bluuebunny/crossref_metadata_2025 huggingface dataset:
Fate and future of the medical students in Ukraine: A silently bubbling educational crisis
Authors: Jain Nityanand , Panag Deepkanwar Singh , Srivastava Mahek , Mohan Srinithi , Chodnekar Swarali Yatin , Akbari Amir Reza , Raj Divyam , Kravarioti Dionysia , Świątek Dorota , Platos Emilia , Khetsuriani Ketevani , Gristina Kitija Lucija , Evangelou Kyriacos , Lica Marinela , Thirumushi Revathi Sairaj , Rozani Sofia , Jain Shivani , Fedirko Pavlo , Reinis Aigars , Pilmane Mara
Published: May 2022

Jain et al. reflect on the Russia‐Ukraine war and argue that although there is a broad consensus on the need for intervention, focus should be on providing immediate accommodative measures.
Pathogenic variants of Valosin‐containing protein induce lysosomal damage and transcriptional activation of autophagy regulators in neuronal cells
Authors: Ferrari Veronica , Cristofani Riccardo , Cicardi Maria E. , Tedesco Barbara , Crippa Valeria , Chierichetti Marta , Casarotto Elena , Cozzi Marta , Mina Francesco , Galbiati Mariarita , Piccolella Margherita , Carra Serena , Vaccari Thomas , Nalbandian Angele , Kimonis Virginia , Fortuna Tyler R. , Pandey Udai B. , Gagliani Maria C. , Cortese Katia , Rusmini Paola , Poletti Angelo
Published: May 2022

Aim

Mutations in the valosin‐containing protein (VCP) gene cause various lethal proteinopathies that mainly include inclusion body myopathy with Paget's disease of bone and frontotemporal dementia (IBMPFD) and amyotrophic lateral sclerosis (ALS). Different pathological mechanisms have been proposed. Here, we define the impact of VCP mutants on lysosomes and how cellular homeostasis is restored by inducing autophagy in the presence of lysosomal damage.

Methods

By electron microscopy, we studied lysosomal morphology in VCP animal and motoneuronal models. With the use of western blotting, real‐time quantitative polymerase chain reaction (RT‐qPCR), immunofluorescence and filter trap assay, we evaluated the effect of selected VCP mutants in neuronal cells on lysosome size and activity, lysosomal membrane permeabilization and their impact on autophagy.

Results

We found that VCP mutants induce the formation of aberrant multilamellar organelles in VCP animal and cell models similar to those found in patients with VCP mutations or with lysosomal storage disorders. In neuronal cells, we found altered lysosomal activity characterised by membrane permeabilization with galectin‐3 redistribution and activation of PPP3CB. This selectively activated the autophagy/lysosomal transcriptional regulator TFE3, but not TFEB, and enhanced both SQSTM1/p62 and lipidated MAP1LC3B levels inducing autophagy. Moreover, we found that wild type VCP, but not the mutants, counteracted lysosomal damage induced either by trehalose or by a mutant form of SOD1 (G93A), also blocking the formation of its insoluble intracellular aggregates. Thus, chronic activation of autophagy might fuel the formation of multilamellar bodies.

Conclusion

Together, our findings provide insights into the pathogenesis of VCP‐related diseases, by proposing a novel mechanism of multilamellar body formation induced by VCP mutants that involves lysosomal damage and induction of lysophagy.
Adenosine, adenosine‐ deaminase and implantable recorder outcome in syncopal patients
Authors: Mitro Peter , Lazúrová Zora , Kerekanič Michal , Farkaš Jan , Popovňáková Marcela
Published: May 2022

Background

Adenosine test was proposed as a tool for identification of syncopal patients who benefit from pacemaker implantation. Aim of the study was to assess the relationship between adenosine levels, the outcome of adenosine test and results of implantable loop recorder (ILR) monitoring in patients with syncope.

Methods

In 29 patients (mean age 59 ± 11 years, 15 men, 14 women) with unexplained syncope ILR was implanted. In addition, adenosine test (intravenous injection of 20 mg adenosine bolus) and assays of plasmatic adenosine and adenosine‐deaminase were performed.

Results

Adenosine test was positive in 15 patients and negative in 14 patients. Patients with positive adenosine test had lower adenosine levels compared to patients with negative test (8.86 ± 2.07 ng/ml vs. 15.18 ± 2.14 ng/ml, p = .04). No difference was observed in adenosine deaminase levels (16.35 ± 2.20 IU/l vs. 13.20 ± 2.48 IU/l, p = .40). There was a negative correlation between adenosine level and AVB duration during adenosine test (p = .04; R2 = 0.22). Patients with positive adenosine test had more frequent asystole during ILR monitoring than patients with negative test (9 pts vs. 1 pt, p = .005). Adenosine levels were lower in patients with asystolic syncope on ILR compared to vasodepressor syncope 8.20 ± 2.86 ng/ml versus 13.27 ± 7.26 ng/ml, p = .05).

