bluuebunny/crossref_metadata_2025 huggingface dataset:
Modeling and control of heat pump system for battery electric buses
Authors: Haddad Rabih Al , Basma Hussein , Mansour Charbel
Published: January 2022

Given the continuous tightening of emissions regulations on vehicles, battery-electric buses (BEB) play an essential role in the transition toward cleaner transport technologies, as they represent the most promising solution to replace diesel buses and reduce their environmental impact in the short term. However, heating the bus cabin leads to a considerable increase in energy consumption under cold weather conditions, which significantly reduces the driving range, given the limited battery capacity. Heat pumps (HP) are the primary heating technology used in BEB for their improved consumption performance compared to other technologies. Therefore, this study aims at optimizing the coefficient of performance (COP) of an HP system in a BEB for maximizing the bus electric driving range under cold weather conditions while maintaining satisfactory thermal comfort levels for passengers. Accordingly, an HP model is developed and integrated into an electric bus model using Dymola. A genetic algorithm (GA) based controller is proposed to find the optimal combination of the HP operating parameters, namely the compressor speed, the air mass flow rate at the inlet of the condenser, and the recirculation rate in order to maximize the system’s COP, and extend the BEB driving at different external temperatures, and as a function of the passengers’ occupancy levels. Results are carried under transient and steady-state operating conditions and show that the proposed GA-based controller saves up to 39% of the HP energy consumption as compared to the conventional HP control strategy, and therefore, enhances the BEB driving range up to 17%.
Preparation and application of poly (hydroxyl ethyl methacrylate) nanocomposite hydrogels containing iron oxide nanoparticles as wound dressing
Authors: Paydayesh Azin , Heleil Leyla , Sh Dadkhah Arezoo
Published: January 2022

In recent years, polymeric hydrogels are widespread in the field of biological materials such as wound dressing and wound care. In this work, we report for the first time the preparation and application of pHEMA nanocomposite hydrogels containing iron oxide nanoparticles as wound dressings. For this purpose, nanocomposite hydrogels based on poly (hydroxyl ethyl methacrylate) (pHEMA) and various amounts of 5, 10, and 15 wt% iron oxide nanoparticles were successfully prepared via radical polymerization. The structure and morphology of nanocomposite hydrogels were determined by Fourier transform infrared spectroscopy (FTIR) and field emission scanning electron microscope (FE-SEM), respectively. The results of gel fraction and the degree of swelling of hydrogels demonstrated that the gel percentage of pHEMA increased, and the degree of swelling decreased with increasing the percentage of nanoparticles. The WVRT and the porosity of hydrogels decreased by increasing the quantity of nanoparticles and were suitable for wound dressing applications. The effect of iron oxide nanoparticles on the mechanical properties of nanocomposite hydrogels was also studied using compression test and hardness shore A durometer. The results indicated that the compression strength, modulus, strain, and hardness are steadily increasing compared to pure hydrogel by adding nanoparticles. The maximum increase was obtained for a hydrogel sample with 15 wt% iron oxide nanoparticles. Antibacterial properties and biocompatibility were determined by the disk-diffusion and MTT assay methods, respectively. Based on the results, nanocomposite hydrogels exhibited higher percentages of cell survival and better antibacterial properties compared to pure pHEMA.
Assessment of Local Adaptive Capacity of Mountain Farmers: A Way Forward for Sustainable Livelihood Development
Authors: Chandra Rommila , Uniyal V. P.
Published: January 2022

This study aims to understand the perception of mountain farmers towards the local adaptive capacity at a household level in an agro-ecological landscape. An indicator-based assessment is conducted to examine the 6 determinants and 27 indicators to give a local adaptive capacity index of the villages around Govind Wildlife Sanctuary and National Park, located in the Indian Himalayan region. The findings indicate that, though the connected and isolated villages have a low and very low adaptive capacity, respectively, the effect of various determinants on the local people varies among the village settlements, based on their socio-economic capacity. Despite the government endeavours to build the livelihood of mountain farmers through different programmes and policies, it still lacks proactive decision-making. The study suggests for an integrated assessment and sustainable enhancement of the landscape as a whole, with a focus on community-level adaptation strategies. It draws attention to the need for enhanced collaboration between research institutions, government and private sectors with the mountain community in the centre.
Vitamin D Deficiency and Outcomes After Ankle Fusion: A Short Report
Authors: Ramanathan Deepak , Emara Ahmed K. , Pinney Stephen , Bell Andrea , Miniaci-Coxhead Sara Lyn
Published: January 2022

Background:

Vitamin D deficiency has been postulated as a cause for impaired bone healing and remodeling. The purpose of this study was to assess the potential association between low vitamin D levels and reoperation for nonunion following ankle fusion surgery.

Methods:

All adult patients (aged ≥18 years) who underwent ankle fusion procedures at a tertiary referral center from January 2010 to January 2019 with available vitamin D levels within 12 months preoperatively were retrospectively reviewed (n = 47). Patients were categorized as vitamin D deficient (<30 ng/mL) vs normal (31-80 ng/mL). The primary outcome was the incidence of reoperation secondary to nonunion. Secondary outcomes included incidence of reoperation not related to nonunion and the need for repeat reoperation.

