bluuebunny/crossref_metadata_2025 huggingface dataset:
AUTOLOGOUS VERSUS SYNTHETIC BONE GRAFTS FOR THE SURGICAL MANAGEMENT OF TIBIAL PLATEAU FRACTURES: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS
Authors: Cooper G. , Kennedy M. , Jamal B. , Shields D.
Published: July 2023

Our objective was to conduct a systematic review and meta-analysis, comparing differences in clinical outcomes between either autologous or synthetic bone grafts in the operative management of tibial plateau fractures: a traumatic pattern of injury, associated with poor long-term functional prognosis.

A structured search of MEDLINE, EMBASE, The Bone & Joint and CENTRAL databases from inception until 07/28/2021 was performed. Randomised, controlled, clinical trials that compared autologous and synthetic bone grafts in tibial plateau fractures were included. Preclinical studies, clinical studies in paediatric patients, pathological fractures, fracture non-union or chondral defects were excluded. Outcome data was assessed using the Risk of Bias 2 (ROB2) framework and synthesised in random-effect meta-analysis. Preferred Reported Items for Systematic Review and Meta-Analysis guidance was followed throughout.

Six comparable studies involving 352 patients were identified from 3,078 records. Following ROB2 assessment, five studies (337 patients) were eligible for meta-analysis. Within these studies, more complex tibia plateau fracture patterns (Schatzker IV-VI) were predominant. Primary outcomes showed non-significant reductions in articular depression at immediate postoperative (mean difference −0.45mm, p=0.25, 95% confidence interval (95%CI): −1.21-0.31mm, I2=0%) and long-term (>6 months, standard mean difference −0.56, p=0.09, 95%CI: −1.20-0.08, I2=73%) follow-up in synthetic bone grafts. Secondary outcomes included mechanical alignment, limb functionality, defect site pain, occurrence of surgical site infections, secondary surgery, perioperative blood loss, and duration of surgery. Blood loss was lower (90.08ml, p<0.001, 95%CI: 41.49-138.67ml, I2=0%) and surgery was shorter (16.17minutes, p=0.04, 95%CI: 0.39-31.94minutes, I2=63%) in synthetic treatment groups. All other secondary measures were statistically comparable.

Our findings supersede previous literature, demonstrating that synthetic bone grafts are non-inferior to autologous bone grafts, despite their perceived disadvantages (e.g. being biologically inert). In conclusion, surgeons should consider synthetic bone grafts when optimising peri-operative patient morbidity, particularly in complex tibial plateau fractures, where this work is most applicable.
COMBINING STRUCTURED LIGHT SCANNING AND 3D PRINTING TO PRODUCE PHYSICAL MODELS OF HUMAN BONES: A PILOT STUDY
Authors: Woodhead J. , Paxton J.
Published: July 2023

While the COVID-19 pandemic highlighted the need for more accessible anatomy instruction tools, it is also well known that the time allocated to practical anatomy teaching has reduced in the past decades. Notably, the opportunity for anatomy students to learn osteology is not prioritised, nor is the ability of students to appreciate osteological variation. As a potential method of increasing accessibility to bone models, this study describes the process of developing 3D-printed replicas of human bones using a combination of structured light scanning (SLS) technology and 3D printing.

Human bones were obtained from the Anatomy Lab at the University of Edinburgh and were digitised using SLS via an Einscan H scanner. The resulting data was then used to print multiple replicas of varying materials, colours, scales and resolutions on an Ultimaker S3 3D printer. To gather opinion on these models and their variables, surveys were completed by anatomy students and educators (n=57). Data was collected using a Likert scale response, as well as free-text answers to gather qualitative information.

3D scans of the scapula, atlas (C1 vertebrae) and femur were successfully obtained. Plastic replicas were produced with defined variables in 4 separate stations e.g. different colours, to obtain results from survey respondents. For colour, 87.7% of survey respondents preferred white models, with 7% preferring orange and 5.3% preferring blue. For material, 47.4% of respondents preferred PLA (Polylactic acid), while 33.3% preferred ABS (Acrylonitrile butadiene styrene), 12.3% preferred Pet-G (Polyethylene terephthalate glycol), 3.5% preferred Glassbend and 3.5% had no preference. Additional results based on scale and resolution were also collected.

This initial study has demonstrated a proof-of-concept workflow for SLS technology to be combined with 3D printing to produce plastic replicas of human bones. Our study has provided key information about the colour, scale, material and resolution required for these models. Our future work will focus on determining accuracy of the models and their use as teaching aids for osteology education.
OUTCOMES FOLLOWING TOTAL HIP AND TOTAL KNEE ARTHROPLASTY IN PATIENTS WITH PAGET'S DISEASE OF BONE: A SYSTEMATIC REVIEW
Authors: Arif M. , Makaram N. , Macpherson G. , Ralston S.
Published: July 2023

Patients with Paget's Disease of Bone (PDB) more frequently require total hip arthroplasty (THA) and total knee arthroplasty (TKA). However, controversy remains regarding their outcome. This project aims to evaluate the current literature regarding outcomes following THA and TKA in PDB patients.

MEDLINE, EMBASE and Cochrane databases were searched on February 15th, 2022. Inclusion criteria comprised studies evaluating outcomes following THA/TKA in PDB patients. Quality of included studies was assessed using the Newcastle-Ottawa Scale.

