bluuebunny/crossref_metadata_2025 huggingface dataset:
Infiltrating immune cells in prostate cancer tissue after androgen deprivation and radiotherapy
Authors: Erlandsson Ann , Lundholm Marie , Watz Johan , Bergh Anders , Petrova Elitsa , Alamdari Farhood , Helleday Thomas , Davidsson Sabina , Andren Ove , Tarish Firas
Published: March 2023

Objectives

Androgen deprivation therapy (ADT) has long been a cornerstone in treatment of advanced prostate cancer (PCa), and is known to improve the results of radiotherapy (RT) for high-risk disease. The purpose of our study was to use a multiplexed immunohistochemical (mIHC) approach to investigate the infiltration of immune cells in PCa tissue after eight weeks of ADT and/or RT with 10 Gy.

Methods

From a cohort of 48 patients divided into two treatment arms, we obtained biopsies before and after treatment and used a mIHC method with multispectral imaging to analyze the infiltration of immune cells in tumor stroma and tumor epithelium, focusing on areas with high infiltration.

Results

Tumor stroma showed a significantly higher infiltration of immune cells compared to tumor epithelium. The most prominent immune cells were CD20+ B-lymphocytes, followed by CD68+ macrophages, CD8+ cytotoxic T-cells, FOXP3+ regulatory T-cells (Tregs), and T-bet+ Th1-cells. Neoadjuvant ADT followed by RT significantly increased the infiltration of all five immune cells. Numbers of Th1-cells and Tregs significantly increased after single treatment with ADT or RT. In addition, ADT alone increased the number of cytotoxic T-cells and RT increased the number of B-cells.

Conclusions

Neoadjuvant ADT in combination with RT results in a higher inflammatory response compared to RT or ADT alone. The mIHC method may be a useful tool for investigating infiltrating immune cells in PCa biopsies to understand how immunotherapeutic approaches can be combined with current PCa therapies.
Instruments Measuring Self-Care and Self-Management of Chronic Conditions by Community-Dwelling Older Adults: A Scoping Review
Authors: Lawless Michael T. , Tieu Matthew , Chan Raymond J. , Hendriks Jeroen M. , Kitson Alison
Published: March 2023

Given the high prevalence of chronic conditions and multimorbidity in older adults, there is a need to better conceptualize and measure self-care and self-management to promote a person-centered approach. This scoping review aimed to identify and map instruments measuring self-care and self-management of chronic conditions by older adults. We searched six electronic databases, charted data from the studies and tools and reported the results in accordance with the PRISMA-ScR guidelines. A total of 107 articles (103 studies) containing 40 tools were included in the review. There was substantial variation in the tools in terms of their aims and scope, structure, theoretical foundations, how they were developed, and the settings in which they have been used. The quantity of tools demonstrates the importance of assessing self-care and self-management. Consideration of the purpose, scope, and theoretical foundation should guide decisions about tools suitable for use in research and clinical practice.
Disentangling Perceived Educational Support Sources and Types in Adolescence and Latinas’ Educational Attainment in Adulthood
Authors: Safavian Nayssan , Lee Glona , Dicke Anna-Lena , Karabenick Stuart A. , Eccles Jacquelynne S.
Published: March 2023

Social support has a well-documented impact on adolescent educational success. Nonetheless, there has been less focus on the relationship between social supports and educational attainment for Latinas. Using a sample of 138 Hispanic females (ages 25–31) from an ongoing longitudinal National Science Foundation (NSF)-funded study (2004–present), we identified key sources of social support (family, teachers, and peers) and types of social support (emotional, informational, and instrumental) in the educational pipeline of Hispanic females. We also examined the associations between social supports and their educational attainment. Through descriptive analyses, we found that family was perceived to provide the most support followed by peers and teachers in adolescence. Through regression analyses, we found that family support positively predicted their educational attainment. Our findings highlight the importance of family-rendered support for educational attainment while also expanding our understanding of the social support mechanisms for Hispanic females.
Ga3+ loaded radiation crosslinked gel-Alg-CMC hydrogels for promoting diabetic wound healing
Authors: Chen Gong , Ren Kang , Wang Hongjian , Wu Lihao , Wang Dai , Xu Ling
Published: March 2023

The metal gallium holds great promise in the fight against infection by disrupting bacterial iron metabolism through a “Trojan horse” technique. It is well worth trying to investigate the potential for gallium-mediated hydrogels for the treatment of infected wounds. In this paper, Ga3+ is innovatively given an important role in hydrogels based on the conventional multi-component hydrogel with metal ion binding gelation strategy. Thus, Ga@Gel-Alg-CMCs hydrogel with broad-spectrum antimicrobial activity is reported on the treatment of infected wounds. The morphology, degradability, and swelling behavior together indicated the excellent physical properties of this hydrogel. Interestingly, in vivo results also showed favorable biocompatibility, slowing down wound infection and promoting diabetic wound healing, making the gallium-doped hydrogel an ideal antimicrobial dressing.
Non-Coking coal as an additive to enhance properties of groundnut shell reinforced polypropylene composites
Authors: MS Santosh , K Chethan , C Vasudev , Guna Vijaykumar , KR Balaji , P Gopinathan , Kumar Manish , Reddy Narendra
Published: March 2023

