bluuebunny/crossref_metadata_2025 huggingface dataset:
Greek engineering students’ views of the nature of engineering
Authors: Gioti Christina , Stylos Georgios , Kotsis Konstantinos T.
Published: May 2023

Nowadays demands on scientific literacy consider nature of engineering as crucial, introducing the scientific and ontological foundations of engineering. As a result, this study was conducted to examine the students’ views on nature of engineering at the Materials Science and Engineering department at University of Ioannina, through the views of first- and fifth-year students. 145 students participated in this research, 75 first-year and 70 graduate students. Participants were asked to complete a questionnaire with open-ended questions that required scientific knowledge, regarding Engineering and Science. After the collection of the questionnaires, statistical processing was carried out regarding the first and the last year student's views, as well as the prospective change of their views during the years of their study. The results of the study revealed that first-year students had already a formed view of engineering; however, their answers tended to be numerous, short and generally formulated, while a complete lack of knowledge on technical engineering issues was observed. At the same time, in elaborated questions that sought to explore their beliefs about nature of engineering, the students’ views were simple, vague, scientifically naive and in some cases non-existent. On the contrary, the fifth-year students seemed to have sufficient and satisfactory knowledge of the cognitive subject, with much more accurate and scientifically correct opinions, mainly regarding technical issues. However, their responses regarding nature of engineering simulated the first-year students, where it was found that the level of assimilation concerning nature of engineering is equally low.
Right to toilets? infra-bio-urbanism over human waste, memories, and housing inequality
Authors: Huang Shu-Mei , Yao Lijin
Published: May 2023

This research attends to how urban tenants bring matong (toilets in the form of urine buckets)—which are a material, semiotic, and marketable piece of infrastructure—into the debates over the remaking of a heritage district in Hongkou, Shanghai. Challenges abound for the site, which is occupied by prewar buildings where Jewish refugees found shelter during the war and more than 10 thousand Chinese tenants moved in after the Jews left. Until 2020, the dilapidated buildings accommodated an aging population of tenants who wish to stay relevant to the redevelopment vision of Shanghai and a variety of community business, including urban waste recycling. To find a crack in the state-led, neoliberal system, the tenants managed to exercise infrapolitics—an everyday form of resistance—over an urban infrastructure that is of particular significance to their bio-well-being and beyond. We analyze a set of spatial politics on sanatory infrastructure in Hongkou to understand how the tenants are desperately capitalizing on their disadvantages and reassembling memories, waste, and housing inequality into something more promising from below. The theorization of infra-bio-urbanism upon toilets sheds light on the accumulating anxiety upon housing inequality and infrastructural mobility in globalizing cities in China and beyond.
Influence of climate on semen quality: A retrospective study
Authors: Padmanabhan Skandhan , Skandhan Avni KP , Sundaram Karimassery Ramaiyer , Ravindran Greeshma C , Prasad Buduru Sreenivasa
Published: May 2023

Introduction:

World over studies are being done by different group of workers to understand the time of deliveries conducted. Surprisingly majority of deliveries were following a pattern, seasonally. Today in this busy world, couples choose comparatively a free time for delivery and preparation for conception is done accordingly. Apart from these, it is clearly shown majority of deliveries are conducted during a particular season. We hypothesised that the change in semen quality during different seasons is responsible for this phenomenon.

Materials and methods:

Present study conducted on semen quality included 12,408 semen samples collected from different laboratories of Bangalore city during 8 years (2000–2007) period of time and were analysed season wise.

Results:

Results showed sperm concentration was significantly lower in monsoon than in winter season. Humidity and pressure influenced sperm count. Forward moving sperms were influenced by temperature and pressure.

The study concludes the change in birth rates seen during different season in a year is due to the quality of semen responsible for conception.
Marketing and Public Policy Implications of Dobbs v. Jackson Women's Health Organization
Authors: Fitzgerald M. Paula , Langenderfer Jeff , Renzelli-Cain Roberta , Critch Elizabeth A.
Published: May 2023

In June 2022, the U.S. Supreme Court ruled that the U.S. Constitution does not grant a right to abortion and that the legality of abortion should be determined by the states ( Dobbs v. Jackson Women's Health Organization). The Dobbs ruling impacts female reproductive health care during the estimated 39 years that females can become pregnant. It also affects health care providers and the organizations in which they work, health insurers, pharmaceutical firms, social media platforms, and employers. Important marketing and policy concerns, including privacy, cross-border commerce, consumer vulnerability, and marketplace information flow, will require study as stakeholders respond to this environmental change. The authors develop a framework for the “typical” female reproductive health care journey to identify some of the most important areas of research for marketing and public policy academics and policy makers.
“No dig, No Ride”: The Communicative Constitution and Consequences of Imperfect Authoritative Texts in Fluid Collective Organizing
Authors: Smith William Roth
Published: May 2023

