bluuebunny/crossref_metadata_2025 huggingface dataset:
ICONS OF THE MOTHER OF GOD IN THE CULTURAL HERITAGE SPACE OF ROME
Authors:   Lviv Polytechnic National University, Hnidyk Iryna
Published: November 2022

The images of the Mother of God in Italy represent a significant part of the cultural heritage of European and world sacred art and icon painting of various chronological periods and stylistic features. A special place in this dimension belongs to the icons of the Mother of God in Rome. Ever since the first centuries, images of the Virgin have been represented in the paintings of the Roman catacombs. The iconographic heritage of Rome represents different periods and a unique interweaving of styles. Over the centuries, ancient icons of the Mother of God have been kept in Rome, made both in the technique of encaustic, tempera, and later in oil painting. Many images of the Mother of God in Rome represent the original samples of the Byzantine style of icon painting of various origins and the works of masters of the Italian artistic environment at the intersection of Western and Eastern artistic styles. A significant number of these icons are crowned and have the status of miraculous. Some of the most ancient and famous icons of the Mother of God in Rome are «Salus Populi Romani», «Madonna del Conforto», «Madonna Avvocata», «Madonna della Clemenza», «Madre del Perpetuo Soccorso», «Santa Maria del Popolo», «Madonna della Catena», «La Madonna dei Martiri» and others. Common iconographic types are Hodegetria, Agiosoritissa, Kyriotissa, Galaktotrofusa, etc. Often, these icons have several Italian-language names, which must be considered when choosing methodological tools for historiographical analysis. The article provides a general overview of the heritage of the icons of the Mother of God in Rome based on the most famous of them. English-language and Italian-language historiography was analyzed to model further relevant research directions in developing this topic by modern specialists in an interdisciplinary context. It is emphasized that in the churches of Rome, there are still many less-known and less-researched icons of the Mother of God, particularly in terms of stylistic features and painting techniques. Their detailed study and analysis of sources can effectively fill this niche in historiography and become an interesting topic for modern interdisciplinary research in the field of history, icon painting, art, restoration, and cultural heritage, as well as the basis of original concepts for exhibitions, photo catalogs, new excursion routes, etc.
Security Enhancement by Identifying Attacks Using Machine Learning for 5G Network
Authors: Keserwani Hitesh , Rastogi Himanshu , Kurniullah Ardhariksa Zukhruf , Janardan Sushil Kumar , Raman Ramakrishnan , Rathod Vinod Motiram , Gupta Ankur
Published: November 2022

Need of security enhancement for 5G network has been increased in last decade. Data transmitted over network need to be secure from external attacks. Thus there is need to enhance the security during data transmission over 5G network. There remains different security system that focus on identification of attacks. In order to identify attack different machine learning mechanism are considered. But the issue with existing research work is limited security and performance issue. There remains need to enhance security of 5G network. To achieve this objective hybrid mechanism are introduced. Different treats such as Denial-of-Service, Denial-of-Detection, Unfair use or resources are classified using enhanced machine learning approach. Proposed work has make use of LSTM model to improve accuracy during decision making and classification of attack of 5G network. Research work is considering accuracy parameters such as Recall, precision and F-Score to assure the reliability of proposed model. Simulation results conclude that proposed model is providing better accuracy as compared to conventional model.
Validation of the CAE model set for a passenger car suspension according to loading criteria
Authors: Kulagin Victor A.
Published: November 2022

BACKGROUND: Development of numerical methods and technology of computer-aided engineering, used in vehicle design, has reached its high level. Results of virtual experiments cannot be totally relied upon without verifying results obtained with the developed mathematical model. That is why the present paper concentrates on the relevant issue of validation of the CAE models, applicable for vehicle suspension components dynamic load analysis.
AIMS: Goal of the research is adequacy confirmation of developed requirements to preparation of simulation models, applicable for dynamic load and fatigue analysis, by means of numerical simulation with validation analysis.
METHODS: CAE models validation is carried out with a comparative method of results obtained from either laboratory or proving ground testing and simulation of a physical object. Strain gauging results are taken for the comparison. The Models are prepaired with using MBS and FEM technologies.
RESULTS: Validation showed of validation show a good convergence of modelling and experiment results, that confirm adequacy of developed requirements to creation of CAE models, applicable for load and fatigue analysis of vehicle suspension components. The selected convergence evaluation criteria have not been used in similar papers yet and have shown an effective outcome of quantitative and qualitative comparison of loading condition of suspension parts in a variety of boundary conditions of mechanical system simulation.
CONCLUSIONS: Validated CAE models of a passenger car suspension, developed accelerated loading cycle, the model design and dynamic loading simulation approach can be used for chassis parts load analysis and fatigue prediction during early stages of development and as support of testing.
Mathematical simulation of the automatic control of the tractor power unit
Authors: Hoodorozhkov Sergey I. , Krasilnikov Andrey A. , Gubachov Matvey S.
Published: November 2022

