Contact Points Research Articles

Leaving the profession as a medical assistant: a qualitative study exploring the process, reasons and potential preventive measures

BackgroundWorldwide growing shortages among health care staff are observed. This also holds true for medical assistants in Germany. Medical assistants mainly work in outpatient care and are the first point of contact for patients while performing clinical and administrative tasks. We sought to explore profession turnover among medical assistants, that is, in terms of the underlying decision-making process, the reasons for leaving the medical assistant profession and potential retention measures from the perspective of former medical assistants.MethodsFor this qualitative study, we conducted semi-structured telephone interviews with 20 former medical assistants between August and November 2023. Eligible for participation were medical assistants who (i) were of legal age, (ii) completed medical assistant vocational training and ii) were formerly employed as a medical assistant, but currently employed in another profession. The interviews were recorded, transcribed verbatim and content-analyzed.ResultsFormer medical assistants expressed various, often interrelated reasons for leaving the profession. These were changes in priorities throughout their career (e.g., in terms of working hours and salary), a constant high workload, barriers to further training, poor career prospects, and poor interpersonal relationships particularly with supervisors, but also within the team and with patients as well as the perception of insufficient recognition by politics and society. Suggestions of former medical assistants to motivate medical assistants to stay in their profession included amongst others higher salaries, more flexible work structures, improved career prospects, and more recognition from supervisors, patients, and society.ConclusionOur study provides insights into the complex decision-making process underlying ultimate medical assistant profession turnover. In light of an already existing shortage of medical assistants, we suggest to further explore how the suggested interventions that aim at retention of working medical assistants can be implemented.

Super‐Strong, Super‐Stiff, and Super‐Tough Fluorescent Alginate Fibers with Outstanding Tolerance to Extreme Conditions

AbstractThe combination of multiple physical properties is of great importance for widening the application scenarios of biomaterials. It remains a great challenge to fabricate biomolecules‐based fibers gaining both mechanical strength and toughness which are comparable to natural spider dragline silks. Here, by mimicking the structure of dragline silks, a high‐performance fluorescent fiber Alg‐TPEA‐PEG is designed by non‐covalently cross‐linking the polysaccharide chains of alginate with AIEgen‐based surfactant molecules as the flexible contact points. The non‐covalent cross‐linking network provides sufficient energy‐dissipating slippage between polysaccharide chains, leading to Alg‐TPEA‐PEG with highly improved mechanical performances from the plastic strain stage. By successfully transferring the extraordinary mechanical performances of polysaccharide chains to macroscopic fibers, Alg‐TPEA‐PEG exhibits an outstanding breaking strength of 1.27 GPa, Young's modulus of 34.13 GPa, and toughness of 150.48 MJ m−3, which are comparable to those of dragline silk and outperforming other artificial materials. More importantly, both fluorescent and mechanical properties of Alg‐TPEA‐PEG can be well preserved under various harsh conditions, and the fluorescence and biocompatibility facilitate its biological and biomedical applications. This study affords a new biomimetic designing strategy for gaining super‐strong, super‐stiff, and super‐tough fluorescent biomaterials.

Advancing the design of interspinous fixation devices for improved biomechanical performance: dual vs. single-locking set screw mechanisms and symmetrical vs. asymmetrical plate designs.

Interspinous devices were introduced in the field of spine surgery as an alternative to traditional pedicle screw fixation in selected patients for treatment of spinal stenosis and fixation. These devices designs have evolved from non-fixated extension blocks to sophisticated interspinous fixation devices (IFDs). There is an absence of literature comparing the biomechanical fixation strength of different IFD plate designs and the role of set screw locking systems. The aim of this study was to evaluate fixation strengths by bench testing static disassembly and pullout strength of two dissimilar IFD designs and locking mechanisms. We hypothesized that the InSpan (InSpan LLC, Burlington, MA, USA) dual-locking symmetrically IFD plate designed will have stronger fixation than the Aspen (ZimVie, Parsippany, NJ, USA) single-locking asymmetric IFD plate design. We conducted two biomechanical bench tests to evaluate the load to failure locking characteristics of symmetrical InSpan and asymmetrical Aspen IFD designs. Static pullout testing involved locking each IFD to the stainless steel and 40 pcf cellular polyurethane foam and measuring pullout load and displacement six times. Seven InSpan and two Aspen IFDs (including the "used" IFDs from the pullout testing) underwent static disassembly tests using a pair of disassembly fixtures positioned between the IFD plates to measure disassembly force and displacement. All tests were performed under ambient conditions using an INSTRON 8874 Bi-Axial Tabletop Servohydraulic Dynamic Testing System (INSTRON, Norwood, MA, USA), and data was collected at a 0.2 mm/s displacement control rate until the test was stopped when there was a drop in the continuously increasing force against resistance (gross failure). The InSpan IFD experienced 94.81% higher resistance to pullout compared to the Aspen IFD in static pullout testing (P<0.05), owing to its notably larger footprint area of 69.8%. Gross failure for both IFD implant designs occurred at the foam block-block interface. In static disassembly testing, pristine InSpan required 60.7% higher force over pristine Aspen and 401.3% for "used" IFDs. Gross failure was characterized by the gradual distraction of the plates and material removal at the set screw contact points. Implant failure at the block-implant interface emphasized the pivotal role of teeth design and the contact surface area of the plates in ensuring stability. The dual-locking symmetrical InSpan IFD outperformed single-locking asymmetric Aspen IFD in both static disassembly and pullout bench tests. This highlights the benefits of InSpan's improved design and its potential for enhanced long-term stability in spinal fixation applications.

