bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effects of Diminished Reality on the Detection of and Response to Notifications
Authors: Richardson Khalaeb , Collins McLaughlin Anne , McDonald Mitchell , Crowson Aaron
Published: November 2021

Many environments contain visual and auditory distractions. Cognitive aids help limit these distractions, support attention, and improve task performance. One way this is done is by adding information to the environment via Augmented Reality (AR). Attention may also be supported by removing distractors using Diminished Reality (DR), a form of AR that computationally erases, de-emphasizes, or otherwise diminishes external stimuli. However, there was no research investigating the design of the control and display system for DR technology and the question of how to redirect or gain someone’s attention when their environment is diminished had not been addressed. This study explored the acceptability and effectiveness of notifications with varying attributes and fills that gap in research. Results indicated that low specificity notifications in a diminished environment are rated as being subjectively better than notifications of other formats; low specificity messages were also recalled at a greater rate.
Tapering Chronic Opioid Medications: A Human Factors Approach to Building a Provider-Facing App
Authors: Kazi Sadaf , Hettinger Aaron Z. , Littlejohn Robin , Busog Deanna-Nicole , Miller Kristen E.
Published: November 2021

Approximately 25.3 million adults in the U.S. take prescription opioid medication to provide relief from their daily pain. Over-prescription of these medications has contributed to the opioid epidemic in the U.S. Many patient desire tapering opioids. However, guidelines of opioid tapering are complex and difficult to translate into practice at the point of care. Our research used human factors methods, including participatory ergonomics, task analysis, interviews, and usability testing to design a provider app to aid safe opioid tapering. We present preliminary prototypes of our app that is currently being deployed across a large 10-hospital healthcare system in the mid-Atlantic region. Our app will be integrated into the electronic health record and comprises five sections: Patient Context, Taper Settings, Create Taper Plan, Withdrawal and Non-opioid Pain Plan, and Summary Dashboard.
Assessment of Driving Automation Interfaces via Visual Attention Measures: A Literature Review
Authors: Kanaan Dina , Powell Mattea , Donmez Birsen
Published: November 2021

Different in-vehicle interface designs have been proposed to support drivers in operating vehicle automation systems. Measures of visual attention are particularly useful in the evaluation of such interfaces, especially in conditions when driving performance measures cannot be used, i.e., when the driver is not physically controlling the vehicle. In this paper, we present a literature review on visual attention measures in the assessment of in-vehicle interfaces to support the use of driving automation. This review was a preliminary pilot study for a larger, ongoing scoping review investigating visual attention and driving automation more broadly. Based on a systematic search of one engineering literature database, this review focused on driving automation that does not require the driver to physically control the vehicle but does require driver involvement in some capacity. The findings of this review contributed to the development of the larger review and can help identify future research trends.
Noncompliance and Decision-Making of Airline Pilots: An Analysis of Narratives From the Aviation Safety Reporting System
Authors: Lang Caitlin J. , Jentsch Florian
Published: November 2021

The purpose of this study was to identify self-reported flight deck noncompliance in aviation safety reports and explore the relationship between adaptive expertise, deliberate vs. non-deliberate actions (errors), and intentional vs. unintentional noncompliance. The heuristics for assessing adaptive thinking and behavior were based on subscales of the Adaptive Expertise Survey (AES; Fisher & Peterson, 2001). We analyzed a random sample of 200 ASRS reports from 2019 and coded them with respect to (a) whether they described intentional or unintentional noncompliance by one or more flightcrew members, (b) whether the decision making was deliberate, and (c) whether the decision-making process involved correlates of adaptive or routine (non-adaptive) expertise. We found that unintentional noncompliance was associated most frequently with non-deliberate actions and non-adaptive behaviors. Adaptive behaviors were strongly associated with deliberate actions and intentional noncompliance. Our on-going research to investigate adaptive expertise and its relationship with predictors of noncompliance is discussed.
Development of a Full-body OpenSim Musculoskeletal Model Incorporating Head-mounted Virtual Reality Headset
Authors: Humphrey Quentin , Srinivasan Manoj , Mubarrat Syed T. , Chowdhury Suman K.
Published: November 2021

In this study, we developed and validated a full-body musculoskeletal model in OpenSim to estimate muscle and joint forces while performing various motor tasks using a virtual reality (VR) system. We compared the results from our developed full-body musculoskeletal model to those from previous studies by simulating kinematic and kinetic data of participants performing pick-and-place lifting tasks using with and without a physically interactive VR system. Results showed that scaling errors between the two environments are comparable, while the overall errors were consistent with previous studies. Overall, the results from the inverse dynamic simulations showed the promise of our developed OpenSim models in determining potential intervention or prevention strategies to reduce the musculoskeletal injury incidences while simulating human-device interaction tasks.
Driver Attention And The Built Environment Initial, Findings From A Naturalistic Driving Study
Authors: Tice Patricia , Dey Tirtha Sudipta , Eluru Naveen
Published: November 2021