Results:

The average level in the vitamin D–deficient group (n = 17; 36.2%) was 16.9 vs 46.4 ng/mL in the normal group (n = 30; 63.8%). All recorded reoperations for nonunion occurred exclusively in the vitamin D–deficient cohort (4/17 [23.5%]; P = .013). There were similar reoperation rates for causes other than nonunion (2/17 [11.8%] vs 4/30 [13.3%]; P > .99) and repeat reoperation rates (3/17 [17.6%] vs 1/30 [3.3%]; P = .128) among vitamin D–deficient vs normal patients.

Conclusion:

Vitamin D deficiency may be associated with an increased risk of reoperation for nonunion after ankle fusion.
Validation of the Five-Factor Model Antagonistic Triad Measure
Authors: Rose Leigha , Miller Joshua D. , Lynam Donald R.
Published: January 2022

The personality constructs psychopathy, narcissism, and Machiavellianism, collectively described as the Dark Triad (DT), all reference socially aversive behavioral tendencies. Each construct is theorized to have features that differentiate it from others. Unfortunately, existing measures of the DT suffer from several problems. The present study compared newly developed measures of psychopathy (Super-Short Form of the Elemental Psychopathy Assessment), narcissism (Super-Short Form of the Five-Factor Narcissism Inventory), and Machiavellianism (Super-Short Form of the Five-Factor Machiavellianism Inventory [FFMI-SSF] based on the Five-Factor Model of personality)—collectively referred to as the Five-Factor Model Antagonistic Triad Measure—to existing DT inventories using a sample of undergraduate students ( N = 516). As predicted, FFMI-SSF showed better divergence from measures of psychopathy and better convergence with the expert Five-Factor Model (FFM) Machiavellianism profile than did existing Machiavellianism measures. Results also demonstrated that the factors within each FFM assessment manifested differentiated correlational profiles, underscoring the utility of the multifaceted assessment of these three constructs. In addition, the use of the FFM as the basis for the new DT measures provides a pathway for the integration of DT research into the larger field of basic and clinical personality science.
The Business of Improving Neighborhoods. A Critical Overview of Neighborhood-Based Business Improvement Districts (NBIDs) in Sweden
Authors: Kusevski Dragan , Stalevska Maja , Valli Chiara
Published: January 2022

This article offers an overview of neighbourhood-based BIDs (NBIDs) in Sweden. Swedish NBIDs tend to appear in stigmatized residential areas engaging with pressing sets of urban issues that have been longstanding concern of social policy. Their overarching goal is raising property values in neighborhoods on the edge between urban decline and (re)development potential. Emerging in a neoliberalizing institutional context, NBIDs present themselves as correctives to public-policy failures by promoting property-oriented solutions. The adaptation of the BID model in the Swedish ‘post-welfare’ landscape, however, exhibits, and arguably exacerbates, the shortcomings found in BID elsewhere. Their opaque institutional structure and lack of accountability contribute to curbing democratic influence over local development, thus reinforcing spatial inequalities. We argue that the growing political advocacy for the institutionalization of the BID model in Sweden presents a new milestone in the neoliberalization of urban governance, as private actors are promoted to legitimate co-creators of urban policy.
How to Be a Man Differently: The intersection of Gender and Disability in the Life Course of a Powerchair Athlete
Authors: Paccaud Laurent , Marcellini Anne
Published: January 2022

This article focuses on the intersection of gender, dis/ability and other social forces in the life course of a young man who has had physical impairments from an early age. Drawing on interactionist theories and applying an ethnographic approach, we analyze the life experiences taking place in multiple social spheres throughout the life phases of Simon, a Swiss powerchair hockey player with cerebral palsy. During his childhood and adolescence, Simon was not in a position to embody the familial ways of performing hegemonic masculinity, and he was functionally dependent on women. Through his ongoing transition to adulthood, his commitment to sport and the process of technologizing his body enabled him to do gender differently and emancipate himself from the familial masculine figure, while remaining reliant on the care provided by women. Thus, we show how the body, context, and life phases contribute to the performances of gender and dis/ability.
Editorial Introduction
Authors: Smith Michael R.
Published: January 2022

This article serves as the editorial introduction to the special issue on Police Use of Force.
Gear Rattle during a start-up transient in a driveline equipped with a tuneable torsional Vibration Damper with Magneto-Rheological Elastomers
Authors: Rocca Ernesto , Russo Riccardo
Published: January 2022

The paper reports a numerical investigation on the dynamic behaviour of a vehicle driveline, equipped with a Torsional Vibration Damper (TVD) based on Magneto-Rheological Elastomeric (MRE) spring elements, during the start-up transient considering an abrupt manoeuvre of clutch engagement. The TVD device consists of a flywheel and a damper disk, with interposed some elastomeric samples which react for relative angular displacements of the two disks. The dynamical parameters of the TVD can be properly tuned by varying the magnetic field surrounding the MRE springs to mitigate the torsional oscillations of the flywheel, causes of many undesired inconveniences as critical speeds or vibro-acoustic issues. The present study promotes the use of the MRE torsional vibration damper to reduce the annoying vibroacoustic phenomenon of “gear rattle” arising in the unloaded gear pairs of the gear box, during and after the rapid clutch engagement transients in the vehicle start-up phase and is conducted on a simplified automotive driveline equipped with a dry clutch. The possibility of quickly tuning the mechanical properties of the MRE-TVD, makes this device particularly eligible for suppressing the above disturbance, adapting to the various operative conditions of the automotive driveline. Results of the analysis, by the help of a Gear Rattle Index (GRI), demonstrate the effectiveness of the proposed device in reducing the vibroacoustic phenomenon during the transient phases of the vehicle start-up, until the vehicles speed conditions are reached.
Thermo-mechanical modelling of the Friction Stir Spot Welding process: Effect of the friction models on the heat generation mechanisms
Authors: Hannachi Nasra , Khalfallah Ali , Leitão Carlos , Rodrigues Dulce
Published: January 2022