19 articles (published between 1976–2022) were included, comprising 58,695 patients (48,766 controls and 10,018 PDB patients), from 209 potentially relevant titles. No study was of high quality. PDB patient pooled mortality was 32.5% at mean 7.8(0.1-20) years following THA and 31.0% at mean 8.5(2-20) years following TKA. PDB patient revision rate was 4.4% at mean 7.2(0-20) years following THA and 2.2% at mean 7.4(2-20) years following TKA. Renal complications, respiratory complications, heterotopic ossification, and surgical site infection were the most common medical and surgical complications.

The largest systematic review, to date, evaluating outcomes following THA and TKA in PDB patients. All functional outcome scores improved. PDB patient revision rate was comparable to UK National Joint Registry. However, there is a significant need for prospective matched case-control studies to robustly compare outcomes in PDB patients with unaffected counterparts.
DEVELOPMENT OF A PRE-CLINICAL EXPERIMENTAL MODEL TO MEASURE MEDIAL MENISCUS POSITION DURING A SIMULATED GAIT CYCLE OF THE KNEE JOINT
Authors: Pounds G. , Liu A. , Jones A. , Jennings L.
Published: July 2023

The aim of this work was to develop a novel, accessible and low-cost method, which is sufficient to measure changes in meniscal position in a whole-knee joint model performing dynamic motion in a knee simulator.

An optical tracking method using motion markers, MATLAB (MATLAB, The MathWorks Inc.) and a miniature camera system (Raspberry Pi, UK) was developed. Method feasibility was assessed on porcine whole joint knee samples (n = 4) dissected and cemented to be used in the simulator (1). Markers were placed on three regions (medial, posterior, anterior) of the medial meniscus with corresponding reference markers on the tibial plateau, so the relative meniscal position could be calculated. The Leeds high kinematics gait profile scaled to the parameters of a pig (1, 2) was driven in displacement control at 0.5 Hz. Videos were recorded at cycle-3 and cycle-50. Conditions tested were the capsule retained (intact), capsule removed and a medial posterior root tear. Mean relative displacement values were taken at time-points relating to the peaks of the axial force and flexion-extension gait inputs, as well as the range between the maximum and minimum values. A one-way ANOVA followed by Tukey post hoc analysis were used to assess differences (p = 0.05).

The method was able to measure relative meniscal displacement for all three meniscal regions. The medial region showed the greatest difference between the conditions. A significant increase (p < 0.05) for the root tear condition was found at 0.28s and 0.90s (axial load peaks) during cycle-3. Mean relative displacement for the root tear condition decreased by 0.29 mm between cycle-3 and cycle-50 at the 0.28s time-point. No statistically significant differences were found when ranges were compared at cycle-3 and cycle-50.

The method was sensitive to measure a substantial difference in medial-lateral relative displacement between an intact and a torn state. Meniscus extrusion was detected for the root tear condition throughout test duration. Further work will progress onto human specimens and apply an intervention condition.
WHAT DO PATIENTS PERCEIVE AS HELPFUL DURING AN INTERDISCIPLINARY MULTIMODAL PAIN THERAPY?
Authors: Schiltenwolf M. , Neubauer E. , Videva M.
Published: July 2023

Chronic pain is recognised as a problem worldwide. Interdisciplinary multimodal pain therapy (MMPT) is currently the gold standard of treatment.

The aim of the present prospective observational study is to research whether chronic pain patients form an intention for lifestyle change during a 4-week-long treatment at the Outpatient Clinic for Pain Therapy and Conservative Orthopedics in Heidelberg, Germany, and how sustainable this change is after 3 months. In addition, we theorized a connection between standardised survey endpoints and the number of therapy units perceived as helpful (TPAH). Finally, the effect of socio-demographic factors on patient perceptions were put into perspective.

Clinical data was collected via 3-part-questionnaires from 95 German-speaking patients at 4 checkpoints between 05/2020 and 11/2021 at admission (T1), after 2 weeks (T2), at discharge (T3) and 3 months post-treatment (T4). The questionnaires consisted of already established scores for surveying chronic pain patients, such as the von Korff Chronification Scale, ODI, HADS, PSEQ/FESS, and FABQ, a grading scale for each therapy unit, and free answers.

Patients were most likely to implement Group Walking in their everyday lives. A higher number of TPAH neither lowered nor improved significantly the change in lifestyle, but both a higher number and bigger lifestyle changes improved significantly the scores across the standardised surveys. Furthermore, no significant change in intention happened between the second and the fourth week. Physical components were perceived throughout as more helpful.

The results of this research support the efficacy of MMPT in multi-faceted improving of the patient's well-being and lowering the possibility for pain chronification. A higher number of TPAH could be translated as having more available techniques to combat chronic pain in everyday life. The number of TPAH and the amount of lifestyle change both influence positively the survey scores, yet no connection between them was found. A third factor could be the reason for this constellation. The possibility that the more mental therapies are offered, the more likely it is for those to be perceived as helpful, cannot be excluded either. Further research is required on both topics.
EVALUATION OF CELL VIABILITY IN LOW CELL DENSITY INTERVERTEBRAL DISC (IVD) TISSUE: TIPS AND TECHNICAL NOTES
Authors: Lazaro-Pacheco D. , Holsgrove T.
Published: July 2023

Little information exists when using cell viability assays to evaluate cells within whole tissue, particularly specific types such as the intervertebral disc (IVD). When comparing the reported methodologies and the protocols issued by manufacturers, the processing, working times, and dye concentrations vary significantly, making the assay's reproducibility a costly and time-consuming trial and error process. This study aims to develop a detailed step-by-step cell viability assay protocol for evaluating IVD tissue.

