bluuebunny/crossref_metadata_2025 huggingface dataset:
Adoption of Technological Change in the Public Sector: Evidence From US States
Authors: Craig Steven G. , Hoang Edward C. , Kohlhase Janet E.
Published: September 2022

Our paper explores the broad influences that stimulate technological change in governmental service delivery. Using panel data by state, we examine whether residents are able to apply for Unemployment Insurance (UI) benefits via technology services such as the internet or automated telephone, or are required to apply in person. The reduced form model tests for the relative influence of residential demand, political pressure, and bureaucratic influence. We find that it is the dispersion of the urban population across a state that provides the impetus for government adoption of new technology, in stark contrast to the importance of urban concentration found for the private sector. A unique additional influence we test is the ability of the entrenched bureaucracy to impede technology options. We find that governors of either political party in their term-limited term—when compromise with bureaucrats is less important—save 4% in administrative costs. We find that technology adoption can be delayed but not prevented by bureaucratic interests.
Knowledge-graph-based explainable AI: A systematic review
Authors: Rajabi Enayat , Etminani Kobra
Published: September 2022

In recent years, knowledge graphs (KGs) have been widely applied in various domains for different purposes. The semantic model of KGs can represent knowledge through a hierarchical structure based on classes of entities, their properties, and their relationships. The construction of large KGs can enable the integration of heterogeneous information sources and help Artificial Intelligence (AI) systems be more explainable and interpretable. This systematic review examines a selection of recent publications to understand how KGs are currently being used in eXplainable AI systems. To achieve this goal, we design a framework and divide the use of KGs into four categories: extracting features, extracting relationships, constructing KGs, and KG reasoning. We also identify where KGs are mostly used in eXplainable AI systems (pre-model, in-model, and post-model) according to the aforementioned categories. Based on our analysis, KGs have been mainly used in pre-model XAI for feature and relation extraction. They were also utilised for inference and reasoning in post-model XAI. We found several studies that leveraged KGs to explain the XAI models in the healthcare domain.
Listening to the unheard and unseen: Information literacy perspectives of the rural bi/multilinguals in Nigeria
Authors: Okonkwo Ebubechukwu A , Cocodia Bulorgbamu , Uba Ebubechukwu E
Published: September 2022

This article aims to investigate information literacy perspectives of bi/multilinguals in Nigeria. The study aims to identify bilingual and multilingual definitions of information literacy, determine factors that influence their information literacy needs and at what point bi/multilinguals need it. This implies that individuals who can speak up to two or three native languages would be used as the population of the study. Despite being a multicultural country, some languages are more recognised in Nigeria and as such, those groups of people are recognised. This research aims to listen to the unheard and unseen individuals who are the rural indigenes while considering a major influencing factor in the study which is language. A focus group interview was used and a transcript-based analysis was used for the study. The results indicate that information literacy is being able to communicate with their environment but more so involves giving back to the society through languages. These findings can provide a solid ground on which inclusion of rural indigenes can be formed. It provides a platform on which library advocacy for the inclusion of the rural community indigenes to enable them to express their form of information literacy and produce intellectual works in indigenous languages can be formed.
Pilot single-arm study to investigate the efficacy and safety of endovenous Microwave ablations for treatment of varicose veins in Singapore – one year results of the MAESTRO registry
Authors: Tang Tjun Yip , Chan Karen Ka Wing , Yap Charyl Jia Qi , Chan Sze Ling , Soon Shereen Xue Yun , Khoo Vanessa , Wong Julian Chi Leung
Published: September 2022

Objectives

Aim was to report a prospective two-centre Singaporean experience using Endovenous Microwave Ablation (EMA) to treat symptomatic primary great saphenous vein reflux. We evaluated 1-year safety, efficacy and patient satisfaction.

Methods

50 patients (63 limbs; 29 females; mean age 58.0 ± 12.1 years) were included. Patients were reviewed at 2-weeks, 3-, 6- and 12-months and underwent Duplex ultrasound assessment. Three quality of life (QoL) questionnaires were completed.

Results

The truncal closure rates at 2-weeks, 3-, 6- and 12-months were 63/63 (100%), 59/59 (100%), 58/58 (100%) and 59/60 (98.3%), respectively. There was 100% technical success and no serious adverse events. There were sustained improvement of QoL questionnaire scores from 2 weeks to 12 months.

