Previous Phases Research Articles

Concept analysis of adoption: A hybrid model.

Adoption is a multidimensional concept affected by cultural and social factors. On the other hand, the number of adoptees has recently increased indicating the need to pay more attention to this issue. However, no clear definition of this concept has been provided so far. The objective of this study was to analyze the concept of adoption. The present study was an analysis using a hybrid model in three phases. During the theoretical phase, using the keyword "adoption,"pertinent articles published between 2010 and 2022 were searched. In the field work phase, eight adoptive parents as the participants were interviewed and the data were analyzed using conventional content analysis method. In the final analysis phase, a general analysis of the two previous phases was performed and a final definition was presented. Adoption is one of the ways of having children that helps infertile couples to experience parental pleasure. If adoption is done wisely based on the abilities of parents, it can provide the best care setting for the child's growth leading to the consolidation of the family and a purposeful life. In adoption, all of the rights and responsibilities of the child are transferred from the biological parents to the adoptive parents, which is affected by religious and cultural beliefs. The analysis of the concept of adoption provided a good basis for identifying the various dimensions of adoption and its challenges. The parents need to pay attention to all dimensions of adoption before selecting this path. It also provided a good platform for future research in the field of adoption.

Pflegeheim-sensitive Krankenhausfälle und Ansätze zur Verringerung der Hospitalisierung von Pflegeheimbewohnerinnen und -bewohnern

ZusammenfassungHintergrundInterventionen zur Vermeidung von potenziell risikobehafteten Krankenhauseinweisungen aus dem Pflegeheim sind von hoher Bedeutung für Patientensicherheit und Versorgungsqualität. Ein Katalog Pflegeheim-sensitiver Krankenhausfälle (PSK) bildet die Grundlage für die Entwicklung von Handlungsempfehlungen.MethodenIn zwei vorangegangenen Forschungsphasen entwickelte ein Expertenpanel einen Katalog mit 58 PSK mittels eines angepassten Delphi-Verfahrens (die RAND/UCLA Appropriateness Methode). Dieses Verfahren wurde von der Nord-Amerikanischen gemeinnützigen Research and Development Organisation (RAND) und Klinikern der Universität von Kalifornien in Los Angeles (UCLA) entwickelt. In der hier vorgestellten dritten Projektphase wurden zunächst in einem Expertenworkshop Interventionsansätze zu deren Reduktion entwickelt. Die Ergebnisse wurden anschließend durch sechs Gutachtende aus themenverwandten Sektoren bewertet, ergänzt und systematisch zur Erstellung von Handlungsempfehlungen verwendet. Mögliche Umsetzungshürden wurden berücksichtigt und der Zeithorizont der Wirksamkeit abgeschätzt.ErgebnisDie Handlungsempfehlungen betreffen Bereiche der Kommunikation, Kooperation, Dokumentation und Versorgungskompetenz sowie einrichtungsbezogene, finanzielle und rechtliche Aspekte. Einzelne Indikationsbündel demonstrieren die Relevanz für das deutsche Gesundheitswesen. Zur Erhöhung der Wirksamkeit empfehlen die Sachverständigen eine sinnvolle Kombination von Handlungsempfehlungen.DiskussionDurch eine Optimierung multidisziplinärer Kommunikation und Kooperation, kombiniert mit einem – auch digitalen – Ausbau der Infrastruktur bei Schaffung einrichtungsbezogener rechtlicher Voraussetzungen und Vergütungsstrukturen, könnten fast 35 % aller Hospitalisierungen aus dem Pflegeheim, rund 220.000 Krankenhausfälle in Deutschland, vermieden werden. Die für Maßnahmen erforderlichen Ausgaben könnten aus Einsparungen durch vermiedene Krankenhausaufenthalte in Höhe von 768 Mio. € refinanziert werden.

Glycopeptide characterization of Sf9-derived SARS-CoV-2 spike protein recombinant vaccine candidates expedited by the use of glycopeptide libraries.