Friction Stir Spot Welding involves complex physical phenomena, which are very difficult to probe experimentally. In this regard, the numerical simulation may play a key role to gain insight into this complex thermo-mechanical process. It is often used to mimic specific experimental conditions to forecast outputs that may be substantial to analyse and elucidate the mechanisms behind the Friction Stir Spot Welding process. This welding technique uses frictional heat generated by a rotating tool to join materials. The heat generation mechanisms are governed by a combination of sliding and sticking contact conditions. In the numerical simulation, these contact conditions are thoroughly dependent on the used friction model. Hence, a successful prediction of the process relies on the appropriate selection of the contact model and parameters. This work aims to identify the pros and cons of different friction models in modelling combined sliding-sticking conditions. A three-dimensional coupled thermo-mechanical FE model, based on a Coupled Eulerian-Lagrangian formulation, was developed. Different friction models are adopted to simulate the Friction Stir Spot Welding of the AA6082-T6 aluminium alloy. For these friction models, the temperature evolution, the heat generation, and the plastic deformation were analysed and compared with experimental results. It was realized that numerical analysis of Friction Stir Spot Welding can be effective and reliable as long as the interfacial friction characteristics are properly modelled. This approach may be used to guide the contact modelling strategy for the simulation of the Friction Stir Spot Welding process and its derivatives.
Increasing flexibility of self-piercing riveting by reducing tool–geometry combinations using cluster analysis in the application of multi-material design
Authors: Kappe Fabian , Schadow Luca , Bobbert Mathias , Meschut Gerson
Published: January 2022

A frequently used mechanical joining process that enables the joining of dissimilar materials is self-piercing riveting. Nevertheless, the increasing number of materials as well as material–thickness combinations leads to the need for a large number of rivet–die combinations as the rigid tool systems are not able to react to changing boundary conditions. Therefore, tool changes or system conversions are needed, resulting in longer process times and inflexibility of the joining processes. In this investigation, the flexibility of the self-piercing riveting process by reducing the required tool–geometry combinations is examined. For this purpose, various joints consisting of similar as well as dissimilar materials with different material thickness are sampled and analysed. Subsequently, a cluster algorithm is used to reduce the number of rivet–die combinations required. Finally, the effect of the changed tool geometries on both the joint formation and the joint load-bearing capacity is investigated. The investigation showed that a reduction by 55% of the required rivet–die combinations was possible. In particular, the rivet length influences the joint formation and the joint load-bearing capacity. An exclusive change of the die (e.g. die depth or die diameter) did not show a significant influence on these parameters.
History and Biology
Authors: Trivers Robert
Published: January 2022

This is a brief history of my intellectual life from age 13 to 29 years—and beyond. It encompasses mathematics, US history, and evolutionary biology, especially social theory based on natural selection.
The Provenance of Selected Sets of Wardrobe in the Costumes Collections of the Cultural Center of the Philippines and GMA Network, Inc.
Authors: Dar Juan Elijah John F.
Published: January 2022

Costumes play a significant role in theatrical and television practice as age, gender, socioeconomic status, occupation, and the setting and climate are shown through them. This paper will enumerate some of the productions in which the costumes are included in the collections of two organizations: the Cultural Center of the Philippines, a government arts agency for the performing arts, and GMA Network, Inc., a media conglomerate that is chiefly in the business of producing and airing television programs. Information on the production plot and setting, key players such as directors, actors, production designers, and costume designers, and general descriptions of costumes are presented in this narrative survey. This work serves as a preliminary attempt to trace the provenance of costume sets in the collection of CCP and GMA Network. It may also awaken the need to document costumes as part of institutional collections.
Contour-Assisted coiling with jailed microcatheter May result in better occlusion (CoCoJaMBO) in wide-necked intracranial aneurysms: Proof of principle and immediate angiographic results
Authors: Wodarg Fritz , Ozpeynirci Yigit , Hensler Johannes , Jansen Olav , Liebig Thomas
Published: January 2022

Purpose

Wide-necked bifurcation aneurysms, partially thrombosed, and recurrences of large and giant aneurysms are challenging to treat. We report our preliminary experience with a Contour-assisted coiling technique and discuss the periprocedural safety, feasibility, and effectiveness of the approach.

Methods

We retrospectively reviewed consecutive patients who received endovascular treatment for intracranial aneurysms with an intra-aneurysmal flow disruptor (Contour) at two neurovascular centres between October 2018 and December 2020 and identified patients treated with a combination of Contour and platinum coils. Clinical and procedural data were recorded.

