bluuebunny/crossref_metadata_2025 huggingface dataset:
Performance analysis of Luminex and ELISA to profile serum IP-10 as a biomarker in systemic lupus erythematosus
Authors: Espinosa-Bautista Fernanda , Coronel Dania , Ramos-Rosillo Varna , Amezcua-Guerra Luis M
Published: August 2022

Objective

Interferon-γ inducible protein-10 (IP-10) is a promising biomarker in systemic lupus erythematosus (SLE). The optimal quantification platform has not yet been identified. We compared the performance of bead-based multiplex assay (Luminex) and high-sensitivity enzyme-linked immunosorbent assay (hs-ELISA) for profiling serum IP-10 as a biomarker of lupus activity.

Methods

A cross-sectional study was conducted on outpatients with SLE. Serum IP-10 was measured simultaneously on Luminex and hs-ELISA, and correlation between platforms was assessed. Additionally, IP-10 levels were tested against disease activity and organ involvement.

Results

One-hundred and forty-one patients (88% women; 38 years old) were studied. Median IP-10 levels were 100.9 (125.2) pg/mL by Luminex and 156.5 (191.7) pg/mL by hs-ELISA. Correlation analysis showed Spearman’s ρ = 0.621 ( p < 0.0001) between Luminex and hs-ELISA. Quantification of IP-10 by Luminex showed a significant correlation (ρ = 0.198; p = 0.021) with disease activity, while this was not observed (ρ = 0.036; p = 0.683) when measured using hs-ELISA. Serum IP-10 levels were lower in quiescent patients than in those with active disease (70.8 [68.4] versus 114.3 [123.9] pg/mL; p = 0.024), with an AUC-ROC = 0.62 ( p = 0.029), sensitivity = 47.9%, specificity = 77.5%, and positive likelihood ratio = 2.1. Patients with active arthritis had higher IP-10 levels than non-arthritis patients (158.1 [505.4] versus 94.1 [114.0] pg/mL; p = 0.008), with an AUC-ROC = 0.73 ( p = 0.0009), sensitivity = 72.7%, specificity = 66.4%, and positive likelihood ratio = 2.1. No other type of organ involvement was identified by serum IP-10.

Conclusions

Luminex performs better than hs-ELISA as a quantification platform for IP-10 as it correlates with disease activity and identifies active arthritis in SLE.
ASIA syndrome with severe lupus – A case report
Authors: Mir Tajamul H , Khan Ajaz K , Parvaiz M Omar , Rath Prasan D , Sharma Alok
Published: August 2022

The autoimmune/inflammatory syndrome induced by adjuvants (ASIA), also known as Shoenfeld’s syndrome, encompasses several autoimmune conditions/phenomena that are triggered following the exposure to materials with an adjuvant activity known to augment an antigen-driven immune response. In some inherently vulnerable patients, they act as second hits to trigger or unmask an autoimmune disorder which ranges from generalized non-specific constitutional symptoms, and autoantibody production, to a new onset, of a fully-fledged autoimmune syndrome. In this manuscript, we present a case of a 37-year-old lady who developed systemic lupus erythematosus characterized by mucocutaneous, musculoskeletal, hematological neurological, and renal involvement a few years after silicone breast implants.
Hierarchical continuous-time inhomogeneous hidden Markov model for cancer screening with extensive followup data
Authors: Meng Rui , Soper Braden , Lee Herbert KH , Nygård Jan F , Nygård Mari
Published: August 2022

Continuous-time hidden Markov models are an attractive approach for disease modeling because they are explainable and capable of handling both irregularly sampled, skewed and sparse data arising from real-world medical practice, in particular to screening data with extensive followup. Most applications in this context consider time-homogeneous models due to their relative computational simplicity. However, the time homogeneous assumption is too strong to accurately model the natural history of many diseases including cancer. Moreover, cancer risk across the population is not homogeneous either, since exposure to disease risk factors can vary considerably between individuals. This is important when analyzing longitudinal datasets and different birth cohorts. We model the heterogeneity of disease progression and regression using piece-wise constant intensity functions and model the heterogeneity of risks in the population using a latent mixture structure. Different submodels under the mixture structure employ the same types of Markov states reflecting disease progression and allowing both clinical interpretation and model parsimony. We also consider flexible observational models dealing with model over-dispersion in real data. An efficient, scalable Expectation-Maximization algorithm for inference is proposed with the theoretical guaranteed convergence property. We demonstrate our method’s superior performance compared to other state-of-the-art methods using synthetic data and a real-world cervical cancer screening dataset from the Cancer Registry of Norway. Moreover, we present two model-based risk stratification methods that identify the risk levels of individuals.
Does the Economic Policy Uncertainty in the USA and China Affect Indian Stock Markets Symmetrically and Asymmetrically? An Empirical Analysis of Pre- and Post-Coronavirus Disease 2019 Timelines
Authors: Syed Aamir Aijaz , Kamal Muhammad Abdul
Published: August 2022

