Limited Physical Space Research Articles

Emergency department staff perspectives on caring for patients experiencing early pregnancy loss (Boston, Massachusetts 2021)

ObjectivesA preimplementation study to examine the context of, and barriers and facilitators to, providing early pregnancy loss care in one emergency department (ED), to inform implementation strategies to improve ED-based early pregnancy loss care. Study designWe recruited a purposive sample of participants and conducted semistructured individual qualitative interviews focused on caring for patients experiencing pregnancy loss in the ED until saturation was reached. For analysis, we used framework coding and directed content analysis. ResultsParticipant roles in the ED included administrators (N = 5), attending physicians (N = 5), resident physicians (N = 5), and registered nurses (N = 5). Most (70%, N = 14) participants identified as female. Primary themes included (1) caring for early pregnancy loss patients is challenging and uncomfortable, (2) inability to provide compassionate early pregnancy loss care causes moral injury, and (3) stigma influences early pregnancy loss care. Participants explained that early pregnancy loss is challenging due to added pressure, patient expectations, and gaps in knowledge. They reported barriers to providing compassionate care that are out of their control, such as systematic workflows, limited physical space, and insufficient time and expressed that these barriers lead to moral injury. Participants also reflected on how early pregnancy loss and abortion stigma affect patient care. ConclusionsCaring for patients experiencing early pregnancy loss in the ED requires unique considerations. ED staff recognize this and desire more early pregnancy loss education, clearer early pregnancy loss tools and protocols, and early pregnancy loss-specific workflows. With concrete needs identified, an implementation plan to improve ED-based early pregnancy loss care can be created, which is important now more than ever, due to the impending influx in the ED for early pregnancy loss care after the Dobbs decision. ImplicationsSince the Dobbs decision, patients are self-managing abortions and/or seeking out-of-state abortion care. Without access to follow-up, more patients are presenting to the ED with early pregnancy loss. By demonstrating the unique challenges emergency medicine clinicians face, this study can support initiatives to improve ED-based early pregnancy loss care.

ManiLoco: A VR-Based Locomotion Method for Concurrent Object Manipulation.

The use of virtual reality (VR) in laboratory skill training is rapidly increasing. In such applications, users often need to explore a large virtual environment within a limited physical space while completing a series of hand-based tasks (e.g., object manipulation). However, the most widely used controller-based teleport methods may conflict with the users' hand operation and result in a higher cognitive load, negatively affecting their training experiences. To alleviate these limitations, we designed and implemented a locomotion method called ManiLoco to enable hands-free interaction and thus avoid conflicts and interruptions from other tasks. Users can teleport to a remote object's position by taking a step toward the object while looking at it. We evaluated ManiLoco and compared it with state-of-the-art Point & Teleport in a within-subject experiment with 16 participants. The results confirmed the viability of our foot- and head-based approach and better support concurrent object manipulation in VR training tasks. Furthermore, our locomotion method does not require any additional hardware. It solely relies on the VR head-mounted display (HMD) and our implementation of detecting the user's stepping activity, and it can be easily applied to any VR application as a plugin.

A First-Class Simulation: In-Situ In-Flight Medical Emergencies Curriculum for Emergency Medicine Residents Aboard a Commercial Airliner.

In-flight medical emergencies occur in an estimated one out of 604 flights. Responding in this environment poses a unique set of challenges unfamiliar to most emergency medicine (EM) providers, including physical space and resource limitations. We developed a novel high-fidelity in-situ training curriculum focused on frequent or high-risk in-flight medical scenarios while replicating this austere environment. Our residency program coordinated with our local airport's chief of security and an airline-specific station manager to arrange the use of a grounded Boeing 737 commercial airliner during late evening/early morning hours. Eight stations reviewing in-flight medical emergency topics were reviewed, five of which were simulation scenarios. We created medical and first-aid kits that reflect equipment used by commercial airlines. Residents' self-assessed competency and medical knowledge were assessed both initially and post-curriculum using a standardized questionnaire. Forty residents attended the educational event as learners. Self-assessed competency and medical knowledge increased after curriculum participation. All tested aspects of self-assessed competency had a statistically significant increasefrom a mean of 15.04 to 29.20 out of a maximum score of forty. The mean medical knowledge score increased from 4.65 to 6.93 out of 10 maximum points. A five-hour in-situ curriculum for reviewing in-flight medical emergencies increased self-assessed competency and medical knowledge for EM and EM-internal medicine residents. The curriculum was overwhelmingly well-received by learners.

