Simulation Training on Extracorporeal Membrane Oxygenation

Conventional extracorporeal membrane oxygenation (ECMO) training usually only consists of didactic lectures and water drill of ECMO circuit. However, learners cannot “experience” changes of clinical condition of patients. Simulation-based learning is a perfect answer to this by providing participantsauthentic, interactive, team-based training without risk to real patients. Hospital Authority (HA) of Hong Kong has implemented a corporatewide ECMO simulation-based training program since 2014. It aims to provide a structural and standardized training opportunity for clinical staff members to gain hands-on experience in ECMO circuit management and troubleshooting technique. In the program, participants will go through three categories of scenarios: (1) replicate common real patient clinical experience; (2) replicate incident that only happens infrequently; and (3) imitate clinical situation that is rarely happened but life threatening, and where prompt and correct actions are necessary. Every scenario has its own debriefing session that covers technical and human factor issues.Since 2014, 32 identical full-day courses were conducted and 285 doctors and nurses were trained. All participants were satisfied with the training and expressed that the simulation was an effective model for ECMO training. The training met their need and they could apply what they learned in real-life practice

Amotivation as a Predictor of Academic Achievement: A Comparative Study of Science and Art Students' GPA

Intrinsic motivation is characterized by engaging in activities for their inherent satisfaction, whereas amotivation is marked by a lack of intention to act, stemming from beliefs of ineffectiveness or disinterest in the activity. Prior research has established a positive correlation between intrinsic motivation and academic performance among science students; however, its applicability to arts students remains unexplored. The present study aims to examine the hypothesis that motivation, in its various forms, correlates with the Grade Point Average (GPA) among both science and arts undergraduates. A convenience sampling strategy yielded 230 science students (GPA range: 1.8 – 3.89) and 284 arts students (GPA range: 1.5 – 3.84), who participated in a structured questionnaire interview. This instrument assessed intrinsic motivation, amotivation, and study effort using a 5-point Likert scale (ranging from 1 = strongly disagree to 5 = strongly agree). Average scores were computed and contrasted between the bottom and top quintiles of GPA within each discipline. The findings revealed a universally high level of study effort across participants. Notably, students within the top 20% GPA bracket reported significantly greater academic effort than their lower 20% counterparts. A distinct pattern of significant amotivation was observed among science students with lower GPAs. Conversely, arts students with lower GPAs exhibited high levels of intrinsic motivation, akin to those observed in students with higher GPAs

Multi-objective Optimization of Wind Farm Layouts Under Energy Generation and Noise propagation

Wind farm design deals with the optimal placement of turbines in a wind farm. Past studies have focused on energymaximization, cost-minimization or revenue-maximization objectives. As land is more extensively exploited for onshore wind farms, wind farms are more likely to be in close proximity with human dwellings. Therefore governments, developers, and landowners have to be aware of wind farms’ environmental impacts. After considering land constraints due to environmental features, noise generation remains the main environmental/health concern for wind farm design. Therefore, noise generation is sometimes included in optimization models as a constraint. Here we present continuous-location models for layout optimization that take noise and energy as objective functions, in order to fully characterize the design and performance spaces of the optimal wind farm layout problem. Based on Jensen’s wake model and ISO-9613-2 noise calculations, we used single- and multiobjective genetic algorithms (NSGA-II) to solve the optimization problem. Preliminary results from the biobjective optimization model illustrate the trade-off between energy generation and noise production by identifying several key parts of Pareto frontiers. In addition, comparison of single-objective noise and energy optimization models show that the turbine layouts and the inter-turbine distance distributions are different when considering these objectives individually. The relevance of these results for wind farm layout designers is explored

How students cope with part-time study

This study provides a qualitative test and illustration of a model of how students cope with the demands of part-time study. The model shows that students who are successful in finding the time to complete the requirements of part-time courses do so by adopting three mechanisms; sacrifice, support and the negotiation of arrangements. All three mechanisms operate in four domains, namely work, family, social lives and the self. The mechanisms and domains were related together in a three by four matrix. Data to verify and illuminate the model were gathered by the researchers through an on-line forum discussion on the topic of coping with part-time study. The researchers themselves were studying part-time in a course called Adult Education and Professional Development. Analysis of the data showed that the work domain was very important but little adaptation was possible. The family was seen as the most important domain and all three mechanisms were used. Time was commonly found for part-time study by sacrificing social lives. The self-domain was interpreted as important in establishing motivation and self-determination

Global sagittal alignment after surgery of right thoracic idiopathic scoliosis in adolescents and adults with and without thoracic hypokyphosis