IVDs were harvested from bovine tails (n=8) and processed at day 0 and after 7 days of culture. Nucleus pulposus (NP) and the annulus fibrosus (AF) 3 mm cuts were incubated at room temperature (26˚C) with a Viability/Cytotoxicity Kit containing Calcein AM and Ethidium Ethidium homodimer-1 for 2 hr, followed by flash freezing in liquid nitrogen. Thirty µm sections were placed in glass slides and sealed with nail varnish or Antifade Mounting Medium. The IVD tissue was imaged within the next 4h after freezing using an inverted confocal laser-scanning microscope equipped with 488 and 543 nm laser lines.

Cell viability at day 0 (NP: 92±9.6 % and AF:80±14.0%) and day 7 (NP: 91±7.9% and AF:76±20%) was successfully maintained and evaluated. The incubation time required is dependent on the working temperatures and tissue thickness. The calcein-AM dye will not be retained in the cells for more than four hours.

The specimen preparation and culturing protocol have demonstrated good cell viability at day 0 and after seven days of culture. Processing times and sample preparation play an essential role as the cell viability components in most kits hydrolyse or photobleach quickly. A step-by-step replicable protocol for evaluating the cell viability in IVD will facilitate the evaluation of cell and toxicity-related outcomes of biomechanical testing protocols and IVD regenerative therapies.
MARKERLESS MOTION CAPTURE FOR CLINICAL MOVEMENT ANALYSIS AND THE INFLUENCE OF CLOTHING ON GAIT METRICS
Authors: Flood M. , Gette P. , Cabri J. , Grimm B.
Published: July 2023

For clinical movement analysis, optical marker-based motion capture is the gold standard.

With the advancement of AI-driven computer vision, markerless motion capture (MMC) has emerged. Validity against the marker-based standard has only been examined for lightly-dressed subjects as required for marker placement. This pilot study investigates how different clothing affects the measurement of typical gait metrics.

Gait tests at self-selected speed (4 km/h) were performed on a treadmill (Motek Grail), captured by 9 cameras (Qualisys Miqus, 720p, f=100Hz) and analyzed by a leading MMC application (Theia, Canada). A healthy subject (female, h=164cm, m=54kg) donned clothes between trials starting from lightly dressed (LD: bicycle tight, short-sleeved shirt), adding a short skirt (SS: hip occlusion) or a midi-skirt (MS: partial knee occlusion) or street wear (SW: jeans covering ankle, long-sleeved blouse), the lattern combined with a short jacket (SWJ) or a long coat (SWC). Gait parameters (mean±SD, t=10s) calculated (left leg, mid-stance) were ankle pronation (AP-M), knee flexion (KF-M), pelvic obliquity (PO-M) and trunk lateral lean (TL-M) representing clinically common metrics, different joints and anatomic planes. Four repetitions of the base style (LD) were compared to states of increased garment coverage using the t-test (Bonferroni correction).

For most gait metrics, differences between the light dress (LD) and various clothing styles were absent (p>0.0175), small (< 2SD) or below the minimal clinically important differences (MCID). For instance, KF-M was for LD=10.5°±1.7 versus MD=12.0°±0.5 (p=0.07) despite partial knee cover. AP-M measured for LD=5.2°±0.6 versus SW=4.1°±0.7 (p<0.01) despite ankle cover-up. The difference for KF-M between LD=10.5°±1.7 versus SWL=6.0°±0.9, SW and SWJ (7.6°±1.5, p<0.01) indicates more intra-subject gait variability than clothing effect.

This study suggests that typical clothings styles only have a small clinically possibly negligible effect on common gait parameters measured with MMC. Thus, patients may not need to change clothes or be instructed to wear specific garments. In addition to avoiding marker placement, this further increases speed, ease and economy of clinical gait analysis with MMC facilitating high volume or routine application.
A NOVEL TYPE THERMOPLASTIC INJECTABLE BONE SUBSTITUTE
Authors: Hsieh Y-H. , Hsieh M-F. , Shu Y-T. , Lee H-M.
Published: July 2023

A spine compression fracture is a very common form of fracture in elderly with osteoporosis. Injection of polymethyl methacrylate (PMMA) to fracture sites is a minimally invasive surgical treatment, but PMMA has considerable clinical risks. We develop a novel type thermoplastic injectable bone substitute contains the proprietary composites of synthetic ceramic bone substitute and absorbable thermoplastic polymer.

We used thermoplastic biocompatible polymers Polycaproactone (PCL) to encapsulate calcium-based bone substitutes hydroxyapatite (Ca10(PO4)6(OH)2, HA) and tricalcium phosphate (TCP) to form a biodegradable injectable bone composite material. The space occupation ration PCL:HA/TCP is 1:9. After heating process, it can be injected to fracture site by specific instrument and then self-setting to immediate reinforce the vertebral body.

