Effect of calibration of a medical review monitor on the visibility of mandibular canal at dental implant sites: A cone beam CT study

Objectives

The aim of this study was to assess the visibility of mandibular canal (MC) on cone beam CT (CBCT) images using a medical review monitor under two different calibration modes. The effect of age, gender, and location of the dental implant site was also assessed.

Materials and Methods

CBCT images of 428 dental implant sites were selected for the study. Images were displayed twice on a medical review monitor using two different calibration modes: standard and DICOM, and two observers evaluated the visibility of the MC using four-point scoring scale (1-4, poor to excellent). Cohen Kappa was used to assess intra and inter-rater reliability. Chi-square test was used to compare proportions of MC visibility by gender and location and one-way ANOVA was used to compare mean age and MC visibility.

Results

Each observer classified the visibility of MC with a total agreement of 100% between DICOM mode and standard mode (Kappa = 1, P < 0.001 for each observer). In each mode, a strong agreement (inter-rater reliability) was detected between the observers (Cohen's kappa = 0.88 for both modes, P < 0.001) with a percent agreement of 95.3% for each mode. Gender and location were not statistically associated with MC visibility (P > 0.05). Age, however, was a significant predictor of MC visibility (P < 0.05).

Conclusions

DICOM calibration had no added value over standard calibration for assessing the visibility of MC at dental implant sites on a medical review monitor. Only the age had significant effect on the visibility.

Evaluating the Role of Anesthesia on Intraoperative Blood Loss and Visibility during Endoscopic Sinus Surgery: A Meta-analysis

BACKGROUND

Previous studies and meta analyses have led to incongruent and incomplete results respectively when total intravenous anesthesia (TIVA) and inhalational anesthesia (IA) are compared in endoscopic sinus surgeries in regards to intraoperative bleeding and visibility.

OBJECTIVE

To perform a more comprehensive meta-analysis on randomized controlled trial (RCTs) comparing TIVA with IA in endoscopic sinus surgery to evaluate their effects on intraoperative bleeding and visibility.

METHODS

A systematic review and meta-analysis of studies comparing TIVA and IA in endoscopic sinus surgery for chronic rhinosinusitis was completed in May 2020. Utilizing databases, articles were systematically screened for analysis and 19 studies met our inclusion criteria. The primary outcome included intraoperative visibility scores combining Boezaart, Wormald and Visual Analogue Scale (VAS). Secondary outcomes included rate of blood loss (mL/kg/min), estimated total blood loss (mL), Boezaart, Wormald scores, VAS, heart rate, and mean arterial pressure (MAP).

RESULTS

19 RCTs with 1,010 patients were analyzed. TIVA had a significantly lower intraoperative bleeding score indicating better endoscopic visibility (Boezaart, VAS, and Wormald) than IA (-0.514, p = 0.020). IA had a significantly higher average rate of blood loss than TIVA by 0.563 mL/kg/min (p = 0.016). Estimated total blood loss was significantly lower in TIVA than IA (-0.853 mL, p = 0.002). There were no significant differences between TIVA and IA in the mean heart rate (-0.225, p = 0.63) and MAP values (-0.126, p = 0.634). The subgroup analyses revealed no significant difference between TIVA and IA when remifentanil was not utilized and whenever desflurane was the IA agent.

CONCLUSION

TIVA seemed to have superior intraoperative visibility scores and blood loss during endoscopic sinus surgery when compared to IA. However, the results are not consistent when stratifying the results based on the use of remifentanil and different inhaled anesthetics. Therefore, the conclusion cannot be made that one approach is superior to the other.

Correlation between visibility and traffic safety visual distance in foggy areas during the daytime

OBJECTIVE

Traffic safety is closely related to the driver's ability to obtain visual information. Low visibility would result in traffic accidents. This study aimed to explore the difference between meteorological visibility and traffic safety visual distance in foggy areas in the daytime, and analyze the difference between dynamic visual ability and static visual ability, so as to calculate the maximum acceptable speed limit that meets the driver's safety visual distance requirement.

METHODS

Visual distances under different visibility conditions were collected for 12 passenger car drivers through static and naturalistic driving visual recognition experiments. The power function relation model between driver's static visual distance and meteorological visibility was established, and the attenuation rates of dynamic visual distance at different driving speeds were obtained.

RESULTS

Traffic safety visual distance (TSVD) gradually grows with the increase of visibility and finally tends to be stable due to the vision limitation of the human eyes under good weather conditions. The drivers' visual ability decreased while driving dynamically, and dynamic TSVD was shorter than static TSVD.

CONCLUSIONS

Traditional meteorological visibility is different from drivers' actual TSVD, but there is a correlation between them. According to the relationship between visibility and dynamic TSVD, the maximum recommended speed limit values under different visibility levels are provided. The calculation of the maximum acceptable speeds under specific visibility conditions can provide a technical basis for road construction and traffic management.

Is Red the New Black? A Quasi-Experimental Study Comparing Perceptions of Differently Coloured Cycle Lanes

Cities and road authorities in many countries have started colouring their cycle lanes. Some road authorities choose red, some blue, and some green. The reasoning behind this choice is not clear, and it is uncertain whether some colours are superior to others. The current study aims to examine whether coloured cycle lanes are viewed more positively than uncoloured lanes, and whether one of the typically chosen colours is perceived as safer and more inviting to cyclists or more deterring to motorists. Participants were invited to respond to a web survey. Respondents (N = 560) were from the four largest cities in Norway, both genders (42.1% women), and of a wide age range (79.6% between 30 and 70). Depending on cycling frequency, respondents were categorised as either motorist (n = 354) or cyclist (n = 206). All respondents rated different cycle lanes (uncoloured, blue, green, and red) on different attributes. The uncoloured lane was consistently rated least positively, with the lowest scores on visibility, perceived safety for both motorists and cyclist and how inviting it seemed to cycle in the lane. It was also estimated to be the lane that would experience the greatest degree of violation from motorists, in terms of driving or stopping in the cycle lane. The green and red lanes were consistently rated more positively than the blue lane, but whether green or red was preferred depended on whether the respondent had lived a place with coloured cycle lanes. People familiar with coloured cycle lanes, which in Norway are red, rated the red lane more positively than the green lane, while the opposite was true for people who were not used to coloured cycle lanes. The difference in ratings between different colours were similar to, or greater than, the difference from uncoloured to coloured, which implies that it not only matters that a lane is coloured, but also which colour it has.

Differentiations in Visibility-Male Advantages and Female Disadvantages in Gender-Segregated Programmes

This article stresses the importance of understanding that women and men in gender-segregated programmes experience their gender minority positions very differently. It stems from an interest in the kind of interventions that academia should address in order to reduce gender segregation and provide women and men with the same educational opportunities and personal development. In relation to the obvious and continuing gender differences along a horizontal dimension, previous research seems to have had a limited impact in breaking gender stereotypes and promoting women and men to more atypical fields. The empirical data consists of 25 semi-structured, individual interviews from underrepresented students' gender-related experiences/thoughts about their programmes. By using the concepts of "visibility," "sense of belonging," and "negotiating otherness" to analyze how negotiation and belonging are part of students' everyday university lives this study's most important contributions are its findings regarding the differentiations in visibility. A continuum of visibility experiences is explored, from men who receive positive attention to women who are being considered as less knowledgeable. Our visibility scale indicates, as does previous research, that there are differences between how female and male students become visible, but the differences can also appear within both groups of students. This knowledge is crucial when designing interventions so as to provide positive study environments for both women and men. Also-in a broader perspective-it is important in order to recruit and ensure that gender minority students remain in the programs.

Impact of Visibility and Accessibility on Healthcare Workers' Hand-Hygiene Behavior: A Comparative Case Study of Two Nursing Units in an Academic Medical Center

OBJECTIVES

This study aims to explore the impacts of visibility and accessibility of alcohol gel-based hand sanitizer dispensers (HSDs) on healthcare workers' hand-hygiene (HH) behaviors.