The study procedure was conducted in accordance to guidelines approved by the institutional clinical research ethics committee (CREC No. 2016.722) and the Declaration of Helsinki. Written informed consent was obtained from all subjects and their parents before participating in this study.AbstractThis study aimed to characterize global sagittal alignment in adolescent idiopathic scoliosis (AIS) with normal kyphosis (NTK, kyphosis > 10°) and with thoracic hypokyphosis (THK, kyphosis < 10°), before and after posterior spinal fusion, and compare them with asymptomatic controls. 27 AIS girls and young adults with right thoracic curves were included (seventeen with age ≤ 18 years, then age > 21). Biplanar radiographies were acquired at baseline, immediate post-operatively, 1-year and 2-year follow-up, and 3D reconstruction of the spine and pelvis was performed. NTK and THK showed different global sagittal alignment, as well as differences compared to controls. AIS with THK at baseline had higher SVA/SFD (2.0 ± 2.9 vs − 0.4 ± 1.9; P < 0.05) and OD-HA (0.2 ± 1.4° vs − 1.3 ± 1.6°; P < 0.05) than controls, indicating that THK had compensated balance with unusual forward leaning posture. Immediately post-operation, SVA/SFD remained high (1.3 ± 3.0) while OD-HA reversed (− 1.2 ± 1.7°), indicating that THK patients had found partially compensated balance. After 2-yeas, both SVA/SFD (− 1.3 ± 2.1) and OD-HA (− 1.4 ± 0.9°) were normalized. The changes in global sagittal alignment and mechanism of balance are different in AIS with or without THK. As the head plays a critical role on balance during immediate and delayed post-operation, OD-HA can be complementary parameter for assessing global balance during post-operative follow-up of AIS patients with THK.The investigation was fully supported by a grant from the General Research Funding of Hong Kong (Project no. 14206716) (W.C.W.C.), and a funding from the BiomecAM Chair Program on Musculoskeletal Modeling (with the support of Société Générale, Covea, Yves Cotrel Foundation, ParisTech Foundation and Proteor) (C.V.)

Identification of microbial community in the urban environment: The concordance between conventional culture and nanopore 16S rRNA sequencing

IntroductionMicrobes in the built environment have been implicated as a source of infectious diseases. Bacterial culture is the standard method for assessing the risk of exposure to pathogens in urban environments, but this method only accounts for <1% of the diversity of bacteria. Recently, full-length 16S rRNA gene analysis using nanopore sequencing has been applied for microbial evaluations, resulting in a rise in the development of long-read taxonomic tools for species-level classification. Regarding their comparative performance, there is, however, a lack of information.MethodsHere, we aim to analyze the concordance of the microbial community in the urban environment inferred by multiple taxonomic classifiers, including ARGpore2, Emu, Kraken2/Bracken and NanoCLUST, using our 16S-nanopore dataset generated by MegaBLAST, as well as assess their abilities to identify culturable species based on the conventional culture results.ResultsAccording to our results, NanoCLUST was preferred for 16S microbial profiling because it had a high concordance of dominant species and a similar microbial profile to MegaBLAST, whereas Kraken2/Bracken, which had similar clustering results as NanoCLUST, was also desirable. Second, for culturable species identification, Emu with the highest accuracy (81.2%) and F1 score (29%) for the detection of culturable species was suggested.DiscussionIn addition to generating datasets in complex communities for future benchmarking studies, our comprehensive evaluation of the taxonomic classifiers offers recommendations for ongoing microbial community research, particularly for complex communities using nanopore 16S rRNA sequencing

Milk Consumption Across Life Periods in Relation to Lower Risk of Nasopharyngeal Carcinoma: A Multicentre Case-Control Study

Background: The much higher incidence of nasopharyngeal carcinoma (NPC) in men suggests sex hormones as a risk factor, and dairy products contain measurable amounts of steroid hormones. Milk consumption has greatly increased in endemic regions of NPC. We investigated the association between NPC and milk consumption across life periods in Hong Kong.Methods: A multicentre case-control study included 815 histologically confirmed NPC incident cases and 1,502 controls who were frequency-matched on age and sex at five major hospitals in Hong Kong in 2014–2017. Odds ratios (ORs) of NPC (cases vs. controls) for milk consumption at different life periods were estimated by unconditional logistic regression, adjusting for sex, age, socioeconomic status score, smoking and alcohol drinking status, exposure to occupational hazards, family history of cancer, IgA against Epstein-Barr virus viral capsid antigen, and total energy intake.Results: Compared with abstainers, lower risks of NPC were consistently observed in regular users (consuming ≥5 glasses of milk [fresh and powdered combined] per month) across four life periods of age 6–12 (adjusted OR 0.74, 95% CI 0.54–0.86), 13–18 (0.68, 0.55–0.84), 19–30 (0.68, 0.55–0.84), and 10 years before recruitment (0.72, 0.59–0.87). Long-term average milk consumption of ≤2.5, >2.5, and ≤12.5, >12.5 glasses per month yielded adjusted OR (95% CI) of 1.00 (0.80–1.26), 0.98 (0.81–1.18), 0.95 (0.76–1.18), and 0.55 (0.43–0.70), respectively (all P-values for trend < 0.05).Conclusion: Consumption of milk across life periods was associated with lower risks of NPC. If confirmed to be causal, this has important implications for dairy product consumption and prevention of NPC