The thermoplastic injection bone substitute can obtain good injection properties after being heated by a heater at 90˚C for three minutes, and has good anti-washout property when injected into normal saline at 37˚C. After three minutes, solidification is achieved. Mechanical properties were assessed using the material compression test system and the mechanical support close to the vertebral spongy bone.

In vitro cytotoxicity MTT assay (3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) was performed and no cell cytotoxicity was observed.

In vivo study with three New Zealand rabbits was performed, well bone growth into bone substitute was observed and can maintain good mechanical support after three months implantation.

The novel type thermoplastic injection bone substitute can achieve (a) adequate injectability and viscosity without the risk of cement leakage; (b) adequate mechanical strength for immediate reinforcement and prevent adjacent fracture; (c) adequate porosity for new bone ingrowth; (e) biodegradability. It could be developed as a new option for treating vertebral compression fractures.
PROTEOMIC IDENTIFICATION OF PREDICTIVE AUTOLOGOUS CHONDROCYTE IMPLANTATION BIOMARKERS IN PLASMA
Authors: Hulme C. , Roberts S. , Gallagher P. , Jermin P. , Wright K.
Published: July 2023

Stratification is required to ensure that only those patients likely to benefit, receive Autologous Chondrocyte Implantation (ACI); ideally by assessing a biomarker in the blood. This study aimed to assess differences in the plasma proteome of individuals who respond well or poorly to ACI.

Isobaric tag for relative and absolute quantitation (ITRAQ) mass spectrometry and label-free proteomics analyses were performed in tandem as described previously by our group (Hulme et al., 2017; 2018; 2021) using plasma collected from ACI responders (n=10) compared with non-responders (n=10) at each stage of surgery (Stage I, cartilage harvest and Stage II, cell implantation).

iTRAQ using pooled plasma detected 16 proteins that were differentially abundant at baseline in ACI responders compared with non-responders (n=10) (≥±2.0 fold; p<0.05). Responders demonstrated a mean Lysholm (patient reported functional score from 0–100) improvement of 33±13 and non-responders a mean worsening of −13±13 points. The most pronounced plasma proteome shift was seen in response to Stage I surgery in ACI non-responders, with 48 proteins being differentially abundant between the two surgical procedures. We have previously noted this marked shift in response to initial surgery in the SF of ACI non-responders, several of these proteins were associated with the Acute Phase Response. One of these proteins, clusterin, could be confirmed in patients’ plasma using an independent immunoassay using individual samples. Label-free proteomic data from individual samples identified only cartilage acidic protein-1 (known to associate with osteoarthritis progression) to be significantly more abundant at Stage I in the plasma of non-responders.

This study indicates that proteins can be identified within the plasma that have potential use in ACI patient stratification. Further work is required to validate the findings of this discovery-phase work in larger ACI cohorts.
IDENTIFICATION OF PATIENT-SPECIFIC RISK FACTORS AFTER ARTHROSCOPIC PARTIAL MENISCECTOMY: TOWARDS THE DEVELOPMENT OF AN INDIVIDUALIZED TREATMENT ALGORITHM
Authors: Stockmann A. , Grammens J. , Lenz J. , Pattappa G. , von Haver A. , Docheva D. , Zellner J. , Verdonk P. , Angele P.
Published: July 2023

Partial meniscectomy patients have a greater likelihood for the development of early osteoarthritis (OA). To prevent the onset of early OA, patient-specific treatment algorithms need to be created that predict patient risk to early OA after meniscectomy. The aim of this work was to identify patient-specific risk factors in partial meniscectomy patients that could potentially lead to early OA.

Partial meniscectomy patients operated between 01/2017 and 12/2019 were evaluated in the study (n=317). Exclusion criteria were other pathologies or surgeries for the evaluated knee and meniscus (n = 114). Following informed consent, an online questionnaire containing demographics and the “Knee Injury and Osteoarthritis Outcome Score” (KOOS) questionnaire was sent to the patient. Based on the KOOS pain score, patients were classified into “low” (> 75) and “high” (< 75) risk patients, indicating risk to symptomatic OA. The “high risk” patients also underwent a follow-up including an MRI scan to understand whether they have developed early OA.

From 203 participants, 96 patients responded to the questionnaire (116 did not respond) with 61 patients considered “low-risk” and 35 “high-risk” patients. Groups that showed a significant increased risk for OA were patients aged > 40 years, females, overweight (BMI >25 kg/m2 ≤ 30 kg/m2), and smokers (*p < 0.05). The “high-risk”-follow-up revealed a progression of early osteoarthritic cartilage changes in seven patients, with the remaining nineteen patients showing no changes in cartilage status or pain since time of operation. Additionally, eighteen patients in the high-risk group showed a varus or valgus axis deviation.

Patient-specific factors for worse postoperative outcomes after partial meniscectomy and indicators for an “early OA” development were identified, providing the basis for a patient-specific treatment approach. Further analysis in a multicentre study and computational analysis of MRI scans is ongoing to develop a patient-specific treatment algorithm for meniscectomy patients.
MOREL-LAVALLÉE LESION INDUCED BY DYNAMIC HIP SCREW (DHS) CUT OUT: A CASE REPORT AND LITERATURE REVIEW
Authors: Alzahrani S. , Aljuaid M. , Bazaid Z. , Shurbaji S.
Published: July 2023

A Morel-Lavallee lesion (MLL) is a benign cystic lesion that occurs due to injury to the soft-tissue envelope's perforating vascular and lymphatic systems, resulting in a distinctive hemolymphatic fluid accumulation between the tissue layers. The MLL has the potential to make a significant impact on the treatment of orthopaedic injuries.