We report the N-glycosylation pattern of Sf9 insect cell-derived recombinant spike proteins being developed as candidate vaccine antigens for SARS-CoV-2 (COVID-19) (Sanofi). The method has been optimised to produce peptides with single, isolated glycosylation sites using multiple protease digests. The development and use of glycopeptide libraries from previous developmental phases allowed for faster analysis than processing datasets from individual batches from first principles. Purified spike proteins were reduced, alkylated, and digested with proteolytic enzymes. Three different protease digests were utilised to generate peptides with isolated glycosylation sites. The glycopeptides were then analysed using a Waters Q-TOF while using a data-dependent acquisition mass spectrometry experiment. Glycopeptide mapping data processing and glycan classification were performed using Genedata Expressionist via a specialised workflow that used libraries of previously detected glycopeptides to greatly reduce processing time. Two different spike proteins from six manufacturers were analysed. There was a strong similarity at each site across batches and manufacturers. The majority of the glycans present were of the truncated class, although at sites N61, N234, and N717/714 high mannose structures were dominant and at N1173/1170 aglycosylation was dominant for both variant proteins. A comparison was performed on a commercially available spike protein and our results were found to be similar to those of earlier reports. Our data clearly show that the overall glycosylation pattern of both spike protein variants was highly similar from batch to batch, and between materials produced at different manufacturing facilities. The use of our glycopeptide libraries greatly expedited the generation of site-specific glycan occupancy data for a large glycoprotein. We compared our method with previously obtained data from a commercially available insect cell-derived spike protein and the results were comparable to published findings.

Deep continual transfer learning with dynamic weight aggregation for fault diagnosis of industrial streaming data under varying working conditions

Catastrophic forgetting of learned knowledges and distribution discrepancy of different data are two key problems within fault diagnosis fields of rotating machinery. However, existing intelligent fault diagnosis methods generally tackle either the catastrophic forgetting problem or the domain adaptation problem. In complex industrial environments, both the catastrophic forgetting problem and the domain adaptation problem will occur simultaneously, which is termed as continual transfer problem. Therefore, it is necessary to investigate a more practical and challenging task where the number of fault categories are constantly increasing with industrial streaming data under varying operation conditions. To address the continual transfer problem, a novel framework named deep continual transfer learning network with dynamic weight aggregation (DCTLN-DWA) is proposed in this study. The DWA module is used to retain the diagnostic knowledge learned from previous phases and learn new knowledge from the new samples. The adversarial training strategy is applied to eliminate the data distribution discrepancy between source and target domains. The effectiveness of the proposed framework is investigated on an automobile transmission dataset. The experimental results demonstrate that the proposed framework can effectively handle the industrial streaming data under different working conditions and can be utilized as a promising tool for solving actual industrial problem.

‘Animal Farm’

This paper presents the results of the excavations carried out in the Chalcolithic contexts from the walled enclosure of Ota (Alenquer, Portugal). Six new absolute dates allow the discussion of the stratigraphical evidence and chronologically frame the zooarchaeological and taphonomical analysis of the faunal assemblage. Domesticated swine, caprine and bovine are prevalent, while wild species, most notably leporids, but also red deer, auroch and wild boar, among others, are less common. Exploitation and management of animals for the acquisition of primary and secondary products are inferred. Existing data suggests that the economic intensification that started during the previous phases was ongoing.

The Evolving Impact of Myocardial Injury in Patients With COVID-19 Amid the Omicron Wave of the Pandemic

