Rationale and Design of a Multi-center, Double-blind, Randomized Controlled Trial

Background: People with atrial fibrillation (AF) have elevated risk of developing cognitive impairment. At present, there is a dearth of randomized controlled trials investigating cognitive impairment management in patients with AF. The Atrial Fibrillation Follow-up Investigation to Recover Memory and learning (AFFIRMING) study is aimed at evaluating the potential for computerized cognitive training to improve cognitive function in patients with AF. Methods: The study is a multi-center, double-blind, randomized controlled study using a 1:1 parallel design. A total of 200 patients with AF and mild cognitive decline without dementia are planned to be recruited. The intervention group will use the adaptive training software with changes in difficulty, whereas the positive control group will use basic training software with minimal or no variation in difficulty level. At the end of 12 weeks, the participants will be unblinded, and the positive control group will stop training. The intervention group will be rerandomized 1:1 to stop training or continue training. All participants will be followed up until 24 weeks. The primary endpoint is the proportion of the improvement of the global cognitive function at week 12 compared with baseline, using the Basic Cognitive Ability Test (BCAT)

Whole-genome sequencing of <em>Oryza brachyantha</em> reveals mechanisms underlying <em>Oryza</em> genome evolution

The wild species of the genus Oryza contain a largely untapped reservoir of agronomically important genes for rice improvement. Here we report the 261-Mb de novo assembled genome sequence of Oryza brachyantha. Low activity of long-terminal repeat retrotransposons and massive internal deletions of ancient long-terminal repeat elements lead to the compact genome of Oryza brachyantha. We model 32,038 protein-coding genes in the Oryza brachyantha genome, of which only 70% are located in collinear positions in comparison with the rice genome. Analysing breakpoints of non-collinear genes suggests that double-strand break repair through non-homologous end joining has an important role in gene movement and erosion of collinearity in the Oryza genomes. Transition of euchromatin to heterochromatin in the rice genome is accompanied by segmental and tandem duplications, further expanded by transposable element insertions. The high-quality reference genome sequence of Oryza brachyantha provides an important resource for functional and evolutionary studies in the genus Oryza

Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.

Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration: ClinicalTrials.gov Identifier: NCT02735707

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570