Drawing upon the theoretical roots of Montreal school communicative constitution of organizing (CCO), this study extends the notion of “authoritative texts” (Kuhn, 2008) to loose, emergent, and fluid forms of organizing. Based on interviews and observations among a fluid collective of bicyclists that maintain a public jump course, findings show how repetitive stories and labor analogies are communicative elements giving rise to an authoritative text, that, although imperfect in many ways, exerts influence on organizing practices. Despite lacking conventional organizational structures, the article demonstrates how the emergence and disciplining function of authoritative texts is made possible by a unique form of indirect assertive speech acts. This work contributes to organizational communication theory by extending authoritative text research to fluid organizing, theorizing differences in the coorientation and scaling up processes forming authoritative texts, and providing precise explanations of how texts discipline through intertextual relations.
An Evaluation into Procalcitonin Levels in Full-Term Neonates Managed for Suspected Early Onset Sepsis due to Probable Maternal Intrapartum Sepsis
Authors: Walker Sarah , Harding Irasha , Soomro Kamran , Bamber Andrew R. , Liebling Rachel E.
Published: May 2023

Purpose

To investigate procalcitonin (PCT) levels in full-term neonates managed for suspected early onset sepsis (EOS) due to probable maternal intrapartum sepsis.

Methods

Prospective longitudinal observational study at University Hospitals of Bristol NHS Foundation trust. Included were a total of 117 neonates managed for suspected EOS from June to October 2020. In addition to routine full-blood-counts and c-reactive protein (CRP) tests, serum PCT levels were also measured as part of the septic screen and follow-up blood tests. Placentas were sent for histopathology analysis. Neonatal parameters were used to categorize cases into: “high-suspicion bacterial sepsis (BS),” “equivocal BS” and “low-suspicion BS.” Statistical test Kruskal-Wallis compared categories with biomarker values and placental histopathology scores.

Results

A higher percentage of PCT levels showed elevation in comparison to CRP levels in the initial testing (55.3% versus 5.9%) and follow-up testing (98.9% versus 35%). There was a significant difference between the “low-suspicion BS” and “high-suspicion BS” categories for both the initial and follow-up PCT results. 71.2% of placentas showed varying degrees of chorioamnionitis.

Conclusion

This study provides evidence to the physiological rise in PCT during the first few days of life. The significant difference in PCT levels according to clinical severity shows that PCT could be utilized in calculating odds for EOS, but as a standalone test will have limited use.
Maximising Undergraduate Medical Radiation Students’ Learning Experiences Using Cloud-Based Computed Tomography (CT) Software
Authors: Chau Minh , Arruzza Elio Stefan
Published: May 2023

Background

Simulation-based learning is a crucial educational tool for disciplines involving work-integrated learning and clinical practice. Though its uptake is becoming increasingly common in a range of fields, this uptake is less profound in diagnostic radiography and computed tomography.

Aim

This study explored whether CT simulator software may be a viable option to facilitate the development of practical clinical skills in an effective, safe and supported environment.

Methods

A cross-sectional mixed methods design was employed. Students in their third year of study undertook formal simulation CT learning using the Siemens SmartSimulator, prior to a six-week off-campus clinical experience. A pre- (n = 42, response rate = 39%) and post-clinical placement Likert scale survey was completed (n = 21, retention rate = 50%), as well as focus group interviews to gather qualitative data (n = 21). Thematic analysis was employed to explore how the simulator developed students’ knowledge of CT concepts and preparedness for clinical placement.

Results

Survey scores were high, particularly in terms of satisfaction and relevancy. Focus groups drew attention to the software’s capacity to build on foundational principles, prepare students for placement and closely emulate the clinical environment. Students highlighted the need for continual guidance and clinical relevance and maintained that interactive simulation was inferior to real-world clinical placement.

Conclusion

The integration of CT simulator software has the potential to increase knowledge, confidence, and student preparation for the clinical environment.
Using Communication Assistants in Qualitative Health Research
Authors: Dee-Price Betty-Jean M.
Published: May 2023

Qualitative health research is hampered by narrow constructs of human communication that privilege participants with access to spoken and written (normative) language. With limited awareness of such things as augmentative and alternative communication (AAC) or the rights of people with complex communication access needs, qualitative research becomes a ‘picker and chooser’ of whose voices are included in studies and whose are not. In order for ‘voices’ to be heard, adaptations are required which include the acknowledgement and support of communication assistants (informal and formal) who can help provide a communication bridge between people with complex communication access needs and researcher(s). Yet little is known of who qualifies as a communication assistant nor the scope and limitations of this role in health research. Beginning with communication diversity arguments the article compares communication assistants with language interpreters before discussing practice and implications for health research.
Association of Haglund Deformity Size and Insertional Achilles Tendinopathy
Authors: Lee Wonyong , Giro Margaret Elizabeth , Crymes Colt
Published: May 2023

Background:

We aimed to investigate the effect of Haglund deformity size on insertional Achilles tendinopathy (IAT) using a new measurement system and identify independent risk factors of IAT with Haglund deformity.

Methods:

We reviewed medical records of patients with IAT and age/sex-matched patients with diagnoses other than Achilles tendinopathy. Radiographs were reviewed to identify posterior heel spur, plantar heel spur, and intra–Achilles tendon calcification, and to measure Fowler-Philip angle, calcaneal pitch angle, and Haglund deformity angle and height. We introduced a new measurement system for Haglund deformity angle and height and evaluated its intraobserver and interobserver reliability. Multivariate logistic regression analysis was performed to identify independent risk factors of IAT with Haglund deformity.

