bluuebunny/crossref_metadata_2025_split huggingface dataset:
‘When I stood up for something it's because I felt a… moral violation’: Trainees' acts of resistance against social harm and injustice
Authors: Wyatt Tasha R. , Jain Vinayak , Ma Ting Lan 
Published: November 2023

AbstractIntroductionAs medical students around the world enter their chosen profession, they inherit a system that they did not design nor create, yet are still responsible for it. This system is rooted in centuries of social harm and inequity. This study examines trainees' professional acts of resistance to understand what trainees hope to accomplish in their resistance efforts, why they are resisting, and the tactics they use.MethodsDrawing on counter‐storytelling and critical theory, we collected in‐depth qualitative interviews from nine medical students and nine residents/fellows across North America. Using theoretical guidance on how to study acts of resistance, data were analysed using a combination of coding techniques to understand resistors' intentions in resisting and the tactics they used to understand what, why, and how trainees were resisting. The analysis was returned to participants for member checking.ResultsTrainees described resisting systems of harm and injustice bequeathed to them by an older generation whose values and practices were reflective of a different time. Their motivations stemmed from deep‐seated moral distress from the mistreatment of patients and learners. They hoped to re‐envision medical education to be patient‐ and learner‐centred. The tactics they chose depended on the level of power they had in the system and the extent to which they wished to have their efforts known.DiscussionTrainees described intentional and deliberate acts of resistance to the social harm and injustice embedded in the broader profession to re‐create the profession. Given that these acts spanned a large geographical area, this study suggests that trainees may be part of a larger social movement aimed at creating widespread change within the profession.
CD52 mRNA expression predicts prognosis and response to immune checkpoint blockade in melanoma
Authors: de Vos‐Hillebrand Luka , Fietz Simon , Hillebrand Philip , Kulcsár Zsófi , Diop Marie Yatou , Hollick Sarah , Maas Alexander Philippe , Strieth Sebastian , Landsberg Jennifer , Dietrich Dimo 
Published: November 2023

AbstractThe immune‐modulating protein CD52 attenuates lymphocyte function and is associated with autoimmune disorders, for example, multiple sclerosis (MS). CD52 represents a therapeutic target in MS and chronic lymphocytic leukemia (CLL). Its expression has prognostic and predictive value in CLL and is prognostic in breast cancer. Its significance in melanoma is unclear. We analyzed CD52 mRNA expression data from tumor bulk tissues of N = 445 untreated melanoma patients from The Cancer Genome Atlas (TCGA) Research Network and of N = 121 melanoma patients undergoing anti‐PD‐1 immune checkpoint blockade (ICB) with regard to outcome (overall survival [OS], disease control [DC], and progression‐free survival [PFS]), single‐cell RNA‐Seq data of N = 4645 cells from N = 19 melanoma tissues, and N = 15,457 cells from normal skin provided by N = 5 donors. Higher CD52 mRNA expression was associated with favorable OS (hazard ratio (HR) = 0.820, [95% CI 0.734–0.916], p < .001) in non‐ICB‐treated melanoma and with PFS (HR = 0.875, [95% CI 0.775–0.989], p = .033) and DC (p = .005) in ICB‐treated melanoma. CD52 expression correlated significantly with distinct immune cell subsets and correlated negatively with immune checkpoint expression in T cells. Moreover, our results suggest CD52 expression by a certain type of tissue‐resident macrophages. CD52 mRNA was expressed in a small subgroup (8%) of immune checkpoint coexpressing melanoma cells. CD52 expression is associated with features of ICB response in melanoma. Concomitant ICB and anti‐CD52 treatment requires critical review.
Functionalism and tacit knowledge of grammar
Authors: Balcarras David 
Published: November 2023

AbstractIn this article, I argue that if tacit knowledge of grammar is analyzable in functional‐computational terms, then it cannot ground linguistic meaning, structure, or sound. If to know or cognize a grammar is to be in a certain computational state playing a certain functional role, there can be no unique grammar cognized. Satisfying the functional conditions for cognizing a grammar G entails satisfying those for cognizing many grammars disagreeing with G about expressions' semantic, phonetic, and syntactic values. This threatens the Chomskyan view that expressions have such values for speakers because they cognize grammars assigning them those values. For if this is true, semantics, syntax, and phonology must be indeterminate, thanks to the indeterminacy of grammar‐cognizing (qua functional‐computational state). So, the fact that a speaker cognizes a grammar cannot explain the determinate character of their language.
Shifting from ependyma to choroid plexus epithelium and the changing expressions of aquaporin‐1 and aquaporin‐4
Authors: Mack Andreas F. , Bihlmaier Ronja , Deffner Felix 
Published: November 2023

