Radiation-free Insertion of Interlocked Intramedullary Tibial Nail in Closed Extra-articular Displaced Tibial Shaft Fractures in an Emergency Setup

Background. Interlocking nailing is considered a gold standard surgical treatment of mid-shaft closed diaphyseal tibial fractures. With increasing exposure of orthopaedic surgeons to radiation, we propose a solution to this health hazard through a study wherein we perform the surgery without any radiation or C-arm exposure. Material and methods. This prospective study was done at GMC Jammu from January 2017 to February 2020 and included 218 patients, with 18 patients having bilateral tibia fractures in the age group 15 to 58 years (mean of 37.6 years), including 63.7% males (n=139) and 36.3% females (n=79). The 236 extra-articular closed tibial mid-diaphyseal fractures were operated on and intramedullary tibial nailing was performed without a single C-arm exposure. Postoperative x-rays were done and reduction assessed by standard acceptable criteria. Results. Among 236 cases in which nailing was done, 227 (96%) patients were successfully distally locked, including 128 (56.3%) locked through the jig and 99 (43.6%) by “hit and trial method.” All cases met acceptability criteria set for management of tibia by nailing. Conclusions. 1.This study strengthens the proof that closed extra-articular diaphyseal fractures of the tibia can be managed by nailing without using the C-arm with excellent results. 2.The C-arm is always available for cases where distal locking could not be achieved. 3. The technique has a great role in centres with limited facilities of intra-operative radiography in emergency operation theatres.

Validation of a Questionnaire to Assess Smoking Habits, Attitudes, Knowledge, and Needs among University Students: A Pilot Study among Obstetrics Students

In Italy, smoking is still widespread among a relatively high percentage of young people. This study aimed to develop and validate a questionnaire to assess smoking habits, passive smoke exposure, electronic cigarette (e-cig) and heated tobacco product (HTP) use, attitudes, knowledge, and needs among undergraduates. A questionnaire consisting of 84 items was developed starting from a literature review and existing questionnaires. A two-round validation was performed by a team of 10 experts. The item-level content validity index (I-CVI), the scale-level content validity index (S-CVI), and the kappa statistics k, taking into account chance agreement, were calculated from the experts’ rating. The questionnaire was emailed to 114 students from the Obstetrics Degree of the University of Milan (Italy) to be pilot tested. After the second round of validation, all indexes were above the respective acceptability criteria: the I-CVI was 1.00 for all but three items, k was >0.74 (“excellent”) for all items, and the S-CVI was 0.964. Eighty-nine students participated in the survey: 17 classified themselves as smokers, eight as new product users, and four as former smokers, 72% students declared to routinely spend free time with smokers, while almost all students believed that healthcare professionals play a pivotal role in preventing smoking towards their patients and society. This questionnaire will be used in a survey among students from the University of Milan as a first step for future campaigns targeting health promotion.

Development of the psychoeducation model to decrease academic stress when Learning From Home (LFH)

This study aimed to develop and test the acceptability and effectiveness of the psychoeducation model to decrease academic stress when learning from home (LFH). This research used a development research design, with two main objectives: developing the product and testing the effectiveness of the product. The instruments used were questionnaires on rating scales about aspects of product utility, feasibility, accuracy and also stress academic scale. Data analysis was carried out quantitatively and qualitatively. Quantitative data were analysed by descriptive statistical analysis, while qualitative data in the form of comments, suggestions and criticisms were analysed qualitatively. Based on the data analysis, it can be concluded that the psychoeducation model developed fulfils the acceptability criteria which includes utility, feasibility and accuracy. The developed psychoeducation model is effective in reducing academic stress among college students when LFH. Keywords: development, psychoeducation model, academic stress, acceptability, effectiveness

Augmenting the Transplant Team With Artificial Intelligence: Toward Meaningful AI Use in Solid Organ Transplant

Advances in systems immunology, such as new biomarkers, offer the potential for highly personalized immunosuppression regimens that could improve patient outcomes. In the future, integrating all of this information with other patient history data will likely have to rely on artificial intelligence (AI). AI agents can help augment transplant decision making by discovering patterns and making predictions for specific patients that are not covered in the literature or in ways that are impossible for humans to anticipate by integrating vast amounts of data (e.g. trending across numerous biomarkers). Similar to other clinical decision support systems, AI may help overcome human biases or judgment errors. However, AI is not widely utilized in transplant to date. In this rapid review, we survey the methods employed in recent research in transplant-related AI applications and identify concerns related to implementing these tools. We identify three key challenges (bias/accuracy, clinical decision process/AI explainability, AI acceptability criteria) holding back AI in transplant. We also identify steps that can be taken in the near term to help advance meaningful use of AI in transplant (forming a Transplant AI Team at each center, establishing clinical and ethical acceptability criteria, and incorporating AI into the Shared Decision Making Model).