Results:

Fifty patients (55 feet) were enrolled in the study group, equaling the size of the age/sex-matched control group. The new Haglund deformity measurement system showed excellent intraobserver and interobserver reliability. No significant differences between the 2 groups were noted in Haglund deformity angle and height: 6.0 degrees in both groups, and 3.3 mm vs 3.2 mm in the study and control group, respectively. The study group had significantly higher calcaneal pitch angle, incidence of posterior heel spur, plantar heel spur, and intra–Achilles tendon calcification: 5.2 vs 23.1 degrees ( P = .044), 81.8% vs 36.4% ( P < .001), 76.4% vs 34.5% ( P = .003), and 67.3% vs 5.5% ( P < .001), respectively. Multivariate logistic regression analysis identified independent risk factors of IAT: posterior heel spur (OR = 3.650, 95% CI = 1.063, 12.532), intra–Achilles tendon calcification (OR = 55.671, 95% CI = 11.233, 275.905), and increased calcaneal pitch angle (OR = 6.317).

Conclusion:

Based on our results, the actual size of Haglund deformity as we have reliably measured was not associated with IAT, suggesting a routine Haglund deformity resection may be unnecessary in the surgical treatment of IAT. If patients with Haglund deformity have posterior heel spur, intra–Achilles tendon calcification, or increased calcaneal pitch angle, a higher chance of IAT can be predicted.

Level of Evidence:

Level III, retrospective cohort study.
Evolocumab is Initiated in Central and Eastern Europe at Much Higher LDL-C Levels Than Recommended in Guidelines: Results from the Observational HEYMANS Study
Authors: Blaha Vladimír , Margoczy Roman , Petrov Ivo , Postadzhiyan Arman , Rašlová Katarína , Rosolová Hana , Bridges Ian , Dhalwani Nafeesa N. , Zachlederova Marie , Ray Kausik K.
Published: May 2023

Purpose: We examined clinical characteristics and low-density lipoprotein cholesterol (LDL-C) lowering in patients initiating evolocumab in real-world practice in a Central and Eastern European (CEE) cohort from the pan-European HEYMANS study. Methods: Patients from Bulgaria, Czech Republic, and Slovakia were enrolled at initiation of evolocumab (baseline) as per local reimbursement criteria. Demographic/clinical characteristics, lipid-lowering therapy (LLT) and lipid values were collected from medical records for ≤6 months before baseline and ≤30 months after evolocumab initiation. Results: Overall, 333 patients were followed over a mean (SD) duration of 25.1 (7.5) months. At initiation of evolocumab, LDL-C levels were markedly elevated in all three countries, with a median (Q1, Q3) LDL-C of 5.2 (4.0, 6.6) mmol/L in Bulgaria, 4.5 (3.8, 5.8) mmol/L in the Czech Republic, and 4.7 (4.0, 5.6) mmol/L in Slovakia. Within the first three months of evolocumab treatment, LDL-C levels were reduced by a median of 61% in Bulgaria, 64% in the Czech Republic, and 53% in Slovakia. LDL-C levels remained low throughout the remaining period of observation. The 2019 ESC/EAS guideline-recommended risk-based LDL-C goals were attained by 46% of patients in Bulgaria, 59% in the Czech Republic, and 43% of patients in Slovakia. LDL-C goal attainment was higher in patients receiving a statin ± ezetimibe-based background therapy (Bulgaria: 55%, Czech Republic: 71%, Slovakia: 51%) compared to those receiving evolocumab alone (Bulgaria: 19%, Czech Republic: 49%, Slovakia: 34%). Conclusion: In the HEYMANS CEE cohort, patients initiated on evolocumab had baseline LDL-C levels approximately three-fold higher than guideline-recommended thresholds for PCSK9i initiation. Risk-based LDL-C goal attainment was highest in patients receiving high-intensity combination therapy. Lowering the LDL-C reimbursement threshold for PCSK9i initiation would allow more patients to receive combination therapy, thus improving LDL-C goal attainment. Trial registration: ClinicalTrials.gov (NCT02770131; registration date: 27 April 2016).
Retrospective study on the efficacy and tolerability of dose modification of PD-1 and PD-L1 inhibitors in hospital-system community outpatient cancer clinics
Authors: Allen Emily , Brown Erika N. , Torre Rodrigo De La , Murthy Asha
Published: May 2023

Background

Anti-programmed cell death (PD)-1 and anti-PD-L1 medications inhibit the PD-1 and PD-L1 interaction and have been shown to be effective in treating several forms of advanced cancers. Since the approval of these agents, standard dosing protocols have been utilized. However, a small population of patients in the community setting has received dose-modified PD-1 and PD-L1 inhibitors secondary to a lack of tolerability. Data from this study suggests possible benefit with different dosing strategies.

Objectives

The purpose of this retrospective study is to assess the efficacy and tolerability in terms of time to progression and adverse effects in patients receiving dose-modified PD-1 and PD-L1 inhibitors in Food and Drug Administration (FDA)-labeled indications.

