bluuebunny/crossref_metadata_2025 huggingface dataset:
Microstructural and interface properties of aluminium alloy coatings on alumina applied by friction surfacing
Authors: Atil Hasan B , Leonhardt Matthias , Grant Richard J , Barrans Simon M
Published: April 2023

Two large groups of materials, namely metals and ceramics, are used in mass quantities in today’s industry because of their outstanding properties. To achieve higher product performance dissimilar materials need to be combined in assemblies, but their joining is challenging. Using friction surfacing technology Al[Formula: see text]O[Formula: see text] ceramic substrates were coated with an aluminium alloy (AlMg4.5Mn0.7). Earlier research by the authors suggested that two major bonding mechanisms, namely mechanical interlocking and van der Waals forces, are responsible for the bonding strengths achieved between the coating and the substrate. Further scanning electron microscopy, scanning transmission electron microscopy, high-resolution transmission electron microscopy and energy dispersive X-ray spectroscopy analysis at a sub nanometre resolution were conducted and are presented in this article. These analytical methods revealed that the aluminium coating and the Al[Formula: see text]O[Formula: see text] grains form a sharp boundary without evidence of either a chemical reaction or diffusion at the interface and suggest that the main bonding mechanisms for the Al/Al[Formula: see text]O[Formula: see text] system are van der Waals forces. In addition, mechanical interlocking may serve to hold in position the interface surfaces, to preserve their close proximity, allowing the van der Waals forces to persist.
Dual generative adversarial networks combining conditional assistance and feature enhancement for imbalanced fault diagnosis
Authors: Li Ranran , Li Shunming , Xu Kun , Zeng Mengjie , Li Xianglian
Published: April 2023

The dataset in the application scenario of existing fault diagnosis methods is often balanced, while the data collected under actual working conditions are often imbalanced. Directly applying existing fault diagnosis methods to this scenario will lead to poor diagnosis effect. In view of the above problems, we proposed a method called dual generative adversarial networks (DGANs) combining conditional assistance and feature enhancement. The method uses data augmentation as a basic strategy to supplement imbalanced datasets by generating high-quality data. Firstly, a new generator is designed to build the basic framework by sharing the dual-branch deconvolutional neural networks, and combining the label auxiliary information and the coral distance loss function to ensure the diversity of generated samples. Secondly, a new discriminator was designed, which is based on deep convolutional neural networks and embedded with auxiliary classifiers, further expanding the function of the discriminator. Thirdly, the self-attention module is introduced into both the generator and the discriminator to enhance deep feature learning and improve the quality of generated samples; finally, the proposed method is experimentally validated on datasets of two different testbeds. The experimental results show that the proposed method can generate fake samples with rich diversity and high quality, using these samples to supplement the imbalanced dataset, the effect of imbalanced fault diagnosis has been substantially improved. This method can be used to solve the problem of fault diagnosis in the case of sample imbalance, which often exists in actual working conditions.
Wheel flat detection on railway vehicles using the angular domain synchronous averaging method: an experimental study
Authors: Zhou Yichang , Tian Qiuyong , Hecht Markus
Published: April 2023

Recently, composite brake blocks have been widely adopted in European railway systems to replace cast iron brake blocks in order to reduce braking noise. However, the poor heat dissipation of composite materials has caused more wheel tread damage, including wheel flats (WFs). The WF, as an undesirable tread defect in railway vehicles, can cause severe wheel/rail impact and increase the damage probability of wheelset components and track structures. Early detection of WFs is vital to ensure operational safety and reduced maintenance costs. In this work, to help understand the dynamic impact caused by WFs, a single WF with a length of 20 mm is artifically produced on a wheel of a tank wagon, and field experiments are performed. The influence of the WF on the axle box accelerations (ABAs), vertical accelerations of the bogie frame and vertical accelerations of the car body is discussed in the time and time-frequency domains. On the other hand, the angular domain synchronous averaging (ADSA) method is used to detect WFs by averaging the ABA signals in the angular domain over a fixed time interval, and it requires ABA data and the axle rotational speed as inputs. This method can greatly reduce the amount of measured data by averaging it in the angle domain and can eliminate the short-time influence of interference signals caused by switches and crossings, rail joints, and so on. The results show that the ADSA of a defective wheel with the WF has a clear peak with an amplitude of 21–104 m/s2 while that of a healthy wheel fluctuates around zero in the polar coordinate. Also, the waveform of defective signals can be well presented in polar coordinates. The effectiveness of this method is compared with the envelope spectrum technology in three scenarios and its application to three journeys is presented.
Crack identification using smart paint and machine learning
Authors: Quqa Said , Li Sijia , Shu Yening , Landi Luca , Loh Kenneth J
Published: April 2023