COVID-19 with myocardial injury, defined as troponin elevation, is associated with worse outcomes. The temporal changes in outcomes during various phases of the pandemic remain unclear. We evaluated outcomes during the Omicron phase compared with previous phases of the pandemic. We analyzed patients who were COVID-19-positive with evidence of myocardial injury who presented to the MedStar Health system (11 hospitals in Washington, District of Columbia, and Maryland) during phase 1 of the pandemic (March to June 2020), phase 2 (October 2020 to January 2021), and phase 3 (Omicron; December 2021 to March 2022), comparing their characteristics and outcomes. The primary end point was in-hospital mortality. The cohort included 2,079 patients admitted who were COVID-19 positive and for whom troponin was elevated (phase 1: n=150, phase 2: n=854, phase 3: n=1,075). Baseline characteristics were similar overall. Inflammatory markers were significantly elevated in phase 1 compared with phases 2 and 3. The use of remdesivir and dexamethasone was highest in phase 2. In phase 3, 52.6% of patients were fully vaccinated. In-hospital mortality, though high, was lower in phase 3 than in phases 1 and 2 (59.3% vs 28.1% vs 23.3%; p <0.001). Patients who were vaccinated showed more favorable in-hospital outcomes than did those who were unvaccinated (18.3% vs 24.2%, p=0.042). In conclusion, patients with COVID-19 with elevated troponin during phase 3 tended to have improved outcomes when compared with patients in earlier waves of the pandemic. This improvement could be attributed to the implementation of the COVID-19 vaccines, advances in COVID-19 treatment options, provider experience, and less virulent variants.

Exploring dual career quality implementation at European higher education institutions: Insights from university experts.

This paper examines the convergence of the opinions of European higher education institution (HEI) experts on possible implementation of dual career policies and provision areas at university level. An online 32-item questionnaire encompassing 26 dual career aspects collected the opinion of European HEI experts as the last phase of a Delphi method preceded by i) focus groups with student-athletes who aimed to identify needs for dual careers and ii) a workshop with 21 dual career experts to generate the statements to be included in the survey. Seventy-one HEI experts from 12 EU member states participated in the survey, rating each dual career aspect identified in previous phases. The relative position of each aspect has been plotted based on relevance (x-axis) and feasibility (y-axis). The Quadrant IV of the resulting scatterplots identified the following nine aspects rated as highly relevant and highly feasible for implementation: tutorship/mentorship, psychological support, programmes based on integration of academic departments and sports services, and adaptable programmes to the needs of each student-athletes (assistance/tutorship area), individual study plans and distance learning (curricula requirements area), publicity for student-athletes and initiatives for increasing the awareness of student-athletes and knowledge of dual career issues (social support area), and access to educational facilities (logistic support area). The HEI experts' views represent a coherent and useful starting point to develop a deep understanding of the considered 26 aspects founded on a phenomenological lifeworld-led approach and emphasizes the need for a minimum standard for dual career policies and provisions.

Virtual Modeling and Experimental Validation of the Line-Start Permanent Magnet Motor in the Presence of Harmonics

The world is experiencing an accelerated energy transition that is driven by the climate goals to be met and that has driven the growth of different potential sectors such as electric mobility powered by electric motors, which continue to be the largest load globally. However, new needs in relation to power density, weight, and efficiency have led manufacturers to experiment with new technologies, such as rare earth elements (REEs). The permanent magnet motor is a candidate to be the substitute for the conventional induction motor considering the new editions of the IEC 60034-30-1, for which study and evaluation continue to be focused on identifying the weaknesses and benefits of its application on a large scale in industry and electric mobility. This work presents a FEM model to assess the line-start permanent magnet motor (LSPMM), aiming to simulate the behavior of the LSPMM under supply conditions with distorted voltages (harmonic content) and evaluate its thermal and magnetic performance. The model created in the FEM software is then validated by bench tests in order to constitute an alternative analysis tool that can be used for studies in previous project phases and even to implement predictive maintenance schemes in industries.