Validation of finite-element-simulated orthodontic forces produced by thermoplastic aligners: Effect of aligner geometry and creep

PurposeFinite element (FE) models for determining the orthodontic forces delivered by clear aligners often lack validation. The aim of this study was to develop and validate accurate FE models for clear aligners, considering the small but important geometrical variations from the thermoforming process and the creep behavior of the aligner material. Methods and materialsThe tooth misalignment considered was a 2.4° torque aberration (rotation about the mesial-distal axis at the level of the center of resistance) of the maxillary left central incisor. FE models were created from Micro-CT scans of a model dental arch and five nominally identical aligners with the aforementioned misfit. Fitting of the aligners onto the dental arch was simulated using Abaqus's Interference Fit function, followed by surface-to-surface frictional interaction. Stress relaxation of the aligner material was measured using double-cantilever beam bending and modeled with a Prony series. The assembled FE models were validated by comparing the predicted forces and moments delivered to the maxillary left central incisor with experimental data, obtained with a custom-built but fully calibrated apparatus. ResultsGood agreement between prediction and measurement was obtained for both the short- and long-term forces and moments. In the short-term, i.e., after 30 s, the dominant force in the labial-lingual direction had a maximum difference of 2.9% between experiment and simulation, and the dominant moment about the mesial-distal axis had a maximum difference of 8.3%. In the long-term, i.e., after 4 h, the experimental and numerical forces had a maximum difference of 8.4%. There were statistically significant differences in the forces delivered among the nominally identical aligners, which were predicted by the geometrically accurate FE models and attributed to the variations in the points of contact between the aligners and the dental arch. The decay in force applied was affected by both the viscoelastic material behavior and friction between the aligner and arch. ConclusionFor accurate prediction of the forces and moments delivered by thermoplastic aligners, FE models that can accurately capture the point contacts between the aligners and the underlying teeth are essential. Stress relaxation of the aligners could be adequately modeled using the Prony series to represent the temporal changes of their elastic modulus.

Freedom Fighter and Location: a Different Story of Partisan Commander Petras Bartkus

The subject of the research in this article is the locations of the partisan warfare determined by the historical events of mid-20th century. The main aim of the research is to highlight the diversity and abundance of the locations of the partisan warfare based on the field data, oral history, archival documents and historical literature. In order to outline the significance of these locations, the case of Petras Bartkus, member of the presidium of the Council of the Movement of the Struggle for Freedom of Lithuania, was selected. The story starts at his birthplace in Pakapurnys Village (Raseiniai District) in 1925 and ends in 1991 in the cemetery of the town of Radviliškis, where the remains of those who had perished in Užpelkių Forest on 13 August 1949 were buried. The partisan warfare theatre connects various locations of the partisan warfare and allows us to speak about a coherent and homogeneous theatre rather than its individual episodes (bunkers and individual locations of the battles, places of death, etc.). Within the area divided by the war, some locations with encoded values and memories about them emerged, which have been included in the general narrative of the fights for freedom and stand out as places of historical memory. Archival and field studies make it possible to expand and provide more details to the space in which Bartkus operated, and subsequently to bring people back into the coherent historical partisan warfare narrative. The text lists the locations visited by Bartkus (and there are certainly more of them) and their diversity and abundance supports the thought that the landscape of freedom fights has been unduly diminished. The text mentions 37 places which are better known or which have been identified and 10 more general places, most of which are directly linked to Bartkus’ activities. They can be allocated to 13 different groups, such as his birthplace, camps, bunkers, shelters, locations of the archives, farmsteads of supporters, contact points, places of meetings, battles, places of death and desecration of dead bodies, and places of burial. Bartkus’ case study brings back an important perception of space during the years of the partisan war, which, after the restoration of an independent state, was generally reduced to the perception consisting of the places of death and burial. A rather comprehensive discussion of Barkus’ life provides supporting details to the environment in which freedom fighters operated, diversity of locations, their change depending on the person’s rank and time of operational activities. Bartkus’ example shows that the perception of the locations of the partisan warfare, which have so far been described as possible locations, but not necessarily existing locations, should be reconsidered. Where possible, the priority should be given to partisan documents, oral history, and field studies, while the documents of the Soviet security structures must be used for the search of additional information.