Information on the presence and location of cracks in civil structures can be precious to support operators in making decisions related to structural management and scheduling informed maintenance. This paper investigates the efficacy of supervised machine learning to solve the inverse electrical impedance tomography problem and to reconstruct the conductivity distribution of a piezoresistive sensing film. This film consists of a conductive paint applied onto structural components, and operators can use its conductivity distribution to identify crack sizes and locations in the underlying structure. A deep neural network is employed to reconstruct a dense conductivity distribution within the painted area by using only voltage measurements collected at sparse boundary locations. Since one of the most challenging aspects of using supervised learning tools for real-world applications is generating a representative training dataset, this paper presents a new approach to test the suitability of synthetic datasets built using a finite element model of the sensing film. Results are reported for four sensing specimens fabricated with two different techniques (i.e., using carbon nanotubes and graphene nanosheets, respectively). Crack-like damage is induced to the substrate of the sensing film and identified using the proposed machine learning technique. Promising results are obtained as compared to conventional methods.
The Value of Circulating Tumor Cells and Tumor Markers Detection in Lung Cancer Diagnosis
Authors: Guo Sumin , Chen Jingyu , Hu Po , Li Chen , Wang Xiang , Chen Ning , Sun Jiale , Wang Yongfeng , Wang Jianling , Gu Weikuan , Wu Shucai
Published: April 2023

Objective

Circulating tumor cells are complete tumor cells with multi-scale analysis values that present a high potential for lung cancer diagnosis. To enhance the accuracy of lung cancer diagnosis, we detected circulating tumor cells by the innovated conical micro filter integrated microfluidic system.

Methods

We recruited 45 subjects of study, including 22 lung cancer patients, 2 precancerous patients, the control group including 14 healthy participants, and 7 patients with lung benign lesions in this prospective study. We calculated the area under the receiver operating characteristic curve of circulating tumor cells, cytokeratin19 fragment, carcinoma embryonic antigen, squamous cell carcinoma, neuron-specific enolase, and their combination, respectively, while compared the circulating tumor cells levels between vein blood and arterial blood. A conical shape filter embedded in a microfluidic chip was used to improve the detection capability of circulating tumor cells.

Results

The study indicated that the sensitivity, specificity, positive predictive value, and negative predictive value of circulating tumor cells detection were 81.8%, 90.5%, 90.0%, and 82.6%, respectively. The circulating tumor cells level of lung cancer patient was significantly higher than that of the control group ( P < .05). The area under the curve of circulating tumor cells, cytokeratin19 fragment, carcinoma embryonic antigen, squamous cell carcinoma, and neuron-specific enolase alone was 0.838, 0.760, 0.705, 0.614, and 0.636, respectively. The combination area under the curve of the 4 tumor markers (cytokeratin19 fragment, carcinoma embryonic antigen, squamous cell carcinoma, and neuron-specific enolase) was 0.805 less than that of circulating tumor cells alone. Together, the total area under the curve of circulating tumor cell and the 4 tumor markers were 0.847, showing the highest area under the curve value among all biomarkers. In addition, this study found that there was no significant difference in positive rate of circulating tumor cell between arterial and venous blood samples.

Conclusion

The circulating tumor cells detection technology by conical micro filter integrated microfluidic could be used for lung cancer diagnosis with high sensitivity and specificity. Complementary combination of circulating tumor cells and conventional 4 lung cancer markers could enhance the clinical application accuracy. Venous blood should be used as a routine sample for circulating tumor cells detections.
Expression profiles of sporulation genes in multidrug-resistant Bacillus species isolated from intensive care units of Ghanaian hospital
Authors: Isawumi Abiola , Ayerakwa Eunice Ampadubea , Abban Molly Kukua , Mosi Lydia
Published: April 2023

Sporulating bacteria such as Bacillus spp. have contributed to severity of opportunistic hospital acquired infections, including postoperative wounds and respiratory tract infections. This study determines the expression profiles of sporulation markers in multidrug-resistant Bacillus spp. isolated from Ghanaian hospital environments. Antimicrobial resistance (AMR) profiles of the bacteria were determined with disk diffusion and broth microdilution. Primer-specific polymerase chain reaction (PCR) amplification was used to profile the sporulation markers, and quantitative reverse transcription polymerase chain reaction (RT-qPCR) was used for the expression of the sporulation markers at different antibiotic concentrations. The strains are multidrug resistant (70–100%) to at least two of the eight classes of the antibiotics tested including cephalosporins, penicillin, aminoglycosides, and glycopeptide. The strains showed different resistance patterns to all the tested antibiotics, which might indicate diverse resistance mechanisms. Common ( spoVK spoVE, spoJ, and sigF) and not commonly ( sigJ, soJ, yrbC, and yjcE) reported sporulation markers were detected in the strains. The study showed an association of the sporulation markers with AMR as indicated by their expression profiles.
Is Microethnography an Ethnographic Case Study? and/or a mini-ethnographic case study? An analysis of the literature
Authors: Bayeck Rebecca Y.
Published: April 2023

Selecting the research approach that addresses the research question is often challenging for novice researchers. However, getting a better understanding of the research approaches available in the field, is likely to help novice researchers identify and choose the research approach that fits their situation. In this paper, we discuss microethnography, ethnographic case study, and mini-ethnography case study in order to show that these approaches may have similarities but are different. The author hopes that this discussion will help researchers get a better understanding of these approaches and dissipate the confusion that may exist.
Knowledge, attitudes, and practices towards fetal alcohol spectrum disorder in the New Zealand social and community sector: An online survey
Authors: McCormack Jessica C. , Chu Joanna Ting Wai , Wilson Holly , Rahman Juma , Marsh Samantha , Bullen Chris
Published: April 2023

