bluuebunny/crossref_metadata_2025 huggingface dataset:
Youth Risk Behaviour among Medical Students in a Medical College in Bengaluru
Authors: Aishwarya S  , Shashikala M
Published: March 2023

Risk taking behaviour is common amongst youth, who comprise of individuals between 15-24 years. They arein the formative stage of life and are vulnerable to developing habits that could be precursors to development ofcommunicable and non communicable diseases. This study was undertaken to assess the risk taking behaviouramong first year medical students as they will be the role models to the community. A cross-sectional study, using asemi-structured questionnaire, was conducted among first year medical students in RajaRajeswari Medical Collegeover a one month period in 2015. The study revealed that most students had risk taking behaviour, especially withregard to unhealthy diet and lack of physical activity. There was a statistically significant association betweenconsumption of junk food and obesity and between BMI and action taken to alter weight. A small percentage ofstudents displayed risk taking behaviour contributing to unintentional injuries, substance abuse and physicalinactivity. Behaviour change communication on health risk behaviours and life skills training among the futuredoctors will go a long way in bringing a change in the community as they will be the role models.
Study of Pre-loading and Vasoconstrictors as Combined Prophylaxis for Hypotension During Sub-Arachnoid Anaesthesia
Authors: Ajay Rakeshvarma Chenna Reddy  , Mallikharjuna Payyavula  , Gudipudi Ramesh
Published: March 2023

Background: Hypotension following spinal anaesthesia is common physiological complications associatedwith nausea, vomiting, dizziness aspiration, syncope and cardiac arrhythmias. Hence proper prophylaxis forhypotension is essentialin lower abdominal and lower limb surgeries.Method: Total sixty patients aged between 35 to 65 years undergoing lower abdominal and inferior extremitieswere studied. Patients were randomly classified into three groups 20 patients in each group. Group-I patientscrystalloid group received RL and placebo. Group-II (Vasoconstrictor) group received Ephedrine and Group-III(combination group) received RL (ringer lactate) and Ephedrine. Hemodynamic parameters and side effects ofeach group was noted and compared.Results: There was significant prophylaxis in all three groups at different intervals of 5, 10, 15, 20, 25 and 30minutes (p<0.001) highly significant P and F values and 1 (5%) hypotension was observed in group-III, followedby 4 (20%) in group-II and 9 (45%) highest hypotension in group-I and least side effects were also observed ingroup-III patients.Conclusion: It is concluded that group-III (combination groups) preloaded with RL solution and Ephedrine afterthe injection of spinal anaesthetic drug proved ideal prophylaxis for hypotension during subarachnoid anaesthesia.
Body Mass Index as a Predictor of Quality of life of Patients with Chronic Obstructive Pulmonary Disease
Authors: Akash Subhashrao Yende
Published: March 2023

Background and Aim: Studies have reported that excessive weight and obesity are common in the early stages ofCOPD, and malnutrition is common in moderate and severe COPD. COPD is known to show “obesity paradox”i.e., obese and overweight COPD patients have better outcome of disease as compared to underweights. The aimof the study was to assess the BMI of COPD patients, its distribution and relationship with various factors.Material and Methods: Present study was conducted at tertiary care institute of India for the duration of oneyear. Total 400 COPD patients were selected to assess their body mass index (BMI) using Quetelet’s formula.Study subjects were selected using a systematic random sampling method. Study subjects were categorized as perWHO’s classification of BMI for Asian populations.Results: Out of a total of 400 subjects enrolled in the study, majority (49%) were obese followed by 35% overweightsand 7% underweights. Health-related quality of life of undernourished patients was most affected. A statisticallysignificant relation was seen across all the components of SGRQ.Conclusion: Present research established that, the disease related malnutrition is common in COPD patients,therefore, BMI might be a useful indicator to predict the prognosis of disease. This calls for an urgent need by ourprimary care physicians to provide simultaneous weight management interventions in COPD patients so as toimprove their nutritional status, enhance the strength of respiratory muscles and reduce the inflammation whichwill be effective in long-term management of the disease.
Perception of E-learning among Medical Students of VIMS, Ballari, Karnataka: A Cross Sectional Study
Authors: Anju Mariam Jacob  , Ramesh K  , R Keerthi  , Pratibharani Reddy  , T Gangadhara Goud
Published: March 2023

