关键词： complementary alternative medicine   Georgia   policy   regulations  

摘要： International bodies such as the WHO call on member states to regulate and, where possible, integrate Complementary and Alternative Medicine (CAM) into health systems, to the benefit and safety of patients. Research on CAM regulations in the Republic of Georgia has been limited. The aim of this study was to identify key actors and analyse the regulatory environment for CAM in Georgia in its local and international contexts. We conducted a health policy analysis using a triangle framework of content, context and processes. We used data from national government, professional associations and academia;and drew from primary qualitative data of stakeholders' perspectives and needs regarding CAM in Georgia. The several CAM associations we identified have limited capacities for self-regulation. CAM practices are currently not effectively regulated in Georgia, while the government has no expressed intention to develop regulatory frameworks. Georgia's CAM health policy is currently not compliant with WHO and European directives and recommendations. Government, lawmakers, public administration, academia, physicians, non-physician CAM practitioners and other actors should constitute a national working group dedicated to CAM regulations in Georgia to identify, classify CAM practices;and develop core principles for policy making for safe and effective CAM practiced in Georgia's health system.

关键词： Decision field theory   Multi-attribute linear ballistic accumulator   Choice modelling   Accumulator models  

摘要： Interest in behavioural realism has gradually led to the introduction of alternatives to random utility models (RUMs) as a paradigm for representing choice behaviour, with notable interest, for example, in random regret minimisation (RRM). These more general models continue to rely on a framework where a single value function is calculated for each alternative in each choice setting, and the choice probabilities are calculated by comparing these value functions across alternatives. By contrast, research in mathematical psychology has used a more dynamic approach, where the preference value of each alternative updates over time in a given situation while the decision maker is deliberating about the choice to make. These accumulator models are well suited to accommodating a variety of context effects, and have been shown to give good performance for data collected in laboratory based settings. The present paper considers two such accumulator models, namely decision field theory (DFT) and the multi-attribute linear ballistic accumulator (MLBA), and addresses limitations that have prevented their use in travel behaviour research. The methodological additions include the ability to capture the influence of socio-demographics, the presence of underlying preferences for specific alternatives, and/or the representation of attributes that have opposite effects on choice probabilities. We develop what we believe to be the first in-depth simultaneous comparison of DFT and MLBA with typical discrete choice models, and test both DFT and MLBA on a revealed preference dataset. We find that each model outperforms typical RUM and RRM implementations for both in-sample estimation and out-of-sample prediction, including in a large scale simulation experiment. (c) 2021 Elsevier Ltd. All rights reserved.

摘要： This commentary is on the original article by Ruiz Brunner et al. on pages 860–865 of this issue.

关键词： ethylene   polymerization   zirconocenes   single-site catalysts   DFT  

摘要： DFT simulations of ethylene polymerization with the participation of neutral Zr-Al-3 hydride species revealed a fundamental difference in catalytic behaviour of t riisobutylaluminium-activated heterocenes and conventional ansa-zirconocenes.

关键词： Aspiration   hemodynamic   intubation   laparoscopic   mask  

摘要： Background and Aims: Newer supraglottic devices with an additional gastric channel offer greater protection from aspiration and avoidance of laryngoscopy for their insertion would result in attenuated hemodynamic responses. The primary objective was to assess hemodynamic responses to insertion of Baska mask as compared to tracheal intubation. The time and attempts taken to secure airway and evidence of regurgitation and pulmonary aspiration of gastric contents were also assessed. Material and Methods: This prospective, randomized study was conducted in 80 patients undergoing laparoscopic cholecystectomy. All patients received standardized anaesthesia protocol. Baska mask was used to secure airway in Group B, while tracheal intubation was done in group T. Methylene blue was injected through Ryle's tube into stomach in both groups. At end of surgery, fibreoptic bronchoscopy was performed to detect bluish staining of trachea and/or main bronchi as evidence of aspiration of gastric contents and bluish staining in oropharynx as evidence of regurgitation. Chi-square test and Independent sample t-test were applied. Results: The time taken to secure airway was significantly longer in Group B as compared to Group T (45.3 +/- 12.6 vs. 24.3 +/- 9.1 sec) Percentage of patients who had oropharyngeal blue stain was comparable in both groups. No patient in both groups had tracheal blue stain. Group T had significantly higher HR and MAP after intubation till 10 min later. Conclusion: Baska mask insertion was associated with attenuated hemodynamic responses, though more time and attempts were required for securing the airway. It could be considered as an alternative to tracheal intubation during laparoscopic surgeries.