BACKGROUND: Many manufacturers of agricultural tractors have machines with automatic gearboxes in their product line. The development of the design of this type of transmissions, the control system and the algorithm of its operation is an urgent technical task.
The article considers the issues of mathematical simulation of the working process of the automatic transmission of a wheeled tractor and the automatic transmission control system.
AIMS: The purpose of the work was to determine the optimal control laws of automatic control of a wheeled agricultural tractor engine and transmission in various operating modes using a digital model of the tractor transmission.
METHODS: Simulation of working conditions is performed in the Matlab program digital software packages and its applications Simulink, Simscape. At the same time, with the help of fundamental data blocks of these applications, models of the physical components of the gearbox and the machine engine and the tractor power transmission control system, are created.
RESULTS: The application procedure of the MATLabSimulink, Simscape software package for mathematical modeling of transmission operation control is considered. With the help of the developed mathematical model, a simulation of the tractor power unit operation in the main operating modes was carried out in order to optimize the characteristics of the tractor control system.
The scientific novelty of the research lies in the selection and optimization of the transmission control laws in accordance with the requirements to agricultural tractors with an automatic step gearbox.
CONCLUSION: The practical utility (value) of the research lies in the possibility of using the proposed control laws to develop a transmission control system for new tractors with an automatic step gearbox.
Forecasting the energy characteristics of a reversible hydraulic machine for a head up to 250 m
Authors: Seleznev Vyacheslav N.
Published: November 2022

BACKGROUND: At present, in the pressure zone of 50650 m for pumped storage power plants, hydroelectric units with classic single-stage radial-axial reversible hydraulic machines, which have a relatively simple design of the impeller and cylindrical guide vane, have received the most widespread energy performance, but are relatively quiet, large-sized and metal-intensive hydraulic machines. Numerical research and design of this type of machines are given special attention. The current trend is the design of flow parts based on numerical simulation of the flow. The most well-known commercial software products that implement finite volume numerical simulations are Ansys Fluent, Ansys CFX, StarCD, Numeca, Flow Vision and CADRUN. In the work under consideration, the calculations were performed using the Ansys CFX software package version 2021R1. Today, due to the lack of numerical capacity, the task of developing and using a technique that will allow obtaining an acceptable result with optimal time spent on data preparation and computational studies remains an urgent task.
AIMS: The aim of the work was to present an economical methodology for numerical simulation of energy characteristics.
METHODS: The methodology consists in describing the problem statement, the computational grids used, and the assumptions made for the optimal use of computing resources without a significant loss in the accuracy of the results.
Object of computational research: The presented article investigates the flow part of a radial-axial pump-turbine designed for application to a maximum head of up to 250 m.
RESULTS: Numerical modeling of power characteristics of on-pump and turbine modes is performed. A brief description of the problem statement, computational grids used, and assumptions made is given. A comparison of calculation results with experimental data of model tests is presented. The comparison results are presented in the relative form for the main parameters: pressure, efficiency, reduced rotational speed and flow rate.
CONCLUSIONS: It is recommended to use SST model of turbulence in a stationary statement in order to predict the power characteristics of pump-turbines. The use of economical block-structured grids, as well as the performing of calculations only in the region of one blade of the guide vanes, one impeller blade and a suction pipe with the use of preliminary results of calculations in a spiral chamber allow using computational resources optimally without significant loss of accuracy of the results.
Determination of steam leaks through faulty labyrinth seals of a steam turbine
Authors: Жинов Andrey A. , Shevelev Denis V.
Published: November 2022

BACKGROUND: When calculating the axial force acting on the thrust bearing of a steam turbine, when calculating the dimensions of the unloading piston, when calculating the efficiency of the turbine stages, it is necessary to determine the amount of steam leakage through its diaphragm and end seals. Existing methods make it possible to calculate leaks only through serviceable, undamaged labyrinth seals of several standard designs. However, during the operation of steam turbines, due to off-design axial and radial displacements of the rotor, labyrinth seals are often damaged - deformed, crushed or broken.
AIMS: The purpose of the study is to develop a method for calculating leaks using direct CFD modeling in serviceable and damaged seals with typical failures, verify the simulation results by comparison with known methods and experimental data, and determine critical steam leaks through faulty labyrinth turbine seals.
MATERIALS AND METHODS: A method for calculating the steam flow rate through serviceable and faulty labyrinth seals of a steam turbine using the capabilities of modern CFD methods is proposed and verified. The computational domain of modeling the front-end seal of the turbine, the features of setting the boundary conditions, the adaptive computational grid, and the numerical mathematical model used are described.
RESULTS: The results of a numerical study of steam leakage through serviceable and damaged labyrinth end seals of the turbine are presented: with bent ridges in the seals, with partial or complete absence of ridges. The operation of the front-end seal of the turbine was simulated with several typical failures. It is shown that partial damage to the ridges of the front-end seal of the turbine, which is often encountered during operation, leads to a significant increase in steam leakage. It has been established that with significant damage to the ridges, an increase in steam leakage can lead to the exhaustion of the capacity of the steam pressure regulator in the seal, which leads to a malfunction of the turbine thrust bearing unloading system.
CONCLUSIONS: The proposed technique and the results obtained can be used to calculate steam leakage through serviceable and faulty diaphragm and end labyrinth seals of turbines, when calculating the value of the axial force acting on the turbine thrust bearing in variable operating modes, the technique is useful in assessing the efficiency of the thrust bearing unloading system.
The study of the possibility of the pumping unit optimization for two operation modes, different from the optimal one
Authors: Lomakin Vladimir O. , Protopopov Alexander A. , Mikheev Konstantin G. , Veselov Alexey A.
Published: November 2022