A 79-year-old male patient community ambulatory with assisting aid (cane) known case of Diabetes mellitus, hypertension, bronchial asthma and ischemic heart disease. He was brought to the Emergency, complaining of right hip discomfort and burning sensation for the last 5 days with no history of recent trauma at all. Patient had history of right trochanteric femur fracture 3 years ago, treated with DHS in a privet service. Clinical and Radiological assessment showed that the patient mostly has acute MLL due to lag screw cut out. We offered the patient the surgical intervention, but he refused despite explaining the risks of complications if not treated and preferred to receive the conservative treatment. Compression therapy management explained to him including biker's shorts (instructed to be worn full-time a day) and regular follow up in clinic. Symptom's improvement was reported by the patient in the subsequent visits.

In the polytrauma patient, a delayed diagnosis of these lesions is conceivable due to the presence of more visible injuries. It's located over the greater trochanter more commonly, but sometimes in other areas such as the lower lumbar region, the thigh, or the calf. Incorrect or delayed diagnosis and care can have unfavorable outcomes such as infection, pseudocyst development, and cosmetologically deformity. Magnetic resonance imaging (MRI) and ultrasound will aid in MLL diagnosis. However, the effectiveness of MLL therapy remains debatable.

We strongly believe that the MLL caused due to tangential shear forces applied to the soft tissue leads to accumulation of the blood and/or lymph between the subcutaneous and overlying fascia and it often misdiagnosed due to other distracting injuries. Nontheless, in our case we reported MLL occur due to internal pressure on the fascia caused by cut out of DHS lag screw.
PCRX-201, A NOVEL GENE THERAPY TREATMENT APPROACH FOR INTERVERTEBRAL DISC DEGENERATION
Authors: Snuggs J. , Senter R. , Whitt J. , Le Maitre C.
Published: July 2023

Low back pain affects 80% of the population with half of cases attributed to intervertebral disc (IVD) degeneration. However, the majority of treatments focus on pain management, with none targeting the underlying pathophysiological causes. PCRX-201 presents a novel gene therapy approach that addresses this issue. PCRX-201 codes for interleukin-1 receptor antagonist (IL-1Ra), the natural inhibitor of the pro-inflammatory cytokine IL-1, which orchestrates the catabolic degeneration of the IVD. Our objective here is to determine the ability of PCRX-201 to infect human nucleus pulposus (NP) cells and tissue to increase the production of IL-1Ra and assess downstream effects on catabolic protein production.

Degenerate human NP cells and tissue explants were infected with PCRX-201 at 0 or 3000 multiplicities of infection (MOI) and subsequently cultured for 5 days in monolayer (n=7), 21 days in alginate beads (n=6) and 14 days in tissue explants (n=5). Cell culture supernatant was collected throughout culture duration and downstream targets associated with pain and degeneration were assessed using ELISA.

IL-1Ra production was increased in NP cells and tissue infected with PCRX-201. The production of downstream catabolic proteins such as IL-1β, IL-6, MMP3, ADAMTS4 and VEGF was decreased in both 3D-cultured NP cells and tissue explants.

Here, we have demonstrated that a novel gene therapy, PCRX-201, is able to infect and increase the production of IL-1Ra in degenerate NP cells and tissue in vitro. The increase of IL-1Ra also resulted in a decrease in the production of a number of pro-inflammatory and catabolic proteins, suggesting PCRX-201 enables the inhibition of IL-1-driven IVD degeneration. At present, no treatments for IVD degeneration target the underlying pathology. The ability of FX201 to elicit anti-catabolic responses is promising and warrants further investigation in vitro and in vivo, to determine the efficacy of this exciting, novel gene therapy.
Dispelling myths and challenging neglect in ‘borderline personality disorder’ healthcare: a lived-experience perspective
Authors: Aves Wren
Published: July 2023

The healthcare experience of many people carrying the label ‘borderline personality disorder (BPD)’ is one of exclusion, discrimination and neglect. The letters ‘BPD’ replace our very humanity, trampling our right to receive evidence-based, appropriate, lawful and compassionate care. Within mental health services our pain, distress, unusual experiences and self-harm/suicidal actions have been reconceptualised as ‘behavioural’ issues, encouraging the promotion of punitive and cruel responses from professionals in an attempt to discourage us from seeking help. ‘Responsibilisation’ narratives, which prioritise personal independence over all else, legitimise institutional neglect. We are told suicide is a choice we have the capacity to make, while care is actively withheld to avoid us becoming dependent on support. Despite the rising suicide rates of people labelled with a personality disorder diagnosis in the UK, our risk continues to be downplayed; rewritten as a risk of death by ‘misadventure’; and accepted by services and coroners as a justifiable outcome of so-called ‘less is more’ care plans. This article explores the current mental health service landscape in which prejudice and stigma direct ‘BPD’ care through the creation and maintenance of clinical mythology, which despite its popularity across healthcare teams, is not supported by ongoing research findings and recommendations.
Necromancing the Stones
Authors: Hodali Suleiman
Published: July 2023