Maintaining driver attention is critical in multimodal urban spaces where risks to vulnerable users are not borne by the drivers that impose them. However, without an understanding of what it is within the built environment that elicits appropriate driver attention, it will be difficult to reduce the escalating tide of pedestrian fatalities we currently are experiencing. This study uses eye glance data from a naturalistic driving study tabulated for on-task vs. off-task driving and detailed tabulations of environmental variables to identify which features within the built environment have a significant impact on driver attention. An econometric utility model was generated that identified corridor pavement width, reduced drivewayspacing, and linearly aligned street trees as design features that have a positive impact on driver attention.One-way streets, undelineated parking or unstriped bicycle lanes reduce drivers need to attend. Recommendations for maintaining driver attention within urban spaces are included.
Solar Installations & Their Occupational Risks
Authors: Duroha Jesse C. , Macht Gretchen A.
Published: November 2021

With the solar industry’s rapid growth, it is crucial to continuously review and assess the occupational risks associated with photovoltaic (PV) installations. PV installers are exposed to severe occupational risks, including but not limited to electrocution, heat stress, fall accidents, and manual handling risks. However, it is unclear what research is being done to mitigate these risks and where more research is required. Therefore, this paper performs a systematic literature review using the Scopus database to comprehensively review and identify: (1) the current knowledge available regarding the occupational risks associated with PV installations, (2) the health and safety effects these risks have on PV installers, (3) the research being done to mitigate them, and (4) the knowledge gaps for future research. This research can guide areas for future research concerning occupational safety and health in the PV installation sector.
Development of a Team Role Behavior Observation Tool: Insights and Considerations for Future Research
Authors: Griggs Andrew C. , Rogers Jordan E. , Gisick Logan M. , Lazzara Elizabeth H. , Keebler Joseph R. , Cohen Tara N.
Published: November 2021

Today’s workforce is dependent on teams. Organizations are interested in positively influencing antecedents to team effectiveness such as team composition. While many factors have been studied thoroughly concerning team composition and effectiveness, team roles have not received comparable attention. Team roles refer to groups of generalizable, goal-directed behaviors that support team performance. Current team role assessments are reliant on surveys and peer ratings. To explore avenues that would enable comparisons between survey-based measures of team roles with benchmarks of observable behavior, we developed a behavior observation tool based on a team role taxonomy known as Team Role Experience and Orientation (TREO). We present the first iteration of this tool based on our review of team role literature, results of an inter-rater reliability assessment, and discuss its potential impact concerning future research and organizational utility. More work is needed to develop a construct-valid behavioral team role assessment.
Do touchscreens make intelligent personal assistants more usable? An initial usability study
Authors: Montalvo Fernando , Schreck Jacquelyn , Krause Kendahl , Sasser Jordan , McConnell Daniel S. , Smither Janan A.
Published: November 2021

Intelligent personal assistants (IPAs) have gained in popularity over the last decade. However, while the devices have been adopted in over a quarter of US households, users often fail to engage with the devices regularly once the initial novelty use wears off and users fail to find new and useful ways in which to interact with the devices. One way companies improve both the usability of the devices and a user’s conceptual model of what an IPA is capable of is through the use of built-in touchscreen displays which can offer passive suggestions to users, increasing knowledge of available features and interactions. We compared two standalone IPAs to test if including a touchscreen on the device improved usability and perceived usefulness. Results indicate that touchscreen displays do not necessarily improve the usability, perceived usefulness, or perceived task effectiveness of an IPA device.
Automated Alert Failures and their Impact on Operator Performance and Trust
Authors: Ferraro James C. , Mouloua Mustapha
Published: November 2021

Despite its rapid advancement, automation remains vulnerable to system failures. The reliability of automation may impact users’ trust and how they interact with it. Additionally, the type of error can uniquely redirect user behavior. This study investigated how reliability and error type impact operator trust and monitoring performance. Participants completed a monitoring task at either 50% or 90% reliability, experiencing either misses or false alarms from an automated alert system. It was hypothesized that automation reliability would impact trust, while error type would also impact reliance and compliance behaviors. Results indicated that misses had a greater impact on monitoring performance than false alarms, while reliability did not influence performance. Trust was not influenced by reliability or error type and showed no relationship with performance measures. These results can help further clarify the way automation failures shape how humans interact with automation and inform the design of future automated systems.
Car Crash Speed Estimates Not Biased by Leading Questions
Authors: Raghunath N. , Fultz A.A. , Sanchez C.A.
Published: November 2021

Individuals’ recollections of events have been shown to be susceptible to external factors, especially when it comes to speed estimations. This study explored the impact of perceptually disfluent presentations and presentation modalities of car crashes on observers’ estimations of speed, in addition to the testing the currently accepted effect of leading questions on the same. Participants viewed videos or images of car crashes, presented in higher or lower visual quality, and reported how fast the vehicles were traveling when they “made contact” or “smashed into” each other. Results showed that neither question phrasing, visual quality, nor presentation modality of car crashes affected speed estimates. Individuals who believe cars to travel at higher speeds, however, in general estimated higher speeds when viewing car crash images, especially when presented in lower visual quality. These findings suggest that a combination of external factors may influence event recall depending on individual’s pre-existing beliefs about car speeds, and should be considered prior to obtaining eyewitness accounts.
Team Role Experience and Orientation Dimensions in Predicting Team Performance in a Spaceship Bridge Simulation
Authors: Fausett Crystal M. , Simonson Richard J. , Griggs Andrew C. , Keebler Joseph R.
Published: November 2021

