bluuebunny/crossref_metadata_2025_split huggingface dataset:
A conditional, a fuzzy and a probabilistic interpretation of self-organizing maps
Authors: Giordano Laura , Gliozzi Valentina , Theseider DuprÉ Daniele 
Published: December 2021

AbstractIn this paper we establish a link between fuzzy and preferential semantics for description logics and self-organizing maps (SOMs), which have been proposed as possible candidates to explain the psychological mechanisms underlying category generalization. In particular, we show that the input/output behavior of a SOM after training can be described by a fuzzy description logic interpretation as well as by a preferential interpretation, based on a concept-wise multipreference semantics, which takes into account preferences with respect to different concepts and has been recently proposed for ranked and for weighted defeasible description logics. Properties of the network can be proven by model checking on the fuzzy or on the preferential interpretation. Starting from the fuzzy interpretation, we also provide a probabilistic account for this neural network model.
Detecting Soldiers’ Fatigue Using Eye-Tracking Glasses: Practical Field Applications and Research Opportunities
Authors: Schweizer Theresa , Wyss Thomas , Gilgen-Ammann Rahel 
Published: December 2021

ABSTRACT

Introduction
Objectively determining soldiers’ fatigue levels could help prevent injuries or accidents resulting from inattention or decreased alertness. Eye-tracking technologies, such as optical eye tracking (OET) and electrooculography (EOG), are often used to monitor fatigue. Eyeblinks—especially blink frequency and blink duration—are known as easily observable and valid biomarkers of fatigue. Currently, various eye trackers (i.e., eye-tracking glasses) are available on the market using either OET or EOG technologies. These wearable eye trackers offer several advantages, including unobtrusive functionality, practicality, and low costs. However, several challenges and limitations must be considered when implementing these technologies in the field to monitor fatigue levels. This review investigates the feasibility of eye tracking in the field focusing on the practical applications in military operational environments.

Materials and Method
This paper summarizes the existing literature about eyeblink dynamics and available wearable eye-tracking technologies, exposing challenges and limitations, as well as discussing practical recommendations on how to improve the feasibility of eye tracking in the field.

Results
So far, no eye-tracking glasses can be recommended for use in a demanding work environment. First, eyeblink dynamics are influenced by multiple factors; therefore, environments, situations, and individual behavior must be taken into account. Second, the glasses’ placement, sunlight, facial or body movements, vibrations, and sweat can drastically decrease measurement accuracy. The placement of the eye cameras for the OET and the placement of the electrodes for the EOG must be chosen consciously, the sampling rate must be minimal 200 Hz, and software and hardware must be robust to resist any factors influencing eye tracking.

Conclusion
Monitoring physiological and psychological readiness of soldiers, as well as other civil professionals that face higher risks when their attention is impaired or reduced, is necessary. However, improvements to eye-tracking devices’ hardware, calibration method, sampling rate, and algorithm are needed in order to accurately monitor fatigue levels in the field.
Predictors of persistent inflammation in children with familial Mediterranean fever
Authors: Gezgin Yıldırım Deniz , Esmeray Senol Pelin , Söylemezoğlu Oğuz 
Published: December 2021

ABSTRACT

Objectives
Persistent inflammation is an insidious feature of familial Mediterranean fever (FMF) that may cause chronic complications. This study aimed to investigate the predictors of persistent inflammation in children with FMF.

Methods
The medical charts of 1077 paediatric FMF patients were retrospectively collected. The patients were divided into two groups: with and without subclinical inflammation.

Results
A total of 133 (12%) patients had persistent inflammation. M694V homozygosity, colchicine resistance, positive family history for FMF, erysipelas-like erythema, leg pain, arthritis, chest pain, inflammatory comorbidities, early disease onset, high PRAS score, and long attack duration were established as independent predictors of persistent inflammation (P &lt; .001, P &lt; .001, P &lt; .001, P &lt; .001, P = 0.006, P &lt; .001, P &lt; .001, P = .014, P &lt; .001, P &lt; .001, and P &lt; .001, respectively). However, gender, abdominal pain, fever, and attack frequency were not found to be independent risk factors for predicting persistent inflammation (P = .412, P = .531, P = .451, and P = .693, respectively).

