bluuebunny/crossref_metadata_2025 huggingface dataset:
Carbon tattooing of axillary lymph nodes in breast cancer patients before neoadjuvant chemotherapy: A retrospective analysis
Authors: Porpiglia Mauro , Borella Fulvio , Chieppa Pierluigi , Brino Carola , Ala Ada , Marra Vincenzo , Castellano Isabella , Benedetto Chiara
Published: June 2022

Background:

This study aimed to investigate the feasibility and accuracy of tattooing suspicious axillary lymph nodes with carbon suspension at the time of breast cancer (BC) diagnosis and the intraoperative correspondence between tattooed lymph node (TLN) and sentinel lymph node (SLN) in patients who underwent neoadjuvant chemotherapy (NACT).

Methods:

In this retrospective study, we analyzed consecutive BC patients who underwent NACT, between April 2019 and May 2021, at the Breast Unit of Sant‘Anna Hospital in Turin, Italy. Before NACT, all suspicious biopsied lymph nodes were marked with carbon suspension. All SLNs, TLNs, and axillary nodal dissection specimens were sent for histopathological examination.

Results:

The study group included a total of 49 patients with BC. The overall identification rate of TLNs was 83.7% (41/49; 95%, confidence interval - CI 0.70-0.92). In patients who underwent target axillary dissection (TAD) the carbon tattooing had an intraoperative identification rate of 84.4% (27/32; 95% CI 0.67-0.95) while, in the case of axillary lymph node dissection, TLNs were detected in 82.3% (14/17; 95% CI 0.56-0.96) of patients. The correlation between TLN and SLN was 71.8% (23/32).

Conclusions:

These results confirmed that tattooing axillary lymph nodes has an acceptable identification rate. We also confirmed that this procedure, in addition to SLN biopsy, improves the accuracy of surgical axillary staging.
Examination of Recent Pedestrian Safety Patterns at Intersections through Crash Data Analysis
Authors: Ammar Dania , Xu Yueru , Jia Bochen , Bao Shan
Published: June 2022

Pedestrians are the most vulnerable road users and are at risk of severe consequences when involved in traffic accidents. The purpose of this research is to determine the factors that have significant impacts on the increasing likelihood of pedestrians being seriously injured or killed when involved in a collision with a single vehicle at an intersection over a recent 6-year period. Both 2013–2015 General Estimates System (GES) and 2016–2018 Crash Report Sampling System (CRSS) crash data were used in the analysis. Logistic regression models for the two crash datasets showed that there were four common significant variables affecting pedestrians’ injury levels. The following pairwise comparisons of these common significant factors using the Wald chi-square statistic test showed similar log-odds with few exceptions, suggesting that these affecting factors share similar effects from 2013 through 2018. In both datasets, results showed that a high likelihood of pedestrians’ severe injuries was associated with pedestrians older than 25, dark lighting conditions, light trucks and buses, and vehicles’ straight maneuver. Furthermore, the GES data distinguished further factors imposing higher threats on pedestrians as being drivers’ 19–25 age group, speeding, pedestrians’ roadway crossings maneuvers, and rain conditions. Crashes that occurred at intersections with more than two lanes or during summertime had significantly higher odds of resulting in severe injuries for pedestrians than crashes at two-lane intersections or during wintertime, respectively, in the CRSS dataset. Results of this study contribute to a better understanding of the recent changes in pedestrian safety at intersections and potential countermeasure design suggestions.
Capitalizing on Drone Videos to Calibrate Simulation Models for Signalized Intersections and Roundabouts
Authors: Shoaib Samandar M. , Chun Gyounghoon , Yang Guangchuan , Chase Thomas , Rouphail Nagui M. , List George F.
Published: June 2022

Simulation is an indispensable tool for the assessment of highway-related capital investments and operational changes. Model calibration, a challenging task in any simulation study, is a crucial step. The model’s robustness, accuracy, and quality are directly dependent on it. Many parameters exist, and field observations are often lacking to aid in their correct specification. Recently, videos from drones have created a uniquely powerful way to aid this process. Observations of the inputs (demand), outputs (vehicles processed), processing rates (e.g., saturation flow rates), and performance results (times in system, queue dynamics, and delays) are all available simultaneously. For signalized intersections, only the signal timing events are missing, and those data can be obtained from signal timing logs. This paper illustrates how modeling teams can use drone data to calibrate model parameters pertaining to intersection operation. It shows how saturation flow rates can be adjusted for signalized intersections so that queue dynamics and delays can be matched. For roundabouts, it illustrates how critical gaps and move-up times can be adjusted to match field observations of performance. Three real-world settings with associated drone data are used as case study examples.
Understanding the Relationships Among E-scooter Ridership, Transit Desert Index, and Health-Related Factors
Authors: Jiao Junfeng , Degen Nathaniel , Azimian Amin
Published: June 2022