Background: Fetal Alcohol Spectrum Disorder (FASD) is a common neurodevelopmental disorder but may be underrecognized and misunderstood by people who provide health and social support services. The aim of the research is to understand the FASD knowledge, attitudes, and practices among people employed by the social and community sector in New Zealand. Methods: We conducted an online survey of people working in the New Zealand social and community sector (i.e., social workers, support workers). The survey focused on the following areas: awareness of FASD; knowledge and beliefs about FASD; the impact of FASD on professional practice; and training needs. Results: Most participants reported a basic understanding of FASD, however only 5% felt very well prepared to support someone with FASD. A large majority of participants believed that FASD diagnosis may be stigmatising for individuals or families. Conclusion: There is a need to improve training, professional development, and workplace support for social and community workers in New Zealand to support people with FASD.
Does animacy affect visual statistical learning? Revisiting the effects of selective attention and animacy on visual statistical learning
Authors: Cox Jolene A , Wu Yizhou , Aimola Davies Anne M
Published: April 2023

Animates receive preferential attentional processing over inanimates because, from an evolutionary perspective, animates are important to human survival. We investigated whether animacy affects visual statistical learning—the detection and extraction of regularities in visual information from our rich, dynamic, and complex environment. Participants completed a selective-attention task, in which regularities were embedded in two visual streams, an attended and an unattended visual stream. The attended visual stream always consisted of line-drawings of non-objects, while the unattended visual stream consisted of line-drawings of either animates or inanimates. Participants then completed a triplet-discrimination task, which assessed their ability to extract regularities from the attended and unattended visual streams. We also assessed participants’ awareness of regularities in the visual statistical learning task, and asked if any learning strategies were used. We were specifically interested in whether the animacy status of line-drawings in the unattended visual stream would affect visual statistical learning. There were four key findings. First, selective attention modulates visual statistical learning, with greater visual statistical learning for attended than for unattended information. Second, animacy does not affect visual statistical learning, with no differences found in visual statistical learning performance between the animate and inanimate condition. Third, awareness of regularities was associated with visual statistical learning of attended information. Fourth, participants used strategies (e.g., naming or labelling stimuli) during the visual statistical learning task. Further research is required to understand whether visual statistical learning is one of the adaptive functions that evolved from ancestral environments.
Validity and reliability of ergonauta encoder to assess countermovement jump performance
Authors: Gheller Rodrigo G , Kons Rafael L , Külkamp Wladymir , Dal Pupo Juliano , Detanico Daniele
Published: April 2023

This study aimed to test the reliability and criterion validity of the Ergonauta encoder to assess countermovement jump (CMJ) performance, considering jump height and mean propulsive velocity metrics. Twenty-three recreationally active men participated in this study. The participants were positioned on a force plate with the Ergonauta individually connected through a belt. Two CMJs were performed, and the jump height and mean propulsive velocity metrics were analyzed. The intraclass correlation coefficient (ICC) and typical error (TE) were used as relative and absolute reliability indicators, respectively. The Pearson correlation was used to verify the relationship between the Ergonauta and force plate derived-metrics, and the Bland-Altman plot was used to verify the agreement between the metrics ( Ergonauta encoder and force plate), with the level of significance set at p < 0.05. The results show excellent relative reliability for both metrics, considering the two evaluation devices (ICC = 0.95–0.99, TE = 1.02–2.46). The jump height and mean propulsive velocity obtained by the Ergonauta encoder and the force plate were strongly correlated ( r = 0.95; r = 0.90, respectively, p < 0.01). The Bland-Altman plot showed good agreement for both metrics (jump height and mean propulsive power) and equipment (close to 0). We concluded that the Ergonauta encoder is reliable and valid for assessing CMJ performance, particularly the jump height and mean propulsive velocity metrics.
Resilience correlates with patient-reported outcome measures at a minimum of 2 years after arthroscopic rotator cuff repair
Authors: Wilson Charlie D , Villamaria Luke J , Welling Benjamin D , Hammonds Kendall AP , Robin Brett N
Published: April 2023

Aims

We aimed to evaluate the correlation between preoperative and postoperative resilience scores and postoperative outcomes at minimum 2-year follow-up after arthroscopic rotator cuff repair.

Methods

We prospectively enrolled 98 patients who underwent rotator cuff repair. We assessed resilience using the Brief Resilience Scale. Postoperatively, we obtained patient-reported outcomes measures including American Society of Shoulder and Elbow Surgeons scores, Single Assessment Numeric Evaluation, and Patient-Reported Outcome Measurement Information System Global Health-10 at minimum 2-year follow-up. We used Spearman correlation coefficients ( r) to assess the relationship between variables.

Results

Ninety-one of 98 patients (93%) provided follow-up at an average of 32 months. Preoperative Brief Resilience Scale did not show a statistically significant correlation with American Society of Shoulder and Elbow Surgeons ( r = 0.156; p = 0.142). However, preoperative Brief Resilience Scale showed statistically significant correlations with Patient-Reported Outcome Measurement Information System Global Health-10 ( r = 0.290; p = 0.005) and Single Assessment Numeric Evaluation ( r = 0.259; p = 0.014). Postoperative Brief Resilience Scale showed statistically significant correlations with American Society of Shoulder and Elbow Surgeons ( r = 0.291; p = 0.005), Single Assessment Numeric Evaluation ( r = 0.384; p < 0.001) and Patient-Reported Outcome Measurement Information System Global Health-10 ( r = 0.515; p < 0.001).

