Effect of Starting Powder Particle Size on the Thermoelectric Properties of Hot-Pressed Bi0.3Sb1.7Te3 Alloys.

P-type Bi0.3Sb1.7Te3 polycrystalline pellets were fabricated using different methods: melting and mechanical alloying, followed by hot-press sintering. The effect of starting powder particle size on the thermoelectric properties was investigated in samples prepared using powders of different particle sizes (with micro- and/or nano-scale dimensions). A peak ZT (350 K) of ~1.13 was recorded for hot-pressed samples prepared from mechanical alloyed powder. Moreover, hot-pressed samples prepared from ≤45 µm powder exhibited similar ZT (~1.1). These high ZT values are attributed both to the presence of high-density grain boundaries, which reduced the lattice thermal conductivity, as well as the formation of antisite defects during milling and grinding, which resulted in lower carrier concentrations and higher Seebeck coefficient values. In addition, Bi0.3Sb1.7Te3 bulk nanocomposites were fabricated in an attempt to further reduce the lattice thermal conductivity. Surprisingly, however, the lattice thermal conductivity showed an unexpected increasing trend in nanocomposite samples. This surprising observation can be attributed to a possible overestimation of the lattice thermal conductivity component by using the conventional Wiedemann-Franz law to estimate the electronic thermal conductivity component, which is known to occur in nanocomposite materials with significant grain boundary electrical resistance.

Adaptation, Academic Performance and Support: Students with and without Disabilities and Future Considerations for Counselling Psychology.

The transition to university is a process that presents young adults with several challenges in adaptation, especially students with disabilities. The current study investigated the differences in adaptation and academic performance between students with and without disabilities and further examined these differences among students with disabilities. Additionally, we explored the role of academic support for students with disabilities' adaptation and academic performance, as well as their perceptions of a proposed specialised package of counselling psychology interventions. The sample consisted of 127 students with disabilities and 127 without disabilities, aged 18-24 years. Results revealed that students with disabilities reported a lower GPA and adaptation than students without disabilities. Additionally, differences among students with disabilities were observed only in terms of GPA, according to their disability type, existence of comorbidity and type of exam accommodations. Interestingly, no differences were found in GPA or adaptation between students with disabilities who utilised psychological therapy and those who did not. Finally, adaptation scores, but not GPA, were higher for students with disabilities who were positive in receiving a specialised package of counselling psychology interventions. The findings are discussed in relation to the existing literature and future considerations of counselling psychology's role in support of students with disabilities.

Signatures of Co-Deregulated Genes and Their Transcriptional Regulators in Kidney Cancers.

There are several studies on the deregulated gene expression profiles in kidney cancer, with varying results depending on the tumor histology and other parameters. None of these, however, have identified the networks that the co-deregulated genes (co-DEGs), across different studies, create. Here, we reanalyzed 10 Gene Expression Omnibus (GEO) studies to detect and annotate co-deregulated signatures across different subtypes of kidney cancer or in single-gene perturbation experiments in kidney cancer cells and/or tissue. Using a systems biology approach, we aimed to decipher the networks they form along with their upstream regulators. Differential expression and upstream regulators, including transcription factors [MYC proto-oncogene (MYC), CCAAT enhancer binding protein delta (CEBPD), RELA proto-oncogene, NF-kB subunit (RELA), zinc finger MIZ-type containing 1 (ZMIZ1), negative elongation factor complex member E (NELFE) and Kruppel-like factor 4 (KLF4)] and protein kinases [Casein kinase 2 alpha 1 (CSNK2A1), mitogen-activated protein kinases 1 (MAPK1) and 14 (MAPK14), Sirtuin 1 (SIRT1), Cyclin dependent kinases 1 (CDK1) and 4 (CDK4), Homeodomain interacting protein kinase 2 (HIPK2) and Extracellular signal-regulated kinases 1 and 2 (ERK1/2)], were computed using the Characteristic Direction, as well as GEO2Enrichr and X2K, respectively, and further subjected to GO and KEGG pathways enrichment analyses. Furthermore, using CMap, DrugMatrix and the LINCS L1000 chemical perturbation databases, we highlight putative repurposing drugs, including Etoposide, Haloperidol, BW-B70C, Triamterene, Chlorphenesin, BRD-K79459005 and ß-Estradiol 3-benzoate, among others, that may reverse the expression of the identified co-DEGs in kidney cancers. Of these, the cytotoxic effects of Etoposide, Catecholamine, Cyclosporin A, BW-B70C and Lasalocid sodium were validated in vitro. Overall, we identified critical co-DEGs across different subtypes in kidney cancer, and our results provide an innovative framework for their potential use in the future.