Design of an AS/RS machine for storage and extraction of items in a warehouse using Finite Element Analysis (FEA)

The globalization of markets and high competitiveness impose new challenges every day on companies that develop their activities in the field of logistics, e-commerce, service, and product distribution. The implementation of automated systems becomes relevant when the objective is to increase productivity, efficiency and reduce costs associated with handling, picking and overhead. The AS / RS systems (i.e., Automated Storage and Retrieval System) are automated machines able to move in the 3 coordinate axes (x, y, z), which are responsible for arranging the items in large warehouses generating a decrease in time delivery and storage. The aim of the article is to show the design of a prototype of an AS / RS (CAD) machine based on Finite Element Analysis (FEA) to verify the behavior before static loads according to Von Misses criteria and to guarantee the appropriate administration, storage, and extraction of each item in the warehouse, respectively. Also, it shows the use of the selection matrix that facilitates the interaction with the articles and execute the primary functions according to customer requirements. The result of this research shows the advantages and disadvantages of the implementation of these systems for companies that manage high volumes of storage, limited physical space and that require an appropriate management of the elements through the help of an easy-to-implement human-machine interface (HMI) that has control over open loop.

Analysis and Discussion of Influential Factors in the Construction of Digital Learning Spaces in the Context of Higher Education Digitization

With the trend of digitization in higher education, digital learning spaces have gained widespread attention as important learning environments. This article first outlines the development trends of digitization in higher education, including digitization of teaching tools, digitization of teaching content, and digital learning spaces. It then analyzes the influential factors in the construction of digital learning spaces, including requirements for digital technology, pedagogical innovation, repositioning of teacher and student roles, breaking the limitations of physical time and space, and the transformation of managerial functions. Finally, it provides an outlook on the development prospects of digital learning spaces.

Vehicle Following on a Ring Road Under Safety Constraints: Role of Connectivity and Coordination

A fundamental problem in traffic networks is driving under safety and limited physical space constraints. In this paper, we design longitudinal vehicle controllers and study the dynamics of a system of homogeneous vehicles on a single-lane ring road in order to understand the interplay of limited space, speed, and safety. Each vehicle in the system either operates in the cruise control mode or follows a vehicle ahead by keeping a safe time headway. We show that if the number of vehicles is less than a certain critical threshold, vehicles can occupy the limited space in many different configurations, i.e., different platoons of different sizes, and they converge to a uniform maximum speed while attenuating errors in the relative spacing upstream a platoon. If the number of vehicles exceeds the threshold, vehicles converge to a unique symmetric configuration and the equilibrium speed decreases as the number of vehicles increases. Next, we consider vehicle-to-vehicle (V2V) communication and show that it increases the critical number of vehicles that can travel with the maximum speed. Finally, we consider vehicle coordination and show that the proposed controllers can force vehicles to converge to a desired configuration specified by the coordinator while maintaining safety and comfort. We demonstrate the performance of the proposed controllers via simulation.

A Model and Experimental Validation for a Piston Rings—Squeeze Film Damper: A Step Toward Quantifying Air Ingestion

Abstract Rotor-bearing systems often rely on squeeze film dampers (SFDs) to increase the dynamic stability and reduce rotor motion amplitudes while traversing critical speeds. In aircraft engines, to increase the damping capacity within a limited physical space, piston rings (PRs) seal the axial ends of a squeeze film land. However, lubricant still leaks through the slit in the PR abutted ends, and air enters into the film to make a bubbly oil mixture with a much reduced damping capability. This paper presents a volume of fluid (VOF) model for a PR sealed ends SFD facing ambient air (not submerged in lubricant and prone to air entrainment) and delivers predictions benchmarked against experimental results obtained in a dedicated test rig. A lubricant feeds pressure and flows large enough to prevent air ingestion vary with the damper geometry, the lubricant inlet and outlet conditions, and the kinematics of the journal. A parametric study for a typical SFD shows the period-averaged gas volume fraction (GVF) increases as the journal squeeze film velocity (vs) increases and as the film clearance decreases. Most importantly, the location of the PR slit relative to the feedhole affects the amount of air drawn into the film. When the PR slit faces a feedhole, the film land is mostly filled with a pure lubricant. The GVF increases as the arc distance from the PR slit to the feedhole increases. The physical model, anchored by the test data, effectively addresses a fundamental challenge in SFD design and operation; namely, quantifying the amount of air ingested and its effect on the damper forced performance.