Globalization and economic interconnections have recently garnered a lot of attention, and scholars and policymakers are delving into the effects of policy uncertainty on macroeconomic fundamentals against this backdrop, the current study investigates the symmetric and asymmetric effects of economic policy uncertainty (EPU) in the USA and China on the Indian benchmark index. Furthermore, the study also analyses the variation in results due to the occurrence of uncertain events. For the empirical analysis, non-linear autoregressive distributed lag (NARDL) and autoregressive distributed lag (ARDL) techniques have been employed, and the findings substantiate an asymmetric relationship between the US EPU and the Indian stock market, while a symmetric relationship between the Chinese EPU and the Indian stock market. The study also reveals that in the short run, the Indian stock market is immune to the fluctuations in the Chinese stock market and policy uncertainty. Moreover, the outcomes further reveal that the US and Indian stock markets project a mirror performance. In addition, the study further reveals that, unlike the pre-Coronavirus Disease 2019 (COVID-19) timeline, during the COVID-19, the short-run volatility was high between the explanatory and outcome variables. The study is an original work and offers several useful recommendations.
Economic Evaluation of Type 2 Diabetes Mellitus Interventions in Low- and Middle-Income Countries: A Systematic Review of the Literature
Authors: Lum Kah Yee , Oppong Raymond , Kigozi Jesse
Published: August 2022

The primary aim of this study is to assess the evidence on the cost-effectiveness of type 2 diabetes mellitus (T2DM) interventions with a focus on diabetes education, lifestyle modifications, surgical intervention, and pharmacological therapy in low- and middle-income countries (LMICs). A systematic review was conducted to identify economic evaluations of T2DM interventions published in LMICs for the period 2009-2019. A total of 25 studies were identified, with more than half of the studies being decision analytic models. Critical appraisal of the identified studies showed they were of good quality. Overall, the reported interventions in this review were very heterogeneous, which made them difficult to compare. However, there was strong evidence suggesting that diabetes education was a very cost-effective strategy in LMICs. Further evidence on affordability and budget impact of bariatric surgery is required before adopting the intervention. Metformin-based therapy showed promising evidence on cost-effectiveness and thus should be offered to T2DM patients in LMICs. On the contrary, the cost-effectiveness of lifestyle modifications remains understudied in LMICs. The findings in this review can inform policy guidance toward the inclusion of T2DM interventions in the benefit packages for Universal Health Coverage in LMICs.
Clinical Applications of Research on Fatigue in Children with Cancer
Authors: White Andrea M.
Published: August 2022

Fatigue is a prevalent problem in the pediatric oncology population but is probably underrecognized and undertreated. The research on fatigue in children with cancer presented in this issue offers a welcome exploration of the subject. Clinical nurses must begin to understand the causes and symptoms of fatigue, as well as supportive care measures for their patients. Fatigue can occur in children who receive chemotherapy, radiotherapy, and biotherapy, and in children who are treated with bone marrow transplantation. Education of the patient and family regarding the potential for fatigue is helpful in preparing them for the cancer experience. Factors that contribute to and alleviate fatigue can be identified for each patient, taking into consideration age, developmental level, and cultural back-ground. Parents and patients, especially adolescent patients, may have differing opinions about what fatigue is and what may be helpful. Further research into fatigue in children with cancer is encouraged, especially in patients suffering from alterations in sleep or nutritional status, and in long-term survivors of childhood cancer.
Social Work Regulation in the United Arab Emirates
Authors: Tedam Prospera , Wagner Beverly , Mitchell Vivienne
Published: August 2022

Purpose: The United Arab Emirates (UAE) is currently developing a social work licensure process to serve as a quality assurance mechanism and enhance the quality of care for service beneficiaries. Methods: This article outlines the opportunities, challenges, and contextual issues associated with the UAE regulation such as differing licensing processes and structures in three of seven emirates that are progressing licensure. With a paucity of information about this process in the UAE, this article reviews a range of international literature to situate the status and development of UAE social work licensure regionally and internationally. Results: The UAE is currently utilizing a social work regulatory process similar to the United States in which regulation is implemented at the Emirate level and licensure is the primary regulatory process. Conclusions: Benefits and risks of the current UAE regulation process are provided that include recommendations for culturally relevant supervisory frameworks and regulation processes.
Evaluating Professional Misconduct: The Effects of Licensure State and Board Membership
Authors: Gricus Michelle
Published: August 2022

Purpose: By further analysis of a subset of data collected from licensed social workers from six selected states, this article explores the effect of respondents’ licensure state and board membership on their perceptions of professional misconduct vignettes. Methods: Using a simplified factorial survey design, 5,388 licensed social workers evaluated versions of vignettes involving social worker misconduct. Respondents rated the vignettes as serious and important to discipline and assigned sanctions to the vignette they viewed as most troubling. The licensure state was a factor in the seriousness and importance of discipline ratings, board membership less so. Results: Results indicated that some factors involved in misconduct are more relevant than others. Respondents generally agreed on the most troubling vignettes and sanctions appropriate to the action. Conclusions: These results may serve as preliminary support for the formation of national licensure standards and processes.
Magnetic Resonance Imaging for Assessing Velopharyngeal Function: Current Applications, Barriers, and Potential for Future Clinical Translation in the United States
Authors: Mason Kazlin N.
Published: August 2022

Objective

The use of magnetic resonance imaging (MRI) in the assessment process for children with cleft/craniofacial conditions remains uncommon, particularly for velopharyngeal assessments. The purpose of this study was to analyze the perceived clinical utility of MRI for cleft/craniofacial providers and identify barriers that exist for clinical translation of this imaging modality to this population of patients.

