bluuebunny/crossref_metadata_2025_split huggingface dataset:
Motorized Intramedullary Lengthening Followed by Osseointegration for Amputees with Short Residual Femurs
Authors: Hoellwarth Jason Shih , Tetsworth Kevin , Akhtar Muhammad Adeel , Oomatia Atiya , Muderis Munjed Al 
Published: March 2023

Context:
Some patients seeking transcutaneous osseointegration for amputees (TOFA) have residual bones so short there is concern whether they provide sufficient surface to support full weight. Our strategy was to lengthen these patients' femurs with a motorized intramedullary lengthening nail (MILN) before TOFA.

Aims:
The aim of this study is to describe 10 transfemoral amputees' experience with MILN before TOFA, focusing on the complications of MILN and TOFA, and also the patients' preoperative and postoperative quality of life (QOL).

Settings and Design:
A retrospective registry review of all MILN before TOFA surgeries was performed.

Subjects and Methods:
The patients' operative complications during/following MILN and TOFA were investigated. Furthermore, the patients' mobility (daily prosthesis wear hours, K-level, Timed Up and Go (TUG), and 6 min Walk Test [6MWT]) and QOL survey data (Questionnaire for Persons with a Transfemoral Amputation [QTFA]) were compared at the initial consultation and at the latest follow-up using Fisher's exact test for frequencies, and Student's t-test for means (significance, P < 0.05).

Statistical Analysis Used:
Fisher's exact test for frequencies, and Student's t-test for means (significance, P < 0.05).

Results:
Seven patients had one operative complication each: Three regenerate (autograft and plating), two nail malfunctions (nail replacement), one broken linkage cable (acute length correction with autografting and fixation), and one early consolidation (re-osteotomy). All ten patients had TOFA, an average of 12.0 ± 3.9 months after MILN surgery. One patient had debridement for infection (implant retained) and one patient had the implant removed due to infection. Significant mobility improvements were K-level >2 (2/9 = 22% vs. 9/10 = 90%, P =0.006) and TUG <15 s (1/8 = 13% vs. 6/8 = 75% P = 0.041). Wear hours and 6MWT improved but not significantly. All three aspects of QTFA significantly improved: Global (44.8 ± 29.9 vs. 75.9 ± 26.8, P =0.050), mobility (50.3 ± 30.8 vs. 74.8 ± 18.2, P =.033), and problem (38.8 ± 18.6 vs. 15.6 ± 18.3, P = 0.017).

Conclusions:
MILN before TOFA reliably achieves stable osseointegration for amputees with short residual femurs. Amputee lengthening remains demanding, but patients report significantly improved QOL and demonstrate improved mobility following TOFA. The minimum length of bone necessary to support a full weight-bearing osseointegrated prosthesis remains unknown.
Transcutaneous Osseointegration for Amputees with Short Residual Bone
Authors: Hoellwarth Jason Shih , Geffner Adam Daniel , Reif Taylor J. , Rozbruch S. Robert 
Published: March 2023

Aims:
Transcutaneous osseointegration for amputees (TOFA) provides improved mobility and quality of life for most patients versus a traditional socket prosthesis. One uncertainty regarding TOFA is whether a minimum residual bone length is necessary to achieve solid fixation. This study evaluated the relationship between residual bone length and occurrence of post-TOFA complications requiring operative intervention.

Patients and Methods:
A retrospective review of our osseointegration registry was performed. Inclusion criterion was index osseointegration at least 12 months prior. Chart review included demographics and whether additional surgery occurred to manage noninfected loosening, periprosthetic fracture, and infection. Occurrence rates were compared using binary logistic regression analysis and by stratifying implants as <140 versus ≥140 mm.

Results:
Sixty segments were included (58 patients and 2 bilateral femur amputees). The implant length averaged 129.4 ± 31.1 (48–200) mm. No noninfected loosening occurred. Six patients (10%) had infection-related post-TOFA operation, at lengths ranging from 130 to 160 mm (representing the central 60% of implant lengths): five were debridement with implant retention and one other was removed. No implants below 130 mm (n = 19, 32%) required debridement or removal. Three patients (5%) had periprosthetic fracture (all femurs), at lengths ranging from 140 to 160 mm (the central 55% of implant lengths); no implants below 140 mm (n = 22, 37%) had periprosthetic fracture. Regression identified no association between length and noninfected loosening (P = 1.000), periprosthetic fracture (P = 0.999), or infection (P = 0.124). Dichotomized <140 versus ≥140 mm rates of complication were as follows: noninfected loosening (0/22 = 0% vs. 0/38 = 0%, P = 1.000), fracture (3/38 = 7.9% vs. 0/22 = 0%, P = 0.292), and infection (5/38 = 13.2% vs. 1/22 = 4.5%, P = 0.400).