Methods

This single-institution retrospective chart review was conducted in an outpatient community setting on patients with cancer that received nivolumab, pembrolizumab, durvalumab, or atezolizumab for an FDA indication at one of the Houston Methodist Hospital infusion clinic site between September 1, 2017 and September 30, 2019. Data collection included demographics, adverse effects, dosing, treatment delay, and number of immunotherapy cycles administered per patient.

Results

This study included 221 patients, who received either nivolumab (n = 81), pembrolizumab (n = 93), atezolizumab (n = 21), or durvalumab (n = 26). There were 11 patients who experienced a dose reduction and 103 patients who experienced a treatment delay. Of the patients with a treatment delay, the median time to progression was 197 days, and for patients with a dose reduction, the median time to progression was 299 days.

Conclusion

The results of this study found that the immunotherapy associated adverse effects led to dosing and frequency changes for tolerance with continued therapy. Our data suggests that there could be potential benefits of dose modifications to immunotherapy treatment, but further large studies are needed to assess the efficacy of specific immunotherapy dose modifications on both outcomes and adverse effects.
Antibacterial, bacteriolytic, and antibiofilm activities of the essential oil of temu giring (Curcuma heyneana Val.) against foodborne pathogens
Authors: Septama Abdi Wira , Tasfiyati Aprilia Nur , Rahmi Eldiza Puji , Jantan Ibrahim , Dewi Rizna Triana , Jaisi Amit
Published: May 2023

Foodborne pathogens may cause foodborne illness, which is among the major health problems worldwide. Since the therapeutic options for the treatment of the disease are becoming limited as a result of antibacterial resistance, there is an increasing interest to search for new alternatives of antibacterial. Bioactive essential oils from Curcuma sp become potential sources of novel antibacterial substances. The antibacterial activity of Curcuma heyneana essential oil (CHEO) was evaluated against Escherichia coli, Salmonella typhi, Shigella sonnei, and Bacillus cereus. The principal constituents of CHEO are ar-turmerone, β-turmerone, α-zingiberene, α-terpinolene, 1,8-cineole, and camphor. CHEO exhibited the strongest antibacterial activity against E. coli with a MIC of 3.9 µg/mL, which is comparable to that of tetracycline. The combination of CHEO (0.97 µg/mL) and tetracycline (0.48 µg/mL) produced a synergistic effect with a FICI of 0.37. Time-kill assay confirmed that CHEO enhanced the activity of tetracycline. The mixture disrupted membrane permeability of E. coli and induced cell death. CHEO at MIC of 3.9 and 6.8 µg/mL significantly reduced the formation of biofilm in E. coli. The findings suggest that CHEO has the potential to be an alternative source of antibacterial agents against foodborne pathogens, particularly E. coli.
Finding the forest in the trees: Enabling performance optimization on heterogeneous architectures through data science analysis of ensemble performance data
Authors: Pearce Olga , Brink Stephanie
Published: May 2023

In this work, we develop novel data science methodologies for ensemble performance data that have the potential to uncover orders of magnitude of performance that is unknowingly being left on the table. Building on years of successful performance tool design and tool integration into million-line codes at Lawrence Livermore National Laboratory (Caliper ( Boehme et al. 2016 ), Hatchet ( Bhatele et al. 2019 ; Brink et al. 2020 ))—successes highlighted as key deliverables in meeting LLNL’s L1 and L2 milestones ( Rieben and Weiss 2020 )—we design a data science methodology for integrating multi-dimensional, multi-scale, multi-architecture, and multi-tool performance data, and provide data analytics and interactive visualization capabilities for further analysis and exploration of the data. Our work provides developers with a comprehensive multi-dimensional performance landscape, enabling enhanced capabilities for pinpointing performance bottlenecks on emerging hardware platforms composed of heterogeneous elements.
Trajectories and Predictors of Change in Emotion Dysregulation and Deliberate Self-Harm Amongst Adolescents with Borderline Features
Authors: Dibaj Iselin Solerød , Tørmoen Anita Johanna , Klungsøyr Ole , Haga Egil , Mehlum Lars
Published: May 2023

Background

Deliberate self-harm (DSH) and emotion dysregulation (ED) peaks in adolescence, and is associated with an increased risk of psychopathology, suicide and lower functioning in adulthood. DBT-A has been established as an effective treatment for reducing DSH, however less is known about changes in emotion dysregulation. This study aimed to identify baseline predictors of treatment response in outcome trajectories of DSH and emotion dysregulation.

Methods

Response trajectories of DSH and ED were investigated using Latent Class Analysis on RCT data comparing DBT-A and EUC for 77 adolescents treated for deliberate self-harm and borderline traits. Logistic regression analysis was used to examine baseline predictors.

Results

Two-class solutions were selected for both indicators, distinguishing between early and late responders in DSH, and responders and non-responders in ED. Higher levels of depression, shorter DSH histories and not receiving DBT-A predicted less favourable response in DSH, while DBT-A was the only predictor of treatment response in ED.