BACKGROUND: The study of factors affecting the vibroacoustic characteristics of pumps is one of the main areas of development in the current pump industry. Improvement of these characteristics allows to extend the service life of pumps by means of vibration levels reduction as well as to decrease the noise level.
AIMS: In this study, the attempt to optimize the flow part of a multi-stage pump was made in order to obtain acceptable noise, vibration and harshness (NVH) characteristics in two operation modes that are different front the optimal one.
METHODS: As the result of the study, it was found that changing these parameters in favour of NVH has a negative impact on the pump efficiency and vice versa. Thereby the optimal balance between these parameters should be found. The optimization was performed with the method of research of the parameter space with use of LP-tau sequences. The following elements were chosen as the optimization parameters: the area at the entrance to downstream, the angle of guide vanes at the entrance to the downstream, the width of rotor at the outlet, the angle of rotor vanes at the inlet and the outlet, the wrap angle of rotor vane. Decrease of the area of the graph of pressure pulsation spectrum was chosen as the optimization criteria. The mathematical model was verified with two designs of the flow part produced and tested earlier. The first sample has an overstated rate of the NVH spectrum in the area of high frequencies, the second sample has an overstated rate of the NVH spectrum in the area of low frequencies.
RESULTS: The compiled mathematical model proved its good quality, showing the same results, which allows to speak about the admissibility of its use for optimization of the flow parts of pumps.
CONCLUSIONS: This study will be useful for specialists in the field of vane hydraulic machines design.
A Phenomenological Study to Examine the Lived Experiences of Successful Young Adults with Disabilities and their Perceptions on the Impact of Self-determination
Authors:   , Mason Tiffany , Sloand Janet Marie
Published: November 2022

During high school, students with disabilities are provided with an Individualized Education Program to help increase their academic performance and ability to access the general education curriculum. Once these individuals turn 16, a transition plan is developed that supports their development and preparation to graduate from high school and attend a post-secondary institution, obtain a career, and to become self-sufficient adults. One of the goals of the transition plan is to increase self-determination. Literature reveals that self-determination can improve the quality of life for individuals with disabilities. The purpose of this phenomenological study was to examine the lived experiences of students with disabilities who matriculated through a large metropolitan east coast school system and have successfully transitioned from high school to college or other post-secondary institutions through their perceptions of the impact of self-determination. This study includes semi-structured interviews and a focus group interview of students who have been in college for at least two consecutive years. This study intends to identify additional support needed to improve self-determination and increase college attendance rates for students with disabilities.
Remote Manipulation of Untethered Bots in Soft Media
Authors:   , Malkova Yulia , Friedman Gary G.
Published: November 2022

Scientific and engineering literature extensively discusses untethered miniature devices, also called bots, as those parts of medical robotic systems that can be manipulated remotely within the human body. There is clear evidence that this topic has gained significant traction based on the spike in publication over the past seven years (Koleoso et al., 2020). Robotic systems that employ micro- and millimeter size bots are thought to have numerous potential medical applications including drug delivery (Jang et al., 2019), localized heating or cooling, cessation of bleeding, clearing of occlusions, establishing a diagnosis based on sensing or biopsy, and minimally invasive surgeries. Most studies focuses on the actuation and control of such bots in fluid environment, typically at low Reynolds numbers. Yet, many medical applications would involve soft tissues, rather than fluids. While controlling tethered devices, such as needles, based on appropriate models of interaction with tissue has been the subject of considerable interest. However, no similar work has been published for untethered miniature devices. The goal of the present thesis is to develop trajectory planning and control methods for untethered solid millimeter size bots in soft tissue under the action of magnetic force. This study employs a recently developed model describing the interaction of untethered bots with soft materials during bot motion by implementing a numerical simulation of the model. Given the highly non-linear and past trajectory (history) dependent nature of the interaction with the medium, in addition to significant model parameter variability throughout soft media, the present thesis hypothesizes that a trajectory control based on the so-called Sliding Mode Control (SMC) method will make it possible for a bot to follow a large class of practical trajectories accurately. Numerical simulations of the proposed SMC method were conducted and experimentally validated for a class of trajectories that could be well approximated by circular and straight segments. The robustness of the proposed method was analyzed numerically by simulating trajectories in media with random variations of various model parameters as well as in the presence of significant delays in the feedback signal used to estimate the bot position. All the work carried out in this thesis applies to bots that are spherical making it possible to simplify the model, trajectory control, and their experimental validation. Furthermore, experimental validations are limited in this work to bots that are on the order of millimeters in diameter. While smaller bots may be of interest in medicine, they would be significantly harder to actuate and image during experimental validation experiments. At the same time, millimeter size bots are commensurate with the typical dimensions of needles widely employed in medical applications. Keywords: Medical Robotics, Micro Robots, Motion control, Robophysics, Soft Media, Untethered Device
The Effects of Autism Training on Empowerment Outcomes for Parents and Caregivers of Autistic Youth
Authors:   , Williams Patricia R. , Haslip Michael J.
Published: November 2022