Team roles have been suggested to be a key predictor of team performance metrics, however, there is little research in this area. We introduce a structural equation model of the relationship between team composition as measured by Team Role Experience and Orientation (TREO) dimensions and team performance metrics in a co-operative spaceship simulation game. The results of the model indicate that variance in team composition operationalized as team roles and mediated by resources accounts for 52.5% of the team’s performance, however, the influence of team roles is minimally predictive. These results call into question the predictive validity of team roles as measured by TREO dimensions when applied as a team input variable. Our investigation suggests further study into team roles’ predictive ability on team performance is needed.
Neuromuscular Analysis Of Various Release Mechanisms In Archery: A Study Of The Preparatory Response Between Trigger And Back-Tension Releases
Authors: T. Stone Richard , Fales Colten , Sabers Hunter , Cavanah Elizabeth , Kim Joseph
Published: November 2021

Archery was originally a tool for hunting but since has been transformed into a sport. Archery technology has evolved with little focus as to its effect on humans. Archery requires high levels of concentration and static muscle activity, which has not been analyzed to be successful. By observing the muscle activity in the bow arm and measuring the vibration effects from the bow, it was determined a presence of an impact to the human arm, which the human then creates anticipation for and braces against. To mitigate this anticipation, another technology was introduced to create a surprise factor in the shooting. To reduce the frequency of archers bracing up for the shot, knowledge of when the shot is going off was taken away. It was observed that the new technology did introduce a surprise factor, but it did not reduce the occurrences of preparatory muscle activation in the human arm.
Beat the Bots: Exploring the Effects of Placebo Manipulation on Performance During Video Gameplay
Authors: Brantley Sean , Wilkinson Michael , Feng Jing
Published: November 2021

This study investigates placebos and video games’ usefulness as psychological research tools. One proposed underlying mechanism of the placebo effect is participants’ expectations. Such expectation effects exist in sports psychology and healthcare domains, but inconsistent findings have emerged on whether similar effects impact a participants’ cognitive performance. Concurrently, using video games as task environments is an emerging methodology relating to expertise and large-scale behavioral data collection. Therefore, this study examines the expectancy effect induced by researcher instructions on in-game performance. The instructional expectancy condition for this study is in-game successes framed using emoting (e.g., emoting under the pretense of subsequent performance increases) versus a control group. Preliminary results showed no evidence of different in-game performance between expectancy conditions. Potential mechanisms that could have led to a lack of effect were discussed.
Assessing Video Game Satisfaction of Gamers with Disabilities
Authors: Van Ommen Carmen , Chaparro Barbara S.
Published: November 2021

According to a survey conducted by the CDC, it is estimated that 26% of Americans are living with a disability. Of those with disabilities in the United States, it is estimated that 33 million play video games. People with disabilities face many barriers in gaming, which is likely to impact game satisfaction. Measuring game satisfaction among this population can be problematic if the scale is not adapted to their needs, which can vary significantly based on the disability. To understand how best to assess game satisfaction among these populations, we discuss the issues people with cognitive, sensory, and/or motor disabilities may face when completing assessment scales and then use the validated Game User Experience Satisfaction Scale (GUESS) as a framework for understanding the game design issues that may impact satisfaction.
Is Virtual Reality Streaming Ready for Remote Medical Education? Measuring Latency of Stereoscopic VR for Telementoring
Authors: Celebi Kerem C. , Bailey Shannon K. T. , Burns Micheal W. , Bansal Kunal
Published: November 2021

Telementoring in healthcare education has been used successfully to teach technical skills and clinical reasoning when in-person instruction is not feasible; however, previous technology for telementoring had limitations such as narrow field-of-view and high latency. Novel virtual reality (VR) livestreaming technology may address issues in traditional 2-dimensional (2D) systems by expanding the field of view while streaming with low latency. Low latency streaming of video and audio is necessary for smooth communication between a medical specialist and remote trainees. If latency is low between the instructor and the remote trainees, conversations can be held without a noticeable delay, supporting synchronous instruction and collaboration. This research reports the first latency test results of a novel VR system that livestreams stereoscopic video and audio to remote VR headsets. Results showed the one-way audio and video latency was less than half a second, confirming the viability of live VR for medical telementoring.
Using Cost Efficient Augmented Reality Glasses in Anatomical Identification
Authors: Krause Q. , McCrory B.
Published: November 2021