Conclusions

DBT-A was associated with a significantly faster reduction of deliberate self-harm in the short-term and improved emotion regulation in the long-term.
Simple solutions to wicked problems: Cultivating true believers of anti-vaccine conspiracies during the COVID-19 pandemic
Authors: Baker Stephanie Alice , McLaughlin Eugene , Rojek Chris
Published: May 2023

The pandemic has produced an abundance of medical misinformation, disinformation and conspiracy theories about the safety and efficacy of vaccines. Many of these narratives appear impervious to scientific evidence and indifferent to the authority of the state. This has resulted in ‘true believers’ being cast as paranoid and irrational. In this article, we take a different approach by exploring the cultural appeal of anti-vaccine conspiracy theories about COVID-19. Drawing on qualitative analysis of two leading figures of the anti-vaccination movement – Robert F. Kennedy Jr. and Joseph Mercola – we demonstrate how these influencers establish authority by staging indignation against a corrupt scientific establishment and positioning themselves as Truthers offering simple solutions to complex (wicked) problems. By conceptualising what we refer to as the Truther Playbook, we examine how anti-vaccine Truthers capitalise on existing grievances and conditions of low institutional trust to further solidify people’s troubled relationship with institutional expertise while drawing attention to the structural conditions and social inequalities that facilitate belief in conspiracy theories. We contend that conspiracy theories offer not only offer alternative facts and narratives but are predicated on identification and in-group membership, highlighting the limits of debunking as a strategy to tackle disinformation.
The Nexus Between Foreign Direct Investment, Informal and Formal Sectors in Sri Lanka
Authors: Bhavan T.
Published: May 2023

The purpose of this study is to investigate the bilateral relationship among formal, informal and foreign direct investment (FDI) in the case of Sri Lanka during the period from 1990 to 2019. Using annual time series data, the Two Stage Least Square method is employed to investigate the relationship among the endogenous variables. The results derived from the analysis suggest that the integration between formal and informal sectors and formal sector and FDI are positive and have significant impacts on each other. However, the negative and significant impacts of the informal sector and FDI on each other further suggest that the integration between the informal sector and FDI did not give an optimistic signal to the country to contemplate that the informal sector is supporting foreign investors. At the same time, a sign that FDI discourages informal sector progression in the results has triggered the attention of further investigations on whether foreign investment agglomeration in Sri Lanka promotes informal-formal sectoral transformation at the cost of the informal sector. However, this study proposes an interest in sound policy requirements to reshape the informal sector towards the interest of foreign direct investors and informal-formal sector transformation.

JEL Codes: E26, F21, J21, J46
Does Rising Energy Prices Lead to Production Fragmentation? An Example from Indian Manufacturing Industries
Authors: Guha Supratik
Published: May 2023

How does the price of energy affect the extent of production fragmentation in India’s manufacturing industries? The prevailing literature has engaged with production fragmentation and trade in middle products for a long time, but the relationship between energy prices and production fragmentation is less understood. This article deals with firm-level panel data of India’s manufacturing industries between 2005 and 2018 to estimate the impact of rising energy prices on the outsourcing decisions/production organization of the manufacturing firms. The article also uses a number of covariates, including wages, welfare expenses, sales, profit after tax, dividend rate, foreign exchange earnings and an interaction term between energy prices and foreign exchange earnings. The empirical results of this article indicate that larger firms tend to outsource production in part to smaller firms in order to cope with rising energy prices and keep their profitability intact. Static and dynamic panel estimates with a variety of robustness analyses support the main conjectures.

JEL Classification: F18, L23, Q410, Q500
The inhibition effect: Privacy concerns disrupt the positive effects of social media use on online political participation
Authors: Ahmed Saifuddin , Lee Sangwon
Published: May 2023

The literature on the relationship between social media and online political participation continues to expand. Yet, attention to the effect of cognitive dispositions central to user engagement on social media is rare. This study advances the current theoretical understanding of the effects of social media news use by focusing on online privacy concerns. Two studies in Singapore (Study 1 using cross-sectional survey data) and the United States (Study 2 using two-wave panel data) find that social media news use is positively associated with online political participation. Still, public concern regarding online privacy is negatively related to online political participation. Moreover, moderation analyses suggest that those with more significant privacy concerns are least likely to engage in online political participation, even at higher social media news use levels. We also identify that those with lower cognitive ability are more likely to curb online participation due to privacy concerns.
Highlights from the 82nd ADA Scientific Sessions and the 58th EASD Meeting on Diabetic Neuropathy
Authors: Tentolouris Anastasios , Eleftheriadou Ioanna , Tentolouris Nikolaos , Papanas Nikolaos
Published: May 2023

Diabetic neuropathy is one of the commonest diabetic complications. It affects 30-50% of people with diabetes mellitus (DM) and may cause severe pain and foot ulcers. Distal symmetric polyneuropathy and diabetic autonomic neuropathy are the main manifestations of diabetic neuropathy. The American Diabetes Association's (ADA) 82nd Scientific Sessions took place in June 2022 in New Orleans, Louisiana, and the 58th European Association for the Study of Diabetes (EASD) Annual Meeting was held in September 2022 in Stockholm, Sweden. Herein, we describe interesting studies in the field of diabetic neuropathy presented in these two meetings.
Research on configuration design and intelligent compliance control of reconfigurable modular flexible upper limb rehabilitation robot
Authors: Zheng Kunming , Zhang Qiuju
Published: May 2023