A Thin Film Model for Meniscus Evolution

In this paper, we discuss a particular model arising from sinking of a rigid solid into a thin film of liquid, i.e. a liquid contained between two solid surfaces and part of the liquid surface is in contact with the air. The liquid is governed by Navier–Stokes equation, while the contact point, i.e. where the gas, liquid and solid meet, is assumed to be given by a constant, non-zero contact angle. We consider a scaling limit of the liquid thickness (lubrication approximation) and the contact angle between the liquid–solid and the liquid–gas interfaces close to π\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\pi $$\\end{document}. This resulting model is a free boundary problem for the equation ht+(h3hxxx)x=0\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$h_t + (h^3h_{xxx})_x = 0$$\\end{document}, for which we have h>0\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$h>0$$\\end{document} at the contact point (different from the usual thin film equation with h=0\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$h=0$$\\end{document} at the contact point). We show that this fourth order quasilinear (non-degenerate) parabolic equation, together with the so-called partial wetting condition at the contact point, is well-posed. Furthermore, the contact point in our thin film equation can actually move, contrary to the classical thin film equation for a droplet arising from the no-slip condition. Additionally, we show the global stability of steady state solutions in a periodic setting.

Abstract B121: Enhancing opportunities for underrepresented minorities conducting cancer and cancer health disparities research nationwide: The Transformative Educational Advancement and Mentoring (TEAM) network

Abstract Background: The Transformative Educational Advancement and Mentoring (TEAM) network is a program funded by the Center to Reduce Cancer Health Disparities (CRCHD) of the National Cancer Institute (NCI). In support of the NCI’s goal to reduce cancer health disparities, the CRCHD drives workforce diversity efforts by supporting trainees from backgrounds underrepresented (UR) in cancer biomedical and behavioral sciences research. The two TEAM programs launched at minority-serving institutions (MSIs) in 2023: The Southwest TEAM (STEAM) network and San Diego State University’s (SDSU) Advancing Cancer Careers for ExceLlence (ACCEL). Each program has a unique model designed to best serve trainees in their respective regions, but both provide: 1) Diverse Training Champions (TCs), role models and navigators who act as the primary point of contact for scholars, provide direct services to trainees, ascertain member needs, develop programmatic offerings, and connect trainees to program components; 2) a mentorship program for pre and postdoctoral scholars and early stage investigators (ESIs); 3) targeted recruitment and professional development of UR scholars; and 4) tailored linkages to professional development and employment opportunities, and NCI/CRCHD funding priorities. This work summarizes the strategies planned across both programs to promote recruitment and retention of investigators from UR backgrounds and cultivate professional development opportunities for students and ESIs. Approach: The STEAM network includes the University of New Mexico, New Mexico State University, Northern Arizona University, and Burrell College of Osteopathic Medicine and leverages the unique programs and expertise of these MSIs to collectively train diverse cancer health disparities researchers with interests in serving Native American, Hispanic and rural communities in the Southwestern United States. The ACCEL Program supports excellence, inclusion and transformation of the cancer research science force, expanding and strengthening the pipeline of UR scholars pursuing cancer research. SDSU, a Carnegie Foundation high activity research institution is one of few institutions to be both a Title Ill/Title V eligible institution for diversity. ACCEL works in close collaboration with the University of California San Diego Moores Cancer Center. We will discuss opportunities and approaches employed by each program in support of scholars to increase the number of diverse scholars in these research pipelines and demonstrate the effectiveness of such coordinated efforts. Conclusion: Supporting TCs to focus on scholars within regional programs will prove to be an efficient and effective way to increase recruitment and retention of diverse investigators in NCI research and community programs. Using novel strategies like TCs, the programs will support the attainment of career goals and enhance and diversify workforce capacity across the cancer research and care continuum. Citation Format: Dolores D. Guest, Martha M. Grimes, Andrew L. Sussman, Elizabeth Y. Jimenez, Graciela Unguez, Ahmed Mohammed, Naomi Lee, Jani Ingram, Krystal Charley, Kristin Gosselink, Jill Nery, Avesta Basraki, Natalie Gude, Rebecca Lewison. Enhancing opportunities for underrepresented minorities conducting cancer and cancer health disparities research nationwide: The Transformative Educational Advancement and Mentoring (TEAM) network [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B121.