Conclusion

EMA is a safe and efficacious venous ablative technology at 12 months and is associated with a high rate of target vein occlusion and sustained QoL improvement.
Trajectory Data Processing and Mobility Performance Evaluation for Urban Traffic Networks
Authors: Wang Xingmin , Jerome Zachary , Zhang Chenhao , Shen Shengyin , Kumar Vivek Vijaya , Liu Henry X.
Published: September 2022

With the rapid development and deployment of vehicle sensing and communication technology, vehicle trajectory data is becoming increasingly available for urban traffic network applications. However, it is difficult to use raw trajectory data points generated from global navigation satellite system (GNSS) coordinates without matching them to traffic networks. Real-world trajectory data is also prone to noise and errors. This paper proposes a trajectory data processing pipeline to serve different urban traffic network applications. The steps of the pipeline include matching the trajectory points to a well defined network representation, splitting them into different movements, and extracting distance information from their GNSS coordinates. Smoothing and filtering algorithms also reduce the influence of noise and errors. Based on the processed trajectory data, this paper also proposes algorithms for calculating different mobility performance indices including vehicle delay, number of stops, space-mean speed, and coordination measurements. These performance indices provide comprehensive evaluations of urban traffic network from different perspectives. Our case study uses real-world trajectory data collected from the Ann Arbor Connected Vehicle Test Environment. Different mobility performance indices are calculated and visualized. The proposed methods and algorithms are efficient, robust, and scalable, and could be applied to large-scale urban traffic networks.
Comprehensive Total Cost of Ownership Framework for Alternative Fuel Public Transportation Buses
Authors: Khan Mansoor J. A. , Onat Nuri Cihat
Published: September 2022

Sustainable fleet management seeks to deliver the best service with a standard of service defined by state regulatory bodies by utilizing and managing large fleets of vehicles in the most efficient, productive, and cost-effective way. Public transport service providers thus seek alternative ways to minimize cost as well as air pollution and carbon emissions from the transportation sector. This study develops a total cost of ownership (TCO) framework for evaluation of different alternative fuel options (diesel, compressed natural gas [CNG], and electric) for bus public transportation based on real-world driving conditions. Electric, CNG, and diesel buses are compared from the life cycle perspective by quantifying a set of sustainability indicators including global warming potential, particulate matter formation, human health impacts, and TCO. According to the results, it was found that TCO of electric buses is less than that of diesel and CNG buses. Specifically, TCO of electric buses is 15% less than that of diesel buses, and compared with CNG it is 5% less over a period of 10 years of use. The proposed framework provides a quantitative basis for a sustainable fleet management approach for public bus service providers.
A novel double parameters based biofeedback system to prevent intradialytic hypotension in clinical practice: Case report
Authors: Mambelli Emanuele , Rigotti Angelo
Published: September 2022

Intradialytic hypotension (IDH) still represents the main complication during dialysis treatment. Patient’s discomfort, reduced dialysis efficiency, reduced treatment time are only some of the main problems that could derive from the need to stop or temporarily interrupt the treatment because of IDH. Up to now, different types of treatment (HDF, HF, or AFB) have been considered to prevent IDH as well as the use of biofeedback systems (Blood Volume Monitoring, Temperature control, Sodium profiling, Blood Pressure monitoring). Recently a new biofeedback system (Biologic Fusion®) controlling simultaneously blood pressure (BP) and relative blood volume changes (RBV) has been developed to prevent IDH. This system runs according to fuzzy logic. We describe how this system works and to a better understanding, we report a clinical case of a patient with frequent IDH treated with the use of this system.
Pullulan as promoting endothelialization capacity of electrospun PCL-PU scaffold
Authors: Fathi-Karkan Sonia , Ghavidel-Kenarsari Fatemeh , maleki-Baladi Reza
Published: September 2022

Objective:

This project’s primary purpose was to create engineered vascular scaffolds using polyurethane, polycaprolactone, and pullulan polymers, along with suitable mechanical-dynamic conditions. Therefore, electrospun scaffolds with optimized intrinsic physiological properties and the ability to support endothelial cells were prepared in vitro, and cell viability was studied in PCL-PU and PCL-PU scaffolds containing Pullulan.

The main methods:

The electrospinning method has been used to prepare PCL-PU and PCL-PU scaffolds containing Pullulan. The scaffold’s surface morphology was evaluated using SEM microscopic imaging. The scaffolds’ physicochemical properties were prepared using ATR-FTIR, strain stress, and water contact angle tests, and the biocompatibility of PCL-PU and PU-PCL-Pl nanofibers was evaluated using the MTT test.

Principal findings:

The test results showed that PCL-PU scaffolds containing Pullulan have more suitable mechanical properties such as stress-strain, water contact angle, swelling rate, biocompatibility, fiber diameter, and pore size compared to PU-PCL. The culture of endothelial cells under static conditions on these scaffolds did not cause cytotoxic effects under static conditions compared to the control group. SEM images confirmed the ability of endothelial cells to attach to the scaffold surface.

Summary and conclusion:

The results showed that PCL-PU substrate containing pullulan could stimulate endothelial cells’ proliferation under static conditions.
Characteristics and predictors of ICU-mortality in critically ill patients with hyperlactatemia requiring CRRT: A retrospective cohort study
Authors: Li Lu , Bai Ming , Zhang Qiaona , Sun Shiren
Published: September 2022

Background:

Hyperlactatemia is a common complication in critically ill patients with high morbidity and mortality. Hyperlactatemia patients who require continuous renal replacement therapy (CRRT) constitute a subgroup with increased mortality risk. The clinical significance of serum lactate in these patients was not well understood and clearance of lactate using CRRT shown no survival benefits. The aim of this study is to investigate the incidence and non-lactate risk factors for ICU mortality in hyperlactatemia patients who underwent CRRT.