Abstract: This article argues that nostalgia, as a spatially-oriented concept which developed around the late eighteenth century, was integral to the development of Romanticism in the period. From this emergent paradigm of nostalgia, Palestine––both as a literal and figural place––acquired a renewed interest and prominence in aesthetic and national cultures of the Romantic period. The article then traces how a multiplicity of native Palestinian Romanticisms developed partly in response to American and European encroachments on Palestine that were themselves partly motivated by Romanticism.
Palestine as Europe’s Future: Antiquity as Contemporaneity in Volney’s Travels , Considerations , and The Ruins
Authors: Beenstock Zoe
Published: July 2023

Abstract: European Romanticism often represents Palestine in ageographical terms. Through an analysis of Volney’s writings on the East, this article traces Palestinian ageography to religiously-inflected discourses that identify Palestine as Europe’s future. Volney juxtaposes antiquarianism, realist travelogue, and science fictional literary modes to represent Palestine’s multiple spiritual pasts, its contemporaneity with Europe, and its prophetic anticipation of revolution. His account of Palestine shapes Romanticism and Mary Shelley’s Frankenstein as arguably the first science fiction novel, demonstrating the importance of religious discourses for Romantic European engagements with Palestine.
George Eliot, Edward Said, and Romantic Zionism
Authors: Chapnick Max L.
Published: July 2023

Abstract: This essay re-examines George Eliot’s Daniel Deronda by way of Edward’s Said’s readings, and argues that in this novel Eliot helps usher into being a Zionism infused with the ideas and feelings of an earlier generation of British Romantics. With allusions to Romantics like Walter Scott and William Wordsworth, Eliot’s literary rendering of Zionism includes Romanticism’s elements of fellow-feeling and providential futurity. The novel’s reception by European Zionists facilitated the mixing of Romantic ideology into Zionism; understanding these future-oriented and sympathetic elements helps us better understand Zionism more generally.
Three-dimensional oxygen concentration monitoring in hydrogels using low-cost phosphorescence lifetime imaging for tissue engineering
Authors: Mei Xu , Fang Qiyin , Selvaganapathy P. Ravi
Published: July 2023

Oxygen concentration measurement in 3D hydrogels is vital in 3D cell culture and tissue engineering. However, standard 3D imaging systems capable of measuring oxygen concentration with adequate precision are based on advanced microscopy platforms, which are not accessible in many laboratories due to the system's complexity and the high price. In this work, we present a fast and low-cost phosphorescence lifetime imaging design for measuring the lifetime of oxygen-quenched phosphorescence emission with 0.25 µs temporal precision and sub-millimeter spatial resolution in 3D. By combining light-sheet illumination and the frequency-domain lifetime measurement using a commercial rolling-shutter CMOS camera in the structure of a conventional optical microscope, this design is highly customizable to accommodate application-specific research needs while also being low-cost as compared to advanced instruments. As a demonstration, we made a fluidic device with a gas-permeable film to create an artificial oxygen gradient in the hydrogel sample. Dye-embedded beads were distributed in the hydrogel to conduct continuous emission lifetime monitoring when nitrogen was pumped through the fluidic channel and changed oxygen distribution in the sample. The dynamics of the changes in lifetime co-related with their location in the gel of size 0.5 mm×1.5 mm×700 µm demonstrate the ability of this design to measure the oxygen concentration stably and precisely in 3D samples.
Analytical propagation formulae of spectrally combined laser beams in nonlinear Kerr media
Authors: He Li , Ji Xiaoling , Li Xiaoqing
Published: July 2023

The analytical propagation formulae of spectrally combined laser beams (SCLBs) in nonlinear Kerr media are derived, and the analytical expression of the ratio of the effect of the photorefractivity to the diffraction of SCLBs propagating in nonlinear Kerr media is also obtained. The validity of the analytical propagation formulae of SCLBs in nonlinear Kerr media is confirmed, and the error of the analytical propagation formulae is also discussed. It is shown the calculation time is reduced greatly by using the analytical propagation formulae. Therefore, a useful method is presented to study the propagation of SCLBs in nonlinear Kerr media.
Doping profile architecture towards lower loss and higher efficiency for laser diodes
Authors: Xu Chuanwang , Qi Aiyi , Wang Juwen , Qu Hongwei , Wang Liang , Meng Fansheng , Han Renbo , Fu Ting , Zhou Xuyan , Zheng Wanhua
Published: July 2023

A doping optimization model towards lower loss and higher efficiency at the target operating current is investigated. This model considers the effect of doping concentration on the series resistance and the internal loss. 780 nm lasers doped with a normal doping profile (Dop_normal) and an optimized doping profile (Dop_optimize) are both designed and fabricated. After doping optimization, the power loss decreased by 17%, the output power of the lasers increased by 26% and the electro-optical conversion efficiency increased by 22%. The model provides significant theoretical guidance for the optimization of the laser doping.
Temperature-dependent THz properties and emission of organic crystal BNA
Authors: Mansourzadeh Samira , Vogel Tim , Shalaby Mostafa , Saraceno Clara J.
Published: July 2023

