bluuebunny/crossref_metadata_2025 huggingface dataset:
Construct validity, responsiveness, and interpretability of the Utrecht Scale for Evaluation of Rehabilitation (USER) in patients admitted to inpatient geriatric rehabilitation
Authors: de Waal Margot W M , Jansen Michael , Bakker Loes M , Doornebosch Arno J , Wattel Elizabeth M , Visser Dennis , Smit Ewout B
Published: September 2023

Objective

The Utrecht Scale for Evaluation of Rehabilitation is a multi-domain measurement with good content validity, structural validity and reliability for measuring physical functioning (mobility, selfcare) and cognitive functioning in geriatric rehabilitation. We aimed to determine the construct validity of both Utrecht Scale for Evaluation of Rehabilitation scales and the responsiveness and interpretability of the scale for physical functioning in geriatric rehabilitation.

Design

Prospective follow-up study embedded in routine care.

Setting

Four care organisations in The Netherlands.

Subjects

Patients admitted for inpatient geriatric rehabilitation (2021–2022).

Main measures

Data collection included the Utrecht Scale for Evaluation of Rehabilitation, Mini-Mental State Examination, Barthel index, and a global rating scale anchor on recovery. Hypothesis testing was used to determine construct validity and responsiveness. For interpretability, minimal important change and floor and ceiling effects were determined.

Results

The mean age of participants ( n = 211) was 77 (SD 10.4). Their mean length of stay was 38.6 days (SD 26.3), and 81% returned home. The Utrecht Scale for Evaluation of Rehabilitation showed adequate construct validity, as all three hypotheses were confirmed for both scales. The Utrecht Scale for Evaluation of Rehabilitation-physical function scale showed adequate responsiveness, with all five hypotheses confirmed. The mean change for physical function (scale range 0–70) was 15.5 points (SD 17.1). The minimal important change for Utrecht Scale for Evaluation of Rehabilitation-physical function was 14.5 points difference for improvement. This scale showed no floor (2%) and ceiling effects (14%) at admission and discharge.

Conclusions

The Utrecht Scale for Evaluation of Rehabilitation showed to be effective for evaluating physical functioning during geriatric rehabilitation as well as screening cognitive functioning. In total, 14.5 points difference has been established as a minimal important change for physical functioning.
Patient characteristics and disease spectrum in a German vascular anomalies center
Authors: Strübing Felix , Laurich Annette , Weiss Christel , Kneser Ulrich , Schoenberg Stefan , Sadick Maliha
Published: September 2023

Background

Vascular malformations are rare diseases that should be treated in dedicated vascular anomaly centers (VAC). There is only a small amount of data on the diagnostic and therapeutic handling of these patients, before they are referred to a VAC.

Purpose

To demonstrate the disease-specific patient characteristics in a German VAC, which are required to determine diagnostic and therapeutic steps.

Material and Methods

In a retrospective study, all patients who were treated in the VAC from April 2014 until August 2021 were identified. In total, 593 patients were included in this study.

Results

Almost all patients had previously consulted a physician (591/593, 99.7%). A mean of two different physicians had been consulted (range 0–10). Patients with more complex, syndromal vascular malformations had significantly more previous appointments ( P = 0.0018). In only 44% (261/593) of patients, the referral diagnosis was made correctly. Most patients had been previously treated for their vascular anomaly: pharmacotherapy (n = 130; 21.9%), compression garments (n = 141; 23.8%), surgical resection (n = 80; 17.3%) and sclerotherapy (n = 68; 11.5%). Fifty-two patients who had been falsely diagnosed had also received therapy prior to their referral to the VAC (8.8%). Most patients received an ultrasound examination in the VAC (n = 464; 78.2%). Most frequently, compression therapy was prescribed (n = 256; 43.2%), followed by sclerotherapy (n = 175, 29.5%) and pharmacotherapy (n = 55; 9.3%).

Conclusion

Patients suffering from vascular anomalies often go through a complicated scheduling with numerous outpatient appointments and have a high risk of misdiagnosis and mistreatment prolonging the medical condition. Therefore, patients with vascular anomalies should be treated in a dedicated vascular anomaly center.
Sticky substance with sticky power: Oil in global production and financial networks
Authors: Grote Michael , Wojcik Dariusz , Zook Matthew
Published: September 2023

To analyse oil, the world’s most traded commodity, we combine Global Production Network (GPN) and Global Financial Network (GFN) approaches into the Global Production and Financial Network (GPFN). The combination offers a dynamic framework, as key actors and geographies in the GPFN change over time. It brings together the production and financial strands of research on oil and overcomes the physical reality v. financial fiction dichotomy in literature. Using a wide range of data on oil networks, prices, historical accounts, as well as industry, media and policy reports, we apply the GPFN to explain the evolution of oil networks, since their inception, as well as the mid- and short-term price anomalies since 2010. Our history of oil GPFN demonstrates the stability of its analytical categories and the stickiness of power wielded by some actors and geographies, while others come and go. Our account of price anomalies shows the inseparability of physical and financial factors in explaining them. As whole the GFPN is an opportunity to understand the evolving broad structures, distribution of power and price formation in markets, and as such represents a way forward for studying other products and sectors.
Law’s place in economic geography: Time, space, and methods
Authors: Potts Shaina
Published: September 2023