Augmented Reality (AR) is an emerging technology capable of integrating visual technology with the physical world in novel ways. AR uses may range from education delivery to the operating room. This study sought to evaluate cost-effective AR glasses compared to a traditional computer screen when identifying anatomical structures in a chest radiograph (X-ray). The purpose of this experiment was to determine if the Vuzix Blade AR technology is feasible for use in the medical field to identify anatomical structures. Novice undergraduate and graduate students (n = 14) were recruited to participate in this feasibility study. Radio-graphic images were compiled, and subjects were asked to identify 12 anatomical structures on each image. Images were randomly assigned to identify structures using either the AR glasses or a traditional computer screen for each set. Images were viewed randomly by each subject using a crossover design to compare traditional computer screen vs. AR screen. Subjects identified statistically fewer anatomical structures using the AR glasses compared to using the traditional computer screen (p<0.01). However, the glasses did not require significantly more subjective workload (NASA-TLX) on the user to use compared to the computer screen. When subjects used the cost-effective AR glasses, subjects were unable to differentiate as many anatomical structures as possible (10 vs. 9 structures at p < 0.01), but the glasses were not more demanding overall. Thus, AR glasses may soon be an integral part of the operating room, provided adequate resolution to visualize the necessary details.
Engagement and time perception in virtual reality
Authors: Read Tyler , Sanchez Christopher A. , De Amicis Raffaele
Published: November 2021

Virtual reality (VR) is a simulation tool that is being used extensively to study the effects of training and perception. However, several studies have shown that some aspects of perception within VR are not always accurate. The present study investigates the perception of time within a VR environment by asking for retrospective time judgments of the length of VR experiences. These environments varied in both the level of interaction with the VR environment, and also the spatial properties of the environment itself. The judged length of time did not significantly differ between conditions based on the level of activity in the environment. However, the spatial properties of the VR environment did produce significantly different time estimations. This finding suggests that careful attention should be paid to what and how users are trained or evaluated in VR.
The Effects of Physical and Psychological Stress on Task Load Assesment and Grammatical Reasoning Among Special Forces Soldiers
Authors: Kallinen Kari , Ojanen Tommi
Published: November 2021

We examined the effects of a stressful training course exercise on soldiers stress hormone (cortisol levels), subjective workload and grammatical reasoning. Saliva samples, Baddeley 3-minute reasoning test and NASA-TLX workload assessment were collected 10 minutes before the course (PRE measurement), immediately after the course (POST measurement) and 12 and 20 minutes after the course (Recovery 1 and Recovery 2 measurements). Workload was lowest in PPE-measurement, highest in POST-measurement immediately after the course and declined near to the PRE level during the recovery measurements. The levels of cortisol concentrations and grammatical reasoning test scores followed the same trend.
Towards a Conceptual Framework of Comprehensive Video Game Player Profiles: Player Models, Mental Models, and Behavior Models
Authors: Williams Jessica , Bendell Rhyse , Fiore Stephen M. , Jentsch Florian
Published: November 2021

Current approaches to player profiling are limited in that they typically employ only a single one of numerous of available techniques shown to have utility for categorizing and explaining player behavior. We propose a more comprehensive Video Game Player Profile Framework that considers the demographic, psychographic, mental model, and behavioral modeling approaches shown to be effective for describing gamer populations. We suggest that our proposed approach can improve the efficacy of video game player profiles by grounding data-driven techniques in game analytics with the theoretical backing of demographic, psychometric, and psychographic measurements. We provide an overview of our proposed framework, discuss the usage and relevance of each component technique, and provide a proof-of-concept demonstration with archived data.
Supporting Social Interactions In Human-Ai Teams: Profiling Human Teammates From Sparse Data
Authors: Bendell Rhyse , Williams Jessica , Fiore Stephen M. , Jentsch Florian
Published: November 2021

Artificial intelligence has been developed to perform all manner of tasks but has not gained capabilities to support social cognition. We suggest that teams comprised of both humans and artificially intelligent agents cannot achieve optimal team performance unless all teammates have the capacity to employ social-cognitive mechanisms. These form the foundation for generating inferences about their counterparts and enable execution of informed, appropriate behaviors. Social intelligence and its utilization are known to be vital components of human-human teaming processes due to their importance in guiding the recognition, interpretation, and use of the signals that humans naturally use to shape their exchanges. Although modern sensors and algorithms could allow AI to observe most social cues, signals, and other indicators, the approximation of human-to-human social interaction -based upon aggregation and modeling of such cues is currently beyond the capacity of potential AI teammates. Partially, this is because humans are notoriously variable. We describe an approach for measuring social-cognitive features to produce the raw information needed to create human agent profiles that can be operated upon by artificial intelligences.
Macular and peripapillary microvasculature after dexamethasone injection in diabetic macular edema
Authors: Ozcalıskan Sehnaz , Pehlıvanoglu Seren , Huseyınhan Zahid , Alagoz Cengiz , Erdogan Gurkan , Artunay Ozgur
Published: November 2021

Purpose

To evaluate the microvascular changes in the macular and peripapillary area after intravitreal dexamethasone implant in diabetic macular edema (DME)

Material and Methods

We included 31 eyes of 31 patients treated with a single dose dexamethasone implant for DME. All subjects underwent swept-source optical coherence tomography (OCT) and OCT angiography imaging before (T0), and one month (T1), two months (T2), and four months (T4) after dexamethasone injection. The foveal avascular zone (FAZ) area of superficial and deep capillary plexus (SCP and DCP) was calculated by delineating the FAZ border using the measurement tool of the device. The vessel density (VD) of SCP and DCP and choriocapillaris (CC) in the macular and peripapillary area were automatically calculated.