Conclusions
M694V homozygosity, colchicine resistance, positive family history, erysipelas-like erythema, leg pain, arthritis, chest pain, inflammatory comorbidities, early disease onset, high activity score, and long attack duration may be predictors of persistent inflammation in FMF. These predictors may help clinicians suspect the occurrence of subclinical inflammation and should aid in better disease management in FMF.
Fairness, Individuality, and Free Riding
Authors: Morgan-Knapp Christopher 
Published: December 2021

Abstract
According to most contemporary theorists, free riding on the cooperative contributions of others is unfair. At the same time, obligations to contribute to cooperative schemes can compel conformity with conventional practices, and can do so to a degree that poses a real threat to individuality. This paper exposes this tension between fairness and individuality, and proposes a way to resolve it. The resolution depends on an alternative approach to understanding fairness—one that appeals to the relational goods fairness is meant to maintain. In particular, norms of fairness protect against the interactions within a relationship becoming disrespectful. Many instances of free riding are indeed disrespectful and hence unfair. But this is not always so: one can choose to live a lifestyle that fails to return the benefits their community provides without disrespecting one's fellows. It is thus possible to free ride without being unfair, and so duties of fairness need not add to those already formidable forces that threaten to extinguish valuable individuality.
An Exploration of the Experiences of Physical Therapists Who Identify as LGBTQIA+: Navigating Sexual Orientation and Gender Identity in Clinical, Academic, and Professional Roles
Authors: Ross Megan H , Hammond John , Bezner Janet , Brown Darren , Wright Andrea , Chipchase Lucy , Miciak Maxi , Whittaker Jackie L , Setchell Jenny 
Published: December 2021

AbstractObjectiveThe purpose of this study was to explore physical therapy through the stories of physical therapists who identify as lesbian, gay, bisexual, transgender, queer, intersex, asexual, and other related identities (LGBTQIA+) to consider how the profession enacts and constructs gender and sexual orientation.MethodsPhysical therapists with clinical, academic, and professional roles who identify as LGBTQIA+ were recruited from Australia, the United Kingdom, Canada, and the United States. In-depth data were collected via narrative interviews. An iterative group discourse analysis was used to examine key discourses underpinning interview narratives and how these relate to the physical therapy profession.ResultsTwenty-two physical therapists were interviewed. Participants had between 1.5 and 40 years of experience across various clinical areas and settings. Participants identified with varying sexual orientations and gender identities. Analysis identified discourses discussed under the following headings: (1) normativity, which related to hetero-normative assumptions about sexual orientation and cisnormative assumptions about gender identity and the intersectionality among sexual orientation, gender identity, and other forms of marginalization; (2) stress and labor, which explored the stress experienced by physical therapists who are LGBTQIA+ (due to fear of discrimination or actual discrimination) and additional emotional and other types of labor or work done in the workplace to hide aspects of their lives to feel safe, educate colleagues, and be a role model; and (3) professionalism, which related to the heterosexual/cisnormative (and other) “norms” that comprised participants’ ideas of presenting as “professional” and positioning physical therapists who are LGBTQIA+ as “unprofessional.”ConclusionFindings suggest that cultural norms may need to be reconceptualized in physical therapy to promote inclusion and belonging of individuals who identify as LGBTQIA+. Approaches to upskill new and existing physical therapists may include elements such as individual and institutional reflexivity, learning and implementing appropriate terminology, displaying indicators of inclusivity, and cultural safety training. These elements may provide the first steps to promote inclusive and culturally safe environments for individuals who identify as LGBTQIA+ within the profession.ImpactThis is the first known study to explore the lived experiences of those who identify as LGBTQIA+ in the physical therapy profession. The findings highlight how prevailing normative discourses in Western society are also present in physical therapy and impact those who identify as LGBTQIA+.
Therapeutic efficacy of denosumab for rheumatoid arthritis: a systematic review and meta-analysis
Authors: Yagita Mayu , Morita Takayoshi , Kumanogoh Atsushi 
Published: December 2021