Simplified model for pre-code RC column exposed to fire followed by earthquake.

The behaviour of pre-code reinforced concrete (RC) columns in sequence of fire and earthquake is not well understood and can be critical in case of buildings which experienced fire and are either unrepaired or poorly repaired when exposed to an earthquake. This study proposes a framework on how to construct a simplified model to assess the post-fire cyclic behaviour of such columns. Emphasis is given to the development of simplified material models which can be used to describe the performance of the confined concrete, as its post-fire behaviour is not well studied. The model's performance is validated against the experimental results of a square, non-seismically designed RC column. Three scenarios are considered. The reference scenario, where the column is exposed only to cyclic loading. In the other two, the column is firstly exposed to an ISO-834 time-temperature curves in a furnace of 30 min and 90 min duration and after it cooled down, it is exposed to cyclic loading. The results showed that simplified material models can be used to capture the post-fire cyclic behaviour of an RC column, built without seismic design. It was also found that the confined model adopted played an important role after the peak strength is reached.

Prioritization of hazards for risk and resilience management through elicitation of expert judgement.

Risk assessment in communities or regions typically relies on the determination of hazard scenarios and an evaluation of their impact on local systems and structures. One of the challenges of risk assessment for infrastructure operators is how to identify the most critical scenarios that are likely to represent unacceptable risks to such assets in a given time frame. This study develops a novel approach for prioritizing hazards for the risk assessment of infrastructure. Central to the proposed methodology is an expert elicitation technique termed paired comparison which is based on a formal mathematical technique for quantifying the range and variance in the judgements of a group of stakeholders. The methodology is applied here to identify and rank natural and operational hazard scenarios that could cause serious disruption or have disastrous effects to the infrastructure in the transnational Øresund region over a period of 5 years. The application highlighted substantial divergences of views among the stakeholders on identifying a single 'most critical' natural or operational hazard scenario. Despite these differences, it was possible to flag up certain cases as critical among the natural hazard scenarios, and others among the operational hazards.

"Donor milk banking: Improving the future". A survey on the operation of the European donor human milk banks.

BACKGROUND: Provision of donor human milk is handled by established human milk banks that implement all required measures to ensure its safety and quality. Detailed human milk banking guidelines on a European level are currently lacking, while the information available on the actual practices followed by the European human milk banks, remains limited. The aim of this study was to collect detailed data on the actual milk banking practices across Europe with particular emphasis on the practices affecting the safety and quality of donor human milk. MATERIALS AND METHODS: A web-based questionnaire was developed by the European Milk Bank Association (EMBA) Survey Group, for distribution to the European human milk banks. The questionnaire included 35 questions covering every step from donor recruitment to provision of donor human milk to each recipient. To assess the variation in practices, all responses were then analyzed for each country individually and for all human milk banks together. RESULTS: A total of 123 human milk banks completed the questionnaire, representing 85% of the European countries that have a milk bank. Both inter- and intra-country variation was documented for most milk banking practices. The highest variability was observed in pasteurization practices, storage and milk screening, both pre- and post-pasteurization. CONCLUSION: We show that there is a wide variability in milk banking practices across Europe, including practices that could further improve the efficacy of donor human milk banking. The findings of this study could serve as a tool for a global discussion on the efficacy and development of additional evidence-based guidelines that could further improve those practices.

Thermoelectric Performance of Mechanically Mixed BixSb2-xTe3-ABS Composites.