Groundnut shells (GNS) are renewable and sustainable sources that can reinforce polypropylene for composites intended for interior building and other applications. However, the hydrophilicity, low thermal and noise insulation of GNS reinforced polypropylene (PP) necessitate the use of additives to improve properties. In this work, non-coking bituminous coal was used as an additive to improve the properties of GNS-PP composites. Up to 30% of coal particles were included and the changes in tensile, flexural properties and noise and thermal insulation were studied. Morphological analysis showed limited interaction of coal with GNS or PP and consequently, there was only marginal improvement in the mechanical properties. However, moisture sorption of the composites decreased by 25% and the limited oxygen index increased to 27 from 24 without any coal. The presence of coal increases sound absorption and the noise absorption coefficient showed high absorption at specific frequencies. Coal is an abundantly available natural material which is suitable to improve the performance of composites.
Making Markets Material: Enactments, Resistances, and Erasures of Materiality in the Graduate Labour Market
Authors: Loza Olga , Roscoe Philip
Published: March 2023

Scholarship on the graduate labour market, preoccupied by structure, agency, and power, has largely focused on the market’s discursive composition. It has not yet paid significant attention to the concrete, material apparatus of the market and how this shapes market outcomes. In contrast, we approach the construction of the graduate labour market from a new materialist perspective and with reference to the growing literature of ‘market studies’. We consider the empirical case of a graduate recruitment hackathon to show how the hackathon’s material features were implicated in enacting a specific occurrence of the graduate labour market. The agendas of the hackathon’s designers and their visions of the graduate labour market were enacted in the hackathon’s material arrangements, but this enactment was not always reliable: in some instances materiality resisted and erased corporate agendas. Our article contributes to the sociology of work by highlighting the dynamic relationship between materiality and power (re)production in the graduate labour market.
Statistical Learning Within Objects
Authors: van Moorselaar Dirk , Theeuwes Jan
Published: March 2023

Research has recently shown that efficient selection relies on the implicit extraction of environmental regularities, known as statistical learning. Although this has been demonstrated for scenes, similar learning arguably also occurs for objects. To test this, we developed a paradigm that allowed us to track attentional priority at specific object locations irrespective of the object’s orientation in three experiments with young adults (all Ns = 80). Experiments 1a and 1b established within-object statistical learning by demonstrating increased attentional priority at relevant object parts (e.g., hammerhead). Experiment 2 extended this finding by demonstrating that learned priority generalized to viewpoints in which learning never took place. Together, these findings demonstrate that as a function of statistical learning, the visual system not only is able to tune attention relative to specific locations in space but also can develop preferential biases for specific parts of an object independently of the viewpoint of that object.
Nonlinear dynamic response of bimorph piezoelectric energy harvester with functionally graded porous core
Authors: Akbar Narges , Soltani Madjid
Published: March 2023

This study deals with piezoelectric energy harvesters carrying the magnet at the free end while a magnifier connected them to the base. The harvester consists of a cantilever beam with Functionally Graded (FG) porous foam core and two piezoelectric faces while taking into account the von-Karman strains and the magnetic interaction of two magnets. The governing equation has been developed using Hamilton’s principle and reduced-order via the Galerkin method. Frequency response of vibrations and voltage derived using harmonic balance method and the adjusted model has been confirmed by parametric studies of the lumped parameter model. A parametric study is also performed to expose the effects of porosity coefficient and pattern, magnifier ratios, and excitation level on the responses. Results show that by correct selection of the magnifier parameters, the proposed harvester can provide a higher output over a wider frequency band. Also, the core porosity increases the flexibility of the beam and raised the voltage by a factor of 1.8.
Book review: Anil K. Khandelwal, Transformational Leadership in Banking: Challenges of Governance, Leadership and HR in a Digital and Disruptive World
Authors: Bhatnagar Jyotsna
Published: March 2023

Anil K. Khandelwal, Transformational Leadership in Banking: Challenges of Governance, Leadership and HR in a Digital and Disruptive World, 2021,. New Delhi: Sage Publications, 514 pp., $45.00. ISBN: 9789353887568 (Hardback).
Patterns of Palliative Treatments in Stage IV Esophageal Cancer
Authors: Cichon Gregory J. , Betts Lucas J. , McKillip Kathleen M. , Silberstein Peter T.
Published: March 2023