Methods

A 38-item survey was disseminated to craniofacial team providers. Workplace context and demographics, MRI as a research and clinical tool, access and barriers for use of MRI, and needs for successfully establishing MRI protocols at clinical sites were investigated. Descriptive statistics were used to identify differences in the clinical use of MRI across disciplines. Chi-square analyses were conducted to determine how different specialties perceived potential barriers.

Results

Respondents reported that MRI is likely to be beneficial for clinical assessments (93.5%) and that this imaging modality is available for use (83.8%). However, only 11.8% of providers indicated the use of MRI in their clinical assessments. This discrepancy highlights a potential disconnect between perceived use and implementation of this imaging methodology on cleft and craniofacial teams. A number of barriers were identified by providers. Challenges and opportunities for clinical translation of MRI protocols were highlighted.

Conclusion

Results may guide the development for improved clinical feasibility and implementation of MRI for clinical planning in this population of patients. Reported barriers highlight additional areas for translational research and the potential for the development of clinical tools related to MRI assessment and protocol implementation.
Effectiveness, Safety, and Predictors of Response to 5% Lidocaine-Medicated Plaster for the Treatment of Patients With Trigeminal Neuralgia: A Retrospective Study
Authors: Yu Bin , Zhang Wei , Zhao Chunmei , Xing Yan , Meng Lan , Luo Fang
Published: August 2022

Background:

Whether 5% lidocaine-medicated plaster (LMP) is a valuable therapeutic option for the treatment of trigeminal neuralgia (TN) is worth exploring. If LMP is proven effective for TN, positive predictors of the analgesic effects of LMP warrant further investigation.

Objective:

To evaluate the efficacy and safety of LMP for the treatment of TN, and to explore the predictive factors for the treatment efficacy of LMP.

Methods:

This is a retrospective and observational study. We analyzed the efficacy of LMP for the treatment of TN between March 2019 and January 2022. The follow-up time was approximately 2 weeks, 1 month, 2 months, and 3 months after LMP treatment. The LMP response was considered the Barrow Neurological Institute (BNI) score of I to III and an improvement in BNI of at least I grade from pretreatment baseline. Univariable and multivariable logistic analyses were performed to identify the predictive factors for LMP response.

Results:

A total of 103 patients were included and analyzed in this study. LMP was effective in some TN patients, with an efficacy rate of 21.4%, 21.4%, 18.4%, and 16.5% after 2 weeks, 1 month, 2 months, and 3 months of LMP treatment, respectively. The overall adverse event rate associated with LMP was 5.8%, and the reported adverse events were all skin reactions. Facial trigger points (odds ratio [OR] = 0.25, 95% confidence interval [CI] = 0.07-0.86, P = 0.03) and a lower BNI score (OR = 0.37, 95% CI = 0.07-0.87, P = 0.01) were identified as potential predictors for initial efficacy (2-week follow-up) of LMP treatment.

Conclusions and Relevance:

LMP has been shown to provide effective and sustained analgesia in some TN patients with minimal risk of systemic adverse reactions. Patients with facial trigger points and mild to moderate pain are more likely to benefit from LMP treatment. Our data suggest that LMP may be an effective treatment option for patients with the aforementioned characteristics of TN.
Self-balancing collaboration between linear and nonlinear adaptive sub-filters for hybrid active noise control
Authors: Zhou Chenghao , Jia Shuhai , Xu Hanbing , Xu Shunjian , Zhang Bao
Published: August 2022

Conventional adaptive filters for active noise control (ANC) are troubled by the trade-off between convergence speed and steady state error, especially when nonlinearity plays an important role in system model. In this paper, a hybrid ANC algorithm called FBFLANN is constructed by the collaboration of FIR and bilinear functional link artificial neural network. The characteristics of linear and nonlinear sub-filters are analyzed and utilized to facilitate the adaptability in noise reduction. A convex factor is employed to automatically balance the contribution of two sub-filters, achieving faster convergence and higher accuracy in the presence of nonlinear distortions. The mathematical working and updating rules of the controller are derived to regulate the ANC process theoretically. The effectiveness of the proposed FBFLANN algorithm is demonstrated by numerous simulation studies considering diverse nonlinear acoustic path models as well as acoustic feedback interference. Hardware ANC platform is built up to verify the real-time noise control performance in physical noisy environments. The simulation and experiment results confirm the applicability and prospects for further development of the presented architecture in noise control scenarios.
A 3D finite element model updating of spinal lumber segment applying experimental modal data and particle swarm optimization algorithm
Authors: Forouzesh Farinaz , Ahmadian Hamid , Navidbakhsh Mahdi
Published: August 2022