Discussion

Resilience may be a valuable predictor of patients at risk of having suboptimal outcomes after rotator cuff repair and a target to improve surgical outcomes through non-surgical means.
Metal Hypersensitivity Following Total Ankle Arthroplasty: Case Series and Literature Review
Authors: Anastasio Albert T. , Balu Abhinav R. , Johnson Lindsey , Crook Bryan , Parekh Selene G.
Published: April 2023

Metal hypersensitivity following total ankle arthroplasty (TAA) is an underreported complication that can manifest as dermal, systematic, and orthopaedic-specific symptoms. It is critical to recognize that metal hypersensitivity is a diagnosis of exclusion; only after all other potential sources of failure, such as loosening or infection are ruled out, can this diagnosis be considered. Aside from imaging and common laboratory analysis, skin patch testing, leukocyte migration inhibition test (LMIT), and lymphocyte transformation test (LTT) are the testing options available for metal allergy. With regards to management of metal hypersensitivity, nonoperative modalities involving topical dermatological management are generally preferred. Severe cases of metal allergy may necessitate operative management consisting of explantation of the implant and either revision TAA with a custom hypoallergenic implant or conversion to an ankle fusion. We present 3 cases of presumed metal hypersensitivity following TAA. In all 3 cases, other forms of TAA failure were carefully ruled out. One patient underwent explantation and conversion to hypoallergenic implant, 1 patient underwent explantation and ankle arthrodesis with hypoallergenic hardware, and 1 patient elected for conservative care. In patients who underwent explantation and conversion to hypoallergenic hardware, no further symptoms associated with metal allergy were noted. Additional research is necessary to improve diagnostic accuracy of metal allergy and make treatment options more effective and accessible.

Level of Evidence: Retrospective case series, IV
Bolstering Policy Support for Disadvantaged Groups Through Humanization
Authors: Findor Andrej , Hruška Matej , Hlatky Roman , Dvorská Alexa , Hrustič Tomáš , Bošeľová Zuzana , Buchel Ondrej
Published: April 2023

Cooley et al. and Hodson and Doucher show that individuals, individuals within groups, and groups evoke different levels of perceived humanity, and that these differences affect sympathy and willingness to help. In three preregistered experiments, we successfully replicate these findings in a different cultural context (Slovakia). We then test whether manipulating these depictions also affects support for policies that benefit the target. We focus on a disadvantaged ethnic minority (the Roma). Finally, we investigate whether internal (under the beneficiary’s control) versus external attribution (outside of the beneficiary’s control) is a mitigating factor. We confirm individuals and group-compositions evoke higher levels of policy support than groups through increases in perceived humanity. However, this relationship only holds under conditions of external attribution. To humanize disadvantaged groups and bolster policy support, advocates should center their communicative messages around individuals rather than unitary groups and avoid stereotype-enforcing internal attributions.
Fortifying the algorithmic management provisions in the proposed Platform Work Directive
Authors: Veale Michael , Silberman Michael ‘Six’ , Binns Reuben
Published: April 2023

The European Commission proposed a Directive on Platform Work at the end of 2021. While much attention has been placed on its effort to address misclassification of the employed as self-employed, it also contains ambitious provisions for the regulation of the algorithmic management prevalent on these platforms. Overall, these provisions are well-drafted, yet they require extra scrutiny in light of the fierce lobbying and resistance they will likely encounter in the legislative process, in implementation and in enforcement. In this article, we place the proposal in its sociotechnical context, drawing upon wide cross-disciplinary scholarship to identify a range of tensions, potential misinterpretations, and perversions that should be pre-empted and guarded against at the earliest possible stage. These include improvements to ex ante and ex post algorithmic transparency; identifying and strengthening the standard against which human reviewers of algorithmic decisions review; anticipating challenges of representation and organising in complex platform contexts; creating realistic ambitions for digital worker communication channels; and accountably monitoring and evaluating impacts on workers while limiting data collection. We encourage legislators and regulators at both European and national levels to act to fortify these provisions in the negotiation of the Directive, its potential transposition, and in its enforcement.
Towards a rights-based approach: victims of violent crime, state-funded compensation and the European Union
Authors: O’Driscoll Liam
Published: April 2023

This article examines the legal provision of state compensation for victims of violent crime in the European Union (EU). In examining the provisions of Directive 2004/80/EC relating to compensation to crime victims, this article analyses the historical development of EU competencies in the fields of criminal justice and victims’ rights. Additionally, the legislative history of Directive 2004/80/EC is considered, as is the interpretation given to the provisions of this Directive by the Court of Justice of the EU. It is demonstrated that the scope of protection, offered to victims of violent crime through Directive 2004/80/EC, has been limited and uncertain as a result of this complicated legislative history and inconsistent CJEU interpretation. Furthermore, this article examines developments in the context of EU action in the field of state-funded compensation in light of the adoption of both the Lisbon Treaty in 2009 and the Victims’ Rights Directive in 2012. With the recent development of a genuine rights-based approach to victim support in EU law and policy, this article highlights priorities for legal reform at the EU level in the context of state-funded compensation.
Ovarian serous borderline tumor with mural nodules of anaplastic carcinoma and omental involvement: A case report
Authors: Hernandez Acevedo Paula I , Carter Gloria J , Courtney-Brooks Madeleine , Clark Beth Z
Published: April 2023