BACKGROUND

Despite the importance of HH in reducing nosocomial infection, few empirical studies have quantitatively investigated the impacts of unit shape and size, and the resulted visibility and accessibility on HH, due to the lack of consistent methods to measure and evaluate visibility.

METHODS

The research was developed as a cross-sectional comparative study of two nursing units (Units A and B) with similar patient acuity and nursing care model but different shape and layout. The study applied quantitative research methods including visibility and accessibility analysis using space syntax, 1-week on-site observation, and secondary data analysis on HH compliance rates.

RESULTS

Results indicate that the unit with higher visibility and accessibility is associated with higher HH frequencies. Unit B has significantly higher visibility of HSDs, p < .001, t(60) = 4.615, and significantly higher frequency of HH activity occurrences, 5.17% versus 1.52%; p < .001, t(16.750) = 5.332, than Unit A, even though Unit B has lower HSD to bed ratio (0.708:1 vs. 1.375:1). The linear regression models also demonstrate that visibility and accessibility of HSDs are significant predictors of HH behavior.

CONCLUSIONS

Overall, this exploratory study identified the importance of visibility of HSDs to improve the chances of HH. It also points out the impacts of nursing unit typology on the visibility of HSDs and in turn affects HH behavior.

The Representational Function of Clinic Design: Staff and Patient Perceptions of Teamwork

OBJECTIVE

This study empirically investigates the relationships between visibility attributes and both patients' and staff members' teamwork experiences.

BACKGROUND

Teamwork among healthcare professionals is critical for the safety and quality of patient care. While a patient-centered, team-based care approach is promoted in primary care clinics, little is known about how clinic layouts can support the teamwork experiences of staff and patients in team-based primary clinics.

METHODS

This article measured teamwork perceptions of staff members and patients at four primary care clinics providing team-based care. Visual access to staff workstations from both staff and patient perspectives was analyzed using VisualPower tool(version 21). The relationships between teamwork perception and visibility attributes were analyzed for each entity: staff members and patients.

RESULTS

The results showed that the visual relationships among staff members and those between staff members and patients have significant associations with overall perceptions of teamwork. While clinics providing more visual connections between staff workstations reported higher teamwork perception of staff members, patient perceptions of staff teamwork were inversely related to the number of visual connections between patients and staff workstations.

CONCLUSIONS

The findings of the study provide implications for designing team-based primary care clinics to enhance the teamwork experience of both staff members and patients, which is also applicable to teamwork perceptions in other settings where both inhabitants and visitors are main user groups of the spaces. This study illustrates the representational function of space: Organizations can emphasize their values via layout design by regulating what they show to inhabitants or visitors.

Wave-Particle-Entanglement-Ignorance Complementarity for General Bipartite Systems

Wave–particle duality as the defining characteristic of quantum objects is a typical example of the principle of complementarity. The wave–particle–entanglement (WPE) complementarity, initially developed for two-qubit systems, is an extended form of complementarity that combines wave–particle duality with a previously missing ingredient, quantum entanglement. For two-qubit systems in mixed states, the WPE complementarity was further completed by adding yet another piece that characterizes ignorance, forming the wave–particle–entanglement–ignorance (WPEI) complementarity. A general formulation of the WPEI complementarity can not only shed new light on fundamental problems in quantum mechanics, but can also have a wide range of experimental and practical applications in quantum-mechanical settings. The purpose of this study is to establish the WPEI complementarity for general multi-dimensional bipartite systems in pure or mixed states, and extend its range of applications to incorporate hierarchical and infinite-dimensional bipartite systems. The general formulation is facilitated by well-motivated generalizations of the relevant quantities. When faced with different directions of extensions to take, our guiding principle is that the formulated complementarity should be as simple and powerful as possible. We find that the generalized form of the WPEI complementarity contains unequal-weight averages reflecting the difference in the subsystem dimensions, and that the tangle, instead of the squared concurrence, serves as a more suitable entanglement measure in the general scenario. Two examples, a finite-dimensional bipartite system in mixed states and an infinite-dimensional bipartite system in pure states, are studied in detail to illustrate the general formalism. We also discuss our results in connection with some previous work. The WPEI complementarity for general finite-dimensional bipartite systems may be tested in multi-beam interference experiments, while the second example we studied may facilitate future experimental investigations on complementarity in infinite-dimensional bipartite systems.

Enhancing Your Virtual Footprint: The School Nurse's Professional Health Office Website

The public narrative of the role of the school nurse is about Band-Aids and management of acute illness and injury. The public does not understand that school nurses are responsible for so much more. Literature recommends that school nurses change the narrative of school nursing by the use of social media and websites, but school nurses are not using websites as evidenced by a national audit of websites and survey of school nurses. The school nurse website toolkit was developed to assist nurses in the development of their own professional practice websites, thereby enhancing their image to stakeholders and changing the public narrative of school nursing.

Comparison of endoscopic visibility and miss rate for early gastric cancers after Helicobacter pylori eradication with white-light imaging versus linked color imaging

BACKGROUND AND AIM

We aimed to investigate whether linked color imaging (LCI) improves endoscopic visibility of early gastric cancers (EGC) after Helicobacter pylori eradication, which are often difficult to detect, and reduces the miss rate when compared with white-light imaging (WLI).

METHODS

The visibility study used two images, one each with WLI and LCI, from 84 consecutive EGC after H. pylori eradication. Endoscopic visibility was evaluated using a visibility score and color difference (CD) value. To analyze miss rates, we studied a library of recorded videos using both WLI and LCI for 70 other consecutive patients after H. pylori eradication, among whom 19 had EGC. Endoscopic screening was done using the same protocol to map the entire stomach. Six endoscopists reviewed the videos in a randomized order. Miss rates of EGC were compared among the modalities.

RESULTS

Mean [(±standard deviation) visibility scores with LCI were significantly higher than those with WLI (3.19 ± 0.84 vs 2.52 ± 0.98, P < 0.001), as were mean CD values (26.3 ± 9.1 vs 13.6 ± 6.3, P < 0.001). Miss rates of the six endoscopists were significantly lower with LCI than with WLI (30.7% vs 64.9%, P < 0.001). Both expert and trainee endoscopists had significantly better results with LCI than with WLI.

CONCLUSIONS

Linked color imaging significantly improved the visibility of EGC after H. pylori eradication compared with WLI using both subjective and objective criteria. Furthermore, LCI significantly reduced miss rates of these lesions compared with WLI.

The Shape of a Vehicle Windshield Affects Reaction Time and Brain Activity During a Target Detection Task

Background: Achieving clear visibility through a windshield is one of the crucial factors in manufacturing a safe and comfortable vehicle. The optic flow (OF) through the windshield has been reported to divert attention and could impair visibility. Although a growing number of behavioral and neuroimaging studies have assessed drivers’ attention in various driving scenarios, there is still little evidence of a relationship between OF, windshield shape, and driver’s attentional efficacy. The purpose of this research was to examine this relationship.

Methods: First, we quantified the OF across the windshield in a simulated driving scenario with either of two types of the windshield (a tilted or vertical pillar) at different speeds (60 km/h or 160 km/h) and found more upward OF along the tilted pillar than along the vertical pillar. Therefore, we hypothesized that the predominance of upward OF around the windshield along a tilted pillar could distract a driver and that we could observe the corresponding neural activity. Magnetic resonance scans were then obtained while the subjects performed a visual detection task while watching the driving scene used in the OF analysis. The subjects were required to press a button as rapidly as possible when a target appeared at one of five positions (leftmost, left, center, right, and rightmost).

Results: We found that the reaction time (RT) on exposure to a tilted pillar was longer than that on exposure to a vertical pillar in the leftmost and rightmost conditions. Furthermore, there was more brain activity in the precuneus when the pillar was tilted than when it was vertical in the rightmost condition near the pillar. In a separate analysis, activation in the precuneus was found to reflect relative changes in the amount of upward OF when the target was at the rightmost position.