Abstract A158: Community-based lung cancer screening navigation for populations at high risk

Abstract Rationale: Lung cancer screening (LCS) can reduce mortality in individuals with a high-risk smoking history, but uptake has been uneven and suboptimal. In our catchment area of Washington state, urban American Indian/Alaska Natives (AI/AN) and sexual and gender minorities (SGM) have high rates of commercial tobacco use and lower uptake of LCS. Mixed-methods community-engaged formative research with both populations revealed barriers to LCS related to social determinants of health, and interest in identity-tailored approaches to LCS care. We used this to develop tailored navigation approaches to LCS. Our study objective was to pilot and evaluate patient navigation programs to facilitate LCS uptake and care completion for these community members. Methods: We conducted parallel LCS navigation pilot studies, with participants who self-identified as AI/AN or as a member of SGM communities and who were LCS screen eligible. Participants were recruited through referrals to our multi-site university-based LCS program, community-based organization partnerships, outreach, and social media. Dedicated patient navigators were trained on LCS processes, navigation, and community-specific best practices. Navigation was guided by handbooks with barrier-specific resources, standardized scripting for contact points, and community-based resources specific to the populations. Participants completed pre- and post-navigation (1-3 months after enrollment) surveys and were followed for LCS uptake, outcomes, and navigation activities through chart review. Results: Between July 1, 2023 and February 1, 2024, 40 participants were enrolled in the navigation pilot studies, 21 in the AI/AN arm and 19 in the SGM arm. The median age of participants was 65 (interquartile range (IQR): 59-69), 80% reported current smoking, and 65% reported a household income below $30,000. Most (55%) reported at least one barrier that delayed access to healthcare in the past year. After enrollment, 35% completed LCS within one month and 55% completed LCS to date. Participants who completed post-surveys (n=22, 55%) indicated that the patient navigator was helpful. Common navigation activities included scheduling assistance, understanding screening results, addressing financial issues, and smoking cessation. Overall, participants approved of navigation approaches with a median Acceptability of Intervention Measure score of 5/5 (IQR: 4.8-5) and a median Patient Satisfaction with Interpersonal Relationship with Navigator score of 44.5/45 (IQR: 39.3-45). Conclusion: These single-arm pilot trials suggest tailored navigation for LCS for AI/AN and SGM communities is a useful approach to engage patients and address barriers and appears acceptable and welcomed. However, substantial variation in LCS completion may reflect complex barriers not addressed through navigation. Community-based and tailored navigation offers a promising approach to address LCS disparities, though further bi-directional refinement of patient navigation is necessary to optimize engagement and LCS completion. Citation Format: Ursula Tsosie, Katie DeCell, Nicolas Anderson, Madison Snidarich, Brandon Omernik, Nicholas Murphy, Matthew Triplette. Community-based lung cancer screening navigation for populations at high risk [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A158.

An atomistic and experimental approach to study the effect of water and nanofillers on the compressive strength of PEGDA hydrogels for cartilage replacement

Polyethylene glycol diacrylate (PEGDA) hydrogel is emerging as a potential candidate for biomedical applications, particularly cartilage replacement. However, due to weak mechanical strength, their applications are still in the infancy for cartilage replacement. In this article, authors have reported the compressive strength of hexagonal boron nitride (h-BN) reinforced PEGDA hydrogels in conjunction with different water content. A combined experimental and atomistic approach (Molecular Dynamics) was employed to explore the compressive strength of nanocomposite hydrogels. It was reported from the experimental analysis that h-BN acts as a superior reinforcement for the compressive strength at lower water content. The Molecular Dynamics (MD) based simulations also predict a similar trend with h-BN and water content. The MD-based study gives insight into scrutinizing the behavior of polymer chains and their entanglement and sheds light on microscale phenomena that are usually inaccessible through experiments alone. It can be concluded from the experiments in conjunction with MD simulations that at higher water content, the contact points between h-BN nanosheets and polymer chains decrease, mitigating the overall compressive strength of PEGDA hydrogels. In summary, this study enables us to obtain meaningful mechanical properties that mimic the strength of human articular cartilage.