In this piece, I make the case for deeper engagement with law and legal methodologies in economic geography. Recent work in and beyond geography has demonstrated that law is constitutive of capitalism. Yet, despite excellent research on many particular spatio-legal topics, there have been few attempts to conceptualize a legal approach to economic geography in any sustained way. Here, I suggest that incorporating law and legal methodologies into existing economic geographic analyses can deepen our explanations of spatio-temporal economic variegation, opening up new research questions and methods for economic geographers and expanding our conceptions of economic governance, agency, and knowledge.
Meniscal Fibrocartilage Repair Based on Developmental Characteristics: A Proof-of-Concept Study
Authors: Yan Wenqiang , Zhu Jingxian , Wu Yue , Wang Yiqun , Du Cancan , Cheng Jin , Hu Xiaoqing , Ao Yingfang
Published: September 2023

Background:

Unlike the adult meniscus, the fetal meniscus possesses robust healing capacity. The dense and stiff matrix of the adult meniscus provides a biophysical barrier for cell migration, which is not present in the fetal meniscus. Inspired by developmental characteristics, modifying the matrix of the adult meniscus into a fetal-like, loose and soft microenvironment holds opportunity to facilitate repair, especially in the avascular zone.

Hypothesis:

Modifying the dense and stiff matrix of the adult meniscus into a fetal-like, loose and soft microenvironment could enhance cell migration to the tear interface and subsequent robust healing capacity.

Study Design:

Controlled laboratory study.

Methods:

Fresh porcine menisci were treated with hyaluronidase or collagenase. The density and arrangement of collagen fibers were assessed. The degradation of proteoglycans and collagen was evaluated histologically. Cell migration within the meniscus or the infiltration of exogenous cells into the meniscus was examined. Dendritic silica nanoparticles with relatively large pores were used to encapsulate hyaluronidase for rapid release. Mesoporous silica nanoparticles with relatively small pores were used to encapsulate transforming growth factor–beta 3 (TGF-β3) for slow release. A total of 24 mature male rabbits were included. A longitudinal vertical tear (0.5 cm in length) was prepared in the avascular zone of the medial meniscus. The tear was repaired with suture, repaired with suture in addition to blank silica nanoparticles, or repaired with suture in addition to silica nanoparticles releasing hyaluronidase and TGF-β3. Animals were sacrificed at 12 months postoperatively. Meniscal repair was evaluated macroscopically and histologically.

Results:

The gaps between collagen bundles increased after hyaluronidase treatment, while collagenase treatment resulted in collagen disruption. Proteoglycans degraded after hyaluronidase treatment in a dose-dependent manner, but collagen integrity was maintained. Hyaluronidase treatment enhanced the migration and infiltration of cells within meniscal tissue. Last, the application of fibrin gel and the delivery system of silica nanoparticles encapsulating hyaluronidase and TGF-β3 enhanced meniscal repair responses in an orthotopic longitudinal vertical tear model.

Conclusion:

The gradient release of hyaluronidase and TGF-β3 removed biophysical barriers for cell migration, creating a fetal-like, loose and soft microenvironment, and enhanced the fibrochondrogenic phenotype of reparative cells, facilitating the synthesis of matrix and tissue integration.

Clinical Relevance:

Modifying the adult matrix into a fetal-like, loose and soft microenvironment via the local gradient release of hyaluronidase and TGF-β3 enhanced the healing capacity of the meniscus.
Stress Symptoms Among Children and Their Parents After ICU Hospitalization
Authors: Daughtrey Hannah R. , Lee Justin , Boothroyd Derek B. , Burnside Georgiana M. , Shaw Richard J. , Anand Kanwaljeet J.S. , Sanders Lee M.
Published: September 2023

Objective: Child survival after intensive care unit (ICU) hospitalization has increased, yet many children experience acute stress that may precipitate mental/behavioral health comorbidities. Parents report stress after their child's hospitalization. Little is known about the individual and family characteristics that may moderate intergenerational relationships of acute stress. Design: Following ICU admission at a large academic medical center, a prospective cross-sectional cohort study assessed the associations between intergenerational characteristics and acute stress among children and families. Patients: Parent–child dyads ( N = 88) were recruited from the pediatric ICU and pediatric cardiovascular ICU (CVICU) following ICU discharge. Eligible children were between 8 and 18 years old with ICU stays longer than 24 hours. Children with developmental delays were excluded. Caregivers were proficient in English or Spanish. Surveys were collected before hospital discharge. Measurements/Main Results: The primary outcome was “child stress” defined as a score≥17, measured by the Children's Revised Impact of Events Scale (CRIES-8). “Parent stress” was defined as an elevated composite score on the Stanford Acute Stress Reaction Questionnaire. We used validated scales to assess the child's clinical and family social characteristics. Acute stress was identified in 34 (39.8%) children and 50 (56.8%) parents. In multivariate linear regression analyses adjusting for social characteristics, parent stress was associated with increased risk of child stress (adjusted odds ratio 2.58, 95% confidence interval 0.69, 4.46, p < .01). In unadjusted analyses, Hispanic ethnicity was associated with greater child stress. In adjusted analyses, race, income, ICU length of stay, and language were not associated with child stress and did not moderate the parent–child stress relationship. Conclusions: Parent stress is closely correlated with child stress during ICU hospitalization. Hispanic ethnicity may be associated with increased risk for child stress, but further studies are required to define the roles of other social and clinical measures.
Pre-clinical characterization of a novel flexible surface stem design for total knee replacements
Authors: Sass Jan-Oliver , Hembus Jessica , Fuhrmann Erik , Vogel Danny , Bauer Eckhard , Link Helmut Detlef , Bader Rainer
Published: September 2023