Mural nodules are rarely identified in cystic ovarian neoplasms, and have been categorized into sarcoma-like, sarcomatous, and anaplastic carcinomatous types. Most reports of these mural nodules have been described in mucinous ovarian tumors. In this case report, we describe an ovarian serous borderline tumor with mural nodules composed of high-grade carcinoma with anaplastic features and necrosis, including the morphologic features, immunoprofile, and results of tumor DNA sequencing. Omental involvement was also identified. Recognition of this phenomenon in serous tumors is important, so that thickened areas of cyst wall in ovarian serous tumors will be thoroughly examined.
Temporal processing deficit in children and adolescents with autism spectrum disorder: An online assessment
Authors: Chan Agnes S. , Ding Zihan , Lee Tsz-lok , Sze Sophia L. , Cheung Mei-Chun
Published: April 2023

Objective

The sensory deficit has been considered as one of the core features in children and adolescents with autism spectrum disorder (ASD). The present study aimed to examine the temporal processing of simple and more complex auditory inputs in ASD children and adolescents with an online assessment that can be conducted remotely.

Methods

One hundred fifty-eight children and adolescents aged 5–17 years participated in this study, including 79 ASD participants and 79 typically developing (TD) participants. The online assessment consisted of two temporal-order judgment tasks that required repeating the sequence of two pure tones or consonant–vowel (CV) syllabic pairs at varying interstimulus intervals (ISIs).

Results

Significantly lower accuracy rates were found in ASD than TD participants in the pure tone and the CV conditions with both short and long ISI. In addition, ASD participants ( M  =  245.97 ms) showed a significantly higher passing threshold than TD participants ( M  =  178.84 ms) in the CV task. Receiver operating characteristic analysis found that the age × ISI passing threshold composite yielded a sensitivity of 74.7% and a specificity of 50.6% at the cutoff point of −0.307 in differentiating ASD participants from TD participants.

Conclusion

In sum, children and adolescents with ASD showed impaired temporal processing of both simple and more complex auditory stimuli, and the online assessment seems to be sensitive in differentiating individuals with ASD from those with TD.
Understanding, Evaluating, and Promoting the Development of Argumentative Competence: An Interview With Dr. Deanna Kuhn From Teachers College, Columbia University
Authors: Song (宋郁) Yu , Shi (石雨晨) Yuchen
Published: April 2023

Purpose

The purpose of this study is to promote the understanding of the nature, development, and evaluation of argumentative competence so that teachers can feel more confident about incorporating argumentative activities into their teaching practices and assess and cultivate students’ argumentative competencies more effectively.

Design/Approach/Methods

The authors invited Dr. Deanna Kuhn to elaborate on her research findings and theoretical underpinnings regarding her 30 years of research that combined educational, psychological, and philosophical perspectives to conduct argumentation studies.

Findings

She asserted that argument should be studied not only as an individual skill but also as a social and cultural practice. She promoted the dialogic argumentation approach as a pathway for developing argumentative competence. She also emphasized that an integrated framework that links the cognitive, metacognitive, epistemological, and affective aspects of argumentative competence holds great promise to advance not only the theoretical study of argumentation but also the related empirical research, classroom practices, and evaluation reforms.

Originality/Value

Dr. Kuhn clarified key issues regarding the nature and development of argumentative competencies and elaborated on the values and implementations of the dialogic argumentation approach across cultures. She suggested that future researchers should study argumentation within a more integrative framework.
Disruptions in Standard Care in Patients After Arthroscopic Rotator Cuff Repair During the COVID-19 Pandemic
Authors: Lee Donghoon , Destine Henson , Gibbs Brian S. , Lencer Adam J. , Paul Ryan W. , Palm Justin , Tjoumakaris Fotios P.
Published: April 2023

Background:

The coronavirus disease–2019 (COVID-19) pandemic led to disruptions in care for orthopaedic patients who underwent surgery just before the outbreak, rendering some unable to participate in standard postoperative care. Many of these patients underwent clinical follow-up and physical therapy via telehealth.

Purpose:

To evaluate the methods of postoperative care in patients who underwent arthroscopic rotator cuff repair (RCR) and had follow-ups during the height of the pandemic versus those who received prior standard of care. We aimed to compare the 1-year outcomes between these cohorts.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

A retrospective chart review was used to identify patients who underwent primary RCR in February and March 2020 (COVID cohort) and the same period in 2019 (control cohort) at a single institution. Excluded were patients who underwent revision RCR, used workers’ compensation, or were incarcerated or deceased. The included patients reported the postoperative care received, their satisfaction with care, physical therapy appointment type (in person, home based, telehealth, or self-guided), satisfaction with physical therapy, and minimum 1-year postoperative American Shoulder and Elbow Surgeons (ASES), Single Assessment Numeric Evaluation (SANE), and Penn Shoulder Score (PSS) outcomes.