Movement guidelines for young children: Engaging stakeholders to design dissemination strategies in the Hong Kong early childhood education context.

Early childhood is a critical period during which patterns of movement behaviors are formed. The World Health Organization had endorsed guidelines for physical activity, sedentary behavior and sleep over a 24-h time period, which had been adopted by the Center for Health Protection of Hong Kong. This paper reports on stakeholder engagements that were conducted to inform the design of strategies to disseminate the guidelines in early childhood education (ECE) settings. Using a mixed-methods study design, we sought to (a) assess the stakeholders' levels of awareness and knowledge of the Hong Kong movement guidelines for young children and (b) identify the factors that influence the uptake of the said guidelines. We conducted an online survey of early childhood education teachers (N =314), twelve focus groups involving teachers (N = 18) and parents (N = 18), and individual interviews of key informants (N = 7) and domestic workers who provide care for preschool-aged children (N = 7). Descriptive statistics were used for the quantitative data, and thematic analysis was performed on the qualitative data using an inductive and semantic approach following a realist framework. Our findings show that teachers were aware of the movement guidelines for young children, but their knowledge of the specific guidelines was deficient; parents and domestic workers had limited awareness and knowledge of the guidelines. Uptake of the movement guidelines is enabled by parent engagement, activities in the ECE centers, home-school cooperation, and community activities for children. The challenges include the time poverty of parents, local curriculum requirements, limited physical spaces, social values, and pandemic-related restrictions. We recommend that dissemination strategies in the ECE context should deliver knowledge content and support stakeholders in mitigating the challenges associated with time, space, and social conditions.

Factorial Design with Simulation for the Optimization of the Level of Service in the Platform-Train Interface of Metro Stations—A Pilot Study

Metro stations are considered complex areas of pedestrian mobility due to the increasing congestion, due to the a high level of demand of different circulation spaces. Given this situation and the limited physical spaces remaining to develop transport systems in urban areas, railways acquire greater relevance given the need to mobilize pedestrians. Within the stations, the most problematic area is the platform-train interface (PTI) due to the high number of interactions between passengers boarding and alighting. The objective of this study is to identify the PTI configuration that maximizes the level of service for passengers, safeguards the operational continuity of the system and improves user experience by reducing dissatisfaction and delay times. For this, a pedestrian microsimulation model is used in order to recreate the reality of a generic metro station and its different scenarios given the combinations of two factors: the platform configurations (topology) and the traffic control elements. Subsequently, these scenarios are analyzed through a factorial design, looking for the situation that optimizes the combination of metrics chosen in a weighted way. Finally, it is found that the PTI configuration that maximizes the level of service for users is the mixed station with signaling. It is this which includes the factors with the greatest positive effect on the chosen metrics.

Effects of COVID-19 on children with autism.

The coronavirus disease 2019 (COVID-19) pandemic affects all countries and populations worldwide, significantly impacting people with autism with a high risk of morbidity and mortality due to COVID-19. Approximately 25% of children with autism have an asymptomatic or symptomatic immune deficiency or dysfunction. In addition, they frequently have various comorbid conditions that increase the severity of COVID-19. In addition, severe COVID-19 during pregnancy may increase the risk of autism in the offspring. Furthermore, severe acute respiratory syndrome coronavirus 2 could target human nervous system tissues due to its neurotrophic effects. The COVID-19 pandemic intensely impacts many patients and families in the autism community, especially the complex management of autism-associated disorders during the complete lockdown. During the complete lockdown, children with autism had difficulties coping with the change in their routine, lack of access to special education services, limited physical space available, and problems related to food and sleep. Additionally, children with autism or intellectual disabilities are more liable to be abused by others during the pandemic when the standard community supports are no longer functioning to protect them. Early detection and vaccination of children with autism against COVID-19 are highly indicated. They should be prioritized for testing, vaccination, and proper management of COVID-19 and other infectious diseases. In this review, we discuss the various effects of COVID-19 on children with autism, the difficulties they face, the increased risk of infection during pregnancy, how to alleviate the impact of COVID-19, and how to correct the inequalities in children with autism.