Conclusions: Overall, these observations suggest that activation in the precuneus may reflect extraneous cognitive load driven by upward OF along the pillar and could distract visual attention. The findings of this study highlight the value of a cognitive neuroscientific approach to research and development in the motor vehicle manufacturing industry.

An Object Model and Interaction Method for a Simulated Experience of Pottery on a Potter's Wheel

This paper introduces an object model and an interaction method for a simulated experience of pottery on a potter's wheel. Firstly, we propose a layered cylinder model for a 3D object of the pottery on a potter's wheel. Secondly, we set three kinds of deformation functions to form the object model from an initial state to a bowl shape: shaping the external surface, forming the inner shape (deepening the opening and widening the opening), and reducing the total height. Next, as for the interaction method between a user and the model, we prepare a simple but similar method for hand-finger operations on pottery on a potter's wheel, in which the index finger movement takes care of the external surface and the total height, and the thumb movement makes the inner shape. Those are implemented in the three-dimensional aerial image interface (3DAII) developed in our laboratory to build a simulated experience system. We confirm the operation of the proposed object model (layered cylinder model) and the functions of the prepared interaction method (a simple but similar method to actual hand-finger operations) through a preliminary evaluation of participants. The participants were asked to make three kinds of bowl shapes (cylindrical, dome-shaped, and flat-type) and then they answered the survey (maneuverability, visibility, and satisfaction). All participants could make something like three kinds of bowl shapes in less than 30 min from their first touch.

The Correlation Between Visibility and Medical Staff Collaborative Communication in Emergency Departments

OBJECTIVES

This study empirically investigates the correlation between visibility and nurses and physicians' collaborative communication in emergency departments (EDs). The researchers hypothesized that higher visibility levels in EDs are associated with higher collaborative communication among nurses and physicians.

BACKGROUND

The review of related literature addresses the role of communication in EDs, and more specifically, how visibility has been found to affect nurse and physician behavior in healthcare facilities.

METHOD

The visibility levels in four EDs within the same hospital system were quantitatively measured in this study. Also, the communication levels among medical staff were explored by two methods. Data collection included computerized floor plan analyses, observations, and surveys.

RESULTS

The researchers found statistically significant relationships between several underlying dimensions of ED visibility and collaborative communication among the medical staff members.

CONCLUSION

Understanding the role of visibility provides a critical design principle for future EDs. The enhancement of ED design helps nurses and physicians to benefit from supportive environments.

Investigating split-filter dual-energy CT for improving liver tumor visibility for radiation therapy

Purpose

Accurate liver tumor delineation is crucial for radiation therapy, but liver tumor volumes are difficult to visualize with conventional single‐energy CT. This work investigates the use of split‐filter dual‐energy CT (DECT) for liver tumor visibility by quantifying contrast and contrast‐to‐noise ratio (CNR).

Methods

Split‐filter DECT contrast‐enhanced scans of 20 liver tumors including cholangiocarcinomas, hepatocellular carcinomas, and liver metastases were acquired. Analysis was performed on the arterial and venous phases of mixed 120 kVp‐equivalent images and VMIs at 57 keV and 40 keV gross target volume (GTV) contrast and CNR were calculated.

Results

For the arterial phase, liver GTV contrast was 12.1 ± 10.0 HU and 43.1 ± 32.3 HU (P < 0.001) for the mixed images and 40 keV VMIs. Image noise increased on average by 116% for the 40 keV VMIs compared to the mixed images. The average CNR did not change significantly (1.6 ± 1.5, 1.7 ± 1.4, 2.4 ± 1.7 for the mixed, 57 keV and 40 keV VMIs (P > 0.141)). For individual cases, however, CNR increases of up to 607% were measured for the 40 keV VMIs compared to the mixed image. Venous phase 40 keV VMIs demonstrated an average increase of 35.4 HU in GTV contrast and 121% increase in image noise. Average CNR values were also not statistically different, but for individual cases CNR increases of up to 554% were measured for the 40 keV VMIs compared to the mixed image.

Conclusions

Liver tumor contrast was significantly improved using split‐filter DECT 40 keV VMIs compared to mixed images. On average, there was no statistical difference in CNR between the mixed images and VMIs, but for individual cases, CNR was greatly increased for the 57 keV and 40 keV VMIs. Therefore, although not universally successful for our patient cohort, split‐filter DECT VMIs may provide substantial gains in tumor visibility of certain liver cases for radiation therapy treatment planning.

Drivers' Visual Perception Quantification Using 3D Mobile Sensor Data for Road Safety

To prevent driver accidents in cities, local governments have established policies to limit city speeds and create child protection zones near schools. However, if the same policy is applied throughout a city, it can be difficult to obtain smooth traffic flows. A driver generally obtains visual information while driving, and this information is directly related to traffic safety. In this study, we propose a novel geometric visual model to measure drivers' visual perception and analyze the corresponding information using the line-of-sight method. Three-dimensional point cloud data are used to analyze on-site three-dimensional elements in a city, such as roadside trees and overpasses, which are normally neglected in urban spatial analyses. To investigate drivers' visual perceptions of roads, we have developed an analytic model of three types of visual perception. By using this proposed method, this study creates a risk-level map according to the driver's visual perception degree in Pangyo, South Korea. With the point cloud data from Pangyo, it is possible to analyze actual urban forms such as roadside trees, building shapes, and overpasses that are normally excluded from spatial analyses that use a reconstructed virtual space.

Building Parasitology Communities to Promote Gender Equality

In an ideal world, there are equal opportunities for women to enter and progress in all scientific disciplines without bias or prejudice. Here, we share our experiences in building communities of women parasitology and offer easy-to-implement guidelines for scientists and institutions to overcome unconscious bias and create environments with better gender equality and diversity.

How the Visitors' Cognitive Engagement Is Driven (but Not Dictated) by the Visibility and Co-visibility of Art Exhibits

The spatial arrangement of artworks is recognized as one of the key elements of exhibition design. The underlying assumption is that the layout can strengthen the impact of individual exhibits, because the way visitors visually engage with artworks affects how they are cognitively processed. This paper explores the influence of the exhibits’ visual properties on the visitors’ attention and their memory of artworks. Attention was recorded with the use of mobile eye-tracking and memory was measured by an unanticipated recognition test immediately after the visit. The paper analyses both the total amount of attention spent on interacting with each artwork, as well as the strategy through which attention was allocated: through primarily longer (“diligent”) looks, versus primarily shorter (“distracted”) glimpses. Results of two experiments demonstrate that the visibility and co-visibility of artworks affected the amount of attention allocated to them, and the strategy of attention allocation. While the amount of attention contributed to improving the recognition memory of pictures, the strategy of attention allocation did not. These findings demonstrate the power of the exhibition’s visual properties to influence the experience of museum visitors but also highlight the visitors’ ability to employ alternative viewing strategies without diminishing the cognitive processing of artworks.

Analysis of the effects of visibility and warning devices on driver injury severity at highway-rail grade crossings considering temporal transferability of data

This study explores the joint effect of visibility and warning devices on driver injury severity at the highway-rail grade crossings (HRGCs), while also considering other contributing factors. For this purpose, four mixed logit models are developed to estimate the determinants of driver injury severity considering the combinations of visibility conditions (daylight vs. no daylight) and type of warning devices (active vs. passive warning). The models were calibrated using the data obtained from the USDOT Federal Railroad Administration for HRGC crashes that occurred over a ten-year period 2008-2017 across the United States. A temporal transferability test was conducted and confirmed the stability of model specifications considering a ten-year span of collected data. The pseudo-elasticity analysis was conducted to ascertain marginal impact of the contributing factors on driver injury severity in each model. While the vehicle speed, train speed, time of day and driver age are found to be common significant factors among the four models, there are marked differences between parameters associated with various crash factors. The study provides new insight into the driver injury severity in train-vehicle collisions considering visibility and type of warning devices, which can help in setting up proper policies to improve safety at HRGCs.