This study measures the effect of an autism training program, Surpassing Obstacles Autism Retreat (SOAR), on empowerment outcomes of 49 parents/caregivers of autistic youth from the state of Maryland in the United States. A retrospective causal-comparative design was used to collect and analyze secondary data about SOAR training participants and compare their empowerment scores to those who attended a traditional peer support program with a child with autism (n = 14) and parents of children with mental health conditions (n=81). Data was collected using a modified pre/post empowerment survey already being used at the agency. Keywords: autism, parent involvement, peer support, empowerment
Exploring the Lived Experiences of College Students Who Completed an Early College High School Program
Authors:   , Woods David A. , Hill Deanna
Published: November 2022

Dual enrollment programs have been in existence for decades in public high schools in the United States. While there is literature on the academic impact of these programs with a focus on high school and college outcomes, there is a gap in the literature regarding what is known about students' experiences in dual enrollment programs that allow students to earn an associate's degree while in high school. The purpose of this qualitative phenomenological study was to explore how students experienced one such program in Pennsylvania. The central research question was: What are the lived experiences of students who graduated from Early College Academy (ECA) at a rural school district in Pennsylvania and transitioned to a four-year college regarding college readiness? The researcher conducted semi-structured interviews and collected demographic data from nine ECA graduates from the first three cohorts. The researcher also kept a researcher's journal for field notes and to mitigate bias. The data was analyzed to gain thick, rich descriptions of the participants' lived experiences. Three thematic findings emerged: 1) transition to college, 2) academic rigor and relevance, and 3) self-regulation and collaboration. The findings informed five results: 1) participating in ECA and being on the college campus in their junior and senior years made participants more knowledgeable about what to expect from college, 2) some of the intended time- and cost-saving benefits of ECA were frustrated by the complexity of advising and articulation, 3) participants were well-prepared for the rigor of their general education and liberal arts courses, but STEM majors were challenged, 4) ECA helped prepare students for diversity, and 5) ECA helped prepare students for self-regulation and collaboration. The researcher offers recommendations for the ECA program and for the state department of education. Keywords: Dual Enrollment, Early College High School, Concurrent Enrollment, Early College Academy, College Readiness
Cloud and HPC Headway for Next-Generation Management of Projects and Technologies
Authors:   Director of Cloud Engineering, Workday Inc., Pleasanton, California, USA, Achar Sandesh
Published: November 2022

In the last decade, cloud computing has changed dramatically. More providers and administration contributions have entered the market, and cloud infrastructure, once limited to single-provider data centers, is expanding. This article discusses the shifting cloud foundation and the benefits of decentralizing computing from data centers. These patterns necessitate novel cloud computing architectures. These models may affect linking people and devices, data-intensive computing, the service space, and self-learning frameworks. Finally, we compiled a list of issues to consider while assessing modern cloud frameworks. Architectural and urban design projects breach scale and predictability constraints and seek enhanced competency, maintainability, energy performance, and cost-efficiency. Simulation and large-scale information processing drive this cycle. Advances in calculations and computer power help address the complex elements of a coordinated whole-structure framework. Adaptability is a barrier to the configuration, control, and development of whole-system frameworks. This position paper proposes several solutions for semi-or fully automated projects, such as short-plan boundary space exploration, large-scope high-accuracy simulation, and integrated multidisciplinary development. These computer-intensive operations were previously only accessible to the exam network. Once empowered by cloud computing and high-performance computing, these methods can stimulate intelligent plan measures, leading to enhanced results and shorter development times.
Influence of IoT Technology on Environmental Monitoring
Authors: Achar Sandesh
Published: November 2022