Method:

Hyperlactatemia patients with a serum lactate level >2 μmol/L who underwent CRRT between January, 2014 and May, 2021 were retrospectively investigated. Demographic characteristics and clinical data were collected from the electronic medical record system. The primary endpoint was predictors for ICU mortality which were identified by using multivariate logistic regression analysis.

Results:

A total of 178 eligible patients were finally included with a mean age of 56.6 ± 17.9 years and a median APACHE II score of 18 (IQR (14–22)). The multivariate regression results showed that male gender (OR 0.55 (95%CI 0.27–1.12), p = 0.1), mechanical ventilation (OR 2.60 (95%CI 1.27–5.34), p = 0.008), history of hypertension (OR 2.40 (95%CI 1.12–5.14), p = 0.02), SOFA score (OR 1.16 (95%CI 1.05–1.28), p = 0.002), AST (OR 1.0005 (95%CI 0.99–1.001), p = 0.08), and PT (OR 1.08 (95%CI 0.99–1.17), p = 0.06) were independently associated with ICU mortality. After adjusting for age, illness severity (APACHE II score), and serum lactate level, the statistical significances of SOFA score (OR 1.16 (95%CI 1.04–1.29), p = 0.005), hypertension (OR 2.25 (95%CI 1.02–4.95), p = 0.04), and mechanical ventilation (OR 2.54 (95%CI 1.22–5.25), p = 0.01) were not affected. The overall ICU mortality was 58.4% (104/178).

Conclusion:

The hyperlactatemia patients who underwent CRRT were at increased ICU mortality. Gender, AST, PT, SOFA score, history of hypertension, and mechanical ventilation were independent predictors for ICU mortality. Future studies with prospectively design, large sample size, and subgroup analyses are warranted to validate these findings.
Arts for Whose Sake? Arts Course-taking and Math Achievement in US High Schools
Authors: Mackin Freeman Daniel , Shifrer Dara
Published: September 2022

Math achievement in U.S. high schools is a consistent predictor of educational attainment. While emphasis on raising math achievement continues, school-level interventions often come at the expense of other subjects. Arts courses are particularly at risk of being cut, especially in schools serving lower socioeconomic status youth. Evidence suggests, however, that arts coursework is beneficial to many educational outcomes. We use data on 20,590 adolescents from the High School Longitudinal Study of 2009 to answer two research questions: (1) Does student accumulation of fine arts courses across different topic areas relate positively to math test scores in high school? (2) Does school SES differentiate this potential association? Results indicate that youth attending higher-SES schools take more art courses and taking music courses is related to higher math test scores. However, this benefit only seems to only apply to more socially advantaged student bodies. Results reveal a site of additional educational advantage for already privileged youth.
Subjective Aging Difficulties among Older Adults with Subjective Cognitive Decline
Authors: Komalasari Renata , Mpofu Elias , Prybutok Gayle , Ingman Stan R.
Published: September 2022

In older adults, subjective cognitive decline (SCD) may progress to an early stage of dementia. Yet, its association with subjective daily functional difficulties in aging is less well studied by experiences of mentally unhealthy days (MUDs). Employing a cross-sectional design approach, we analyzed the Behavioral Risk Factor Surveillance System dataset on 7429 older adults with SCD (aged 65 to >80, 45% males, 55% females) to explore SCD in instrumental daily activities of living (SCD-IADLs) and healthcare access mediation by MUDs and moderated mediation by age cohort, controlling gender and education. The bias-corrected percentile bootstrap with 5000 samplings revealed that MUDs partially mediate the relationship between SCD-IADLs and healthcare access, with a 28.2% mediating effect. Age cohort moderated the relationship between healthcare access and MUDs, MUDs and SCD-IADLs. Specifically, the predictive effects from healthcare access to MUDs and MUDs to SCD-IADLs were more profound in the 70–74 age cohort.
Wettability and biological responses of titanium surface’s biomimetic hexagonal microstructure
Authors: Hu Yahui , Duan Junyu , Yang Xiaoyang , Zhang Chunqiu , Fu Weihua
Published: September 2022

In this research, an experiment was conducted on how the surface wettability and biocompatibility of staplers’ titanium nails impact the healing of gastrointestinal tissue. Firstly, the bionic hexagonal structure was prepared on the surface of Ti metal by laser processing technology, and the laser textured titanium samples were observed by scanning electron microscope. Then, the liquid-solid contact angle-measuring instrument was used to characterize the wettability of titanium samples. Finally, cells were cultured on the surface of different titanium samples, CCK8 assay and qRT-PCR were carried out to investigate cell adhesion and collagen secretion on the surface of different samples. The results showed that the bionic hexagonal surface increased the surface roughness, reduced the liquid-solid contact angle, and promoted the adhesion and collagen secretion of fibroblasts. The increased wettability provided a better growth environment for cell growth. Microtexture is an important factor affecting the behavior of cells and its size parameters regulate cell gene expression, which is worthy of further study.
A Test of the Career Construction Theory Model of Adaptation with Turkish Final Year Undergraduate Students
Authors: Ulaş-Kılıç Özlem , Peila-Shuster Jacqueline J.
Published: September 2022