The upper limb exoskeleton rehabilitation robot can realize the partial functional compensation of upper limb and complete the various types of rehabilitation training for each joint of upper limb. However, the existing upper limb exoskeleton rehabilitation robots are lack of flexible reconfigurability, which are difficult to meet the diversified patient objects and rehabilitation needs, and have some problems, such as insufficient motion compliance, poor portability, and wearing comfort. To effectively solve the above problems and improve the effect of upper limb rehabilitation training, this project plans to carry out the following research: Firstly, analyze the structural characteristic and movement mechanism of upper limb, clarify the configuration theory of the modular flexible upper limb exoskeleton rehabilitation robot with reconfigurable, and design and optimize the mechanism form and structural parameters of the reconfigurable modular flexible upper limb exoskeleton rehabilitation robot. Secondly, based on the perspective of rigid–flexible coupling integration of bone–muscle–robot, the integrated equivalent mechanism model is constructed and the integrated dynamics model is established to plan compliance motion and develop intelligent compliance control strategy. Finally, the simulation experimental platform is built for simulation experimental demonstration of upper limb rehabilitation training. The implementation of this study will provide new idea and method for realizing the effect of flexible, compliance, light, and comfortable of upper limb rehabilitation training.
Inflammation in pathogenesis of chronic pain: Foe and friend
Authors: Fang Xiao-Xia , Zhai Meng-Nan , Zhu Meixuan , He Cheng , Wang Heng , Wang Juan , Zhang Zhi-Jun
Published: May 2023

Chronic pain is a refractory health disease worldwide causing an enormous economic burden on individuals and society. Accumulating evidence suggests that inflammation in the peripheral nervous system (PNS) and central nervous system (CNS) is the major factor in the pathogenesis of chronic pain. The inflammation in the early- and late phase may have distinctive effects on the initiation and resolution of pain, which can be viewed as friend or foe. On the one hand, painful injuries lead to the activation of glial cells and immune cells in the PNS, releasing pro-inflammatory mediators, which contribute to the sensitization of nociceptors, leading to chronic pain; neuroinflammation in the CNS drives central sensitization and promotes the development of chronic pain. On the other hand, macrophages and glial cells of PNS and CNS promote pain resolution via anti-inflammatory mediators and specialized pro-resolving mediators (SPMs). In this review, we provide an overview of the current understanding of inflammation in the deterioration and resolution of pain. Further, we summarize a number of novel strategies that can be used to prevent and treat chronic pain by controlling inflammation. This comprehensive view of the relationship between inflammation and chronic pain and its specific mechanism will provide novel targets for the treatment of chronic pain.
Preserving choice in breast cancer treatment: A different perspective on contralateral prophylactic mastectomy
Authors: Pender Kelly , Dodge Daleela , Collins Jessica M
Published: May 2023

Contralateral prophylactic mastectomy is the removal of both breasts when only one is affected by cancer. Rates of this controversial cancer treatment have been increasing since the late 1990s, even among women who do not have the kind of family history or known genetic mutation that would put them at high-risk for another breast cancer. Citing contralateral prophylactic mastectomy’s lack of oncologic benefit and increased risk of surgical complications, the American Society of Breast Surgeons discourages contralateral prophylactic mastectomy for average-risk women with unilateral cancer, as does most of the medical literature on this topic. Within this literature, desire for contralateral prophylactic mastectomy is often painted as the product of an emotional overreaction to a cancer diagnosis and misunderstanding of breast cancer risk. Drawing on the personal experience of a breast cancer survivor, as well as relevant medical literature on breast cancer screening and surgery, this article offers a different perspective on the ongoing popularity of contralateral prophylactic mastectomy, one that focuses on practical experiences and logical deliberations about those experiences. Specifically, it calls attention to two features of the contralateral prophylactic mastectomy decision-making situation that have been inadequately covered in the medical literature: (1) the way that breast cancer screening after a breast cancer diagnosis can become a kind of radiological overtreatment, even for “average-risk” women; and (2) how desire for bodily symmetry after breast cancer, which can best be achieved through bilateral reconstruction or no reconstruction, drives interest in contralateral prophylactic mastectomy. The goal of this article is not to suggest that all women who want contralateral prophylactic mastectomy should have the surgery. In some cases, it is not advisable. But many “average-risk” women with unilateral cancer have good reasons for wanting contralateral prophylactic mastectomy, and we believe their right to choose it should be protected.
An overview of the management of osteoporosis in the aging female population
Authors: Amin Usman , McPartland Aoife , O’Sullivan Miriam , Silke Carmel
Published: May 2023

Osteoporosis is a systemic skeletal disease that is a cause of morbidity and mortality. It can affect all ages but most frequently postmenopausal women. It is a silent condition, however, osteoporotic fractures can lead to significant pain and disability. In this review article, we aim to review the clinical approach to the management of postmenopausal osteoporosis. We include risk assessment, investigations, and the various pharmacological and non-pharmacological options used in the treatment of osteoporosis. We have discussed the pharmacological options individually including their mechanism of action, safety profile, effects on bone mineral density and fracture risks, and duration of use. Potential new treatments are also discussed. The importance of sequence in the use of osteoporotic medicine is also highlighted in the article. An understanding of the different treatment options will hopefully help in the management of this very common and debilitating condition.
Hand infection: a management approach based on a new understanding of combined bacterial and neutrophil mediated tissue damage
Authors: McGrouther Duncan Angus
Published: May 2023