With COVID-19 pandemic disrupting the educational system, the professional medical teaching has been shiftedto online mode soon after the Government’s decision to impose nation-wide lock-down.A cross sectional study was carried out among medical undergraduate in VIMS to know their perception on elearning.The questionnaire was administered through google forms and the results were analysed using descriptivestatistics. Among 340 study subjects, the mean age was found to be 20.47 and the majority of responders were firstyear undergraduates. Most students depended on smartphones for attending classes. The maximum satisfactionindex (55.47%) observed with more time spend on homework and the minimum (39.85%) with greater ability toconcentrate in online class. On a Likert scale of perception assessment 32.9% of students disagreed with conductingonline classes followed by 31.2% remained neutral. Overall experience recorded bad with 57.6%. Online learninghas been the need of the hour but it should be backed up with traditional learning for effective results.
Современные проблемы управления горно-химическим комплексом России
Authors:   Институт экономических проблем им. Г.П. Лузина ФИЦ КНЦ РАН, Березиков С. А. ,   ФЕДЕРАЛЬНЫЙ ИССЛЕДОВАТЕЛЬСКИЙ ЦЕНТР  «КОЛЬСКИЙ НАУЧНЫЙ ЦЕНТР РОССИЙСКОЙ АКАДЕМИИ НАУК», Дядик В. В. ,   Институт экономических проблем им. Г.П. Лузина ФИЦ КНЦ РАН,   ФЕДЕРАЛЬНЫЙ ИССЛЕДОВАТЕЛЬСКИЙ ЦЕНТР  «КОЛЬСКИЙ НАУЧНЫЙ ЦЕНТР РОССИЙСКОЙ АКАДЕМИИ НАУК», Ларичкин Ф. Д. ,   Институт экономических проблем им. Г.П. Лузина ФИЦ КНЦ РАН,   ФЕДЕРАЛЬНЫЙ ИССЛЕДОВАТЕЛЬСКИЙ ЦЕНТР  «КОЛЬСКИЙ НАУЧНЫЙ ЦЕНТР РОССИЙСКОЙ АКАДЕМИИ НАУК», Левенцов В. А. ,   Институт экономических проблем им. Г.П. Лузина ФИЦ КНЦ РАН,   ФЕДЕРАЛЬНЫЙ ИССЛЕДОВАТЕЛЬСКИЙ ЦЕНТР  «КОЛЬСКИЙ НАУЧНЫЙ ЦЕНТР РОССИЙСКОЙ АКАДЕМИИ НАУК», Череповицын А. Е. ,   Институт экономических проблем им. Г.П. Лузина ФИЦ КНЦ РАН,   ФЕДЕРАЛЬНЫЙ ИССЛЕДОВАТЕЛЬСКИЙ ЦЕНТР  «КОЛЬСКИЙ НАУЧНЫЙ ЦЕНТР РОССИЙСКОЙ АКАДЕМИИ НАУК»
Published: March 2023

Представлено исследование, системно раскрывающее проблемы и возможности развития горно-химического комплекса России. На примере ведущих представителей российского горно-химического комплекса (ПАО «ФосАгро», ПАО «Акрон», АО «МХК “ЕвроХим”», ПАО «Уралкалий») выполнена оценка ресурсного потенциала сектора добычи минеральных удобрений, определены основные финансовые показатели ведущих производителей, проведен сравнительный анализ компаний и рассмотрены основные формы их взаимодействия. Проанализирован спрос и предложение на минеральные удобрения трех видов за последние несколько лет. Применительно к горнодобывающей отрасли определены ключевые тенденции цифровизации, в числе которых: автоматизация, роботизация, интернет вещей, большие данные, данные в реальном времени, машинное обучение, искусственный интеллект и 3D-печать. Подробно рассмотрена корпоративная социальная ответственность (КСО) горно-химических предприятий Мурманской области как фактор устойчивого развития местных сообществ арктических моногородов. Показано, что корпоративная социальная политика крупных горно-химических предприятий Мурманской области отвечает требованиям масштабности и комплексности, а конкретные меры КСО ориентированы на удовлетворение интересов основных стейкхолдеров. Выявлены основные тенденции во внешнем и внутреннем направлениях политики социальной ответственности компаний. Издание предназначено для руководителей и специалистов, занятых в секторе добычи полезных ископаемых, преподавателей и студентов профильных вузов.
Пора оздоравливать Арктику. Биологические способы очистки и восстановления нефтезагрязненных территорий
Authors:   Федеральный исследовательский центр «Кольский научный центр Российской академии наук», Мязин В. А. ,   Институт проблем промышленной экологии Севера КНЦ РАН,   Полярно-альпийский ботанический сад-институт им. Н. А. Аврорина, Иванова Л. А. ,   Федеральный исследовательский центр «Кольский научный центр Российской академии наук»,   Институт проблем промышленной экологии Севера КНЦ РАН,   Полярно-альпийский ботанический сад-институт им. Н. А. Аврорина, Чапоргина А. А. ,   Федеральный исследовательский центр «Кольский научный центр Российской академии наук»,   Институт проблем промышленной экологии Севера КНЦ РАН,   Полярно-альпийский ботанический сад-институт им. Н. А. Аврорина, Фокина Н. В. ,   Федеральный исследовательский центр «Кольский научный центр Российской академии наук»,   Институт проблем промышленной экологии Севера КНЦ РАН,   Полярно-альпийский ботанический сад-институт им. Н. А. Аврорина, Корнейкова М. В. ,   Федеральный исследовательский центр «Кольский научный центр Российской академии наук»,   Институт проблем промышленной экологии Севера КНЦ РАН,   Полярно-альпийский ботанический сад-институт им. Н. А. Аврорина, Евдокимова Г. А. ,   Федеральный исследовательский центр «Кольский научный центр Российской академии наук»,   Институт проблем промышленной экологии Севера КНЦ РАН,   Полярно-альпийский ботанический сад-институт им. Н. А. Аврорина,   Полярно-альпийский ботанический сад-институт им. Н. А. Аврорина
Published: March 2023