Conclusion:
Residual bone length does not appear to be associated with post-TOFA reoperation to address noninfected loosening, periprosthetic fracture, or infection. The "minimum necessary" length of bone to achieve stable transcutaneous osseointegration capable of supporting full body weight remains uncertain.
Femoral Lengthening Using Ilizarov Ring Fixator and Slotted Plate
Authors: Kulkarni Sujay Milind , Kulkarni Ruta M. 
Published: March 2023

Background:
Femoral lengthening is generally considered a cumbersome procedure due to the long fixator duration and complexity of the surgery. Lengthening over nail and lengthening over plate (LOP) have solved most of the problems but are associated with the risk of deep infection and plate prominence, respectively. We report a series of 14 cases with the use of a slotted plate to minimize both the problems.

Materials and Methods:
The study includes 14 patients, 8 females and 6 males, including four children. The average age of patients was 17.8 years, ranging from 7 years to 30 years. Femoral lengthening was performed with Ilizarov external fixator and slotted plate.

Results:
The target length ranged from 3 cm to 7 cm with an average of 4.6 cm. External fixator duration achieved ranged from 42 days to 92 days with a mean external fixator duration of 61.5 days. The mean external fixator index was 13.3 days/cm. We had no incidence of plate prominence or deep infection. We had four cases of knee stiffness, of which one needed surgery. All the patients had good quality regenerate and consolidation.

Conclusion:
The use of a slotted plate for LOP in femoral lengthening is a useful technique to minimize the incidence of plate prominence associated with LOP.
Identification and Consequences of Fine Wire and Half-pin Loosening for External Framing
Authors: Nutt James , Sinclair Lucy , Graham Simon Matthew , Trompeter Alex 
Published: March 2023

This review article discusses the published methods of identification and consequences of fine wire and half-pin loosening. The evidence is reviewed and presented for the clinical, radiological, and histological analysis of the half-pin and fine wire to bone interface.

Materials and Methods:
A PRISMA compliant systematic review was conducted. Studies investigating the use of external fixators with descriptions on measurement of half-pin and fine wire loosening were included in this review.

Results:
Eight studies were eligible and included. No randomized controlled trials were identified. Torque measurement was most frequently used to quantify the half-pin-to-bone interface, histological analysis was performed by three studies, and radiographic analysis was performed by five papers including plain film and microcomputed tomography CT techniques.

Discussion:
The available evidence was of poor quality, with a lack of homogeneity in quantitative data for torque measurements and a prevalence of arbitrary figures for the definition of loosening. There was no mechanical analysis of fire wire loosening, and the most common clinical measure used for loosening was a scale validated for infection. Micro-CT was validated against torque figures and appears to be the most repeatable measure which could be applied clinically, however has only been used in canine studies. We recommend a study to compare the clinically relevant measurement of loosening against a standard model to provide a validated method of identification or prediction of half-pin and fine wire loosening.
An Efficient Approach for Driver Drowsiness Detection at Moderate Drowsiness Level Based on Electroencephalography Signal and Vehicle Dynamics Data
Authors: Houshmand Sara , Kazemi Reza , Salmanzadeh Hamed 
Published: March 2023

Background:
Drowsy driving is one of the leading causes of severe accidents worldwide. In this study, an analyzing method based on drowsiness level proposed to detect drowsiness through electroencephalography (EEG) measurements and vehicle dynamics data.

Methods:
A driving simulator was used to collect brain data in the alert and drowsy states. The tests were conducted on 19 healthy men. Brain signals from the parietal, occipital, and central parts were recorded. Observer Ratings of Drowsiness (ORD) were used for the drowsiness stages assessment. This study used an innovative method, analyzing drowsiness EEG data were in respect to ORD instead of time. Thirteen features of EEG signal were extracted, then through Neighborhood Component Analysis, a feature selection method, 5 features including mean, standard deviation, kurtosis, energy, and entropy are selected. Six classification methods including K-nearest neighbors (KNN), Regression Tree, Classification Tree, Naive Bayes, Support vector machines Regression, and Ensemble Regression are employed. Besides, the lateral position and steering angle as a vehicle dynamic data were used to detect drowsiness, and the results were compared with classification result based on EEG data.