Conclusions

Patients with positive adenosine test have decreased production of endogenous adenosine compared to patients with negative adenosine test. Positivity of adenosine test and low adenosine level in the peripheral blood were associated with more frequent asystolic episodes during ILR monitoring.
Feeding habits of the Middle Triassic pseudosuchian Batrachotomus kupferzellensis from Germany and palaeoecological implications for archosaurs
Authors: Mujal Eudald , Foth Christian , Maxwell Erin E. , Seegis Dieter , Schoch Rainer R.
Published: May 2022

Bite traces on fossil bones are key to deciphering feeding ecology and trophic interactions of vertebrate past ecosystems. However, similarities between traces produced by different carnivorous taxa with similar dentitions, and misidentifications due to equifinality, hinder confident identifications of the bite makers. Here, we correlate bite traces with macroscopic wear and microanatomy of the teeth of the pseudosuchian archosaur Batrachotomus kupferzellensis from the Triassic Lower Keuper fossil lagerstätten (southern Germany), untangling its feeding habits and shedding light on the bite traces generated by ziphodont teeth (teeth with serrated carinae). Individually, bite traces reflect tooth morphology, whereas composite bite traces and their frequency are related to feeding behaviour and explain tooth macroscopic wear and microanatomy. Therefore the identification of the bite maker is possible by analysing composite bite traces, their location on bones, and their relative abundance. In addition, tooth macroscopic wear and microanatomy are proven as independent lines of evidence of feeding ecology. Comparing bite traces on fossil and present‐day bone assemblages, we observe that bone modifications by the crocodylomorph lineage (from Triassic pseudosuchian archosaurs to extinct and extant crocodylians) are strikingly similar, including taxa with and without ziphodont teeth. Such a set of features differs from bone modification assemblages produced by taxa with similar ziphodont teeth outside the pseudosuchian lineage, such as theropod dinosaurs and the Komodo monitor, suggesting phylogeny is a better predictor of feeding ecology among saurian reptiles than tooth morphology.
Function deficiency of GhOMT1 causes anthocyanidins over‐accumulation and diversifies fibre colours in cotton (Gossypium hirsutum)
Authors: Ke Liping , Yu Dongliang , Zheng Hongli , Xu Yihan , Wu Yuqing , Jiao Junye , Wang Xiaoli , Mei Jun , Cai Fangfang , Zhao Yanyan , Sun Jie , Zhang Xianlong , Sun Yuqiang
Published: May 2022

Naturally coloured cotton (NCC) fibres need little or no dyeing process in textile industry to low‐carbon emission and are environment‐friendly. Proanthocyanidins (PAs) and their derivatives were considered as the main components causing fibre coloration and made NCCs very popular and healthy, but the monotonous fibre colours greatly limit the wide application of NCCs. Here a G. hirsutum empurpled mutant (HS2) caused by T‐DNA insertion is found to enhance the anthocyanidins biosynthesis and accumulate anthocyanidins in the whole plant. HPLC and LC/MS‐ESI analysis confirmed the anthocyanidins methylation and peonidin, petunidin and malvidin formation are blocked. The deficiency of GhOMT1 in HS2 was associated with the activation of the anthocyanidin biosynthesis and the altered components of anthocyanidins. The transcripts of key genes in anthocyanidin biosynthesis pathway are significantly up‐regulated in HS2, while transcripts of the genes for transport and decoration were at similar levels as in WT. To investigate the potential mechanism of GhOMT1 deficiency in cotton fibre coloration, HS2 mutant was crossed with NCCs. Surprisingly, offsprings of HS2 and NCCs enhanced PAs biosynthesis and increased PAs levels in their fibres from the accumulated anthocyanidins through up‐regulated GhANR and GhLAR. As expected, multiple novel lines with improved fibre colours including orange red and navy blue were produced in their generations. Based on this work, a new strategy for breeding diversified NCCs was brought out by promoting PA biosynthesis. This work will help shed light on mechanisms of PA biosynthesis and bring out potential molecular breeding strategy to increase PA levels in NCCs.
What are parents reading about the sunscreen controversy?
Authors: Shiosaki Jessica , Yamamoto Loren G.
Published: May 2022

The benefits of sunscreen use have been well‐established. However, discussion of its risks remains on the internet. Given this point of controversy, a web search of 50 websites on children's sun safety was performed and indicated that the information online is variable and incomplete when informing parents on the benefits and risks of sunscreen use.
Role of the type‐B authentic response regulator gene family in fragrant rice under alkaline salt stress
Authors: Rehman Obaid Ur , Uzair Muhammad , Chao Haoyu , Fiaz Sajid , Khan Muhammad Ramzan , Chen Ming
Published: May 2022