Results

For this analysis, 8 patients (5 female) aged 60.1  ±  9.2 years on average were identified. Three of 8 aneurysms were associated with previous acute subarachnoid hemorrhage (SAH). The mean average dome height was 12.8  ±  7.6 mm, mean maximum dome width 10.3  ±  5.4 mm, and neck width 5.5  ±  2.5 mm. The mean dome-to-neck ratio was 1.9  ±  1.0. Immediate complete occlusion of the aneurysm was seen in 5 of 8 cases. In one SAH patient, a parent vessel was temporarily occluded but could be reopened rapidly. One device detached prematurely without any sequelae. No other procedural adverse events were recorded.

Conclusion

From this initial experience, Contour with adjunctive coiling is a safe and technically feasible method for endovascular treatment of large, wide-necked, partially thrombosed, recurrent, or ruptured bifurcation aneurysms. Further studies with larger numbers of patients and longer follow-up are needed to confirm our results.
Chrysoeriol Enhances Melanogenesis in B16F10 Cells Through the Modulation of the MAPK, AKT, PKA, and Wnt/β-Catenin Signaling Pathways
Authors: Oh So-Yeon , Hyun Chang-Gu
Published: January 2022

Chrysoeriol is a 3′-O-methoxy flavone, chemically a derivative of luteolin, which is commonly found across the plant kingdom. Chrysoeriol is of great scientific interest because of its promising anti-inflammatory, anti-cancer, antioxidative, anti-lipase, anti-xanthin oxidase, and antimicrobial activities against multidrug-resistant (MDR) bacterial pathogens; however, its effects on melanogenesis have not yet been elucidated. Here, we report a novel effect of chrysoeriol on melanogenesis in B16F10 cells. Chrysoeriol treatment significantly increased the expression of the melanogenic enzymes tyrosinase (TRY), tyrosinase-related protein-1 (TRP-1), and TRP-2 and upregulated the expression of microphthalmia-associated transcription factor (MITF) in a concentration-dependent manner. Furthermore, chrysoeriol suppressed the phosphorylation of extracellular signal-regulated kinase (ERK) and protein kinase B (AKT) in a concentration-dependent manner. In addition, chrysoeriol treatment increased the phosphorylation of p38 mitogen-activated protein kinase (MAPK), glycogen synthase kinase (GSK)-3β, β-catenin, and protein kinase A (PKA) and decreased the production of β-catenin, which is involved in the transcriptional activation of MITF in melanogenesis. Finally, the structure–activity relationship (SAR) of chrysoeriol and its derivatives, including luteolin and apigenin, with regard to their melanin inhibitory activity was also investigated; we identified the significance of the 4′-OH group and C-3′ methoxylation in melanogenesis. Together, these findings indicate that chrysoeriol promotes melanogenesis in B16F10 cells by upregulating the expression of melanogenic enzymes through the MAPK, phosphatidylinositol 3-kinase (PI3K)/AKT, PKA, and Wnt/β-catenin signaling pathways; thus, chrysoeriol may be used as a cosmetic ingredient to promote melanogenesis or as a therapeutic agent against hypopigmentation disorders.
Clinical Problem Solving: Decreased Level of Consciousness and Unexplained Hydrocephalus
Authors: Niznick Naomi , Lun Ronda , Lelli Daniel A. , Fantaneanu Tadeu A.
Published: January 2022

We present a clinical reasoning case of 42-year-old male with a history of type 1 diabetes who presented to hospital with decreased level of consciousness. We review the approach to coma including initial approach to differential diagnosis and investigations. After refining the diagnostic options based on initial investigations, we review the clinical decision-making process with a focus on narrowing the differential diagnosis, further investigations, and treatment.
Use of tocilizumab, remdesivir, and high-dose methylprednisolone prevents intubation in an ESRD patient with COVID-19 pneumonia
Authors: Judge Ramzan , Kolaski Stephanie , Qadeer Farhan
Published: January 2022

Coronavirus disease 2019 (COVID-19) has affected over 200 million patients worldwide. COVID-19 is transmitted through respiratory droplets from patient to patient or by touching a surface that has been contaminated by an infected patient. Many COVID-19 patients have other comorbidities, such as end-stage renal disease. Currently, management of COVID-19 in patients with end-stage renal disease is unclear. Some studies have shown improvement in this population with the use of tocilizumab, a humanized interleukin-6 monoclonal antibody, in addition to the standard therapy as per guidelines published by the National Institutes of Health. In this case report, we present a patient case where the use of remdesivir, tocilizumab, and pulse-dose methylprednisolone significantly improved symptoms and inflammatory biomarkers associated with COVID-19 in a patient with end-stage renal disease.
Digital phenotyping and the (data) shadow of Alzheimer's disease
Authors: Milne Richard , Costa Alessia , Brenman Natassia
Published: January 2022