This study aims to analyze electric scooter (e-scooter) markets in transit deserts and oases in the U.S. The four cities of Austin, Chicago, Portland, and Minneapolis were selected as case studies to determine the prevalence of e-scooter rides as related to locations with limited public transportation options. A t-test was performed to analyze the difference in the number of e-scooter rides between the transit deserts and transit oases. Overall, the arithmetic means of the e-scooter rides between the transit deserts and transit oases were not significantly different in Austin, Chicago, and Portland. The results confirm that the transit index score was among the top three predictors of trips in Austin, Minneapolis, and Portland. In Chicago, health-related characteristics such as crude prevalence of arthritis, diabetes, and obesity were found to be the most important predictors of trips in Chicago.
Heterogeneity Analysis of Operating Mode Distribution for Modeling Energy Consumption of Light-Duty Vehicles
Authors: Zhang Leqi , Song Guohua , Zhang Zeyu
Published: June 2022

The use of vehicle operating mode (OpMode) distribution is widely accepted for estimating energy consumption and emissions in the Motor Vehicle Emission Simulator (MOVES) model. However, the heterogeneity of driving behavior may lead to errors when using the default OpMode distribution. To improve the accuracy of energy consumption estimations, it is necessary to recognize the heterogeneity in OpMode distribution among different driving behaviors. With this aim, this paper designs a speed-specific indicator of energy efficiency reflecting driving behavior based on the speed-specific vehicle-specific power (VSP) distribution. The paper uses field data from 26,082 drivers recorded second by second during workdays. It also discusses the intra-heterogeneity and inter-heterogeneity of driving behavior based on unsupervised algorithm clustering. The findings of this paper are as follows. (1) The speed-specific VSP distribution clearly reflects the differences in energy efficiency of individuals’ driving behavior. (2) The energy efficiency indicator reflects the multidimensional inter-heterogeneity and intra-heterogeneity of driving behavior. (3) Drivers’ varied driving behavior causes heterogeneity in energy efficiency at different speeds, possibly causing an error of 6.34% in the emissions estimations. (4) Drivers of electric vehicles (EVs) and hybrid electric vehicles (HEVs) show more aggressive driving behaviors than drivers of conventional vehicles (CVs), which may cause an energy estimation error of over 6% for EVs and HEVs. Thus, the OpMode distribution of EVs, HEVs, and CVs should be modeled separately for on-road energy estimations.
Road Grade Estimation Based on Power Demand Difference of Heavy-Duty Diesel Trucks for Emission Estimation
Authors: Wang Xin , Song Guohua , Wu Yizheng , Zhai Zhiqiang
Published: June 2022

Road grades have significant impacts on the emissions of heavy-duty diesel trucks (HDDTs), even in the same operating mode. Existing gradient identification methods are time-consuming and difficult to conduct for entire road networks; moreover, few previous studies have considered uncertainty of HDDT emissions caused by various road grades. In this study, an estimation method for road grade was developed based on second-by-second field operating data, with noise reduction performed using the Kalman filter. The consistency and symmetry of the road grade calculated by the proposed method were then analyzed. Finally, differences in emission rate and emission factor for carbon dioxide (CO2), carbon monoxide (CO), total hydrocarbon (THC), and nitrogen oxides (NOx) under various grades were compared. The results indicated that the grade recognition results of each truck were consistent, with an average grade difference of 0.153%. Based on symmetry analysis of the estimation results in opposite directions, the two opposite road grades were found to have a strong negative correlation, and the average error of the grade was 0.125%. Pollutant results showed the emission rate of CO was most affected by grade, followed by NOx, and THC was the least affected. The emission factors of CO2, CO, THC, and NOx were found to increase by 32.4% to 82.8%, 75.6% to 198.4%, 19.9% to 39.9%, and 73.1% to 186.3%, respectively at 1.0%, 2.0%, and 3.0% gradients compared with 0.0% gradient. This study can improve the estimation accuracy for HDDT emissions, especially in areas with undulating terrain such as mountains and hills.
Enhancement of Highway Conditions during Winter Weather Operations through Coupling Raised Pavement Markers with Rumble Strips
Authors: Al-Amin Md , Turkar Vivek , Rung Mike , Douglas Ferron Raissa
Published: June 2022

The use of snowplows in northern Texas frequently results in the loss of retroreflective raised pavement markers (RPMs). The loss of RPMs is not only costly but also creates unsafe driving conditions during inclement weather. Pavement sections in many regions across the state of Texas often use a centerline rumble strip for safety. Traditionally, these rumble strips have precluded the use of metal-encased RPMs (i.e., snowplowable RPMs). This paper is focused on determining the efficacy of inserting commercially available RPMs into the trough regions of the rumble strips, and thus enabling the rumble strips to be multifunctional by not only providing a sound warning to drivers passing over the centerline but also giving nighttime lane delineation visibility to drivers by preventing the loss of RPMs because of snowplows. Field screening studies on small roadway segments and pilot implementation in a couple of highway segments in northern Texas were conducted. The studies reveal that embedding RPMs in existing rumble strips can be a viable approach for centerline delineation of highways that mitigates the issues of dislodgement of RPMs as a result of snowplow operations.
Structural Considerations and Implications Related to Foundation Movements in AASHTO LRFD
Authors: Samtani Naresh C. , Kulicki John M.
Published: June 2022