Results:
According to the results of classifying EEG data, classification tree and ensemble regression classifiers detected over 87.55% and 87.48% of drowsiness at the moderate level, respectively. Furthermore, the classification results demonstrate that if only the single-channel P4 is used, higher performance can achieve than using data of all the channels (C3, C4, P3, P4, O1, O2). Classification tree classifier and regression classifiers showed 91.31% and 91.12% performance with data from single-channel P4. The best classification results based on vehicle dynamic data were 75.11 through KNN classifier.

Conclusion:
According to this study, driver drowsiness could be detected at the moderate drowsiness level based on features extracted from a single-channel P4 data.
Force Generation and Muscle Activation of Knee Extensor and Flexor Muscles in Type 2 Diabetes Mellitus Patients
Authors: Shahrjerdi Samira , Bahrpeyma Farid , C. M. Savelberg Hans H. , Bagherian Seyed Ahmad , Jamshidpour Boshra 
Published: March 2023

Background:
Type 2 diabetes mellitus (T2DM) is associated with decreased muscle force generation. The disturbed force generation process in T2DM could be attributed to either or both agonist and antagonist muscles activation. The present study aims to assess the effects of T2DM on the interaction of antagonist and agonist muscles in the knee joint.

Methods:
The peak torque, root mean square (RMS) of the SEMG signals, the ratio of torque/RMS, and the interaction of antagonists and agonist muscles were compared between healthy and T2DM patients. Surface ElectroMyoGraphy (SEMG) of knee flexor and extensor muscles were recorded during concentric contraction with an isokinetic dynamometer at 60°/s in 13 T2DM and 12 healthy subjects. The independent sample t-tests were used to compare diabetic and healthy subjects. The significance level was set at 0.05.

Results:
The antagonist/agonist interaction during maximal extension (P = 0.010) and flexion (P = 0.022) torques of the knee joint showed significantly lower activation of antagonist muscles in T2DM patients than in healthy subjects. Lower knee flexion (41.3%) and extension torques (49.1%) and RMS of agonist and antagonist muscles were observed in T2DM. The torque/RMS ratio (P > 0.05) showed no significant differences in T2DM and healthy subjects.

Conclusion:
The reduced maximal knee flexor and extensor torques in T2DM are accompanied with the decreased myoelectric activity of corresponding muscles. The related mechanism could be attributed to lower values of antagonist/agonist interaction, which may point out some neural compensatory processes to preserve the functional capacity of the neuromuscular system in T2DM.
A Novel Pulse-Taking Device for Persian Medicine Based on Convolutional Neural Networks
Authors: Nafisi Vahid Reza , Ghods Roshanak , Shojaedini Seyed Vahab 
Published: March 2023

Background:
In Persian medicine (PM), measuring the wrist pulse is one of the main methods for determining a person's health status and temperament. One problem that can arise is the dependence of the diagnosis on the physician's interpretation of pulse wave features. Perhaps, this is one reason why this method has yet to be combined with modern medical methods. This paper addresses this concern and outlines a system for measuring pulse signals based on PM.

Methods:
A system that uses data from a customized device that logs the pulse wave on the wrist was designed and clinically implemented based on PM. Seven convolutional neural networks (CNNs) have been used for classification.

Results:
The pulse wave features of 34 participants were assessed by a specialist based on PM principles. Pulse taking was done on the wrist in the supine position (named Malmas in PM) under the supervision of the physician. Seven CNNs were implemented for each participant's pulse characteristic (pace, rate, vessel elasticity, strength, width, length, and height) assessment, and then, each participant was classified into three classes.

Conclusion:
It appears that the design and construction of a customized device combined with the deep learning algorithm can measure the pulse wave features according to PM and it can increase the reliability and repeatability of the diagnostic results based on PM.
Gas Array Sensors based on Electronic Nose for Detection of Tuna (Euthynnus Affinis) Contaminated by Pseudomonas Aeruginosa
Authors: Astuti Suryani Dyah , Isyrofie Achmad Ilham Fanany Al , Nashichah Roichatun , Kashif Muhammad , Mujiwati Tri , Susilo Yunus , Winarno  , Syahrom Ardiyansyah 
Published: March 2023

Background:
Fish is a food ingredient that is consumed throughout the world. When fishes die, their freshness begins to decrease. The freshness of the fish can be determined by the aroma it produces. The purpose of this study is to monitor the odor of fish using a collection of gas sensors that can detect distinct odors.