In this paper, we examine the practice and promises of digital phenotyping. We build on work on the ‘data self’ to focus on a medical domain in which the value and nature of knowledge and relations with data have been played out with particular persistence, that of Alzheimer's disease research. Drawing on research with researchers and developers, we consider the intersection of hopes and concerns related to both digital tools and Alzheimer's disease using the metaphor of the ‘data shadow’. We suggest that as a tool for engaging with the nature of the data self, the shadow is usefully able to capture both the dynamic and distorted nature of data representations, and the unease and concern associated with encounters between individuals or groups and data about them. We then consider what the data shadow ‘is’ in relation to ageing data subjects, and the nature of the representation of the individual's cognitive state and dementia risk that is produced by digital tools. Second, we consider what the data shadow ‘does’, through researchers and practitioners’ discussions of digital phenotyping practices in the dementia field as alternately empowering, enabling and threatening.
A Review of the Literature on the Relationship of Music Education to the Development of Socio-Emotional Learning
Authors: Váradi Judit
Published: January 2022

Social-emotional learning (SEL) is a topic of increasing focus in the education sector. SEL is the process by which children acquire the knowledge, skills, and attitudes to effectively recognize and manage emotions, to formulate positive goals, to feel empathy for others, to establish and maintain functioning social relationships. It develops to take responsible decisions, determine students’ successful academic performance, transformation into adulthood, useful work, a good quality of life, and well-being. By the end of the 20th century the educational role of music has come into the spotlight, and in addition to the impact of music on the development of general skills, its social and emotional effects are also the subject of research. This paper undertakes to explore the literature about the connections between music education and social-emotional skill development. For the collection and analysis of information, online sources of peer-reviewed scientific journals in addition to the university library were used. The study also examined the relationship between social-emotional learning and the world-wide well-known Kodály Concept and the effect of Kodály’s vision of music education as a forerunner of socio-emotional skills development. The relationship between social-emotional skills and music was explored by reviewing the international music-specific literature from music psychology, music education, music therapy, and music for health and wellbeing. In order to illuminate the problem and to develop a holistic approach, the 100 studies presented here summarize research findings made and presented in different countries around the world.
Immigrant Children in a Pol(ICE) State
Authors: Rodriguez Vega Silvia
Published: January 2022

Guided by the following questions: (1) What are the experiences of immigrant children attending schools in communities experiencing police brutality and anti-immigrant sentiments? (2) How do middle school children of immigrants visually represent their experiences with legal violence? and (3) What are children’s visions of freedom and community safety in this context?, this article highlights the understudied preadolescent children of immigrants through a 2-year study of a multidisciplinary theater class at a local elementary school in South Central Los Angeles. Data includes child interviews, class observations, artwork, and performance videos, from recently arrived Mexican and Central American children aged 10 to 13 years. Findings reveal how children come to understand policing, reinforcing concepts like “good cop/bad cop,” conflating local police and ICE (Immigration and Customs Enforcement) agents, but also imagining alternatives for community safety outside of police systems. This work contributes to the fields of immigration, abolitionist education, and ethnic studies, among others, offering new ways of supporting immigrant children through the use of arts-based tools.
Individual-Inclusive Ecosystem Model of Rehabilitation for Inclusion of Children with Disabilities in Childcare Institutions
Authors: Anthony Josephine
Published: January 2022

In childcare institutions (CCIs) in India, children with mild or moderate levels of disability are often placed with non-disabled children for care and protection. Generally, children with intellectual disability (ID), learning disability, hearing and speech impairment and multiple disabilities with ID are found to be living in these CCIs. In this best practice article, the challenges faced by these children with disabilities and the potential for inclusion within the CCI are discussed based on the field action project intervention of the Tata Institute of Social Sciences (TISS), Mumbai, with selected government CCIs. The article suggests a multi-pronged intervention approach for the Children with disability (CWD) at the levels of the individual CWD, peer group, CCI and the juvenile justice (JJ) System, which are together recognised as the stakeholders of an ‘inclusive ecosystem’. The article arrives at the ‘Inclusive Ecosystem Model of Rehabilitation’ by drawing from the individual–environment interaction model of disability.
Medical Students’ Attitude Towards Robotic Surgery: A Cross-Sectional Survey
Authors: Sultan Intessar , Bardi Mohammed Fuad , Baatta Abdulrahman Mohammed , Almaghrabi Saif , Mohammed Rehab Abdelfattah
Published: January 2022

Introduction

The robotic surgery and procedures are increasing worldwide. It is unknown whether medical students are well prepared for their future exposure to such technology.

Objectives

This study aimed to explore the knowledge and attitude of medical students from Saudi Arabia (SA) towards the robotic surgery.

Methods

We performed a cross-sectional survey of medical students at different colleges of medicine in SA. A web-based self-administered questionnaire using google forms was completed over a 2-month period starting on June 2021. Comparison between those with and without background about robotic surgery was performed.

Results

A total of 239 medical students from both governmental (46%) and private colleges (54%) responded to the questionnaire. 51.9% were interested in the surgical field and 37.7% considered themselves tech-savvy persons. Only (22.6%) had previous background about robotic surgery mainly from internet. Many (63.2%) showed positive attitude towards robotic surgery and expected that using robots will improve surgical outcomes. 48.5% of the students expected that patients in SA will not accept the robotic surgeries. Some (51.1%) concerned that robots could replace the surgeons and could make them less professional. Many believed that SA should invest and expand the robotic surgeries (69.1%). Students with background in robotic surgery had significantly younger median age (p < 0.030), earlier academic years (p < 0.001), higher GPA (p < 0.025), and more tech-savvy personality (p < 0.000) compared to those without background.