The newly connected globe has the potential to become a more environmentally friendly and sustainable place if more efficiencies can be brought to various industries. We will look at examples of how the Internet of Things technology is helping to improve the world. Relatively recently, the technology of the fourth industrial revolution has given rise to the characteristics of things constantly expanding, and everything, including people, things, people, and the environment, is connected based on the Internet. In particular, the network structure is connected to various Internet of Things devices and transitioning from wired to wireless. Gateways both within and outside the smart home can now be used to control other devices, in contrast to users who previously owned each device individually. However, due to these changes, the environment is now susceptible to attacks from the outside. For example, when an attacker gains access to a gateway, he can attempt various attacks, such as port scans, OS and service detection, and denial of service assaults on Internet of Things devices. As a result, the findings of the study reveal the influence of IoT technology, which has the potential to improve environmental monitoring to enhance environmental safety.
Modified School-Based Facing Your Fears for Students with Autism Spectrum Disorder and Anxiety: A Preliminary Quasi-Experimental and Qualitative Analysis
Authors: Kester Karen , Lucyshyn Joseph
Published: November 2022

With a high prevalence of anxiety among children with Autism Spectrum Disorder, researchers have identified implementing effective treatments in real-world settings as a priority. In the present study, multiple methods were employed to evaluate the effectiveness of educators delivering a modified school-based Facing Your Fears Cognitive Behavior Therapy program to treat anxiety among students with Autism Spectrum Disorder. Participants included 5 students, 6 educators and 7 parents. Settings were a public elementary school and private school. Multiple methods included a quasi-experimental group design, time series design, semi-structured interviews and focus groups. Quantitative results indicated that with training and on-going feedback educators obtained a modest level of fidelity in implementing the intervention. Non-significant decreases in student anxiety symptoms across all informant ratings (students, parents and teachers) were observed. Social validity ratings across participants were high. Qualitative findings revealed the following themes: (a) outcomes; (b) program structure; (c) inclusion; and (d) factors critical for success. These preliminary results offer a model for researchers to collaborate with key stakeholders in adapting interventions for use in schools, bridging the gap between research and practice. They highlight educator’s ability to deliver empirically-supported treatments to address anxiety among students with Autism Spectrum Disorder.
Context, Proximity, and Individual Risk for Early-Pandemic Fear of Covid-19 Infection: A Multilevel Analysis of American Adults in March 2020
Authors: Fitzpatrick Kevin , Harris Casey , Drawve Grant , Tidwell Caitlin
Published: November 2022

Background: The current study explores how characteristics of individuals, their communities, and their relative exposure to nearby Covid-19 cases are associated with specific fears or perceived threat/risk of the virus itself during the early stages of the pandemic in March 2020. Aims: Drawing from research emphasizing the intersectional relationships between individual social vulnerabilities, community characteristics, and Covid-19 outbreak locales, we test several hypotheses predicting fear. Method: Using data from a large-scale survey of 10,368 U.S. adults from March 2020, we construct a series of hierarchical linear and logistic regression models that nest individuals within their residential counties in order to account for key socio-demographic characteristics of individuals, communities, and each respondent’s geographic proximity to Covid-19 cases. Results: Results show that individual fear and perceived risk to oneself and family is predicted by individual social vulnerabilities, the type of community in which respondents live, and the relative presence of the virus in nearby places. Conclusion: Our findings highlight the importance of understanding fear, particularly as a possible mediator for both mental and physical health outcomes. Likewise, we emphasize ongoing efforts aimed at understanding how different groups and communities respond to fear and/or concern over Covid-19 as the pandemic remains ongoing.
Intravenous Immunoglobulin Suppresses Chemotherapy-Induced Peripheral Neurotoxicity Via Macrophage Modulation in Rats and Mice
Authors: Tanaka Jun , Kajii Masahiko
Published: November 2022

Chemotherapy-induced peripheral neurotoxicity (CIPN) is a serious adverse effect that leads to treatment discontinuation by patients receiving anticancer therapy. Treatment discontinuation is a serious and life-threatening problem for patients with cancer; hence, there is a need for drugs that suppress the induction of CIPN by anticancer drugs. Here, using rat and mouse models, we showed that intravenous immunoglobulin (IVIg) can suppress CIPN induced by not only paclitaxel but also by doxorubicin. Furthermore, the suppressive effect of IVIg is eliminated when macrophages are depleted. Here, we proposed two novel independent mechanisms underlying the alleviation of CIPN by IVIg. First, IVIg suppresses CIPN in a macrophage-dependent manner. Second, IVIg combined with anticancer drugs can avoid restrictions on the use of anticancer drugs owing to CIPN induction. However, further research is necessary for the bench-to-bedside translation of these novel applications of IVIg. Our findings lay a strong foundation for research on IVIg therapeutics.
Blood Pressure Variability: Mechanisms, Measurement, Subtypes, and Clinical Implications
Authors: Izzo Joseph
Published: November 2022