Primary stability is crucial for implant osseointegration and the long-term stability of cementless total joint replacements. Biomechanical studies have shown the potential of femoral stems for total knee replacements to reduce micromotions at the bone-implant interface. However, approaches such as focusing on the structural elasticity of the femoral stems are rarely described. Three groups with different femoral stem designs were investigated: group 1: flexible surface stem, group 2: flexible surface stem with open-porous structured lamellas, and group 3: solid stem (reference). The stems were implanted into bone substitute material and dynamically loaded for 1000 cycles. Relative movement and subsidence were measured optically, and axial pull-out forces were determined after dynamic testing. Relative movements increased to 0.10 mm (groups 1 and 2) compared to 0.03 mm (group 3). Subsidence increased to 0.08 mm (group 1) and 0.11 mm (group 2) compared to 0.06 mm (group 3). For each group, subsidence mainly occurred during the first 500 cycles. A similar convergence was observed in the further course. Pull-out forces increased to 1815.0 N (group 1) and 1347.1 N (group 2) compared to 1306.4 N (group 3). The flexible surface stem design resulted in higher relative movements and subsidence, but also exhibited increased pull-out forces. The relative movements were below the critical limit of 0.15 mm and represent a superposition of the elastic deformations of the interacting implant components as well as the micromotion at the bone-implant interface. Therefore, the novel flexible surface stem design appears to offer promising primary implant fixation.
Sentiment Analysis Using Machine Learning in Stock Market: A Bibliometric Visualization
Authors: Shivani  , Bodla Bhag Singh
Published: September 2023

Sentiments, opinions and emotions are considered as the basis for various kinds of analysis and anticipations. Sentiment analysis as a concept of generating the polarity from written, visual and verbal content is burgeoning in the advanced technological era. The article aims to carry out a bibliometric visualization study that reviews the current status, worldwide collaboration, evolution and potential emergence of machine learning-based sentiment analysis in the area of financial market along with several other themes. A corpus of 610 research publications from the Web of Science database during 2008–2022 is the base for depicting the contribution of eminent authors, journals, countries and research themes. Outcomes of the study reveal the wide scope of the ‘Sentiment Analysis’ theme in the existing research world along with providing a direction for future studies which may embed several advanced topics. The theme-related publications are segmented into four clusters where the ‘sentiment analysis and predictions using machine learning’ reflects the future emergence with existing growth. This concept has widely spread in India, China and the USA. Potential researchers can implement this concept in the stock market and financial predictions, sarcasm detection and behavioural mapping as major contributions to the firms’ effective decisions.
Ponicidin Induces Apoptosis and Inhibits Tumor Growth in C666-1 Nasopharyngeal Cancer Cells
Authors: Shen Yuanfeng , Zhang Lu , Hou Aihui , Suresh Kaviya , Balu Anbarasan , Gong Zhe
Published: September 2023

Background

Nasopharyngeal carcinoma (NPC), predominant in Southern China and Southeast Asia, is a malignant tumor that arises from the epithelial lining of the nasopharynx. Current NPC treatments result in unfavorable side effects. Natural compounds with anti-proliferative capabilities are gaining popularity as a way to mitigate the toxicity of radiation and synthetic antitumor drugs. Ponicidin, an ent-kaurane diterpenoid, has been demonstrated to possess several pharmacological activities, including antitumor, antibacterial, immunoregulatory, antiviral, and anti-inflammatory properties.

Materials and Methods

In the current investigation, the anti-carcinogenic activity of Ponicidin against nasopharyngeal cell line C666-1, has been investigated. The influence of Ponicidin on cell viability, apoptotic induction, mitochondrial membrane potential (MMP), reactive oxygen species (ROS) generation, and apoptotic markers has been examined. Doxorubicin was selected as the positive control for the experiments.

Results

The effect of Ponicidin on the viability of C666-1 cells revealed that its cytotoxic potential increased in a dose-dependent pattern and the optimum concentration chosen for further experiments was 7.5 µM. The Ponicidin-treated cells demonstrated a significant increase in the amount of TBARS, whereas it reduced the activity of superoxide dismutase (SOD) and glutathione (GSH) levels, indicating augmented oxidative stress and lower antioxidant activity in the C666-1 cells. The acridine orange/ethidium bromide (AO/EtBr) staining technique was used to assess morphological changes with respect to apoptosis, which confirmed its apoptotic nature. Furthermore, Ponicidin elevated the ROS generation, modified the mitochondrial membrane permeability, elevated the apoptotic marker levels (caspase-3, caspase-9, and Bax) and reduced the Bcl-2 expression in C666-1 cell lines.