AbstractObjectivesDenosumab is used for osteoporosis because it inhibits osteoclast maturation and suppresses bone resorption. Although denosumab is expected to inhibit the bone erosion in RA, its therapeutic efficacy is not well established. The aim of this study was to estimate the effects of denosumab on RA through a meta-analysis.MethodsA systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. PubMed, Web of Science and Scopus were searched for original studies providing information on BMD, joint destruction and disease activity in denosumab-treated RA. A random-effects model was used in the meta-analysis.ResultsOf the 367 studies identified, 18 met the selection criteria. The BMDs of the lumbar spine, total hip and femoral neck at 12 months after denosumab treatment increased by 5.27% (95% CI: 4.37, 6.18), 2.82% (2.46, 3.18) and 3.07% (2.66, 3.48), respectively. In the sensitivity analysis, age and sex tended to influence the effect of denosumab therapy on the rate of variation of BMD, but not glucocorticoid use. The changes in the modified total sharp, erosion and joint space narrowing scores at 12 months after denosumab treatment were significantly smaller with denosumab than with placebo, although the DAS did not change after denosumab treatment.ConclusionAlthough denosumab has an inhibitory effect on the bone resorption in RA, its effects might be influenced by the age and sex of RA patients, but not by glucocorticoid use.
Hydroxyapatite composited PEEK with 3D porous surface enhances osteoblast differentiation through mediating NO by macrophage
Authors: Liu Xingdan , Ouyang Liping , Chen Lan , Qiao Yuqin , Ma Xiaohan , Xu Guohua , Liu Xuanyong 
Published: December 2021

Abstract
The adverse immune response mediated by macrophages is one of the main factors that are prone to lead poor osseointegration of polyetheretherketone (PEEK) implants in clinic. Hence, endowing PEEK with immunomodulatory ability to avoid the adverse immune response becomes a promising strategy to promote bone repair. In this work, sulfonation and hydrothermal treatment were used to fabricate a 3D porous surface on PEEK and hydroxyapatite (HA) composited PEEK. The HA composited PEEK with 3D porous surface inhibited macrophages polarizing to M1 phenotype and downregulated inducible nitric oxide synthase protein expression, which led to a nitric oxide concentration reduction in culture medium of mouse bone marrow mesenchymal stem cells (mBMSCs) under co-culture condition. The decrease of nitric oxide concentration could help to increase bone formation-related OSX and ALP genes expressions and decrease bone resorption-related MMP-9 and MMP-13 genes expressions via cAMP–PKA–RUNX2 pathway in mBMSCs. In summary, the HA composited PEEK with 3D porous surface has the potential to promote osteogenesis of PEEK through immunomodulation, which provides a promising strategy to improve the bone repair ability of PEEK.
Automated Segmentation of Spinal Muscles From Upright Open MRI Using a Multiscale Pyramid 2D Convolutional Neural Network
Authors: Dourthe Benjamin , Shaikh Noor , Pai S. Anoosha , Fels Sidney , Brown Stephen H.M. , Wilson David R. , Street John , Oxland Thomas R. 
Published: December 2021

Study Design.
Randomized trial.

Objective.
To implement an algorithm enabling the automated segmentation of spinal muscles from open magnetic resonance images in healthy volunteers and patients with adult spinal deformity (ASD).

Summary of Background Data.
Understanding spinal muscle anatomy is critical to diagnosing and treating spinal deformity.
Muscle boundaries can be extrapolated from medical images using segmentation, which is usually done manually by clinical experts and remains complicated and time-consuming.

Methods.
Three groups were examined: two healthy volunteer groups (N = 6 for each group) and one ASD group (N = 8 patients) were imaged at the lumbar and thoracic regions of the spine in an upright open magnetic resonance imaging scanner while maintaining different postures (various seated, standing, and supine). For each group and region, a selection of regions of interest (ROIs) was manually segmented. A multiscale pyramid two-dimensional convolutional neural network was implemented to automatically segment all defined ROIs. A five-fold crossvalidation method was applied and distinct models were trained for each resulting set and group and evaluated using Dice coefficients calculated between the model output and the manually segmented target.

Results.
Good to excellent results were found across all ROIs for the ASD (Dice coefficient >0.76) and healthy (dice coefficient > 0.86) groups.