In the United States, highway bridge design practice is based on the LRFD method developed by AASHTO. In AASHTO LRFD, which is based on the concept of limit states, the effect of foundation movements on structural elements is expressed as a force effect rather than a geotechnical resistance. In fact, all design codes worldwide recognize this observation by including a representation of structural effects of foundation movements as a force. AASHTO LRFD uses the designation “ SE” for the geotechnical demands to be considered. An associated load factor, γ SE, is specified for each load combination where SE is applicable. The product of γ SE and SE is the factored demand, or factored force. The structural effect of foundation movements is manifested in the form of additional force effects such as induced torques, moments, and shears in a bridge structure that can lead to adverse consequences such as cracking. In AASHTO LRFD, the SE load factor occurs in four out of the five load combinations for Strength Limit State and three out of the four load combinations for Service Limit State. This paper presents a study that explores the structural considerations and implications related to use of SE load factor and the effects of foundation movements in AASHTO LRFD.
Structural Performance of an Asphalt Pavement Containing Cold Central Plant Recycling and Full-Depth Reclamation
Authors: Diefenderfer Brian K. , Flintsch Gerardo , Xue Wenjing , Meroni Fabrizio , Boz Ilker , Timm David
Published: June 2022

Pavement recycling techniques are often perceived as only applicable to lower traffic volume roadways. However, recent studies have shown their potential for long service lives in higher traffic volume applications. This study documented the response of an asphalt pavement section, constructed using full-depth reclamation (FDR) and cold central plant recycling (CCPR), on a portion of I-64 in Virginia reconstructed between 2016 and 2019. The pavement section was instrumented and the response was compared with a similarly instrumented pavement section (Section S12) placed at the National Center for Asphalt Technology (NCAT) Test Track in 2012. Previous studies have shown that Section S12 is a long-life pavement and it carried 30 million equivalent single axle loads (ESALs) while showing no evidence of deterioration at the pavement surface or from installed instrumentation. The results from the I-64 Segment II project showed that it had much lower horizontal strain values at the bottom of the asphalt layers but slightly higher vertical pressure values on top of the subgrade when compared with NCAT Section S12. Despite the slightly higher values (about 1 pounds per square inch [psi] difference), the vertical pressure on top of the subgrade was very low for both pavement sections. The study confirmed that a recycled pavement section could be constructed and result in low strain and pressure values and is expected to have a long service life in a high traffic volume environment.
Joint Model of Transit Usage Frequency and In-Vehicle Safety Perception During the COVID-19 Pandemic
Authors: Mashrur Sk. Md. , Lavoie Brenden , Wang Kaili , Loa Patrick , Habib Khandker Nurul
Published: June 2022

Social distancing strategies and strict hygiene adherence during the pandemic have added an extra dimension to the safety requirements of transit usage. Thus, travelers’ altered safety perceptions, which can affect transit usage, need to be assessed for effective policy decisions for the post-pandemic period. This study examined the interaction between in-vehicle safety perception and transit usage using an integrated approach by jointly modeling them, considering the fear of virus infection. A multivariate ordered probit model was developed for the investigation using a dataset collected through a web-based travel survey conducted in the Greater Toronto Area, Canada. The results reveal that, along with socioeconomic attributes, many pandemic-related variables and latent attitudinal factors affect the propensity to use transit. It is observed that those having a better safety perception of the bus are more inclined to use transit more frequently than others. Apart from safety perception, those who were more cautious, over the age of 34, and shifted to working from home during the pandemic had an adverse propensity to use transit. However, a higher propensity toward transit usage was observed for pre-pandemic transit users and for those who had a higher level of satisfaction with transit attributes during the pandemic. A similar tendency was also observed for fully vaccinated residents.
Dynamic Surrogate Trip-Level Energy Model for Electric Bus Transit System Optimization
Authors: Foda Ahmed , Mohamed Moataz , Bakr Mohamed
Published: June 2022

The introduction of electric mobility solutions mitigates transportion-related greenhouse gas emissions. Transit buses are considered a promising candidate for electrification. This study contributes to the growing literature on battery-electric buses (BEBs) and aims to quantify the optimal allocation of BEB infrastructure and charging schedules. A generic model for the charging capacity and scheduling of the BEB network is developed. The proposed model proposes an algorithm for the calculation of trip-level BEB energy consumption based on a surrogate model-based space mapping algorithm. Instead of using vehicle simulators or constant values for the energy consumption rate for each trip, the input space mapping has been applied to a simple coarse model to build an accurate surrogate model. The proposed algorithm is tested on the bus transit network in Belleville City in Canada considering BEBs using both Flash and Opportunity charging. The results show the efficiency of the proposed model and highlight the impact on the optimization results of calculating the trip-level energy consumption compared with the traditional methods.
Blowover Risk Assessment for Tractor-Trailer Trucks in High Winds Using a Blowover and Statistical Model
Authors: Neupane Adarsha , Ohara Noriaki , Ahlenius Kathy
Published: June 2022