As high-average power ultrafast lasers become increasingly available for nonlinear conversion, the temperature dependence of the material properties of nonlinear crystals becomes increasingly relevant. Here, we present temperature-dependent THz complex refractive index measurements of the organic crystal BNA over a wide range of temperatures from 300 K down to 80 K for THz frequencies up to 4 THz for the first time. Our measurements show that whereas the temperature-dependent refractive index has only minor deviation from room temperature values, the temperature-dependent absorption coefficient decreases at low temperature (−24% from 300 K to 80 K). We additionally compare these measurements with conversion efficiency and spectra observed during THz generation experiments using the same crystal actively cooled in the same temperature range, using an ultrafast Yb-laser for excitation. Surprisingly, the damage threshold of the material does not improve significantly upon active cooling, pointing to a nonlinear absorption mechanism being responsible for damage. However, we observe a significant increase in THz yield (+23%) at lower temperatures, which is most likely due to the reduced THz absorption. These first findings will be useful for future designs of high-average power pumped organic-crystal based THz-TDS systems.
Enhancement of the phase sensitivity with two-mode squeezed coherent state based on a Mach-Zehnder interferometer
Authors: Liu Jun , Shao Tao , Wang Yuanxiang , Zhang Mingming , Hu Youyou , Chen Dongxu , Wei Dong
Published: July 2023

We theoretically study the phase estimation based on a Mach-Zehnder interferometer (MZI) with a two-mode squeezed coherent state. By maximizing the quantum Fisher information, we find that the quantum Cramér-Rao bounds (QCRB) can reach sub-Heisenberg limit under the phase-matched condition. The optimal phase sensitivity can reach the sub-shot noise limit (SNL) and approach the QCRB by employing the intensity difference detection. Meanwhile, compared with the MZI fed with a coherent plus a single-mode squeezed vacuum state, this scheme can have better performance by adjusting the squeezing parameter and the mean photon number. With the same parameter, our scheme shows more sensitive phase measurement than the SU(1,1) interferometer with a coherent plus a vacuum state. We also show that the phase sensitivity of our proposal can still reach the SNL when the loss of the photon is 36%. This scheme can provide potential applications in optical sensors.
Towards 200 Gbit/s low-bias-operation vertical Ge-on-Si waveguide photodetectors
Authors: Alasio Matteo , Vallone Marco , Tibaldi Alberto , Namnabat Soha , Adams Donald , Gothoskar Prakash , Forghieri Fabrizio , Masini Gianlorenzo , Bertazzi Francesco , Ghione Giovanni , Gioannini Mariangela , Goano Michele
Published: July 2023

We discuss the characterization and numerical simulation of vertical Ge-on-Si waveguide photodetectors (WPDs) of the Cisco platform for data communications in the O-band (1.31 μm), with the goal of optimizing their frequency response while integrating them into low-power systems.
The photodetectors under test have an electro-optic bandwidth of more than 40 GHz at a standard bias voltage of -2 V.
Bandwidths larger than 10 GHz are observed even at zero bias, suggesting that vertical WPDs can be exploited in optical communication systems with minimal power consumption.
In fact, the characterization campaign has allowed the validation of a complex multiphysics model that is providing design guidelines towards bandwidths not only wider than 60 GHz at -2 V, suitable for application in 200 Gbit/s systems, but also wider than 40 GHz at zero bias.
The Inventory of Nonordinary Experiences (INOE): Evidence of validity in the United States and India
Authors: Taves Ann , Ihm Elliott , Wolf Melissa , Barlev Michael , Kinsella Michael , Vyas Maharshi
Published: July 2023

Researchers increasingly recognize that the mind and culture interact at many levels to constitute our lived experience, yet we know relatively little about the extent to which culture shapes the way people appraise their experiences and the likelihood that a given experience will be reported. Experiences that involve claims regarding deities, extraordinary abilities, and/or psychopathology offer an important site for investigating the interplay of mind and culture at the population level. However, the difficulties inherent in comparing culture-laden experiences, exacerbated by the siloing of research on experiences based on discipline-specific theoretical constructs, have limited our ability to do so. We introduce the Inventory of Nonordinary Experiences (INOE), which allows researchers to compare experiences by separating the phenomenological features from how they are appraised and asking about both. It thereby offers a new means of investigating the potentially universal (etic) and culture-specific (emic) aspects of lived experiences. To ensure that the INOE survey items are understood as intended by English speakers in the US and Hindi speakers in India, and thus can serve as a basis for cross-cultural comparison, we used the Response Process Evaluation (RPE) method to collect evidence of item-level validity. Our inability to validate some items drawn from other surveys suggests that they are capturing a wider range of experiences than researchers intend. Wider use of the RPE method would increase the likelihood that survey results are due to the differences that researchers intend to measure.
A multidisciplinary study on the social customs of the Tang Empire in the Medieval Ages
Authors: Zhao Dongyue , Chen Yang , Xie Gaowen , Ma Pengcheng , Wen Yufeng , Zhang Fan , Wang Yafei , Cui Yinqiu , Gao Shizhu
Published: July 2023