Conclusion.
This study represents a fundamental step toward the development of an automated spinal muscle properties extraction pipeline, which will ultimately allow clinicians to have easier access to patient-specific simulations, diagnosis, and treatment.
Safety and Vascular Impact of Perforator Propeller Flaps during Distal Lower Limb Reconstruction
Authors: Eldahshoury Tarek , Cacciola Roberto , El-Gazzar Khaled 
Published: December 2021

Background:
In distal lower limb defects, the paucity of local tissues dictates a free-flap (FF)-based reconstruction frequently. The propeller perforator flap (PPF) offers a good alternative when the patient or the limb or both are not fit for FF-based reconstruction. Also, in contexts of restricted healthcare resources, armed conflict scenarios, or during pandemics like the ongoing COVID-19 pandemic, PPF is considered a valuable alternative to free-flap-based reconstruction. Additionally, PPFs are less sacrificing in terms of major limb vessels and distal limb vascularity. Yet, the distal lower limb vascular impact for PPF-based reconstruction has not been studied before.

Methods:
In total, 23 patients with distal lower limb defects were reconstructed with PPFs. By using U/S arterial duplex, the peak arterial velocity (PA velocity) was measured pre and postoperatively in 15 (65.2%) out of the 23 patients. This measurement was done to the vessel segment distal to the used perforator.

Results:
An estimated 21 out of 23 flaps succeeded to reconstruct the patients’ defects safely and to give all patients stable coverage without further surgeries. Only two patients had flap failure, which was managed successfully through additional reconstruction sessions. The difference between pre- and postoperative PA velocity was not statistically significant.

Conclusions:
PPFs are a safe cost-effective reconstruction modality for distal lower limb defects. This advantage is very valuable in cases of restricted healthcare resources, wars, and during pandemics. In terms of distal limb vascularity, PPFs have no significant impact and can be used safely.
Right-sided Electrocardiogram in Patients With Acute Pulmonary Embolism
Authors: Jahanian Sekineh , Ayati Aryan , Hosseini Kaveh , Heidari Firouzeh , Yadangi Somayeh , Ahmadian Tahereh , Hosseinsabet Ali , Jenab Yaser 
Published: December 2021

Background:
Acute pulmonary embolism (APE) is an emergent condition. The diagnostic tools are CT angiography and echocardiography. However, all of these modalities can be used under stable and nonemergent conditions. As electrocardiographic (ECG) studies are more feasible under emergent situations, Objective: we aimed to study right-sided ECG (RS-ECG) in patients with APE with further analysis regarding echocardiographic findings and pulmonary embolism severity index (PESI).

Methods:
Right-sided and standard electrocardiogram were obtained from 143 patients with confirmed APE. T-wave inversion, ST segment elevation (STE), and QS pattern in RS-ECG have been considered as abnormal changes.

Results:
T-wave inversion, STE, and QS pattern were found in 78.3%, 42%, and 39.9% of patients, respectively. 88.1% of patients showed at least one of these abnormalities in their RS-ECGs. Sensitivity of RS-ECG for APE was 0.88, which was higher than sensitivity of standard ECG (0.79). Patients with STE in right precordial leads, had increased right to left ventricular (RV/LV) diameter ratio (P = 0.021) and had higher PESI score (P = 0.000). Moreover, STE in RS-ECG was an independent predictor for PESI score in patients with moderate (odds ratio 4.05; 95% confidence interval [CI], 1.37-11.96; P < 0.05) and high 30-day mortality risk (odds ratio 8.42; 95% CI, 2.08-33.93; P < 0.05).

Conclusions:
Abnormal changes in RS-ECG were associated with an increase in RV/LV diameter ratio and higher PESI score, which may be indicated poor prognosis in patients with APE. The most clinically useful ECG finding was STE which was associated with increased RV/LV diameter ratio and PESI score.
CHOROIDAL NEOVASCULARIZATION IN TORPEDO MACULOPATHY TREATED BY AFLIBERCEPT: LONG-TERM FOLLOW-UP USING OPTICAL COHERENCE TOMOGRAPHY AND OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY
Authors: Ghezzaz Amina , Idlefqih Wafa , Chahed Sadri , Mahdjoubi Amir 
Published: December 2021

Purpose:
To report a case of torpedo maculopathy (TM) in an elderly patient complicated by choroidal neovascularization (CNV) and that was treated by intravitreal aflibercept injections and monitored during 30 months using optical coherence tomography (OCT) and OCT angiography.

Methods:
A 74-year-old woman complained of a metamorphopsia in the left eye. Visual acuity was 20/25 while fundus examination showed a hypopigmented torpedo-shaped chorioretinal lesion in the temporal macula associated with a retinal exudation.