Обобщен многолетний опыт исследований по разработке и возможности применения биологических способов очистки и восстановления почв, загрязненных нефтью и нефтепродуктами, в Мурманской области. Биотехнологии способны стать альтернативным способом очистки загрязненных территорий в экстремальных условиях Евро-Арктического региона. Предлагаемые методы биоремедиации могут найти свое применение как при доочистке почвы после ликвидации разливов нефти и нефтепродуктов, так и при устранении старых загрязнений в рамках сокращения площади территорий с накопленным экологическим ущербом. Рекомендуемые биотехнологии позволяют с минимальными негативными последствиями и побочными эффектами очищать загрязненные участки и восстанавливать нарушенные территории Арктики и Субарктики. Природные механизмы, лежащие в основе методов биостимуляции, биоаугментации и сорбционно-биологической очистки, способствуют восстановлению экосистем и поддержанию биоразнообразия. Представленные материалы могут быть полезны экологическим службам промышленных предприятий, организациям, занимающимся ликвидацией разливов нефтепродуктов, а также компаниям, осуществляющим добычу, транспортировку, переработку нефти и другие операции с нефтепродуктами.
GENDER, CLASS AND IDENTITY: A CRITICAL DISCOURSE ANALYSIS OF A SONG OF ICE AND FIRE
Authors: Dhantal Smita
Published: March 2023

Fantasy Fiction unifies supernatural elements and life with the help of imagination to build something novel. Though it is considered far removed from the primary world, it remains a reflection to reality. George R. R. Martin, an American Writer, created a whole new world as a setting for his Fantasy Fiction series, A Song of Ice and Fire. This he did, not only in the geographical sense but also in the social, political and religious sense. Martin invented religions, customs, traditions, legal systems, and languages to suit these, in order to make his world authentic. His inspirations from Medieval Europe are seen in the architecture, attire, food, mannerisms, social rules, language, and so on, which he constructed for his texts. The series has a complex structure and plot, with more complex characters. It is meant to be a heptalogy, but two more volumes are yet to be published. Gender, Class and Identity are some major concepts being discussed in academics. In this article, understanding of these key terms will be established. Subsequently, select instances from the text will be used to demonstrate how these concepts resonate in the selected text. For this purpose, Critical Discourse Analysis will be used as a method to examine the language used in the select instances. Critical Discourse Analysis is a transdisciplinary tool developed borrowing thoughts from fields like Sociology, Psychology, Linguistics, and Criticism. It is also a part of Hermeneutics as discourse analysis is used to explore the possible interpretations of a text and is, in itself, not a substantiating theory
En memoria de Antonio Manzanares Palarea (1948-2022)
Authors: Zamora Juan
Published: March 2023

Hoy, después de varios días roto de dolor por el fallecimiento repentino de mi viejo amigo Antonio Manzanares Palarea, me siento con fuerzas para escribir estas líneas sobre él, sobre su vida y legado.
Analisis Kinerja Simpang Non-APILL (Studi Kasus: Simpang Jalan Pulau Galang – Jalan Taman Pancing – Jalan Tukad Baru)
Authors: Yogeswari Saraswati Ni Putu Delima , Kwintaryana P. , Budiarnaya Putu , Gusmao Rudolfo Xavier Lobato
Published: March 2023

Population growth in Denpasar City continues to increase from year to year. This indirectly causes the number of vehicle ownership in Denpasar City to continue to increase while the existing facilities are inadequate. We can see this in traffic problems such as congestion that often occurs, especially at intersections. Jalan Pulau Galang - Jalan Taman Pancing - Jalan Tukad Baru is an example of an intersection that has irregular traffic conflict points, especially during rush hours. This junction is a non APILL junction. This location was chosen as the research because in addition to the irregular traffic flow at certain hours, at this intersection there are also residential and shopping areas which trigger more congestion at this intersection. From the problems that arise at the Jalan Pulau Galang intersection - Jalan Taman Pancing - Jalan Tukad Baru, a study was carried out which aims to determine the performance and service level of the intersection. If the service level at the intersection is in the safe category, then preventive measures to avoid congestion must be analyzed. The results of the calculations that have been carried out show that the value for the intersection capacity (C) is 6,213 smp/jam with the degree of saturation (DS) being 0,363 smp/jam. The DS (Degree of Saturation) value indicates that the intersection is included in the service level category B according to the 2014 PKJI, which has stable flow characteristics, but the operating speed is starting to be limited by traffic conditions. Service level B has an NVK value between 0.20-0.44. For this reason, it is necessary to supervise the location of the intersection so that the location of the intersection still has an adequate level of service and does not increase in height to avoid severe traffic jam
Analisis Kinerja Ruas Jalan (Studi Kasus Jalan Tangkuban Perahu, Denpasar Barat)
Authors: Darma Yoga I Wayan Gede , Marcal Roger Bastiano Lica-Lica Dias , Putri Dewa Ayu Putu Adhiya Garini , Ariawan Putu
Published: March 2023

Denpasar city is one of the big cities that has a very high population, it can be seen from the population of Denpasar city of 962,900.000 million people, (BPS, 2020). Over time, the traffic density on the road has increased, in addition to the increasing number of residents and the increasing number of private vehicle ownership, it is also caused by the location adjacent to shopping centers and restaurants. This research was conducted using primary data. Primary data was obtained from survey results in the form of traffic survey data,Road Capacity, Degree of Saturation, and Level of Service using the 2014 PKJI method. Based on the results of the discussion, it can be concluded that the performance of the Tangkuban Perahu road is at Level of Service F, which means it is very bad, with the following indicators. The peak hour volume is 2394 cur/hour. Capacity 2381 cur/hour. The side resistance is 98,4, for the side resistance class it is classified as very low, which is 0.96. The degree of saturation (DJ) > 1.00 is 101 cur/hour. The average travel speed of vehicles at a distance of 100m is 21,69 km/hour.
Perencanaan Mix Desain Cemen Treated Recycling Base (CTRB) Untuk Lapis Pondasi Atas Dengan Menggunakan Material Recycle Hasil Garukan Dari Aspal Hot Mix
Authors: Budiarnaya Putu , Ariawan Putu , Swasdita I Gede
Published: March 2023