Globally, rice is being consumed as a main staple food and faces different kinds of biotic and abiotic stresses such drought, salinity, and pest attacks. Through the cytokinin signaling, Type‐B authentic response regulators (ARR‐Bs) respond positively towards the environmental stimuli. ARR‐Bs are involved in abiotic stress tolerance and plant development but their molecular mechanisms in fragrant rice are still not fully explored. The current study showed the genome‐wide characterization of OsARR‐B genes under alkaline salt stress. Results showed that in total, 24 OsARR‐B genes were found and divided into four subgroups on the basis of a phylogenetic analysis. These genes were located on all rice chromosomes except 8 and 10. Analysis of gene duplications, gene structure, cis‐elements, protein–protein interactions, and miRNA were performed. Gene ontology analysis showed that OsARR‐B genes are involved in plant development through the regulation of molecular functions, biological processes, and cellular components. Furthermore, 117 and 192 RNA editing sites were detected in chloroplast and mitochondrial genes, respectively, encoding proteins of OsARR‐B. In chloroplast and mitochondrial genes, six and nine types of amino acid changes, respectively, were caused by RNA editing, showing that RNA editing has a role in the alkaline salt stress tolerance in fragrant rice. We also used a comparative transcriptome approach to study the gene expression changes in alkaline tolerant and susceptible genotypes. Under alkaline salt stress, OsARR‐B5, OsARR‐B7, OsARR‐B9, OsARR‐B10, OsARR‐B16, OsARR‐B22, and OsARR‐B23 showed higher transcript levels in alkaline salt tolerant genotypes as compared to susceptible ones. Quantitative RT‐PCR showed upregulation of gene expression in the alkaline tolerant genotypes under alkaline stress. Our study explored the gene expression profiling and RESs of two rice contrasting genotypes, which will help to understand the molecular mechanisms of alkaline salt tolerance in fragrant rice.
The related factors to the re‐thrombosis of hemodialysis arteriovenous graft after endovascular salvage
Authors: Janjindamai Phurich , Hongsakul Keerati , Sungsiri Jitpreedee , Bannangkoon Kittipitch , Liabsuetrakul Tippawan
Published: May 2022

Background

Only a few issues of the related factors to hemodialysis access dysfunction have been evaluated, and the effects of antiplatelets to improve the patency of hemodialysis access remained controversial. Hence, this study aimed to determine the related factors to the re‐thrombosis of arteriovenous grafts (AVGs) after endovascular treatment.

Methods

This retrospective study was conducted at a university‐affiliated teaching hospital in Southern Thailand. All patients who underwent hemodialysis with thrombosed AVG, who had pharmacomechanical thrombolysis from January 2016 to December 2018, were enrolled. Post‐intervention primary patency was analyzed by the Kaplan‐Meier method, and the related factors to the re‐thrombosis of AVG were evaluated using logistic regression.

Results

A total of 157 patients with thrombosed hemodialysis AVG were enrolled. The most common graft location and configuration was a forearm loop graft (65%). Post‐intervention primary patency rate at 1, 3, and 6 months were 79.0%, 67.1%, and 54.0%, respectively. Diabetes mellitus (DM) was a significant related factor for re‐thrombosis (hazard ratio [HR], 1.89; 95% confidence interval [CI], 1.20–2.98; p = 0.006). A single antiplatelet after the procedure was a protective factor for re‐thrombosis (HR, 0.58; 95% CI, 0.38–0.89; p = 0.013). The median post‐intervention primary patency was 15.7 months in the group of single antiplatelet usage, which was better than that of the non‐antiplatelet group (p = 0.012).

Conclusion

DM and antiplatelet usage were significant related factors to the re‐thrombosis of hemodialysis AVG after endovascular salvage.
A GIS representation framework for location‐based social media activities
Authors: Wei Xuebin , Yao Xiaobai
Published: May 2022

The past couple of decades have witnessed tremendous growth of location‐based social media activities (LBSMA) data in virtual spaces, including virtual geographic environments. Such data become innovative resources for the analysis of human activities. Meanwhile, a shift of human interactions from geographical spaces to virtual spaces has been observed. Although this is an exciting research opportunity, it also imposes significant challenges on GIScience, as current GIS representation models are no longer sufficient to handle the increased sophistication of human activities data. This research formalizes an ontology for LBSMA data and a conceptual framework for representing such data in GIS. The framework contributes to GIScience as it enables interconnections of human activities in both the physical and virtual worlds to be represented, organized, retrieved, analyzed, and visualized. The proposed GIS representation model integrates a social dimension into the existing spatial–temporal representation models and allows data analysis in the spatial–temporal–social (STS) dimensions. The research tested this conceptual framework with a prototype and a case study using Facebook data. The prototype and the case study prove that the proposed framework can significantly enhance GIS capabilities for data organization, retrieval, and analysis of LBSMA data in STS dimensions.
Learn German, Buy German? Language‐learning opportunities abroad and exports
Authors: Fieles‐Ahmad Omar Martin , Huber Matthias
Published: May 2022

Using data on the presence of the Goethe Institutes (GI) in 134 importer countries between 1978 and 2014, we study the effect that language learning opportunities abroad have on German exports. We employ a gravity model of trade with a single exporter and use the Poisson Pseudo‐Maximum Likelihood (PPML) estimator to measure the relationship of interest. To gauge the importance of potential reverse causality, we also estimate the effect that institutes have on Swiss exports. Our findings for both Germany and German‐speaking Swiss cantons show that institutes do stimulate exports to GI‐hosting countries but that this effect is confined to institutes offering language training services. This finding suggests that language requirements and acquisition underlie the positive link found between institutes and exports. This reading of our findings receives further support in additional explorations, where we study exports differentiated by Rauch (1999, Journal of International Economics, 48(1), 7) product categories to account for differing communication requirements in trading.
Reviewer Acknowledgements
Authors: Gibbs Nikki
Published: May 2022

