bluuebunny/crossref_metadata_2025_split huggingface dataset:
Should Steering Settings be Changed by the Driver or by the Vehicle Itself?
Authors: Melman Timo , Weijerman Mark , de Winter Joost , Abbink David 
Published: September 2022

Introduction Cars are increasingly computerized, and vehicle settings such as steering gain (SG) can now be altered during driving. However, it is unknown whether transitions in SG should be adaptable (i.e., triggered by driver input) or adaptive (i.e., triggered automatically). We examined this question for road segments expected to require different SG. Objective This paper aimed to investigate whether SG mode changes should be made by the driver or automatically. Methods Twenty-four participants drove under four conditions in a simulator: fixed low gain (FL), fixed high gain (FH), a machine-initiated steering system, which switched between the two SG levels at predetermined locations (MI), and a driver-initiated steering system, in which the SG level could be changed by pressing a button on the steering wheel (DI). Results Participants showed poorer lane-keeping and reported higher effort for FH compared to FL on straights, while the opposite held true on curved roads. On curved roads, the MI condition yielded better lane-keeping and lower subjective effort than the DI condition. However, a substantial portion of the drivers gave low preference rankings to the MI system. Conclusion Drivers prefer and benefit from a steering system with a variable rather than fixed gain. Furthermore, although automatic SG transitions reduce effort, some drivers reject this concept. Application As the state of technology advances, MI transitions are becoming increasingly feasible, but whether drivers would want to delegate their decision-making authority to a machine remains a moot point.
Changing Definitions of Leadership or Same old “Hero” Leader?
Authors: Eddy Pamela L. , VanDerLinden Kim , Hartman Catherine 
Published: September 2022

Objective/Research Question: The urgency to replace retiring community college leaders has been a topic of research and discussion for the past two decades. Concurrently, expansive definitions of leadership and collaborative approaches to leading have emerged. The central research question for this study was: How do sitting community college leaders define leadership? The sub-questions included: Do definitions of leadership differ by gender? Do definitions of leadership differ by position? Methods: Coding of survey data from approximately 770 sitting leaders occurred based on responses to the prompt: How do you define leadership? Descriptive statistical analysis occurred based on demographics and on position related to the coded responses. Results: This study found three prevalent ways of defining leadership: leader-focused (leader’s abilities mentioned); other-focused (leader included others, collaboration mentioned); institution-focused (leader focused on institutional needs/mission). About half of both women and men used leader-focused definitions, with slightly more men than women in the tallies. More women than men used other-focused definitions, whereas men used definitions more institutionally focused compared to women (not statistically significant). Leader-focused definitions were also most prevalent by position, with mid-level leaders using this definition slightly more than top-level leaders. Top-level leaders used a combination of institution-focused definitions more so than mid-level leaders, however (not statistically significant). Conclusions: A shift to more other-focused ways of leading is emerging. Those in mid-level positions hold onto leader-focused definitions of leadership, and this points to the need to reconceptualize mid-level leadership and ideas of leading that include others and connect to institutional missions and initiatives. The complex nature of today’s organizations requires broader conceptions of leadership.
Analysis of the Efficacy and Safety of Intratymapanic Dexamethasone for Treating Meniere’s Disease: A Randomized Controlled Trial
Authors: Yin Gendi , Zhicheng Li  , Zhang Shuqi , Wang Xinyi , Yang Jiali , Cai Hao , Zeng Xiangli 
Published: September 2022