Upaya untuk memperbaiki kerusakan jalan adalah untuk mengembangkan basis Cemen Treated Recycling Base (CTRB), sebagai lapisan dasar. Teknologi daur ulang dapat menghemat penggunaan agregat 45% hingga 60% dalam aspal baru. Ini juga meningkatkan nilai ekonomi bahan abrasif, menghemat energi saat mengangkut material, mempertahankan bentuk jalan dan ketinggian jalan raya, dan melestarikan sumber daya alam. Penelitian ini menggunakan metode eksperimen dimana dilakukan eksperimen laboratorium untuk mendapatkan data yang diperlukan. Kadar semen yang digunakan dalam penelitian ini adalah 4% dan 5% serta 6% untuk  nilai UCS (Unlimited Compressive Strength), dan material yang digunakan adalah 40% agregat RAP (Reclaimed Asphalt Aggregate) 60% Grade A ethm agregat. Kandungan semen yang memenuhi syarat Unlimited Compressive Strength (UCS) untuk Cemen Treated Recycling Base (CTRB) adalah 5% dengan kuat tekan rata-rata 29,48 atau 2,948 MPa.
Analisis Keselamatan dan Kesehatan Kerja Menggunakan Metode Hazard Identification And Risk Assessment Pada Proyek Konstruksi
Authors: Sari Yusra Aulia , Baskara I Wayan Yoga , Riana I Nengah , Ariana Komang Agus
Published: March 2023

The construction service sector is one of the many business fields that are classified as very prone to accidents. This research takes a case study, namely the Bali Kura-Kura Creative Campus Development Project which requires a lot of human resources and is of course prone to construction accidents due to negligence or human error. The purpose of this study is to determine the level of accident risk that occurs and provide K3 recommendations after knowing the level of accident risk. In this study the questionnaire was used as a data collection tool. Questionnaires were compiled from predetermined research variables. After knowing the variables and data, the next step is to apply the Hazard Identification and Risk Assessment (HIRA) method

The conclusion that can be drawn from this research is the calculation using the HIRA method, which is that there are activities with a low risk level of 3 (15%) sources in the excavation area. Then there are 5 sources (25%) that are included in the medium risk level and 10 sources (50%) of the risk that are included in the high risk category found in all activity areas. Meanwhile, in the extreme risk category, there are 2 sources (10%) found in the excavation area and based on the analysis, it can be seen that the recommendations for improvement proposals that can be made include tightening supervision on each worker activity, enforcing SOPs for each activity, providing safety signs on certain areas that may pose a potential hazard, provide personal protective equipment (PPE).
Modeling Uncertainty Quantification of NDVI of Agricultural Fields through Bayesian Linear Regression in Time Series Prediction
Authors:   Lab for Spatial Informatics, International Institute of Information Technology, Hyderabad, Telangana 500032, India, Srinivas M. , Prasad P. R. C.
Published: March 2023

The current research discusses the applications of Bayesian linear regression to predict the uncertainty of remote sensing data. To predict the uncertainty, the study considered the SENTINEL-2 satellite data of agricultural fields of Uttar Pradesh state of India. Using the stratified sampling method in Google Earth Engine, the random points generated are mapped to agricultural fields. Data was collected in the form of maximum Normalized Difference Vegetation Index (NDVI) values of each agricultural field. The dynamics of the time series predictions were explored with Bayesian linear regression, a probabilistic deep learning method. The model uncertainty defined as epistemic uncertainty is evaluated with the prior and posterior probability parameters of Bayesian statistics in linear regression. The number of regression lines predicted for the same data shows evidence of uncertainty. The Bayesian linear regression models show evidence of high uncertainty for the predicted NDVI values. The variation in model uncertainty is measured by dividing the dataset into samples and it is observed that with increase in data the uncertainty is reduced. Also, with the increase in data, the posterior density becomes sharper which corresponds to a decrease in variance. Further, the study extended the concept of regression analysis with Gaussian basis functions to determine the effect of model uncertainty with an increase in data. The analysis has shown the same result in knowing the effect of uncertainty with the increase in data. Further, a nonlinear polynomial regression model with a Gaussian distribution as a basis function was developed to evaluate the marginal probabilities of the evidence function in capturing the uncertainty with varying degrees of freedom. The polynomial regression with a Gaussian distribution using Bayesian statistics has captured the uncertainty and confirmed that the uncertainty is captured at lower degrees of freedom.
АКТУАЛЬНЫЕ ИССЛЕДОВАНИЯ
СТУДЕНТОВ И АСПИРАНТОВ
В ОБЛАСТИ ГУМАНИТАРНЫХ, ОБЩЕСТВЕННЫХ, ЮРИДИЧЕСКИХ И ЭКОНОМИЧЕСКИХ НАУК
Authors: Жебо А. В. , Лешковой О. В.
Published: March 2023

В сборник вошли научные статьи, подготовленные в 2021 г. по результатам научного мероприятия ХГУЭП «Дни студенческой науки». В представленных статьях рассмотрены актуальные проблемы развития теории и совершенствования практических подходов в области экономики и права. Статьи выполнены под руководством педагогов общеобразовательных организаций и профессорско-преподавательского состава вузов.
Материалы научного мероприятия представлены в авторской редакции.
Авторы статей несут ответственность за подбор и точность приведенных фактов, цитат, статистических данных и прочих сведений, а также за то, что в материалах не содержатся сведения, не подлежащие открытому опубликованию.
Application of Deep Reinforcement Learning to Major Solar Flare Forecasting
Authors: Yi Kangwoo , Moon Yong-Jae , Jeong Hyun-Jin
Published: March 2023