Background: The 5 year survival rate of esophageal cancer is under 20%. Studies have shown that early palliative treatments can improve patient quality of life and lower depressed mood without expediting mortality. Despite these benefits, few studies have analyzed factors associated with the national variation among patients who received palliative treatment for esophageal cancer. Methods: This is a retrospective study of adults diagnosed with stage IV esophageal cancer between 2004 and 2018 in the National Cancer Database (NCDB) who received palliative treatment or not (n = 43,599). Cross tabulation and binary logistic regression were performed and evaluated using SPSS. Exclusion criteria included concurrent tumors, patients under age 18, and missing data. Results: Of the 43,599 patients, 26.1% of patients received palliative interventions (n = 11,371). The majority of palliative treatment patients lived less than 6 months after diagnosis (54%) and received radiation (35.7%) or chemotherapy (34.5%) with palliative intent. The patients who received palliative treatment tended to be non-Hispanic (96.6%), white (87.2%), male (83.3%) patients between age 61 and 75 (43.8%) at a comprehensive community cancer program (38.7%) with adenocarcinoma histology (71.8%). Palliative treatment patients most commonly relied on Medicare as their primary payor (45.9%) and had a median household income over $48,000 (54.5%). Conclusion: We identified trends among stage IV esophageal cancer patients receiving palliative treatments. Patients receiving palliative treatments tended to be white, non-Hispanic men. Compared to patients who did not receive palliating treatments, this cohort was more likely to receive treatment at a comprehensive, academic, or integrated network facility.
The Mortality of Family Business Leaders: Using a Palliative Care Model to Re-imagine Letting Go
Authors: Forster-Holt Nancy , DeSanto-Madeya Susan , Davis James
Published: March 2023

The succession literature frames a leader's reluctance to let go as the single largest deterrent to succession planning, and early literature pointed to the stronghold that mortality can have on letting go. The notion has not captured our continued curiosity, preventing a full understanding of the tensions and antecedents of family business succession. Most scholarship on letting go describes a quest for immortality and in this sense, ‘mortality’ has been misapplied and one dimensional. In an interdisciplinary boost to family business, we turn to palliative care, where it is believed that the acknowledgment of one's mortality will facilitate letting go. We develop four typologies of letting go by combining elements of mortality awareness and planning that offers nuance and insights into long-held beliefs about this most vital and finite ‘soft issue’. We discuss emotion governance tools that help change the mortality awareness trajectory and support family business succession.
A Rolling Bearing Fault Diagnosis Method via 2D Feature Map of CSCoh After Denoising and MSCNN Under Different Conditions
Authors: Chen Xihui , Lou Wei , Zhao Weiheng , Yang Guanxiong , Ding Kun , Zhang Jingwei
Published: March 2023

The vibration signal of rolling bearing is interfered by the coupling of other various components and environment, which brings challenges to effective feature expression and the establishment of accurate predictor. A fault diagnosis method via 2D feature map of cyclic spectral coherence (CSCoh) after denoising and multi-scale convolutional neural network (MSCNN) under different conditions is proposed. The original vibration signal is processed by DTCWPT and threshold denoising, and a 2D feature map extraction model based on CSCoh is established to reflect hidden periodic characteristics. The feature differences can be highlighted and the coupling interference can be further eliminated. The multi-scale convolution kernels are proposed to build a parallel structure, and a fusion structure is followed. Benefit by the structures in MSCNN, the local and global features of 2D feature map can be preserved comprehensively, the learning ability and diagnostic performance can be improved. Finally, the verification experiments of rolling bearings in different positions under different operating conditions are carried out, and the experimental results show the proposed method has better generalization ability and comprehensive accuracy of more than 95% under different conditions.
Family Functioning Style as a Predictor of the Quality of Cognitive Functioning of Primary School Students With ADHD
Authors: Walenista Wiktoria , Izydorczyk Bernadetta , Lipowska Małgorzata , Markevych Iana , Baumbach Clemens , Mysak Yarema , Szwed Marcin , Sitnik-Warchulska Katarzyna
Published: March 2023

Objective:

This study aimed to specify whether family communication and satisfaction are predictors of a child’s executive functions and whether attention deficit hyperactivity disorder (ADHD) severity lies in the pathway between these variables.

Method:

Two hundred Polish children with ADHD, aged 10 to 13, were tested using Conners 3, the PU1 Battery of Cognitive Tests and Stanford-Binet Intelligence Scale, Fifth Edition (SB5). Parents filled out the FACES IV-SOR questionnaire. Structural equation modeling (SEM) was used to test the hypotheses.

Results:

The quality of family communication and satisfaction did not predict executive functioning in children with ADHD, and ADHD severity did not play a mediating role neither in boys or in girls. Intelligent quotient was the only predictor of executive functioning in the group of boys.

Conclusion:

These results contrast with those of previous studies that have shown the existence of similar associations in other cultural contexts.
Oxidative and Inflammatory Parameters in Children and Adolescents With ADHD
Authors: Koç Sümeyye , Güler Eray Metin , Derin Songül , Gültekin Fatih , Aktaş Selman
Published: March 2023

Objective:

This study aims that oxidative stress and inflammation status in children and adolescents with attention deficit hyperactivity disorder (ADHD) compared to their healthy peers.

Method:

Thirty ADHD and healthy controls were included in this study. ADHD diagnosis according to the DSM-V and Conners’ teacher and parent rating scale by a structured psychiatric interview. Total oxidant status (TOS), total antioxidant status (TAS), and total and native thiol levels were determined using photometric methods. Presepsin, Interleukin (IL) 1-ß, IL-6, and Tumor Necrosis Factor-alpha (TNF-α) levels were measured with commercial ELISA kits.