Conclusion

Most medical students are unaware of robotic surgery, but they have positive attitude with some concerns. Young students who consider themselves tech-savvy persons are in a better position, but they access their knowledge from internet rather than from their medical education. Medical curricula and residency training program should take these findings into consideration for preparing the future surgeons in SA.
Lessons Learned from Clinical and Translational Science Faculty and Student Survey as COVID-19 Pandemic Continues to Shift Education Online
Authors: Forkner Katherine A. , Wissman Adam W. , Jimison Ryan C. , Nelson Kristina B. , Wuertz Ryan E. , Silvano Carmen J. , Barreto Erin F. , Eckel Passow Jeanette E. , Enders Felicity T. , Staff Nathan P.
Published: January 2022

Introduction

As the pandemic continues with new variants emerging, faculty and students require support with education's rapid shift to the virtual space. The Mayo Clinic Center for Clinical and Translational Science curriculum team works closely with faculty to support a smooth transition to offering graduate courses in a virtual learning environment. The aim of the present project was to explore faculty and student perceptions of these remote learning strategies to gain an understanding of the innovations required to improve future educational offerings.

Methods

All faculty and learners involved in nine Clinical and Translational Science courses in spring 2020 were invited to participate in a web-based questionnaire. Quantitative analysis was performed on closed-ended items, including 5-point Likert-scale questions used to assess the range of views. Qualitative free-text responses were independently analyzed for repetitive themes and summarized. Additionally, comparisons of faculty and course evaluations and student grade point averages (GPAs) from the in-person courses and their subsequent virtual course offerings were considered.

Results

Survey results indicated several positive impacts with moving courses into the virtual environment, including increased accessibility as well as more student-centered education. Learners joining from sites outside of the originating campus were especially grateful for the virtual classroom because they felt newly integrated within classes. Faculty and course evaluations, as well as student GPAs, remained consistent.

Conclusion

New COVID-19 variants continue to shift education online, and innovative ideas are required to further improve future virtual course offerings. Increased engagement is warranted, both from faculty to incorporate activities designed specifically for a virtual classroom, and from students to increase participation by activating their microphones and webcams. Greater opportunities for global involvement and connectedness arise. Finally, this project advocates for adequate eLearning staffing to support quality online education as the need for pedagogical and technical provision continues.
The making of an uneven shore: How coastal management and housing policies shaped racial inequality in asbury park NJ
Authors: Eisenhauer David C.
Published: January 2022

Recent work in urban geography and political ecology has explored the roots of housing segregation in the United States within governmental polices and racial prejudice within the real estate sector. Additional research has demonstrated how coastal management practices has largely benefited wealthy, white communities. In this paper, I bring together insights from these two strands of research to demonstrate how both coastal management and governmental housing policies combined to shape racial inequalities within and around Asbury Park, New Jersey. By focusing on the period between 1945 and 1970, I show how local, state, and federal actors repeatedly prioritized improving and protecting the beachfront areas of the northern New Jersey shore while promising to eventually address the housing and economic needs of the predominately Black ‘West Side’ neighbourhood of Asbury Park. This paper demonstrates that not only did governmental spending on coastal management largely benefit white suburban homeowners but also came at the expense of promised spending within Black neighbourhoods. The case study has implications for other coastal regions in the United States in which housing segregation persists. As climate change and sea level rise unfold, the history of racial discrimination in coastal development raises important considerations for efforts to address emerging hazards and risks.
The safety and efficacy of using moxibustion and or acupuncture for cancer-related insomnia: a systematic review and meta-analysis of randomised controlled trials
Authors: Wang Carol Chunfeng , Han Ellen Yichun , Jenkins Mark , Hong Xuepei , Pang Shuqin , Whitehead Lisa , Kirk Deborah L. , Williams Anne
Published: January 2022

Introduction:

This study aimed to synthesise the best available evidence on the safety and efficacy of using moxibustion and/or acupuncture to manage cancer-related insomnia (CRI).

Methods:

The PRISMA framework guided the review. Nine databases were searched from its inception to July 2020, published in English or Chinese. Randomised clinical trials (RCTs) of moxibustion and or acupuncture for the treatment of CRI were selected for inclusion. Methodological quality was assessed using the method suggested by the Cochrane collaboration. The Cochrane Review Manager was used to conduct a meta-analysis.

Results:

Fourteen RCTs met the eligibility criteria. Twelve RCTs used the Pittsburgh Sleep Quality Index (PSQI) score as continuous data and a meta-analysis showed positive effects of moxibustion and or acupuncture ( n = 997, mean difference (MD) = −1.84, 95% confidence interval (CI) = −2.75 to −0.94, p < 0.01). Five RCTs using continuous data and a meta-analysis in these studies also showed significant difference between two groups ( n = 358, risk ratio (RR) = 0.45, 95% CI = 0.26–0.80, I2 = 39%).

