Technical Report Research Articles

Competency based medical education implementation at the institutional level: A cross-discipline comparative program evaluation

Introduction As an early adopter of competency-based medical education (CBME) our postgraduate institution was uniquely positioned to analyze implementation experience data across programs, while keeping institutional factors constant. We described participants’ experiences related to CBME implementation across programs derived from early program evaluation efforts within our setting. Methods This evaluation focused on eight residency programs at a medium-sized academic institution in Canada. Participants (n = 175) included program leaders, faculty, and residents. The study consisted of 3 phases: (1) describing intended implementation; (2) documenting enacted implementation; and (3) comparing intended with enacted implementation to inform adaptations. Each program’s findings were summarized in technical reports which were then analyzed thematically. Cross program data were organized by themes. Results Six themes were identified. All groups emphasized the need for ongoing refinement of CBME resulting from shared tensions such as increased assessment burden. However, there were some disparate CBME-related experiences between programs such as the experience with entrustable professional activities, the interpretation of retrospective entrustment anchors, and quality of feedback. Conclusion We detected several cross-program successes and important challenges related to CBME. Our experience can inform other programs engaging in implementation and evaluation of CBME.

Large language models overcome the challenges of unstructured text data in ecology

The vast volume of currently available unstructured text data, such as research papers, news, and technical report data, shows great potential for ecological research. However, manual processing of such data is labour-intensive, posing a significant challenge. In this study, we aimed to assess the application of three state-of-the-art prompt-based large language models (LLMs), GPT-3.5, GPT-4, and LLaMA-2-70B, to automate the identification, interpretation, extraction, and structuring of relevant ecological information from unstructured textual sources. We focused on species distribution data from two sources: news outlets and research papers. We assessed the LLMs for four key tasks: classification of documents with species distribution data, identification of regions where species are recorded, generation of geographical coordinates for these regions, and supply of results in a structured format. GPT-4 consistently outperformed the other models, demonstrating a high capacity to interpret textual data and extract relevant information, with the percentage of correct outputs often exceeding 90% (average accuracy across tasks: 87–100%). Its performance also depended on the data source type and task, with better results achieved with news reports, in the identification of regions with species reports and presentation of structured output. Its predecessor, GPT-3.5, exhibited slightly lower accuracy across all tasks and data sources (average accuracy across tasks: 81–97%), whereas LLaMA-2-70B showed the worst performance (37–73%). These results demonstrate the potential benefit of integrating prompt-based LLMs into ecological data assimilation workflows as essential tools to efficiently process large volumes of textual data.

Technical Development Report

Technical Development Report

The DUNE Far Detector Vertical Drift Technology. Technical Design Report

DUNE is an international experiment dedicated to addressing some of the questions at the forefront of particle physics and astrophysics, including themystifying preponderance of matter over antimatter in the early universe. The dual-site experiment will employ an intense neutrino beam focused on a near and a far detector as it aims to determine the neutrino mass hierarchy and to make high-precision measurements of the PMNS matrix parameters, including the CP-violating phase. It will also stand ready to observe supernova neutrino bursts, and seeks to observe nucleon decay as a signature of a grand unified theory underlying the standard model.The DUNE far detector implements liquid argon time-projection chamber (LArTPC) technology, and combines the many tens-of-kiloton fiducial mass necessary for rare event searches with the sub-centimeter spatial resolutionrequired to image those events with high precision. The addition of a photon detection system enhances physics capabilities for all DUNE physics drivers and opens prospects for further physics explorations. Given its size, the far detector will be implemented as a set of modules, with LArTPC designs that differ from one another as newer technologies arise.In the vertical drift LArTPC design, a horizontal cathode bisects the detector, creating two stacked drift volumes in which ionization charges drift towards anodes at either the top or bottom. The anodes are composed of perforated PCB layers with conductive strips, enabling reconstruction in 3D.Light-trap-style photon detection modules are placed both on the cryostat's side walls and on the central cathode where they are optically powered.This Technical Design Report describes in detail the technical implementations of each subsystem of this LArTPC that, together with the other far detector modules and the near detector, will enable DUNE to achieve its physics goals.