Exploring Access and Utilization of Early Intervention Services Among Families Experiencing Homelessness: A Qualitative Study.

Children experiencing homelessness face particular barriers to accessing early interventions. Our study sought to explore the experiences of families in accessing Early Intervention Program services (EI) while living in a family shelter. Semi-structured in-depth interviews were undertaken with nineteen caregivers who had recently experienced or were contemporaneously experiencing homelessness from three shelter sites in Boston, Massachusetts. Our findings demonstrate the role of the shelter both in inhibiting and promoting access to early intervention. Shelter-related barriers included limited physical space, lack of care continuity amidst frequent relocations, and mistrust due to feelings of stigma. Early interventionists played a crucial role in mitigating challenges but were often unable to fully overcome these and other barriers tied to shelter environments. Effective strategies included flexibility in accommodating shifting schedules, provision of socioemotional support, and proactively linking caregivers to additional upstream resources. Efforts to mitigate shelter-related challenges will require interdisciplinary collaboration at both local and state levels. Further efforts should focus on providing increased continuity of care in a manner that acknowledges the structural barriers of homelessness.

Evaluation of School Libraries in Terms of Quantity and Quality

School libraries are supplementary places enabling students to acquire reading habits and reading culture. The purpose of this study is to determine the status of libraries in schools and to take the opinions of teachers towards school libraries. For this purpose, a case study design has been utilized in the current research and observation and interview techniques have been employed. In the research, the libraries of all schools in a city centre have been observed. Through stratified purposeful sampling and criterion sampling methods, interviews were carried out with teachers working in school libraries. The research data were analysed via content analysis. As a result of the research, it was determined that two-thirds of the schools had libraries. Besides, it was revealed that the capacity of the school libraries is inadequate due to the limited physical space of the libraries in schools. Although there were computers and the internet in libraries, digitalization was determined to be limited. It was also shown that there were mostly classical works and the libraries covered inadequate number of contemporary books. When examining the genres of the books in libraries, it may be said that there were novels and story book by a majority, referring to a limited variety of genres. It has been concluded that students can not effectively use school libraries as expected due to by virtue of the limited library facilities. Accordingly, in order to ensure the effective use of school libraries by students, the physical conditions of the libraries should be improved as well as the variety and quality of the documents should be increased.

Media Mirror: A Study of Behavioral Logic in Z Generation’s Accompanying Learning Live Broadcast

Since the outbreak of the COVID-19 pandemic in 2020, people’s social distance has been forced to extend. At the same time, the development of media technology has broken through the limitations of physical time and space to a certain extent. New media has catalyzed the formation of new situations, and online learning has become the norm for many people. In recent years, accompanying learning live broadcast has gradually emerged. In the exploration of the behavioral logic root of the rise of the phenomenon of accompanying learning live broadcast, the author believes that the learning scene of the audience gazing at the anchor through the screen is very similar to the scene of the baby seeking self-confirmation in the mirror, and the process of their identity identification is in line with Lacan’s mirror stage. Based on Lacan’s mirror theory, this paper aims to interpret the behavioral logic in the accompanying learning live broadcast from the perspective of psychoanalysis and reflect on this media phenomenon. This paper adopts participatory observation and case analysis to collect data, analyzes how the audience and the anchor mirror each other, which constitutes self-identification in the process of accompanying learning live broadcast. This study puts forward some suggestions on how to treat this media phenomenon correctly.

Impact of the COVID-19 Pandemic on the Prevalence of HAIs and the Use of Antibiotics in an Italian University Hospital.