The dynamic loadings can be more harmful than static ones for the human lumbar spine health. Consequently, the prediction of the spine behavior under dynamic and vibration loads is vital and can be achieved by creating a precise finite element model in which the dynamic mechanical properties of the components need to be estimated. For this purpose, noninvasive experimental modal analysis can be applied to evaluate the dynamic mechanical properties of the spine in the numerical simulation by supplying the structural dynamic characteristics (natural frequencies, mode shapes, and damping ratio) of the system. Since the most adequate model for the human lumbar segment is a sheep model, in this paper, a 3D finite element model of a fresh spinal lumber segment of a sheep is generated based on the poroelasticity theory via Abaqus and is updated utilizing particle swarm optimization (PSO) algorithm and experimental modal analysis. In this regard, the frequency response function (FRF) of the specimen is obtained by performing the experimental modal test and the modal parameters are derived by using the rational fraction polynomial method. Afterward, the sensitivity analysis is carried out to determine the appropriate design variables. Finally, the PSO algorithm using experimental data is employed to update the design variables, including the elastic material properties and the structural damping factors of the specimen components, and the stiffness and damping coefficient of the suspension system. According to the results, the error percentage between the numerical FRF and the experimental one decreases remarkably after model updating indicating the high efficiency of the methods used.
Investigation on model order reduction methods for flexible bodies with contact-impact based on partition modeling
Authors: Wang Hongdong , Wang Jianyao , Liu Zhuyong
Published: August 2022

The finite element method is widely used to solve the problem of flexible bodies with contact-impact. To express the high-frequency and high-transient characteristics of the impact process and the high stress distribution of the local contact region, the amount of the node coordinates will be very large, which brings great burden to the dynamic simulation. It is particularly important to reduce the degrees of freedom of the system in the contact-impact problem. However, as the impact itself is a strong nonlinear problem, the linear model reduction techniques cannot be used directly. The partition method is presented to solve this problem, in which the deformation of the contact region is described by finite element node coordinates to preserve the local nonlinear characteristic while the deformation of the non-contact region is described by the reduced elastic coordinates. Different model reduction techniques including modal truncation method and Krylov subspace method are used to reduce the degrees of freedom of the non-contact region of an experimental rod-plate impact case, and the results are compared with that of the finite element method and the experiment. The simulation results show that the partition method can effectively reduce the degrees of freedom of the system and maintain good accuracy. Moreover, the Krylov subspace method has an advantage over the modal method in the model reduction of contact-impact problem.
AsianCrit and Autoethnography: A Future-Focussed Fugue of Critical Collaborative Inquiry
Authors: Teo Aaron
Published: August 2022

Despite the considerable influence of the “Asian Century” on Australian Government policy and the purported centrality of Asia to Australian national identity, the outbreak of the COVID-19 pandemic has simultaneously highlighted and intensified the deleterious impacts of anti-Asian racism. Specifically, Orientalist discourses and a “fear of invasion” that underpin the differential racialized treatment of the Asian diaspora in Australia have manifested in both old and new racisms that have had significant impacts on the mental and physical wellbeing of Asian Australians. In response to this crisis, this autoethnographic paper acknowledges the growing methodological complexity of Critical Race Theory and advances a novel, future-focussed Asian Australian social justice agenda in solidarity with other racialized minorities by interrogating the collaborative potential of Asian Critical Race Theory (AsianCrit) and Autoethnography through an investigation of their respective theoretical and methodological intersections.
Symmetry classification of plane deformations of hyperelastic compressible materials
Authors: Arrigo Daniel J , Chism Travis C
Published: August 2022

The governing equations for plane deformations of isotropic compressible hyperelastic materials are highly nonlinear, and consequently, very few exact solutions are known. For materials known as harmonic materials, only one solution of any generality is known. It is natural to ask whether the governing equations possess some special property for this particular material. In this paper, we show that the governing equations admit an extensive class of symmetries for these so-called harmonic materials and further show that there exists a second class of strain-energy functions, where the governing equations admit a general class of symmetries. We further show that for this strain-energy function, the governing equations are linearizable.
Haemodialysis access profile in failed kidney transplant patients: Analysis of data from the Catalan Renal Registry (1998–2016)
Authors: Roca-Tey Ramon , Arcos Emma , Comas Jordi , Tort Jaume
Published: August 2022

Background:

Data about vascular access (VA) use in failed kidney transplant (KT) patients returning to haemodialysis (HD) are limited. We analysed the VA profile of these patients, the factors associated with the likelihood of HD re-initiation through fistula (AVF) and the effect of VA in use at the time of KT on kidney graft (KTx) outcome.

Method:

Data from the Catalan Registry on failed KT patients restarting HD and incident HD patients with native kidney failure were examined over an 18-year period.