Spectral transmission of commercially available high-energy visible light-filtering spectacle lenses.

High-energy visible (HEV) light-filtering spectacle lenses are being widely promoted despite limited evidence to support their use. The spectral transmission properties of commercially available lenses varied, particularly in the HEV light region, and they do not perform in the same way for transmission of ultraviolet (UV)-A and HEV light. Although HEV light is important for several visual and nonvisual functions, there are concerns over the potential adverse effects of increased HEV light exposure. High-energy visible light-filtering spectacle lenses are being widely marketed to promote ocular health and improve sleep by reducing exposure to HEV light. This study reports on the spectral transmission characteristics of commercially available HEV light-filtering spectacle lenses based on the recommendations of the Spectral Bands Task Force technical report. The spectral transmission of light through nine afocal plastic lenses, including eight commercially available HEV light-filtering lenses and one clear uncoated control lens, was evaluated using a Cary 5000 UV-Vis-NIR spectrophotometer (Agilent Technologies, Johannesburg, South Africa) for wavelengths 250 to 780 nm. The percentage transmission values are reported for UV radiation and visible light, with emphasis for HEV light (380 to 500 nm) and the three subbands therein. All lenses blocked UV-C and UV-B radiation (250 to 315 nm). For UV-A radiation (315 to 380 nm), six lenses showed optimal 100% absorption, whereas three lenses allowed ≤12%. The transmission values for the HEV light-filtering lenses ranged from 55 to 90% and 75 to 95% for HEV light of wavelengths 400 to 455 nm and 455 to 500 nm, respectively. In contrast, the control lens showed 92 (400 to 455 nm) and 93% (455 to 500 nm) transmission. The HEV light-filtering spectacle lenses varied in their transmission properties and do not necessarily perform in the same way for transmission of UV-A and HEV light. Optometric personnel should consider these transmission properties, particularly for HEV light, when making recommendations to patients about HEV light-filtering spectacle lenses.

The Use of Silicone Simulators for Bile Duct Anastomosis Education in Medical Conferences for the Purpose of Improving the Canadian Medical Education Directives for Specialists (CanMEDS) Competencies.

This technical report explores the potential of including silicone bile duct simulators for the purpose of completing a bile duct anastomosis (BDA)in medical conferences. The purpose is to target the need for exposure to more surgical skills and to contribute to the Canadian Medical EducationDirectives for Specialists (CanMEDS) requirements, as per the Royal College of Physicians and Surgeons of Canada. Data collection was completed at the 2023 Canadian Conference for the Advancement of Surgical Education (C-CASE) in Montreal, Canada. For several years, the quality improvement feedback received at the end of these conferences suggested a few areas of improvement, one of which was related to the concept of return on investment (ROI). The participants spend a considerable amount of funds to travel to the conferences but feel that the only measurable gains are at a research capacityand thus only relate to two CanMEDS competencies. By leveraging C-CASE, the aim is to enhance students' educational experience during events they already intend to attend. Initially, students participated in a five-part simulation workshop and engaged in a think-aloud protocol (TAO). From there, nine participants were recruited for a focus group to further understand the perceived educational valueand feedback on both the simulators and the conference structure.

Management of a Twisted Flow Diverting Stent With a Balloon Mounted Cardiac Stent in a Pediatric Aneurysm: A Technical Report.

Giant aneurysms can present technical challenges during treatment with flow diversion including inability to access the aneurysm outflow directly. Encircling the aneurysm with a microwire/microcatheter has been well described; however, it can result in a twisted stent because of catheter twisting during the reduction maneuver, which, in turn, could lead to thromboembolic complications. Here, we describe a novel technique to manage the twist of the flow diverter in a giant internal carotid artery aneurysm using a combination of angioplasty and off-label placement of a balloon-mounted cardiac stent within the flow diverter. At 1 year, the aneurysm is completely occluded on digital subtraction angiography and MRI, and the patient is neurologically intact.