Conclusion:

The meta-analyses demonstrated that moxibustion and or acupuncture showed a positive effect in managing CRI. Such modalities could be considered an add-on option in the current CRI management regimen.
Weil’s Disease Death Investigation and Outbreak Control Measures Instituted in the Field Area of a Family Health Center in Thiruvananthapuram, Kerala—A Case Report
Authors: Vasisht Pranav V.
Published: January 2022

Introduction:

Weil syndrome, a rare infectious disorder, is a severe form of the bacterial infection caused by Leptospira bacteria known as leptospirosis. Weil syndrome is characterized by dysfunction of the kidneys and liver, abnormal enlargement of the liver (hepatomegaly), persistent yellowing of the skin, mucous membranes, whites of the eyes (jaundice), and/or alterations in consciousness. In most cases, Weil syndrome occurs among individuals who are exposed to affected animals.

Case Presentation and Summary:

The investigation of death was done by a team consisting of doctor, junior health inspector, and ASHA workers of the area. We did a qualitative approach of in-depth interview of the wife and daughter-in-law of the deceased for data collection. The patient’s name and other details are not revealed for anonymity. No particular statistical analyses are used for this case reporting. The CARE guidelines were followed for writing this report.

Conclusion:

Leptospirosis is a disease of outbreak potential and has high case fatality rate. Timely identification of cases and institution of preventive measures is very important in preventing outbreaks. The surveys conducted in the area did not reveal any signs of an imminent or ongoing outbreak of leptospirosis.
Patellar MACI With Tibial Tubercle Osteotomy
Authors: Matthews John R. , Paul Ryan W. , Freedman Kevin
Published: January 2022

Background:

Chondral pathology is frequently encountered during knee arthroscopies with a prevalence rate of 63% to 66%. Prior studies have demonstrated that unaddressed or excised fragments result in poor knee function and arthritis. As a result, chondral-related procedures have increased in popularity, and now more than 200,000 procedures are performed annually.

Indications:

We present a case of an active 32-year-old woman, prior collegiate basketball player, with persistent left knee pain noted to have a full-thickness patellar articular cartilage defect and maltracking.

Technique:

A patellar autologous matrix-induced chondrocyte is implanted with a concomitant tibial tubercle osteotomy (TTO) and lateral retinacular lengthening.

Results:

At 9 weeks, the patient had no knee pain with full range of motion symmetric to the contralateral side while slowly progressing with quadriceps strengthening.

Discussion/Conclusion:

Successful outcomes addressing large patellar chondral defects and maltracking can be achieved with matrix autologous chondrocyte implantation and concomitant TTO with lateral retinacular lengthening.
Echocardiography and Laboratory Factors Associated With Prolonged Postoperative Pericardial Effusion
Authors: Alihajdaraj Rrezarta , Grbolar Adem , Krasniqi Xhevdet , Bekteshi Tefik , Bakalli Aurora
Published: January 2022

Objective:

Pericardial effusion is a frequent finding in patients who undergo cardiac surgery. There are currently limited data providing information regarding the factors that may contribute to postoperative pericarditis. The aim was to evaluate laboratory and echocardiographic features that may influence the presence of pericardial effusion 6 to 8 weeks following coronary artery bypass grafting (CABG).

Materials and Methods:

This was a prospective cross-sectional study that included 90 patients after CABG operation who were divided into two groups. A total of 32 (35.56%) patients with pericardial effusion on follow-up echocardiography formed the first group and 58 patients without pericardial effusion the second group, which were compared in respect to components that were taken prior to the operation.

Results:

The groups did not differ regarding sex (males 65.62% vs 63.79%, P = .86) or age (59.59 ± 9.29 vs 61.69 ± 10.71, P = .35). Platelet count (184.74 ± 58.79 vs 222.62 ± 88.97, P = .03) and left ventricular (LV) global longitudinal strain (GLS) (−14.64 ± 6.86 vs −16.96 ± 4.1, P = .04) demonstrated statistical significance.

Conclusion:

Prolonged postoperative pericardial effusion in small amounts may be found in patients, with preoperative lower thrombocyte count and LV GLS, which could be possible predisposing factors.
Single-cell immune profiling reveals a developmentally distinct CD4+ GM-CSF+ T-cell lineage that induces GI tract GVHD
Authors: Piper Clint , Hainstock Emma , Yin-Yuan Cheng , Chen Yao , Khatun Achia , Kasmani Moujtaba Y. , Evans John , Miller James A. , Gorski Jack , Cui Weiguo , Drobyski William R.
Published: January 2022

Gastrointestinal (GI) tract involvement is a major determinant for subsequent morbidity and mortality arising during graft-versus-host disease (GVHD). CD4+ T cells that produce granulocyte-macrophage colony stimulating factor (GM-CSF) have emerged as central mediators of inflammation in this tissue site as GM-CSF serves as a critical cytokine link between the adaptive and innate arms of the immune system. However, cellular heterogeneity within the CD4+ GM-CSF+ T-cell population due to the concurrent production of other inflammatory cytokines has raised questions as to whether these cells have a common ontology or if a unique CD4+ GM-CSF+ subset exists that differs from other defined T helper subtypes. Using single-cell RNA sequencing analysis (scRNAseq), we identified two CD4+ GM-CSF+ T-cell populations that arose during GVHD and were distinguishable according to the presence or absence of interferon-γ (IFN-γ) coexpression. CD4+ GM-CSF+ IFN-γ− T cells, which emerged preferentially in the colon, had a distinct transcriptional profile, used unique gene regulatory networks, and possessed a nonoverlapping T-cell receptor repertoire compared with CD4+ GM-CSF+ IFN-γ+ T cells as well as all other transcriptionally defined CD4+ T-cell populations in the colon. Functionally, this CD4+ GM-CSF+ T-cell population contributed to pathologic damage in the GI tract that was critically dependent on signaling through the interleukin-17 (IL-7) receptor but was independent of type 1 interferon signaling. Thus, these studies help to unravel heterogeneity within CD4+ GM-CSF+ T cells that arise during GVHD and define a developmentally distinct colitogenic T helper subtype GM-CSF+ subset that mediates immunopathology.
Contribution of causal factors to disease burden: how to interpret attributable fractions
Authors: Counil Emilie
Published: January 2022