Incorporating cumulative environmental effects of finfish mariculture into Canadian environmental assessment

A Traffic Light Decision Support System (DSS) used in marine finfish federal environmental assessments was expanded to include regional and cumulative environmental impacts. A retrospective review of 23 existing mariculture farms in southwestern New Brunswick indicated whether cumulative interactions would have justified site approvals. Six new criteria were added to the far-field component and other existing criteria were amended. Scores of A, B+, B⁻, C and pre-emptive C were based on acceptability criteria. Calculations of cumulative ecosystem indices and potential site indices revealed site acceptability, and the index combinations suggested potential site approvals predicted using Hargrave's (2002) three-colour Traffic Light scheme. Before mitigation was considered, 19 of 23 sites failed the amended set of criteria and after considering mitigation, 8 sites failed. Combining the site and ecosystem indices yielded varying site acceptability scores. The role of mitigation and other factors in hindering sustainable siting was discussed

Incorporating cumulative environmental effects of finfish mariculture into Canadian environmental assessment

A Traffic Light Decision Support System (DSS) used in marine finfish federal environmental assessments was expanded to include regional and cumulative environmental impacts. A retrospective review of 23 existing mariculture farms in southwestern New Brunswick indicated whether cumulative interactions would have justified site approvals. Six new criteria were added to the far-field component and other existing criteria were amended. Scores of A, B+, B⁻, C and pre-emptive C were based on acceptability criteria. Calculations of cumulative ecosystem indices and potential site indices revealed site acceptability, and the index combinations suggested potential site approvals predicted using Hargrave's (2002) three-colour Traffic Light scheme. Before mitigation was considered, 19 of 23 sites failed the amended set of criteria and after considering mitigation, 8 sites failed. Combining the site and ecosystem indices yielded varying site acceptability scores. The role of mitigation and other factors in hindering sustainable siting was discussed

The Promotions of Sustainable Lunch Meals in School Feeding Programs: The Case of Italy

School is considered a privileged environment for health education and school feeding represents an opportunity for promoting sustainable foods to young generations. The objective of this paper is to demonstrate that is possible to select, from existing school menus, recipes that combine healthy foods with low environmental impact. A national sample of Italian school menus was collected and a total number of 194 recipes were included on a database containing 70 first courses, 83 s courses, 39 side dishes, 1 portion of fruit, and 1 portion of bread. A mathematical model was conceived to combine nutritional adequacy and acceptability criteria while minimizing GHGs emissions. The result is a four-week menu characterized by large vegetable components that were used not only as side dishes but also as ingredients in the first and second courses. Legumes and pasta are often included, and white meat is selected instead of red meat. The findings presented in this paper demonstrated that it is possible to design environmental-friendly meals from existing school menus. The mathematical model developed in this work has the potentiality of being completely scalable, easily updatable, and widely utilizable in different settings either for design or monitoring purposes as well as for research data collection.

Numerical parametric study on steel-concrete composite floor beams vibrations due to pedestrian traffic

Human perception of floor vibrations and uncompromised serviceability of equipment are two most important acceptability criteria considering floor vibrations. While verification of deflection is a simple and well-known procedure in structures' design for serviceability limit state, the fulfilment of floor vibrations acceptability criteria are presented in different standards in the form of various calculation procedures. Results achieved through those calculation procedures are presented in the form of various classification of floor structures. Classification of composite floor structures due to vibrations is inconsistent considering different calculation procedures. Comparison of various calculation procedures for the definition of composite floor vibrations is presented in this paper. In addition, a parametric analysis is performed on the wide range of steel-concrete composite floor structures, through analysis of various composite floor layouts and a wide range of imposed loads values. The analysis of the relation between deflection, vertical vibrations and accelerations of steel-concrete composite floor beams is presented in this paper. The results of the parametric analysis are given through direct relation between deflections of composite beams and achieved floor class for the fulfilment of vibrations acceptability criteria due to the pedestrian walking.

Anisotropic charged realistic models in f(R) gravity under Durgapal transformation

In this paper, we investigate the charged static spherically symmetric models in [Formula: see text] theory of gravity. We consider a linear equation of state (EoS) in the background of anisotropic matter configuration. We formulate the modified field equations and implement Durgapal transformation to examine the gravitational nature of compact stellar objects. For this purpose, we choose a specific gravitational potential and electric charge intensity to analytically solve the set of field equations. We generate three special cases of solutions for specific parametric values of [Formula: see text] appearing in the expression of gravitational potential. The evolution of physical observables, such as energy density, anisotropy parameter, radial and tangential pressures and electric field intensity, are presented in all cases. Via physical analysis, it is observed that the solution of charged compact spheres satisfies acceptability criteria, models are well behaved, and depict stability and consistency in accordance with [Formula: see text] gravity for generated models.