The complex topic of short- and long-term blood pressure (BP) variability confounds the diagnosis, classification, and management of hypertension. True pathophysiologic BP variation (systematic and non-systematic deviations between- and within-individuals) is related to heart rate, respiration, complex responses of the sympathetic nervous system, vascular reactivity, and arterial stiffness. Measurement errors (systematic biases and random error) further compound the analysis. Most studies use serial clinic BP values, 24-hour ambulatory BP recordings, or home BP values with standard statistical indicators (standard deviation, variance, or coefficient of variation) or absolute real variability (mean difference of successive values). Clinical impact in retrospective secondary analyses includes a modest increase in cardiovascular disease (CVD) risk (equivalent to a few mmHg in mean systolic BP) yet questions remain whether adjustment for mean BP is needed. BP variability is reduced to a small degree by calcium antagonists and increased by ACE inhibitors, beta-blockers, and alpha-blockers but no interventional trial has addressed the question of whether reducing BP variability confers CVD risk protection. BP variability is not specifically discussed in practice guidelines but it is tacitly acknowledged by recommendations to repeat BP measurements, standardize technique, and confirm the hypertension diagnosis by home or ambulatory BP measurements to account for the “white coat effect.” There is no formal consensus on how to quantitate or manage BP variability despite a real-world need for better diagnostic and therapeutic guidance. Practitioners should thus focus on control of (mean) BP using combinations of agents that improve CVD outcomes. Future consensus guidance should directly address BP variability and should include educational materials for physicians, patient-contact staff, and patients.
Operating Room Improvements Based on Environmental Quality Index Risk Prediction can help Reduce Surgical Site Infections
Authors: Wagner Jennifer , Gormley Thomas , Markel Troy , Greeley Damon
Published: November 2022

Importance: The role of the operating room (OR) airborne environment in the incidence of surgical site infections (SSI) has ranked behind patient and perioperative team-related factors associated with risk for SSI. Emerging evidence demonstrates that the design and performance of the OR environment impacts the airborne microbiome both within the sterile field and at tables where instruments and implants are exposed. However, the correlation between OR air quality and the risk of SSI continues to be challenged. Objective: To determine if improving the asepsis of the airborne environment in ORs contributes to reduced SSI rates. Design: The performance of air delivery systems in fourteen operating rooms was evaluated using the Environmental Quality Indicator (EQI) risk picture method to identify potential improvements to airflow management that reduce airborne contamination and operating costs. SSI rates for colon and abdominal hysterectomy procedures were tracked in these ORs for 39 months before and after improvements were implemented. SSI rates were also tracked for the same time frame for six control ORs in which no improvements were made. Airborne microbial data was collected. Setting: Twenty ORs in an academic medical center, Midwest USA. A convenience sample of all surgical patients, de-identified, was used in the twenty ORs studied. Results: SSI rate was reduced from 8.4% to 5.7% (p=.0039) in ORs in which improvements were implemented. Reduction of SSI rate in control ORs was not significant (p=.76). Fewer airborne microbes were detected in areas of OR with improvements (p<.0001). Conclusion: Areas for environmental quality improvement in ORs was identified and mapped by relative risk of contamination. Implementation of these improvements resulted in decreased microbial contamination and contributed to significant reduction in surgical site infection.
Remote Clinical Consultations in Restorative Dentistry
Authors: Martin Nicolas , King David , Hyde Sam , Shahrbaf Shirin , El-Dhuwaib Bilal , Gate Sam , Elmougy Abdulrahman
Published: November 2022

Specialist consultations are routine in medical and oral healthcare provision. These take place as an 'in-person' event in the secondary care centres. The primary outcome of the specialist consultation is to provide the dentist and the patient with a specialist assessment, diagnosis, prognosis and a proposed care plan. This in-person procedure remains the gold-standard as it is a considered safe and effective. It presents a number of shortcomings: (1) The referring clinician is not actively involved in the decision-making process. (2) The patient must travel to the secondary care centre for the consultation, creating inequalities of care provision. (3) The patient travel has a carbon footprint. (4) The setting of the referral centre can be unfamiliar and intimidating to the patient. (5) The outbreak of COVID-19 highlighted the need for alternative system to address this need. This clinical study assessed the feasibility and effectiveness of undertaking remote clinical consultations in restorative dentistry between a patient and dentist co-located in a clinical primary care dental practice and a specialist consultant in a remote secondary care centre. Method: A remote clinical consultation in restorative dentistry was conducted that enabled full engagement between the remote consultant and the patient/General Dental Practitioner (GDP) in the dental surgery. A comprehensive bespoke high-speed secure internet connected hardware and software platform was used. Each participant completed a semi-structured interview and a validated questionnaire covering four domains: Patient safety, communication between different parties, formulation of a treatment plan, and effectiveness of the technology. Results: Effective and safe clinical consultations were carried out in all the cases, regardless of gender, age and presenting complaint. Neither the process nor the outcomes were inferior to an in-person consultation. Conclusion: This pilot in-practice clinical effectiveness study identified that Remote Clinical Consultations (RCCs), as conducted in this study, are effective for the delivery of specialist consultations in restorative dentistry. They are not inferior to an in-person consultation. Secondary outcomes: Three-way discussion was very positive; high levels of acceptability from the patients and the referring GDPs; an alternative to patient travel, reducing travel inconvenience, cost and the environmental burden from the associated carbon dioxide emissions.
Cerebral Venous Thrombosis as The Sole Presenting Manifestation of Human Immunodeficiency Virus and Hepatitis B Virus Co-Infection
Authors: Dutta Ajitava , Ghosh Ritwik , Pandit Alak , Ray Adrija , Bhattacharya Dwaipayan , Chakraborty Arkaprava , Chakraborty Uddalok , Dubey Souvik , Benito-León Julián
Published: November 2022