Results

There was an insignificant reduction in FAZ area measurements of SCP after dexamethasone injection in DME patients (p = 0.846). The FAZ area of DCP were significantly smaller compared to T0 measurements at T1, T2, and T4 (p = 0.013, p = 0.031, and p = 0.029, respectively). The mean average parafoveal VD measurements were significantly decreased after dexamethasone injection in SCP and DCP (p = 0.004, p = 0.005). The peripapillary VD in retinal capillary plexuses and choriocapillaris showed no significant difference after dexamethasone injection.

Conclusion

Intravitreal dexamethasone leads to a significant FAZ area decrease in DCP with a reduction in parafoveal VD measurements. In addition, no significant VD changes were observed in the peripapillary area after dexamethasone. These findings indicate that dexamethasone may improve macular ischemia with no significant effects on peripapillary microvasculature in DME patients.
Effectiveness and safety of intravenous dexmedetomidine sedation for ophthalmic surgery under regional anesthesia
Authors: De Nucci Annalisa , Scialdone Antonio , Lando Gabriele , Monaco Gaspare , Cacioppo Viviana , Campbell Davies Sophia , Casalino Giuseppe , Gemma Marco
Published: November 2021

Purpose

To assess the effectiveness and safety of intravenous (IV) dexmedetomidine for sedation in ophthalmic surgery.

Methods

Prospective, observational, uncontrolled, single-center study. Patients were sedated with a continuous dexmedetomidine IV infusion started 15 min before regional anesthesia administration and maintained up to the end of surgery. Effectiveness of dexmedetomidine was assessed by the Modified Observer's Assessment of Alertness and Sedation (MOAA/S) targeted at 5. Safety was assessed by the incidence of patients’ movements/snoring and by the incidence of respiratory and haemodynamic complications. An eleven-point numerical rating scale (NRS) was used to assess the level of satisfaction of both the surgeon and the patient.

Results

123 patients (73 males, mean age: 63 ± 13) were included; 81 (81/123; 65.8%) patients reached the requested MOAA/S score of 5. Any intraoperative movement – mostly voluntary – occurred in 34 (34/123; 27.6%) cases with no need for a switch to general anaesthesia; no ocular complications related to the intraoperative movements occurred. Intraoperative snoring occurred in 30 (30/123; 24.4%) patients and it did not affect the surgical manoeuvres. Respiratory drive depression requiring manual or mechanical ventilation never occurred. Bradycardia occurred in 14 (14/123; 11.3%), cases but only 4 (4/123; 3.2%) patients required atropine administration, which was always effective. Intraoperative analgesia was consistently obtained and both the surgeons and the patients reported a high NRS satisfaction score.

Conclusion

Dexmedetomidine provided adequate sedation in patients undergoing ocular surgery under local anaesthesia and showed a good effectiveness and safety profile. Upper airway obstruction, apnoea and snoring can occur.
Implementation of ultrasound after central venous catheter insertion: A qualitative study in early adopters
Authors: Ablordeppey Enyo A , Keating Shannon M , Brown Katherine M , Theodoro Daniel L , Griffey Richard T , James Aimee S
Published: November 2021

Background:

The adoption rate of point of care ultrasound (POCUS) for the confirmation of central venous catheter (CVC) positioning and exclusion of post procedure pneumothorax is low despite advantages in workflow compared to traditional chest X-ray (CXR). To explore why, we convened focus groups to address barriers and facilitators of implementation for POCUS guided CVC confirmation and de-implementation of post-procedure CXR.

Methods:

We conducted focus groups with emergency medicine and critical care providers to discuss current practices in POCUS for CVC confirmation. The semi-structured focus group interview guide was informed by the Consolidated Framework for Implementation Research (CFIR). We performed qualitative content analysis of the resulting transcripts using a consensual qualitative research approach (NVivo software), aiming to identify priority categories that describe the barriers and facilitators of POCUS guided CVC confirmation.

Results:

The coding dictionary of barriers and facilitators consisted of 21 codes from the focus group discussions. Our qualitative analysis revealed that 12 codes emerged spontaneously (inductively) within the focus group discussions and aligned directly to CFIR constructs. Common barriers included provider influences (e.g. knowledge and beliefs about POCUS for CVC confirmation), external network (e.g. societal guidelines, ancillary staff, and consultants), and inertia (habit or reflexive processes). Common facilitators included ultrasound protocol advantage and champions. Time and provider outcomes (cognitive offload, ownership, and independence) emerged as early barriers but late facilitators.