What proportion of the risk in a given population is attributable to a risk factor? The population attributable fraction (PAF) answers this question. “Attributable to” is understood as “due to”, which makes PAFs closely related to the concept of potential impact or potential benefits of reducing the exposure. The PAF is a tool at the border between science and decision making. PAFs are estimated based on strong assumptions and the calculations are data intensive, making them vulnerable to gaps in knowledge and data. Current misconceptions include summing up PAFs to 100% or subtracting a PAF for a factor from 100% to deduce what proportion is left to be explained or prevented by other factors. This error is related to unrecognised multicausality or shared causal responsibility in disease aetiology. Attributable cases only capture cases in excess and should be regarded as a lower bound for aetiological cases, which cannot be estimated based on epidemiological data alone (exposure-induced cases). The population level might not be relevant to discuss prevention priorities based on PAFs, for instance when exposures concentrate in a subgroup of the population, as for occupational lung carcinogens and other workplace hazards. Alternative approaches have been proposed based on absolute rather than relative metrics, such as estimating potential gains in life expectancy that can be expected from a specific policy (prevention) or years of life lost due to a specific exposure that already happened (compensation).
Epidemiology of trauma in the subarctic regions of the Nordic countries
Authors: Steinvik Tine , Raatiniemi Lasse , Mogensen Brynjólfur , Steingrímsdóttir Guðrún B. , Beer Torfinn , Eriksson Anders , Dehli Trond , Wisborg Torben , Bakke Håkon Kvåle
Published: January 2022

Background

The northern regions of the Nordic countries have common challenges of sparsely populated areas, long distances, and an arctic climate. The aim of this study was to compare the cause and rate of fatal injuries in the northernmost area of the Nordic countries over a 5-year period.

Methods

In this retrospective cohort, we used the Cause of Death Registries to collate all deaths from 2007 to 2011 due to an external cause of death. The study area was the three northernmost counties in Norway, the four northernmost counties in Finland and Sweden, and the whole of Iceland.

Results

A total of 4308 deaths were included in the analysis. Low energy trauma comprised 24% of deaths and high energy trauma 76% of deaths. Northern Finland had the highest incidence of both high and low energy trauma deaths. Iceland had the lowest incidence of high and low energy trauma deaths. Iceland had the lowest prehospital share of deaths (74%) and the lowest incidence of injuries leading to death in a rural location. The incidence rates for high energy trauma death were 36.1/100000/year in Northern Finland, 15.6/100000/year in Iceland, 27.0/100000/year in Northern Norway, and 23.0/100000/year in Northern Sweden.

Conclusion

We found unexpected differences in the epidemiology of trauma death between the countries. The differences suggest that a comparison of the trauma care systems and preventive strategies in the four countries is required.
German emergency department measures in 2018: a status quo based on the Utstein reporting standard
Authors: Wallstab Florian , Greiner Felix , Schirrmeister Wiebke , Wehrle Markus , Walcher Felix , Wrede Christian , Habbinga Kirsten , Behringer Wilhelm , Brammen Dominik
Published: January 2022

Background

Compelling data on clinical emergency medicine is required for healthcare system management.

The aim of this survey was to describe the nationwide status quo of emergency care in Germany at the healthcare system level using the Utstein reporting template as the guideline to measure the data collected.

Methods

This cross-sectional survey collected standardized data from German EDs in 2018. All 759 of the EDs listed in a previously collected ED Directory were contacted in November 2019 using the online-survey tool SoSci Survey.

Exclusively descriptive statistical analyses were performed. Absolute as well as relative frequencies, medians, means, ranges, standard deviations (SD) and interquartile ranges (IQR) were reported depending on distribution.

Main Results

A total of 150 questionnaires of contacted EDs were evaluated (response rate: 19.8%). Hospitals had a median of 403 inpatient beds (n=147). The EDs recorded a median of 30,000 patient contacts (n=136). Eighty-three EDs (55%) had observation units with a median of six beds. The special patient groups were pediatric patients (< 5 years) and older patients (> 75 years) with a median of 1.7% and 25%, respectively. Outpatients accounted for 55%, while 45% were admitted (intensive care unit 5.0%, standard care unit 32.3%, observation unit 6.3%) and 1.2% transferred to another hospital.

Conclusions

The use of the Utstein reporting template enabled the collection of ED descriptive parameters in Germany. The data can provide a baseline for upcoming reforms on German emergency medicine, and for international comparisons on admission rates, initial triage categories, and patient populations.