The primary purpose of this study was to test career construction theory’s model of adaptation among Turkish undergraduate students in their final year. Additionally, the Career Commitment Scale was adapted for Turkish university students to ensure its appropriateness as a measure in testing the model of adaptation. Data obtained from the first sample (172 undergraduate students) were used to adapt the Career Commitment Scale and data obtained from a second group (243 undergraduate students in their final year) was used to test the career construction theory model of adaptation. The results of the study support the career construction theory’s model of adaptation. Additionally, the eight-item model for the adapted Career Commitment Scale demonstrates good fit and acceptable internal consistency.
Polypharmacy and Healthcare Service Use Among Prescription Opioid Poisoning Cases Age 50+
Authors: Choi Namkee G. , Choi Bryan Y. , DiNitto Diana M. , Marti C. Nathan , Baker S. David
Published: September 2022

Objectives: To examine relationships between polypharmacy and level of healthcare service use among prescription opioid poisoning cases age 50 and older. Methods: Data came from the American Association of Poison Control Center’s National Poison Data System, 2015-2020. We used multinomial logistic regression to examine the study questions. Results: Of the 77 946 cases with prescription opioid exposures, 64.5% were managed at a healthcare facility (HCF). Of HCF-managed cases, 41.2% were treated/evaluated and released and 21.3% and 37.5% were admitted for noncritical care and critical care, respectively. Medications for cardiovascular disease, benzodiazepines, other types of sedatives/hypnotics, antipsychotics, muscle relaxants, acetaminophen, and gabapentin were associated with increased risk of admission to both noncritical and critical care compared to treatment/evaluation and release. Acetaminophen use had the highest relative risk ratios (RRRs) for noncritical care (1.70, 95% CI = 1.51-1.91) and critical care (1.56, 95% CI = 1.39-1.76). Each additional medication/substance used was associated with 1.14 (95% CI = 1.11-1.17) and 1.19 (95% CI = 1.16-1.22) greater risk of noncritical and critical care admissions, respectively. Conclusions: Among older-adult poison control center cases for prescription opioid exposures, co-use of several commonly prescribed/used medicines was associated with increased risk of admissions to both noncritical and critical care units. Careful monitoring of medication use among older adults who use prescription opioids may reduce the risk of unintentional and intentional opioid poisoning.
Religiosity and Physical Health of Middle–Old Aged African Americans: The Linking Role of Self-Control
Authors: Wickrama Kandauda A. S. , Ralston Penny A.
Published: September 2022

Objective: This study examined a psychological process (i.e., sense of control) that links religiosity to self-reported physical health in older African Americans. Methods: Two waves of data from 231 middle–old aged African Americans (AAs) were used to test two specific hypotheses: (a) religiosity influences changes in sense of control middle–old aged AAs, and (b) sense of control influences changes in global physical health in middle–old aged AAs. The analysis used two modeling approaches: (a) an autoregressive cross-lagged modeland (b) a parallel growth/change model. Results: The results of both types of models showed that religiosity positively influenced changes in sense of control and that sense of control positively influenced changes in physical health in middle–old aged AAs over time. Discussion: These findings provide evidence that sense of control links religiosity to physical health in older African Americans. The theoretical and practical implications of the findings are discussed.
Machine learning based prediction of rail transit signal failure: A case study in the United States
Authors: Dai Junyan , Liu Xiang
Published: September 2022

Signals are an important part of the urban rail transit system. Signals being in functioning condition is key to rail transit safety. Predicting rail transit signal failures ahead of time has significant benefits with regard to operating safety and efficiency. This paper proposes a machine learning method for predicting urban rail transit signal failures 1 month in advance, based on records of past failures and maintenance events. Because signal failure is a relatively rare event, imbalanced data mining techniques are used to address its prediction. A case study based on data provided by a major rail transit agency in the United States is developed to illustrate the application of the proposed machine learning method. The results show that our model can be used to identify approximately one-third of signal failures 1 month ahead of time by focusing on 10% of locations on the network. This method can be used by rail transit agencies as a risk screening and ranking tool to identify high-risk hot spots for prioritized inspection and maintenance, given limited resources.
Marine shellfish exploitation as a means of reducing vulnerability to resource uncertainty in southern coastal Peru (200 BCE–150 CE)
Authors: Weinberg Camille , Osborn Jo , Espino Huaman Richard
Published: September 2022