Maximum acceptable speed based on physiological performance for different alignments of rural roads under the influence of visibility in fog-a driving simulator study

Objectives: The goals of this research are to: (i) investigate whether the driver's physiological performance has a significant impact on driving speed choice, considering the visibility level under fog conditions and the horizontal and vertical alignment of a rural road; (ii) quantify the relationships among these variables; (iii) calculate the maximum acceptable speed that meets the driver's physiological tolerance threshold.Methods: A driving simulator study was conducted. A total of 30 participants were recruited, and each completed 5 driving simulator trials under varying visibility levels, radii of curvature and vertical grades. A multiple linear regression model was established to measure the association between normalized heart rate, driving speed, visibility, radius of curvature and gradient.Results: The results indicated that driving speed, visibility, radius of curvature and gradient all significantly affected the normalized heart rate. For instance, an increase in driving speed and vertical grade and a reduction in the radius of curvature are related to an increase in normalized heart rate. Moreover, an acceptable speed model that considered the driver's normalized heart rate was constructed, given the visibility level and horizontal and vertical alignment.Conclusions: The study shows a significant correlation between the drivers' physiological performance and his or her driving speed choice under the influence of visibility in fog. Given visibility conditions and road alignment parameters, we can calculate the maximum acceptable speed that meets the driver's physiological requirements. Such findings should be indicative of real-time traffic management that could reduce the crash risk under inadequate visibility conditions in fog.

Experiences with stigmatization among transgender individuals after transition: A qualitative study in the Netherlands

Background: Transgender individuals belong to one of the most stigmatized groups in society. Although the social stigma of transgender individuals has been examined many times, post transition stigma experiences among transgender individuals have received limited research attention. The aim of this study was to examine experiences with stigmatization among Dutch transgender individuals after their transition. Method: Ten trans women (age: M = 58.50, SD = 9.49) and 10 trans men (age: M = 42.90, SD = 13.62) participated in face-to-face semistructured interviews. Grounded theory was used to conceptualize and analyze the data. We examined the positive and negative reactions that transgender individuals experienced in the period after their transition. Furthermore, we explored differences between experiences of trans men and trans women. Finally, we examined differences between cisgender men and women regarding their reactions toward transgender individuals. Results: Participants reported improved psychological well-being since transition. However, they still experienced different forms of stigmatization. Trans women appeared to experience stronger social stigma than trans men. Trans women also experienced lower social status after their transition. They mainly experienced negative responses from cisgender men. Participants emphasized the importance of social and peer support. Conclusion: The current study findings demonstrate the presence of stigmatization after transition and argue for psychological aftercare. Social and peer support appeared to be important for coping with stigmatization, and improving the social network of transgender individuals is beneficial. Health providers and researchers are recommended to promote the development of constructive coping skills for transgender individuals with interventions especially targeting trans women.

The Influence of Visibility on Medical Teamwork in Emergency Departments: A Mixed-Methods Study

AIM

This mixed-methods study delivers empirical evidence on the influence of visibility on healthcare teamwork in Emergency Departments (EDs). This study researchers hypothesized that with changes of visibility in EDs, teamwork among medical staff members will be impacted.

BACKGROUND

Prior research results suggest that visibility can influence health-setting efficacy. Teamwork is one of the components of each healthcare system that can be supported by environmental design.

METHOD

Visibility in four subject sites from the same healthcare system was objectively measured by morphology plan analyses. Teamwork among medical staff members was the behavioral variable of interest and explored through field observations, interviews, and surveys.

RESULTS

The qualitative outcomes demonstrated that teamwork can be enhanced by improved visibility, while the quantitative findings supported the idea that some specific measures of visibility were correlated with teamwork.

CONCLUSION

This study provides a model for future research on the association between healthcare staff behavior and ED plan configuration. The enhancement of ED design, considering the significance of visibility, enhances the perceptions of nurses and physicians in terms of teamwork.

Collecting Data: Where Do I Start?

It is important for all school nurses to collect data. This brief article provides steps for a school nurse to follow to begin the process.

Backstage Staff Communication: The Effects of Different Levels of Visual Exposure to Patients

OBJECTIVE

This article examines how visual exposure to patients predicts patient-related communication among staff members.

BACKGROUND

Communication among healthcare professionals private from patients, or backstage communication, is critical for staff teamwork and patient care. While patients and visitors are a core group of users in healthcare settings, not much attention has been given to how patients' presence impacts staff communication. Furthermore, many healthcare facilities provide team spaces for improved staff teamwork, but the privacy levels of team areas significantly vary.

METHOD

This article presents an empirical study of four team-based primary care clinics where staff communication and teamwork are important. Visual exposure levels of the clinics were analyzed, and their relationships to staff members' concerns for having backstage communication, including preferred and nonpreferred locations for backstage communication, were investigated.

RESULTS

Staff members in clinics with less visual exposure to patients reported lower concerns about having backstage communication. Staff members preferred talking in team areas that were visually less exposed to patients in the clinic, but, within team areas, the level of visual exposure did not matter. On the other hand, staff members did not prefer talking in visually exposed areas such as corridors in the clinic and visually exposed areas within team spaces.

CONCLUSIONS

Staff members preferred talking in team areas, and they did not prefer talking in visually exposed areas. These findings identified visually exposed team areas as a potentially uncomfortable environment, with a lack of agreement between staff members' preferences toward where they had patient-related communication.

Impacts of Nursing Unit Design on Visibility and Proximity and Its Influences on Communication, Privacy, and Efficiency

OBJECTIVES

This study examines the role of visibility and proximity on nurse communication patterns, perception of privacy, and efficiency in double-corridor nursing units.

BACKGROUND

Nurses are extremely important for the quality of healthcare. The literature suggests that visibility and proximity have a substantial impact on the delivery of care and staff experience. However, few studies have empirically examined nursing units in China.

METHOD

Questionnaire surveys, observations, and simulations of medication administration tasks were employed.

RESULTS

Visibility and proximity influenced communication patterns, perceptions of privacy, and efficiency. The type of wall in the medication room could impact nurses' perception of privacy and efficiency. A partial glass wall in the medication room could achieve balance between privacy and visibility. A medication room that is adjacent to and is easily accessed from the nurse station (NS) could provide efficient communication and efficient work. The partition type between the NS and the doctor's office and the layout of the medication room could impact communication patterns. The relative position of the NS, medication room, and disposal room could influence the flow of medication administration tasks, and a geographically contiguous spatial layout could enhance work efficiency.

CONCLUSIONS

The findings contribute to the body of knowledge on the impact of visibility and proximity on nurses' communication patterns, perception of privacy, and efficiency. Recommendations to improve the design of double-corridor nursing units are also provided.

Out of Sight, Out of Mind? Geographic and Social Predictors of Flood Risk Awareness

The persistent gap in flood risk awareness in Canada, and elsewhere in North America, is a continual source of worry for researchers and emergency managers; many people living in at-risk places are simply unaware of risks and of their proximity to hazards. This study seeks to understand which residents were aware of flood risk, using unique representative survey data of Calgary residents living in the city's flood-prone neighborhoods collected after the devastating and costly 2013 Southern Alberta Flood. The article uses logistic regression models to analyze which residents were aware of risk to their homes. Findings indicate that, in addition to various demographic predictors, many of the geographic predictors (including the elevation of one's home relative to the river) are significant predictors of awareness. Having a direct sight line to one of Calgary's two rivers is also a significant predictor in some of the models, suggesting that the visibility of hazards matters for flood risk perception, although this effect fades when many of the geographic predictors are added. Finally, the models indicate that several variables related to local, neighborhood-based social networks are significant as well. These findings reveal that both physical surroundings and social context are important for understanding risk awareness. The article concludes by discussing the relevance for social science research on disasters and hazards, as well as for planners and emergency managers.