In this study, we present the application of deep reinforcement learning to the forecasting of major solar flares. For this, we consider full-disk magnetograms at 00:00 UT from the Solar and Heliospheric Observatory/Michelson Doppler Imager (1996–2010) and the Solar Dynamics Observatory/Helioseismic and Magnetic Imager (2011–2019), as well as Geostationary Operational Environmental Satellite X-ray flare data. We apply Deep Q-Network (DQN) and Double DQN, which are popular deep reinforcement learning methods, to predict “Yes or No” for daily M- and X-class flare occurrence. The reward functions, consisting of four rewards for true positive, false positive, false negative, and true negative, are used for our models. The major results of this study are as follows. First, our deep-learning models successfully predict major solar flares with good skill scores, such as HSS, F1, TSS, and ApSS. Second, the performance of our models depends on the reward function, learning method, and target agent update time. Third, the performance of our deep-learning models is noticeably better than that of a convolutional neural network (CNN) model with the same structure: 0.38 (CNN) to 0.44 (ours) for HSS, 0.47 to 0.52 for F1, 0.53 to 0.59 for TSS, and 0.09 to 0.12 for ApSS.
An annotated checklist of grasshoppers (Orthoptera, Acridoidea) from Mongolia
Authors: Gankhuyag Enkhtsetseg , Dorjsuren Altanchimeg , Choi Eun Hwa , Hwang Ui Wook
Published: March 2023

Grasshoppers (Acridoidea, Orthoptera) are the dominant herbivores in grassland ecosystems worldwide. They can increase rangeland productivity by stimulating plant growth and accelerating nutrient cycling. This article presents a comprehensive checklist of grasshoppers in Mongolia. Until then, the available information was very scattered, based on old studies of Mongolian grasshoppers, recorded in a few international catalogues and databases, individual records and research work on agroecosystem communities. However, the available information on the composition of the Orthopteran fauna in Mongolia was sometimes unclear or non-existent and these dubious data were excluded from the present study. In addition, the grasshopper distribution analysis used the standardised personal collection of D. Altanchimeg. We also present a list of grasshoppers, as well as their distribution and abundance, in countries adjacent to Mongolia, such as Russia, China and South Korea. The surveys covered six types of natural zones: high mountain, taiga, forest-steppe, steppe, desert steppe and desert; desert steppe and steppe zones are the most widely distributed. We hope to have contributed significantly to the study of the distribution of grasshopper species in all these natural zones.

In this study, a total of three families of Acridoidea belonging to eight subfamilies, 17 tribes, 52 genera and 128 species are reported for the various natural zones. The recorded species belong to eight subfamilies: Gomphocerinae are the most numerous with 56 species recorded, followed by Oedipodinae (51 species), Thrinchinae (nine species), Melanoplinae (six species), Calliptaminae (three species), Dericorythinae, Acridinae, Egnatiinae (one species each).
Histological analysis of TGFβ1 and VEGFR expression in cervical carcinoma treated with Rhodomyrtus tomentosa
Authors: Situmorang Putri Cahaya , Simanullang Rostime Hermayerni , Abdi Syahputra Rony , Hutahaean Masta Melati , Sembiring Hizkianta , Nisfa Lailatun , Sari Endang Ratna
Published: March 2023

Cervical carcinoma is one of the most common malignant carcinomas around the world, including Indonesia. Rhodomyrtus tomentosa is an herbal medicine that is often used in Asia as a therapeutic agent to stop cancer metastases. The process of neoangiogenesis in cervical cancer depends on VEGFR activity. Increased TGFβ1 production is also linked to cervical cancer, suggesting that gene inactivation contributes to the emergence of cervical carcinoma.

Group C- was the control group, Group C+ was the cancer model group, CER100 was the group of rats with cancer + 100 mg/kg body weight (BW) of R. tomentosa, CER200 was the group of rats with cancer + 200 mg/kg BW of R. tomentosa, and CER400 was the group of rats with cancer + 400 mg/kg BWR. tomentosa. Rats were dissected after administration of R. tomentosa for 30 days. Immunohistochemical staining of the cervical tissue was performed with TGFβ1 and VEGFR antibodies. VEGFR expression was significantly different from TGFβ1 expression (p < 0.01). The highest expression was observed at the lowest dose of R. tomentosa (100 mg/kg BW), and the lowest expression was observed at 200 and 400 mg/kg BW. The administration of R. tomentosa can repair tissue damage and decrease the expression of TGFβ1 and VEGFR via histopathological parameters, indicating the importance of the activity of these proteins in the development of neoangiogenesis in cervical cancer.
An Evaluation of Burnout Among US Rheumatology Fellows: A National Survey
Authors: McGoldrick Jenna , Molina-Ochoa Diego , Schwab Pascale , Edwards Samuel T. , Barton Jennifer L.
Published: March 2023

Objective

To evaluate levels of burnout and correlates of burnout among US rheumatology fellows.

Methods

US rheumatology fellows were invited to complete an electronic survey in 2019. Burnout was assessed using the Maslach Burnout Inventory. Measures of depression, fatigue, quality of life, and training year were also collected. Open-ended questions about perceived factors to promote resiliency and factors leading to increased burnout were included. Bivariate and multivariate regression analyses were used to examine correlates of burnout. Open-ended responses were analyzed using thematic analysis.