The effects of El Niño Southern Oscillation (ENSO) are notoriously hazardous for human populations of the hyperarid Peruvian coast. Yet, ENSO climate fluctuations are fundamental to the ecology of desert plant and animal resources that have been incorporated into human subsistence economies for millennia. We examine marine shellfish exploitation among early complex societies in southern coastal Peru at the end of the first millenium BCE to better understand the subsistence vulnerability of communities in arid environments with variable resource availability and productivity. We analyze new shellfish data from Jahuay, a shoreline fishing settlement in the Topará Quebrada occupied amidst new regional social hierarchies and intensifying inner-valley agriculture. We compare mollusk taxonomic diversity and taxa rank order with published assemblages from four near-contemporaneous sites to assess local and regional trends in resource exploitation. At Jahuay, a unique focus on foraging plentiful Donax obesulus clams resistant to ENSO effects may reflect a local buffering strategy to ensure a resource supply through interannual and decadal climate oscillations. Our comparative results suggest regional reliance on intertidal resource patches, especially rocky habitats, for consumable shellfish. The relative convenience of gathering sessile intertidal taxa that form dense settlements may partly explain their regional popularity. The potential to dry and exchange mollusk meat as a protein source likely enhanced diet diversification while supporting economic and social relationships between communities. Overall, our findings imply that mollusks and intertidal foraging landscapes were important within a broad-spectrum subsistence strategy suited to maintaining and coordinating food availability in a dynamic environment.
Temporalities of vulnerability: Unemployment tactics during the Spanish crisis
Authors: Briales Álvaro
Published: September 2022

In this paper I analyse the processes of vulnerabilisation related to unemployment, based on the case of Spain in the period 2010–2020. I conceptualise unemployment time as empty time that unemployed people attempt to fill using temporal tactics. To explain the degree of temporal agency of the unemployed, I shall analyse their tactics according to four social conditions: previous work socialisation, duration of unemployment, domestic relationship and social class. In terms of method, this study was based on quantitative time data obtained from the most recent Time Use Survey for Spain (from 2009 to 2010), and on qualitative time use data obtained from eight discussion groups and 49 interviews with unemployed people. Drawing on these data, I analyse relationships between temporal tactics in unemployment, the social conditions of the subjects and their processes of vulnerability, and define five temporal tactics, which I term: the investing time tactic, the domestic hyperactivity tactic, the domestic work rejection tactic, the constant effort tactic and the non-tactic. I conclude by demonstrating that these tactics can be sequenced as stages in a process of vulnerability associated with gradual desynchronisation from pre-unemployment times, underlining the importance of socio-temporal categories and conditions in understanding vulnerability.
A triangulated approach for understanding scientists’ perceptions of public engagement with science
Authors: Calice Mikhaila N. , Bao Luye , Beets Becca , Brossard Dominique , Scheufele Dietram A. , Feinstein Noah Weeth , Heisler Laura , Tangen Travis , Handelsman Jo
Published: September 2022

Scientists are expected to engage with the public, especially when society faces challenges like the COVID-19 pandemic or climate change, but what public engagement means to scientists is not clear. We use a triangulated, mixed-methods approach combining survey and focus group data to gain insight into how pre-tenure and tenured scientists personally conceptualize public engagement. Our findings indicate that scientists’ understanding of public engagement is similarly complex and diverse as the scholarly literature. While definitions and examples of one-way forms of engagement are the most salient for scientists, regardless of tenure status, scientists also believe public engagement with science includes two-way forms of engagement, such as citizen and community involvement in research. These findings suggest that clear definitions of public engagement are not necessarily required for its application but may be useful to guide scientists in their engagement efforts, so they align with what is expected of them.
Economic complexity and firm performance in the cultural and creative sector: Evidence from Italian provinces
Authors: Burlina Chiara , Casadei Patrizia , Crociata Alessandro
Published: September 2022

Several studies have detected a positive relationship between the spatial dynamics of cultural and creative industries (CCIs) and their social and economic outcomes. In this article, we draw upon the Economic Complexity Index (ECI) as a proxy to capture the social interactive nature that characterises CCIs and the way this affects firm performance. Our assumption is that more complex locations, endowed with different types of more sophisticated production capabilities, allow CCI firms to perform more strongly. This can depend on the higher opportunities of complex knowledge sharing and cross-fertilisation processes among different types of CCI firms or with non-CCI firms. The focus is on Italy, a country with a long-standing historical tradition in culture and creativity. We draw upon an original panel database at firm and province level (for the period 2010–2016) to compute two different ECIs, one for the CCIs and another one for the rest of the economy. Moreover, we analyse the effects these two types of complexity on the performance of firms within sectors with different levels of cultural and commercial value. We find that economic complexity of CCIs but not economic complexity of the rest of the economy matters for CCI firm performance. However, the effect is relatively weak. The same finding applies to all CCI firms, irrespective of their type of sector. Policy implications and directions for future research are discussed.
The Lived Experience of COVID-19 Survivors During the Third Wave of the Pandemic and the Political Crisis in Myanmar: A Qualitative Study
Authors: Maw Su Su
Published: September 2022