Objectives Our objective was to study the efficacy and safety of intratymapanic dexamethasone (ITD) for treating in Méniere’s disease in southern China. Methods A total of 124 patients with Méniere’s disease were randomly divided into 2 groups: ITD group (n = 62) and intratympanic lidocaine (ITL) group (n = 62). The ITD group was further randomly divided into 2 groups based on dexamethasone dosage: ITD1 (2 mg/ml) (n = 31) and ITD2 (5 mg/ml) group (n = 31). Symptom alleviation and complications were recorded after every treatment. Results Vertigo was improved in 65% of patients who received ITD compared with 55% of patients who received ITL patients ( P < .05). Three patients in the ITD2 group had from otomycosis, and 2 of these patients had a perforation; no tympanic membrane perforation was observed in the ITL and ITD1 group. Conclusions Compared with lidocaine, dexamethasone is more effective in alleviating vertigo, and a lower concentration of dexamethasone can reduce the occurrence of complications.
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.
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.
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.
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.
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.
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.
Cost Analysis of Surgical and Medical Uterine Evacuation Methods for First-Trimester Abortion Used in Public Hospitals in Mexico
Authors: Sanchez-Morales Jorge Eduardo , Rodriguez-Contreras Jose Luis , Ruiz-Lara Leslie , Ochoa-Torres Beatriz , Zaragoza Mara , Padilla-Zuniga Karen 
Published: September 2022

Background: Data on abortion procedures costs are scarce in low- and middle-income countries. In Mexico, the only known study was conducted more than a decade ago, with data from years before the abortion legislation. This study estimated the costs, from the health system’s perspective, of surgical and medical abortion methods commonly used by women who undergo first-trimester abortion in Mexico. Methods: Data were collected on staff time, salaries, medications, consumables, equipment, imaging, and lab studies, at 5 public general hospitals. A bottom-up micro-costing approach was used. Results: Surgical abortion costs were US$201 for manual vacuum aspiration and US$298 for sharp curettage. The cost of medical abortion with misoprostol was US$85. The use of cervical ripening increases the costs by up to 18%. Staff comprised up to 72% of total costs in surgical abortions. Hospitalization was the area where most of the spending occurred, due to the staff and post-surgical surveillance required. Conclusions: Our estimates reflect the costs of “real-life” implementation and highlight the impact on costs of the overuse of resources not routinely recommended by clinical guidelines, such as cervical ripening for surgical abortion. This information will help decision-makers to generate policies that contribute to more efficient use of resources.
Metabolic and Anthropometric Parameters of Persons at Risk of Developing Type 2 Diabetes Mellitus Before and After 3 Months of Consuming Insoluble Dietary Fiber
Authors: Khalangot Mykola D , Gurianov Vitaly G , Zakharchenko Tamara F , Pysarenko Yurii M , Kravchenko Victor I 
Published: September 2022

Background: Observational studies have shown that insoluble fiber (IF) can be effective in preventing type 2 diabetes (T2D), but there is a lack of experimental data on the effect of short-term consumption of IF on metabolic parameters. We tried to investigate whether there was an improvement in glycemia and body composition in individuals at risk for T2D after 3 months of IF consumption. Methods: This “Type 2 Diabetes Mellitus Prevention Ukraine (T2DPUA)” study describes participants with impaired fasting glucose (IFG) as determined by ADA criteria. The study involved 30 people, including 21 women (70%). Daily, 15 g of IF derived from wheat was used. T2DPUA did not have a placebo group and the intervention lasted 3 months. Evaluation of fasting plasma glucose (FPG) and 2h plasma glucose (2hPG), glycated hemoglobin (HbA1c), total cholesterol, HDL-cholesterol, triacylglycerols, uric acid, and γ-glutamyl transferase was performed. The baseline and 3-monthly anthropometric examinations included measurements of weight, waist and hip circumference. Fat mass was assessed by bioelectrical impedance analysis. Paired samples t-test or Wilcoxon test were used. Result: A decrease of FPG ( P = .042), HbA1c ( P < .001), 2hPG ( P = .005), weight ( P < .001), body mass index ( P < .001), the proportion of body fat ( P = .006), and the absolute amount of fat ( P < .001), increases in systolic ( P < .001) and diastolic ( P = .008) blood pressure was shown. The number of people with hypertension did not change. The absolute amount of body fat decreased by almost 5% and tolerance to the standard glucose load improved by 15%. The dynamics of other metabolic parameters were not revealed. Conclusion and Recommendation: Data about improvement of glycemia and body composition over a short period of using IF by individuals with IFG are new and deserve larger studies.