Economic and legal mechanisms of material and technical support of health care institutions

The paper shows that the formation of a network of state and communal health care institutions is a multifactorial process aimed at ensuring high quality, accessibility and efficiency of medical care for all citizens. It is shown that the state plays a key role in the organization of material and technical support of the health care system in order to guarantee the population an appropriate level of medical and rehabilitation assistance. It ensures the availability of the necessary resources to provide the population with a guaranteed level of medical and rehabilitation assistance to individuals and medical institutions, including in the form of equipment, tools, medicines and other necessary materials. The role and imperative of compliance with standards of medical care, clinical protocols, rehabilitation care protocols, as well as material and technical equipment reports in all health care institutions have been defined. It is shown that the record of material and technical equipment plays a key role in ensuring a high level of medical services, optimizing resources and increasing the efficiency of health care institutions and private medical practices. It has been proven that under the conditions of martial law, the role of the Ministry of Defense of Ukraine in the logistical support of health care facilities increases, as it ensures constant monitoring of the effectiveness of approved standards and lists, as well as their regular updating in accordance with new technologies and changes in combat tactics and medical science Medical products and aids must be suitable for use in combat environments, including extreme conditions, mobility and speed of care. The functions of the Ministry of Defense of Ukraine are an important component of ensuring the appropriate level of medical care for servicemen in combat conditions, which contributes to increasing their safety and effectiveness on the battlefield. A comprehensive approach to the logistical support of health care is proposed, which allows to ensure a high level of medical care, support innovations in the medical field, and promote the development of the national medical industry.

A Structural Equation Modeling of the Impact of Teacher Self-Efficacy on Teachers' Teaching Practice in Saudi Arabia: Evidence from TALIS 2018

This paper intends to investigate the causal relationship between teachers' self-efficacy and teacher teaching practices in Saudi Arabia using Structural Equation Modeling (SEM) based on the public database of the Teaching and Learning International Survey (TALIS 2018). In this study, 2744 teachers responded to the survey, representing lower secondary in mainstream public and private schools in Saudi Arabia. Based on the literature review and the exploratory factor analysis presented in the TALIS 2018 technical report, three constructs represent teacher teaching practices including (clarity of instructional, cognitive activation, and classroom management practices). Teacher self-efficacy includes two constructs (classroom management efficacy and instruction efficacy). After applying structural equation modeling, the main finding indicates a positive influence of teacher self-efficacy on the clarity of instructional practices, cognitive activation practices, and classroom management practices.

Serial dilation to enable ulnar artery access for endovascular neurointervention: Technical report and systematic review of the literature

BackgroundFor rare neuro-endovascular cases in which transfemoral access is not feasible and the palmar circulation is insufficient for radial artery access, ulnar artery access may be considered. Materials and methodsMechanical thrombectomy via ulnar artery access was performed to preserve the dominant radial artery. The ulnar artery was serial dilated to 7-French with microdilator. Angiography was performed using a diagnostic catheter. The sheath was exchanged for a guide catheter, and a triaxial system was inserted. A mechanical thrombectomy was performed. The systematic literature review included all studies pertaining to techniques for ulnar artery access for neurointervention in the last 20 years (2003–2023) published in the PubMed, Web of Science, and Embase databases. Results67-year-old male developed left MCA syndrome in the setting of an infected abdominal aortic endograft. A transfemoral approach was ruled out due to concern for crossing the infected endograft. Allen test and ultrasound demonstrated that the right radial artery was of adequate size for access, but the ulnar artery was insufficient to support the palmar arch. Mechanical thrombectomy resulted in TICI 3 reperfusion. Systematic review of the literature yielded 2 case series and 1 case report of transulnar neurovascular procedures. Access site complications were rare and included 3 access site hematomas and 1 ulnar artery occlusion. ConclusionWe report our technique of serial dilation of the ulnar artery for neuroendovascular procedures and provide a systematic review of the literature for complication avoidance in ulnar artery access.

