Abstract Context With the surge of the novel coronavirus (SARS-CoV-2 [COVID-19]), the modality of teaching anatomy has shifted from in-person cadaveric dissection to virtual lessons for incoming first-year medical students. As a result, we aim to assess the impact that this curriculum change has on student perspectives. Objectives This study aims to understand the relative effect of a virtual anatomy course implemented during the pandemic (2019–2020) on the confidence, skills, and perspectives of first-year medical students compared to medical students who had traditional in-person anatomy at Rowan University School of Osteopathic Medicine (Rowan SOM) in Stratford, New Jersey. Methods The authors developed a 14-question survey to target gross anatomy students of the Classes of 2023 and 2024 at Rowan SOM. The Class of 2024 had a virtual anatomy lab compared to the Class of 2023, who had an in-person anatomy lab in their first year of medical school. The responses were analyzed to understand the difference between a hands-on cadaver lab and a virtual anatomy lab utilizing SPSS. Results The survey was administered to approximately 400 people, from which we received 149 responses (37.3%). Among all responses, 36.2% (n=54) belonged to the Class of 2023 who encountered hands-on cadaver experience, whereas 63.8% (n=95) belonged to the Class of 2024 who gained virtual anatomy lab experience. An independent t-test statistical analysis was utilized. Under the confidence domain, when students were asked about the understanding of trauma after their respective anatomy labs, 64.0% of the Class of 2023 (n=50) showed significantly higher confidence with p<0.001, compared to 15.4% for the Class of 2024 (n=78). Under the skills domain, the Class of 2023 (n=50) felt more comfortable with ultrasound (64.0%), identifying all of the pertinent anatomical structures and their respective locations on imaging (72.0%), and identifying the pathology (90.0%) with respective p values of <0.001, <0.001, and 0.004. Only 36.9% of Class of 2024 respondents shared similar comfort with ultrasound (n=84), 30.9% identifying pertinent anatomical structures (n=84) and 65.4% in identifying pathology (n=84). Under the attitude domain, the Class of 2023 (n=50) had more respect toward the human body with their hands-on cadaver experience (88.0%) than the Class of 2024 (n=89, 33.3%). Conclusions Based on current results, it can be established that medical students who had in-person cadaveric dissection had a favorable attitude toward their anatomy course compared to students who had virtual anatomy during the COVID-19 pandemic.

Abstract Context Masks have long been utilized to prevent the spread of airborne pathogens and diseases in the healthcare setting. Recently, due to the COVID-19 pandemic, mask use has been expanded to all public areas to help slow the spread of this virus. One such location where masks can be seen is gyms. While exercising, the needs of the body are altered due to the increased stress being placed upon it. Normal physiology is thus adjusted to meet these new demands and to maintain optimal functioning. Therefore, it is possible that adding a mask covering the mouth and nose while exercising could further exacerbate this physiologic alteration, causing potential concerns. Objectives The goal of this study is to identify the impact of mask use on normal perceived physiology (breathing, heart rate, temperature, exertion, stamina, and quality of workout) within the exercising population. Methods To obtain data focused on the research question, a self-reporting, online, anonymous Qualtrics survey was administered in local gyms and social media outlets. A total of 280 total participants were recruited between the ages of 18 and 65 who have ever exercised while wearing a mask. All results were analyzed utilizing descriptive statistics, bivariate correlations, Mann–Whitney U tests, and Kruskal–Wallis tests. A Cronbach’s alpha was also calculated to check internal validity. The significance level utilized was p≤0.05. Results Completion of a Kruskal–Wallis test revealed statistical significance regarding the perception of masks in general and the participants’ rating of the perceived physiological parameters (breathing: p<0.001; heart rate: p<0.001; temperature: p<0.001; exertion: p<0.001; stamina: p<0.001; and quality of workout: p<0.001), the duration of time the mask was utilized during the workout, and the participants’ rating of the perceived physiological parameters (breathing: p=0.001; heart rate: p=0.020; temperature: p<0.001; exertion: p<0.001; stamina: p=0.001; quality of workout: p<0.001; and perception of mask: p<0.001), and the change in the number of days that the participants exercised per week during the pandemic as well as some of the participants’ ratings of the perceived physiological parameters (breathing: p=0.042; exertion: p=0.015; stamina: p=0.027; and quality of workout: p=0.016). Conclusions Any alterations to normal physiology perception while exercising with a mask appear to be psychological and adaptive in nature. Masks alone did not contribute to the perception of their physiologic changes.

This research focuses on the gravitational creation of a water vortex stream, which is a novel technique in hydropower engineering. The water enters a wide straight inlet and then through a vertical conical tube, creating a vortex that exits at the shallow basin's centre floor. The blades of the turbine can spin in the vortex, which generates electricity from a generator. The gravitational vortex turbine is the name for this kind of turbine. The turbine is driven by the vortex's dynamic force rather than the pressure differential. Since no discretization of the flow domain is needed, this study relies on simulation to provide the specifics of water vortex creation. The computational fluid dynamics (CFD) models' boundary conditions are added depending on the experiment configuration. Two different hole sizes for water discharge were tested in two different environments. The first condition's effect shows that the vortex heights in the experiment and CFD agree. The final vortex height of the CFD model differs from the experiment outcome in the second condition. More turbulent flow has set in as the discharge hole becomes larger, creating more errors in the CFD model's prediction of water vortex formation.