Building thermal resilience framework (BTRF): A novel framework to address the challenge of extreme thermal events, arising from climate change

Over the past 2 decades, many parts of the world have experienced unprecedented record-breaking temperatures; these extremes fall on both ends of the temperature spectrum ranging from excessively hot to freezing low. Moreover, recently, the rate and the impacts of these extremes have increased, despite all the mitigation efforts, necessitating a resilience-based approach to address these challenges stemming from the accelerated global warming and the advent of climate change. Examples of such extremes include the 2003 and 2022 heatwaves in Europe, claiming approximately 4,000 and 12,000 lives, respectively as well as the 2021 heatwave in the Pacific Northwest region of North America and the deep freeze in Southeast Texas. In this paper, we reflect on previous studies, identifying both internal and external aspects that contribute to a building’s thermal performance. We then incorporate these factors into a proposed framework, covering the important phases of a building’s life cycle, to reflect its thermal resilience. During each phase, an associated Building Thermal Resilience Profile (BTRP), taken from accumulated data of previous phases, provides the needed assessment of the building, and is regularly adapted to changes in the building and its surroundings. BTRP will be a valuable tool for the resilience evaluation of different design options. Furthermore, during the operation phase, it will contribute to real-time monitoring and assessment, facilitating disaster management and response, at both the buildings and city scale, reducing the causalities of extreme events. Thus, the BTRF has the potential to expand into various fields such as healthcare, green and resilient buildings rating systems, and even to improve the municipal regulations. Nevertheless, the prime aim of this paper is to address the challenge of extreme thermal events, arising from climate change, and pave the way for the adoption of effective thermal resilience in building design and operation practices.

Abstract 10255: The Evolving Impact of Myocardial Injury in COVID-19 Patient Amid the Omicron Wave of the Pandemic

Introduction: Coronavirus disease 2019 (COVID-19) with evidence of myocardial injury, defined as troponin elevation, has been demonstrated to be associated with worse outcomes. The temporal changes in outcomes in these patients during various phases of the pandemic remain unclear. Hypothesis: We sought to evaluate outcomes during the Omicron phase compared to previous phases of the pandemic. Methods: We analyzed COVID-19-positive patients with myocardial injury who presented to the MedStar Health system (11 hospitals in Washington, DC and Maryland) during Phase 1 of the pandemic (March 1 - June 30, 2020), Phase 2 (October 1, 2020 - January 31, 2021) and Phase 3 (Omicron) (December 1, 2021 - March 31, 2022) comparing their characteristics and outcomes. The primary end point was in-hospital mortality. Results: The cohort included 2079 COVID-19-positive admitted patients for whom troponin-I or high-sensitive troponin was elevated (Phase 1: n=150, Phase 2: n=854, Phase 3 [Omicron]: n=1075). Baseline characteristics were overall similar. Inflammatory markers were significantly elevated in Phase 1 as compared to Phase 2 and the Omicron Phase. The use of remdesivir and dexamethasone was most seen in Phase 2. In the Omicron Phase, 52.6% of patients were fully vaccinated. In-hospital mortality although high was lower in the Omicron Phase as compared to Phase 1 and Phase 2 (23.3% vs. 59.3% vs. 28.1%; p&lt;0.001). Those vaccinated demonstrated even more favorable outcomes as compared to those patients unvaccinated (18.3% vs 24.2%, p = 0.042). Conclusions: COVID-19 patients with elevated troponin during the Omicron Phase still have significant mortality rates despite overall improved outcomes when compared to the first and second waves of the pandemic. This improvement in outcomes could be attributed to the implementation of the COVID-19 vaccine, advances in available COVID-19 treatment options, provider experience with the novel disease and less virulent variants.

Evolutionary emergence of collective intelligence in large groups of students.

The emergence of collective intelligence has been studied in much greater detail in small groups than in larger ones. Nevertheless, in groups of several hundreds or thousands of members, it is well-known that the social environment exerts a considerable influence on individual behavior. A few recent papers have dealt with some aspects of large group situations, but have not provided an in-depth analysis of the role of interactions among the members of a group in the creation of ideas, as well as the group's overall performance. In this study, we report an experiment where a large set of individuals, i.e., 789 high-school students, cooperated online in real time to solve two different examinations on a specifically designed platform (Thinkhub). Our goal of this paper 6 to describe the specific mechanisms of idea creation we were able to observe and to measure the group's performance as a whole. When we deal with communication networks featuring a large number of interacting entities, it seems natural to model the set as a complex system by resorting to the tools of statistical mechanics. Our experiment shows how an interaction in small groups that increase in size over several phases, leading to a final phase where the students are confronted with the most popular answers of the previous phases, is capable of producing high-quality answers to all examination questions, whereby the last phase plays a crucial role. Our experiment likewise shows that a group's performance in such a task progresses in a linear manner in parallel with the size of the group. Finally, we show that the controlled interaction and dynamics foreseen in the system can reduce the spread of "fake news" within the group.