Applied Economics and Finance (AEF) would like to acknowledge the following reviewers for their assistance with peer review of manuscripts for this issue. Many authors, regardless of whether AEF publishes their work, appreciate the helpful feedback provided by the reviewers. Their comments and suggestions were of great help to the authors in improving the quality of their papers. Each of the reviewers listed below returned at least one review for this issue.Reviewers for Volume 9, Number 2 Abdulaziz Abdulahman, Marmara University, USAAlbert Henry Ntarmah, Jiangsu University, GhanaALI DARUB KASSAR, Univ. of Baghdad, IraqBabacar Seck, University of Bahrain, BahrainGetamesay Bekele Meshesha, Ethiopian Civil Service University, EthiopiaIulia Lupu, Victor Slavescu” Centre for Financial and Monetary Research, Romanian Academy, RomaniaLiao Zhu, Cornell University, USAMarco Muscettola, Independent Researcher-Credit Risk Manager, ItalyMurad Harasheh, University of Milan-Bicocca, ItalyOmer Allagabo Omer Mustafa, Sudan Academy for Banking and Financial Sciences, SudanRomeo Victor Ionescu, Dunarea de Jos University, RomaniaShahram Fattahi, Razi University, IranVictoria Cociug, Academy of Sciences of Moldova, MoldovaY. Saidi, M’sila University, Algeria  Nikki GibbsEditorial AssistantOn behalf of,The Editorial Board of Applied Economics and FinanceRedfame Publishing9450 SW Gemini Dr. #99416Beaverton, OR 97008, USAURL: http://aef.redfame.com
Abandono de los estudiantes de una institución universitaria privada y su intención de retorno en época de COVID-19: un análisis para la toma de decisiones
Authors: Millones Liza Dany Yudet , García-Salirrosas Elizabeth Emperatriz
Published: May 2022

Este trabajo investigó las causas que llevan a los estudiantes universitarios a abandonar sus carreras, así como los motivos que impulsarían su retorno. Con la aplicación de la métrica Net Promoter Score (NPS) se encontró que del total de 551 estudiantes que abandonaron la institución 301 (69,95 %) no retornaron. Dentro de las causas que explican el abandono se identificaron: el factor económico (56,8 %), la organización académica (20,0 %) y la salud (13,6 %). Los estudiantes estarían dispuestos a retornar si la institución mejora las plataformas tecnológicas (27,2 %), reduce los costos de enseñanza y matrícula (31,8 %) e implementa una bolsa de trabajo (27,3 %). Se identificó a los estudiantes promotores (23,6 %), pasivos (34,9 %) y detractores (41,5%), siendo los promotores aquellos que están dispuestos a recomendar a la institución educativa y, en el otro extremo, los detractores que son capaces de perjudicar la imagen de la institución; se concluye que la intención de retorno depende el tipo de estudiante.
Factores que influyen en la hibridación de metodologías de emprendimiento. Una exploración de las motivaciones de académicos y profesionales
Authors: López Castro Verónica Itzel , Borbolla Albores Alberto
Published: May 2022

Este artículo presenta un análisis de las razones y motivaciones de varias figuras educativas en la construcción de metodologías híbridas a través de combinaciones fundamentadas en la educación emprendedora como método. Se llevó a cabo un estudio exploratorio cualitativo, cuyos datos fueron recolectados a través de 19 entrevistas semiestructuradas. Los datos fueron analizados mediante una técnica de análisis del discurso que permitió apreciar que las metodologías híbridas se construyen como parte de un proceso de contextualización que busca aplicar correctamente dichas metodologías a la cultura, el contexto e incluso el estilo personal del educador de ese momento. Comprender el papel que juega el contexto del educador en su elección de contenidos y enfoques de enseñanza podría ayudar a evitar sesgos y crear prácticas educativas transformadoras.
Energy Savings of an Optimized Daylight-Pipe System With Single and Dual Reflectors in Tropical Climates of India
Authors: Azad Abdus Salam , Kiran Kumar Donthu E. V. S. , Wan Man Pun , Kaushik S. C. , Rakshit Dibakar
Published: May 2022

Buildings in India consume over one-third of the country’s total electricity consumption and out of which about 28% and 25% are accounted for lighting energy in the residential and commercial buildings, respectively. Passive daylighting system using tubular daylight-pipe is a promising technique to save lighting energy by illuminating deep building interiors that have no daylight access through exterior windows. In this study, an innovative daylight-pipe has been designed and developed for enhanced daylighting performance by optimizing configurations of single and dual reflectors at its receiver. A detailed daylight assessment has been carried out using controlled experimentation while varying the reflectors position and orientation inside the hemispherical receiver of the daylight-pipe. It has been found that the single reflector oriented toward south has the best performance with a light transmission efficiency of 35.6%. Furthermore, monthly electrical energy savings due to the advanced daylight-pipe along with various supplementary electrical lighting options such as incandescent bulb, compact fluorescent lamp (CFL), and light emitting diode (LED) were estimated and compared for various climatic locations of India. From these evaluations, a lighting energy saving up to 23% has been observed in the summer month of May for temperate climate of Pune and hot-dry climate of Jodhpur.
A Numerical Investigation Into the Flow Development and Heat Transfer Characteristics for Different Tube Geometry Configurations in a Water in Glass Evacuated Tube Solar Water Heater
Authors: Roshith K. , Varghese James
Published: May 2022