Results

The response rate was 18% (105/582 pediatric and adult rheumatology fellows). Over one-third (38.5%) of postgraduate year (PGY) 4 and 16.7% of PGY5/6 fellows reported at least 1 symptom of burnout. Of PGY4 fellows, 12.8% met criteria for depression compared with 2.4% of PGY5/6 fellows. PGY4 fellows reported worse fatigue and poorer quality of life compared with PGY5/6. In multivariable models controlling for training year and gender, older age (> 31 years) was associated with lower odds of burnout. Thematic analysis of open-ended responses identified factors that help reduce burnout: exercise, family/friends, sleep, support at work, and hobbies. Factors contributing to burnout: pager, documentation, long hours, demands of patient care, and presentations and expectations.

Conclusion

This national survey of US rheumatology fellows reveals that early trainee level and younger age are associated with worse levels of fatigue, quality of life, and burnout. Although awareness of and strategies to reduce burnout are needed for all fellows, targeted interventions for younger fellows and those in their first year of training may be of highest yield.
Biological Sex Inequality in Rheumatology Wait Times During the COVID-19 Pandemic
Authors: Katz Steven J. , Ye Carrie
Published: March 2023

Objective

To examine the effect of biological sex on wait times to first rheumatology appointment in a central triage system before and during the coronavirus disease 2019 (COVID-19) pandemic.

Methods

Deidentified data of all referred patients between November 2019 and June 2022 were extracted from the electronic medical record. Variables, including time from referral to first appointment, biological sex, referral period, urgency status, age, and geographic location were collected and analyzed.

Results

Twelve thousand eight hundred seventeen referrals were identified. Wait times increased by 24.23 days in the peri-COVID period (P< 0.001). In the pre-COVID period, there was no significant difference in wait times by biological sex or age. Triage urgency was a predictor of wait time, with semiurgent referrals seen 8.94 days (95% CI −15.90 to −1.99) sooner than routine referrals and urgent referrals seen 25.42 days (95% CI −50.36 to −0.47) sooner than routine referrals. In the peri-COVID period, there was a significant difference in wait time by biological sex with women waiting on average 10.03 days (95% CI 6.98-13.09) longer than men (P< 0.001). Older patients had shorter wait times than younger patients, with a difference of −4.64 days for every 10-year increase in age (95% CI −5.49 to −3.78). Triage urgency continued to be a predictor of wait time.

Conclusion

Women and younger patients appear to have been affected by wait time increases during the COVID-19 pandemic. This finding should be further investigated to determine its pervasiveness across other specialities and to better understand the underlying cause of this finding.
Subchondroplasty for Osteonecrosis of the Knee
Authors: Fitzpatrick Brendan R. , Hasanspahic Bilal , Kuechle Joseph B.
Published: March 2023

Subchondroplasty is a relatively new minimally invasive procedure that has been used to treat bone marrow edema associated with osteoarthritis. Subchondroplasty as treatment for early stage osteonecrosis of the knee has not been extensively studied. The authors hypothesized that subchondroplasty may be an effective treatment for relieving pain, improving function, and preventing collapse in osteonecrosis. In this study, a retrospective review of 11 cases of subchondroplasty of the distal femur was conducted. There were no surgical complications with the procedure, and patients reported statistically significant improvement in pain and function. The mean Knee injury and Osteoarthritis Outcome Score for Joint Replacement improved from 44.3±4.9 preoperatively to 65.73±17.2 postoperatively. The mean visual analog scale score for knee pain was 7.8±1.18 preoperatively and 3.7±1.57 postoperatively. There has been one case of recurrence of osteonecrosis and no cases of joint collapse since the procedures occurred between 2018 and 2021. Previously, subchondroplasty for the treatment of osteonecrosis of the talus as well as of the knee joint showed positive results. This study affirms that subchondroplasty may also be a useful treatment option for relieving pain, improving function, and preventing joint collapse in osteonecrosis of the knee. [
Orthopedics
. 2023;46(5):e287–e290.]
Offset Acetabular Liners: Safer Than Previously Thought
Authors: Patel Arpan , Guntin Jonathan , Sobh Ali , Gerlinger Tad L.
Published: March 2023

High offset liners help to restore soft tissue tension after primary total hip arthroplasty (THA). However, prior research has reported increased rates of aseptic loosening when using offset components. The purpose of this study was to examine the postoperative complication and revision rates of neutral vs offset acetabular liners at our institution. Two hundred eight primary THAs in 206 patients performed between 2016 and 2018 using neutral or offset liners were reviewed. All patients had a minimum 2-year clinical follow-up (mean, 3.3 years; range, 2.0–5.7 years). Postoperative complications and revision surgeries were reviewed. All offset liners were 4 mm in thickness. Twelve (10.0%) complications occurred in the neutral liner group, and 13 (14.8%) complications occurred in the offset liner group. Two cases of aseptic loosening occurred in the neutral liner group, with no cases reported in the offset liner group. Nine cases (7.5%) in the neutral group required revision surgery, whereas 3 cases in the offset group required revision surgery. Chi-square analysis found no difference between the groups in the rate of postoperative complications,
χ
2
(1, N=208)=1.09 (
P
>.05), or the rate of revision,
χ
2
(1, N=208)=1.56 (
P
>.05). We found no significant differences between the neutral and offset groups regarding the rates of postoperative complications, aseptic loosening, or revision surgery. Our findings suggest that contemporary high offset liners, up to 4 mm, are safe and effective when attempting to restore native hip mechanics after THA. [
Orthopedics
. 2023;46(5):e298–e302.]
Factors Associated With 30-Day Morbidity and Mortality Following the Surgical Treatment of Olecranon Fractures
Authors: Zhang Dafang , Blazar Philip , Earp Brandon E.
Published: March 2023