The impact of eHealth use on general practice workload in the pre-COVID-19 era: a systematic review

BackgroundIn recent years, eHealth has received much attention as an opportunity to increase efficiency within healthcare organizations. Adoption of eHealth might consequently help to solve perceived health workforce challenges, including labor shortages and increasing workloads among primary care professionals, who serve as the first point of contact for healthcare in many countries.The purpose of this systematic review was to investigate the impact of general eHealth use and specific eHealth services use on general practice workload in the pre-COVID-19 era.MethodsThe databases of CINAHL, Cochrane, Embase, IEEE Xplore, Medline ALL, PsycINFO, Web of Science, and Google Scholar were searched, using combinations of keywords including ‘eHealth’, ‘workload’, and ‘general practice’. Data extraction and quality assessment of the included studies were independently performed by at least two reviewers. Publications were included for the period 2010 – 2020, before the start of the COVID-19 pandemic.ResultsIn total, 208 studies describing the impact of eHealth services use on general practice workload were identified. We found that two eHealth services were mainly investigated within this context, namely electronic health records and digital communication services, and that the largest share of the included studies used a qualitative study design. Overall, a small majority of the studies found that eHealth led to an increase in general practice workload. However, results differed between the various types of eHealth services, as a large share of the studies also reported a reduction or no change in workload.ConclusionsThe impact of eHealth services use on general practice workload is ambiguous. While a small majority of the effects indicated that eHealth increased workload in general practice, a large share of the effects also showed that eHealth use reduced workload or had no impact. These results do not imply a definitive conclusion, which underscores the need for further explanatory research. Various factors, including the study setting, system design, and the phase of implementation, may influence this impact and should be taken into account when general practices adopt new eHealth services.Study registration numberPROSPERO (International Prospective Register of Systematic Reviews) CRD42020199897; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=199897.

Using a combination of cognitive behavioral therapy, case management and eHealth components for patients with depression or panic disorders in primary care practices in Hesse, Germany: an exploration of healthcare professionals’ lived experiences

BackgroundDepression and panic disorders have high prevalence rates in primary care. Given the crucial role of general practitioners in diagnosing and treating mental disorders, the two-arm cluster-randomized, controlled PREMA trial was designed. PREMA was aimed at investigating a new intervention combining cognitive behavioral therapy, case management and eHealth components for patients with depression and/or panic disorder with or without agoraphobia in primary care practices in Germany. This qualitative study, embedded in the PREMA trial, explores primary healthcare professionals’ lived experiences in using the new treatment program. Using a qualitative design, we conducted eleven interviews with general practitioners and medical assistants from Hesse, Germany, between July 2021 and March 2022. For both groups we relied on a semi-structured interview guide covering the following subjects: study procedures, implementation, practicality, and individual components of the treatment program. Interviews were audio-recorded, transcribed verbatim and analyzed by two researchers using content analysis. A deductive-inductive approach was used for the analysis according to Kuckartz.ResultsWe narratively summarized the facilitators and barriers from two different stakeholders across five key themes regarding experiences of feasibility and practicability of the new treatment program: study instruction materials, individual components of the treatment program, practicality, target population, and benefits of the treatment program. Facilitators to become familiar with the study include study instruction materials that are easy to understand and not too complex, considering the limited time resources available; barriers included text-heavy instruction materials, lack of collegial exchange, and issues especially with digital materials also involved access and log-in difficulties on the online platform. Facilitators for using the treatment program include the combination of face-to-face consultations and the use of an online platform, enabling a structured approach and regularity; barriers included patients feeling unsupported in performing anxiety exercises independently at home. For practicality, the professional skills of medical assistants and their central role as points of contact for patients facilitated the implementation; barriers included time-intensive organization and planning of monitoring phone calls and consultations. Regarding the target population, general practitioners and medical assistants state that the treatment program would be most appropriate for patients with mild to moderate depression and for those waiting for psychotherapeutic treatment; it would be less suitable for older patients, and those with negative attitudes towards technological tools. For benefits of the program, facilitating factors included free and low-threshold access to the online platform and strengthening the relationship between medical assistants and patients; barriers included a preference for in-person conversations and the inability of some people to use online applications.ConclusionsThe complexity of the new treatment program and the associated high workload underline the need for further adjustments to the treatment approach. Team-based care and the expanded responsibilities of medical assistants demonstrated promising results.Trial registrationThe study was registered in the German Clinical Trials Register (DRKS00016622) on February 22, 2019.