AbstractThe cells of the choroid plexus (CP) epithelium are specialized ependymal cells (ECs) but have distinct properties. The CP cells and ECs form single‐cell sheets contiguous to each other at a transitional zone. The CP is underlined by a basal lamina and has barrier properties, whereas the ECs do not. The basal lamina of the CP is continuous with the glia limitans superficialis and, consequently, the CP stroma is continuous with the meninges along entering blood vessels. The CP has previously been reported to express aquaporin‐1 (AQP1) mostly apically, and ECs show mostly basolateral aquaporin‐4 (AQP4) expression. Recent evidence in various systems has shown that in changing conditions the expression and distribution of AQP4 can be modified, involving phosphorylation and calmodulin‐triggered translocation. Studies on the human CP revealed that AQP4 is also expressed in some CP cells, which is likely to be increased during ageing based on mouse data. Moreover, subependymal astrocytic processes in the ependyma–CP transition, forming a glial plate around blood vessels and facing the CP stroma, were strongly positive for AQP4. We propose that the increased AQP4 expression might be a compensatory mechanism for the observed reduction in CSF production in the ageing human brain. The high AQP4 density in the transition zone might facilitate the transport of water into and out of the CP stroma and serve as a drainage and clearing pathway for metabolites in the CNS.
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A Review of Kinematic Theories and Practices Compiled for Biomechanics Students and Researchers
Authors: Erdman Arthur , Lehman Malachi 
Published: November 2023

Abstract
The topic of kinematics is fundamental to engineering and has a significant bearing on clinical evaluations of human movement. For those studying biomechanics, this topic is often overlooked in importance. The degree to which kinematic fundamentals are included in Biomedical engineering (BmE) curriculums is not consistent across programs and often foundational understandings are gained only after reading literature if a research or development project requires that knowledge. The purpose of this paper is to present the important theories and methods of kinematic analysis and synthesis that should be in the “toolbox” of students of biomechanics. Each topic is briefly presented accompanied by an example or two. Deeper learning of each topic is left to the reader, with the help of some sample references to begin that journey.
An In Silico Model for Predicting the Efficacy of Edge-to-Edge Repair for Mitral Regurgitation
Authors: Ooida Junichi , Kiyohara Naoki , Noguchi Hironaga , Oguchi Yuichiro , Nagane Kohei , Sakaguchi Takuya , Aoyama Gakuto , Shige Fumimasa , Chapman James V. , Asami Masahiko , Kofoed Klaus Fuglsang , Pham Michael Huy Cuong , Suzuki Koshiro 
Published: November 2023

Abstract
In recent years, transcatheter edge-to-edge repair (TEER) has been widely adopted as an effective treatment for mitral regurgitation (MR). The aim of this study is to develop a personalized in silico model to predict the effect of edge-to-edge repair in advance to the procedure for each individual patient. For this purpose, we propose a combination of a valve deformation model for computing the mitral valve (MV) orifice area (MVOA) and a lumped parameter model for the hemodynamics, specifically mitral regurgitation volume (RVol). Although we cannot obtain detailed information on the three-dimensional flow field near the mitral valve, we can rapidly simulate the important medical parameters for the clinical decision support. In the present method, we construct the patient-specific pre-operative models by using the parameter optimization and then simulate the postoperative state by applying the additional clipping condition. The computed preclip MVOAs show good agreement with the clinical measurements, and the correlation coefficient takes 0.998. In addition, the MR grade in terms of RVol also has good correlation with the grade by ground truth MVOA. Finally, we try to investigate the applicability for the predicting the postclip state. The simulated valve shapes clearly show the well-known double orifice and the improvement of the MVOA, compared with the preclip state. Similarly, we confirmed the improved reverse flow and MR grade in terms of RVol. A total computational time is approximately 8 h by using general-purpose PC. These results obviously indicate that the present in silico model has good capability for the assessment of edge-to-edge repair.
Sensitivity Analysis of Upper Limb Musculoskeletal Models During Isometric and Isokinetic Tasks
Authors: Diaz Maximillian T. , Harley Joel B. , Nichols Jennifer A. 
Published: November 2023