Conclusion:

Our qualitative analysis demonstrates real and perceived barriers against implementation of POCUS for CVC position confirmation and pneumothorax exclusion. Our findings discovered organizational and personal constructs that will inform development of multifaceted strategies toward implementation of POCUS after CVC insertion.
Vessel diameter and close surveillance helps predict early patency in native arteriovenous fistulas
Authors: Kirkham Emily N , Fallon John , Foy Chris , Harris Sophie , Birch Gemma , Bullingham Julie , Pickett Thomas M , Kulkarni Sachin R , Paravastu Sharath CV , Cooper David G
Published: November 2021

Introduction:

Arteriovenous fistulas are the preferred method of vascular access for haemodialysis. Data suggests patency rates can be low and may be related to vessel diameters prior to creation. We use specific size criteria for fistula selection. We aimed to establish patency rates in relation to vessel size and whether other factors affect fistula patency.

Methods:

Consecutive patients undergoing radiocephalic (RCF) or brachiocephalic (BCF) creation between 2016 and 2018 were analysed. Preoperative arterial and venous diameters were collected. Six-week and six-month primary and secondary patency rates were analysed to establish any impact of vessel size on patency and re-intervention rates between groups. A univariate analysis was performed.

Results:

Ninety four RCFs and 101 BCFs were created. Median artery and vein size for RCF were 2.7 and 3.0 mm respectively. For BCF, they were 4.6 and 4.3 mm respectively. At 6-weeks, overall satisfactory patency for RCF and BCF combined was 91.8%. 89.7% demonstrated primary patency; 2.1% secondary patency. At 6-months, overall patency was 78.7%; 58.5% demonstrated primary patency, 20.2% secondary patency. A univariate analysis, for both groups, revealed vein size was a significant predictor of overall satisfactory patency at 6-weeks, with larger veins more likely to remain patent ( p = 0.025 RCF, p = 0.007 BCF). However, artery size was not predictive ( p = 0.1 RCF, p = 0.5 BCF). At 6-months, neither artery nor vein diameter were predictive in either group. When comparing size of vessel based on fistula type, vessels used to create RCFs were smaller than those for BCFs ( p < 0.001). RCFs were more likely to receive endovascular intervention or occlude when compared to BCFs ( p = 0.014).

Discussion:

Excellent patency and maturation rates can be achieved using fairly strict vessel size criteria. Vein size might be the more important predictor of early success. RCFs can be challenging due to smaller vessels, but maturation rates can be optimised by close surveillance and aggressive re-intervention.
The power struggle: exploring the reality of clinical reasoning
Authors: Pillay Thiani , Pillay Mershen
Published: November 2021

Purpose:

Historically, clinical reasoning has largely been considered from an empirical, biomedical standpoint. This epistemology, rooted in imperial rule, is influential in how healthcare practitioners practice. An empirical approach to healthcare often oversimplifies the complex nature of clinical reasoning by obscuring the influence of imperial ideologies on decision-making. This can perpetuate inequitable approaches to healthcare delivery which deepen social, political and economic divides globally. This paper aims to explore and challenge this standpoint by exploring how power, imperialism and performativity influences healthcare provision and decision-making amongst healthcare practitioners in dysphagia rehabilitation.

Methods:

Qualitative exploratory interviews were undertaken with seven South African trained SLPs with experience working in dysphagia. To allow for participation and collaboration from participants, three data collection tools were employed within the interviews: oral histories, cognitive mapping and arts-based tasks. An initial modified thematic analysis followed by a further ideological analysis were undertaken to analyse the data collected.

Results:

The results suggest that the participants felt influenced by several manifestations of power within healthcare. We argue that this demonstrates that imperial practices can influence knowledge, interaction and context and therefore affect how healthcare practitioners make decisions.

Conclusion:

By acknowledging the impact of imperialism and power dynamics on healthcare provision and clinical reasoning we can potentially begin to transform the epistemology from which we approach healthcare provision in favour of one which is better suited to the current realities of healthcare to allow for equitable service provision.
Music as a Healing Medicine in COVID-19 Pandemic
Authors: Situmorang Dominikus David Biondi
Published: November 2021

This article presents that the use of music like “A Prayer for Nation” during the COVID-19 outbreak is an alternative healing medicine helping people to reduce their loneliness, depression, stress, and anxiety. In a multicultural, pluralistic country like Indonesia, this song has the pastoral power to uplift, unite, and heal.
The Impact of Privatization on Minority Faith Prison Chaplains in Canada
Authors: Abdulkadir Adar , Long Ibrahim J.
Published: November 2021

Canadian federal prison chaplaincy underwent a major shift in 2013 when the provision of its services was privatized and outsourced to a single for-profit company. This article presents a summary of the experiences and concerns expressed by minority faith chaplains serving in federal correctional institutions following privatization. It is based on ten in-depth, semi-structured interviews with minority faith prison chaplains. The results show that minority faith federal prison chaplains are concerned about increased levels of bureaucratization that have compromised the quality of spiritual care available to prisoners, reductions in resources for chaplains, and increased levels of emotional exhaustion and frustration among themselves and fellow minority faith chaplains serving in Canadian correctional facilities.
Syntheses, crystal structures, and fluorescent properties of three coordination polymers with 5-sulfoisophthalic acid anion and 4-phenylpyridine
Authors: Chen Fangmin , Zhou Chichi , Li Yan , Zhang Xiuqing
Published: November 2021