Background Ample evidence indicates that everyday perceptions of the social environment can affect health behaviors; these include social comparisons (i.e., self-evaluations compared to others) and positive versus negative social interactions. However, relations between social perceptions and healthy behaviors have received little attention among specific medical populations for whom an improved understanding of behavioral determinants could inform updates to tailored interventions. Research methods that capture and differentiate between stable, person-level differences and dynamic, within-person variability in these relations would be particularly useful, both for identifying their nature in daily life and informing improvements to tailored interventions. Methods We conducted a series of three formative research studies to adapt and test the measures and instructions for an ecological momentary assessment (EMA) protocol with midlife women who had elevated risk for cardiovascular disease (CVD; e.g., current diagnosis of hypertension, type 2 diabetes). Study 1 involved a pilot test of initial EMA items, sent to participants' smartphones 5 times per day for 7 days (N=13; MAge =47, MBMI =33.7 kg/m2), as well as brief exit interviews to identify points of confusion and suggestions for improvement. Study 2 used 1-hour, individual qualitative interviews with a new sample to elicit women's perceptions of revised items and identify additional opportunities for refinement (N=10, MAge =52, MBMI =29.8 kg/m2). In Study 3, a new sample of participants completed 7 days of EMA with revised items and instructions (5 times per day; N=13, MAge =50, MBMI =33.4 kg/m2). Results Item performance in Study 3, including the frequencies of reporting social comparisons and interactions, was compared to that in Study 1 using multilevel modeling; these tests showed meaningful improvement in reporting patterns between Studies 1 and 3 (e.g., changes of d=0.33-0.75 where appropriate). Conclusions Together, findings from this series of studies demonstrate the utility of a multi-study approach to refining EMA methods for use with midlife women who have elevated CVD risk, which may generalize to other populations of interest.

Electrical Energy has become one of the basic needs of an individual in this era.The requirement for energy is constantly rising day by day.The majority of electricity is presently generated by traditional thermal or hydro power plants.Renewable sources are very fashionable and popular for green energy and very widespread used nowadays.The electricity provided by photovoltaic (PV) systems is a very typical example of a clean renewable energy supply.When it comes to using PV as a renewable energy source, components like as an inverter are frequently utilized in this circumstance, and many ways have been presented to date to extract the most produced power from a PV system.This article recommends a 50 kW 3-phase grid-associated system with different topologies such as, single stage and dual stage P&O based MPPT techniques.A DC-AC converter, based on PWM for processing the energy generated by a solar array that is composed of SunPower SPR-230E-WHT-D PV modules with high power factor at any solar radiation.To improve the power quality, A control approach is presented in this article using Park's transformation (dq0 transformation) operators with for any scenario of solar radiation, a current control function in three phase grid-connected solar power generation with unity power factor is used.Harmonic components and reactive power provided by loads attached to the device can be compensated by the system and along with this a PSO based topology for MPPT to compare PSO with P&O technique and obtain best results. .

Aim To compare the impact of four surgical procedures (mini-gastric bypass, sleeve gastrectomy, ileal transposition and transit bipartition) vs medical management on gut peptide secretion, beta-cell function and resolution of hyperglycaemia in people with type 2 diabetes. Research design and methods A mixed-meal tolerance test was administered 6-24 months after each surgical procedure (mini-gastric bypass, sleeve gastrectomy, ileal transposition and transit bipartition; n=30 in each group) and the results were compared with those obtained in matched lean (n=30) and obese (n=30) people with type 2 diabetes undergoing medical management. Results Participants in the mini-gastric bypass and ileal transposition groups had a greater increase in plasma glucose concentration after the mixed-meal tolerance test than those in the sleeve gastrectomy and transit bipartition groups. Participants in the mini-gastric bypass group exhibited the greatest increase in the incremental area under the curve of plasma glucose concentration above baseline (P<0.0001). Insulin sensitivity was similar across surgical groups, and statistically greater in participants in the surgical groups than in obese participants in the non-surgical group (P<0.0001). beta-cell responsiveness to glucose was greater in participants in the sleeve gastrectomy and transit bipartition groups than in the mini-gastric bypass and ileal transposition groups (P<0.001) despite a smaller incremental increase above baseline in the area under the plasma glucagon-like peptide-1 concentration curve relative to ileal transposition. Postoperative beta-cell function was the strongest predictor of hyperglycaemia resolution. Conclusions The present study showed that the level of beta-cell function after bariatric surgery is the strongest predictor of hyperglycaemia resolution. The study also demonstrates a disconnect between postprandial GLP-1 levels and beta-cell function among the studied surgical procedures.