Tractor-trailer blowover crashes caused by strong winds are a major concern for the safety of their operators and others sharing the road. These crashes also trigger highway closures resulting in considerable economic impact. This study presents a blowover model based on stability forces that integrates the wind field, road geometry, and vehicle specifications to provide a critical vehicle speed for blowovers. A high-frequency sonic anemometer was deployed at the study area which witnessed three blowover crashes during the study period. The results showed that the critical vehicle speed from the model dipped below the posted speed limit at the time of blowovers for all three blowover crashes. The risk of a blowover crash was quantified as an exceedance probability of the fitted distribution to the temporal critical vehicle speed variations based on the high-frequency wind data within every 15-min time window. This framework, when applied to a stretch of road, was able to demonstrate the ability to identify the instances and the locations of higher blowover risk using wind measurements from the more prevalent mechanical anemometers.
Investigation of Ground-Penetrating Radar, Impact Echo, and Infrared Thermography Methods to Detect Defects in Concrete Bridge Decks
Authors: Coleman Zachary W. , Schindler Anton K.
Published: June 2022

A reinforced concrete bridge deck is often at risk of many forms of deterioration which affect its service life and maintenance cost. Nondestructive test (NDT) methods have seen increasing use by departments of transportation to locate deterioration in bridge decks before their condition rating becomes critically low and to help plan bridge deck preservation activities. Nonetheless, uncertainty in what forms of bridge deck deterioration each NDT method can identify has posed challenges in best deploying NDT methods for deck condition assessments. Thus, in this study, a full-scale 18 ft by 31 ft reinforced concrete bridge was constructed with defects in the deck simulating reinforcing steel corrosion, delaminations, concrete deterioration, voids, and poorly constructed concrete. The deck was evaluated with ground-penetrating radar, infrared thermography, and impact-echo nondestructive technologies to evaluate their potential for defect detection. Receiver operator characteristic analysis was implemented to quantify the capability of a given NDT method to detect a particular defect. Conclusions concerning which forms of concrete bridge deck deterioration each NDT method can detect were developed. It was found that of the three NDT methods considered, impact-echo testing was the most effective to evaluate the condition of bridge decks. Impact echo was able to detect both shallow and deep delaminations as thin as 0.01 in., shallow corrosion-induced delaminations, concrete deterioration, and some of the shallow voids; however, it was unable to detect deep voids, poorly constructed concrete, and mildly deteriorated concrete.
Measuring the Impact of Airspace Restrictions on Air Traffic Flow Using Four-Dimensional System Fundamental Diagrams for Urban Air Mobility
Authors: Cummings Christopher , Mahmassani Hani S.
Published: June 2022

To ease urban congestion, advanced air mobility (AAM) proposes the use of small aerial vehicles at low altitudes for uses such as package delivery and passenger services. In a developed state, an AAM service is predicted to involve thousands of trips daily, creating much higher densities of aircraft than currently exist in any airspace. Airspace structures have been proposed to help manage the high-density aircraft traffic. One such airspace structure is tube airspace, in which vehicles fly along predefined paths at specified altitudes. Tube airspaces have the advantage of aligning vehicle trajectories to reduce conflicts, however, traffic flow through restricted tube airspaces is not yet well understood. This paper defines how to measure traffic flow in a restricted network of airspace. These definitions are applied to measure traffic flow in several simulated scenarios of tube airspace constructs. By analyzing and comparing the macroscopic traffic flow patterns of tube airspace, several insights about the benefits and drawbacks of tube airspace are found. The results of this paper could improve decisions about creating and managing tube airspaces, and therefore would be of interest to AAM network planners and operators. They are also of interest to aviation researchers who could use these scenarios and findings to study further AAM services in airspace.
Moving Beyond the Vision Zero Slogan
Authors: Shi Ge , Methoxha Vannesa , Atkinson-Palombo Carol , Garrick Norman
Published: June 2022

Safe System is a holistic way of managing traffic safety based on all components within that system including road environments, speed regimes, vehicle safety, and post-crash intervention. The ultimate goal is to achieve zero road death and serious injury. Safe System was pioneered in the Netherlands and Sweden in the 1990s and gradually began to influence traffic safety management in other countries, including the U.S. Our research shows that since the adoption of Safe System in the Netherlands and Sweden, the risk of fatality has decreased at a rate far outpacing that in the U.S. The improvements have been particularly impressive when it comes to pedestrians and bicyclists who now have fatality risks that are as low as that of people in cars. Our paper outlines details of the Dutch and Swedish approach to Safe System that is associated with their tremendous success in reducing traffic fatality. The synthesis suggests that to embrace the Safe System approach, we need a paradigm shift that puts safety and quality of life at the forefront of our thinking about transportation planning, design, and implementation. We argue that there is a need for a broader dissemination, understanding, and adoption of the underlying principles of Sustainable Safety, and recommend that universities improve engineering and planning education with more Sustainable Safety thinking. We also argue for greater coordination between federal, state, and municipal agencies, and a move away from victim blaming toward the achievable goal of zero road deaths through the adoption of Sustainable Safety approaches.
Improved Practices for Temporary Work Zone Guide Signs
Authors: Theiss LuAnn , Higgins Laura , Ullman Gerald L.
Published: June 2022