Results:
Multimodal imaging showed a severe chorioretinal excavation confirming the diagnosis of TM associated with an exudative Type 1 CNV. Intravitreal aflibercept injections allowed an initial good anatomical and functional improvement, but multiple recurrences occurred. At the last visit, 30 months after the start of 14 intravitreal aflibercept injections, a persistent subretinal fluid was present with a decreased visual acuity to 20/32 while the CNV surface grew in OCT angiography.

Conclusion:
This first case of long-term follow-up of CNV secondary to TM showed an anti-VEGF dependency or even a resistance with extension of CNV. Thus, a deep retinochoroidal atrophy could be the late evolution of TM that may result on severe CNV in advanced stages. A regular TM monitoring including OCT and OCT angiography would be necessary to detect any potential CNV for an early and aggressive treatment.
EXTENSIVE ORBITAL AND PARAPHARYNGEAL EMPHYSEMA REQUIRING URGENT CANTHOTOMY AND CANTHOLYSIS AFTER PARS PLANA VITRECTOMY
Authors: Nithianandan Harrish , Nassrallah Georges , Al-Kaabi Abdullah , Politis Michael , Campagnoli Thalmon , Khan Zainab , Kapusta Michael A. 
Published: December 2021

Purpose:
The authors report the emergent management of a case of orbital and parapharyngeal emphysema causing orbital compartment syndrome and signs of peripheral neuropathy days after pars plana vitrectomy.

Methods:
Case report.

Results:
A 20-year-old woman underwent 3-port 23-gauge pars plana vitrectomy in the right eye for total retinal detachment under general anesthesia. All sclerotomies were secured with 7-0 polyglactin 910 (Vicryl; Ethicon) sutures before instillation of 15% C3F8 gas. On the third postoperative day, the patient presented with a 3-mm proptosis, near-total ophthalmoplegia, jaw protrusion, head deviation, tongue protrusion, and facial twitching. Computed tomography showed extensive subcutaneous gas in the right orbit and bilateral parapharyngeal spaces, and a tethered right optic nerve with globe tenting. A decision was made to perform urgent lateral canthotomy and cantholysis. Three hours after canthotomy and cantholysis, her neurologic signs had resolved except for intermittent tongue protrusion, which resolved thereafter. At postoperative Week 7, the patient's vision was 20/70 and her intraocular pressure was 13 mmHg.

Conclusion:
To the authors' knowledge, this is the only report of a modern small-gauge vitrectomy procedure being complicated by orbital compartment syndrome and extensive emphysema causing peripheral neuropathy, and successfully treated with urgent canthotomy and cantholysis.
Prevalence and Appropriateness of Antipsychotic Prescribing in an Italian Prison
Authors: Pelizza Lorenzo , Maestri Davide , Paulillo Giuseppina , Pellegrini Pietro 
Published: December 2021

Abstract

Purpose/Background
Although the prevalence of mental disorders in prisoners is known to be higher than in the general population, less is known about the antipsychotic (AP) prescribing rate in jail. The aim of this research was to investigate prevalence and appropriateness of AP prescription in an Italian prison to expand our understanding on this crucial area of clinical-forensic practice.

Methods/Procedures
A cross-sectional (census day) design was used among male adults in the Parma Penitentiary Institutes (PPI). Sociodemographic, clinical and prescription data were collected from the PPI electronic clinical database management system. The AP prescribing appropriateness was examined in accordance with the therapeutic indications included in the Italian National Formulary. A descriptive statistical analysis was performed.

Findings/Results
A total of 98 (14.1%) of 696 PPI prisoners were taking AP medications. Moreover, 90 (91.8%) of the 98 PPI participants were also taking other psychotropic medications concurrently. Quetiapine and olanzapine were the most common prescribed APs. Antipsychotic medications were most likely to be prescribed for off-label indications (74.4%). Less than one fifth of all AP prescriptions were for psychotic disorders.

Implications/Conclusions
Antipsychotic medications are widely used in prison, often together with other psychotropic drugs. Considering their common adverse effects, it is crucial to longitudinally monitor their potential risk of metabolic, cardiovascular, and extrapyramidal symptoms and signs, as well as their early risk of mortality. Given the high prevalence of AP off-label prescription, the rationale for AP prescribing should be clearly documented and regularly reviewed within the prison by mental health professionals.