Conclusion

The findings suggest that Ponicidin successfully inhibited cancer cell proliferation by following the mitochondrial apoptotic pathway and thus could be effectively utilized as a potent anti-cancer agent for the treatment of nasopharyngeal cancer.
Catalpol Ameliorates Myocardial I/R Injury Through PI3k/Akt/P53 Signaling-mediated Anti-autophagy and Anti-apoptosis
Authors: Hu Lingai , Sun Yukun , Zhang Hongsheng , Cao Yong , Zhang Jinguo
Published: September 2023

Background

Myocardial infarction (MI) is a leading cardiovascular disease worldwide, with high mortality.

Purpose

The study aimed to observe the mechanism of catalpol inhibiting apoptosis and autophagy in H9c2 cells after ischemia/reperfusion (I/R) injury.

Materials and Methods

We grouped H9c2 cells into 4 groups: control, I/R injury, catalpol (I/R injury +1 ug/mL catalpol treatment), and wortmannin (I/R injury + 1 ug/mL catalpol +150 nM wortmannin treatment) groups. Both catalpol and wortmannin group cells were given drug treatment 30 min before I/R injury. At 2h post-I/R insult, we used flow cytometry for detecting cellular apoptosis and reactive oxygen species (ROS) levels. We identified p-PI3K, p-Akt, PI3K, Akt, p53, Bcl-2, Caspase-3, Bax, beclin1, LC3II, and LC3I protein expression levels.

Results

I/R significantly increased the apoptosis rate and ROS level of H9c2 cells, increased expression levels of p53, LC3II/LC3I, and Caspase-3, and decreased p-Akt/Akt, beclin1, Bcl-2/Bax, and p-PI3K/PI3K expression levels. Catalpol can reduce the expressions of p53, Caspase-3, and LC3II/LC3I ( p < 0.5). Catalpol can increase the expression levels of Akt/ p-Akt, Bax/ Bcl-2, and beclin1. Also, it can inhibit apoptosis and autophagy levels of H9c2 cells ( p < 0.5). Wortmannin, a PI3 K-specific inhibitor, was able partially to block the catalpol’s and anti-autophagic and anti-apoptotic effects.

Conclusion

Catalpol can inhibit apoptosis, reduces excessive autophagy, and alleviates the effects of myocardial ischemia-reperfusion through PI3K/Akt/p53 pathway.
Understanding and Addressing Mental Health Disparities and Stigma in Serious Illness and Palliative Care
Authors: Gerhart James , Oswald Laura Bouchard , McLouth Laurie , Gibb Lindsey , Perry Laura , England Ashley Eaton , Sannes Timothy , Schoenbine Delaney , Ramos Katherine , Greenberg Jared , O’Mahony Sean , Levine Stacie , Baron Aliza , Hoerger Michael
Published: September 2023

Patients receiving palliative care experience stigma associated with their illness, personal identity, and healthcare utilization. These stigmas can occur at any stage of the disease process. Varying stigmas combine to cause palliative care patients to feel misunderstood, contribute to treatment barriers, and further negative stereotypes held by clinicians. Stigma surrounding palliative care patients stems from complex intersections of varied access to resources, familial and physical environment, socioeconomic status, mental health and disorders, and identity characteristics. This article examines the relationship between the stigmatization of mental health and palliative care through three pathways: stigma and barriers existing within healthcare, the tendency of this stigma to undermine social support, and patient deferral of treatment-seeking in response to stigma. Recommendations to address and diminish stigmatization are presented, including advocacy, increased research and assessment, and contextual and intersectional awareness. Clinicians are also encouraged to turn to their colleagues for peer support and team-based care.
Locus of Control and Scientific Temper of Student Teachers at the Secondary Level
Authors: Netto Sibu G. , Dominic Priya
Published: September 2023

Scientific temper is a mindset that welcomes new knowledge and ideas, seeks evidence before judgment, doubts traditional practices and superstitions honestly, and employs reasoning in various situations. Even man has acquired all kinds of comforts and sophistication through the headway of science and technology; still, he goes behind superstitions. In this catastrophe, teachers have a significant role in eradicating superstitions. A random sample of 200 student teachers from secondary teacher education institutions of Ernakulam, Kerala, India, was assessed for scientific temper and the nature of their locus of control. The results indicate a significant positive association between the variables.
Relationships Between Response Styles and the Hofstede and GLOBE Dimensions of Culture in a Sample of Adolescents From 33 Countries
Authors: Bonjeer Tamilka , Vonkova Hana
Published: September 2023

A number of studies have examined the relationships between response styles and the Hofstede and GLOBE cultural indices; however, studies involving adolescent samples or examining the effects of national wealth on observed relationships are scarce. This study addresses these gaps by applying simple and partial correlation analysis to the data of 15-year-olds in 33 PISA 2006 countries. The study found that the relationships between response styles and cultural indices in the two frameworks are similar to those in past studies of adult populations. After accounting for GDP per capita, the majority of relationships remained unchanged. However, others, such as Hofstede’s power distance and acquiescence and dis-acquiescence, lost significance, and Hofstede’s masculinity and extreme response styles only gained significance when GDP per capita was held constant. The findings highlight the influence of cultural values on students’ questionnaire-response behaviours, which should be recognised in comparative studies.
Structural optimization and experimental study on the Ti-alloy Kagome structure formed by the superplastic forming/diffusion bonding process
Authors: Wu Dipeng , Wu Yong , Chen Minghe , Fan Ronglei , Yan Keming , Xiao Wenchao
Published: September 2023