Background: Cerebral venous thrombosis (CVT) following either human immunodeficiency virus (HIV) infection or hepatitis B virus (HBV) infection is a very rare condition. Moreover, it has never been reported as the presenting manifestation of HIV and HBV co-infection, even more so when the patient had a normal CD4 count and no demonstrable opportunistic infections. We aimed to report the first case of an adult Indian male, an intravenous drug abuser who developed CVT as the presenting manifestation of HIV-HBV co-infection. Methods: Patient data were obtained from medical records from the Bangur Institute of Neurosciences, Institute of Post Graduate Medical Education and Research & SSKM Hospital, Kolkata, West Bengal, India. Results: A 25-year-old male with a history of intravenous drug abuse and a normal CD4 count developed CVT as the presenting manifestation of HIV-HBV co-infection. His CD4 count was normal, and he had no demonstrable opportunistic infections. He had an uneventful recovery of the condition (CVT) following the institution of conventional anticoagulation therapy alongside anti-retroviral therapy. Conclusion: Whether illicit drug abuse or HIV/HBV infection itself or all in combination led to this thrombotic event cannot be precisely established. Notwithstanding, we recommend serologic testing for HIV and HBV in patients suffering from CVT with high-risk behavior.
NEURODEVELOPMENTAL IMPAIRMENTS IN CHILDHOOD AFTER MODERATE AND LATE PRETERM BIRTH IN FINLAND A SUMMARY OF NATIONAL REGISTER STUDIES
Authors: Tammela Outi
Published: November 2022

About 80% of premature (< 37 gestational weeks) infants have been born moderately preterm (32+0-33+6 weeks) and late preterm (34+0-36+6 weeks). Very preterm birth (<32 weeks) is a well-known risk factor for adverse neurodevelopmental outcome, but the risks concerning moderately and late preterm infants have earlier been underestimated. Lately, concern about later neurodevelopmental impairments among these children has been emerged. Our project was to undertake a national register study on the incidence and risk factors of sensory impairments, cerebral palsy (CP) and intellectual disabilities (ID). The aim of this review article is to provide a summary of our work and earlier publications on this topic. Our study comprised all children (N= 1039263) born alive in Finland in 1991-2008. After exclusions (missing data on gestational age (N=5520), major congenital malformations (N= 13007) and death before the age of one year (N=2659) the population consisted of 1018256 children, who were followed up to the age of seven years or up to 2009. They were divided into four groups as follows: very preterm (N= 6329), moderately preterm (N=6796), late preterm (N= 39928) and term (N=965203). Incidences of sensory impairments, CP and ID (intellectual quotient ≤ 70) were explored by linking health register data. Antenatal, birth-related and neonatal predictors of disabilities were established by multivariate analysis. The incidences of sensory impairments, CP and ID decreased with increasing gestational age. Compared with term birth, moderately and late preterm births were significantly associated with the risk of visual disturbances, blindness and CP. Late preterm birth predicted a risk of hearing loss. Preterm birth seemed not to be associated with an increased risk of intellectual disability. The most significant predictors of neurodevelopmental disabilities among moderately and late preterm born children included one-minute Apgar score < 7, intracranial hemorrhage, male sex, small for gestational age, smoking during pregnancy and early antibiotic treatment. These results are mostly in accordance with other reports on the outcome of moderately and late preterm born children. In conclusion, moderately and late preterm born children seemed to be at an increased risk of sensory impairments and cerebral palsy, but not intellectual disability.
Vulnerability and environmental risk in the Sierra Otomí Tepehua (Hidalgo, México)
Authors: Medina-Pérez Patricia Catalina , Tapia-Fernández Héctor Jesús , Castillo-Martínez Antonio
Published: November 2022