This study aims to numerically assess the heat transfer performance of water-in-glass evacuated tube solar water heater (WGET-SWH) for various parameters. It is observed that the natural circulation flowrate, velocity, and temperature distribution are strongly dependent on WGET-SWH geometry and operating conditions. The natural circulation flowrate is found to be increasing with tube length, diameter, inclination angle, and circumferential heat input. However, the heat transfer rate decreases with an increase in aspect ratio. The average Nusselt number increases with an increase in inclination angle till 45 deg and then decreases. Also, the study shows that thermal stratification in reservoir fluid is greatly influenced by circulation flowrate, flow momentum, collector outlet temperature, thermal acceleration, and buoyancy effect.
A Numerical Scheme for Fractional Mixed Convection Flow Over Flat and Oscillatory Plates
Authors: Nawaz Yasir , Arif Muhammad Shoaib , Abodayeh Kamaleldin
Published: May 2022

A fractional scheme is proposed to solve time-fractional partial differential equations. According to the considered fractional Taylor series, the scheme is compact in space and provides fourth-order accuracy in space and second-order accuracy in fractional time. The scheme is conditionally stable when applied to the scalar fractional parabolic equation. The convergence of the scheme is demonstrated for the system of fractional parabolic equations. Moreover, a fractional model for heat and mass transfer of mixed convection flow over the flat and oscillatory plate is given. The radiation effects and chemical reactions are also considered. The scheme is tested on this model and the nonlinear fractional Burgers equation. It is found that it is more accurate than considering existing schemes in most of the regions of the solution domain. The compact scheme with exact findings of spatial derivatives is better than considering linearized equations. The error obtained by the proposed scheme with the determination of exact spatial derivatives is better than that obtained by two explicit existing schemes. The main advantage of the proposed scheme is that it is capable of providing the solution for convection-diffusion equations with compact fourth-order accuracy. Still, the corresponding implicit compact scheme is unable to find the solution to convection-diffusion problems.
Meatome: A Novel Clamp for Single Step Urethral Meatal Stenosis Surgery
Authors: Hartmann Thomas , Song Sang-Eun , Swana Hubert S
Published: May 2022

Meatotomy is a surgical procedure performed primarily on infants and adolescents to widen the urethral opening (meatus). The current standard surgical meatotomy requires several steps and multiple instruments. The procedure is oftentimes performed with local anesthesia in the office setting.

We present a novel, all-inclusive device that utilizes a centrally-located blade on the upper jaw flanked on all sides by parallel grooves acting as a crimping platform. The simultaneous action of these two important steps aims to improve patient cooperation by minimizing the tools and steps required for this procedure. Qualitative data is used to compare the novel device to current surgical tools. In addition, modeling material and chicken skin are used to illustrate the workflow of the metal 3D-printed prototype. Ultimately, we plan to fabricate a device with the potential to become the preferred instrument for meatotomy procedures.
A Low-Cost and Easy-to-Use Laser Corneal Reshaping Device for Educational, Research and Training Purposes
Authors: Abdelhalim Ibrahim , Hamdy Omnia
Published: May 2022

Recently, many vision disorders such as myopia and hyperopia can be corrected via LASIK refractive surgery. Based on the photo-ablation effect of UV-laser pulses (at 193 nm for most commercial devices), the shape of the treated cornea is modified in order to regain the normal vision capability. In laser corneal reshaping process, the laser parameters must be adjusted to maintain the desired photo-ablation effect. Moreover, the design of the employed device plays an important role in performing successful surgeries with optimum results. However, the commercial devices are designed for specific operations with a limited access to their optical system and software. Besides, these devices are not available for research or training. Consequently, we provide a low-cost and easy-to-use ablation device that can be utilized as an educational, research, and training tool for the specialists in corneal reshaping and related procedures at universities, research institutes, or medical centers. The device has a special opening to enable entry of external laser source for any desired experimental investigations. Moreover, the binocular in commercial devices is replaced by live view screen to decrease the device’s cost. There are no access limitations to the software or the optical system of the proposed device.
Development of a Self-Decoupled Wire-Driven Robotic Universal Joint Toward Medical Application
Authors: Bulbul Chowdhury A M Masum , Cheng Jinsai , Yu Dylan , Shen Tao
Published: May 2022

Robots for surgery and rehabilitation have emerged and are gaining popularity among patients and medical doctors with their obvious benefits, such as overcoming obstacles from human users’ physical restraints, reducing physicians’ workload, and enhancing the efficacy of medical treatment. The development of medical robots meets two challenges related to their special application environments, including sterilization hazards and size/weight limitation. Medical robots (e.g., surgical robots) usually need to have close contact with human skin or organs, which need to be sterilized. However, chemical or heat sterilization on the robots poses an inevitable risk of damage on the motors, sensors, and other electronic components. The size of the surgical robot needs to be compact to gain access to surgical sites. The rehabilitation robots that patients wear have to limit their size and weight. Wire-driven actuation is a potential solution to solve these issues by avoiding the use of bulky mechanical gears and links and locating the electronic components far away from the sterilization environment. This paper presents the development of a novel wire-driven universal joint for medical robot design. With its special structure, this robotic joint has self-decoupled kinematics which can simplify its control system and increase motion accuracy. Benchtop experiments are conducted to verify the functionality of this joint and the effectiveness of its self-decoupled kinematics.
Finite Element Modeling Using Patient-Specific Geometry to Predict Aortic Valve Insufficiency During Percutaneous Pulmonary Valve Implantation
Authors: Donahue Carly L. , Aggarwal Varun , Barocas Victor H.
Published: May 2022