Results:

We showed that TOS and oxidative stress index were significantly higher in the ADHD group, and TAS was lower than in the control group ( p<.001). Similarly, IL1-ß, IL-6, and TNF-α levels were statistically higher in the ADHD group. Backward LR regression analysis reveals that TOS and IL-6 predicted ADHD.

Conclusion:

TOS and IL-6 levels may play a role in the pathogenesis of ADHD.
Aquatic Exercise Impact on Pain Intensity, Disability and Quality of Life in Adults with Low Back Pain: A Systematic Review and Meta-analysis
Authors: Heidari Fatemeh , Mohammad Rahimi Nasser , Aminzadeh Reza
Published: March 2023

Background

Low back pain is a common, multifaceted disorder that directly affects diverse aspects of people’s lives in terms of health, personal and social lives. A variety of pathological disorders, including low back pain, may benefit from hydrotherapy.

Objective

This study aimed to systematically analyze the efficacy of aquatic exercise on pain intensity, disability, and quality of life among adults with low back pain.

Data sources

A systematic search was conducted in PubMed, Web of Science, Medline, and Scopus up to February 2023 for randomized controlled trials (RCTs) that which examined the impact of aquatic exercise. The most relevant articles were selected based on research criteria. The PEDro scale was applied to assess the quality of the included studies. Review Manager 5.3 was used for conducting all analyses.

Study selection

Out of 856 articles, 14 RCTs ( n = 484 participants; 257 in the experimental groups and 227 in the control groups) met our inclusion criteria.

Results

Pooled results illustrated that aquatic exercises significantly reduced pain (mean differences (MD): −3.82; p < 0.00,001), improved disability (standardized mean differences (SMD): 1.65; p < 0.00,001), and improved quality of life in both the physical component score (mean difference (MD), 10.13; p < 0.00,001) and the mental component score (MD, 6.45; p < 0.0001) when compared with a control group.

Conclusion

The current review showed that aquatic exercise regimens were effective among adults with low back pain. High-quality clinical investigations are still needed to support the use of therapeutic aquatic exercise in a clinical setting.
The photoreal new-age innovative pedagogical & counseling tool for glaucoma with 3D augmented reality (Eye MG AR)
Authors: Ramesh Prasanna Venkatesh , Ray Prajnya , Joshua Tensingh , Devadas Aji Kunnath , Raj Prakash Michael , Ramesh Shruthy Vaishali , Ramesh Meena Kumari , Rajasekaran Ramesh
Published: March 2023

In this manuscript, we have reported an augmented reality (AR) application named, ‘Eye MG AR’ innovated by us, to show different anatomical/pathological parts of the eyeball pertaining to glaucoma, from multiple customized angles of the user's choice to simplify glaucoma learning and clinical counseling. It is available free of cost from the Google Play Store for Android users. Procedures ranging from a simple outpatient department procedure (yttrium aluminium garnet peripheral iridotomy) to a complex surgical technique (trabeculectomy/tube surgery) can be explained and counseled with this Android application. Also, complex structures such as the angle of the anterior chamber and optic nerve head, are constructed in advanced real-time three-dimensional (3D) high-resolution confocal images. These 3D models are useful for glaucoma neophytes’ immersive learning and 3D patient counseling experiences. This AR tool aims to reinvent the approach to glaucoma counseling with ‘Unreal Engine’ software and is created in a patient-friendly approach. Incepting 3D pedagogy and counseling with AR in glaucoma with real-time and high-resolution TrueColor confocal images has never been reported in the literature according to our knowledge.
Young Adults’ Electronic Cigarette Use and Perceptions of Risk
Authors: Kelsh Shelby , Ottney Anne , Young Mark , Kelly Michelle , Larson Rodney , Sohn Minji
Published: March 2023

In the United States, 18.6% of college students between 19-and 22-years old report e-cigarette use in the last 30 days. Information regarding e-cigarette use and perceptions in this age group may assist in understanding how to decrease initiation of e-cigarettes in a population that may otherwise not use nicotine. The purpose of this survey was to determine current e-cigarette use and how e-cigarette use history relates to a college student’s perceptions of health risks associated with e-cigarettes. A 33-item questionnaire was sent to students at a Midwestern university in Fall 2018. Overall, 3754 students completed the questionnaire. More than half of the respondents (55.2%) had used e-cigarettes and 23.2% identified as current users of e-cigarettes. Current e-cigarette users were more likely to agree that e-cigarettes are a safe and effective option to quit smoking, while never users were more likely to disagree (safe P < .001, effective P < .001). Current users were less likely to agree that e-cigarettes may harm a person’s overall health than never users ( P < .001). Young adults continue to be frequent users of e-cigarettes. There are significant differences in perceptions of e-cigarettes associated with use history. Additional research is needed to see how perceptions and use of e-cigarettes have changed considering lung injury reports and increased regulations in the U.S.
Sleep Disturbances in Children With Atopic Dermatitis: A Scoping Review
Authors: Lee Dong Goo , Gui Xi Yao , Mukovozov Ilya , Fleming Patrick , Lynde Charles
Published: March 2023