Results:

Overall, 428 patients were included for final analysis—–199 in the COVID cohort and 229 controls. Follow-up data were collected for 160 patients in the COVID group (80.4%) and 169 control patients (73.8%). In the COVID group, 110 patients (68.8%) had ≥1 clinical visit conducted via telehealth, compared with zero in the control group. There were no differences between the COVID and control groups in the ASES (84.2 ± 16.5 vs 86.5 ± 17; P = .27 ), SANE (83.9 ± 15.4 vs 84.8 ± 17.5; P = .66), PSS (84.8 ± 15.3 vs 87.1 ± 15.1; P = .22), or patient satisfaction with the care received (81.7 ± 22.6 vs 86.3 ± 23.5; P = .09). Satisfaction with physical therapy was significantly higher in the control group (88.3 ± 18.9 vs 81.9 ± 22.5; P = .01).

Conclusion:

Despite disruptions in care, RCR patients had comparable 1-year outcomes during the pandemic versus before the pandemic. Telehealth clinical follow-up appointments did not adversely affect patient-reported outcome measures and may be appropriate for RCR patients beyond the pandemic.
Clinical and Magnetic Resonance Imaging Outcomes After Human Cord Blood–Derived Mesenchymal Stem Cell Implantation for Chondral Defects of the Knee
Authors: Song Jun-Seob , Hong Ki-Taek , Kim Na-Min , Hwangbo Byung-Hun , Yang Bong-Seok , Victoroff Brian N. , Choi Nam-Hong
Published: April 2023

Background:

There is a paucity of literature reporting clinical and magnetic resonance imaging (MRI) outcomes after allogeneic umbilical cord blood–derived mesenchymal stem cell (UCB-MSC) implantation for chondral defects of the knee.

Purpose:

To report clinical and MRI outcomes after UCB-MSC implantation for chondral lesions of the knee.

Study Design:

Case series; Level of evidence, 4.

Methods:

Inclusion criteria were patients aged between 40 and 70 years with focal chondral lesions of grade 3 or 4 on the medial femoral condyle, defect sizes >4 cm2, and intact ligaments. Exclusion criteria were patients who required realignment osteotomy or who had a meniscal deficiency, ligamentous instability, or a concomitant full-thickness chondral defect in the lateral or patellofemoral compartment. A mixture of human UCB-MSCs and sodium hyaluronate was implanted into the chondral defect through mini-arthrotomy. MRI at 1-year follow-up was performed to evaluate repaired cartilage hypertrophy. Repaired cartilage thickness was measured, and hypertrophy was classified as grade 1 (<125%), grade 2 (<150%), or grade 3 (<200%). Patient-reported outcomes (PROs; International Knee Documentation Committee, visual analog scale for pain, and Western Ontario and McMaster Universities Osteoarthritis Index) were evaluated preoperatively and at 1, 2, and 3 years postoperatively. Repaired cartilage hypertrophy was evaluated for a correlation with PRO scores.

Results:

Enrolled were 85 patients with a mean age of 56.8 ± 6.1 years and a mean chondral defect size of 6.7 ± 2.0 cm2. At follow-up, a significant improvement in all PRO scores was seen compared with preoperatively ( P < .001 for all). MRI at 1-year follow-up demonstrated that 28 patients had grade 1 repaired cartilage hypertrophy, 41 patients had grade 2, and 16 patients had grade 3. MRI performed in 11 patients at 2 years after surgery indicated no difference in repaired cartilage hypertrophy between the 1- and 2-year time points. The grade of repaired cartilage hypertrophy did not correlate with PRO scores.

Conclusion:

Clinical outcomes improved significantly at short-term follow-up after UCB-MSC implantation. Although all patients showed repaired cartilage hypertrophy, it did not correlate with clinical outcomes.
An Innovative Undergraduate Medical Curriculum Using Entrustable Professional Activities
Authors: Bremer Anne E , van de Pol Marjolein H J , Laan Roland F J M , Fluit Cornelia R M G
Published: April 2023

The need to educate medical professionals in changing medical organizations has led to a revision of the Radboudumc's undergraduate medical curriculum. Entrustable professional activities (EPAs) were used as a learning tool to support participation and encourage feedback-seeking behavior, in order to offer students the best opportunities for growth. This paper describes the development of the Radboudumc's EPA-based Master's curriculum and how EPAs can facilitate continuity in learning in the clerkships. Four guiding principles were used to create a curriculum that offers possibilities for the students’ development: (1) working with EPAs, (2) establishing entrustment, (3) providing continuity in learning, and (4) organizing smooth transitions. The new curriculum was designed with the implementation of EPAs and an e-portfolio, based on these 4 principles. The authors found that the revised curriculum corresponds to daily practice in clerkships. Students used their e-portfolios throughout all clerkships, which stimulates feedback-seeking behavior. Moreover, EPAs promote continuity in learning while rotating clerkships every 1 to 2 months. This might encourage curriculum developers to use EPAs when aiming for greater continuity in the development of students. Future research needs to focus on the effect of EPAs on transitions across clerkships in order to further improve the undergraduate medical curriculum.
Hyperuricemia in a patient with Waldenström’s Macroglobulinemia: An innocent bystander?
Authors: Smith Zachary , Goyal Pankaj , Pandya Vrajesh , Thakar Charuhas V , Gudsoorkar Prakash S
Published: April 2023

Background:

Paraproteins often cause factitious biochemical measurements by forming opaque precipitates with the test reagents and interfering with various automated assays. These interferences may be difficult to anticipate as they are intermittent and patient-specific. Increased IgM has been shown to result in the underestimation of uric acid levels and pseudo-hypouricemia; however, there are no reported cases of pseudo-hyperuricemia in the setting of paraproteinemia.