Validation of a miniaturized handheld arterial pressure monitor for guiding full and partial REBOA use during resuscitation.

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a well-validated method for the control of noncompressible truncal hemorrhage. In lower resource or battlefield settings, the need for arterial line setup and monitoring is problematic and potentially prohibitive. We sought to evaluate the accuracy and precision of a miniaturized portable device (Centurion COMPASS®) versus standard arterial pressure monitoring using standard ER-REBOA and partial REBOA (pREBOA) as a high-fidelity and space-/time-conserving alternative. A total of 40 swine underwent a four-phase validation/precision study (each phase using five ER-REBOAs and five pREBOAs). Phases I/II evaluated accuracy with full and pREBOA in uninjured animals. Phases III/IV duplicated the previous phases but in a severe hemorrhagic shock model. Carotid and femoral pressures were monitored with both intra-arterial pressure systems and the COMPASS® device. The vascular flow was measured by aortic flow probes. Correlation and Bland-Altman analysis were performed. There was a strong correlation in accuracy testing of proximal and distal COMPASS® devices compared to standard intra-arterial pressure monitoring (r = 0.94, 0.8; p < 0.005) as well as during precision testing (r = 0.98, 0.89 p < 0.005) in the uninjured phases. Similar accuracy and reliability were demonstrated in hemorrhagic shock, with a strong correlation for the proximal and distal COMPASS® devices (r = 0.98, 0.97; p < 0.005), as well as during precision testing (r = 0.99, 0.95; p < 0.005) in both full and pREBOA scenarios. Bland-Altman analysis showed extremely low bias between the COMPASS® and arterial line for both proximal (bias = 1.9) and distal (bias = 0.8) pressure measurements. The COMPASS® provides accurate and precise pressure measurements during standard and partial REBOA in both uninjured and shock conditions. This device may help extend and enhance capability in any low-resource/battlefield settings, or even eliminate the need for standard intra-arterial invasive pressure monitoring and external setup.

Post-neoliberalization and the Irish private rental sector

Recent years have witnessed new policy interventions in many countries seeking to get to grips with challenges in the private rental sector (PRS), including rent regulation and enhanced security of tenure. This raises the possibility of a shift away from market-based approaches which have characterized neoliberal housing regimes over recent decades. This article adds to emerging work on post-neoliberalism by examining policy change in the Irish PRS. The Irish PRS is an illustrative example because it has experienced rapid increases in the proportion of households renting and in average rents, but also because of the large volume of reforms introduced since 2015. Examining these shifts through the lens of ‘market rule’, the article conceptualizes the Irish PRS as in a process of ‘post-neoliberalization’ in that it has moved away from the commodification of PRS housing, and yet continues to be shaped by the transnational political economy of institutional investment, itself largely a product of previous phases of neoliberalization.

The study of adptive potentialof the winter common wheat varieties developed by the Agricultural Research Center “Donskoy” according to the trait 1000-grain weight