摘要： The ongoing novel Coronavirus disease 2019 (COVID-19) pandemic has created many threats as well as opportunities for the career development of physicians-in-training. Institutional responses to the demand for patient care reduced the time many residents have to pursue clinical electives, scholarship projects, and other experiences meant to clarify and advance their personal and professional goals. Moreover, many academic medical centers experienced profound fiscal losses that require thoughtful revisions to budgets and curricula. In this article, the authors recommend strategies for residency programs to mitigate these losses and capitalize on growth in virtual education, scholarship opportunities, and relationships arising from the pandemic. Drawing from career development guidelines from the National Career Development Association and existing literature about factors associated with positive career outcomes, the authors suggest leadership roles, curricula, and events that training programs can quickly and inexpensively implement to help residents grow as professionals, achieve personal training goals, produce scholarship, and attain future employment. To help trainees manage their careers, the authors recommend structured mentorship and education in career pathways and the preparation of job application materials. To foster attainment of specific knowledge and cultivate lifelong learning, the authors recommend leveraging existing resources to provide time, funding, academic coaching, and skills training for scholarship projects. To promote development of effective work relationships and community, the authors recommend appointment of a faculty champion for career advancement, scholarship showcases, attendance at virtual journal clubs, and networking through social media outlets. These recommendations for supporting career advancement may apply to early career faculty development as well as undergraduate and postgraduate medical education beyond the pandemic era.

关键词： Electrodeposition   Tribology   Hard chromium   MoS2 nanoparticles  

摘要： The hard chromium coatings have drawn vast attention due to their fascinating tribological behavior, however, there is a serious determination to alleviate their industrial applications. In this assay, an attempt is made to evaluate whether the electrodeposited Co?P?MoS2 films with various loadings of MoS2 nanoparticles, 0?20 g/L, fabricated under different current densities from 20 to 35 A dm-2 are suitable alternative tribological coatings to hard chromium. The tribomechanical behavior of layers was assessed using Vickers microhardness and pin-ondisc surveys. Co?P-10 g/L MoS2 film obtained at 25 A dm-2 offers the highest wear resistance. An increase of 18% in microhardness, a decrease of 50% in the coefficient of friction, and a decrease of 95% in wear volume loss are obtained.

关键词： biodiesel   feedstock   interesterification   methyl acetate   triacetin  

摘要： Environmental challenges and decreasing fossil reserves due to increased utilization of fossil fuels have propagated the importance of alternative energy sources. Increased biodiesel production promoted excess waste crude glycerol leading to environmental issues, thereby inhibiting the sustainability of the process. This review paper discusses the different types of feedstocks utilized to produce glycerol-free biodiesel by reacting with methyl acetate via interesterification. Methyl acetate is used as an advantageous alternative to methanol in biodiesel production to overcome the environmental challenge associated with excess waste glycerol. The by-product, triacetin from the interesterification reaction, has shown excellent qualities as a fuel additive, thereby making the process cleaner and more sustainable as a result of not separating the triacetin from biodiesel. The resulting product referred to as biodiesel fuel (BDF) has been found to exhibit useful properties and applications as fatty acid methyl esters (FAME). The promising environmental and sustainability merits of the process far outweigh the slow interesterification kinetics demerits of the process, which can be overcome by suitable processing conditions. The prospects associated with biodiesel production by interesterification are also pointed out.

关键词： Higg MSI   Textile   Apparel   Decision support   Interpretation   Aggregation   Sustainability   LCA  

摘要： Purpose The Higg Materials Sustainability Index (MSI) consists of five life cycle indicators to help the apparel industry inform material selection at the design stage. Until 2020, the Higg MSI applied a single score and after much debate, in 2021, indicators will no longer be aggregated. The problem of tradeoffs remains, and so this study evaluates potential aggregation approaches to help decision makers deal with tradeoffs that solve previous issues and allow for an integrated view. Methods Aggregation can be compensatory such as in the case of the weighted sum in the previous Higg MSI, or partially compensatory, and this relates as to how tradeoffs are managed. This study compares aggregation in the Higg MSI to four other aggregation methods via a comparative application using six textile materials (cotton, wool, PET, nylon 6, lyocell, and viscose) that, while not functionally equivalent on a mass basis, serve as an illustration of the effects of aggregation. This paper compares three compensatory aggregation methods to results from the Higg MSI-internal normalization of division by maximum, global normalization, monetization-and one partially compensatory method-stochastic multi-attribute analysis (SMAA). Methods were chosen to ensure a broad coverage according to their applicability to the Higg MSI. Results and discussion The comparison of raw materials using the impact categories used in the MSI Higg show tradeoffs, particularly for two materials which are the best performing materials in two impact categories and worse performing materials in the other two impact categories (out of four categories). For materials presenting tradeoffs, results show a distinct pattern between compensatory methods and SMAA. Compensatory single score methods place these materials in the lowest ranks, even lower than a material which is not the best performing material in any category. In SMAA, these same two materials rank above the mediocre material. There is a difference in how