Methods:
The sensor was tested with three kinds of samples, namely Pseudomonas aeruginosa, tuna, and tuna that was contaminated with P. aeruginosa bacteria. During the process of collecting sensor data, all samples were placed in a vacuum so that the gas or aroma produced was not contaminated with other aromas. Eight sensors were used which were designed and implemented in an electronic nose (E-nose) device that can withstand aroma. The data collection process was carried out for 48 h, with an interval of 6 h for each data collection. Data processing was performed by using the principal component analysis and support vector machine (SVM) methods to obtain a plot score visualization and classification and to determine the aroma pattern of the fish.

Results:
The results of this study indicate that the E-nose system is able to smell fish based on the hour with 95% of the cumulative variance of the main component in the classification test between fresh tuna and tuna fish contaminated with P. aeruginosa.

Conclusion:
The SVM classifier was able to classify the healthy and unhealthy fish with an accuracy of 99%. The sensors that provided the highest response are the TGS 825 and TGS 826 sensors.
The Cloud FIBER-FIT Model for Physical Fitness Check-Up
Authors: Rakpongsiri Kedsara , Rakpongsiri Pornchai 
Published: March 2023

Background:
Physical fitness refers to the ability of the body to perform tasks or do one of the physical activities well without being tired quickly. The objective of this research is to develop a physical fitness instrument for measuring oneself heart rate, grip strength, and reaction time that could develop a model for a self-check-up on physical fitness which helps to plan the improvement for health which is called the “FIBER-FIT” model.

Methods:
The physical fitness measuring instrument is composed of three modules; (1) heart rate meter module using a green light emitting diode and a photosensor, (2) grip strength meter module using a load cell transducer, and (3) reaction time meter module using a computer graphical function. All modules are controlled by computer programming, LabVIEW. The program could measure the physical fitness parameters in real-time and display the results in graphs, values on a computer monitor. The data could be recorded on cloud storage and could be retrieved for viewing and analyzing from anywhere via the internet.

Results:
Getting the “FIBER-FIT” model, a physical fitness measuring instrument to evaluate and analyze the results in real time. Overall performance test results were comparable to the standard commonly used instruments. The satisfaction survey scores from the participants were 33.33% and 66.67% for the highest level and the high level, respectively.

Conclusions:
The Cloud “FIBER-FIT” model is recommended for physical fitness applications for health improvement.
Sepsis-related pediatric acute respiratory distress syndrome
Authors: Prasertsan Pharsai , Anantasit Nattachai , Walanchapruk Suchanuch , Roekworachai Koonkoaw , Samransamruajkit Rujipat , Vaewpanich Jarin 
Published: March 2023

OBJECTIVES:
This study aimed to compare the risk factors and outcomes for organ dysfunction between sepsis-related Pediatric acute respiratory distress syndrome (PARDS) and nonsepsis PARDS.

METHODS:
We prospective cohort recruited intubated patients with PARDS at four tertiary care centers in Thailand. The baseline characteristics, mechanical ventilation, fluid balance, and clinical outcomes were collected. The primary outcome was organ dysfunction.

RESULTS:
One hundred and thirty-two mechanically ventilated children with PARDS were included in the study. The median age was 29 months and 53.8% were male. The mortality rate was 22.7% and organ dysfunction was 45.4%. There were 26 (19.7%) and 106 (80.3%) patients who were classified into sepsis-related PARDS and nonsepsis PARDS, respectively. Sepsis-related PARDS patients had a significantly higher incidence of acute kidney injury (30.8% vs. 13.2%, P = 0.041), septic shock (88.5% vs. 32.1%, P < 0.001), organ dysfunction (84.6% vs. 35.8%, P < 0.001), and death (42.3% vs. 17.9%, P = 0.016) than nonsepsis PARDS group. Multivariate analysis adjusted for clinical variables showed that sepsis-related PARDS and percentage of fluid overload were significantly associated with organ dysfunction (odds ratio [OR] 11.414; 95% confidence interval [CI] 1.40892.557, P = 0.023 and OR 1.169; 95% CI 1.0121.352, P = 0.034).