Introduction. 1000-grain weight is an essential element of a yield, which depends on many components that have their effect in the previous phases of ontogenesis. The analysis of the statistical parameters of correlation between 1000-grain weight and environmental conditions, the study of the adaptive properties of genotypes make it possible to select the initial material in the most orderly manner when developing highly productive wheat varieties.Methods. The objects of the study were 14 winter bread wheat varieties developed by the FSBSI “ARC “Donskoy””. The work was carried out in 2018–2021 on the fields of the department of winter wheat breeding and seed production, the forecrop was sunflower, the variety Don 107 was used as a standard.Results. In the course of the current study, there has been found that the varieties Krasa Dona, Kaprizulya, Ermak, Polina, Ayuta and Premiera were characterized by a high response to environmental changes (bi = 1.12–1.30). The varieties possessing high adaptability and high stability included Kaprizulya (bi = 1.13 and S2d = 0.02) and Krasa Dona (bi = 1.12 and S2d = 0.04). The varieties Zolotoy Kolos, Zhavoronok, Podarok Krymu and Don 107 had highest homeostatic values (Hom = 27.68–38.13) and lowest coefficients of variation (Cv = 10.57–12.78%). The varieties Zolotoy Kolos, Zhavoronok and Podarok Krymu had high breeding value (Sc = 31.44–33.30) and stress resistance (from -10.20 to -11.70). The most genetically flexible varieties were Zhavoronok, Ayuta and Premiera (43.85–44.30).

Constraining CMIP6 Projections of an Ice‐Free Arctic Using a Weighting Scheme

AbstractEmploying a model democracy in which each model is equally weighted may lead to a poor estimation of the true uncertainty in climate projections from phase 6 of the Coupled Model Intercomparison Project (CMIP6). The improvement and increase in number of CMIP6 models compared with previous phases of CMIP indicate that both model skill and independence need to be considered to provide convincing projections. In this study, we use a weighting scheme, which weights both the skill and independence of multi‐model simulations, to efficiently constrain the large uncertainty in the projection of the timing of an ice‐free Arctic. The uncertainty‐constrained projections of CMIP6 show that the multi‐model spread of the projected first year of an ice‐free Arctic can be reduced by about 29 years under the Shared Socioeconomic Pathway (SSP)3–7.0 scenario (a regional rivalry scenario), indicating a faster tendency to an ice‐free Arctic summer than projections based solely on model democracy. A fossil‐fuel‐based development scenario (i.e., SSP5‐8.5) leads to an ice‐free Arctic before the 2070s (ranging from 2038 to 2071), while an ice‐free Arctic occurs slightly later (by ∼10 years) under the SSP2‐4.5 scenario (i.e., intermediate scenario) and the SSP3‐7.0 scenario, but is inevitable this century. The sustainable development scenario (i.e., SSP1‐2.6) is likely to prevent the occurrence of an ice‐free Arctic. Internal variability strongly affects the projection estimated by the equally weighted ensemble; however, it has a negligible impact on the results obtained by the weighting scheme, thereby indicating that the results of this study are robust and convincing.

Safety of Control Systems with Dual Architecture Based on PLCs

The implementation of safety functions, in contrast to ordinary control functions, requires a different approach to the design of the hardware and software of the control system. The reason for the different approaches is that each safety function must meet the required Safety Integrity Level (SIL). This has two aspects: safety integrity against random failures and safety integrity against systematic failures. Hardware is primarily related to random failure safety integrity, and software primarily to systematic failure safety integrity. The focus of this contribution lies in the design of a method that will allow the software of a safety function for industrial applications to be designed using a model of the functional behavior of this function. Since commercially available programmable logic controllers (PLCs) with a defined SIL level (so-called safety PLC) do not support such solutions, a dual architecture based on standard PLCs, including their software control, is proposed in the paper. Such an approach will make it possible to significantly limit the occurrence of systematic errors in the creation of application software, as well as to test the created application software and reveal deficiencies that arose in previous phases of the life cycle (e.g., when specifying safety functions). To implement the method proposed in this paper, a dual architecture created from the safety PLC Simatic series S7-1500 is used. With the help of this architecture, the safety function “Muting” is implemented.

An Evaluation of a Web-Based Decision Aid for Treatment Planning of Small Kidney Tumors: Pilot Randomized Controlled Trial.