The structural optimization of Ti-alloy lattice structure formed by the superplastic forming/diffusion bonding (SPF/DB) process is a high-nonlinear problem with multiple design variables. The problem is solved in this research by introducing the modified Kriging response surface model based on structural mechanics analysis and the genetic algorithm into the optimization design of the Kagome structure. The comprehensive influence of the structural parameters on the shape and compressive strength of the structure is analyzed, and the optimized structural parameters are obtained. The SPF/DB forming and performance test of the optimized Kagome structure are carried out for verifying the accuracy of the model. The results show that the modified Kriging response surface model of the Kagome structure performs well in describing the relationships between the structural parameters and the simulation results, the average relative error of the predicted groove depth and compression strength are 2.4% and 4.5%, respectively. The specific compression strength and the specific compression modulus of the optimized Kagome structure are [Formula: see text] and [Formula: see text]. Based on the compression strength results calculated by the Kriging model, a new Ashby plot for the compressive strength as function of density is obtained.
Attachment and comorbid anxiety in ADHD
Authors: Akman Hazal , Serdengeçti Nihal , Yavuz Mesut , Kadak Muhammed Tayyib , Ercan Oya , Doğangün Burak
Published: September 2023

Anxiety comorbidity is quite common in children with attention-deficit hyperactivity disorder (ADHD). What is known about the relationship between anxiety, attachment and emotion regulation in such children is still limited. We aimed to investigate the associations between attachment, emotion regulation and comorbid anxiety in children with ADHD. 100 children with ADHD and 100 children without any diagnosis aged 8–13 years were included. After the participants were clinically evaluated, Turgay ADHD Scale, Emotion Regulation Checklist, Revised Child Anxiety and Depression Scale-Child Version (RCADS-CV) and Kerns’ Security Scale were completed. According to the RCADS-CV scores, ADHD/ANX(+), ADHD/ANX(−), and control groups were formed. The emotional lability/negativity levels were higher in the ADHD groups compared to the non-ADHD controls. Paternal and maternal attachment security levels were lower in the ADHD/ANX(+) group compared to the controls. The regression analysis indicated that higher hyperactivity/impulsivity symptom levels and lower maternal attachment quality were associated with higher anxiety in children with ADHD. These results suggest that focusing on attachment quality and emotion regulation problems may be significant in management of core symptoms and comorbid anxiety problems in children with ADHD.
Assessing the perceived credibility of deepfakes: The impact of system-generated cues and video characteristics
Authors: Jin Xinyi , Zhang Zhuoyue , Gao Bowen , Gao Shuqing , Zhou Wenbo , Yu Nenghai , Wang Guoyan
Published: September 2023

The adverse effects of deepfakes are becoming apparent; however, less is known about what affects individuals’ credibility judgments concerning deepfakes. This article conducted two randomized controlled 2 × 2 × 2 experiments ( N = 518) to explore the influence of heuristic cues (including the number of followers, popularity, and description as variables) generated by the system and video characteristics (including definition, duration, and editing as variables). The results suggest that the number of the source’s followers and the video’s popularity are positively associated with perceived credibility. Moreover, high-definition deepfakes are more efficient at deceiving viewers. Interestingly, an interaction effect indicates that it is not easy for users to detect editing traces in relatively long videos (greater than 30 s). Our study is an initial step to better understand how individuals assess video credibility and lay the grounds for approaches to combat the negative effects of deepfakes.
A study of the phenomenon of “crackle” associated with the noise of high-performance aircraft at afterburner
Authors: Tam Christopher KW , Spyropoulos John T , Aubert Allan C , Powers Russell W
Published: September 2023

Ffowcs Williams et al were the first to discover crackle in the noise of the Concorde when the Olympus 593 engine which propelled Concorde was operating at afterburner power. Ffowcs Williams et al described crackle as a transient phenomenon. The primary objective of the present investigation is to show that the noise of F-18E aircraft has crackle. The fundamental elements in the noise of a crackling jet described by Ffowcs Williams et al are sawtooth-like pulses, bursts and trains of bursts. All these characteristic features of pressure pulses are identified in the noise of F-18E aircraft. By including a minimum pulse amplitude requirement based on the level found in the noise of the Concorde by Ffowcs Williams et al, a set of sufficiency conditions for the presence of crackle is established. It is found that crackle exists in the noise of an F-18E aircraft over a fairly large angular sector in the downstream direction. In the literature, the existence of sawtooth-like sound pulses in a noise field is often taken as an indicator of the presence of crackle. The importance of pressure pulse waveform on its impact on human hearing is briefly investigated by using a simple mechanical model of the ear.
Bronchoalveolar Lavage as Potential Diagnostic Specimens to Genetic Testing in Advanced Nonsmall Cell Lung Cancer
Authors: Lin Xuwen , Cai Yazhou , Zong Chenyu , Chen Binbin , Shao Di , Cui Hao , Li Zheng , Xu Ping
Published: September 2023