Freeway reconstruction projects often involve adding lanes and improving entrance and exit ramps. Sign supports for overhead guide signs are sometimes removed early in the project to make way for construction activities. In addition, roadside guide signs may need to be relocated and replaced with temporary guide signs. The Manual on Uniform Traffic Control Devices provides guidance for work zone guide signs in Part 6, stating that temporary guide signs shall have black legend and border on an orange background. But permanent guide signs follow Part 2 of the MUTCD, which prescribes white legend and border on a green background for guide signs in general. Thus, many long-term freeway work zones may have guide signs in both color schemes that change throughout the project as the construction work progresses. The constrained conditions often seen in these work zones can also result in guide signs that use a variety of fonts, font sizes, sign sizes, and placement positions. This paper describes the human factors study that was performed to assess motorist understanding of various work zone guide signage strategies. Based on the results, the researchers were able to develop recommendations for long-term work zone guide sign design and placement to improve uniformity for the traveling public.
On the Effect of COVID-19 on Drivers’ Behavior: A Survey Study
Authors: Lopetrone Erika , Biondi Francesco N.
Published: June 2022

COVID-19 had a disruptive effect on the global community. This study looks at the effects that the stringent lockdown measures enacted in March 2020 had on motorists’ driving patterns. In particular, given the greater portability of remote working associated with the drastic decline in personal mobility, it is hypothesized that these may have served as accelerators for distracted and aggressive driving. To answer these questions, an online survey was conducted in which 103 respondents were asked to report on their own and other drivers’ driving behavior. While respondents agreed they drove less frequently, they also indicated that they were not prone to more aggressive driving or engaging in potentially distracting activities whether for work or personal purposes. When asked to report on other motorists’ behavior, however, respondents indicated they had witnessed more aggressive and distracting drivers on the road after March 2020 relative to the time before the pandemic. These findings are reconciled with the existing literature on self-monitoring and self-enhancement bias, and the existing literature on the effect of comparable large-scale, disruptive events on traffic patterns is used to discuss the hypothesis on how driving patterns may change after the pandemic.
Comparison of Fully Probabilistic and Partially Probabilistic Choice Set Models for Mode Choice
Authors: Kunhikrishnan Parthan , Srinivasan Karthik K.
Published: June 2022

Contemporary models consider choice sets to be either fully deterministic or fully probabilistic. Deterministic choice set models do not account for stochasticity in the choice set formation, whereas probabilistic choice set models fail to recognize that exclusion and inclusion can be deterministic for some alternatives and individuals and yet random for others. A more general scenario is, therefore, where some alternatives are deterministically included or excluded and others probabilistically included. This paper proposes a richer framework that combines the features of both deterministic and probabilistic choice set models and explicitly allows an alternative to be deterministically included, deterministically excluded, or probabilistically considered in the choice set. This framework is better than the conventional models in four aspects: (a) the factors influencing consideration type are explicitly and parametrically analyzed instead of assumption as 0 or 1; (b) the specification can disentangle factors that affect the inclusion outcome from the type of consideration; and (c) the specification also permits differential sensitivity to factors in conditional choice probability among those who consider an alternative deterministically versus probabilistically. The partially probabilistic choice set model, a special case of the proposed generalized framework, developed using empirical data collected from working commuters in Chennai city, is benchmarked against the fully probabilistic choice set models. The results show that the former had improved goodness-of-fit, realistic consideration probability estimates, and better predictability of mode shares than the latter. Relevant policies have been evaluated by identifying the appropriate target segments at both the consideration and choice stages using the proposed model.
Securely Sharing and Visualizing Connected Vehicle Analytics: THEA CV Pilot Performance Evaluation Dashboard
Authors: Dokur Omkar , Concas Sisinnio , Kamrani Mohsen , Kourtellis Achilleas , Kummetha Vishal
Published: June 2022