Concepts of tissue damage from sepsis are rooted in the works of Pasteur regarding colonization by microorganisms, and Lister’s observation of avoiding suppuration by their exclusion. The reactive inflammation has been considered a beneficial defence mechanism. A more complex biology is now unfolding of pathogenic mechanisms with toxins produced by the organisms now being placed in a broad category of virulence factors. Neutrophils are key cells in providing innate immunity and their trafficking to sites of infection results in entry to the extracellular space where they attack pathogens by release of the contents of neutrophil granules and neutrophil extracellular traps. There is now considerable evidence that much of the tissue damage in infection is due to excessive host innate immunological reaction; a hyperinflammatory response, whether localized or systemic. In addition to traditional surgical methods of drainage and decompression there is now a focus on dilution of inflammatory mediators. This emerging knowledge can potentially alter the way we approach hand infections.
Day-by-day symptom relief after corticosteroid injection for trigger digit: a randomized controlled study of two techniques
Authors: Bitar Hasan , Zachrisson Anna K , Byström Martin , Strömberg Joakim
Published: May 2023

This prospective randomized controlled study compared two injection techniques for trigger digit: either dorsal to the tendons in the proximal phalanx (PP group) or anterior to the tendons at the A1 pulley level (A1 group) in 106 patients. The primary outcome was the number of days to total relief of pain, stiffness and triggering, as recorded by the patients on visual analogue scales day-by-day for 6 weeks. The median number of days to complete symptom relief was 9 days in the PP group and 11 days in the A1 group for pain, 11 days and 15 days for stiffness and 21 and 20 days for triggering, respectively. Ninety-one per cent of all patients did not require any additional treatment, but 11 patients in both groups reported some remaining symptoms at 6 weeks. This study did not detect any significant difference between the two injection techniques, but provides detailed data of the rate and order of symptomatic relief after corticosteroid injection for this common condition.

Level of evidence: I
Dynamics of emotion trends in Canadian Twitter users during COVID-19 confinement in relation to caseloads: Artificial intelligence-based emotion detection approach
Authors: Weerasinghe Swarna , Oyebode Oladapo , Orji Rita , Matwin Stan
Published: May 2023

Multiple waves of COVID-19 have significantly impacted the emotional well-being of all, but many were subject to additional risks associated with forced regulations. The objective of this research was to assess the immediate emotional impact, expressed by Canadian Twitter users, and to estimate the linear relationship, with the vicissitudes of COVID caseloads, using ARIMA time-series regression. We developed two Artificial Intelligence-based algorithms to extract tweets using 18 semantic terms related to social confinement and locked down and then geocoded them to tag Canadian provinces. Tweets (n = 64,732) were classified as positive, negative, and neutral sentiments using a word-based Emotion Lexicon. Our results indicated: that Tweeters were expressing a higher daily percentage of negative sentiments representing, negative anticipation (30.1%), fear (28.1%), and anger (25.3%), than positive sentiments comprising positive anticipation (43.7%), trust (41.4%), and joy (14.9%), and neutral sentiments with mostly no emotions, when hash-tagged social confinement and locked down. In most provinces, negative sentiments took on average two to three days after caseloads increase to emerge, whereas positive sentiments took a slightly longer period of six to seven days to submerge. As daily caseloads increase, negative sentiment percentage increases in Manitoba (by 68% for 100 caseloads increase) and Atlantic Canada (by 89% with 100 caseloads increase) in wave 1(with 30% variations explained), while other provinces showed resilience. The opposite was noted in the positive sentiments. The daily percentage of emotional expression variations explained by daily caseloads in wave one were 30% for negative, 42% for neutral, and 2.1% for positive indicating that the emotional impact is multifactorial. These provincial-level impact differences with varying latency periods should be considered when planning geographically targeted, time-sensitive, confinement-related psychological health promotion efforts. Artificial Intelligence-based Geo-coded sentiment analysis of Twitter data opens possibilities for targeted rapid emotion sentiment detection opportunities.
Form of government, electoral system, and party system fragmentation: A global comparison
Authors: Ünal Serkan , Metin Abdullah , Anckar Carsten , Tekin Bilgehan
Published: May 2023

This study aims to determine the characteristics of party systems within the context of electoral systems, forms of government, and continents. There is no study in the literature that quantitatively reveals the relationship between the party system and forms of government. Furthermore, this study differs from other studies in that it deals with the relationship between the electoral system and the party system on a global scale. In the study, the effective number of parties (ENEP and ENPP) was calculated for the last three legislative elections of the countries governed by presidential, president–parliamentary, premier–presidential and parliamentary forms of government, using the Laakso–Taagepera Index. The dataset was then analyzed with ANOVA and post-hoc tests. The study revealed that party systems do not differ significantly from forms of government, that is, forms of government do not determine party systems. Similarly, party systems do not significantly differ in terms of the continents, that is, there are no continental party system characteristics of the forms of government. Also, the study confirmed that it is the electoral system that determines the party systems.
Mortality in the Oldest-Old Adults After Discharge From Acute Geriatric Ward
Authors: Tal Sari
Published: May 2023