When the third wave of the COVID-19 epidemic broke out, the double burden of the pandemic and political instability meant that people in Myanmar did not have access to adequate hospital care. The aim of this study was to explore the lived experience of COVID-19 survivors in the community. A qualitative, descriptive, phenomenological approach was used, and participants were selected through purposive sampling. Fifteen individuals described their experiences using four themes and 17 categories. The main themes were the aggressive natures of the pandemic, suffering from the disease, receiving vital support for survival, and the hardships due to political pressure. The pandemic and subsequent waves of different variants should not be underestimated, and people’s health should take priority over economic development and political crisis. Knowledge and practices of family members and society should be promoted by providing timely and comprehensive information regarding pandemic diseases.
The Effect of Serious Games on Medical Students’ Motivation, Flow and Learning
Authors: Zairi Ihsen , Ben Dhiab Mohamed , Mzoughi Khadija , Ben Mrad Imtinene
Published: September 2022

Background and aim

Serious games are interactive games with a purpose for education, developed generally under software technology, serious games also include tabletop games (board games and card games), and many of them are used in medical settings like hospital training. Previous work indicates that serious games can enhance students' motivation, interaction, and engagement. This study aimed to evaluate the effectiveness of a serious game on medical students' learning outcomes and determine its effect on students' flow and motivation and examine the relationship between the flow and motivation.

Methods

This was a prospective study performed for two years (2018-2019 and 2019-2020 academic years). A total of 108 third-year medical students participated in this study. Students were asked to play a serious game on a computer for twenty minutes. A set of questionnaires containing evaluation grids to measure the flow and the motivation were given to students. The effectiveness of the game was assessed using pre-and post-tests.

Results

Complete datasets were available for 97 students. Flow and motivation dimensions experienced by the students were generally high (mean = 54,5). Significant and positive relationships between the sub-scale of flow experience and intrinsic motivation to know, intrinsic motivation to experience simulation, and the three types of extrinsic motivation were found. There was a negative correlation between the flow dimension and intrinsic motivation toward accomplishments and amotivation. There was a significant difference between the mean scores of pre-tests and post-tests ( p < .01).

Conclusion

The serious game is regarded as a particularly active and problem-solving form of learning that promote medical students' motivation, flow and learning achievements.
Palliative Ventilator Withdrawal Practices in an Inpatient Hospice Unit
Authors: Kaur Ramandeep , Harmon Elizabeth , Joseph Augustin , Dhliwayo Nyembezi L , Kramer Neha , Chen Elaine
Published: September 2022

Background

Palliative ventilator withdrawal (PVW) involves removal of mechanical ventilation in patients not expected to survive to allow a peaceful death. This process traditionally occurs in Intensive Care Units (ICU) and recently has evolved to occur in Inpatient Hospice and Palliative Care Units (IPU).

Objectives

To describe the process and response of patients undergoing PVW in an IPU setting.

Methods

This is a longitudinal observational cohort study of adult patients who underwent PVW in an IPU from January 2021 through March 2022.

Results

Among 25 enrolled subjects, median age was 68 (IQR 62.5-76.5) years and 14 (56%) were females. Median time from PVW to death was 16.8 (IQR 2.6-100) hours. A registered nurse and attending physician were present in all the cases, while a respiratory therapist was present in 20 (80%) and chaplain in 9 (36%) of the cases. Before PVW, opioids and benzodiazepines were administered to 24 (96%) patients. Post PVW, respiratory distress was noted among 16 (64%) patients and medication was given to 15 (60%) patients for respiratory distress. There was a significant association between the presence of respiratory distress and administration of medication within 30 minutes after PVW ( P = .009). The rituals performed during PVW were reciting prayers for 11 (44%), playing music for 8 (32%), and observing silence for 6 (24%) of the patients.

Conclusion

This study describes the PVW practices in an IPU setting where a multidisciplinary team was present during PVW for most of the cases and two-third of the patients undergoing PVW experienced respiratory distress immediately after PVW.
Life Experiences of Patients With Multiple Sclerosis About Their Spasticity: A Phenomenological Study
Authors: Özkan İlknur , Polat Dunya Cansu , Demir Serkan
Published: September 2022

Spasticity is one of the main symptoms that is most common in patients with Multiple Sclerosis and causes increased disability. The aim of this study is to understand the experiences of patients with Multiple Sclerosis about their spasticity from their perspective. This study was conducted as a qualitative study with a Hermeneutic phenomenological framework. The data were evaluated by using VanManen’s thematic analysis method. As a result of the data analysis, four main themes were elicited, namely, “the meaning of spasticity for the patient,” “the difficulties of living with spasticity,” ‘coping with spasticity,” and “the new me created by spasticity.” It was understood that spasticity is a symptom that brings about difficulties in psychological, social, and working life as well as physical difficulties. Nurses should be aware of the psychological symptoms as well as the physical symptoms that patients experience due to spasticity and should create a patient-specific management program.
Ain’t No Fortunate Son: The Political Calculus of Conscription
Authors: Atkinson Douglas B. , Fahey Kevin
Published: September 2022