The Role of Smart Materials, Sustainable Engineering Practices, and IoT Integration in Advancing Engineering Solutions

This study explores the role of smart materials, sustainable engineering practices, and Internet of Things (IoT) integration in advancing modern engineering solutions. The primary objective is to qualitatively analyze the literature on how these innovative components contribute to the development of efficient, sustainable, and intelligent engineering systems. The research employs a qualitative literature review methodology, examining a broad range of academic articles, technical reports, and case studies related to smart materials, sustainable engineering, and IoT applications. The literature review methodology involves systematically collecting and analyzing relevant scholarly sources to identify key trends and insights. The study categorizes the literature into major themes, such as the properties and applications of smart materials, the principles and benefits of sustainable engineering, and the impact of IoT integration on engineering processes. By synthesizing findings from diverse sources, the research provides a comprehensive overview of the advancements and challenges associated with these technologies. The findings reveal that smart materials, such as shape-memory alloys, piezoelectric materials, and self-healing composites, offer significant potential for enhancing the functionality and durability of engineering systems. Sustainable engineering practices, including the use of renewable materials and energy-efficient designs, are critical for reducing environmental impact and promoting long-term sustainability. IoT integration enables real-time monitoring, data-driven decision-making, and improved system efficiency, thus transforming traditional engineering approaches.

Prevention of ear‐looped face mask‐induced pressure injury on ears: A Technical report with review of literature

In modern times, protective masks with flexible loops are commonly used to prevent the spread of microorganisms during surgical procedure the constant contact of the stretching bands caused by wearing a mask for several hours’ daily causes pressure on this cartilage, leading to painful and erythematous lesions on the skin behind the auricles. Patients and the public now wear masks for extended periods of time. Over time, wearing this mask frequently can cause damage to the ear. Consequently, people regularly switch out their masks to alleviate pressure, increasing their chances of getting infected. Doctors and other healthcare professionals should be aware that continued use may cause damage to the ears and auricles. This article addresses a novel method to alleviate stress on the ear loops of surgical masks and examines the typical ear injuries or pressure injuries on the ear mentioned in literature regarding prolonged mask usage and ways to prevent them.Keywords: Pressure injury; Ear injury; Pinna injury; Surgical masks; Elastic ear loops

The politics of land management after disasters: the case of post-earthquake reconstruction in Türkiye

PurposeIn this paper, we explore the impact of land management practices on post-disaster housing, to draw lessons from the case of reconstruction in Türkiye.Design/methodology/approachWe conducted two qualitative case studies of two reconstruction experiences following the 2020 Elazığ and İzmir earthquakes. We analyzed 70 articles, technical reports and press releases and then used a set of policy analysis tools to examine five policy documents in depth. Finally, we wanted to understand how key officers interpreted these policy documents, so we closely analyzed the transcripts of eight semi-structured interviews.FindingsTürkiye’s legal framework comprises five main policies that concentrate power in the central government and are not tailored to post-disaster reconstruction. This framework facilitates the construction of rubber-stamped apartment buildings, which disregard cultural and social contexts and practices. The current reconstruction policy neglects alternative options like cooperative housing, which could better respond to communal needs and expectations. It also often leads to the loss of land rights among affected residents.Research limitations/implicationsWe only analyzed decision-making processes in two case studies and based our study on a limited number of interviews. Therefore, it is difficult to generalize our results and apply them to other contexts. Further quantitative and qualitative work is necessary to conceptualize the links between land management and post-disaster housing reconstruction.Practical implicationsOur findings suggest a need for legislative frameworks specifically designed to address land management during post-disaster reconstruction. The concentration of power in central governments is problematic, thus it remains crucial to empower local authorities by reinforcing technical expertise and facilitating administrative autonomy.Originality/valueThis study offers unique insights into how power relations influence land management practices in post-disaster housing reconstruction. Examining the centralization of power and its impact on cultural and social practices identifies common forms of dispossession and points to key areas for policy improvement.