The COVID-19 pandemic has massively affected healthcare systems globally, causing a possible reduction in attention to traditional infection prevention programs. The objective of this study was to estimate the prevalence of healthcare-associated infections (HAIs) and the use of antimicrobials in an Italian University Hospital and to investigate whether the intensification of hospital infection control measures during the COVID-19 pandemic has affected the prevalence of bacterial HAIs. A point prevalence survey was conducted according to the simplified ECDC protocol. The survey identified a local HAI prevalence of 9.0%, revealing an increase compared to pre-pandemic values (7.3%). The survey also identified an antimicrobial exposure of 40.8%, revealing a decrease in their use compared to the study carried out in the pre-pandemic era (44.6%). Among the organizational challenges experienced during the COVID-19 pandemic, despite the greater attention paid to infection prevention measures aimed at reducing SARS-CoV-2, many healthcare facilities had to contend with the controlled availability of personnel, physical space limitations and a large number of patients. Active surveillance in hospital wards and the consequent reporting by personnel specialized in infection control is fundamental for hospitals to recognize gaps in prevention and report any observed increases in HAIs.

P133 Pivoting to Online Nutrition Education During the COVID-19 Pandemic: Results and Lessons Learned from Cooking Matters

ObjectiveEvaluate the process and outcomes associated with pivoting Cooking Matters curriculum to online nutrition education during the COVID-19 pandemic.Use of Theory or ResearchCooking Matters uses evidence-based curricula built upon the Social Cognitive Theory, with a focus on increasing self-efficacy through participatory food skills education to enable positive behavior change.Target AudienceLow-income adults, parents and caregivers, and families receiving services or programming from schools and community-based organizations across the United States from June 2020 until June 2021.Program DescriptionCooking Matters curriculum was pivoted to an online nutrition education setting at the onset of the COVID-19 pandemic to teach participants how to shop for and prepare healthy meals on a limited budget.Evaluation MethodsWith support from IMPAQ International, LLC (a third-party evaluator), Cooking Matters online delivered programming was evaluated through 9,187 participant surveys completed post-participation and through virtual/Zoom in-depth interviews with 24 individuals from 13 partner organizations implementing the curricula.ResultsParticipants reported high confidence to apply food skills such as making mealtimes positive and high intention to use food skills in the future such as money-saving tips. Over 90% of participants were satisfied with the instructor and class environment. Partners described that online programming accommodated more participants due to lack of physical space limitations, was convenient for participants because it decreased travel time, allowed for food preparation in participants' kitchens, was more burdensome for staff, decreased curriculum engagement at times, and did not foster the same communal ties as in-person.ConclusionsOnline delivery allowed Cooking Matters to continue offering programming during the pandemic. To ensure responsiveness to participant and partner needs, we centered the voice of our end users, developed nutrition education reflective of these unique needs and desires, and released our new online approach focusing on digital delivery. Based on this evaluation, Cooking Matters will continue supporting partners in delivering virtual programming as an additional means of reaching busy parents and caregivers.FundingNone

Additively manufactured strain sensors for in-pile applications

Accurate, real-time monitoring of strain in fuel, cladding, and structural components of nuclear reactors is critical to better understand radiation induced phenomena during reactor tests and operations. The data provided is crucial to verify physics-based, multiscale modeling and simulation efforts, which aim to shorten the timeline for the development of new nuclear materials. Resistive strain gauges have limited performance during in-pile experiments due to the harsh operating conditions and limited physical space between fuel and cladding components. In this work, aerosol jet printing using silver nanoparticle inks was used to fabricate interdigitated electrode capacitive strain gauges on aluminum alloy 6061 tensile specimens. To simulate the temperatures of a traditional light water reactor, the capacitive strain gauges were tested with a mechanical test frame up to 300 °C and compared to commercially available bondable resistive strain gauges. The printed capacitive strain gauges exhibited a gauge factor of 1.0 and showed higher reproducibility and predictability of strain sensing performance than the resistive strain gauge. The results demonstrate the potential of aerosol jet printing to fabricate strain sensors with predictable performance and reduced invasiveness for high-temperature applications with confined spacing.