In the current study, polymer-based composites, consisting of Acrylonitrile Butadiene Styrene (ABS) and Bismuth Antimony Telluride (BixSb2-xTe3), were produced using mechanical mixing and hot pressing. These composites were investigated regarding their electrical resistivity and Seebeck coefficient, with respect to Bi doping and BixSb2-xTe3 loading into the composite. Experimental results showed that their thermoelectric performance is comparable-or even superior, in some cases-to reported thermoelectric polymer composites that have been produced using other complex techniques. Consequently, mechanically mixed polymer-based thermoelectric materials could be an efficient method for low-cost and large-scale production of polymer composites for potential thermoelectric applications.

Surface and passive/active air mould sampling: A testing exercise in a North London housing estate.

Despite indoor mould being one of the most common problems in residential properties in the UK, there are not any widely accepted methodologies for its measurement. This paper focusses on this problem of measurement and reports on the findings from a rigorous testing scheme carried out to quantify air and surface mould concentrations and particle counts within 71 rooms from 64 properties in North London, some with and some without visible mould. The aim was to investigate the potential of passive and active air sampling strategies (sampling from still and actively mixed air, respectively) to explain visible mould, and understand how home/room characteristics correlate with the obtained readings. Airborne mould levels were quantified using an Andersen sampler (passively and actively), as well as by a chemical method based on the quantification of the N-acetylhexosaminidase (NAHA) activity (actively), which was also used to quantify surface mould. The mould levels were then correlated against physical characteristics of the tested homes/rooms, collected by means of survey sheets developed as part of this study. The findings did not reveal any independent variable governing all or most of the response variables, but a complex analysis suggested that whether it is a house or a flat could depict mould levels in the air and on the surfaces. It was also shown that a robust testing protocol should combine air and surface based methods, and an active air sampling strategy leads to a more accurate appraisal of airborne mould levels. Finally, the results showed that while there is some correlation between visible mould (and other moisture induced problems such as condensation) and measured air mould concentrations, lack of visible mould within a room does not necessarily mean low air mould concentrations, and thus one should not rely solely on visual inspection.

Do experts practice what they profess?

We investigated the variation of drilled regions of expert and trainee surgeons performing virtual temporal bone surgery to identify their compliance with standard drilling procedures. To this end, we recruited seven expert and six trainee ENT surgeons, who were asked to perform the surgical preparations for cochlear implantation on a virtual temporal bone. The temporal bone was divided into six regions using a semi-automated approach. The drilled area in each region was compared between groups using a sign test. Similarity within groups was calculated as a ratio of voxels (3D points) drilled by at least 75% of surgeons and at least 25% of surgeons. We observed a significant difference between groups when performing critical tasks such as exposing the facial nerve, opening the facial recess, and finding the round window. In these regions, experts' practice is more similar to each other than that between trainees. Consistent with models of skills development, expertise and expert-performance, the outcome of the analysis shows that experts perform similarly in critical parts of the procedure, and do indeed practice what they profess.

Comparison of Experts and Residents Performing a Complex Procedure in a Temporal Bone Surgery Simulator.

OBJECTIVE: To investigate the use of automated metrics from a virtual reality (VR) temporal bone surgery simulator to determine how the performance of experts and trainees differs when performing a complex otological procedure (mastoidectomy with posterior tympanotomy and cochleostomy). STUDY DESIGN: Cohort study. METHODS: Using the University of Melbourne VR temporal bone surgery simulator, seven ENT consultants and seven ENT residents performed two trials of the surgical approach to cochlear implantation on a virtual temporal bone. Simulator recordings were used to calculate a range of automated metrics for each stage of the procedure, capturing efficiency, technique characteristics, drilled bone regions, and damage to vital anatomical structures. RESULTS: Results confirm that experts drilled more efficiently than residents. Experts generally used larger burrs and applied higher forces, resulting in faster material removal. However, they exercised more caution when drilling close to anatomical structures. Residents opened the temporal bone more widely, but neglected important steps in obtaining a clear view toward the round window, such as thinning the external ear canal wall and skeletonizing the medial aspect of the facial nerve. Residents used higher magnification and reoriented the temporal bone more often than experts. CONCLUSION: VR simulation provides metrics that allow the objective analysis of surgical technique, and identification of differences between the performance of surgical residents and their senior colleagues. The performance of residents could be improved with more guidance regarding how much force they should apply, what burr size they should use, how they should orient the bone, and for cochlear implant surgery guidance regarding anatomical regions requiring particular attention, to visualize the round window.