Extreme geomorphological and hydrometeorological events cause landslides (gravitational processes) in vulnerable and marginalized communities, where the risk and effects of a natural disaster reduce responsiveness to environmental adversities. In the state of Hidalgo (Mexico) exists dangers as slope instability and processes of massive removal of soil, but in some municipalities of the Sierra Otomí-Tepehua (SOT) does not exist a municipal instrument that provides information on high-risk localities. This study evaluated landslide risk in 220 localities located in three municipalities of the Sierra Otomí-Tepehua region (SOT) using information from the 2020 national census. A geospatial analysis was built in localities with landslide risk, further social vulnerability was evaluated in 33 localities located on hillsides, and the Social Vulnerability Index of Housing (IVSV) was determined. 109 localities with a high and very high level of social vulnerability were identified due to the physical condition of the dwellings located in areas with landslide risk. Finally, risk map of landslides was developed through multi-criteria analysis to focus on mitigate and prevent disasters in the most vulnerable localities of the SOT.
Lateral medullary syndrome: an unwanted ischemia to identify early
Authors: Prajjwal Priyadarshi , Inban Pugazhendi , Nagre Abhijit , Shah Mujtaba Hussain , Chaudhary Ansh , Ranjan Raunak , Chaudhary Bhupendra
Published: November 2022

Lateral medullary syndrome also referred to as Wallenberg syndrome, posterior inferior cerebellar artery (PICA) syndrome, or vertebral artery syndrome is a cluster of neurological symptoms and signs brought on by obstructions in the blood vessels supplying the medulla, which causes ischemia or infarction of the brainstem. The vertebral artery or the posterior inferior cerebellar artery are the arteries most frequently affected with lateral medullary syndrome. The most prevalent symptom is transient ischemic attack (TIA) with dizziness or vertigo and atherosclerosis in the posterior cerebral circulation being the most common cause. Lateral Medullary Syndrome patients suffer from strokes or infarction and also present with vomiting, nausea, gait impairment, instability, hoarseness, and swallowing difficulties. Depending on the particular nuclei and fibers involved, different indications will appear. CT/MRI imaging is used to diagnose conditions. The majority of management is supportive, including risk factor reduction for additional ischemia events as well as speech and occupational therapy following an acute intervention. In this review article, we discuss the etiopathogenesis and factors leading to lateral medullary syndrome along with a comprehensive discussion on its clinical features, challenges in diagnosis, and treatment.
Furos em blocos cerâmicos para fins estruturais: estudo de características estáticas e dinâmicas através de experimentos e modelos numéricos
Authors: Almeida Orlando Matheus De Lima , Almeida Orlando Gabriel De Lima , Melo Arlan De Araújo , Diógenes Hidelbrando José Farkat
Published: November 2022

A alvenaria estrutural possui elevada relevância no mercado da construção e alto emprego em decorrência da competitividade do sistema em pequenas e médias construções. O bloco cerâmico possui papel fundamental no sistema de alvenaria estrutural, responsável direto pela segurança estrutural e cuja integridade e capacidade resistiva devem ser preservadas com o intuito de proteger também o sistema. Todavia, alterações nos blocos cerâmicos realizadas pelos próprios usuários são comuns; a execução de furos nas paredes estruturais, por exemplo, para o emprego de chumbadores, pode – em casos extremos – comprometer a segurança estrutural. Este trabalho, então, analisa os efeitos nas propriedades estáticas e dinâmicas de blocos cerâmicos para alvenaria estrutural em decorrência de perfurações não concebidas em projeto. Para tanto, levou-se em conta ensaios de compressão axial, técnica de excitação por impulso (IET) junto à elaboração de um modelo numérico dos blocos. Foram avaliadas as alterações na resistência à compressão e nas frequências naturais dos blocos cerâmicos, observando-se não apenas as modificações que de fato ocorreram, mas também o seu nível de influência nas características do bloco. Observaram-se, em alguns casos, variações da ordem de 14% na segunda frequência de maior relevância, além de alterações em modos de ruptura a partir das perfurações realizadas e claras mudanças na distribuição de esforços no modelo numérico, com aumento de mais de 42% das tensões em alguns elementos. Apesar de algumas alterações no comportamento dos blocos, as perfurações não aparentam ser determinantes para suas propriedades estáticas e dinâmicas; as resistências máximas sofreram pouca variação e as frequências de interesse variam, em sua maioria, menos que 6%.
Study of Chemical Composition of an Industrial Crop for Russia – Miscanthus Ч giganteus Harvested in 2019–2021
Authors: Gismatulina Yu.A. , Kortusov A.N. , Budaeva V.V. , Sakovich G.V.
Published: November 2022

A chemical composition assessment was performed on a industrial crop in Russia, Miscanthus Ч giganteus harvested in 2019–2021. It was found that, regardless of the habitat, after the second year of vegetation, Miscanthus Ч giganteus has a cellulose content exceeding 50 %, which makes it a cellulose-based material. The positive impact of Miscanthus Ч giganteus on the environment was demonstrated. Cultivation of Miscanthus Ч giganteus regulates CO2 exchange, and its processing into cellulose, biofuels and high-tech products will reduce deforestation.