The objective of this study was to identify factors independently associated with complications, hospital readmission, reoperation, and death in the 30-day period after surgical treatment of isolated olecranon fractures. A retrospective case-control study was performed using the National Surgical Quality Improvement Program database by querying the
Current Procedural Terminology
code for patients who underwent surgical treatment of isolated olecranon fractures from 2011 to 2020. A total of 4404 patients were included. The main study outcomes were 30-day medical or wound complications, hospital readmission, reoperation, and death. A bivariate screen was performed for explanatory variables associated with our outcome variables, and variables with
P
<.1 in the bivariate screen were included in multivariable regression models. Of the 4404 patients in our cohort, 29 patients (0.7%) developed medical or wound complications, 157 patients (3.6%) were readmitted, 123 patients (2.8%) underwent reoperation, and 12 patients (0.3%) died during the 30-day postoperative period. Multivariable logistic regression analysis showed that older age, smoking, bleeding disorders, and higher American Society of Anesthesiologists classification were associated with readmission; that older age, bleeding disorders, and higher American Society of Anesthesiologists classification were associated with reoperation; and that bleeding disorders were associated with mortality. No identifiable factors were independently associated with medical or wound complications. In this National Surgical Quality Improvement Program database study of olecranon fractures treated surgically during a recent 10-year period, we identified demographic and comorbid factors independently associated with 30-day postoperative readmission, reoperation, and mortality. Our findings are relevant for preoperative risk stratification and counseling. [
Orthopedics
. 2023;46(5):e310–e316.]
Orthopedic Surgery Residencies: The Leap to Social Media
Authors: Bellam Krishna , Yakkanti Ramakanth , Amaya Andrés , Qiu Michelle Feng , Conte Brianna , Aiyer Amiethab
Published: March 2023

Social media has been previously shown to influence applicants' perception of plastic surgery residencies and increase their likelihood to apply, interview, and rank the program. We wanted to analyze this hypothesized trend in the context of orthopedic surgery residency while also characterizing the content of orthopedic surgery residency program accounts. A current list of US orthopedic residency programs was acquired from the American Orthopaedic Association and cross-referenced with the Accreditation Council for Graduate Medical Education webpage of all orthopedic surgery residencies. Forty-five of 185 (24%) residencies had residency-specific Instagram accounts. We analyzed the number of followers, the number of posts, and the date of the first post for each account. We characterized content by categories including science education, recruitment or hospital promotion, resident highlight, news coverage, events, and community building posts. We analyzed the “social currency” of each post and program, tracking the number of likes, comments, and followers. Twenty-seven of 45 (60%) active residency Instagram pages were created in 2020, with 13 of 45 (29%) pages created in June 2020 alone. Residency programs are increasingly turning to Instagram to showcase the residents at their programs, their lifestyles, and program strengths. Sixty percent of all orthopedic residency Instagram accounts were created in 2020 alone, likely precipitated by travel concerns from COVID-19 forcing programs to conduct online interviews and cancel away rotations this application cycle. Going forward, residency programs will continue using Instagram to recruit potential residents, leaving programs without social media accounts at a relative disadvantage in terms of visibility and their ability to recruit qualified applicants. [
Orthopedics
. 2023;46(5):e281–e286.]
The Fate of the Inconclusive Periprosthetic Joint Infection Workup and Reliability of Data Points
Authors: Antonios Joseph K. , Lim Elisabeth S. , Chang Yu-Hui H. , Bingham Joshua S. , Clarke Henry D. , Spangehl Mark J. , Schwartz Adam J.
Published: March 2023

In 2018, periprosthetic joint infection (PJI) criteria were revised to include a new category labeled “inconclusive.” The purpose of this study was to characterize and describe the fate of the inconclusive PJI workup and to analyze preoperative factors associated with outcomes. We reviewed all PJI workups at our institution during a 3-year period (426 patients). Patients were labeled “infected,” “not infected,” or “inconclusive” according to 2018 PJI preoperative criteria. In addition to standard diagnostic variables, the presence or absence of clinical elements that increase the pretest probability of infection were collected. Patients with any missing preoperative diagnostic test results and those with clinical follow-up less than 30 days were excluded. Logistic regression was used to identify the factors associated with infection. Two hundred ninety-six workups remained after exclusion criteria were applied, consisting of 66 (22.2%) with a preoperative score of 6 or greater defined as infected, 52 (17.6%) inconclusive (score 2–5), and 178 (60.1%) not infected (score 0–1). Postoperative re-scoring of the inconclusive group based on intraoperative findings as per the 2018 criteria identified 6 of 52 (11.5%) as infected, 12 (23.1%) inconclusive, and 34 (65.4%) not infected. Among those preoperatively scored as inconclusive, variables statistically correlated with the presence of infection included history of PJI, factors that increase skin barrier penetration (eg, psoriasis and venous stasis), and presence of comorbidities predisposing to infection. For patients labeled inconclusive, clinical elements of the pretest probability for infection (eg, history of prior PJI) were as reliable as any diagnostic test, including alpha-defensin, in the diagnosis of PJI. [
Orthopedics
. 2023;46(5):e291–e297.]
Energy absorption and multi-objective optimization of TPMS filled cylinder shell structures
Authors: Liang Laiyu , Zhu Huaiming , Wei Dong , Wu Yaozhong , Li Weijia
Published: March 2023