Dashboards are increasingly being used by organizations to process and visualize complex information and to reduce data complexity for planning and reporting. Their main function is to synthesize information for rapid and smarter decision making. This paper details the development of an innovative interactive dashboard to process connected vehicle (CV) data securely, report CV application evaluation analytics, and monitor CV infrastructure system performance. We detail the methods used to process complex, high-frequency (up to 10 Hz) information generated by more than 1,000 participants’ vehicles in the Tampa Hillsborough Expressway Authority (THEA) CV Pilot deployment over the course of two and half years of operation. The dashboard provides advanced query capabilities and custom visualization via interactive maps, graphics, and dynamic reporting to help inform decision making and securely share information. Further, individual CV application warnings can be analyzed using the warning profile feature that is equipped with visual animation replay. This novel approach not only compensated for the lack of in-vehicle dashboard cameras integrated into the CV Pilot infrastructure to assess behavioral responses to the human–machine interface, but also sped up manual validation time. The dashboard allows different levels of user access with customized views to meet a variety of stakeholder types and needs. This tool has been successfully used by the THEA CV Pilot evaluation team and U.S. Department of Transportation independent evaluators to perform precursory evaluations and to automate and perform false positive assessments of vehicle-to-vehicle and vehicle-to-infrastructure safety and mobility applications.
Performance of rapid test for antibodies to hepatitis C virus (anti-HCV) in hemodialysis patients and kidney transplant recipients
Authors: Becker Smile Calisto da Costa , Medina-Pestana José Osmar , Canziani Maria Eugenia Fernandes , Souza Ana Lucia Silva , Amaral Ana Cristina , Vieira Gustavo Almeida , Ferraz Maria Lucia
Published: June 2022

Rapid tests (RT) have been widely used for screening of hepatitis C virus (HCV) in general population, but its performance in hemodialysis (HD) patients and mainly in kidney-transplant recipients (RTx) is less known. The aim of this study was to evaluate the accuracy of RT for detection of anti-HCV in HD and RTx patients. Patients were prospectively included subdivided in four groups according to the positivity for anti-HCV detected by conventional serology: (1) HD patients anti-HCV +, (2) HD patients anti-HCV −, (3) RTx patients anti-HCV +, and (4) RTx patients anti-HCV −. All patients were retested for HCV using the commercial kit Alere HCV® Bioeasy Rapid Test (Bioeasy Diagnóstica LTDA—Minas Gerais, Brazil) in capillary whole blood samples. During the period of study were included 46 HD patients anti-HCV+, 62 HD patients anti-HCV −, 53 RTx patients anti-HCV + and 56 RTx patients anti-HCV −. In patients on HD, the RT showed sensitivity (S), specificity (SP), positive predictive value (PPV), negative predictive value (NPV), and accuracy of 100%. In RTx patients, S of 96%, SP of 100%, PPV of 100% and NPV of 97% were found (accuracy of 98%). In conclusion, in patients on HD there was 100% agreement between RT and the conventional immunoassay. In the RTx group, although the agreement was not 100%, the RT performed very well when compared to conventional serology. This study demonstrates that the RT can be an alternative to conventional serology in HCV screening of patients on HD and RTx.
PO2 21% oxygenated hypothermic machine perfusion in kidney transplantation: Any clinical benefit?
Authors: Pravisani Riccardo , Baccarani Umberto , Molinari Elena , Cherchi Vittorio , Bacchetti Stefano , Terrosu Giovanni , Avital Itzhak , Ekser Burcin , Adani Gian Luigi
Published: June 2022

Background:

In deceased donor kidney transplantation (KT), the use of hypothermic machine perfusion (HMP) has been acquiring the status of best practice in the pre-transplant management of kidney grafts. Two types of HMP are currently available, oxygenated HMP and non-oxygenated HMP. However, data on the real clinical impact of oxygenation on KT outcome are still heterogeneous.

Methods:

Retrospective study on a cohort of 103 patients transplanted with a single kidney graft that was managed either with end-ischemic oxygenated (O2 group, Waves Machine, n = 51, 49.5%) or non-oxygenated HMP (no-O2 group, Life Port Kidney Transporter Machine, n = 52, 50.5%), during the period January 2016–December 2020. Oxygenation was performed at pO2 21%.

Results:

The median cold ischemia time was 29 h:40 min [IQR 26 h:55 min–31 h:10 min] and the prevalence of grafts from extended criteria donors (ECD) was 46.7%, with a median kidney donor profile index (KDPI) of 72 [41–94]. The study groups were homogeneous in terms of recipient characteristics, ischemia times and donor characteristics. O2 and no-O2 groups showed comparable outcomes in terms of delayed graft function (O2 vs no-O2, 21.5% vs 25%, p = 0.58), vascular (0.2% vs 0.2%, p > 0.99) and urologic (13.7% vs 11.5%, p = 0.77) complications, and episodes of graft rejection (11.7% vs 7.7%, p = 0.52). At 1 year follow up, even creatinine serum levels were comparable between the groups (1.27 mg/dL [1.09 and 1.67] vs 1.4 mg/dL [1.9–1.78], p = 0.319), with similar post-transplant trend ( p = 0.870). No significant benefit was either observed in ECD or KDPI > 60 subgroups, respectively.