A newly digitized ice-penetrating radar data set acquired over the Greenland ice sheet in 1971–1979

Abstract. We present an ice-penetrating radar data set acquired over the Greenland ice sheet by aircraft during the years 1971, 1972, 1974, 1978, and 1979. The data set comprises over 177 000 km of flight lines and contains a wealth of information on the state of the Greenland ice sheet, including information on ice thickness and englacial properties. During data collection in the 1970s, the data were recorded on optical film rolls, and in this paper, we document the digitization of these film rolls and their associated geographical information. Our data digitization enables interaction with and analysis of the data and facilitates comparison with modern-day radar observations. The complete data set in full resolution is available in the Stanford Digital Repository (https://doi.org/10.25740/wm135gp2721; Karlsson et al., 2023), with the associated technical reports. Part of the data set is available as low-resolution JPG files at the Technical University of Denmark's data repository (https://doi.org/10.6084/m9.figshare.c.7235299.v1; Karlsson et al., 2024), with associated technical reports and digitized geographical information . The Stanford Digital Repository serves as long-term storage, providing archival historic preservation in perpetuity, and is not intended as a primary data access point. The Technical University of Denmark (DTU) data repository serves as a primary entry point for data access, with files organized according to acquisition year and flight line in a simple folder structure. Here, we release the full data sets to enable the larger community to access and interact with the data (Karlsson et al., 2023).

Augmentation genioplasty using discarded bone fragments following proximal segment osteotomy of the ramus in intraoral vertical ramus osteotomy (IVRO)

BackgroundBased on a three-dimensional (3D) orthognathic simulation, this technical report introduces a method for augmentation genioplasty using a proximal bone fragment of the mandible, which is typically discarded in intraoral vertical ramus osteotomy (IVRO).ResultsA 43-year-old female patient diagnosed with Class III malocclusion, presenting with a protruding mandible and long facial height, underwent surgical treatment. The surgical plan involved mandibular setback position using IVRO and augmentation genioplasty. The 3D orthognathic surgery including augmentation genioplasty simulation was performed. An excessively elongated proximal segment was sectioned following IVRO. The inferior part of the sectioned proximal bone fragment of the mandible was positioned to align with the requirements of advancement genioplasty. After ensuring that the placement of the fragment matched that of the simulated surgery, each bone fragment was fixed. At 1.5 years post-surgery, the grafted bone on the augmentation genioplasty was well maintained, with slight bone resorption.ConclusionsAugmentation genioplasty using the proximal bone fragment of the mandible, which is typically discarded in IVRO, reduces the surgical complications associated with chin osteotomy. When a secondary genioplasty is required, genioplasty with osteotomy, movement of the cut bone fragments, partial bone-shaving osteotomy, and additional bone grafting are viable options.

Modified Two-Step Impressions via the Incorporation of Venting Holes: A Technical Report.

This study presents a methodology for obtaining a precise impression of the crown margin of prepared teeth by utilizing a two-step impression technique. The method begins with the fabrication of a custom tray made from heat-cured acrylic resin, followed by the acquisition of an initial impression using putty elastomeric material. Subsequently, the impression is relieved around the prepared teeth, and vent holes are strategically placed through both the impression and the tray. Finally, a light-body consistency impression material is applied. This streamlined technique enhances efficiency and minimizes the errors commonly encountered with traditional two-step impression methods.

Critical Infrastructure in Historical Perspective: The Portuguese Railroad Network in the Second Half of the Nineteenth Century

In the 1850s, Portugal initiated an ambitious public works program spearheaded by railroads. In this article, I analyze how policymakers (congressmen, government officials, engineers, and military officers) debated and managed the construction and operation of the Portuguese railroad network using the theoretical framework of critical infrastructure. I show that railroads were deemed critical to modernize the country, draw it closer to the European core nations and further from the periphery, and to attract traffic to the Portuguese harbors. The absence of railroads was considered a vulnerability that could jeopardize Portugal as a nation and it fostered a sense of urgency that motivated policymakers to act, to a large extent, hastily. The construction of the network brought about other vulnerabilities that, for different motives, could threaten the future of the country. In a parallel way, the implementation of the system was marked by vulnerabilities that originated within or surrounding it, which limited its technical potential. Balancing between a literature review and the use of primary sources (parliamentary debates, technical reports, the press, and photography), I argue that the criticality associated with railroads, as a sociotechnical construction, was central to motivate their construction, but different vulnerabilities, inherent or external to the system, limited their influence and the advantages touted by its promoters.