"Principled coordination" by R. Avenarius: points of contact with the "life world" of E. Husserl

Based on the texts of primary sources, the article presents an analysis of the research and development of the doctrine of "principled empiriocritical coordination" by the Swiss philosopher Richard Avenarius. The relevance of the study is due, firstly, to the fact that for a long time the works of representatives of the "second positivism", including R. Avenarius, were considered from the point of view of "subjective idealism", as stated in V. I. Lenin's work "Materialism and Empirio-criticism". In addition, many works of empirio-critics were translated into Russian at the beginning of the twentieth century. and they have not been reprinted. In this regard, we attempt to show what the philosopher himself wrote about and what the conclusions of his research logic are. Secondly, the interest in the philosophy of "everyday life", in that directly experienced experience, which forms the fabric of real human life, which persists and moreover increases if this experience is considered as the basis for all subsequent scientific and philosophical constructions. The purpose of the study is to establish a connection and relationship between the concept of R. Avenarius and the phenomenological doctrine of E. Husserl's "life world" through the method of comparative analysis of primary source texts. In his works, R. Avenarius develops two theories – "elements and characters" and "life series", while simultaneously asserting the method of "pure description" of data as the only possible one in the process of cognition of the facts of reality. Applying this method, R. Avenarius asserts, through the elimination of "introjection" and through "principled coordination" between the individual and the environment, a person's natural view of reality as the foundation for building subsequent philosophical and scientific concepts of explaining and understanding the world of experience. This position of R. Avenarius is in many ways consistent with E. Husserl's concept of the experience of direct experience of everyday life as a "soil" for scientific idealization and rationality. На основании текстов первоисточников в статье представлен анализ исследования и разработки учения о «принципиальной эмпириокритической координации» швейцарским философом Рихардом Авенариусом. Актуальность исследования обусловлена, во-первых, тем, что долгое время работы представителей «второго позитивизма», в том числе и Р. Авенариуса, рассматривались под углом зрения «субъективного идеализма», как о том было заявлено в работе В. И. Ленина «Материализм и эмпириокритицизм». Кроме того, многие сочинения эмпириокритиков были переведены на русский язык еще в начале ХХ в. и не переиздавались. В связи с этим нами предпринимается попытка показать то, о чем писал непосредственно сам философ и каковы выводы именно его логики исследования. Во-вторых, интересом к философии «повседневности», к тому непосредственно переживаемому опыту, который и составляет ткань реальной человеческой жизни, который сохраняется и более того возрастает, если этот опыт рассматривается как основа для всех последующих научных и философских построений. Целью исследования является установление связи и соотношения между концепцией Р. Авенариуса и феноменологическим учением о «жизненном мире» Э. Гуссерля посредством метода сравнительного анализа текстов первоисточников. В своих работах Р. Авенариус разрабатывает две теории – «элементов и характеров» и «жизненного ряда», одновременно утверждая метод «чистого описания» данных как единственно возможный в процессе познания фактов действительности. Применяя этот метод, Р. Авенариус утверждает посредством устранения «интроекции» и благодаря «принципиальной координации» между индивидом и окружающей средой естественное представление человека о действительности как фундамент для построения последующих философских и научных концепций объяснения и понимания мира опыта. Это положение Р. Авенариуса во многом согласуется с концепцией Э. Гуссерля об опыте непосредственного переживания повседневности как «почвы» для научной идеализации и рациональности.

Comparisons of Inverse Dynamics Formulations in a Spatial Redundantly Actuated Parallel Mechanism Constrained by Two Point Contact Higher Kinematic Pairs.

A spatial redundantly actuated parallel mechanism (RAPM) constrained by two point contact higher kinematic pairs (HKPs) has been designed, arising from the inspiration of mastication in human beings: the end effector is the lower jaw, the six kinematic chains are the primary chewing muscles, and the constraints at HKPs are the temporomandibular joints. In this paper, firstly, the constrained motions of the mechanism are described in detail; thereafter, five models are formulated by the well-known Newton-Euler's law, the Lagrangian equations, and the principle of virtual work, to explore its rigid-body inverse dynamics. The symbolic results show that the model structures based on these approaches are quite different: the model via the Newton-Euler law well reflects the nature of the mechanism in terms of the constraint forces from HKPs with six equations and eight unknowns, and the existence of reaction forces at the spherical joints is tightly dependent on the number of kinematic chains. In comparison, from the latter two methods, the constraint forces and the reaction forces at spherical joints do not appear in the four models in which there are only four equations and six unknowns. Further, by using the dynamics model of the non-redundantly actuated counterpart as the core in both the second models from the energy and virtual work-related methods, their computational cost is only about 16.7% and 36.63% of the two first models, respectively. Finally, the comparisons between the dynamics models of the RAPM and its counterpart clarify that the HKP constraints greatly alter the model structures and raise the technical difficulties.