Atopic dermatitis (AD) is associated with various quality of life concerns including poor sleep. Sleep impairments in children with AD are associated with increased risk of short stature, metabolic syndrome, mental illness and neurocognitive dysfunction. Although the association between AD and sleep disturbance is well established, the specific types of sleep disturbance in pediatric AD patients and their underlying mechanisms are not fully understood. A scoping literature review was performed to characterize and summarize the types of sleep disturbance in children (less than 18 years of age) with AD. 31 papers met inclusion criteria and extracted data were analyzed in an iterative manner. Two types of sleep disturbances were found to be more prevalent in pediatric AD patients in comparison to controls. One category was related to loss of sleep (increased frequency or duration of awakenings, increased sleep fragmentation, delayed sleep onset, decreased total sleep duration, and decreased sleep efficiency). Another category was associated with unusual behaviors during sleep (restlessness/limb movement/scratching, sleep-disordered breathing including obstructive sleep apnea and snoring, nightmares, nocturnal enuresis and nocturnal hyperhidrosis). Some mechanisms underlying these sleep disturbances include pruritus and induced scratching and increased proinflammatory markers induced by sleep loss. Sleep disturbance appears to be associated with AD. We recommend clinicians to consider interventions that may reduce sleep disturbances in children with AD. Further investigation of these sleep disturbances is needed to elucidate pathophysiology, develop additional treatments, and reduce negative impacts on the health outcomes and quality of life in pediatric AD patients.
Government partisans: A practical typology
Authors: Camerlo Marcelo , Castaldo Antonino
Published: March 2023

The party affiliation of cabinet ministers is a critical but neglected notion. While its application and theoretical centrality is indisputable in many research fields, explicit definitions are difficult to find, while operationalizations tend to rely on rudimentary categorizations. Departing from formulating a definition consistent with the party government model, we propose a flexible typology to categorize and rank variants of partisans both within and beyond consolidated parliamentary democracies. We show that the new approach can capture important unobserved dynamics well.
Editorial Introduction: Special Section on older-age migrants and sexualities
Authors: Lulle Aija , Schweppe Cornelia
Published: March 2023

Research on migration in older age has been flourishing during the recent years. However, motives and experiences related to love, sexuality and intimacy are still a sensitive desideratum in older-age migration research. The Special Section approaches this gap and encourages interdisciplinary research to further contribute to this field. We argue that older-age migration and sexuality are closely linked concepts that deserve nuanced attention across the broad social sciences themes of inequality, inclusion and self-expression and across diverse geographies.
Shipping on the edge: Negotiations of precariousness in a Chinese real-person shipping fandom community
Authors: Tang Jack Lipei
Published: March 2023

The fandom community has been one of the most engaging and active segments in the global participatory culture. However, fans face multilevel and intertwined constraints from various social forces while seeking pleasure and fantasies. This study zooms in on a real-person shipping fan community in China where shippers are doubly marginalized as they fantasize about two male idols being in a romantic relationship in a society with both the derogative projection of fans and low levels of acceptance of same-sex relationships. Relying on a mixed-methods approach, this study found that the radical and disruptive practices are the results of tactical and calculative negotiations in relation to political, social, and technological risks while being driven by pleasure-seeking. I call these practices precarious shipping. The contextualized understanding of the fandom community emphasizes the importance of realizing the local tensions that are rarely addressed in previous literature that focuses on Western fandom.
Investigation into the thermal comfort and some passive strategies for traditional architecture of Li nationality in South China
Authors: Ruan Jinming , Liu Jiaping
Published: March 2023

The ecological experience of traditional regional architecture provides an excellent reference for coping with increased energy consumption from cooling in tropical developing countries. However, the thermal comfort of traditional architecture and the effectiveness of its passive measures still need to be further verified in summertime conditions in hot and humid regions. In this study, we selected the traditional Li architecture, including boat- and Kim-shaped houses, for thermal environment tests. Subsequently, we analyzed the operative temperature and PMV-PPD index to determine their indoor thermal comfort and major passive strategies under hot summer conditions. Finally, we propose suggestions for improving the deficiencies of existing passive strategies. Our results show that the traditional Li architecture failed to satisfy indoor thermal comfort for more than half of the test time during the summer. Gable bottom openings and entry door ventilation can increase indoor ventilation with negligible increases in heat gain; however, existing ventilation efficiency is too low to substantially improve indoor thermal comfort. Additionally, we found that the evolution from boat- to Kim-shaped houses was not fully compatible with the significance of climatic adaptation. Kim-shaped houses benefited from the change in the envelope and external environment and its indoor moisture dissipation rate was accelerated; however, their eave shading made the wind speed attenuation more remarkable between indoor and outdoor. These results can help improve the indoor thermal comfort of traditional architecture in hot and humid regions.
The impact of dementia family caregiving on adolescent well-being: A scoping review
Authors: Kates Jeannette , Pogorzelska-Maziarz Monika , Uppal Muskaan , Gerolamo Angela M.
Published: March 2023