Adaptive Redirection: A Context-Aware Redirected Walking Meta-Strategy.

Previous research has established redirected walking as a potential answer to exploring large virtual environments via natural locomotion within a limited physical space. However, much of the previous work has either focused on investigating human perception of redirected walking illusions or developing novel redirection techniques. In this paper, we take a broader look at the problem and formalize the concept of a complete redirected walking system. This work establishes the theoretical foundations for combining multiple redirection strategies into a unified framework known as adaptive redirection. This meta-strategy adapts based on the context, switching between a suite of strategies with a priori knowledge of their performance under the various circumstances. This paper also introduces a novel static planning strategy that optimizes gain parameters for a predetermined virtual path, known as the Combinatorially Optimized Pre-Planned Exploration Redirector (COPPER). We conducted a simulation-based experiment that demonstrates how adaptation rules can be determined empirically using machine learning, which involves partitioning the spectrum of contexts into regions according to the redirection strategy that performs best. Adaptive redirection provides a foundation for making redirected walking work in practice and can be extended to improve performance in the future as new techniques are integrated into the framework.

Readout electronics for the CMS Phase II Endcap Calorimeter: system overview and prototyping experience

The frontend readout system for the silicon section of the CMS Phase II Endcap Calorimeter faces unique challenges due to the high channel count and associated bandwidth, limited physical space, as well as radiation tolerance requirements. I will give an overview of the frontend electronics design and will discuss the recent experience obtained from the first test system that integrates the HGCROC2 readout ASIC, lpGBT, and VTRX+ in a realistic manner, linking together prototypes of the hexaboard, engine, and wagon boards.

Operation management of academic libraries in Hong Kong under COVID-19

PurposeThis research studies the influence of the COVID-19 pandemic on the operation management of Hong Kong academic libraries for understanding the difficulties and challenges for librarians to adapt to the special arrangements during the pandemic.Design/methodology/approachQualitative semi-structured interviews were conducted with librarians in major universities and higher education institutions of Hong Kong. Participants were interviewed either in the face-to-face format or text-based format.FindingsParticipants provided a broad scope about the actual library management and operation changes during the COVID-19. According to the respondents, the most challenging problem for librarians during COVID-19 was to strike a balance between concerns of library staff and users. While they described how these arrangements and changes affected the service quality of academic libraries from different perspectives, the pandemic situation also brought some opportunities, such as pushing the digitalization of all collections and using online resources for future development. A hybrid model for library service would be more common in the future with more demands toward online resources and digital collection, in which academic libraries should be prepared after the pandemic.Originality/valueThis paper provided broad insights into library management and the future development of academic libraries for the post-COVID-19 period. There are scant studies of this topic, especially in an Asian metropolis context with dense population, small campus and limited library physical spaces.

Polarization‐Induced Band‐Alignment Transition and Nonvolatile p‐n Junctions in 2D Van der Waals Heterostructures

Abstract2D van der Waals (vdW) p‐n junctions based on vertically stacked atomically thin semiconductor materials have shown tremendous potential in high‐performance integrated electronics and optoelectronics. However, unlike traditional semiconductors, the conventional doping methods to achieve p‐type and n‐type doping in 2D semiconductors remain a large challenge due to their ultrathin structures with limited physical space. Here, by means of density functional theory computations, a nonvolatile doping strategy to obtain self‐defined p‐n junctions in 2D vdW heterostructures created by assembling monolayer transition metal dichalcogenides (TMDs) on polar semiconductors (PSs) is reported. The calculated results show that the quantum‐confined Stark effect causes the band inclination of 2D PSs along the polarization direction, which allows to manipulate the type of band alignment and spatial distribution of carriers in the heterostructures via the polarization modulation. In particular, the realization of nonvolatile p‐n junctions in type‐III TMD/PS heterostructures with ultrahigh carrier concentration (≈1013 ‐ 1014 cm‐2) is demonstrated, and the spatial distribution of charge carriers in the heterostructures can be tuned by the polarization switching. This work provides a nondestructive doping strategy to obtain programmable vdW p‐n junctions with high carrier concentration and band‐engineering approach for the development of versatile 2D electronics and optoelectronics.