Three coordination polymers—{[Ag2(SIP)(4-pp)]·[Ag(4-pp)2]·H2O}n, [Pb4(SIP)2( μ3-OH)2(H2O)2]n, and {[Zn2(SIP)2(4-pp)4][Zn(4-pp)2(H2O)4]·4H2O}n (SIP = 5-sulfoisophthalic acid anion, 4-pp = 4-phenylpyridine)—are constructed under hydrothermal or solvothermal conditions using sodium m-phthalate 5-sulfonate (NaH2SIP) and 4-phenylpyridine as ligands. The structures of the three complexes are determined by single-crystal X-ray diffraction, powder X-ray diffraction, thermogravimetric analyses, Fourier-transform infrared analysis, and photoluminescence. The fluorescent properties of the complexes in the solid state are investigated at room temperature, and the results indicate that they all show photoluminescent properties.
Radical men and sympathizing women? Gendered constructions of agency in charges of terrorism in Germany
Authors: Eppert Kerstin , Roth Viktoria
Published: November 2021

In the past, scholarly research in extremism and terrorism studies tended to analyse women’s engagement with violent ideology-based groups from a normative angle, framing female commitment to radical ideologies and violence as cases of inherent victimization or as instigated by a dominant male. Particularly in the negotiation of women’s transnational support of terror organizations in Syria, gendered frames of political agency have been reproduced in the institutional practices of the judiciary. Taking the case of Germany and four appeals lodged at the Federal Court of Justice between 2015 and 2017 as examples, this article analyses gendered conceptions of agency in argumentation with respect to criminal liability in the context of extremist engagement in Syria. It identifies, first, the gendered construction of defendants before the courts and inherently gendered assumptions about agency and second, a formal organizational understanding in the terrorism clauses as the two underlying problems and suggests that current concepts in terrorism norms at national, EU und international levels deflect the focus on the wider conflict dynamics where civilians’ support to violence is concerned.
Evaluating the Sustainability Issues in Tourism Development: An Adverse-Impact and Serious-Level Analysis
Authors: Wu Zilin , Lai Ivan Ka Wai , Tang Huajun
Published: November 2021

Sustainable tourism has become an increasingly important topic in tourism development research. This study attempts to identify a set of sustainability issues that negatively affect residents’ attitudes toward tourism development. This study extends the importance-performance analysis (IPA) into the “adverse-impact and serious-level analysis” (AISLA) to evaluate sustainability issues in tourism development. A survey was carried out with 430 residents in Macau. According to the results of AISLA, the government was recommended to take “concentration” actions to reduce the levels of impacts of some economic (including inflation, urban service charge, and housing price) and environmental (including noise pollution and destruction of natural landscapes) issues. Furthermore, the government of Macau should take “keep down” actions for most of the socio-cultural issues. This work provides a new perspective for the government to develop sustainable tourism.
The Use of Anglicisms in the Field of Education: A Comparative Analysis of Romanian, German, and French
Authors: Șimon Simona , Stoian Claudia E. , Dejica-Carțiș Anca , Kriston Andrea
Published: November 2021

The era of globalization has led to frequent communication among people with different linguistic and cultural backgrounds, carried out usually in English, the modern lingua franca. English has influenced the languages of the world, which have started to borrow words in order to keep up with progress and internationalization. Anglicisms are used in almost every field, education being one of them. This paper highlights the presence of Anglicisms in the field of education, and focuses on a multilingual dictionary of education, from which it gathers a corpus in three different languages: Romanian, German, and French. The study aims to identify the Anglicisms employed in the educational field in the three languages aforementioned, and to analyze them comparatively, pointing out the similarities and differences among the languages in question.
Comparison of Initial Stability of Oblong, Large Circular, and Multiple-Plug “Snowman” Osteochondral Autografts for Elongated Focal Cartilage Lesions: A Biomechanical Study in a Porcine Model
Authors: Dwivedi Shashank , Kutschke Michael , Nadeem Maheen , Owens Brett D.
Published: November 2021

Background:

Distal femoral osteochondral allograft transplantation (OAT) is an effective treatment of osteochondral lesions in the knee measuring >2 cm2 in select patients. Prior studies have demonstrated that the morphology of the plug can affect graft-host interference fit. To our knowledge, there are no data comparing the initial biomechanical stability of standard cylindrical plugs with multiple-plug and oblong-plug morphologies.

Hypothesis:

Large cylindrical single-plug (LCSP) and oblong single-plug (OSP) grafts will have greater pull-out strength, and therefore greater initial stability, than multiple-plug (MP) grafts in a cadaveric porcine femur model.

Study Design:

Controlled laboratory study.

Methods:

A total of 55 porcine distal femurs were divided into 3 groups—LCSP (n = 18), OSP (n = 19), and MP (n = 18)—according to the plug morphology used. The method of graft harvesting and implantation was based on technique guides for the respective implant systems. The sizes (length × width × depth) of the osteochondral defects created in each of the groups were approximately 20.2 × 20.2 × 9.4–mm for the LCSP group, 14.4 × 30.5 × 7.9–mm for the OSP group, and 14.8 × 14.8 × 9.9–mm for the MP group. Tensile testing was performed on each graft to determine pull-out strength.