Case presentation:

We present a case of Waldenström’s Macroglobulinemia (WM), resulting in a marked elevation of the uric acid level in the absence of tumor lysis syndrome (TLS). On evaluation, it was noted that the elevation in the uric acid levels was spurious, potentially due to high IgM levels resulting in increased serum viscosity. Identifying actual and pseudo-abnormal laboratory results is critical to guide further workup and conserve scarce healthcare resources. The absence of other concomitant laboratory abnormalities and clinical symptoms should raise a suspicion of factitious results. In addition to uric acid, many other assays are affected by paraproteinemia, commonly including electrolytes, lipids, glucose, and liver function tests.
Emerging roles and opportunities for rare disease patient advocacy groups
Authors: Patterson Amy M. , O’Boyle Megan , VanNoy Grace E. , Dies Kira A.
Published: April 2023

Background:

Patient advocacy groups (PAGs) serve a vital role for rare disease patients and families by providing educational resources, support, and a sense of community. Motivated by patient need, PAGs are increasingly at the forefront of policy, research, and drug development for their disease of interest.

Objectives:

The study explored the current landscape of PAGs in order to guide new and existing PAGs on available resources and challenges to research engagement. We aim to inform industry, advocates, and healthcare personnel about PAG achievements and ways they are increasingly involved in research.

Design:

We chose PAGs from the Rare Diseases Clinical Research Network (RDCRN) Coalition for Patient Advocacy Groups (CPAG) listserv and the National Organization for Rare Disorders (NORD) ‘Find a patient organization’.

Methods:

We surveyed eligible PAG leaders about the demographics, goals, and research activities of their organization. For analysis, PAGs were bucketed by size, age, prevalence of disease, and budget. Data were de-identified for cross-tabulation and multinomial logistic regression analysis with R.

Results:

Research engagement was an extremely important goal for most PAGs (81%), though ultra-rare disease and high-budget PAGs were most likely to cite it as the top priority. In total, 79% reported research engagement in some capacity, including registries, translational research, and clinical trials. ‘Ultra-rare’ PAGs were less likely than ‘rare’ PAGs to have an ongoing clinical trial.

Conclusion:

While PAGs of varying sizes, budgets, and maturity levels reported an interest in research, limited funding and lack of disease awareness continue to create barriers to achieving their goals. While support tools exist to make research more accessible, often their utility depends on the funding, sustainability, maturity of the PAG itself, and the level of investment of collaborators. Despite the availability of current support systems, there are challenges related to both the start-up and sustainability of patient-centric research efforts.
Problems with quantitative categorization: An argument for qualitative approaches
Authors: Martin Michael E , Swanlund David , Schuurman Nadine
Published: April 2023

As data science gains traction, it often brings quantitative approaches and positivist epistemologies. While these can generate powerful insights, we argue for methodological hybridity in modern data science. We demonstrate the power of complementary qualitative approaches and flexible ontologies. Using an example of classifying segments™ on Strava, neither quantitative nor qualitative approaches alone were adequate to meaningfully classify segments, but together allowed accurate, useful, and intuitive categories to emerge. Drawing on this experience, we discuss qualitative data science and argue the ontological discussions within Critical GIS from the 1990s and 2000s are increasingly relevant and informative amidst our platial paradigms.
Collaborative projection and the twin ecstasies of DIY cineworlding
Authors: MacDonald Michael B.
Published: April 2023

The notion that ethnographic practice needs to be normative in order to be rigorous is problematic, especially when the partners in that research are producing experimental and resistant DIY cultures. Nonnormative ethnographers are “activist” in their critical engagement with dominant regimes of truth and must contend with digital disruption and platform capitalism that has vastly expanded DIY production. It is no longer possible to identify DIY culture with self-production because digital self-production is simply demanded for the “digital citizenship” of platform capitalism. In this article, the psychoanalytic concept of projection is turned upside down and understood as a socially performed digital-bodying that worlds. The screen becomes a location of dissensus, projecting the ecstatic truth of Modern/capitalist worldings or Altermodern/anti-capitalist worldings. Cinematic research-creation, CineWorlding, is an activist cinematic posthumanographic study of the interstices that infold concepts, bodies, social, technological, and environmental ecologies into worldings.
4-Octyl itaconate attenuates LPS-induced acute kidney injury by activating Nrf2 and inhibiting STAT3 signaling
Authors: Xu Lujun , Cai Juan , Li Chenrui , Yang Ming , Duan Tongyue , Zhao Qing , Xi Yiyun , Sun Liya , He Liyu , Tang Chengyuan , Sun Lin
Published: April 2023

Background

Septic acute kidney injury (S-AKI) is the leading form of acute kidney failure among hospitalized patients, and the inflammatory response is involved in this process. 4-octyl itaconate (4-OI) is a multi-target itaconate derivative with potent anti-inflammatory action. However, it remains elusive whether and how 4-OI contributes to the regulation of S-AKI.