Results:

The VA profile of 675 failed KT patients at HD re-initiation compared with that before KT and with 16,731 incident patients starting HD was (%): AVF 79.3 versus 88.6 and 46.2 ( p = 0.001 and p < 0.001), graft AVG 4.4 versus 2.6 and 1.1 ( p = 0.08 and p < 0.001), tunnelled catheter TCC 12.4 versus 5.5 and 18.0 ( p = 0.001 and p < 0.001) and non-tunnelled catheter 3.9 versus 3.3 and 34.7 ( p = 0.56 and p < 0.001). The likelihood of HD re-initiation by AVF was significantly lower in patients with cardiovascular disease, KT duration >5 years, dialysed through AVG or TCC before KT, and females. The analysis of Kaplan-Meier curves showed a greater KTx survival in patients dialysed through arteriovenous access than in patients using catheter just before KT (λ2 = 5.59, p = 0.0181, log-rank test). Cox regression analysis showed that patients on HD through arteriovenous access at the time of KT had lower probability of KTx loss compared to those with catheter (hazard ratio 0.71, 95% CI 0.55–0.90, p = 0.005).

Conclusions:

The VA profile of failed KT patients returning to HD and incident patients starting HD was different. Compared to before KT, the proportion of failed KT patients restarting HD with AVF decreased significantly at the expense of TCC. Patients on HD through arteriovenous access at the time of KT showed greater KTx survival compared with those using catheter.
Tribological performance of phosphonium-based halogen-free ionic liquids as lubricant additives
Authors: Bambam Arun Kumar , Alok Anupam , Rajak Ashish , Gajrani Kishor Kumar
Published: August 2022

In recent years, ionic liquids have shown great potential as an additive in lubricants. However, most of the explored ionic liquids for machining applications contain halogen-based anions, which are sensitive to moisture and have a tendency to produce harmful halogen acids (HX) after reacting with water/moisture. These acids are harmful to the environment and can corrode the working surfaces. This study investigates the effectiveness of halogen-free ionic liquids as potential additives to vegetable oil (canola oil). Two halogen-based ionic liquids (1-methyl 3-butylimidazolium tetrafluoroborate [BMIM BF4] and 1-methyl 3-butylimidazolium hexafluorophosphate [BMIM PF6]) and one halogen-free ionic liquids (trihexyl tetradecyl phosphonium bis (24,4-trimethylpentyl) phosphinate P6,6,6,14 [i(C8)2PO2]) were blended individually with canola oil. The percentage ratio of ionic liquid to canola oil is 1:99. Dynamic viscosity and contact angles of different lubricants were measured. Sliding tests were conducted in various conditions; dry, canola oil, and three different blends of ionic liquid with canola oil. Further, to connect tool-chip tribology with machining, turning experiments were carried out under similar lubricating conditions. Results show that the sliding friction, pin surface temperature, and wear were reduced by 48.1%, 44%, and 69.6%, respectively, due to better lubricating ability and spreading tendency of halogen-free ionic liquid blended with canola oil. The microscopic analyses of pin surfaces and the morphology of counter disc surfaces further supported better lubrication between the sliding pair. For P6,6,6,14 [i(C8)2PO2] ionic liquid blended with canola oil, the average cutting temperature and machined workpiece surface roughness reduces by 43.6% and 62.4% compared to dry machining.
State-level heterogeneity in associations between structural stigma and individual health care access: A multilevel analysis of transgender adults in the United States
Authors: Tran Nguyen K , Baker Kellan E , Lett Elle , Scheim Ayden I
Published: August 2022

Objective

State-level variation in how restrictive policies affect health care access for transgender populations has not been widely studied. Therefore, we assessed the association between structural stigma and four measures of individual health care access among transgender people in the United States, and the extent to which structural stigma explains state-level variability.

Methods

Data were drawn from the 2015–2019 Behavioral Risk Factor Surveillance System and the Human Rights Campaign’s State Equality Index. We calculated weighted proportions and conducted multilevel logistic regression of individual heterogeneity and discriminatory accuracy.

Results

An increase in the structural stigma score by one standard deviation was associated with lower odds of health care coverage (OR = 0.80; 95% CI: 0.66, 0.96) after adjusting for individual-level confounders. Approximately 11% of the total variance for insurance coverage was attributable to the state level; however, only 18% of state-level variability was explained by structural stigma. Adding Medicaid expansion attenuated the structural stigma-insurance association and explained 22% of state-level variation in health insurance. For the remaining outcomes (usual source of care, routine medical check-up, and cost-related barriers), we found neither meaningful associations nor considerable between-state variability.

Conclusions

Our findings support the importance of Medicaid expansion and transgender-inclusive antidiscrimination protections to enhance health care insurance coverage. From a measurement perspective, however, additional research is needed to develop and validate measures of transgender-specific structural stigma to guide future policy interventions.
Influence of learning-space enclosure on attention in undergraduate students measured by eye-tracking technology
Authors: Liu Chao , Jing Xiaotong , Zhang Yalin , Gao Weijun
Published: August 2022