Meta-analysis Followed by Replication Identifies Loci in or near CDKN1B, TET3, CD80, DRAM1, and ARID5B as Associated with Systemic Lupus Erythematosus in Asians

Systemic lupus erythematosus (SLE) is a prototype autoimmune disease with a strong genetic involvement and ethnic differences. Susceptibility genes identified so far only explain a small portion of the genetic heritability of SLE, suggesting that many more loci are yet to be uncovered for this disease. In this study, we performed a meta-analysis of genome-wide association studies on SLE in Chinese Han populations and followed up the findings by replication in four additional Asian cohorts with a total of 5,365 cases and 10,054 corresponding controls. We identified genetic variants in or near CDKN1B, TET3, CD80, DRAM1, and ARID5B as associated with the disease. These findings point to potential roles of cell-cycle regulation, autophagy, and DNA demethylation in SLE pathogenesis. For the region involving TET3 and that involving CDKN1B, multiple independent SNPs were identified, highlighting a phenomenon that might partially explain the missing heritability of complex diseases

Effect of Nozzle-nozzle Interaction on Lean Flame Transitions in a Multi-swirler Combustor

This work investigates the transition between different flame stabilization modes in a gas turbine model combustor consisting of a linear array of five interacting nozzles, which is representative of advanced designs for next generation engines. Simultaneous multi-kHz repetition rate OH planar laser induced fluorescence and stereoscopic particle image velocimetry were used to examine the hydrodynamics and nozzle-nozzle interactions during the transient flame blowoff and reattachment processes. Two different reactants feeding configurations were designed to isolate the effects of different operating and geometric parameters on the combustor's fuel lean performance. In the first configuration, reactants to each nozzle were fed through a common plenum; while reactants to each nozzle were controlled separately in the second configuration. The lean blowoff point was tested for different inter-nozzle spacings, by changing the nozzles receiving reactants. The combustor's lean operability was optimized when only two nozzles were operated, as a result of the complex interaction between the cross-nozzle flame transport, fluid dynamic strain field, and the recirculation strength. Nevertheless, blowoff occurred at a relatively constant Damkӧhler number. The blowoff/reattachment process for an individual flame was initiated in a similar manner to isolated bluff-body stabilized flames, though with cross-nozzle flame interactions providing additional means of re-stabilizing a partially extinguished flame. In the connected plenum configuration, blowoff/reattachment dynamics of the three central nozzles were coupled to each other. Blowoff transitions were preferentially initiated in one of the off-center nozzles, with the transition of subsequent nozzles occurring in a random order. Similarly, the center nozzle tended to be the last nozzle to reattach. However, such temporal coincidence of the blowoff/reattachment transitions were not observed in the individual plenum configuration, suggesting the upstream coupling is significant in the combustor dynamics. A statistical analysis demonstrated that changes in downstream conditions would lead to flow re-distribution inside the connected plenum. Both in-chamber and upstream cross-nozzle interactions are equally important in flame blowoff transitions inside a practical combustor, while the in-chamber cross-nozzle interaction plays a more important role in reattachment transitions.Ph.D

Development of Thermographic Phosphor Diagnostics For Gas Turbine Temperature Measurements

Laser induced phosphorescence (LIP) thermometry can provide spatially and temporally resolved temperature fields in harsh environment like gas turbine combustors with high-accuracy and a relatively simple setup. For measurement in gas turbine combustor, the employed thermographic phosphor (TP) should have high sensitivity and signal yield at high temperatures. It is known that phosphor composition, crystallinty, and morpholgy can affect the TP phosphorescence properties. Four high-temperature phosphors with different composition were prepared with sol-gel synthesis (SGS) here, viz. YAG:Dy, YAG:Dy:Er, YABNG:Dy, and YABG:Dy. The phosphor crystallinity and morphology were determined by x-ray diffraction spectroscopy (XRD) and scanning electron microscopy (SEM), respectively. The phosphor emissions were measured with a setup consisted of a UV laser, high temperature oven, and spectrometer. The integral of YABNG:Dy emission was 1.5 to 2 times higher than other investigated phosphors at temperatures above 1200 K. The increment in emission intensity improved the precision at high temperatures.M.A.S