BackgroundSurgery is the most common treatment for localized small kidney masses (SKMs) up to 4 cm, despite a lack of evidence for improved overall survival. Nonsurgical management options are gaining recognition, as evidence supports the indolence of most SKMs. Decision aids (DAs) have been shown to improve patient comprehension of the trade-offs of treatment options and overall decision quality, and may improve consideration of all major options according to individual health priorities and preferences.ObjectiveThis pilot randomized controlled trial (RCT) primarily aims to evaluate the impact of a new web-based DA on treatment decisions for patients with SKM; that is, selection of surgical versus nonsurgical treatment options. Secondary objectives include an assessment of decision-making outcomes: decisional conflict, decision satisfaction, and an understanding of individual preferences for treatment that incorporate the trade-offs associated with surgical versus nonsurgical interventions.MethodsThree phases comprise the construction and evaluation of a new web-based DA on SKM treatment. In phase 1, this DA was developed in print format through a multidisciplinary design committee incorporating patient focus groups. Phase 2 was an observational study on patient knowledge and decision-making measures after randomization to receive the printed DA or institutional educational materials, which identified further educational needs applied to a web-based DA. Phase 3 will preliminarily evaluate the web-based DA: in a pilot RCT, 50 adults diagnosed with SKMs will receive the web-based DA or an existing web-based institutional website at urology clinics at a large academic medical center. The web-based DA applies risk communication and information about diagnosis and treatment options, elicits preferences regarding treatment options, and provides a set of options to consider with their doctor based on a decision-analytic model of benefits/harm analysis that accounts for comorbidity, age group, and tumor features. Questionnaires and treatment decision data will be gathered before and after viewing the educational material.ResultsThis phase will consist of a pilot RCT from August 2022 to January 2023 to establish feasibility and preliminarily evaluate decision outcomes. Previous study phases from 2018 to 2020 supported the feasibility of providing the printed DA in urology clinics before clinical consultation and demonstrated increased patient knowledge about the diagnosis and treatment options and greater likelihood of favoring nonsurgical treatment just before consultation. This study was funded by the National Cancer Institute. Recruitment will begin in August 2022.ConclusionsA web-based DA has been designed to address educational needs for patients making treatment decisions for SKM, accounting for comorbidities and treatment-related benefits and risks. Outcomes from the pilot trial will evaluate the potential of a web-based DA in personalizing treatment decisions and in helping patients weigh attributes of surgical versus nonsurgical treatment options for their SKMs.Trial RegistrationClinicalTrials.gov NCT05387863; https://clinicaltrials.gov/ct2/show/NCT05387863International Registered Report Identifier (IRRID)PRR1-10.2196/41451

Metrics for Evaluating CMIP6 Representation of Daily Precipitation Probability Distributions

Abstract The performance of GCMs in simulating daily precipitation probability distributions is investigated by comparing 35 CMIP6 models against observational datasets (TRMM-3B42 and GPCP). In these observational datasets, PDFs on wet days follow a power-law range for low and moderate intensities below a characteristic precipitation cutoff scale. Beyond the cutoff scale, the probability drops much faster, hence controlling the size of extremes in a given climate. In the satellite products analyzed, PDFs have no interior peak. Contributions to the first and second moments tend to be single-peaked, implying a single dominant precipitation scale; the relationship to the cutoff scale and log-precipitation coordinate and normalization of frequency density are outlined. Key metrics investigated include the fraction of wet days, PDF power-law exponent, cutoff scale, shape of probability distributions, and number of probability peaks. The simulated power-law exponent and cutoff scale generally fall within observational bounds, although these bounds are large; GPCP systematically displays a smaller exponent and cutoff scale than TRMM-3B42. Most models simulate a more complex PDF shape than these observational datasets, with both PDFs and contributions exhibiting additional peaks in many regions. In most of these instances, one peak can be attributed to large-scale precipitation and the other to convective precipitation. Similar to previous CMIP phases, most models also rain too often and too lightly. These differences in wet-day fraction and PDF shape occur primarily over oceans and may relate to deterministic scales in precipitation parameterizations. It is argued that stochastic parameterizations may contribute to simplifying simulated distributions.