With rates of dementia on the rise and upward trends in multigenerational households, the number of families providing care to persons with dementia is likely to increase. Although caregiver stress in adults has been well-documented, less is known about the impact of dementia family caregiving on adolescents. We conducted a scoping review to assess research on the impact of dementia family caregiving on adolescents. Eight articles representing five studies were identified. Findings suggest that while adolescents developed strategies to cope with the challenges of dementia caregiving, the long-term impact of caregiving on overall well-being has not been well described. Further, research has shown inconsistent findings with studies reporting both improved and strained adolescent relationships. The paucity of research on the impact of dementia family caregiving on the well-being of adolescents is a serious omission given that adolescents are at high-risk for emerging health problems.
Geometric design and dynamic characteristics of a novel abnormal cycloidal gear reducer
Authors: Mo Jingyu , Gong Xu , Luo Shanming , Fu Shenping , Chang Xuefeng , Liao Longxing
Published: March 2023

A precision reducer with a high ratio and a small size is essential for precise control of the position of a robotic arm. The rotate vector (RV) is a reducer widely applied in robotic joints. However, its complex structure, over-positioning and difficult assembly restrict its application industrial robots. Herein, a novel abnormal cycloidal gear (ACG) reducer is proposed. In comparison to the RV reducer, the proposed reducer has the characteristics of compact structure, less over-positioning and high ratio. The compound tooth profile of “epicycloid-involute hypocycloid” is used as the driving teeth for improving the performance of the reducer. The operating principle, mechanism design and reduction ratio of the proposed reducer is investigated, and the design method of the ACG tooth profile is also introduced. A dynamic characteristic model is established to verify the correctness of the design method of the reducer. A prototype of the ACG reducer is fabricated by using the computer numerical control (CNC) machining technology. Results show that the ACG reducer is capable to cover a wide range of reduction ratios with a simple mechanism. The numerical and theoretical results are in agreement, which depict the structural feasibility and correctness of the design method of the reducer. The adaptation of the ACG tooth profile as the driving teeth helps in improving the performance of the reducer.
Consciousness, (meta)cognition, and culture
Authors: Frith Chris D
Published: March 2023

Our conscious experience is determined by a combination of top-down processes (e.g., prior beliefs) and bottom-up processes (e.g., sensations). The balance between these two processes depends on estimates of their reliability (precision), so that the estimate considered more reliable is given more weight. We can modify these estimates at the metacognitive level, changing the relative weights of priors and sensations. This enables us, for example, to direct our attention to weak stimuli. But there is a cost to this malleability. For example, excessive weighting of top-down processes, as in schizophrenia, can lead to perceiving things that are not there and believing things that are not true. It is only at the top of the brain’s cognitive hierarchy that metacognitive control becomes conscious. At this level, our beliefs concern complex, abstract entities with which we have limited direct experience. Estimates of the precision of such beliefs are more uncertain and more malleable. However, at this level, we do not need to rely on our own limited experience. We can rely instead on the experiences of others. Explicit metacognition plays a unique role, enabling us to share our experiences. We acquire our beliefs about the world from our immediate social group and from our wider culture. And the same sources provide us with better estimates of the precision of these beliefs. Our confidence in our high-level beliefs is heavily influenced by culture at the expense of direct experience.
A hybrid algorithm for large-scale non-separable nonlinear multicommodity flow problems
Authors: Tran Trung Hieu , Nguyen ThuBa T , Jiang Yirui
Published: March 2023

We propose an approach for large-scale non-separable nonlinear multicommodity flow problems by solving a sequence of subproblems which can be addressed by commercial solvers. Using a combination of solution methods such as modified gradient projection, shortest path algorithm and golden section search, the approach can handle general problem instances, including those with (i) non-separable cost, (ii) objective function not available analytically as polynomial but are evaluated using black-boxes, and (iii) additional side constraints not of network flow types. Implemented as a toolbox in commercial solvers, it allows researchers and practitioners, currently conversant with linear instances, to easily manage large-scale convex instances as well. In this article, we compared the proposed algorithm with alternative approaches in the literature, covering both theory and large test cases. New test cases with non-separable convex costs and non-network flow side constraints are also presented and evaluated. The toolbox is available free for academic use upon request.
Secret objects in the home: Potency, (in)visibility and everyday relationships
Authors: Woodward Sophie , Mayr Cornelia
Published: March 2023

This article argues that the material dimensions of secrecy, which have been neglected within academic research into consumption and into material culture, are ripe for sociological analysis and attention. We draw on two empirical projects – one using qualitative interviews to talk to women about their sex toys and the other ethnographically informed research into things people keep but are no longer using - to explore secret things within the home. By taking a facet methodology approach, we consider secret objects in relation to each other and interrogate how secrets are made (in)visible through strategies and practices around objects within the home and how the potency of secret objects is managed. We make two key arguments: first, considering the relationship between secrecy and intimacy, we argue that there are three dimensions of secrecy (which do not always coalesce): what is known about, what is verbalised, and what is materialised. Second, we redirect the idea of relational work to material things, looking at where things are kept, who they are revealed to and the silences around things, and argue that these practices are part of the work of everyday relationships and intimacies. The article demonstrates that objects are vital in understanding how secrecy, intimacy and everyday relationships are lived and forms part of a wider argument for the sociology of culture to centre the unnoticed and mundane.
Telementoring With Project ECHO: A New Era in Diabetes-Related Continuing Education for Primary Care to Address Health Disparities
Authors: Ehrhardt Nicole , Bouchonville Matt , Peek Monica E. , Thomas Celeste C. , Zou Tracy , Cuttriss Nicolas , Desimone Marisa , Weinstock Ruth S. , Baer Linda G. , Gabbay Robert A.
Published: March 2023