Although the use of enclosed learning space appears to influence both attention and learning in undergraduates, this issue has rarely been investigated. This study used four types of desktop spaces with different degrees of enclosure, namely, unenclosed, enclosed on one side, enclosed on two sides and enclosed on three sides, with enclosure degrees of 0, 25, 50 and 75%, respectively. Subjective evaluations, attention tests and eye tracking were used to analyze the effects of the four types of enclosure on attention in 38 undergraduates. Subjective evaluations showed that the three-sided enclosure was favoured by 52.63% of the undergraduates, 84.21% of which considered that it contributed to improved attention. The objective data showed that quiz times were shortened by 25.95% in unenclosed spaces compared with 75%-enclosed spaces, with increases in the mean pupil diameter, area of interest attention and target fixation rate of 11.36, 8.15 and 6.89%, respectively. These results indicated that the attention level increased in correspondence with the degree of enclosure of the learning space and that highly enclosed spaces were more conducive to attention and learning in undergraduates. This suggests that relatively closed spaces should be recommended to learning institutions to improve the learning efficiency of undergraduates.
A review on application of biomaterials for medical and dental implants
Authors: Abraham Adarsh Mathew , Venkatesan Subramani
Published: August 2022

Biological tissues in the body stop functioning normally at certain times due to genetic abnormalities, ageing, sickness, trauma, degeneration or accidents. Over the past few decades, biomaterials have been extensively used in the medical and dental fields. It is used as an alternate for natural bone with inflammation or mechanical integrity. The usages of biomaterials in various applications are implant materials, integral approach to promote healing of tissues, regeneration of tissues, probes and nanoparticles, biosensors and drug delivery system. Significant research and development are still being carried out for orthopaedic implants, dental screws, bone replacement, etc. Materials designed for biomedical applications have gone through three generations, with the first generation being bioinert materials, the second being bioactive and biodegradable materials and the third being molecular responses to materials (tissue level). Biocompatibility (biological and mechanical), corrosion resistance, wear resistance and osseointegration are factors to consider while using biomaterials for longer duration. Metals and their alloys, ceramics, polymers and composites are some bioimplant materials that are being used in the modern world. Some of the most important criteria for the selection or development of new biomaterials are kinds of oxide coatings generated on the surface and the mechanical properties of materials. The article reviews out categories of bioimplants and outlines the properties exhibited by various implant material, biological and mechanical factors favouring material selection, and few challenges shown by the materials.
Unpacking ableist discourses in Cypriot education policy during the pandemic
Authors: Symeonidou Simoni
Published: August 2022

During the COVID-19 pandemic, children with disabilities were confronted with ableist discourses that justified unfair policy measures. This study is concerned with the discourses recorded in a range of education documents, published during the pandemic within the Republic of Cyprus. It employs an interdisciplinary framework, informed by Critical Discourse Analysis, Inclusive Education, and Critical Disability Studies, to examine the powerful actors and the ideologies that influenced the formation of discourses. The paper undertakes a critical interpretation of the disability discourses developed in Cyprus during the pandemic, links this with other relevant research conducted in other European countries prior to and during the pandemic, and suggests policy actions/measures that value children with disabilities and their families.
Single-center Evaluation of Safety & Efficacy of Glucagon-Like Peptide-1 Receptor Agonists in Solid Organ Transplantation
Authors: Sweiss Helen , Hall Reed , Zeilmann Dominik , Escamilla Jesus , Bhayana Suverta , Patel Rupal , Long Christina
Published: August 2022

Introduction: Given the negative outcomes associated with uncontrolled diabetes mellitus, non-insulin therapies with glycemic, cardiovascular, and weight-loss benefits in the general population, such as the glucagonlike peptide-1 receptor agonists (GLP1-RA) have become a more alluring therapeutic option in transplant populations. However, limited evidence exists to demonstrate its safety and efficacy in solid organ transplant. Methods: This program evaluation included adult kidney, liver, lung transplant recipients initiated on a GLP1-RA for diabetes mellitus management for a minimum of 3 months, had at least one follow-up visit after starting therapy, and had at least one hemoglobin A1c (HbA1c) level drawn between 3–12 months after GLP1-RA initiation. Outcomes were assessed at time of initiation of GLP1-RA (baseline) and 3–12 months post-initiation. Nadir values between 3–12 months were utilized to assess outcomes. Results: One-hundred eighteen patients met study inclusion criteria. Seventy-percent of patients received a kidney transplant, 19.5% received a liver transplant, and 6.8% received a lung transplant. A statistically significant difference was observed in median fasting blood glucose and HbA1c at baseline to 3–12-month nadir (P < 0.0001). A significant weight loss benefit was also observed. The rate of adverse drug reactions was low. Seven-percent of patients experienced nausea, 4.2% developed pancreatitis, and 7.1% reported having had at least one hypoglycemic event. Discussion: This is the largest study evaluating GLP1-RA in organ transplantation and demonstrates GLP1-RA is both safe and effective. Further assessment on long-term use of these agents on cardiovascular and renal outcomes is still needed.
“She's Built Like a Tank”: Player Reaction to Abby Anderson in The Last of Us: Part II
Authors: Tomkinson Sian
Published: August 2022