Vertical‐Switching Conductive Bridge Random Access Memory with Adjustable Tunnel Gap and Improved Switching Uniformity Using 2D Electron Gas

AbstractOwing to the high reactivity and diffusivity of Ag and Cu ions, controlling the atomic filament formation and rupture processes in conductive bridge random‐access memory (CBRAM) is challenging. In this study, it is demonstrated that by using a 2D electron gas (2DEG) as the bottom electrode (BE) in a vertical‐switching CBRAM (V‐CBRAM), filament formation and rupture can be effectively managed and the tunnel gap distance created by partial filament formation can be adjusted. The 2DEG BE induces partial filament formation by limiting the number of electrons required for this process in the V‐CBRAM device, as verified via current fitting to the quantum point contact model. Varying the electron concentration and activation energy for electrons trapped in the 2DEG, when paired with various programming voltages, leads to transitions in the device resistance state via changes in the distance of the tunnel gap. This tunnel‐gap‐tunable 2DEG V‐CBRAM device, which exhibits superior switching uniformity, can be employed for nonvolatile memory applications in the sub‐G0 conductance regime, such as 3‐bit multilevel cells and selector‐less memory.

Fluorescent alginate fiber with super-strong and super-tough mechanical performances for biomedical applications

Emerging research attentions are focused on the development of fluorescent biomaterials for various biomedical applications, including fluorescence-guided surgery. However, it is still challenging to prepare biomolecules-based fluorescent fibers with both satisfactory biocompatibility and optimal mechanical properties. Here, we develop a fluorescent robust biofiber through using a tetraphenylethene-containing surfactant as the contact points between polysaccharide chains of alginate. This newly developed contact points not only strengthen the cross-linking network of polysaccharide chains, but also afford enough energy-dissipating slippage for polysaccharide chains. Consequently, the generated fluorescent fiber is endowed with highly improved mechanical performances from plastic strain stage. The experimental results indicate that the fluorescent fiber shows good mechanical properties of breaking strength of 1.10 GPa (12.09 cN/dtex), Young's modulus of 39.81 GPa and toughness of 137.26 MJ/m3, which are comparable to those of dragline silk and outperforming spider silk proteins and other artificial materials. More importantly, its satisfactory biosafety and wound healing-promoting ability as a fluorescent suture are solidly proved by both in vitro and in vivo assays, which opens an opportunity for its biological and biomedical applications. This study provides a novel strategy for the development of robust fluorescent biomaterials.

Oboe educators’ perspectives on playing-related injury, Part I: Lived experience and perceptions surrounding injury

Music students experiencing the potentially debilitating effects of playing-related injury (PRI) often first turn to their music teachers for help. This paper aims to document music instructors’ lived experience and perceptions surrounding PRI and better understand how teachers currently support students’ musculoskeletal health. Using a qualitative description approach, in-depth interviews with 10 oboe teachers (7 male, 3 female) documented their lived experience with or without injury and perceptions of PRI. Self-identified uninjured participants ( n = 5) described PRI-adjacent and non-PRI problems which elicited empathy for injured musicians, and self-reflective practices that contributed to better health. Injured participants described varied relationships to their pain, including pain as a source of guilt, distress, learning, and growth, and described diverse coping mechanisms including physical therapy, medication, mindfulness, and self-experimentation. Participants’ observations and experiences of PRI influenced their teaching, and several described seeking greater efficiency in students’ instrument set-up and body use. Resources for injured musicians were perceived to be difficult to access due to financial constraints, unawareness, jargon-filled language, and misinformation. These results suggest a need for more outreach from performing arts health professionals connecting music teachers, often the first point of contact for injured students, with high-quality resources which support student wellbeing.