Percutaneous pulmonary valve implantation (PPVI) is a non-surgical treatment in which a stented valve is delivered via catheter to replace a stenosed or leaky pulmonary valve. Stent oversizing is used to anchor the valve within the right ventricular outflow tract (RVOT), but overexpansion may interfere with adjoining structures specifically the aortic root and coronary arteries. Potential devastating consequences include distortion of the aortic sinus, causing aortic valve insufficiency, and/or compression of the coronary arteries. Because the outcome of PPVI is determined by the patient’s anatomy, we propose a method that uses patient-specific finite-element (FE) models constructed from pre-procedural cross-sectional CT scan images to evaluate these potential risks prior to clinical intervention. In five cases from an ongoing retrospective study, our preliminary results demonstrate our model’s ability to accurately identify the risk of aortic valve insufficiency as a consequence of the PPVI procedure.
Power Assisted Walker: Rising Above Seated Mobility
Authors: Ratner Edward R , Goldish Gary , Hansen Andrew , Bliss Jared , Bornstein A Soleil , Gustavson Allison M , Morin Steve , Wacek Amber
Published: May 2022

Nearly half of older people cannot easily walk 400 meters. Powered mobility aids such as seated scooters discourage healthful walking and have limitations due to size and cost. Using human-centered design, we have developed a novel power assisted walker (PAW), which can be used as a manual walker or as a standing electric scooter. A user can push the device manually supported by a four-wheeled walker or step onto a footplate and ride it as a three wheeled standing scooter, with safety enhanced by two anti-tip casters. A working prototype has demonstrated the feasibility of this design. It also meets user-defined requirements for safety, usability, and transportability. Designs for additional prototypes overcome several engineering challenges and will enable a wide variety of users to meet their mobility needs in the community.
Fully Untethered and Stretchable Wearable Electronic Bandage for Measuring Knee Motion
Authors: McManigal Matthew , Wilson Renick , McManigal Patrick , Beran Brooke , Wellsandt Elizabeth , Markvicka Eric J.
Published: May 2022

Wearable electronics capable of measuring three-dimensional knee joint angle would provide new methods to predict both anterior cruciate ligament (ACL) injuries and the risk of developing early knee osteoarthritis. However, knee joint angle assessment is currently limited, due to the lack of validated wearable and untethered technologies that can be deployed in natural environments and rural or community settings. To address this challenge, we created a fully untethered, wearable electronic device to continuously measure knee joint angle using two inertial measurement unit (IMU) sensors. The wearable device is composed of a stretchable circuit assembled on a spandex-blend fabric substrate that allows the device to conform to the knee without restricting natural human movement. The fabric substrate allows the electronic circuit to be reused, while increasing the robustness of the device. Finally, we demonstrate the ability of the device to continuously measure sagittal plane knee joint angle during natural human movements outside of a laboratory environment.
Design and Development of Novel Anatomical Scapular Fracture Fixation Plates: Population-Based and Fracture-Focused Design
Authors: Yimam Habtamu M. , Dey Roopam , Roche Stephen J.L. , Sivarasu Sudesh
Published: May 2022

Surgical fixation is a recommended procedure for displaced and unstable scapular fractures to restore anatomical alignment and articular congruency of the fracture fragments. Anatomically Precontoured scapular plates are designed to guide the fracture reduction, used as a template, and stabilize the fixation. However, anatomical variation of the scapula and the complexity of the fracture patterns limit the usability of these plates. The aim of this study was to design and develop population-based novel anatomical scapular plates. An average three-dimensional (3D) scapular bone model was developed from 22 healthy cadaver scapulae of target population (South Africans) using Statistical Shape Modelling (SSM) method. The fracture region of interests was identified using a fracture map of 70 scapular fracture patterns. Using the average 3D scapular model as a reference template and the common fracture zones as a reference fracture pattern, anatomical plates were designed for the critical scapula fracture patterns. Lateral border, medial border, glenoid fossa & neck, glenoid fossa & body, and acromion plates were designed. Combining 3D CT image based statistical shape modelling and fracture pattern analysis with CAD is relatively quick and efficient method to develop clinically meaningful population-based anatomical plates.
Concept Exploration: Respiratory Rate Monitoring Garment Using Digital Zero-Crossing Detection
Authors: Martini Angela K. , Carlson Sam , Hoang Dung T. , Wawersich Sandra A. , Compton Crystal , Clarke-Sather Abigail R.
Published: May 2022

Measuring respiratory rate is a vital metric for monitoring human health in any setting. Despite its importance for detecting oncoming medical crises, it is often neglected due to the difficulties in accurate measurement. To combat this neglect, a respiratory rate monitoring smart garment was developed that measures breathing rate in real time in a manner that is unobtrusive to the patient. This paper focuses on a concept exploration of a non-invasive wearable garment to measure real time breathing rate using a digital zero-crossing detection signal processing approach. A respiratory rate monitoring garment was developed with a stitched sensor that wraps around the patient’s chest and operates based on the relationship between resistance and displacement. As a person breathes, the chest expands and contracts, displacing the stitched sensor causing a change in resistance that can be measured and then counted as a breath. Unlike current solutions that utilize the fast Fourier transform (FFT) for signal processing of breathing rate, digital zero-crossing detection is used in this garment for improved accuracy and lower computational power. Four participants took part in a total of 15 trials where their normal breathing rate was measured by the stitched sensor and by at least two independent observers. The average sensor breath count was 2.44 breaths below the manually observed breath count. Major contributions to error were due to manual calibration of the sensor, and these discrepancies will be addressed in further prototype development. Despite the error between the sensor and manual breath count, the performance of the garment indicates respiratory rate monitoring in real time is possible, which increases the feasibility of more accurate and frequent respiratory rate monitoring thus increasing the potential for improved patient health.
An Anti-Fouling Airway Stent
Authors: Glumac Daniel , Kadowaki Koji , Cho Roy , Peterson Gregory , Hunter Ryan , Kent Leslie , MacIver Robroy , Pandey Vidhu , Tanahashi Kazuhiro
Published: May 2022