The depiction of female characters in video games is highly contentious. The pushes for increased diversity following Gamergate have heralded more varied representations of women in both independent and Triple A games. One particularly interesting video game in this context is Naughty Dog's 2020 action-adventure title The Last of Us: Part II. The game received extremely divisive criticism in part due to Abby Anderson and her functions in the game. Many players were outraged at her muscular, “masculine” build, considering it inaccurate for a woman living in a post-apocalyptic setting, and a form of virtue-signalling. In this paper I examine these players’ complaints regarding Abby and consider how they fit within gaming discourses of realism, immersion, and escapism. I explore what elements players consider to be acceptable as ‘realism' in the context of a post-apocalyptic action-horror video game, considering a prevalent discourse that video games are being increasingly politicised.
Discordance in tests used to detect inhibition of the P2Y12 receptor in patients undergoing interventional neuroradiology procedures
Authors: Gegri Mansour , Cheves Tracey A , Anderson Matthew N , McTaggart Ryan , Sweeney Joseph D
Published: August 2022

Background

Clopidogrel is an inhibitor of the P2Y12 platelet receptor but testing to demonstrate a drug effect is controversial since there are often discordant results between different tests methods.

Methods

Samples from patients taking clopidogrel prior to intracranial flow-diversion procedures were tested using light transmission aggregometry (LTA), whole blood impedance aggregometry (WBIA) and the VerifyNow device (VND). Samples were classified as concordant if all test results were either responsive (inhibition) or resistant. Discordant results were separated using the VND into those with a responsive versus a resistant test result.

Results

Samples from 96 patients were studied. Concordance for all three tests was seen in 53/96 (55%) of samples, of which 41 (43%) were responsive and 12 (12%) were resistant. Discordance was observed in 43 samples (45%), 37 (28%) of which were caused by responsive VND and either a resistant WBIA or LTA and 6 (7%) of which were caused by a resistant VND but a responsive test result using either WBIA or LTA. These two discordant groups differed in both platelet count and hematocrit, but no such difference was present between the two concordant groups.

Conclusion

Discordance in P2Y12 inhibition testing may be partly explained by sample platelet count and hematocrit.
Prediction of knee trajectory based on surface electromyogram with independent component analysis combined with support vector regression
Authors: Zhu Meng , Guan XiaoRong , Li Zhong , Gao YunLong , Zou KaiFan , Gao XinAn , Wang Zheng , Li HuiBin , Cai KeShu
Published: August 2022

In recent years, surface electromyogram signals have been increasingly used to operate wearable devices. These devices can aid to help workers or soldiers to lower the load in the task to boost efficiency. However, achieving effective signal prediction has always been a challenge. It is critical to use an appropriate signal preprocessing method and prediction algorithm when developing a controller that can accurately predict and control human movements in real time. For this purpose, this article investigates the effect of various surface electromyogram preprocessing methods and algorithms on prediction results. Walking data (surface electromyogram angle) were collected from 10 adults (5 males and 5 females). To investigate the effect of preprocessing methods on the experimental results, the raw surface electromyogram signals were grouped and subjected to different preprocessing (bandpass/principal component analysis/independent component analysis, respectively). The processed data were then imported into the random forest and support vector regression algorithm for training and prediction. Multiple scenarios were combined to compare the results. The independent component analysis-processed data had the best performance in terms of convergence time and prediction accuracy in the support vector regression algorithm. The prediction accuracy of knee motion with this scheme was 94.54% ± 2.98. Notably, the forecast time was halved in comparison to the other combinations. The independent component analysis algorithm’s “blind source separation” feature effectively separates the original surface electromyogram signal and reduces signal noise, hence increasing prediction efficiency. The main contribution of this work is that the method (independent component analysis + support vector regression) has the potency of best prediction of surface electromyogram signal for knee movement. This work is the first step toward myoelectric control of assisted exoskeleton robots through discrete decoding.
Psychological sequelae of hand injuries: an integrative review
Authors: Maddison Kay , Perry Lin , Debono Deborah
Published: August 2022

This integrative review investigated reports of psychological impact and sequelae of traumatic hand injuries. A systematic search using Medline, PsychINFO, PubMed, EMBASE, CINAHL and hand-searching methods was conducted from 2008 to 2020. Nine included articles with a total of 503 participants were reported in prospective cross-sectional or longitudinal cohort studies. Depression and anxiety were common, affecting between 7% and 71% and between 23% and 71% of patients, respectively. Post-traumatic stress disorder affected between 3% and 95% of patients. Factors reported predicting psychological sequelae of hand injuries included injury severity, pain, limb dysfunction, negative perceptions of injured limbs, suboptimal coping mechanisms and limited social support. Symptoms persisted for protracted periods of follow-up but broadly attenuated after 3 months. We conclude that the high prevalence and enduring nature of psychological symptoms demonstrate an urgent need for further research to optimize treatment.

Level of evidence: III
Investigating Accessibility of Hospitals in Cold Regions: A Case Study of Harbin in China
Authors: Wu Yue , Xia Lei , He Jun , Meng Qi , Yang Da , Liu Fangfang , Liu Nan
Published: August 2022

Objective:

The objective of this study is to explore healthcare resource accessibility in Harbin, a typical city in a cold region in China.

Background:

Recently, investments in the construction of medical resources have been increasing annually in China, and consequently, the allocation of these resources has improved. Snow and ice on surfaces in China’s cold regions have certain effects on the traffic capacity of urban roads, leading to a great difference in the accessibility of medical resources in winter and summer.