Project ECHO® is a telementoring workforce development model that targets under-resourced communities lacking access to specialty care. The model builds virtual communities of practice, including specialists and community primary care professionals (PCPs) to combat clinical inertia and health disparities. While the ECHO model has gained global recognition, implementation of the model related to diabetes is lagging compared to other specialty conditions. This review highlights diabetes-endocrine (ENDO)-focused ECHOs using data reported in the ECHO Institute’s centralized data repository (iECHO) and the learning collaborative for diabetes ECHOs. It also describes the implementation of diabetes ECHOs and their evaluation. Learner and patient-centered outcomes related to diabetes ECHOs are reviewed. Program implementation and evaluations have demonstrated utility of the ECHO model for diabetes programs to (1) address unmet needs of diabetes care in the primary care setting, (2) improve knowledge and confidence in managing complex diabetes and change provider prescribing habits, (3) improve patient outcomes, and (4) address diabetes quality improvement practices in primary care. More studies with broader collaboration among sites are needed to evaluate the model related to diabetes, especially applied to addressing therapeutic inertia, adoption of diabetes technology, and reducing health disparities.
Adeno-Associated Virus-Delivered Fibroblast Growth Factor 18 Gene Therapy Promotes Cartilage Anabolism
Authors: Hollander Judith M. , Goraltchouk Alex , Rawal Miraj , Liu Jingshu , Luppino Francesco , Zeng Li , Seregin Alexey
Published: March 2023

Objective

To determine the characterization of chondrogenic properties of adeno-associated virus type 2 (AAV2)-delivered hFGF18, via analysis of effects on primary human chondrocyte proliferation, gene expression, and in vivo cartilage thickness changes in the tibia and meniscus.

Design

Chondrogenic properties of AAV2-FGF18 were compared with recombinant human FGF18 (rhFGF18) in vitro relative to phosphate-buffered saline (PBS) and AAV2-GFP negative controls. Transcriptome analysis was performed using RNA-seq on primary human chondrocytes treated with rhFGF18 and AAV2-FGF18, relative to PBS. Durability of gene expression was assessed using AAV2-nLuc and in vivo imaging. Chondrogenesis was evaluated by measuring weight-normalized thickness in the tibial plateau and the white zone of the anterior horn of the medial meniscus in Sprague-Dawley rats.

Results

AAV2-FGF18 elicits chondrogenesis by promoting proliferation and upregulation of hyaline cartilage–associated genes, including COL2A1 and HAS2, while downregulating fibrocartilage-associated COL1A1. This activity translates to statistically significant, dose-dependent increases in cartilage thickness in vivo within the area of the tibial plateau, following a single intra-articular injection of the AAV2-FGF18 or a regimen of 6 twice-weekly injections of rhFGF18 protein relative to AAV2-GFP. In addition, we observed AAV2-FGF18-induced and rhFGF18-induced increases in cartilage thickness of the anterior horn of the medial meniscus. Finally, the single-injection AAV2-delivered hFGF18 offers a potential safety advantage over the multi-injection protein treatment as evidenced by reduced joint swelling over the study period.

Conclusion

AAV2-delivered hFGF18 represents a promising strategy for the restoration of hyaline cartilage by promoting extracellular matrix production, chondrocyte proliferation, and increasing articular and meniscal cartilage thickness in vivo after a single intra-articular injection.
Perceived Attractiveness of Tax Consultancy and Auditing Professions: Insights From a German-Speaking Area
Authors: Graschitz Sabine , Holzknecht Simona , Steller Marcel
Published: March 2023

Recruiting professionals in tax consultancy and auditing is becoming increasingly difficult in Germany and Austria. This study analyzes the attractive factors of a profession, specifically the tax consultancy and auditing profession, based on a survey of students ( n = 225) and practitioners ( n = 148) in a German-speaking setting. We find that the most attractive factors for tax consultancy and auditing are different company insights and consulting activities. Career opportunities and auditing activities are perceived as incentives to enter the auditing profession. Knowledge obtained during studies is perceived as less satisfactory for students compared to practitioners who assess it as good in retrospect. Students from different regions valued the tasks differently, which implies that strategies must be adapted to attract students. The number of accounting courses and internships significantly influenced career entry for both professions. Thus, higher education institutions are responsible for making professions more appealing to students.
“If You are Going to Step on This Campus, You Have to Get Vaccinated”: A Qualitative Understanding of COVID-19 Vaccine Hesitancy Among Black Emerging Adults Returning to College Campuses
Authors: Soboti Jacqueline Mercedes
Published: March 2023