Conclusions:

Oxygenation at pO2 21% during HMP seems not to significantly enhance the KT outcomes in terms of postoperative complications or graft function.
Associations between Homelessness and Alzheimer’s Disease and Related Dementia: A Systematic Review
Authors: Babulal Ganesh M. , Rani Rohan , Adkins-Jackson Paris , Pearson Adam C. , Williams Monique M.
Published: June 2022

The homeless population in the United States is rapidly aging, with a parallel increase in Alzheimer’s disease and related dementia (ADRD). During an evolving pandemic that jeopardizes employment and housing, assessing the relationship between ADRD and homelessness is critical since the latter is potentially intervenable. The objective of this study is to review the literature and determine whether there is an association between homelessness and dementia risk. A systematic review of existing studies was conducted through PubMED, SCOPUS, and EMBASE among others. Of the 228 results found, nine met inclusion criteria. Homeless studies mainly centered on veteran populations ( n = 6/9). There is a complex relationship suggesting homelessness as a risk for and consequence of ADRD but also co-occurrence with psychiatric disorders, substance abuse, and traumatic injuries. Future studies should employ enumeration surveys with modular longitudinal tracking and measure social determinants of health, discrimination, chronic stress, and mood disorders.
Feasibility and Acceptability of a Remotely Delivered Weighted Blanket Intervention for People Living With Dementia and Their Family Caregivers
Authors: Harris Melissa L. , Titler Marita G.
Published: June 2022

The COVID-19 pandemic amplified the need for interventions to support community-dwelling families living with dementia. This study examined the feasibility and acceptability of a remotely delivered weighted blanket intervention for people living with dementia, and the feasibility of collecting outcome measures specific to people with dementia and caregivers. A prospective, within subjects, pre-post design was used; 21 people with dementia and their caregivers participated. Measures of feasibility (days blanket was used for the recommended duration, injuries/adverse events, enrollment, and withdrawal rate, time to recruit sample) and acceptability (tolerability, satisfaction, and benefit perceived by participants with dementia and caregivers) were examined. Feasibility of collecting measures was examined through missing data. Results indicated high feasibility and acceptability. Collecting caregiver completed outcome measures was feasible, but measures completed by self-report by people with dementia was not. Weighted blankets are a promising tool for this population that warrant further examination to determine efficacy.
The Role of Teacher Self-Efficacy in Special Education Teacher Candidates’ Sensemaking: A Mixed-Methods Investigation
Authors: Mathews Hannah M. , Myers Anna M. , Youngs Peter A.
Published: June 2022

Shifts in special education over the last 25 years have increased the pressure on special education teacher preparation programs to improve the quality of opportunities to learn provided to teacher candidates. One aspect of quality that has not been extensively explored in the literature is the interaction between the individual candidate—the learner—and preparation experiences. Using survey and interview data from special education teacher candidates across six teacher preparation programs, we explore how candidates with differing levels of teacher self-efficacy (TSE) experience preparation. Findings suggest that TSE shaped how candidates made sense of preparation and what they took up from their opportunities to learn. Across phases, candidates with low- and high-TSE differed in how they reported on their learning opportunities and then how they interpreted these opportunities as shaping their future practice. We end with implications for research, policy, and practice in special education teacher preparation.
Methodological Training in Special Education Doctoral Programs: A Mixed-Methods Exploration
Authors: Corr Catherine , Love Hailey , Snodgrass Melinda R. , Kern Justin L. , Chudzik Mia
Published: June 2022

Doctoral education is the primary time in which scholars learn about research methodologies and begin to develop their own research agendas and skills. Yet, to date, few research studies have examined graduate students’ perceived value of, and access to, training in multiple research methodologies. The purpose of this study was to explore special education doctoral students’ experiences at research-intensive universities in relation to mixed methods, quantitative, and qualitative methodologies. Using a mixed-methods research design, we explore the extent to which research judgments, skills, paradigmatic values, and methodological identities are diverse and how those features interact when doctoral students judge research. First, doctoral students were invited to participate in a survey (replicating McKim, 2017). Then, students who volunteered during the survey were individually interviewed about their methodological training and identity. We present the results and discuss how they can inform personnel preparation for the next generation of research scholars and consumers.
Exploring students’ and graduates’ attitudes to the process of transition to the labour market
Authors: Hooley Tristram , Hanson Jill , Clark Lewis
Published: June 2022

This article explores how UK students and recent graduates experience the process of transitioning to the labour market, based on a secondary analysis of 1969 survey responses from current students and recent graduates using an online jobs board. It finds that gender, class and ethnicity all structure students’ experience of transition in a multitude of ways. The article reports 24 aspects of the transition process with statistically significant differences between students from different demographic backgrounds. These include students’ vocational focus and career aspirations, mobility, values, the social aspects of work, whether they feel informed about career and recruitment, how they want to communicate with employers, and their experience of the Covid-19 pandemic. Most of these differences are small, but cumulatively they suggest that demographics are shaping the process of transition in complex, intersectional and heterogeneous ways. There is a need for key stakeholders involved in this process, notably higher education careers services and employers, to attend to these differences and use them to reform the graduate transition process in ways that make it more equitable.
Thermodynamic performance study on a novel trans-critical CO2 heat pump cycle integrated with expander and internal heat exchanger
Authors: Pan Shulin , Nie Shijun , Li Jiao , He Song
Published: June 2022