Conducting two evidence syntheses in six weeks – experiences with and evaluation of a pilot project

BackgroundEvidence synthesis organisations are trying to meet commissioners’ needs for rapid responses to their evidence synthesis commissions. In this project we piloted an intensive process, working to complete evidence syntheses within six-weeks, rather than the standard lead time of 4–6 months. Our objective was to explore how researchers experience working intensively, identify barriers and facilitators, and determine how a more intensive approach to evidence synthesis could be more systematically introduced in the future.MethodsIn a pre-planning phase, an intensive work group was established, and two commissions were selected for this pilot project. The evidence synthesis process was divided into two phases: planning and intensive. The planning phase, involved scheduling the intensive phase, exploring new digital tools, and identifying peer reviewers. The intensive phase encompassed the entire evidence synthesis process. Two review teams were formed, each with a team lead supported by a process lead and leadership contact point. Throughout the project, teams engaged in reflective meetings to evaluate and adjust processes as needed.ResultsDuring the planning phase, teams identified significant uncertainties regarding scopes, research questions, and inclusion criteria. To address this, they engaged with commissioners earlier than originally planned, clarified these aspects, and prepared protocols. Despite some minor deviations from the original plan, both reviews were completed on schedule, with one team expanding their scope due to the absence of eligible studies. Teams operated flexibly, held regular meetings, and found the process seamless due to fewer interruptions. Machine learning tools facilitated rapid study selection. The process lead role, created to guide and evaluate the project, proved beneficial, providing structure and support, although clearer role delineation with the leadership contact point could have improved efficiency.ConclusionsOverall, the intensive process fostered focus and productivity, allowing teams to manage short-term deliverables effectively. The researchers preferred working intensively with one evidence synthesis over being involved with many projects at the same time. They felt that time use was more effective, and they were able to complete the tasks in a focused way. However, there are several implications that should be considered before implementing an intensive approach in future evidence syntheses.

Corporate Communication Through Podcasts: The Impact of Voice-Fit and Attention During Listening on Parasocial Interaction with the Host and Persuasive Effects

ABSTRACT Companies increasingly integrate their own podcasts into their communication strategies and are thus using a medium in which the host’s voice is the primary contact point for recipients. Since podcasts are generally listened to either with full concentration or in parallel with other activities, the question arises as to how voice characteristics exert an influence in different attention conditions. A 2 × 2-between-subjects-laboratory-experiment (N = 129) shows that attention, but not voice-fit with the company, increases parasocial interaction (PSI) with the host. However, deeper message processing due to higher PSI leads to negative persuasive effects. Scientific and practical implications of these findings are discussed.

Experimental recurrence of an unreported fire risk of power cable: Discharge of bracket cable metallic grounding under coupled vibration conditions

In environments like bridges and tunnels, power cables are laid on metal brackets (hereinafter referred to as bracket cables). If the aluminum sheath and metal bracket form a metallic grounding fault, the air gap near the contact point may bear an intermittent discharge under the cable vibration, which is a potential source of cable fires. However, current research on cable grounding systems does not focus on analyzing the physical metallic grounding process. Discharge from coupled vibrations has been overlooked. This study accomplished the experimental recurrence of discharge at the metallic grounding point of cables under coupled vibration. According to the experimental observations, intermittent electric sparks and AC arc occur with the contact and separation of the aluminum sheath and the metal bracket due to vibrations. Under coupled vibration conditions, metallic grounding faults in cables pose a risk of causing cable fires.

Theoretical and experimental approaches for flexible cage dynamic characteristics of four-point contact ball bearing considering multi-point contact behaviors

Multi-point contact often occurs between the balls and raceways of the four-point contact ball bearing (FPCBB) due to operating conditions and manufacturing errors, which can lead to unstable motion and wear of the cage. A dynamic analysis method for FPCBB with a flexible cage under multi-point contact is presented in this paper. Initially, the boundary conditions for different contact points (two-point, three-point, and four-point contact) are clarified through the research of the dynamic interaction and collision mechanisms between the balls and the raceways. Subsequently, based on the structure flexibility, and the collision effect among the balls, cage, and guiding ring, a dynamic model for FPCBB is constructed, and the heightened accuracy and superiority of the model are substantiated through comparative analyses with the conventional rigid cage model. Furthermore, the influence of operating conditions and manufacturing errors on the rotational stability and the wear degree of the cage are explored, and the accuracy and reliability of the model are experimentally verified. The results show that the degree of cage wear is strongly influenced by the contact state, and the maximum wear degree varies at different positions. Reasonable speeds, loads, and manufacturing error range can effectively improve the contact conditions, thereby augmenting cage motion stability and mitigating wear. This research contributes novel insights into the failure analysis and structural optimization of the FPCBB.