Background Midlife women are at an elevated risk for cardiovascular disease (CVD) and associated mortality. Those who have additional risk conditions such as obesity or hypertension report specific barriers to engaging in cardioprotective behaviors such as physical activity (PA). Considerable effort has been devoted to understanding PA determinants and designing interventions for midlife women, although with suboptimal success, as increasing PA could meaningfully attenuate CVD risk. An updated approach to understanding PA among midlife women could improve upon existing resources by focusing on novel psychosocial influences on PA in this population (ie, body satisfaction, social interactions, social comparisons, mood state) and within-person relations between these influences and PA in the natural environment. Objective The overarching goal of Project WHADE (Women’s Health And Daily Experiences) is to use an ecological momentary assessment (EMA) approach to capture ecologically valid relations between midlife women’s psychosocial experiences and PA as they engage in their normal daily activities. The primary aim of the study is to identify within-person psychosocial predictors of variability in PA (ie, experiences associated with higher vs lower PA for a given individual). Methods Midlife women (aged 40-60 years) with one or more additional risk markers for CVD (eg, hypertension) will be recruited from primary care clinics and the general community (target n=100). Eligible women will complete an initial survey and a face-to-face baseline session before engaging in a 10-day EMA protocol. Psychosocial experiences will be assessed using a brief self-report via a smartphone 5 times per day, and PA will be assessed throughout waking hours using a research-grade monitor. Participants will return for a brief exit interview at the end of 10 days. Multilevel models that address the nested structure of EMA data will be used to evaluate the study aims. Results Recruitment and enrollment are ongoing, and a total of 75 women have completed the protocol to date. Data collection is expected to be completed in Fall 2020. Conclusions Project WHADE is designed to identify naturally occurring psychosocial experiences that predict short-term variability in midlife women’s PA. As such, the results of this study should advance the current understanding of PA among midlife women by providing further insight into within-person psychosocial influences on PA in this group. In the future, this information could help inform the design of interventions for this population. International Registered Report Identifier (IRRID) DERR1-10.2196/19044

The onset of the COVID-19 pandemic created an opportunity to find a way to maintain a family medicine(FM)/behavioral health co-preceptorship model when treating patients and educating resident physicians via telehealth. The ability to identify and treat mental health disorders is a core skill for FM

Wearable flexible sensors have recently gained much attention as they have the potential to revolutionize the way we monitor activities of the human body. Electronic sensors fabricated on flexible substrates provide compactness, comfort, and flexibility. In this letter, we report a novel design of wearable and mechanically flexible bioimpedance analyzers. We fabricate the analyzers by printing electronic circuits on paper and plastic substrates. The sensor module is lightweight, comfortable, and can be worn on the wrist to measure the body impedance continuously. Failure analysis is performed by bending the flexible sensor modules with the circuit breaking angles at 53 degrees +/- 4 degrees and 42 degrees +/- 3 degrees for paper and plastic substrates, respectively. The performance of the flexible sensors is compared with an analyzer developed on a conventional rigid printed circuit board. In an active mode, the paper-based sensor consumes more power (83.3 mW) than the plastic (65.7 mW) and rigid (53.42 mW) sensors. The flexible sensor modules are integrated with dry electrodes, while gel-based Ag/AgCl electrodes are attached to the rigid sensor module for bioimpedance measurements. The experiments are conducted on 12 healthy human subjects by using all three sensor modules. The integrated dry electrodes of the flexible sensor modules provide lower skin-electrode contact impedance along with enhanced convenience, durability, and reusability, as compared to commercial Ag/AgCl electrodes.

This study examined primary care patients’ experiences with support for weight loss efforts. Adult patients (N = 106) were recruited through primary care clinics and completed an electronic survey pertaining to their weight loss efforts. The majority (76%) received support from their existing social network (e.g., family members, professionals); 59% had used apps and <20% had used social media for support. Findings reveal differences in satisfaction with support between men and women and between support sources, which will be useful for informing weight loss interventions in primary care.

Dry electrodes are gaining popularity in the area of electronic health for biosignal measurements due to their reusability and comfort as compared to traditional gel-based wet Ag/AgCl electrodes. This paper presents a performance comparison of dry and wet electrodes for medical devices, in particular, for bioelectrical impedance analysis (BIA). BIA is an emerging technology widely used for body composition analysis by computing the impedance of the human body. The designed system for BIA consists of a wearable silicone ring with four copper electrodes. The experiment is conducted on 40 healthy human subjects using both the ring and the Ag/AgCl electrodes. The linear regression demonstrates a high correlation between both electrodes (r = 0.96 for resistance and r = 0.93 for reactance). The measurement of root mean square noise is determined for both electrodes. The dry electrodes demonstrate a higher noise level (1.96 mV) as compared to the wet electrodes (0.282 mV), mainly due to the absence of conductive gel. Moreover, fast Fourier transform is performed to determine and filter out unwanted signals and to reduce the noise level in the dry electrodes. The results demonstrate that the designed ring electrodes have a comparable performance with commercial Ag/AgCl electrodes and can be used in mobile wearable medical devices.