This paper presents a novel trans-critical CO2 heat pump cycle with expander (TCCE) for increasing COP in the warm period and the suction preheating in the cold period. This cycle has two main operation modes. One is TCCEA for warm period and the other is TCCEB for cold period. Theoretical simulations are conducted to study energy efficiency and exergy efficiency of this novel cycle as well as the basic cycle. The results show that in the warm period TCCEA has an excellent COP and exergy efficiency and at low discharge pressure, the COP of TCCEA is improved by up to 31.49% compared with the basic cycle. Additionally, in the cold period, using TCCEB is helpful to avoid liquid suction. Compared with the basic cycle, the heating capacity of TCCEB can be improved by up to 12%. Taking the heating capacity into account, TCCEB is the best system under the warm period. According to the simulation results, this novel cycle is better suited for warm or cold weather.
Predictive model of risk and severity of enteritis in systemic lupus erythematosus
Authors: Zhang Weijin , Huang Guohai , Lin Jianqun , Lin Qisheng , Zheng Kedi , Hu Shijian , Zheng Shaoyu , Du Guangzhou , Matucci-Cerinic Marco , Furst Daniel E , Wang Yukai
Published: June 2022

Introduction

To describe the clinical and laboratory features of systemic lupus erythematosus (SLE) enteritis and to establish a predictive model of risk and severity of lupus enteritis (LE).

Methods

Records of patients with SLE complaining about acute digestive symptoms were reviewed. The predictive nomogram for the diagnosis of LE was constructed by using R. The accuracy of the model was tested with correction curves. The receiver operating characteristic curve (ROC curve) program and a Decision curve analysis (DCA) were used for the verification of LE model. Receiver operating characteristic curve was also employed for evaluation of factors in the prediction of severity of LE.

Results

During the eight year period, 46 patients were in the LE group, while 32 were in the non-LE group. Abdominal pain, emesis, D-dimer >5 μg/mL, hypo-C3, and anti-SSA positive remained statistically significant and were included into the prediction model. Area under the curve (AUC) of ROC curve in this model was 0.909. Correction curve indicated consistency between the predicted rate and actual diagnostic rates. The DCA showed that the LE model was of benefit. Forty-four patients were included in developing the prediction model of LE severity. Infection, SLE disease activity index (SLEDAI), CT score, and new CT score were validated as risk factors for LE severity. The AUC of the combined SLEDAI, infection and new CT score were 0.870.

Conclusion

The LE model exhibits good predictive ability to assess LE risk in SLE patients with acute digestive symptoms. The combination of SLEDAI, infection, and new CT score could improve the assessment of LE severity.
“Why Would I Talk To Them About Sex?”: Exploring Patient-Provider Communication Among Black Women Experiencing Sexual Pain
Authors: Thorpe Shemeka , Iyiewuare Praise , Ware Samuella , Malone Natalie , Jester Jasmine K. , Dogan Jardin N. , Hargons Candice N.
Published: June 2022

Ineffective patient-provider communication poses a potential health risk to Black women if medical providers are not addressing their needs or concerns. Additionally, less than half of OBGYNs report asking their patients about sexual difficulties, which limits women’s opportunities to disclose their experiences of sexual pain. The purpose of this qualitative study is to explore Black women’s experiences of patient-provider communication about sexual pain (reoccurring unwanted genital pain). Specifically, we aimed to describe the pathway from sexual pain disclosure to treatment among N = 25 premenopausal Black women living in the southern United States who were experiencing sexual pain. Using constructivist grounded theory, open-ended responses to six interview questions related to healthcare experiences, treatment, and patient-provider communication were qualitatively analyzed and categorized to form a conceptual framework of patient-provider communication about sexual pain. Five key categories emerged related to Black women’s experiences with their medical providers regarding sexual pain: (1) provider preferences, (2) healthcare experiences, (3) reasons for non-disclosure, (4) provider responses to sexual pain, and (5) treatment for sexual pain. Useful strategies to improve patient-provider communication are presented for both patients and providers.
Mapping Men’s Mental Health Help-Seeking After an Intimate Partner Relationship Break-Up
Authors: Oliffe John L. , Kelly Mary T. , Gonzalez Montaner Gabriela , Seidler Zac E. , Kealy David , Ogrodniczuk John S. , Rice Simon M.
Published: June 2022

Deleterious effects of separation and divorce on men’s mental health are well-documented; however, little is known about their help-seeking when adjusting to these all-too-common life transitions. Employing interpretive descriptive methods, interviews with 47 men exploring their mental health help-seeking after a relationship break-up were analyzed in deriving three themes: (1) Solitary work and tapping established connections, (2) Reaching out to make new connections, and (3) Engaging professional mental health care. Men relying on solitary work and established connections accessed relationship-focused self-help books, online resources, and confided in friends and/or family. Some participants supplemented solitary work by reaching out to make new connections including peer-based men’s groups and education and social activities. Comprising first-time, returning, and continuing users, many men responded to relationship break-up crises by engaging professional mental health care. The findings challenge longstanding commentaries that men actively avoid mental health promotion by illuminating wide-ranging help resources.