Airway stents are used to keep airways open for those patients symptomatic from tracheobronchial disease. Tracheobronchial disease or central airway obstruction (CAO) can occur with benign or malignant disease, or complications from lung transplantation. Although stents can offer symptomatic relief for CAO, complications such as granulation tissue formation, stent fracture, and infection commonly occur after stent placement. Currently, all airway stents promote mucus buildup which can lead to stent failure and airway complications. In this paper, we demonstrate the use of special anti-fouling coatings to prevent mucus buildup. The coatings have been tested: 1) for wettability, 2) using XPS and TOF-SIMS to characterize surface properties, and 3) in the laboratory (in vitro) to study effects of mucin incubation. Findings include significant improvement in limiting mucus adhesion in a lab model.
Wireless, Battery Free Wearable Electronic Nose
Authors: Finnegan Jason , Peterkin Bridget , Han Hee-Chan , Yentes Jennifer M. , Rennard Stephen I. , Markvicka Eric J.
Published: May 2022

Volatile organic compounds (VOCs) are excreted through the skin or exhaled breath. They are end products of human metabolism, metabolism of gut microflora, and ingested or inhaled substances. VOCs can be noninvasively sampled and could be a useful marker for disease. However, medical diagnostics rarely considers the VOCs that are expelled from the body. Here, we introduce a miniature, low-cost, and battery-free electronic nose (e-nose) sensor for passively identifying chemical patterns that are excreted from the human skin or exhaled breath. The platform is composed of an array of conductive polymer filaments created with a two-layer system of multi-walled carbon nanotubes and four different, solution processable polymers. The “breathprint” signature–consisting of the resistance of each filament–can be read from the sensor using a near-field communication-enabled device, such as a smartphone. The e-nose sensor contains a system on a chip with near-field communication (NFC) functionality and a radio frequency antenna to harvest power. The sensor was tested against six common VOCs that are released from the human body.
Additive Manufacturing of Medical Microdevices
Authors: Saracaydin Renc , Hara Seth A.
Published: May 2022

Additive manufacturing is a growing field, but its application in the fabrication of medical microdevices has not been fully explored. Traditionally, medical microdevices are manufactured via a combination of techniques such as photolithography, laser-cutting, and micromolding, which collectively have challenges such as multiple fabrication steps, limited design freedom, high fabrication cost, and significant fabrication time. Micro vat photopolymerization is presented here as an alternative method to produce four different microscale medical devices that have applications in microfluidics, drug delivery, and bioscaffolding. In terms of minimum feature size and resolution, the presented structures are comparable, if not superior, to literature quoted parts fabricated through conventional manufacturing methods. The fabrication steps, process parameters, design considerations, learnings, and future research directions are outlined.
Evaluating The Dispersal Volume of a Six-Port Arborizing Catheter in Agarose as a Function of Infusion Flow Rate and Catheter Retraction Speed
Authors: Campbell Etse-Oghena Y. , Hsu Fang-Chi , Rylander Christopher G.
Published: May 2022

Convection-enhanced delivery (CED) is an emerging method for treating highly aggressive and infiltrative forms of brain cancer, like glioblastomas. However, drawbacks of utilizing CED include limited availability of tools capable of bypassing the blood-brain barrier and blood-brain tumor barrier to deliver therapeutics to saturate the tumor and adjacent tumor periphery where highly infiltrative glioma cells may be located. The consequence is that tumor recurrence at or near the original tumor site is inevitable.

The Convection-Enhanced Thermo-Therapy Catheter System (CETCS) is a remote-operable device comprising of an arborizing catheter and therapeutic delivery control system designed to maximize the distribution of therapeutics in target tissue volumes. In this study, we evaluate the performance of the CETCS in agarose gel brain tissue phantoms while monitoring the volume of infusate delivered, the dispersal volume of the infusate, and the mean distribution ratio of infusate. We report high infusion flow rates increase infusate dispersal volume but can result in backflow up the microneedles tracts; constant microneedle retraction maximizes infusate dispersal volume; and finally, low infusion flow rates resulted in better control of infusion cloud shape and minimized occurrence of backflow along microneedles.
Aberrant Coronary Artery: A Rare Congenital Anomaly Examined Through Pre- And Post-Procedural 3D Anatomical Modeling
Authors: Tenhoff Amanda C. , Iles Tinen L. , Iaizzo Paul A. , MacIver Robroy
Published: May 2022