Terms of Latin origin relating to sample characterization (IUPAC Technical Report)

Abstract The use of Latin origin terms, relevant for sample characterization modalities, is described with a focus on samples under controlled conditions, samples within devices, and samples during physico-chemical evolution. The terms in vitro, in vivo, in situ, ab initio, in silico, post mortem, ex situ, posthumous, in vacuo, (in) operando, post facto, and ex post facto, as used in the scientific literature, are considered. Uses of the Latin origin terms in situ, extra situm, in operando, in vivo, in vacuo, in vitro, extra vivum, post facto and ex post facto, ab initiis, computatro, and post mortem are discussed. It is suggested that these terms are to be used without hyphenation and that all Latin derived terms are set in italic font.

An Industrial Perspective for Sustainable Polypropylene Plastic Waste Management via Catalytic Pyrolysis—A Technical Report

Recycling plastics on an industrial scale is a key approach to the circular economy. This study presents a techno-economic analysis aimed at recycling polypropylene waste, one of the main consumer plastics. Specifically, it evaluates the technical and economic feasibility of achieving a large-scale cracking process that converts polypropylene waste into an alternative fuel. Pyrolysis is considered as a promising technique to convert plastic waste into liquid oil and other value-added products, with a dual benefit of recovering resources and providing a zero-waste solution. This study concerns a fast catalytic pyrolysis in a fluidized bed reactor, with the presence of a fluid catalytic cracking catalyst of low acidity for high heat transmission, for an industrial plant with a capacity of 1 t/h of polypropylene waste provided by the Greek Petroleum Industry. From the international literature, the operational conditions were chosen pyrolysis temperature at 430 °C, pressure at 1atm, heating rate at 5 °C/min, and yields of products to 71, 14, and 15 wt.%, for liquid fuel, gas, solid product, respectively. The plant design includes a series of apparatuses, with the main one to be the pyrolyzer. The catalytic method is selected over the non-catalytic because the presence of catalyst increases the quantity and quality of the liquid product, which is the main product of the plant. The energy loops of recycling pyrolysis gas and char as a low-carbon fuel in the plant were considered. The production cost, annual revenue, for 2023, are anticipated to reach €13.7 million (115 €/t) and €15 million (15 €/t), respectively, with an estimated investment equal to €5.3 million. The Payback Time is estimated to 2.4 years to recover the cost of investment. The endeavor is rather economically sustainable. A critical parameter for large scale systems is securing feedstock with low or negligible price.

Grey literature in the intelligence domain: twilight or revival?

ABSTRACT Grey literature encompasses documentary material that is not commercially produced and includes a large and heterogeneous body of sources such as technical reports, working papers, business documents, and conference proceedings. Intelligence organisations worldwide have long incorporated grey literature in their collection and analysis activities as a cost-effective and indispensable source of valuable information that provides strategic insights and helps to form operational decisions. Despite advancements in electronic collection methods, the sourcing of grey literature in many instances still requires the physical presence of a collector, especially in countries and regions with low informational availability, limited digital infrastructure, and those ruled by authoritarian regimes. The classification of grey literature within other ‘INTs’ in general and open source intelligence (OSINT) in particular poses a challenge as it blurs the boundaries between human intelligence (HUMINT) and OSINT. Outsourcing OSINT collection, analysis, and dissemination to private vendors has been gaining speed and volume over the last decade. The article identifies three categories of private vendors active in collecting and analysing grey literature for the intelligence community while seeking to draw renewed attention to the importance of this source of information.