Visibility and hotspots of outdoor tobacco advertisement around educational facilities without an advertising ban: Geospatial analysis in Surabaya City, Indonesia

INTRODUCTION

Despite having over 60 million smokers in 2018, Indonesia still lacks tobacco control measures, including an outdoor tobacco advertising ban. This study aimed to provide evidence on the visibility and hotspots of advertisements around educational facilities in a city without a ban.

METHODS

We collected data on the locations of outdoor tobacco advertisements and schools and universities in Surabaya city. We conducted buffer and hotspots analyses using ArcMap. Using Getis-Ord Gi* statistics, hotspot analysis identifies significant clusters with a high number of advertisements.

RESULTS

We found 307 large and medium-sized outdoor tobacco advertisements and 1287 educational facilities (1199 schools, 88 universities). Almost 80% of those advertisements (237 units) were just 300 m away (10-minute walk) from primary schools and high schools in the city. More than half of all schools (652) and two-thirds of all universities (59) were inside hotspots where there were statistically significant clusters with a high number of advertisements. These hotspots were more densely populated and more-deprived areas.

CONCLUSIONS

There was high visibility of large and medium-sized outdoor tobacco advertisements around educational facilities in the city without the ban.

Characterizing the Role of Wind and Dust in Traffic Accidents in California

Wind is a common ground transportation hazard. In arid regions, wind-blown dust is an added risk. Here, we analyzed the relationship between accidents and wind speed, dust events to study how they may have contributed to vehicular accidents in California. The California Highway Patrol reports information about weather conditions that potentially contributed to traffic accidents, including a code for wind but not for reduced visibility due to dust. For the three counties that contain the major dust source regions in California (the Mojave Desert and the Imperial Valley), we found greater daily maximum wind speed for days with accidents coded for wind compared to all days with accidents. The percentage of people injured in accidents attributed for weather other than wind and coded for wind were the same; however, the percentage of people who died in wind-related accidents was about double the deaths in accidents caused by weather other than wind. At ground meteorological stations closest to accidents, we found lower median minimum visibility for days with wind-related accidents compared to all days with accidents. Across the region, wind speed recorded at ground meteorological stations increased the probability of high satellite-derived dust optical depth values. Over the period of 2006 to 2016, the correlation between daily minimum visibility and daily maximum satellite-estimated dust optical depth was negative. Our analysis of the correlation between dust and accidents shows that with increased wind storm and dust-event frequency in the future, the risk of traffic incidents due to wind and dust could increase.

[Characteristics of Atmospheric PM2.5 Pollution and Its Influence on Visibility in Background Areas of Ji'nan]

In order to study the seasonal variations in the chemical composition of atmospheric particulate matter with diameters less than 2.5 μm (PM_2.5) and its influence on visibility in background areas, atmospheric PM_2.5 samples were collected in spring, summer, autumn, and winter 2016 at Qixingtai in Ji'nan. The pollution characteristics of water-soluble ions components, organic carbon (OC), and elemental carbon (EC) were analyzed, and their regional transmission contributions were studied. The results show that NH₄⁺, SO₄^2-, and NO₃^- were the main components of water-soluble ions, accounting for 90.24% of the annual total ion concentration. The secondary water soluble inorganic ions were polluted severely. NO₃^-/SO₄^2- presented obvious seasonal variations of high (low) levels in winter (summer). In each season, SO₄^2- and NH₄⁺ existed mainly in the form of (NH₄)₂SO₄. The value of secondary OC (SOC)/OC ranged from 21.17% to 54.21%, indicating the presence of relatively severe secondary organic pollution in this area. The sulfur oxidation ratio (SOR) value in all seasons was greater than 0.1, indicating that the secondary generation of SO₄^2- occurs in all seasons in this region, and the value of nitrogen oxidation ratio (NOR) in all seasons was higher than the SOR value. The secondary transformation of NO₂ in the Qixingtai region was stronger than that of SO₂. The range of atmospheric extinction coefficient (B_ext) was 172.68-320.61 Mm^-1, with an annual mean of 256.48 Mm^-1. The atmospheric extinction coefficient showed an obvious seasonal trend of the lowest (highest) in summer (winter). The backward airflow trajectory shows that the Qixingtai was affected mainly by the long-distance transmission from Northwest China and the ocean in spring and summer and by local sources in autumn and winter. A comparison of the characteristics of atmospheric PM_2.5 pollution in Ji'nan in 2008 revealed that the influence of motor vehicles on the atmospheric environment has been significantly improved.

Personalized 3D printed coronary models in coronary stenting

Background

3D printing has shown great promise in cardiovascular disease, with reports mainly focusing on pre-surgical planning and medical education. Research on utilization of 3D printed models in simulating coronary stenting has not been reported. In this study, we presented our experience of placing coronary stents into personalized 3D printed coronary models with the aim of determining stent lumen visibility with images reconstructed with different postprocessing views and algorithms.

Methods

A total of six coronary stents with diameter ranging from 2.5 to 4.0 mm were placed into 3 patient-specific 3D printed coronary models for simulation of coronary stenting. The 3D printed models were placed in a plastic container and scanned on a 192-slice third generation dual-source CT scanner with images reconstructed with soft (Bv36) and sharp (Bv59) kernel algorithms. Thick and thin slab maximum-intensity projection (MIP) images were also generated from the original CT data for comparison of stent lumen visibility. Stent lumen diameter was measured on 2D axial and MIP images, while stent diameter was measured on 3D volume rendering images. 3D virtual intravascular endoscopy (VIE) images were generated to provide intraluminal views of the coronary wall and stent appearances.

Results

All of these stents were successfully placed into the right and left coronary arteries but 2 of them did not obtain wall apposition along the complete length. The stent lumen visibility ranged from 54 to 97%, depending on the stent location in the coronary arteries. The mean stent lumen diameters measured on 2D axial, thin and thick slab MIP images were found to be significantly smaller than the actual size (P<0.01). Thick slab MIP images resulted in measured stent lumen diameters smaller than those from thin slab MIP images, with significant differences noticed in most of the measurements (4 out of 6 stents) (P<0.05), and no significant differences in the remaining 2 stents (P=0.19-0.38). In contrast, 3D volume rendering images allowed for more accurate measurements with measured stent diameters close to the actual dimensions in most of these coronary stents, except for the stent placed at the right coronary artery in one of the models due to insufficient expansion of the stent. Images reconstructed with sharp kernel Bv59 significantly improved stent lumen visibility when compared to the smooth Bv36 kernel (P=0.01). 3D VIE was successfully generated in all of the datasets with clear visualization of intraluminal views of the stents in relation to the coronary wall.

Conclusions

This preliminary report shows the feasibility of using 3D printed coronary artery models in coronary stenting for investigation of optimal coronary CT angiography protocols. Future studies should focus on placement of more stents with a range of stent diameters in the quest to reduce the need for invasive angiography for surveillance.

[Relationship Between Atmospheric Visibility and PM2.5 Concentrations and Distributions]

Monitoring data were used to analyze the relationships among relative humidity (RH), visibility, and PM_2.5 concentrations. A strong, linear relationship expression between the extinction coefficient and PM_2.5 concentrations at different relative humidities is proposed. The mean correlation coefficient at RH 40%-90% was higher than 0.75 for most of Central and Eastern China, and reached 0.9 in Beijing. Comparatively, the extinction efficiency of PM_2.5 was much larger in Beijing, the Yangzi River Delta Region, and Sichuan than in other regions. However, the influence of RH on visibility varied from region to region. In Beijing, RH dominated the decrease in visibility when RH>90%, while in Guangzhou, this was the case when RH>80%. From 1980 to 1996, the annual variation in PM_2.5 concentrations was not significant in Beijing and the PM_2.5 concentrations were significantly higher than in the 2000s because of the dominant mode of heating. From 1997 to 2009, PM_2.5 concentrations in Beijing showed a slow downward trend, and from 2010 to 2012, showed an upward trend. Since 1980, PM_2.5 concentrations in the entire country have been rising. PM_2.5 concentrations have always been higher in North China than in other parts of the country.