Cylinder shell (CS) structures are widely applied in marine industry applications with the characteristics of high loading ability and high energy absorption performance. In this study, the triply periodic minimal surfaces (TPMS) lattices were filled into double cylinder shell structures to construct the cylinder shell (TPMS-CS) structures. The mechanical and energy absorption performances of these structures were investigated by simulation analysis. First, the finite element (FE) model of TPMS-CS structures was verified by experiments. Then, the crashworthiness characteristics of three different kinds of TPMS-CS, namely, primitive, diamond, and gyroid, under axial loading were studied using FE simulation. The results indicate that the diamond-based TPMS-CS structures exhibit a higher energy absorption efficiency compared to their counterparts. Next, parametric studies were carried out to investigate the influence of the design parameters (the relative density of the TPMS, and the inner and outer shell thickness) on the crashworthiness of TPMS-CS structures. Finally, to obtain the optimum design for the TPMS-CS, an optimization framework was proposed by combining the three surrogate models (KGR, PRS, RBF) and multi-objective particle swarm optimization. The optimum design of the D-TPMS-CS structures was obtained based on the proposed optimization framework. The TPMS-CS structures proposed in this study can also be applied in other engineering applications as energy absorbers.
EVALUATING THE CLIMATIC POTENTIAL OF PASSIVE STRATEGIES FOR RESIDENCES IN FOUR CITIES UNDER THE WARM-HUMID CLIMATE OF SOUTH INDIA
Authors: Visakha Ar. Vishnubhotla Lakshmi , Srinivas Dr Tadepalli
Published: March 2023

Design guidelines prescribed by climate analysis tools are broad and similar for various cities under the same climate zone overlooking the impact of altitude, latitude, and surrounding geographical features. Boundary conditions determined by International Standards underestimate the cooling potential of passive strategies in the free-running mode in warm-humid climates. Thus, a climate file-based study is conducted to determine city-specific requirements for the residential building program. Indices like Climatic Potential for Natural Ventilation and Climatic Cooling Potential are used in conjunction with the Indian Model for Adaptive Comfort to define boundary conditions for Natural Ventilation, Nocturnal Ventilation Potential, and Thermal Mass Potential in four inland and coastal cities in the warm-humid climate of South India. With the least Natural Ventilation Potential, mixed-mode operation of buildings is feasible in Nagercoil. Elevated airspeeds benefit Tiruchirappalli and Chennai during the day. With a Nocturnal Ventilation Potential of 10–20%, passive dehumidification is favorable in all cities. Results show that the climatic potential for each strategy varies with location and plays an important role in developing city specific design inputs for residences.
HABITAT SAFETY EVALUATION OF SUSTAINABLE HOUSING FROM THE PERSPECTIVE OF HOUSEHOLDS
Authors: She Yujun , Wu Shurui , Wang Yu , Zhu Yahui , Jiao Liudan
Published: March 2023

In recent years, the housing market has developed rapidly during the process of urbanization. Since people require adequate housing safety, safety challenges associated with housing have received increasing attention. Although development of sustainable housing was rapid in the last few decades, insufficient studies considered households’ needs and examined the health and psychological safety issues in sustainable housing. This study aims to establish an indicator system and develop a model to evaluate habitat safety from three dimensions: physical safety, health safety, and psychological safety. This study develops an evaluation system containing 46 indicators to assess the safety performance of sustainable housing from households’ perspectives. In addition, criteria importance through intercriteria correlation (CRITIC) method is combined with the Cloud Model to provide systematic and visual evaluation results. A government-funded sustainable housing project in Chongqing, China, is selected as a case study and questionnaire surveys were delivered to collect the raw data of subjective ratings on the 46 safety indicators. The following findings are observed: (1) there is a prominent demand for improvement in psychological safety of sustainable housing, followed by health safety; (2) different age groups have different safety needs; and (3) regulations and standards are very important to improve the habitat safety of sustainable housing. The study considers safety issues from households’ perspectives and introduces a different idea of human safety in sustainable housing. It provides an effective method to evaluate housing safety and could be a useful reference for further development of sustainable housing.
AN OVERVIEW OF TRADITIONAL HEATING, VENTILATION, AND ILLUMINATION TECHNOLOGIES IN HISTORIC BATHS AND THEIR CONTEMPORARY INSPIRATIONS
Authors: Gülşen Dişli , İsmail Atan
Published: March 2023

Passive heating, lighting, and ventilation techniques in historic buildings and their sustainability in conjunction with new designs are essential to maintaining a greener, ecological environment. This article describes a framework for identifying and disclosing the passive survival strategies and resulting solutions applied to historic baths in Anatolia. The aim is to first increase knowledge and awareness of ancient systems and to discuss and examine their contemporary inspirations and considerations of existing and new construction technologies. A total of four baths from the Roman, Byzantine, Principalities and Ottoman periods in Anatolia were selected. Their original heating, lighting, and ventilation systems were determined largely through on-site observations, literature review, and archival sources. The results indicate that in today’s modern residential, industrial or commercial buildings, reflections of these ancient technologies and traditional concepts can be observed as the main source of inspiration. They can be seen either in the form of light pipes, underfloor heating systems, or a double-skin façade. The old technologies and solutions of historic baths are mostly sustainable and ecological. Looking back at these historic technologies can inspire further ecological design developments and symbiotic implementation possibilities in new building designs.