Methods

We employed a lipopolysaccharide (LPS)-induced AKI murine model and explored the potential renoprotective effect of 4-OI in vivo. In vitro experiments, BUMPT cells, a murine renal tubular cell line, were conducted to examine the effects of 4-OI on inflammation, oxidative stress, and mitophagy. Moreover, STAT3 plasmid was transfected in BUMPT cells to investigate the role of STAT3 signaling in the 4-OI-administrated state.

Results

We demonstrate that 4-OI protects against S-AKI through suppressing inflammation and oxidative stress and enhancing mitophagy. 4-OI significantly reduced the levels of Scr, BUN, Ngal as well as the tubular injury in LPS-induced AKI mice. 4-OI restrained inflammation by reducing macrophage infiltration and suppressing the expression of IL-1β and NLRP3 in the septic kidney. 4-OI also reduced ROS levels, as well as cleaved caspase-3 and boosted antioxidants such as HO-1, and NQO1 in mice. In addition, the 4-OI treatment significantly promoted mitophagy. Mechanistically, 4-OI activated Nrf2 signaling and suppressed phosphorylated STAT3 in vivo and vitro. Molecular docking revealed the binding affinity of 4-OI towards STAT3. ML385, a specific Nrf2 inhibitor, partially repressed the anti-inflammatory and anti-oxidative effects of 4-OI and partially restricted the mitophagy induced by 4-OI in vivo and in vitro. Transfected with STAT3 plasmid partially suppressed mitophagy and the anti-inflammatory effect provoked by 4-OI in vitro.

Conclusion

These data suggest that 4-OI ameliorates LPS-induced AKI by suppressing inflammation and oxidative stress and enhancing mitophagy through the overactivation of the Nrf2 signaling pathway, and inactivation of STAT3. Our study identifies 4-OI as a promising pharmacologic for S-AKI.
ATF5 regulates tubulointerstitial injury in diabetic kidney disease via mitochondrial unfolded protein response
Authors: Liu Yifei , Zhang Lei , Zhang Shumin , Liu Jialu , Li Xiaohui , Yang Kexin , Yang Danyi , Liu Yu , Sun Lin , Liu Fuyou , Xiao Li
Published: April 2023

Background

Mitochondrial quality control (MQC) plays a critical role in the progression of tubulointerstitial injury in diabetic kidney disease (DKD). The mitochondrial unfolded protein response (UPRmt), which is an important MQC process, is activated to maintain mitochondrial protein homeostasis in response to mitochondrial stress. Activating transcription factor 5 (ATF5) is critical in the mammalian UPRmt via mitochondria-nuclear translocation. However, the role of ATF5 and UPRmt in tubular injury under DKD conditions is unknown.

Methods

ATF5 and UPRmt-related proteins including heat shock protein 60 (HSP60) and Lon peptidase 1 (LONP1), in DKD patients and db/db mice were examined by immunohistochemistry (IHC) and western blot analysis. Eight-week-old db/db mice were injected with ATF5-shRNA lentiviruses via the tail vein, and a negative lentivirus was used as a control. The mice were euthanized at 12 weeks, and dihydroethidium (DHE) and TdT-mediated dUTP nick end labeling (TUNEL) assays were performed to evaluate reactive oxygen species (ROS) production and apoptosis in kidney sections, respectively. In vitro, ATF5-siRNA, ATF5 overexpression plasmids or HSP60-siRNA were transfected into HK-2 cells to evaluate the effect of ATF5 and HSP60 on tubular injury under ambient hyperglycemic conditions. Mitochondrial superoxide (MitoSOX) staining was used to gauge mitochondrial oxidative stress levels, and the early stage of cell apoptosis was examined by Annexin V-FITC kits.

Results

Increased ATF5, HSP60 and LONP1 expression was observed in the kidney tissue of DKD patients and db/db mice and was tightly correlated with tubular damage. The inhibition of HSP60 and LONP1, improvements in serum creatinine, tubulointerstitial fibrosis and apoptosis were observed in db/db mice treated with lentiviruses carrying ATF5 shRNA. In vitro, the expression of ATF5 was increased in HK-2 cells exposed to high glucose (HG) in a time-dependent manner, which was accompanied by the overexpression of HSP60, fibronectin (FN) and cleaved-caspase3 (C-CAS3). ATF5-siRNA transfection inhibited the expression of HSP60 and LONP1, which was accompanied by reduced oxidative stress and apoptosis in HK-2 cells exposed to sustained exogenous high glucose. ATF5 overexpression exacerbated these impairments. HSP60-siRNA transfection blocked the effect of ATF5 on HK-2 cells exposed to continuous HG treatment. Interestingly, ATF5 inhibition exacerbated mitochondrial ROS levels and apoptosis in HK-2 cells in the early period of HG intervention (6 h).

Conclusions

ATF5 could exert a protective effect in a very early stage but promoted tubulointerstitial injury by regulating HSP60 and the UPRmt pathway under DKD conditions, providing a potential target for the prevention of DKD progression.