Results:

The pull-out strength was significantly lower in the OSP group (65.7 N) versus the LCSP (133 N; P = .0005) and the MP (117.6 N; P = .001) groups. There was no statistically significant difference in pull-out strength between the LCSP and MP groups ( P = .42). There were no statistically significant differences in displacement at maximum load among any 2 of the 3 groups.

Conclusion:

These findings suggest that while initial stability may play a role in the clinical outcomes of osteochondral allograft (OCA) implantation, the biological milieu in vivo for each graft setting perhaps has a greater impact on the success of an OAT procedure. Further study is needed on the relationship between OCA biomechanics and clinical outcomes of OAT.
Local Infiltration Analgesia Versus Femoral Nerve Block for Pain Control in Anterior Cruciate Ligament Reconstruction: A Systematic Review With Meta-analysis
Authors: Shin Seong Kee , Lee Do Kyung , Shin Dae Won , Yum Tae Hoon , Kim Jun-Ho
Published: November 2021

Background:

Anterior cruciate ligament reconstruction (ACLR) is often performed on an outpatient basis; thus, effective pain management is essential to improving patient satisfaction and function. Local infiltration analgesia (LIA) and femoral nerve block (FNB) have been commonly used for pain management in ACLR. However, the comparative efficacy and safety between the 2 techniques remains a topic of controversy.

Purpose:

To compare pain reduction, opioid consumption, and side effects of LIA and FNB after ACLR.

Study Design:

Systematic review; Level of evidence, 3.

Methods:

A systematic search of MEDLINE, Embase, and Cochrane Library databases was performed to identify studies comparing pain on the visual analog scale (a 100-mm scale), total morphine-equivalent consumption, and side effects between the 2 techniques after ACLR at the early postoperative period. The LIA was categorized into intra-articular injection and periarticular injection, and subgroup analyses were performed comparing either intra-articular injection or periarticular injection with FNB. Two reviewers performed study selection, risk-of-bias assessment, and data extraction.

Results:

A total of 10 studies were included in this systematic review and meta-analysis. In terms of VAS pain scores, our pooled analysis indicated that FNB was significantly more effective at 2 hours postoperatively compared with LIA (mean difference, 8.19 [95% confidence interval (CI), 0.75 to 15.63]; P = .03), with no significant difference between the 2 techniques at 4, 8, and 12 hours postoperatively; however, LIA was significantly more effective at 24 hours postoperatively compared with FNB (mean difference, 5.61 [95% CI, −10.43 to −0.79]; P = .02). Moreover, periarticular injection showed a significant improved VAS pain score compared with FNB at 24 hours postoperatively (mean difference, 11.44 [95% CI, −20.08 to −2.80]; P = .009), and the improvement reached the threshold of minimal clinically important difference of 9.9. Total morphine-equivalent consumption showed no difference between the 2 techniques, and side effects were unable to be quantified for the meta-analysis because of a lack of data.

Conclusion:

Compared with FNB, LIA was not as effective at 2 hours, comparable within 12 hours, and significantly more effective at 24 hours postoperatively for reducing pain after ACLR. Total morphine-equivalent consumption showed no significant differences between the 2 techniques.
Syndecan-2 enriches for hematopoietic stem cells and regulates stem cell repopulating capacity
Authors: Termini Christina M. , Pang Amara , Li Michelle , Fang Tiancheng , Chang Vivian Y. , Chute John P.
Published: November 2021

The discovery of novel hematopoietic stem cell (HSC) surface markers can enhance understanding of HSC identity and function. We have discovered a population of primitive bone marrow (BM) HSCs distinguished by their expression of the heparan sulfate proteoglycan Syndecan-2, which serves as both a marker and a regulator of HSC function. Syndecan-2 expression was increased 10-fold in CD150+CD48–CD34–c-Kit+Sca-1+Lineage– cells (long-term HSCs [LT-HSCs]) compared with differentiated hematopoietic cells. Isolation of BM cells based solely on syndecan-2 surface expression produced a 24-fold enrichment for LT-HSCs and sixfold enrichment for α-catulin+c-kit+ HSCs, and yielded HSCs with superior in vivo repopulating capacity compared with CD150+ cells. Competitive repopulation assays revealed the HSC frequency to be 17-fold higher in syndecan-2+CD34–KSL cells compared with syndecan-2–CD34–KSL cells and indistinguishable from CD150+CD34–KSL cells. Syndecan-2 expression also identified nearly all repopulating HSCs within the CD150+CD34–KSL population. Mechanistically, syndecan-2 regulates HSC repopulating capacity through control of expression of Cdkn1c (p57) and HSC quiescence. Loss of syndecan-2 expression caused increased HSC cell cycle entry, downregulation of Cdkn1c, and loss of HSC long-term repopulating capacity. Syndecan-2 is a novel marker of HSCs that regulates HSC repopulating capacity via control of HSC quiescence.