Do the electoral incentives of political leaders influence who is compelled to serve in the military? We argue that conscription policy is designed by political actors who care about winning elections. In wartime, politicians face the twin threats of military and electoral defeat. Therefore, they will shield swing communities, who hold considerable sway over the outcome of elections, from some costs of military service. We leverage a novel database of 9.2 million U.S. service-members during World War II. We find that counties that narrowly voted for President Roosevelt and Democratic members of Congress had substantially fewer conscripts in the Army during 1942, 1943, and 1945. Substantively, 139,000 fewer soldiers—six times the number of soldiers who landed at Normandy—were enlisted from swing counties than expected. Our findings imply that democratic leaders do not want to lose re-election during wartime, and in doing so sacrifice democratic norms of fairness.
Particularism or Policy? When Distributive Outlays Flow to the President’s Core Supporters
Authors: Fu Shu
Published: September 2022

The literature on distributive politics reveals that presidents regularly influence federal spending and disproportionately direct federal grants toward their core supporters. This paper offers a comprehensive assessment of the interpretation of core-supporter targeting. Empirical evidence shows that the underlying patterns of partisan targeting do not accord with standard accounts of party-building activities nor electoral considerations that are evidence of presidential particularism. Instead, this paper argues that presidential policy priority better explains core-state targeting. Presidents use agencies that are ideologically aligned with them or associated with their policy priorities to enhance the largesse they bestow on core constituencies, and this is the consequence of presidents pursuing ideological and policy goals. Collectively, it indicates a less cynical point of view on the orientation of the American presidency.
The Recurrence of Cervical Precancerous Lesion Among HIV Positive and Negative Ethiopian Women After Cryotherapy: A Retrospective Cohort Study
Authors: Bogale Agajie Likie , Teklehaymanot Tilahun , Ali Jemal Haidar , Kassie Getnet Mitike , Medhin Girmay
Published: September 2022

Background

Early testing and treatment is among the successful strategies for the prevention and control of cervical precancerous and invasive cancer, and a paramount for women with HIV. In Ethiopia, visual inspection with acetic acid for screening and cryotherapy treatment is commonly practiced, though the recurrence of the precancerous lesion after treatment has not been well documented.

Objective

This study was aimed to estimate the association of HIV status and the recurrence of cervical precancerous lesion after cryotherapy among Ethiopian women.

Methods

We conducted a retrospective cohort study from January to April 2021. The time to the incidence of recurrence was compared between HIV positive and HIV negative women. Cox regression models were used to adjust the analyses for potential confounders, and only women treated with cryotherapy after a positive Visual Inspection with Acetic acid (VIA) screening test were included.

Results

A total of 140 eligible patient cards were included in the analysis with the median follow-up of 15.5 months. The overall recurrence rate was 15.7% (22/140), with a greater proportion among HIV negative women, 19.0% (4/21) than HIV positive 15.1% (18/119). Prolonged use of corticosteroid and higher age were the major significant predictors of a higher likelihood of recurrence. The recurrence of screening positive lesion was higher among women aged above 39 years (hazard ratio (HR) of 11.94 (95% CI, 1.07-133.04; P = .04), and women with prolonged use of corticosteroid (HR = 7.82, 95% CI = 1.04-58.75; P = .046) than their counterparts.

Conclusion

The recurrence of cervical precancerous lesion after cryotherapy was higher than the expert panel report by WHO with a higher proportion among women of old age and prolonged corticosteroid use. Cryotherapy showed a satisfying performance against the recurrence of cervical disease diagnosed through VIA. To substantiate, our findings, further prospective cohort study is also recommended.
Supporting Middle School Student Behavior Change Through Motivational Interviewing
Authors: Gersib Jenna A.
Published: September 2022

Motivational interviewing (MI) is an established, research-based intervention that focuses on building intrinsic motivation to promote lasting, healthy changes in a variety of situations. In school settings, MI has been used to improve student motivation, attendance, punctuality, confidence in schoolwork, and self-determination as well as increase student academic grades. Students who exhibit challenging behaviors in schools often feel ambivalent toward change, and teachers often have a difficult time motivating them toward positive and prosocial behaviors and actions. This article describes the framework of MI and gives specific descriptions of how middle school teachers and other school personnel can use MI to help their students who are experiencing challenging behaviors due to lack of motivation increase their likelihood of school success.
Relaxed design conditions using Takagi-Sugeno fuzzy models and Lyapunov-Floquet transformation for controlling time-varying periodic systems
Authors: Travassos Marco A , Cardim Rodrigo , Teixeira Marcelo CM , Assunção Edvaldo
Published: September 2022

This manuscript approaches the Takagi-Sugeno fuzzy control technique, the Lyapunov-Floquet transformation, and their applications for controlling linear time-varying systems. Each of the techniques is applied in the control of a linear time-varying periodic system in order to compare their effectiveness. A hybrid control method involving the Takagi-Sugeno fuzzy control and the Lyapunov-Floquet transformation is proposed. In this method, the stability of the closed-loop system is mathematically guaranteed. In addition, this new procedure can reduce the conservatism of time-varying periodic systems with uncertainties in the input matrix. Finally, an application of the hybrid method is presented in a time-varying periodic system considering a constraint on input and uncertainties on the input matrix.
Vibration band gap characteristics of two-dimensional functionally graded grids using the spectral element method
Authors: Yan Liang , Shi Dongyan , Zhang Yu , Wang Chuanlong , Wang Lifu
Published: September 2022