Show Me More! The Influence of Visibility on Sustainable Food Choices

Visual cues are omnipresent in an in-store environment and can enhance the visibility of a product. By using these visual cues, policy makers can design a choice environment to nudge consumers towards more sustainable consumer behavior. In this study, we use a combined nudge of display area size and quantity of displayed products to nudge consumers towards more sustainable meat choices. We performed a field experiment of four weeks in a butchery, located in a supermarket. The size of the display area and quantity of displayed poultry products, serving as the nudging intervention, were increased, whereas these were decreased for less sustainable meat products. In order to evaluate the effectiveness of our nudging intervention, we also collected data from a control store and performed a pre-and post-intervention measurement. We kept records of the sales data of the sold meat (amount of weight & revenue). When conducting a three-way ANOVA and post hoc contrast tests, we found that the sales of poultry increased during the nudging intervention, but did not decrease for less sustainable meat products. When removing the nudge again, the sales of poultry decreased again significantly in the experimental store. Changing the size of display area and the amount of products displayed in this display area created a shift in the consumers' purchase behavior of meat.

Total intravenous versus inhalational anesthesia in endoscopic sinus surgery: A meta-analysis

OBJECTIVE

Achieving optimal intraoperative surgical field visibility and minimizing blood loss are two important parameters in endoscopic sinus surgery (ESS). The aim of this meta-analysis was to compare two total intravenous anesthesia (TIVA) and inhalational anesthesia (IA) to determine if either conferred superior outcomes of these and other parameters based on randomized control trials (RCTs) only.

METHODS

The recommended Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines were followed, and searches of electronic databases from inception to September 2018 identified 157 articles for screening. Data were extracted and analyzed using meta-analysis of proportions.

RESULTS

In total, we identified 15 RCTs that satisfied our selection criteria. There were 828 ESS cases described, with 391 (47%) and 437 (53%) being managed by TIVA and IA, respectively. Pooled analysis demonstrated significantly superior visibility scores for TIVA compared to IA based on 10-point grading scores (P = 0.049, visual analog scale; P = 0.009, Wormald scale) and 5-point grading scores (P = 0.002, Boezaart scale). Blood loss was significantly less following TIVA (P = 0.003), with no significant difference in intraoperative heart rate (P = 0.70) or mean arterial pressure (P = 0.96). Additionally, duration of surgery (P = 0.16) and anesthesia (P = 0.39) were comparable between the two approaches.

CONCLUSION

This meta-analysis indicates that TIVA has the potential to confer superior surgical field visibility and reduce intraoperative blood loss compared to IA in ESS. Currently, there are significant heterogeneity concerns in this meta-analysis, which temper any expectations that either approach is absolutely superior to the other. Caution should be exercised when interpreting these results until further validation can be achieved.

LEVEL OF EVIDENCE

1A Laryngoscope, 130:575-583, 2020.

Investigating SSH Research and Publication Practices in Disciplinary and Institutional Contexts. A Survey-Based Comparative Approach in Two Universities

In this paper, we comparatively analyze, present and discuss the results from a survey on increasing the visibility of research achievements in the social sciences and humanities (SSH) that was carried out at the University of Vienna (Austria) and the University of Navarra (Spain) in 2016 and 2017. Covering four major topics—searching and finding literature, publishing, the visibility of research, and the assessment of research outputs—we ask the following questions: are there disciplinary differences to be identified, and how do they present themselves in the two institutional contexts? Discussing the results, we showcase how disciplinary and institutional traditions and contexts are important factors that influence research and publication practices in the SSH. Our results indicate that the practices of searching and finding literature as well as publication practices and behavior are shaped by disciplinary traditions and epistemic cultures. On the contrary, assessment and valuation of research outputs are influenced by institutional and national contexts in which SSH research is organized and carried out.

[Modification and Performance Tests of Visibility Parameterizations for Haze Days]

In order to select a visibility parameterization scheme that can be applied well to the Beijing-Tianjin-Hebei (BTH) region and provide better forecasting, a modified parameterization of visibility based on the aerosol volume concentration and RH is developed in this study. This upgraded parameterization scheme (S1) and other schemes based on PM_2.5 and RH (S2) and Mie theory (S3) are evaluated using forecast data from Rapid refresh Multi-scale Analysis & Prediction System-CHEM (RMAPS-CHEM v1.0). A performance test using data from February 2017 showed that:① The concentration of PM_2.5 is forecast well in the BTH region. The correlation coefficients of the observed and forecast daily average PM_2.5 in most areas are higher than 0.8, and the forecasted values are close to those observed. The mean errors (ME) are -7.54, -0.46, and -11.0μg·m^-3 for the forecast domain, south and north of Hebei province, and 12.04, 2.02, and -13.31 μg·m^-3 for the cities of Beijing, Tianjin, and Shijiazhuang, respectively. The correlation coefficients for the forecast and observed hourly relative humidity in the three typical cities are above 0.78, and the mean errors are lower than 3.91%. ② All three parameterization schemes predict the time evaluation of visibility in the BTH region during February 2017 well. In general, the visibility predicted with S1 is the lowest, while that of S3 is the highest; the predictions of S2 are intermediate. In most areas of the BTH region, S1 has the minimum root mean squared error (RMSE) and normalized mean error (NME) between the observed and forecast visibility, while S3 has the maximum RMSE and NME. The error of S2 is between that of S1 and S3, but it shows the best performance in the Beijing area. ③ When the observed visibility is higher than 10 km, the predicted visibilities of the three schemes are all lower than the observed visibility, and S3 has the lowest mean error (ME) and RMSE. S1 has the lowest MB, RMSE, and NME when the visibility is lower than 10 km, especially for visibilities of 1 km to 5 km, which occurred more frequently during heavy haze episodes. The comparison of the results indicated that S1 is best for application to haze forecasting in the BTH region.

VisNet: Deep Convolutional Neural Networks for Forecasting Atmospheric Visibility

Visibility is a complex phenomenon inspired by emissions and air pollutants or by factors, including sunlight, humidity, temperature, and time, which decrease the clarity of what is visible through the atmosphere. This paper provides a detailed overview of the state-of-the-art contributions in relation to visibility estimation under various foggy weather conditions. We propose VisNet, which is a new approach based on deep integrated convolutional neural networks for the estimation of visibility distances from camera imagery. The implemented network uses three streams of deep integrated convolutional neural networks, which are connected in parallel. In addition, we have collected the largest dataset with three million outdoor images and exact visibility values for this study. To evaluate the model’s performance fairly and objectively, the model is trained on three image datasets with different visibility ranges, each with a different number of classes. Moreover, our proposed model, VisNet, evaluated under dissimilar fog density scenarios, uses a diverse set of images. Prior to feeding the network, each input image is filtered in the frequency domain to remove low-level features, and a spectral filter is applied to each input for the extraction of low-contrast regions. Compared to the previous methods, our approach achieves the highest performance in terms of classification based on three different datasets. Furthermore, our VisNet considerably outperforms not only the classical methods, but also state-of-the-art models of visibility estimation.

Optimization of the Maritime Signaling System in the Lagoon of Venice

Aids to Navigation (AtoN) are auxiliary devices intended to support maritime navigation. They include both traditional signals (e.g., buoys and lights) and electronic aids, as for example those transmitted to ships through automatic tracking systems. In both cases, international organizations together with local authorities define technical specifications and standards on their use. Work still being finalized in the Venetian Lagoon made it necessary an assessment of the existing signaling system to guarantee the maximum level of safety in the waterways. Considering the severe atmospheric conditions to which the Lagoon is frequently subjected and the bathymetry restrictions affecting the navigation, an alternative aid system has been formalized for the first time in Italy. It is based on electronic and identification devices employed to virtualize the AtoN that will not be located at sea but only remotely identified by their coded messages, thus guaranteeing the continuity of port operations in any visibility conditions. This paper presents the procedures followed to reach a solution in line with the safety and efficiency standards given for the AtoN systems, considering position and luminous characteristics of physical signals in the first case, theoretical and statistical studies on Virtual AIS AtoN placement in the second case.