Background: There is limited knowledge on the yield of performing capture-based targeted ultradeep sequencing on bronchoalveolar lavage (BAL) specimens from advanced nonsmall cell lung cancer (NSCLC) patients. This study aimed to evaluate gene variations and performance characteristics in BAL and tissue specimens using targeted sequencing. Methods: This cohort study retrospectively enrolled 20 patients with advanced NSCLC. The variant detection percentage, correlation of tumor mutation burden (TMB), and allele frequency heterogeneity (AFH) were compared between paired BAL and tissue samples. A three-tiered system was also applied for the interpretation of gene variants according to the guidelines. Results: No statistical difference was observed in variant detection between BAL and tissue samples ( P = .591 for variant tier and P = .409 for variant type). In general, BAL achieved higher detection rates in tier I variants (96.2% vs 84.6%) and gene fusions (75% vs 50%) compared with tissue samples; tissue samples had better variants detection rates for other variants, such as tier II (89.6% vs 76.0%), tier III (87.1% vs 72.6%), single nucleotide variant (SNV, 89.6% vs 76.5%), insertion/deletion/duplication (InDel, 74.6% vs 69.8%) and copy number variation (CNV, 93.8% vs 43.8%). Besides, there were significant correlations of TMB ( R2 = 0.96, P < .001) and AFH ( R2 = 0.87, P < .001) between BALs and paired tissues. Conclusions: The findings demonstrate that BAL may serve as a supplement in liquid biopsy for mutation detection and for routine utilization in clinical settings.
Let's Meetup? Board Game Communities in Hong Kong
Authors: Harrington Johnathan
Published: September 2023

Modern board games are becoming more prevalent, increasing their market share on a year-by-year basis. However, since board games are physically oriented media, their community growth has been distinct across regions. While China saw growth through a wangba model focused on socially oriented games, western countries have grown through hobbyism. Hong Kong exists at a cultural crossroads, and its board game communities form directly in response to this larger board game landscape. In this paper, I analyze the two largest board game groups on Meetup in Hong Kong—Board Game Oasis, an Anglophone group; and BGHK, a Cantophone group. By analyzing six months of events hosted, I will show how board game selection goes beyond player preference, and how these communities are heavily influenced by board game distribution and access, motivation behind play, as well as language dependency leading to two distinct communities further entrenching a systemic board gamer separation.
Progression From Steroid Injection to Surgery in Carpal Tunnel Syndrome Patients With Concurrent Ulnar Nerve Compression: A Retrospective Analysis
Authors: Mubin Nailah F. , Mubin A. Numa , Fogel Joshua , Morrison Elizabeth
Published: September 2023

Background:

Steroid injections are a common treatment option in the management of carpal tunnel syndrome (CTS). This study assesses various prognostic factors for progression to carpal tunnel release (CTR) after a first-time steroid injection for CTS with specific focus on concomitant ulnar nerve compression (UNC).

Methods:

This is a retrospective study of 426 hands with CTS treated with a first-time steroid injection in the Long Island region of New York. The main predictor variable was UNC measured in two analytical models of positive UNC and location of UNC (wrist or elbow). Multivariate logistic regression analyses adjusted for demographic, medical, and CTS-related variables for 2 study outcomes occurring within 1 year: (1) CTR; and (2) steroid reinjection.

Results:

Overall progression to CTR within 1 year of steroid injection was 23.0%. Ulnar nerve compression was present in 16.7% of patients and was significantly associated with increased odds for CTR but not with steroid reinjection. These results were further localized to be specific for UNC at the elbow. A moderate or severe result on electrodiagnostic studies was associated with increased odds for CTR. Increased age was associated with slightly increased odds of steroid reinjection while a history of distal radius fracture was associated with decreased odds of steroid reinjection.

Conclusions:

Carpal tunnel syndrome patients with UNC may benefit from earlier definitive treatment with CTR rather than attempting steroid injections, as they are more likely to seek reintervention within 1 year of their initial injection.
Where Does Ultrasound Fit in the Diagnostic Algorithm for Cubital Tunnel Syndrome?
Authors: Chirokikh Alexander Alexei , Carroll Thomas John , Hoffman Samantha , Speach David , Jones Courtney Marie Cora , Ketonis Constantinos
Published: September 2023

Background:

Ultrasound (US) has emerged as a promising supplement to electrodiagnostic studies (EDX) in the diagnosis of cubital tunnel syndrome (CuTS) and has potential to be performed by novice operators. Our objective is to understand the discrepancies in assessment between the two modalities and to assess the utility of US in CuTS diagnosis by a novice operator.

Methods:

Patients who presented to a single tertiary academic medical center and clinically diagnosed with CuTS were prospectively enrolled. Electrodiagnostic studies were performed along with US measurements of the cross-sectional area (CSA) of the ulnar nerve by both a board-certified physiatrist and novice operator. Electrodiagnostic study and US outcomes were compared among four diagnostic impression groups: EDX–/US–, EDX+/US–, EDX–/US+, and EDX+/US+.

Results:

Sixteen patients were classified as abnormal by both EDX and US, 14 were classified abnormal by US only, 3 were classified abnormal by EDX only, and 6 were classified normal by both EDX and US ( P = .008, K = 0.14). The EDX+/US+ group had a significantly reduced sensory amplitude compared with the EDX–/US+ ( P = .04) group. Diagnostic classifications between a board-certified physiatrist and novice operator were in moderate agreement (K = 0.58, P = .08).