Developing effective automated feedback in temporal bone surgery simulation.

OBJECTIVE: We aim to test the effectiveness, accuracy, and usefulness of an automated feedback system in facilitating skill acquisition in virtual reality surgery. STUDY DESIGN: We evaluate the performance of the feedback system through a randomized controlled trial of 24 students allocated to feedback and nonfeedback groups. SETTING: The feedback system was based on the Melbourne University temporal bone surgery simulator. The study was conducted at the simulation laboratory of the Royal Victorian Eye and Ear Hospital, Melbourne. SUBJECTS AND METHODS: The study participants were medical students from the University of Melbourne, who were asked to perform virtual cortical mastoidectomy on the simulator. The extent to which the drilling behavior of the feedback and nonfeedback groups differed was used to evaluate the effectiveness of the system. Its accuracy was determined through a postexperiment observational assessment of recordings made during the experiment by an expert surgeon. Its usability was evaluated using students' self-reports of their impressions of the system. RESULTS: A Friedman's test showed that there was a significant improvement in the drilling performance of the feedback group, χ(2)(1) = 14.450, P < .001. The postexperiment assessment demonstrated that the system provided timely feedback (when trainee behavior was detected) 88.6% of the time and appropriate feedback (accurate advice) 84.2% of the time. Participants' opinions about the usefulness of the system were highly positive. CONCLUSION: The automated feedback system was observed to be effective in improving surgical technique, and the provided feedback was found to be accurate and useful.

Comparison of oral surgery task performance in a virtual reality surgical simulator and an animal model using objective measures.

The use of virtual reality (VR) simulation for surgical training has gathered much interest in recent years. Despite increasing popularity and usage, limited work has been carried out in the use of automated objective measures to quantify the extent to which performance in a simulator resembles performance in the operating theatre, and the effects of simulator training on real world performance. To this end, we present a study exploring the effects of VR training on the performance of dentistry students learning a novel oral surgery task. We compare the performance of trainees in a VR simulator and in a physical setting involving ovine jaws, using a range of automated metrics derived by motion analysis. Our results suggest that simulator training improved the motion economy of trainees without adverse effects on task outcome. Comparison of surgical technique on the simulator with the ovine setting indicates that simulator technique is similar, but not identical to real world technique.

The construct validity and reliability of an assessment tool for competency in cochlear implant surgery.

INTRODUCTION: We introduce a rating tool that objectively evaluates the skills of surgical trainees performing cochlear implant surgery. METHODS: Seven residents and seven experts performed cochlear implant surgery sessions from mastoidectomy to cochleostomy on a standardized virtual reality temporal bone. A total of twenty-eight assessment videos were recorded and two consultant otolaryngologists evaluated the performance of each participant using these videos. RESULTS: Interrater reliability was calculated using the intraclass correlation coefficient for both the global and checklist components of the assessment instrument. The overall agreement was high. The construct validity of this instrument was strongly supported by the significantly higher scores in the expert group for both components. CONCLUSION: Our results indicate that the proposed assessment tool for cochlear implant surgery is reliable, accurate, and easy to use. This instrument can thus be used to provide objective feedback on overall and task-specific competency in cochlear implantation.

A temporal bone surgery simulator with real-time feedback for surgical training.

Timely feedback on surgical technique is an important aspect of surgical skill training in any learning environment, be it virtual or otherwise. Feedback on technique should be provided in real-time to allow trainees to recognize and amend their errors as they occur. Expert surgeons have typically carried out this task, but they have limited time available to spend with trainees. Virtual reality surgical simulators offer effective, repeatable training at relatively low cost, but their benefits may not be fully realized while they still require the presence of experts to provide feedback. We attempt to overcome this limitation by introducing a real-time feedback system for surgical technique within a temporal bone surgical simulator. Our evaluation study shows that this feedback system performs exceptionally well with respect to accuracy and effectiveness.