Abstract
Sensitivity coefficients are used to understand how errors in subject-specific musculoskeletal model parameters influence model predictions. Previous sensitivity studies in the lower limb calculated sensitivity using perturbations that do not fully represent the diversity of the population. Hence, the present study performs sensitivity analysis in the upper limb using a large synthetic dataset to capture greater physiological diversity. The large dataset (n = 401 synthetic subjects) was created by adjusting maximum isometric force, optimal fiber length, pennation angle, and bone mass to induce atrophy, hypertrophy, osteoporosis, and osteopetrosis in two upper limb musculoskeletal models. Simulations of three isometric and two isokinetic upper limb tasks were performed using each synthetic subject to predict muscle activations. Sensitivity coefficients were calculated using three different methods (two point, linear regression, and sensitivity functions) to understand how changes in Hill-type parameters influenced predicted muscle activations. The sensitivity coefficient methods were then compared by evaluating how well the coefficients accounted for measurement uncertainty. This was done by using the sensitivity coefficients to predict the range of muscle activations given known errors in measuring musculoskeletal parameters from medical imaging. Sensitivity functions were found to best account for measurement uncertainty. Simulated muscle activations were most sensitive to optimal fiber length and maximum isometric force during upper limb tasks. Importantly, the level of sensitivity was muscle and task dependent. These findings provide a foundation for how large synthetic datasets can be applied to capture physiologically diverse populations and understand how model parameters influence predictions.
A Model for Competency-Based Grading and Its Effect on Student Outcomes in a Biomechanics Course
Authors: Fischer Kenneth J. , Fischer Christopher J. 
Published: November 2023

Abstract
Competency-based grading (CBG) can take different forms in different subject areas. We present a method for implementing CBG in a biomechanics course with nine primary learning objectives. Competency in each learning objective is measured by the student's ability to correctly answer knowledge questions and solve analytical problems in the field of biomechanics. The primary goal of implementing CBG was to provide more opportunities for lower-performing students to learn the material and to demonstrate that learning. To determine the efficacy of CBG to improve student learning, the primary measure was course grade distribution before and after implementation of CBG. The course grade distribution data indicated that CBG has primarily helped midperforming students to improve their grades. Because of the limitations of course grades as a measure of learning, we also performed analysis of student performance on successive attempts which indicated initial and secondary attempts are best, with student success declining on subsequent attempts. Anecdotally, many students improved performance, and thus their grade, on the (optional) final exam attempts. Limitations of the study include the limited course offerings with CBG (three), and that effects of COVID-19 may be confounding CBG data. Also, the approach places nearly all the grade on quizzes or exams. However, the approach could be modified to include homework grades, projects, and the like. Overall, the student learning in this course and implementation appears to be only positively affected, so this approach appears to have benefits in a biomechanics course.
Cryogenic Air Supply Feasibility for a Confined Space: Underground Refuge Alternative Case Study
Authors: Yan Lincan , Yantek Dave S. , DeGennaro Cory R. , Srednicki Justin R. , Lambie Brandin , Carr Jacob 
Published: November 2023