[A Method of Aerosol Particle Number Size Distribution Inversed by PM2.5 Mass Concentration in PRD]

The aerosol particle number size distribution(PNSD) is of great importance in calculating atmospheric radiation and optics. It can effectively supplement the inadequate observation of PNSD using the widely known aerosol mass concentration (PM_2.5) measurement to invert PNSD. It would be valuable for research that needs PNSD data, like atmospheric visibility calculation. This paper created a PNSD inversed method based on the statistics and parameterization of the dry aerosol PM_2.5 and PNSD dataset from the Guangzhou urban site's simultaneous measurements from November 2014 to January 2015. The inversed results appeared good in the accumulation mode, whereas more differences showed with higher PM_2.5 loading. The applicability and stability of this method makes it preferable. It would provide advanced technical support for the visibility calculation and application in PRD.

In Vitro Evaluation of a Novel Root Canal Endoscope for Visualizing the Apex of Curved Root Canal Models and an Extracted Tooth

INTRODUCTION

In straight root canals, intraradicular structures around the root canal orifice and apical foramen can be visualized with a dental operating microscope and commercially available root canal endoscopes. However, the root apex area, including the apical foramen, in a curved root canal cannot be visualized using these devices. In the present study, the potential of a newly developed root canal endoscope implementing an image fiber was examined in 3 types of root canal models and extracted teeth.

METHODS

A straight and 2 curved (10° and 30°) resin block models were prepared. A resolution chart was set at the outer surface of the apical foramen in each model. Using the microscope and the endoscope, the resolution chart was observed, and the captured images were analyzed quantitatively. Additionally, fracture lines in 20 extracted teeth were observed with both devices.

RESULTS

With the dental operating microscope, a resolution chart line was clearly observed in the straight canal model with 18.0 line pairs/mm resolution and an observing capability of 0.16 at 40 × magnification but not in the curved root canal models. With the root canal endoscope, resolution charts in all types of root canal models were visualized, and the resolution and observing capability were 16.0 line pairs/mm and 0.053, respectively. Fracture lines and the apical foramen of the extracted teeth were observed more clearly with the endoscope than the microscope.

CONCLUSIONS

The newly developed root canal endoscope using an image fiber is useful for accurate visualization of the apex area of curved root canals.

Effects of Emergency Department Physical Design Elements on Security, Wayfinding, Visibility, Privacy, and Efficiency and Its Implications on Staff Satisfaction and Performance

OBJECTIVE

The purpose of this study was to identify the role of emergency department (ED) design on ED staff satisfaction and performance.

BACKGROUND

High patient volume, surging workloads, and violent behaviors are expected pressures for ED staff. Literature suggests the substantial role of the physical environment in the delivery of care and its role in staff and patient experiences. Nevertheless, limited studies have explored simultaneous interactions between ED physical design elements, attributes (security, wayfinding, visibility, privacy, and efficiency), and staff satisfaction or performance.

METHOD

Interviews, surveys, visibility graph analysis, and agent simulations were employed to understand the connection between ED physical design, attributes, performance, and staff satisfaction.

RESULTS

Enhanced security, effective wayfinding, team visibility, noise reduction, adequate privacy, and accessible supplies and equipment were significant predictors of staff satisfaction and performance. Unobstructed views in waiting and triage and controlled entrances were critical for improving security. To improve wayfinding, eye-level signage, reducing surveillance obstacles, and creating direct public routes were recommended. Rectangular units with multiple perpendicularly connected corridors and linear pod arrangements enhanced movement. Including team rooms and enclosed ERs were recommended for privacy improvements. Visibility was critical for team communication and improved by including short-distanced perpendicular corridors and eliminating columns. Enhancing access to supplies or equipment and reducing noise levels improved the perception of staff efficiency.

CONCLUSION

The findings contribute to the general body of knowledge on the impact of ED physical design on attributes that potentially improve staff satisfaction and work performance.

Scandal mining: political nobodies and remediated visibility

This article considers the 2015 federal election in Canada as the emergence of seemingly citizen-led practices whereby candidates' past missteps are unearthed and distributed through social and news media channels. On first pass, these resemble citizen-led engagements through digital media for potentially unmappable political goals, given the dispersed and either non-partisan or multi-partisan nature of these engagements. By bringing together journalistic accounts and social media coverage alongside current scholarship on citizenship and visibility, this case study traces the possibility of political accountability and the political weaponisation of mediated visibility through the targeted extraction of candidate details from dispersed profiles, communities and databases.

Self-Reported and Network Scale-Up Estimates of Substance Use Prevalence among University Students in Kerman, Iran

Background: This study aimed to estimate the prevalence of substance use among university students measured by direct and indirect methods, and to calculate the visibility factor (VF) defined as ratio of indirect to direct estimates of substance use prevalence.

Study design: A cross-sectional study.

Methods: Using a multistage non-random sampling approach, we recruited 2157 students from three universities in Kerman, Iran, in 2016. We collected data on substance use by individual face-to-face interview using direct (i.e. self-report of their own behaviors) and indirect (NSU: Network scale up) methods. All estimates from direct and indirect methods were weighted based on inverse probability weight of sampling university.

Results: The response rate was 83.6%. The last year prevalence of water pipe, alcohol, and cigarettes indirect method was 44.6%, 18.1%, and 13.2% respectively. Corresponding figures in NSU analysis were 36.4%, 18.2%, and 16.5% respectively. In the female population, VF for all types of substance was less than male.

Conclusions: Considerable numbers of university students used substances like a water pipe, alcohol, and cigarettes. NSU seems a promising method, especially among male students. Among female students, direct method provided more reliable results mainly due to transmission and prestige biases.

[Effect of Relative Humidity on Particulate Matter Concentration and Visibility During Winter in Chengdu]

The effect of relative humidity (RH) on particulate matter concentrations and atmosphere visibility were investigated using the continuous on-line observed data of Chengdu city during December 2015, including RH, visibility, the concentrations of particulate matters (PM₁₀, PM_2.5 and PM₁) and gaseous pollutants (SO₂ and NO₂), and the concentrations of SO₄^2- and NO₃^- in PM_2.5. The results showed that the haze process occurred because of the synergistic effects of higher particulate matter concentrations and RH, leading to the reduction of visibility. The average ratio of PM_2.5 to PM₁₀ was 64% and it significantly increased with the increase of RH during observation period, which indicated that the pollution of fine particles during winter in Chengdu was serious, and high RH aggravated the pollution caused by fine particles.Visibility decreased exponentially with the increase of particulate matter concentrations. When RH was higher, visibility was lower at the same concentrations of particulate matter.RH had a strong effect on visibility at lower particle concentrations, while the effect of RH on the visibility decreased, and atmospheric extinction was controlled by PM_2.5 concentrations at higher particle concentrations. With RH increasing from less than 40% to more than 70%, the average sulfur oxidation ratio (SOR) and nitrogen oxidation ratio (NOR) increased from 0.27 and 0.11 to 0.40 and 0.19, respectively, indicating that higher RH significantly promoted the formation of secondary sulfate and nitrate. Secondary sulfate and nitrate separately or coordinatively influenced the air quality.

Does observability affect prosociality?

The observation of behaviour is a key theoretical parameter underlying a number of models of prosociality. However, the empirical findings showing the effect of observability on prosociality are mixed. In this meta-analysis, we explore the boundary conditions that may account for this variability, by exploring key theoretical and methodological moderators of this link. We identified 117 papers yielding 134 study level effects (total n = 788 164) and found a small but statistically significant, positive association between observability and prosociality (r = 0.141, 95% confidence interval = 0.106, 0.175). Moderator analysis showed that observability produced stronger effects on prosociality: (i) in the presence of passive observers (i.e. people whose role was to only observe participants) versus perceptions of being watched, (ii) when participants' decisions were consequential (versus non-consequential), (iii) when the studies were performed in the laboratory (as opposed to in the field/online), (iv) when the studies used repeated measures (instead of single games), and (v) when the studies involved social dilemmas (instead of bargaining games). These effects show the conditions under which observability effects on prosociality will be maximally observed. We describe the theoretical and practical significance of these results.