CONCLUSIONS:
Sepsis-related PARDS patients had more severe illness, organ dysfunction, and mortality than nonsepsis PARDS patients. The higher percentage of fluid overload and presentation of sepsis was the independent risk factor of organ dysfunction in PARDS patients.
Postkomünist Dönemde İç ve Dış Faktörler Bağlamında Bulgaristan’da Dış Politikanın Dönüşümü
Authors: IŞIK Mustafa 
Published: March 2023

Soğuk Savaş sonrası dünya siyasetinde meydana gelen radikal değişimler, devletlerin dış politikalarını yapısal değişikliğe sevk etmiştir. Bu değişim ve dönüşüm süreci sadece sistemik boyutta kalmayıp, devlet ve lider profillerine de yansımıştır. Postkomünist süreç içerisinde Bulgaristan dış politikasında yaşanan değişimleri açıklama amacı güden çalışmamız; kuramsal çerçeve olarak Neoklasik Realizmi kullanmaktadır. Sistemik etkinin tetiklemesi ile güç dengelerinin değiştiği bir ortamda Doğu Avrupa ve Balkanlar’daki komünist rejimler çökerken, meydana gelen bu güç boşluğu eski Doğu Bloğu ülkelerini yeni dış politika arayışlarına yöneltti. Bu süreç Balkan ülkelerinde Avrupa-Atlantik yapı ile bir yakınlaşma meydana getirdi. Bu bağlamda temel araştırma sorumuz ; Eski bir Doğu Bloğu ülkesi olan Bulgaristan’ın Soğuk Savaş sonrası izlediği Avrupa-Atlantik yanlısı dış politikalarını nasıl açıklayabiliriz? Dış politikanın dönüşüm sürecini devlet-içi faktörler ve liderler nasıl etkilemiştir?
Postkomünist dönemde Bulgaristan’ın iç ve dış politikasında büyük değişiklikler yaşandı. İç politikada yeni lider profilleri meydana çıkarken, AB ve NATO yanlısı siyasal oluşumlar siyasal alana dahil olmuştur. Bu değişim sürecinde Türk ve Müslüman azınlık ise siyasal sistem içerisinde önemli roller üstlenerek AB ve NATO yanlısı politikaları desteklemiştir. Bu süreçte Bulgaristan Komünist Partisi eskinin temsili politikaları yürütmeye çalışsa da iç ve dış politikada meydana gelen değişimlere direnememiştir. Azınlıkların kurduğu siyasi partiler ve Avrupa ile entegrasyonu savunun yeni siyasi oluşumlar devlet-içi düzeyde değişimin ana dinamiklerinden biri olmuştur. Bu bağlamda Türk ve Müslüman azınlığın dış politikaya etkisi de araştırma kapsamı içerisinde değerlendirilecektir.
Neoklasik realizm uluslararası sistemin içerisindeki güç değişimlerini dikkate almakla beraber devlet-içi faktörleri de analize dahil etmektedir. Bulgaristan’daki değişimi çok boyutlu olarak ele alma imkânı veren Neoklasik realist teori aynı zamanda liderlere de önemli bir alan açmaktadır. Neoklasik realizm, iç ve dış faktörleri beraber ele alması hasebiyle dış politika analizlerini derinleştirmektedir. Dış politikadaki değişimleri açıklama noktasında neoklasik realizmin iç faktörleri de analize dahil ederek daha sistemik ve kapsamlı bir analiz çerçevesi sunduğu görülmektedir.
Impact of Media and Information Literacy in Nigerian Colleges of Education Curriculum: A Case of Detecting Fake News
Authors: Nasir Mohammed Jibril , Ciroma Abdulmalik 
Published: March 2023

Purpose: This study sought to determine if students at colleges of education in northern Nigeria had developed the psychomotor skills required to recognize fake news (i.e., picture news, video news, and written social media/blog/website news).
Methodology: This paper adopted a quasi-experimental (one group post-test only) design. A sample size of 384 was drawn from a population of 28,050 students across six randomly selected colleges of education situated in northern Nigeria for the academic year 2020–2022. The participants were selected through a mixed-methods sample (cluster and purposive). A cluster sample was used to group students into different geopolitical zones and schools (faculty), and then, the researchers selected members (64 participants) from each college using a purposive sample. Data were collected with the aid of a questionnaire, presented on tables, and analyzed using the descriptive statistic.
Findings: The study found that Nigeria Certificate in Education (NCE) students in northern colleges lack psychomotor capability to verify fake news either through a manual or automatic method. The findings showed that only 23.7% of participants verified a picture without a background, 21.9% of participants were able to verify picture with background, 16.7% of participants verified video news, and 27.9% of participants verified written blog/website/ social media news.
Unique contribution to policy: The study observed a lack of psychomotor capability in verifying fake news among NCE students in the selected colleges of education. Therefore, the authors urged curriculum planners, educators, and other stakeholders to design more practical skills, especially in the area of detecting fake news on traditional and social media, in light of the study's findings.