Conclusions:

Ultrasound detected a greater proportion of patients as abnormal than EDX. A subset of patients with clinical diagnoses of CuTS had normal sensory amplitudes but increased maximum nerve CSAs. Competency in US may be easily acquired with minimal training, suggesting its potential to be extended for use by other members of the health care team.
Patient-reported outcomes after free muscle flap coverage for therapy-resistant neuropathic pain from the ulnar nerve
Authors: List Emile B. , Boers Nadine , Martin Enrico , Krijgh David D. , Henk Coert J.
Published: September 2023

Extensive microsurgical neurolysis followed by free gracilis muscle flap coverage can be performed as a last resort for patients with persistent neuropathic pain of the ulnar nerve. All patients who had this surgery between 2015 and 2021 were identified. Data were collected from the medical records of 21 patients and patient-reported outcomes were collected from 18 patients, with a minimum follow-up of 12 months. The median visual analogue pain score decreased significantly 8 months postoperatively from 8.0 to 6.0 and stabilized to 5.4 at the 3-year follow-up. Health-related quality-of-life scores remained diminished compared to normative data. In the treatment of therapy-resistant neuropathic pain of the ulnar nerve, extensive neurolysis with a subsequent free gracilis muscle flap coverage shows a promising reduction of pain that persists at long-term follow-up.

Level of evidence: IV
The effect of congenital hand differences on handedness in children
Authors: Jones Christopher , Lekuse Kara , Duncan Orla , Lam Wee Leon
Published: September 2023

We investigated whether handedness is influenced by the presence of a congenital hand difference (CHD). Among 31 children with right-sided CHDs, 13 were left-handed and 18 were right-handed, regardless of severity. This was significantly different from the normal population, suggesting that CHD does influence handedness.
The anatomy of the extensor tendon insertion in the arthritic distal interphalangeal joint: a cadaveric study
Authors: Houghton Eleanor Ruth , Moulton Lawrence Stephen , Keogh Angus
Published: September 2023

Dissection of arthritic cadaveric digits revealed an expanded extensor tendon footprint involving the dorsal osteophyte on the terminal phalanx. Osteophyte attachments can be safely released up to the width of a number 15 scalpel blade without risking the integrity of the extensor tendon.
Developing the UVA/Padova Type 1 Diabetes Simulator: Modeling, Validation, Refinements, and Utility
Authors: Cobelli Claudio , Kovatchev Boris
Published: September 2023

Arguably, diabetes mellitus is one of the best quantified human conditions. In the past 50 years, the metabolic monitoring technologies progressed from occasional assessment of average glycemia via HbA1c, through episodic blood glucose readings, to continuous glucose monitoring (CGM) producing data points every few minutes. The high-temporal resolution of CGM data enabled increasingly intensive treatments, from decision support assisting insulin injection or oral medication, to automated closed-loop control, known as the “artificial pancreas.” Throughout this progress, mathematical models and computer simulation of the human metabolic system became indispensable for the technological progress of diabetes treatment, enabling every step, from assessment of insulin sensitivity via the now classic Minimal Model of Glucose Kinetics, to in silico trials replacing animal experiments, to automated insulin delivery algorithms. In this review, we follow these developments, beginning with the Minimal Model, which evolved through the years to become large and comprehensive and trigger a paradigm change in the design of diabetes optimization strategies: in 2007, we introduced a sophisticated model of glucose-insulin dynamics and a computer simulator equipped with a “population” of N = 300 in silico “subjects” with type 1 diabetes. In January 2008, in an unprecedented decision, the Food and Drug Administration (FDA) accepted this simulator as a substitute to animal trials for the pre-clinical testing of insulin treatment strategies. This opened the field for rapid and cost-effective development and pre-clinical testing of new treatment approaches, which continues today. Meanwhile, animal experiments for the purpose of designing new insulin treatment algorithms have been abandoned.
Anti-inflammatory Mechanism of Morin Hydrate by Suppressing the NF-κB/MAPKs Mediated Cell Migration and Modulating Src/FAK and β-Catenin
Authors: Jayakumar Thanasekaran , Sheu Joen-Rong , Yuan Kuo-Ching , Yen Ting-Lin , Hsia Chih-Wei , Huang Wei-Chieh , Tseng Li-Ning , Chen Chun-Han , Hsia Chih-Hsuan
Published: September 2023

Background: Macrophage migration plays a critical role in inflammation and the development of pathological processes. Thus, inhibiting macrophage migration is a potential approach for reducing inflammation. Besides, mitigation of inflammatory mediators also inhibits macrophage migration. Morin hydrate (MH), a bioflavonoid found in fruits, vegetables, and herbs, has demonstrated various pharmacological effects, including anti-inflammatory and immunosuppressive properties. However, the specific molecular mechanisms underlying MH's anti-inflammatory effects and its impact on macrophage migration remain unclear. This study focused on MH's anti-inflammatory molecular mechanism and also elucidated how it is associated with inhibiting macrophage migration. Methods: The anti-inflammatory and antimigration effects of MH were investigated in lipopolysaccharide (LPS)-stimulated RAW264.7 cells, a murine macrophage cell line. The production of nitric oxide (NO) and the expression of inducible nitric oxide synthase (iNOS) were assessed by various assays. Additionally, the expression of key signaling molecules, such as extracellular signal-regulated kinase (ERK), JNK, p65, pSrc, focal adhesion kinase (FAK), β-catenin, COX-2, p-p38, and p-Akt, was analyzed in response to MH treatment. Results: MH treatment reduced LPS-induced NO production and downregulated the mRNA and protein expression of iNOS in RAW264.7 cells. It concentration dependently inhibited the expression of ERK and JNK. At a high concentration of 20 µM, MH also suppressed the expression of p65, pSrc, and pFAK. Moreover, MH effectively attenuated LPS-induced β-catenin expression, while it did not exhibit a significant effect on COX-2, p-p38, and p-Akt expressions in LPS-stimulated RAW264.7 cells. Furthermore, MH pretreatment inhibited the migration of LPS-induced macrophages. Conclusion: This study reveals that MH exerts its anti-inflammatory effects by inhibiting NO production, downregulating iNOS expression, and modulating ERK/JNK and p65 phosphorylation. Additionally, MH suppresses Src/FAK phosphorylation and downregulates β-catenin expression induced by LPS. The findings demonstrate a complex interplay between the inflammatory response and MH's impact on macrophage migration being intertwined with its anti-inflammatory properties.
Common Skin Infections in High School Athletes and the Role of the School Nurse
Authors: Bultas Margaret W. , Brueggemann Elissa M. , Daily Hannah
Published: September 2023