Abstract
A breathable air source is required for a confined space such as an underground refuge alternative (RA) when it is occupied. To minimize the risk of suffocation, federal regulations require that mechanisms be provided and procedures be included so that, within the refuge alternative, the oxygen concentration is maintained at levels between 18.5% and 23% for 96 h. The regulation also requires that, during use of the RA, the concentration of carbon dioxide should not exceed 1%, and the concentration of carbon monoxide should not exceed 25 ppm. The National Institute for Occupational Safety and Health (NIOSH) evaluated the cryogenic air supply's ability to provide breathable air for a refuge alternative. A propane smoker was used to simulate human breathing by burning propane gas which will consume O2 and generate CO2 and H2O. The rate of propane burned at the smoker was controlled to represent the O2 consumption rate for the breathing of a certain number of people. Two 96-h tests were conducted in a sealed shipping container, which was used as a surrogate for a refuge alternative. While burning propane gas to simulate human oxygen consumption, cryogenic air was provided to the shipping container to determine if the cryogenic air supply would keep the O2 level above 18.5% and CO2 level below 1% inside the shipping container as required by the federal regulations pertaining to refuge alternatives. Both of the 96-h tests simulated the breathing of 21 persons. The first test used the oxygen consumption rate (1.32 cu ft of pure oxygen per hour per person) specified in federal regulations, while the second test used the oxygen consumption rate specified by (Bernard et al. 2018, “Estimation of Metabolic Heat Input for Refuge Alternative Thermal Testing and Simulation,” Min. Eng., 70(8), pp. 50–54) (0.67 cu ft of pure oxygen per hour per person). The test data shows that during both 96-h tests, the oxygen level was maintained within a 21–23% range, and the CO2 level was maintained below 1% (0.2–0.45%). The information in this paper could be useful when applying a cryogenic air supply as a breathable air source for an underground refuge alternative or other confined space.
Design, Development and Validation of a Smart Cochlear Three-Dimensional-Printed Model to Train ENT Surgeons
Authors: Dauterman Michala , Jeyakumar Anita , Gautam Ishwor , Mahajan Alisha , Khanna Sahana , Mahajan Ajay 
Published: November 2023

Abstract
This paper presents a platform for self-learning cochlear insertion using computer vision in a three-dimensional surrogate model. Self-learning and practice experiences often improve the confidence associated with eventual real-world trials by novice medical trainees. This helps the trainees practice electrode insertion to minimize the effect of suboptimal electrode placement such as incomplete electrode insertion, electrode kinking, and electrode tip fold-over. Although existing mastoid fitting templates improve insertion trajectories, extensive training is still required. Current methods that use cadavers, virtual training, or physical models from reconstruction images are not good enough for training purposes. The model presented here simulates the dimensions, texture, and feel of inserting the electrode into the cochlea. Currently, the temporal bone is not included, hence it is not meant for practicing drilling and other procedures to access the cochlear. The insertion process is observed in real-time using a camera and a Graphical User Interface that not only shows the video feed, but also provides depth, trajectory, and speed measurements. In a trial conducted for medical trainees, there was an overall improvement in all four metrics after they were trained on the hardware/software. There was a 14.20% improvement in insertion depth, 44.24% reduction in insertion speed, 52.90% reduction in back-outs, and a 64.89% reduction in kinks/fold-overs. The advantage of this model is that medical trainees can use it as many times as they like, as the whole setup is easy, economical, and reusable.
Influence of Noncondensable Gas–Dust Mixture on Direct Contact Condensation of Steam at Atmospheric Pressure
Authors: Berti Luca , Pesetti Alessio , Raucci Michele , Giambartolomei Guglielmo , Aquaro Donato 
Published: November 2023

Abstract
At the Department of Civil and Industrial Engineering (DICI) of the University of Pisa, an experimental research program, funded by International Thermonuclear Experimental Reactor (ITER) Organization, concerning steam direct condensation in a flux containing also noncondensable gas and dust, was carried out. This mixture of fluids and dust is injected into the ITER pressure suppression tanks during a loss of coolant accident (LOCA) in the Vacuum Vessel. The aim of the research program is to determine the steam condensation efficiency in such conditions. Experimental tests were performed injecting this mixture in a tank partially filled with water. Alumina was used to simulate the actual dust present in the ITER Vacuum Vessel. Mass flow rates, temperature, and pressure of the different fluids involved were recorded during the tests. The steam condensation into the subcooled water pool at a temperature ranging between 318 and 369 K was investigated to determine the condensation regimes occurring during the mixture injection. The values of the fraction of the energy absorbed by water, dust, and metallic structures of the heat losses and of the average heat transfer coefficient were determined considering pure steam, steam-dust and steam-air–dust injection. The average heat transfer coefficient, determined calculating the steam jet surfaces by means of image elaboration, was compared with empirical correlations.
The Seated Trunk Control Test: Investigation of Reliability and Known-Groups Validity Using Individuals Post-Anterior Cruciate Ligament Reconstruction
Authors: Pollen Travis R. , Roe Chelsey , Johnson Darren L. , Silfies Sheri P. , Noehren Brian 
Published: November 2023