Aim: To examine risk factors for post-discharge mortality in the oldest-old patients. Methods: We have assessed the risk factors for mortality after discharge from acute geriatric ward in 448 patients aged ≥90. Results: Low albumin, high urea, and full dependence were risk factors for mortality within 1 month and within 1 year after discharge from hospital. Age-adjusted Charlson Comorbidity Index score, neuroleptic drug treatments and frailty were specific risk factors for post-discharge mortality within 1 year. By Cox regression analysis, the risk factors associated with higher hazard ratios for post-discharge mortality within 14 years follow-up were age-adjusted Charlson Comorbidity Index score, poor functional status, anemia and dementia as comorbidities, neuroleptic drug treatments, low albumin, high urea, and high vitamin B12. Conclusion: Optimal treatment of the condition due to which the patient has been hospitalized and of the medical complications that occurred during hospitalization, while preventing functional decline, might secure longer post-discharge survival.
Caring for patients with advanced COPD: beyond the inhalers…
Authors: Murray Michelle A. , Mulryan Kathryn , Ní Chléirigh Maedhbh , Redmond Karen C. , Kelly Emer
Published: May 2023

COPD affects millions of people worldwide. Patients with advanced COPD have a high symptom burden. Breathlessness, cough and fatigue are frequent daily symptoms. Guidelines often focus on pharmacological treatment, especially inhaler therapy, but other approaches in combination with medications offer symptomatic benefit.

In this review, we take a multidisciplinary approach with contributions from pulmonary physicians, cardiothoracic surgeons and a physiotherapist. The following areas are addressed: oxygen therapy and noninvasive ventilation (NIV), dyspnoea management, surgical and bronchoscopic options, lung transplantation and palliative care. Oxygen therapy prescribed within guidelines improves mortality in patients with COPD. NIV guidelines offer only low-certainty instruction on the use of this therapy on the basis of the limited available evidence. Dyspnoea management can take place through pulmonary rehabilitation. Specific criteria aid decisions on referral for lung volume reduction treatments through surgical or bronchoscopic approaches. Lung transplantation requires precise disease severity assessment to determine which patients have the most urgent need for lung transplantation and are likely to have the longest survival. The palliative approach runs in parallel with these other treatments, focusing on symptoms and aiming to improve the quality of life of patients and their families facing the problems associated with life-threatening illness. In combination with appropriate medication and an individual approach to symptom management, patients' experiences can be optimised.

Educational aims

To understand the multidisciplinary approach to management of patients with advanced COPD.

To recognise the parallel approaches to oxygen, NIV and dyspnoea management with consideration of more interventional options with lung volume reduction therapy or lung transplantation.

To understand the high level of symptomatology present in advanced COPD and the relevance of palliative care alongside optimal medical management.
Imaging the brain and vascular reactions to headache treatments: a systematic review
Authors: Messina R. , Christensen R. H. , Cetta I. , Ashina M. , Filippi M.
Published: May 2023

Background

Neuroimaging studies have made an important contribution to our understanding of headache pathophysiology. This systematic review aims to provide a comprehensive overview and critical appraisal of mechanisms of actions of headache treatments and potential biomarkers of treatment response disclosed by imaging studies.

Main body

We performed a systematic literature search on PubMed and Embase databases for imaging studies investigating central and vascular effects of pharmacological and non-pharmacological treatments used to abort and prevent headache attacks. Sixty-three studies were included in the final qualitative analysis. Of these, 54 investigated migraine patients, 4 cluster headache patients and 5 patients with medication overuse headache. Most studies used functional magnetic resonance imaging (MRI) (n = 33) or molecular imaging (n = 14). Eleven studies employed structural MRI and a few used arterial spin labeling (n = 3), magnetic resonance spectroscopy (n = 3) or magnetic resonance angiography (n = 2). Different imaging modalities were combined in eight studies.

Despite of the variety of imaging approaches and results, some findings were consistent. This systematic review suggests that triptans may cross the blood–brain barrier to some extent, though perhaps not sufficiently to alter the intracranial cerebral blood flow. Acupuncture in migraine, neuromodulation in migraine and cluster headache patients, and medication withdrawal in patients with medication overuse headache could promote headache improvement by reverting headache-affected pain processing brain areas. Yet, there is currently no clear evidence for where each treatment acts, and no firm imaging predictors of efficacy. This is mainly due to a scarcity of studies and heterogeneous treatment schemes, study designs, subjects, and imaging techniques. In addition, most studies used small sample sizes and inadequate statistical approaches, which precludes generalizable conclusions.

Conclusion

Several aspects of headache treatments remain to be elucidated using imaging approaches, such as how pharmacological preventive therapies work, whether treatment-related brain changes may influence therapy effectiveness, and imaging biomarkers of clinical response. In the future, well-designed studies with homogeneous study populations, adequate sample sizes and statistical approaches are needed.