Skin infections in high school athletes pose a risk of transmission to other student athletes. Therefore, it is important to promptly identify possible skin infections and refer them to the healthcare provider for treatment so athletes can return to play quickly and with little interruption to the team. Common skin infections include bacterial infections such as Streptococcus and Staphylococcus, viral infections such as herpes simplex and molluscum contagiosum, and fungal infections such as tinea corporis and capitis. The National Federation of State High School Associations provides guidance for the prevention of skin infections as well as return to play guidelines. The school nurse and high school athletic trainer are both healthcare professionals who play a role in preventing, identifying, monitoring, and caring for student athletes who contract skin infections.
Vection induced by a pair of patches of synchronized visual motion stimuli covering total field of views as small as 10 square-degrees
Authors: Dizmen Coskun Joe , So Richard H.Y.
Published: September 2023

Vection (illusion of self-motion) is known to be induced by watching large field-of-view (FOV) moving scenes. In our study, we investigated vection induced by small FOV stimuli. Three experiments were conducted in 45 sessions to analyze vection provoked by moving scenes covering total FOVs as small as 10 square-degrees. Results indicated that 88% of the participants reported vection while watching two small patches of moving dots (1° horizontal by 5° vertical, each) placed on the left and right sides of the observers. This is less than a quarter of the total visual area of two Apple Watches viewed at a distance of 40 cm. Occlusion of the visual field between the two display patches significantly increased the levels of rated vection. Similarly, increasing the speed of the moving dots of the two display patches from about 5 to 25 °/sec increased the levels of rated vection significantly. The location of the two patches in the horizontal visual field did not affect the vection perception significantly. When the two straight stripes of dots were moving in opposite directions, participants perceived circular vection. The observers connected the two stimuli in their minds and perceived them as parts of a single occluded background. The findings of this study are relevant to the design of mobile devices (e.g., smartphones) and wearable technology (e.g., smart watches) with small display areas.
Intention to Emigrate Again and Destination Preference: A Study of Indian Nurses Returning from Gulf Cooperation Council Countries
Authors: Tsujita Yuko , Oda Hisaya , Rajan S. Irudaya
Published: September 2023

This article empirically investigates the migration patterns of Indian nurses who have returned from Gulf countries, where obtaining long-term visas and citizenship is difficult, to determine whether their return should be considered a temporary or permanent settlement. The study addresses the likelihood of future migration and explores migration trajectories among these individuals. Our analysis reveals that returned nurses are more inclined to migrate again if currently employed in India’s private sector, which offers lower financial rewards compared to the public sector. On the other hand, those in contract-based public sector jobs express a willingness to relocate to Western countries but not back to Gulf countries. The limited occurrence of circular migrations to Gulf countries among nurses highlights their lower position in the hierarchy of destination countries. This study illustrates the complexities of nurse migration decisions, demonstrating that migration trajectories do not always follow a linear path towards perceived ‘better’ destinations.
He Does (Not) Care: COVID-19 Volunteers’ Assessments of Donald Trump’s Responses to the Pandemic
Authors: Leap Braden , Stalp Marybeth C. , Kelly Kimberly
Published: September 2023

How right-wing populist politicians do gender has gained increasing attention. Far less consideration has been granted to how citizens assess such politicians’ genders. Using 78 interviews and 662 self-administered questionnaires completed by American adults who were voluntarily producing personal protective equipment in response to the COVID-19 pandemic, we analyze respondents’ descriptions of then-President Donald Trump’s responses to the pandemic. Drawing on the emerging caring masculinities literature, we argue that respondents linked the legitimacy of Trump’s authority to whether he sought to care for them by protecting their well-being or dominate them for his own benefit. Supporters described Trump as an effective leader who strategically cared about and for Americans despite nefarious attempts to undermine him. Critics portrayed Trump as an irrational authoritarian seeking to consolidate and expand his power—regardless of the impacts on Americans. These results provide preliminary evidence that perceived acts of care by right-wing populists can be especially important to how members of the public evaluate such politicians’ genders and their claims to power. While right-wing populists are often described as cultivating especially aggressive, tough masculinities, our results suggest populists’ abilities to be perceived as caring can also be significant to legitimating their access to state power.