Multidisciplinary research on human remains can provide important information about population dynamics, culture diffusion, as well as social organization and customs in history. In this study, multidisciplinary analyses were undertaken on a joint burial (M56) in the Shuangzhao cemetery of the Tang Dynasty (618–907 AD), one of the most prosperous dynasties in Chinese history, to shed light on the genetic profile and sociocultural aspects of this dynasty. The archaeological investigation suggested that this burial belonged to the Mid-Tang period and was used by common civilians. The osteological analysis identified the sex, age, and health status of the three individuals excavated from M56, who shared a similar diet inferred from the stable isotopic data. Genomic evidence revealed that these co-buried individuals had no genetic kinship but all belonged to the gene pool of the ancient populations in the Central Plains, represented by Yangshao and Longshan individuals, etc. Multiple lines of evidence, including archaeology, historic records, as well as chemical and genetic analyses, have indicated a very probable familial joint burial of husband and wives. Our study provides insights into the burial customs and social organization of the Tang Dynasty and reconstructs a scenario of civilian life in historic China.
Reassessing the terminal ballistic performance of trilobate and quadrilobate arrow points on Iron Age battlefields
Authors: Pettigrew Devin B. , Taylor William
Published: July 2023

In the Eurasian Iron Age arrow points comprise a prominent class of artifact. Projectile experiments are useful for studying the ballistic performance of ancient arrow points and implications of arrow point innovations in warfare and shifting socio politics in Eurasia. However, when projectile experiments are not representative of past weapon use, they can lead to misinterpretations of the archaeological record. Notable problems arise when homogeneous target simulants used in controlled experiments are not representative of the targets past weapons were designed to encounter. This article explores the relationship between arrow point morphology and design choices in the Iron Age using different target media. Shooting arrow points into pottery clay leads to the conclusion that more blades reduced penetrating performance on ancient battlefields, but a very different result obtains by shooting the same points into thick tooling leather as a simulant for leather body armor. The results help explain patterns observed in the Eurasian archaeological record, where trilobate arrow points–initially developed by lightly armored horse archers on the Eurasian steppe–were increasingly adopted by a wide range of societies across Eurasia throughout the Iron Age.
“The algorithm will screw you”: Blame, social actors and the 2020 A Level results algorithm on Twitter
Authors: Heaton Dan , Nichele Elena , Clos Jeremie , Fischer Joel E.
Published: July 2023

In August 2020, the UK government and regulation body Ofqual replaced school examinations with automatically computed A Level grades in England and Wales. This algorithm factored in school attainment in each subject over the previous three years. Government officials initially stated that the algorithm was used to combat grade inflation. After public outcry, teacher assessment grades used instead. Views concerning who was to blame for this scandal were expressed on the social media website Twitter. While previous work used NLP-based opinion mining computational linguistic tools to analyse this discourse, shortcomings included accuracy issues, difficulties in interpretation and limited conclusions on who authors blamed. Thus, we chose to complement this research by analysing 18,239 tweets relating to the A Level algorithm using Corpus Linguistics (CL) and Critical Discourse Analysis (CDA), underpinned by social actor representation. We examined how blame was attributed to different entities who were presented as social actors or having social agency. Through analysing transitivity in this discourse, we found the algorithm itself, the UK government and Ofqual were all implicated as potentially responsible as social actors through active agency, agency metaphor possession and instances of passive constructions. According to our results, students were found to have limited blame through the same analysis. We discuss how this builds upon existing research where the algorithm is implicated and how such a wide range of constructions obscure blame. Methodologically, we demonstrated that CL and CDA complement existing NLP-based computational linguistic tools in researching the 2020 A Level algorithm; however, there is further scope for how these approaches can be used in an iterative manner.
Caregivers’ perception and acceptance of malaria vaccine for Children
Authors: Bam Victoria , Mohammed Abdulai , Kusi-Amponsah Abigail , Armah Jerry , Lomotey Alberta Yemotsoo , Budu Hayford Isaac , Atta Poku Collins , Kyei-Dompim Joana , Dwumfour Catherine
Published: July 2023

Background

Malaria is a disease of public health concern and in endemic areas, pregnant women and children under-five years are vulnerable to the disease. The introduction of the pilot program of a malaria vaccine for children under-five years in Ghana is an intervention to further reduce the burden of the disease. However, the availability of the vaccine does not necessarily mean it will be accepted by the public. This is why the perceptions and acceptance of the vaccine among mothers of these children are worth exploring.

Method

A descriptive qualitative study, with the aid of a semi-structured interview guide, was utilized in collecting data from ten (10) purposively sampled mothers whose children were taking the malaria vaccine in a municipality in Ghana. Written informed consent was obtained from all participants. The audiotaped interviews were transcribed verbatim and inductively analyzed into themes describing their perceptions and acceptance.

Results

Participants were aged between 22 and 40 years with eight (8) of them married. Three themes emerged from the study. "Awareness of malaria and the malaria vaccine" (1), “Insight into the malaria vaccine” (2), where participants communicated the beliefs and judgments formed on the vaccine, its benefits, and the need for vaccinating their children. With the third theme "Reaction to vaccine” (3), participants communicated their motivation to vaccinate their children and their concerns about the administration of the vaccine.

Conclusion

The caregivers had positive perceptions about the malaria vaccine for children, with fewer hospital admissions and saving money as some benefits. Healthworkers played a significant role in influencing the acceptance of the vaccine. However, the fear of the unknown concerning the side effects of the vaccine serve as a possible barrier to recommending the vaccine to other caregivers. Health education must also address the fears of caregivers in order to enhance recommending the malaria vaccine to other caregivers and promote uptake of the vaccination.