Context: Decreased trunk neuromuscular control is a risk factor for both upper- and lower-extremity injuries, yet there are few reliable and valid clinical tests to identify deficits. Objective: The purpose of this study was to determine the reliability and known-groups validity of a novel clinical test, the seated trunk control test (STCT). Design: Cross-sectional reliability and known-groups validity study. Setting: Laboratory. Participants: 89 unique participants: 34 were 3 months postoperative anterior cruciate ligament reconstruction (ACLR) and 55 healthy controls. Methods: For the STCT, participants sat on a balance board with their eyes closed for three 30-second trials while investigators counted balance errors. Intraclass correlations (ICCs) were used to assess interrater reliability (N = 20) and test–retest reliability (N = 40). To assess known-groups validity, independent t tests were used to compare STCT errors at 3 months post-ACLR with healthy matched controls (N = 34/group). Area under a receiver operating characteristic curve identified an optimal cutoff for distinguishing between groups. Results: The STCT had perfect interrater reliability (ICC2,3 = 1.00) and good test–retest reliability (ICC3,3 = .79; 95% confidence interval = .61–.89). The ACLR group made significantly more errors on the STCT (mean [SD] = 15.5 [5.4]) than controls (mean [SD] = 8.2 [4.1]; P < .001, Cohen d = 1.52). The STCT’s ability to distinguish between groups was excellent (area under a ROC curve = 0.86). A cutoff of 12 errors maximized sensitivity (76%) and specificity (85%). Conclusions: The STCT is reliable between raters and across days. It also has excellent ability to distinguish between individuals with a recent ACLR and healthy matched controls, which provides initial evidence to suggest that the STCT may be clinically useful for identifying deficits in trunk neuromuscular control.
GaMF1.39’s antibiotic efficacy and its enhanced antitubercular activity in combination with clofazimine, Telacebec, ND-011992, or TBAJ-876
Authors: Ragunathan Priya , Shuyi Ng Pearly , Singh Samsher , Poh Wee Han , Litty Dennis , Kalia Nitin Pal , Larsson Simon , Harikishore Amaravadhi , Rice Scott A. , Ingham Philip W. , Müller Volker , Moraski Garrett , Miller Marvin J. , Dick Thomas , Pethe Kevin , Grüber Gerhard 
Published: November 2023

ABSTRACT

The
Mycobacterium tuberculosis
(
Mtb
) F-ATP synthase generates most of the biological energy currency ATP. Previously, we identified the mycobacterium-specific loop of the F-ATP synthase subunit γ as a new anti-tuberculosis target and discovered the novel diaminopyrimidine GaMF1, whose potency was improved by structure-activity relationship studies leading to the analog GaMF1.39. Here, we report that GaMF1.39 depletes cellular ATP formation by targeting the mycobacterial F-ATP synthase without affecting proton coupling or oxygen consumption. The antimycobacterial compound is bactericidal and potent against
Mtb
in macrophages without inducing phenotypic changes in biofilm formation, planktonic bacteria, or being toxic to zebrafish larvae. Combining GaMF1.39 with the NADH dehydrogenase inhibitor clofazimine, the cyt-

bcc:aa
3

inhibitor Telacebec, or the F-ATP synthase inhibitor TBAJ-876 showed enhanced whole ATP synthesis inhibition and anti-tuberculosis activity. These results suggest that GaMF1.39 may add value to a compound combination targeting oxidative phosphorylation for tuberculosis treatment.

IMPORTANCE

New drugs are needed to combat multidrug-resistant tuberculosis. The electron transport chain (ETC) maintains the electrochemical potential across the cytoplasmic membrane and allows the production of ATP, the energy currency of any living cell. The mycobacterial engine F-ATP synthase catalyzes the formation of ATP and has come into focus as an attractive and rich drug target. Recent deep insights into these mycobacterial F
1
F
O
-ATP synthase elements opened the door for a renaissance of structure-based target identification and inhibitor design. In this study, we present the GaMF1.39 antimycobacterial compound, targeting the rotary subunit γ of the biological engine. The compound is bactericidal, inhibits infection
ex vivo
, and displays enhanced anti-tuberculosis activity in combination with ETC inhibitors, which promises new strategies to shorten tuberculosis chemotherapy.