Congenital heart disease – structural abnormalities of the heart that are present at and persistent beyond birth – affects about one in every 100 live births every year in the United States [1]. One such disease is that of the aberrant coronary artery, which describes abnormalities of coronary artery morphology. In our case, we examine a patient exhibiting complex aberrant right coronary artery – a rare congenital heart defect. Pre- and post-procedural imaging was acquired from this case, and subsequent three-dimensional (3D) anatomical models were created. These models were used postoperatively to identify and describe the patient’s disease presentation for the purposes of research and education, and were incorporated into virtual reality (VR) scenes in order to further educational insights.
Design and Analysis of a 2-DOF Uterus Manipulator for Use During Total Laparoscopic Hysterectomy
Authors: Fournelis Nicolette , Song Sang-Eun
Published: May 2022

Uterus manipulators are one of the most useful tools utilized while performing Total Laparoscopic Hysterectomy (TLH). While highly convenient, there are many issues that are presented when using this surgical tool. Slipping, mobility, and the overwhelming varieties of manipulators all create a stressful environment for a surgeon performing this delicate procedure. This suggests that there is room for the development of a robust, multi-functional uterus manipulator that can minimize these issues, and thus create a safer and more effective surgical procedure in the operating room. As a proof-of-concept development, a 3-D Computer-Aided Design (CAD) model was produced and then simulated such that it could be tested for determining key parameters of deformation, degrees of freedom, and range of motion. From Finite Element Analysis (FEA), it was found that the suggested design can reduce slippage, has comparable range of motion to that of uterus manipulators on the market, and has increased flexion within the vaginal canal. These results encourage further development and testing to enhance the safety and efficacy of this new design.
Week 96 Genotypic and Phenotypic Results of the Fostemsavir Phase 3 BRIGHTE Study in Heavily Treatment-Experienced Adults Living with Multidrug-Resistant HIV-1
Authors: Gartland Margaret , Cahn Pedro , DeJesus Edwin , Diaz Ricardo Sobhie , Grossberg Robert , Kozal Michael , Kumar Princy , Molina Jean-Michel , Mendo Urbina Fernando , Wang Marcia , Du Fangfang , Chabria Shiven , Clark Andrew , Garside Louise , Krystal Mark , Mannino Frank , Pierce Amy , Ackerman Peter , Lataillade Max
Published: May 2022

In the phase 3 BRIGHTE study in heavily treatment-experienced adults with multidrug-resistant HIV-1, fostemsavir plus optimized background therapy (OBT) resulted in sustained rates of virologic suppression through 96 weeks. HIV-1 RNA <40 copies/mL was achieved in 163/272 (60%) Randomized Cohort (RC) participants (with 1 or 2 remaining approved fully active antiretrovirals) and 37/99 (37%) Non-randomized Cohort (NRC) participants (with 0 fully active antiretrovirals).
Fulminant myocarditis spreading from the right ventricle treated with extracorporeal membrane oxygenation and impella
Authors: Karashima Chihiro , Fujimoto Noritaka , Yonezu Keisuke , Takahashi Naohiko
Published: May 2022

Although the pathogenesis of fulminant myocarditis varies, it is usually recognised by symptoms such as chest pain or syncope, echographic findings such as abnormal left ventricular (LV) wall motion, elevated cardiac enzymes and arrhythmias. We encountered a case of acute myocarditis with syncope, electrocardiographic changes suggestive of coronary artery disease in the inferior wall with abnormal wall motion in the right ventricle, which eventually developed into fulminant disease. Multidetector CT showed a contrast effect localised to the right ventricle in the late-contrast phase, suggesting a right ventricular myocardial injury. Thereafter, the LV function rapidly decreased. Finally, mechanical circulatory support with extracorporeal membrane oxygenation and an intra-aortic balloon pump was needed. A myocardial biopsy of the right ventricular septum showed severe degenerative findings such as myocyte tearing and segmentation with infiltration of inflammatory cells including lymphocytes. After insertion of an Impella pump, the right ventricular function gradually improved.
Biobanking in Latinos: current status, principles for conduct, and contribution of a new biobank, El Banco por Salud, designed to improve the health of Latino patients of Mexican ancestry with type 2 diabetes
Authors: Parra Oscar D , Kohler Lindsay N , Landes Lori , Soto Alexis A , Garcia Diana , Mullins Jacqueline , Molina Patty , Pereira Eladio , Spegman Douglas J , Soltani Lisa , Mandarino Lawrence J
Published: May 2022

Underserved Latino communities experience a greater burden of type 2 diabetes mellitus (T2DM) than the general population. Predictors of glycemic control are likely to include both biological/genetic and social determinants of health (SDOH). A variety of approaches have been used with cohorts of Latino patients to study aspects of this health disparity, and those are reviewed briefly here. Such projects range from cohorts that are studies for a primary purpose, for example, to discover genetic variation associated with T2DM or to examine a particular aspect of SDOH that might be involved. Other studies have been conducted more as infrastructure that is broadly based in order to provide a resource that can be used by many investigators to address a variety of questions. From our experience and those of others, we propose a set of principles to ensure that needs of the community are identified and taken into account during the conduct of these studies. As an example of the implementation of these principles, we also describe a new biobankEl Banco por Salud(El Banco), which was designed to improve access to studies designed to improve glycemic control and health in Latinos in partnership with Federally Qualified Health Centers in Arizona.