Perceived Past and Current COVID-19-Stressors, Coping Strategies and Psychological Health among University Students: A Mediated-Moderated Model.

The COVID-19-pandemic entailed abrupt/long-lasting changes in university students’ lives, resulting in growing stress and stress-related outcomes. Although nowadays the pre-pandemic-life is gradually re-establishing, past-COVID-19-stressful experiences and strategies adopted to adjust to this condition may significantly impact students’ current experiences. Therefore, the development of research exploring the complex interplay between perceived past/present COVID-19-related experiences, coping strategies, and psychological health currently reported by students is needed. This study simultaneously tests the associations between Past-COVID-19-stressors and Current-COVID-19-stressors as moderated by Coping Strategies and the associations between Past-COVID-19-stressors and Psychological Symptoms as mediated by Current-COVID-19-stressors. A mediated-moderated model was tested on 355 university students. COVID-19-Student-Stress-Questionnaire (CSSQ) was used to assess COVID-19-stressors. Two CSSQ-versions were used, one of which was adjusted to assess Past-COVID-19-stressors recalled from previous restrictive pandemic phases. Coping-Orientation-to-Problem-Experienced-New-Italian-Version and Symptom-Checklist-90-Revised were used to assess, respectively, Coping Strategies and Psychological Symptoms. Findings confirmed the hypothesized Mediated-Moderated Model. The effects of Past-COVID-19-stressors on Current-COVID-19-stressors were moderated by Coping Strategies, and the effects of Past-COVID-19-stressors on Psychological Symptoms were mediated by Current-COVID-19-stressors. Unique psychopathological risk profiles deriving from the interplay between specific past/present stressors and coping strategies were found. Researchers and clinicians can use these findings to develop updated research and timely evidence-based interventions fostering students’ adjustment in the current period. Future research should further explore the impact of the complex interplay between perceived past/present COVID-19-related experiences and individual characteristics on psychological health conditions reported by people in the aftermath of the COVID-19 pandemic.

Оцінка впливу експлуатаційних параметрів на роботу авіаційного газотурбінного двигуна

This paper considers the possibilities of improving the reliability and efficiency of the aircraft engine, which are one of the main indicators of quality and require high-quality fuel. Modern gas turbine engines (GTE) are much more powerful and economical compared with those produced 50 years ago. Nevertheless, manufacturers are constantly working to improve gas turbine engines with the main emphasis on their fuel efficiency. Mechanical impurities present in the fuel can clog the fuel filters, thereby cutting off the fuel supply. The presence of resins in the fuel leads to the formation of various deposits on engine parts, and the content of sulfur, acids and alkalis increases the corrosiveness of the fuel. The completeness of combustion and the tendency of carbon formation are the main performance characteristics of hydrocarbon fuels, which are of great practical importance in improving the efficiency and service life of the engine. Currently, there are many options for improving technical and economic indicators. The proposed ways to prepare a better fuel mixture before supplying it to the engine. The preparation of aviation fuel is carried out because of the electrophysical effects on the fuel. The electrophysical effect on the fuel is determined by a magnetic installation with a sign-changing magnetic field. Studies were conducted to determine the effect of electrophysical impact on the completeness of combustion of aviation fuel and carbon formation in the combustion chamber of a gas turbine engine. The method allows to give a comparative assessment of the completeness of combustion and carbon formation of fuels for engines with a small amount of fuel consumed for testing. It has been established that under electrophysical action on aviation fuel, the fuel combustion efficiency increases by 10...12 %, carbon formation in the gas turbine engine combustion chamber decreases by 20...25 %. The positive effect on the combustion process in the previous phases decreases the afterburning phase, therefore, a decrease in the temperature of the exhaust gases, a decrease in the concentration of nitrogen oxide by 12...16 %, carbon monoxide by 0.64...0.7 % and hydrocarbon by 25...35 %. After the electrophysical impact and the fuel running time, the content of resinous compounds increased four times, the content of oxygen compounds decreased by ~23 %, and the content of sulfur compounds decreased by ~25 %.