Methods:

The basic spatial data, including spatial road data, medical facility data, and population distribution data, are analyzed using geographic information system. Then, a spatial barrier model is used to measure healthcare accessibility based on geographic and population weighting; we explore the accessibility of hospitals under the influence of weather by defining a novel distance attenuation function. Finally, the accessibility of medical institutions in the study area is explored by analyzing data about the related separation factors.

Results:

It was found that the spatial distribution of medical resources was not equal, and the dominant resources were concentrated in the city center. Some regions are always in an advantageous position regardless of traffic conditions. In contrast, in areas far from the city center, the accessibility of medical resources significantly decreases in winter.

Conclusions:

These results will help optimize the layout of medical institutions and improve medical equality and propose strategies for the optimization of the accessibility of urban medical institutions in cold regions of China.
Early Outcomes of Combined Total Ankle Total Talus Replacement Using a 3D-Printed Talus Component With Hindfoot Arthrodesis
Authors: Madi Naji S. , Fletcher Amanda N. , Pereira Gregory F. , Balu Abhinav , DeOrio James K. , Parekh Selene G.
Published: August 2022

Late-stage talar avascular necrosis (AVN) results in devascularization of the talus with osteonecrosis and subchondral collapse. A combined total ankle and total talus replacement (TATTR) with hindfoot arthrodesis may be utilized for end-stage talar AVN with tibiotalar and hindfoot joint arthritis. The purpose of this study is to evaluate the short-term outcomes of combined TATTR with hindfoot arthrodesis. Patients who underwent a combined TATTR or TTR with a hindfoot arthrodesis (subtalar with or without talonavicular arthrodesis) from 2016 to 2020 were retrospectively reviewed. Patient demographics, comorbidities, and surgical data were collected. Outcomes included the Visual Analog Scale (VAS) scores, range of motion, radiographic parameters, union rates, and complications. A total of 18 patients were reviewed. Nine patients were included with an average of 19.4 months follow-up. Significant postoperative improvements were observed in VAS scores (P < .001), ankle plantarflexion (P = .04), talocalcaneal height (P = .03), and tibiotalar alignment (P = .02). All patients achieved a successful union of their subtalar and talonavicular joints arthrodesis. There was one reoperation for a persistent varus ankle deformity. This is the first study to evaluate the clinical outcomes, radiographic outcomes, and union rate in combined TATTR with hindfoot arthrodesis. The early results demonstrated significant clinical improvement with 100% hindfoot union rate and no prosthetic failure.

Level of Evidence: IV
Dignity, mega-projects, and the problem of scale
Authors: Lauermann John
Published: August 2022

I extend Grossman and Trubina's argument about dignity in urban geography in one direction: the problem of scale. It is worth noting that both of their case studies – mega-events, and large housing estates – involve mega-projects. There is an inherent conflict between the micro-scale of the individual and community – where the lived experience of dignity occurs – and the much bigger scale of the mega-project – where much contemporary city-making occurs. Governance for the micro-scale is inherently skeptical of big urban transformations, prioritizing individual rights to the city: to home, to neighborhood, to public space. In contrast, governance for the mega-scale values big picture thinking and economies of scale, where the common good might trump the dignity of individual urban citizens. Reconciling these scalar conflicts is a foundational problem in the ‘urban age’ of rapid and global mega-urbanization.
Approaches to reducing fragmented care in systemic lupus erythematosus (SLE) and other multimorbid conditions: A realist review
Authors: Sumpter IJ , Phillips SM , Magwood GS
Published: August 2022

Introduction

Fragmented care overwhelmingly affects populations with multimorbid chronic conditions, like systemic lupus erythematosus (SLE). However, strategies to mitigate care fragmentation typically focus on singular disease frameworks with insufficient evidence regarding approaches for individuals with two or more concurrent chronic conditions (multimorbidity). This review explores the literature to identify the (C)ontextual influences, underlying (M)echanisms, and associated (O)utcomes of fragmented care prevention in SLE and other multimorbid conditions.

Methods

A realist review was applied to systematically examine literature, including the search of >1300 published articles focused on SLE and multimorbidity, continuity of care, and approaches to mitigate fragmented care. The analysis was guided by care continuity elements and organized by fragmented care concepts explicated by the MacColl Institute for Healthcare Innovations Care Coordination Model and further grouped for context–mechanism–outcome (CMO) configurations.

Results

Fourteen articles met inclusion/exclusion criteria and were included in the sample to illustrate the relationship between C-M-O for approaches focused on fragmented care prevention. Favorable outcomes in mechanisms that produced positive responses to resources relevant to fragmented care prevention included 1) opportunities for exposure and negotiation within professional teams, 2) structured health education, role clarity, and access to adherence services for patients, and 3) awareness of workflow waste and use of clinical algorithms.

Discussion

Review findings suggest using a multidimensional approach to mitigate fragmented care in SLE and other multimorbid conditions. Multidimensional approaches should focus on shared decision-making, social support, social–cultural–economic factors, patient engagement, and technological infrastructure to support the complex care needs of the multimorbid patient.