The effect of fidelity: how expert behavior changes in a virtual reality environment.

OBJECTIVES/HYPOTHESIS: We compare the behavior of expert surgeons operating on the "gold standard" of simulation-the cadaveric temporal bone-against a high-fidelity virtual reality (VR) simulation. We aim to determine whether expert behavior changes within the virtual environment and to understand how the fidelity of simulation affects users' behavior. STUDY DESIGN AND METHODS: Five expert otologists performed cortical mastoidectomy and cochleostomy on a human cadaveric temporal bone and a VR temporal bone simulator. Hand movement and video recordings were used to derive a range of measures, to facilitate an analysis of surgical technique, and to compare expert behavior between the cadaveric and simulator environments. RESULTS: Drilling time was similar across the two environments. Some measures such as total time and burr change count differed predictably due to the ease of switching burrs within the simulator. Surgical strokes were generally longer in distance and duration in VR, but these measures changed proportionally to cadaveric measures across the stages of the procedure. Stroke shape metrics differed, which was attributed to the modeling of burr behavior within the simulator. This will be corrected in future versions. CONCLUSION: Slight differences in drill interaction between a virtual environment and the real world can have measurable effects on surgical technique, particularly in terms of stroke length, duration, and curvature. It is important to understand these effects when designing and implementing surgical training programs based on VR simulation--and when improving the fidelity of VR simulators to facilitate use of a similar technique in both real and simulated situations.

Constructive real time feedback for a temporal bone simulator.

As demands on surgical training efficiency increase, there is a stronger need for computer assisted surgical training systems. The ability to provide automated performance feedback and assessment is a critical aspect of such systems. The development of feedback and assessment models will allow the use of surgical simulators as self-guided training systems that act like expert trainers and guide trainees towards improved performance. This paper presents an approach based on Random Forest models to analyse data recorded during surgery using a virtual reality temporal bone simulator and generate meaningful automated real-time performance feedback. The training dataset consisted of 27 temporal bone simulation runs composed of 16 expert runs provided by 7 different experts and 11 trainee runs provided by 6 trainees. We demonstrate how Random Forest models can be used to predict surgical expertise and deliver feedback that improves trainees' surgical technique. We illustrate the potential of the approach through a feasibility study.

Towards defining dental drilling competence, part 1: a study of bone drilling technique.

Technical skills are critical for dentists. Computer-based simulation offers a range of potential benefits for surgical training, but to date the development of simulators has not been characterized by a structured investigation of specific mechanisms by which trainees attain competence. This two-part study contributes to the understanding of the manner in which surgical psychomotor skills are acquired so that this knowledge can be incorporated into the design of training simulations. We studied participant groups of varying skill levels as they performed a drilling task in oral surgery. In this first part of our study, we investigated the elements of surgical technique and differences in the drilling performance of novice, competent, and expert dentists. Our results indicate that novice dentists employ a technique that differs considerably in drilling stroke length and duration from that employed by experts. Expert dentists perform faster, apply more force, lift the bur off the bone less, and produce superior results compared with novices.

Towards defining dental drilling competence, part 2: a study of cues and factors in bone drilling.

The study of expertise in surgery aims to facilitate the development of improved training methods by understanding the characteristics of expert practitioners. In this article and its companion, we present our study of the characteristics of competence and expertise in the field of oral surgery. We observed participants of different skill levels as they performed an ex vivo drilling task designed to test the psychomotor skill of distinguishing the material boundaries between tooth and bone. Part 1 of this study examined the physical characteristics of drilling performance, while this article examines the cognitive aspects of performance. In this article we investigate the psychomotor cues used for decision making during drilling and explore other factors that affect a participant's ability to distinguish tooth from bone. Our results suggest that visual and tactile cues were the most important cues guiding drilling performance in all participant groups. Our results also suggest that when compared to experts, novices relied more on visual cues rather than tactile cues and lacked the psychomotor skills required to utilize the broader range of cues used by experts.