In this article, the band gap characteristics of two-dimensional periodic grid structures composed of functionally graded materials are studied. According to the first-order shear deformation theory and the spectral element method, the motion equation of the functionally graded beam is established at first, and then the spectral stiffness matrix of the lattice structure is assembled through the coordinate transformation matrix. With the aid of the Bloch theorem, the in-plane wave dispersion relation of periodic grid structures composed of two functionally graded materials is analyzed. The availability and accuracy of the band gap calculation method are verified by structural vibration transmission results based on the finite element method. In addition, the influence of the material parameters of the structure on the dispersion relation of the in-plane wave is obtained. The results extend the range of research on two-dimensional grids which can be applied to the design of filters.
Maternal History of Childhood Maltreatment and Brain Responses to Infant Cues Across the Postpartum Period
Authors: Bublitz Margaret H. , Swain James , Lustig Shoshanna , Barthelemy Christine , DeYoung Lena , Dickstein Daniel
Published: September 2022

Adults with histories of childhood maltreatment (CM) are more likely to display problematic parenting behaviors. The goal of this study was to examine changes in maternal brain activation to negative infant cues over the early postpartum period among new mothers with and without histories of CM, as this is a period of immense neuroplasticity in the maternal brain. CM was measured using the Adverse Childhood Experiences Scale. Functional magnetic resonance imaging (fMRI) conducted at approximately 5 and 13 weeks postpartum measured brain responses to own and unfamiliar infant cues in primiparous women. Women with histories of CM displayed increasing activation in the anterior cingulate cortex, and greater increases in anterior cingulate cortex activation was associated with maternal reports of less regulatory capacity in their infants. Preliminary results suggest that new mothers with CM histories display greater brain responses to negative infant cues compared to new mothers without CM histories. Women with CM histories may benefit from additional supports during the transition to parenthood.
What About the Children? Co-Occurrence of Child Maltreatment and Parental Separation
Authors: van Berkel Sheila R. , Prevoo Mariëlle J. L. , Linting Mariëlle , Pannebakker Fieke , Alink Lenneke R. A.
Published: September 2022

The aim of this study was to investigate (a) the extent to which child maltreatment co-occurs with parental separation and (b) associations between different types of child maltreatment and various types of separation-associated interparental conflict. Professionals working with children ( N = 785) reported each case of suspected child maltreatment they observed during a 3-month period and indicated whether parental divorce or separation was about to take place or had taken place. This resulted in 530 reported cases that matched the definitions of child maltreatment for which information on parental relationship status was available. Most of the maltreated children (60%) also experienced (impending) parental separation. In 69% of these cases child maltreatment was associated with parental separation. Particularly, cases of emotional neglect, and emotional abuse co-occurred with parental separation. In addition, four clusters of separation-associated interparental conflict were distinguished— No observed conflict, Non-physical conflict, Verbal and physical conflict, and Multiple conflict—which were associated with child and family characteristics and specific types of child maltreatment. The results of this study suggest that child maltreatment often co-occurs with parental separation, especially when there is a considerable amount of interparental conflict.
Determinants of Effective Information Sharing in Publicly Funded Infrastructure Projects: A Scoping Review
Authors: Kashef Al-Ghetaa Rayeh , Shaw James , Alabousi Mostafa , Klein David , Imtiaz Daniel , Teja Bijan , Brown Adalsteinn
Published: September 2022

Using qualitative (content) analysis, we provide a framework highlighting the determinants of effective inter-organization information sharing in developing infrastructure projects. We examined the determinants of effective inter-organization information sharing in publicly funded physical infrastructure projects, focusing mainly on health, education, and transportation projects. The literature search identified 2,330 citations. A review of these abstracts led to the retrieval of 86 full-text articles, of which 40 met the inclusion criteria. Coordination and collaboration were identified as two of the most important inter-organization processes required for the successful development of transportation, health, and education infrastructure projects. These two processes are enabled by several elements of inter-organization information sharing such as human resources and expertise; incentives and rewards; and effective contract management and record-keeping. Our review also demonstrated that for organizations to effectively implement the determinants of inter-organization information sharing, they must first ensure they form effective interpersonal and intra-organization information sharing.
From Grey to Green: Transforming Abandoned, Redundant, or Unwanted Infrastructure Into Parks
Authors: Lau Clement
Published: September 2022

This article discusses the conversion of abandoned, redundant, or unwanted infrastructure into parks to meet the needs of Los Angeles County residents. The author draws primarily from experience gained through the development and implementation of the Puente Hills Landfill Park Master Plan. The landfill is 1365 acres in size and has been closed since 2013. Completed in 2016, the Master Plan proposes to transform 142 acres of the landfill into the county’s first new regional park in over 30 years. This case study covers topics such as interagency coordination, community engagement, park master plan development, and funding to develop, operate, and maintain the park. Lessons learned are applicable for the conversion of landfills to parks in other places as well as the transformation of other infrastructure into parkland, especially in park-poor areas where the remaining opportunities to create new parks are largely limited to the restoration of degraded lands.