[Important Effect of Secondary Inorganic Salt Extinction on Visibility Impairment in the Northern Suburb of Nanjing]

Observed data regarding the visibility and aerosol chemical composition from May 2013 to May 2014 were used to analyze the variation of visibility, the relationship between aerosol chemical composition and visibility variations, and their contributions to atmospheric light extinction. An important effect of secondary inorganic salt extinction on the visibility impairment was determined. The present study suggests that the average visibility during the observation period was (6.78±3.68) km, and there was obvious seasonal variation in the visibility. Fine particles with size less than 2.1 μm have a great influence on visibility, with the main chemical components of SO₄^2-, NO₃^-, NH₄⁺, and OC. The secondary inorganic ions make significant contributions to visibility degradation. The mean light extinction coefficient of Nanjing was (527.2±295.2) Mm^-1, which was calculated by using the revised IMPROVE equation. Regarding the chemical composition of PM_2.1, the most contributive species to the light extinction coefficient were ammonium sulfate, ammonium nitrate, and organic species, which accounted for 80.6%. Although the light extinction contribution of organic matter was as high as 43.51% on a clear day (VR>10 km), with the decrease of visibility, the extinction contribution of organic matter decreased, but the contribution of secondary inorganic salt increased. The contribution of extinction was 58.96% for heavy haze days with low visibility (VR<5 km). This proves that the secondary inorganic salt extinction plays a significant role in visibility impairment.

The association between local meteorological changes and exacerbation of acute wheezing in Kandy, Sri Lanka

BACKGROUND

Severe wheezing is a common medical emergency. Past studies have demonstrated associations between exacerbation of wheezing and meteorological factors and atmospheric pollution. There are no past studies from Sri Lanka that analyzed correlation between daily multiple meteorological variables and exacerbation of wheezing.

OBJECTIVES

To determine the correlations between daily counts of patients nebulized at the Outpatient Department (OPD) of Teaching Hospital - Kandy (THK) and local meteorological variables, and to explore the utility of that information.

DESIGN

We considered daily counts of patients nebulized at the OPD of THK as an indicator of exacerbations of wheezing in the population catered to by this hospital. We determined the correlations between daily counts of patients nebulized at OPD and the following meteorological variables for four years: daily rainfall, minimum temperature, maximum temperature, diurnal temperature range, difference between maximum temperature and the temperature at 1800 hours, daytime humidity, nighttime humidity, barometric pressure and visibility. We utilized wavelet time series method for data analysis.

RESULTS

All nine meteorological parameters studied were correlated with the daily counts of patients nebulized with average lag periods ranging from 5 to 15 days. Peaks of daily rainfall, maximum temperature, diurnal temperature range, difference between maximum temperature and the temperature at 1800 hours and daytime humidity were followed by peaks of counts of patients nebulized (positive correlations). Troughs of minimum temperature, nighttime humidity, barometric pressure and visibility were followed by peaks of patients nebulized (negative correlations).

CONCLUSIONS

The THK shall expect more patients with acute wheezing after extremes of weather. Minimum temperature has been consistently correlated with the exacerbation of respiratory symptoms in the past studies in other countries as well. Hence, prescribing the inhalation of more drugs on unusually cold days (prophylactically) may help prevent acute exacerbation of wheezing in patients on treatment for asthma and COPD.

The Short-Term Effects of Visibility and Haze on Mortality in a Coastal City of China: A Time-Series Study

Few studies have been conducted to investigate the acute health effects of visibility and haze, which may be regarded as proxy indicators of ambient air pollution. We used a distributed lag non-linear model (DLNM) combined with quasi-Poisson regression to estimate the relationship between visibility, haze and mortality in Ningbo, a coastal city of China. We found that the mortality risk of visibility was statistically significant only on the current day, while the risk of haze and PM₁₀ peaked on the second day and could last for three days. When the visibility was less than 10 km, each 1 km decrease of visibility at lag 0 day was associated with a 0.78% (95% CI: 0.22–1.36%) increase in total mortality and a 1.61% (95% CI: 0.39–2.85%) increase in respiratory mortality. The excess risk of haze at lag 0–2 days on total mortality, cardiovascular and respiratory mortality was 7.76% (95% CI: 3.29–12.42%), 7.73% (95% CI: 0.12–15.92%) and 17.77% (95% CI: 7.64–28.86%), respectively. Greater effects of air pollution were observed during the cold season than in the warm season, and the elderly were at higher risk compared to youths. The effects of visibility and haze were attenuated by single pollutants. These findings suggest that visibility and haze could be used as surrogates of air quality where pollutant data are scarce, and strengthen the evidence to develop policy to control air pollution and protect vulnerable populations.

The Impact of Visibility on Teamwork, Collaborative Communication, and Security in Emergency Departments: An Exploratory Study

The aim of this study was to examine the influence of visibility on teamwork, collaborative communication, and security issues in emergency departments (EDs). This research explored whether with high visibility in EDs, teamwork and collaborative communication can be improved while the security issues will be reduced. Visibility has been regarded as a critical design consideration and can be directly and considerably impacted by ED's physical design. Teamwork is one of the major related operational outcomes of visibility and involves nurses, support staff, and physicians. The collaborative communication in an ED is another important factor in the process of care delivery and affects efficiency and safety. Furthermore, security is a behavioral factor in ED designs, which includes all types of safety including staff safety, patient safety, and the safety of visitors and family members. This qualitative study investigated the impact of visibility on teamwork, collaborative communication, and security issues in the ED. One-on-one interviews and on-site observation sessions were conducted in a community hospital. Corresponding data analysis was implemented by using computer plan analysis, observation and interview content, and theme analyses. The findings of this exploratory study provided a framework to identify visibility as an influential factor in ED design. High levels of visibility impact productivity and efficiency of teamwork and communication and improve the chance of lowering security issues. The findings of this study also contribute to the general body of knowledge about the effect of physical design on teamwork, collaborative communication, and security.

High beam headlamp use rates: Effects of rurality, proximity of other traffic, and roadway curvature

OBJECTIVE

The few observational studies of the prevalence of high beam use indicate the rate of high beam use is about 25% when vehicles are isolated from other vehicles on unlit roads. Recent studies were limited to 2-lane rural roads and used measurement methods that likely overestimated use. The current study examined factors associated with the rate of high beam use of isolated vehicles on a variety of roadways in the Ann Arbor, Michigan area.

METHODS

Twenty observation sites were categorized as urban, rural, or on a rural/urban boundary and selected to estimate the effects of street lighting, road curvature, and direction of travel relative to the city on high beam use. Sites were selected in pairs so that a majority of traffic passing one site also passed through the other. Measurement of high beams relied on video data recorded for 2 nights at each site, and the video data also were used to derive a precise measure of the proximity of other traffic. Nearly 3,200 isolated vehicles (10 s or longer from other vehicles) were observed, representing 1,500-plus vehicle pairs.

RESULTS

Across the sample, 18% of the vehicles used high beams. Seventy-three percent of the 1,500-plus vehicle pairs used low beams at each paired site, whereas 9% used high beams at both sites. Vehicles at rural sites and sites at the boundaries of Ann Arbor were more likely to use high beams than vehicles at urban sites, but use in rural areas compared with rural/urban boundary areas did not vary significantly. Rates at all sites were much lower than expected, ranging from 0.9 to 52.9%. High beam use generally increased with greater time between subject vehicles and leading vehicles and vehicles in the opposing lane. There were mixed findings associated with street lighting, road curvature, and direction of travel relative to the city.

CONCLUSION

Maximizing visibility available to drivers from headlights includes addressing the substantial underuse of high beam headlamps. Advanced technologies such as high beam assist, which switches automatically between high and low beam headlamps depending on the presence of other traffic, can help to address this problem.