For the academic year 2021–2022, many American colleges mandated the COVID-19 vaccine for students to return to campus. However, when academic leaders put these mandates into effect, they may have failed to consider the emotional impact on vaccine hesitant students, especially students who have been historically marginalized or underrepresented such as Black emerging adults. This qualitative study explored how vaccine hesitant Black emerging adults describe and understand their return to academia and, how the historical mistreatment of Black Americans influenced their feelings and decision-making process around the vaccine mandates. The researcher conducted semi-structured interviews with 14 respondents, ages 18–25. The following themes were identified using thematic analysis: “…The Black Experience”: Historical Racism and Medical Misrepresentation; Personal and External Reasons for Vaccine Hesitancy; Factors Impacting the Final Decision to get Vaccinated; Experiencing Varied Emotions about being Vaccinated. Findings demonstrate that the historical mistreatment of Black individuals shaped respondents’ experience and informed their hesitancy about being vaccinated. Further, while all respondents ultimately complied with the vaccine mandate and were able to return to campus, overall feelings post vaccination varied. Implications for future research, higher education, and clinical practice are discussed.
Criteria Used to Determine Unrestricted Return to Activity After ACL Reconstruction in Pediatric and Adolescent Patients: A Systematic Review
Authors: Romanchuk Nicholas J. , Livock Holly , Lukas Kenneth J. , Del Bel Michael J. , Benoit Daniel L. , Carsen Sasha
Published: March 2023

Background:

The rates of anterior cruciate ligament (ACL) graft failure or contralateral ACL rupture range from 17% to 30% in pediatric patients after ACL reconstruction (ACLR). A contributing factor to the high reinjury rate in this population may be the limited evidence regarding appropriate criteria for allowing unrestricted return to activity (RTA) postoperatively.

Purpose:

To review the literature and identify the most commonly used criteria when determining unrestricted RTA after ACLR in pediatric patients.

Study Design:

Systematic review; Level of evidence, 4.

Methods:

A search was performed of the Medline/PubMed, Cochrane Central Register of Controlled Trials, Embase, CINAHL, and SPORTDiscus databases using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The authors identified studies that included pediatric patients (<19 years of age) and specified the criteria used to determine RTA after ACLR.

Results:

A total of 27 articles met all criteria for review, of which 13 studies only used 1 criterion when determining RTA. Objective criteria were the most common type of criteria for RTA (17 studies). Strength tests (15 studies) and hop tests (10 studies) were the most commonly used tasks when deriving RTA criteria. Only 2 studies used validated questionnaires to assess the patient’s physiological readiness for RTA, and only 2 studies used an objective assessment of movement quality before RTA.

Conclusion:

Only 14 of the 27 reviewed studies reported using >1 criterion when determining RTA. Furthermore, few studies used patient-reported outcome measures or lower limb kinematics as RTA criteria, indicating that more research is needed to validate these metrics in the pediatric population.
Ulnar Collateral Ligament Reconstruction with Hamstring Autograft
Authors: Fu Michael C. , Vadhera Amar S. , Wessels Morgan , Mehta Nabil , Dasari Suhas P. , Garrigues Grant E. , Verma Nikhil N.
Published: March 2023

Background:

Ulnar collateral ligament (UCL) reconstructions have become increasingly common, particularly in youth overhead throwing athletes. These injuries are most commonly due to overuse and repetitive trauma on the inner elbow. Throwers with a deficient UCL often report decreased pitching speeds in addition to elbow pain and instability.

Indication:

The indications for this procedure include symptomatic valgus elbow instability during overhead throwing motions and a verified rupture of the UCL on advanced imaging.

Technique Description:

The ipsilateral gracilis tendon is harvested and prepared as an autograft. A 5-cm incision is then made centered over the medial epicondyle. The ulnar nerve is identified and neurolysis is performed both proximally and distally. The fascia overlying the flexor carpi ulnaris is incised, and the two heads of the muscle are split. From this base, the sublime tubercle is identified, and the UCL is opened longitudinally in line with its fibers. A standard guide is used to drill holes in the posterior and anterior aspects of the sublime tubercle. These holes are then connected using a curved curette, and a suture is passed along the tunnels for later graft passage. A 15-mm blind-end tunnel is drilled two-thirds from the tip to the base of the epicondyle. Two smaller tunnels are then drilled with K-wires to pass sutures through the posterior aspect of the epicondyle. The native UCL is closed, and the graft is then passed through the sublime tubercle tunnels. One end of the graft is docked into the epicondylar tunnel, and a docking procedure is then undertaken so that both ends are docked within the humeral tunnel. Stay sutures are tied over a bone bridge, and the two limbs of the graft are sutured together to appropriately tension the graft.

Results:

In our experience, 94% of athletes return to previous levels of play and experience high patient-reported outcome scores.

Discussion/Conclusion:

Advancements in UCL reconstruction techniques and our understanding of elbow anatomy should prompt surgeons to continue considering this treatment for patients with significant throwing pain and a strong desire to return to high levels of throwing.

Patient Consent Disclosure Statement:

The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.