26199 research outputs found
Sort by
Biomechanical Assessment of Grasping Postures in Individuals with Rheumatoid Arthritis when holding Adaptive Silverware
No full textIntroduction. Utensils with built-up handles are often recommended to minimize the required finger joint angles for functional grasping to reduce pain and help individuals with Rheumatoid Arthritis (RA) overcome participation barriers. However, there is a paucity of data describing the impact of built-up handles on range of motion (ROM) requirements of the hand. Therefore, the purpose of this study was to evaluate how built-up handles of varying thickness affect hand ROM in individuals with RA.
Methods. Thirty-five individuals with RA were instructed to grasp a standard handle spoon, a 1.00 inch, and a 1.50 inch built-up handle spoon and perform a simulated eating task. Electrogoniometers were used to measure the finger joint angles of the metacarpophalangeal (MCP), proximal interphalangeal (PIP), and distal interphalangeal (DIP) joints for digits 2-5.
Results. In general, there were significant decreases in finger joint flexion as handle diameters increased. Twenty-nine of the thirty-five individuals selected the 1.50 inch handle to take home with the remainder choosing the 1.00 inch.
Discussion. This study is the first to provide quantitative data to support the notion that the grasping postures required when using built-up handled spoons utilizes reduced finger joint angles for individuals with RA when compared to a standard handle spoon which could help providers when assessing patient needs and when designing hand orthoses. We recommend practitioners provide built-up handled utensils where possible, or educate people with RA on where to buy or how to make adaptive utensils, to assist the independence of individuals with RA.
Conclusion. This paper supports the appropriate prescription and use of adaptive silverware by healthcare providers in the promotion of independence for individuals with RA
Too many or too massive? Investigating the high- z demography of active SMBHs from JWST
No full textRecent JWST observations have unveiled a numerous population of low-luminosity active galactic nuclei (AGN) at 4 ≲ z ≲ 10, with space densities roughly an order of magnitude above pre-JWST estimates, and many of these AGN have masses orders of magnitude above the local black hole mass–stellar mass (MBH − M⋆) scaling relations. We investigate the consistency of these observations within a data-driven framework that links the galaxy stellar mass function to the supermassive black hole (SMBH) mass function and AGN luminosity functions using different MBH − M⋆ relations and the observed Eddington-ratio distribution. By comparing our predictions against observed AGN luminosity functions at z ∼ 5.5 we find that observations can be reproduced either by highly-elevated MBH − M⋆ relations paired with low duty cycles (fAGN ∼ 0.08), or moderate relations with higher duty cycles (fAGN ∼ 0.5). Through the Sołtan argument, we find that MBH − M⋆ relations that are modestly above the local relation for AGN produce consistency between multiple tracers of the SMBH demography at z ∼ 5.5, while more extreme normalisations would require a weakly-evolving luminosity function at z ≥ 5.5. Continuity-equation modelling shows that initially high MBH − M⋆ relations predict a strong two-phase evolutionary scenario and very steep low-mass SMBH mass functions in tension with several current estimates, while more moderate relations generate local SMBH mass functions in better agreement with present determinations and near-constant scaling relations. Our results favour a scenario where SMBHs at z ∼ 5 on average lie modestly above local AGN scaling relations, with elevated but physically plausible duty cycles. Future wide-field clustering and demographic studies will help break the remaining degeneracies between SMBH scaling relations and AGN duty cycles at early cosmic times
Oral Impacts on Quality of Life and Dental Attendance in 12- and 15-Year-Old Children in the UK
No full textStudies on links between Oral Health-Related Quality of Life (OHRQoL) and use of dental services among UK children are lacking. This study aimed to assess the relationship between OHRQoL and dental attendance in 12- and 15-year-old children in the UK using secondary data from the UK Child Dental Health Survey (CDHS, 2013). Methods: OHRQoL was measured as the exposure using the Child-OIDP (Oral Impacts on Daily Performances), and dental attendance was the outcome in this analysis. Dental attendance was measured by asking children whether they visited the dentist regularly, only when in trouble, or never. Logistic regression models analysed the relationship between OHRQoL and dental attendance accounting for potential confounding factors such as socio-demographic characteristics, health behaviours, and anxiety. Results: Data from 4136 children aged 12 and 15 years found that the prevalence of dental attendance ‘only when in trouble or never’ was 20.5% among children who reported at least one impact, compared to 13.6% among children reporting no impacts. A social gradient was apparent, as 28% of children living in deprived areas exhibited problem-oriented dental attendance compared with 8.6% in affluent areas. Logistic regression unadjusted estimates of children who reported at least one impact on QoL had 1.64 times greater likelihood of visiting the dentist ‘only when in trouble or never’ compared to children reporting no impacts (OR: 1.64, 95%CI: 1.24, 2.17). Adjusting for confounders reduced this to OR 1.39 (95% CI: 1.10, 1.77). Furthermore, the greater the number of negative impacts that were reported, the higher the odds of visiting a ‘dentist only when in trouble or never’. In the fully adjusted model, children who reported either two or more impacts had higher odds of visiting the dentist ‘only when in trouble’. Children who reported only one impact were as likely to seek dental treatment ‘only when in trouble’ as children reporting no impacts. Conclusions: Both poorer OHRQoL and problem-oriented attendance were more evident in children from lower-socio-economic backgrounds. Barriers to regular dental attendance affecting children from disadvantaged backgrounds should be addressed and dental care prioritised
Portable Measurement of Catenary Geometry Parameters
No full textDetecting catenary geometric parameters is essential in railway maintenance and operation. Key parameters include contact wire height, stagger at the locator, and steady arm orientation angle, along with automatic number plate recognition for rapid fault localization and improved maintenance workflows. This paper presents a portable detection device that integrates LiDAR and image recognition for automated, high-precision measurement of these parameters. The system simultaneously captures height, stagger, and locator angle while recognizing catenary mast identification numbers. Experimental validation confirms outstanding performance, measurement error within 3%, and recognition accuracy over 90% for both locator angles and number plates. These results demonstrate the device’s reliability and practicality for field deployment in railway systems
Trace Elements as Molecular Orchestrators of Health and Disease: A Biochemical and Pathophysiological Perspectives
No full textTrace elements, though required in minute quantities, play fundamental roles in maintaining physiological homeostasis, enzymatic functions, and cellular integrity. Essential trace elements, such as zinc, copper, selenium, iron, and manganese, act as cofactors for key enzymatic reactions, regulate redox balance, and contribute to immune function, neuroprotection, and metabolic processes. Dysregulation of these elements, either through deficiency or excess, has been implicated in a wide spectrum of diseases, including cardiovascular disorders, neurodegenerative conditions, diabetes, cancer, and others. Zinc and copper homeostasis are critical for immune competence and oxidative stress modulation, while selenium exerts profound effects on redox signalling and thyroid function. Iron imbalance is closely associated with anemia, oxidative stress, and neurodegeneration, whereas manganese plays a pivotal role in mitochondrial function and antioxidant defense. Emerging research highlights the role of trace element interactions, metal ion transporters, and metalloproteins in disease pathophysiology. This chapter explores the intricate biochemical and molecular mechanisms through which trace elements can influence health and diseases, emphasizing their diagnostic and therapeutic potential in precision medicine and clinical nutrition. Understanding the homeostatic regulation and pathophysiological implications of trace elements may provide novel insights into disease prevention and targeted interventions
The Role of Antioxidant-Associated Trace Elements in the Development Diabetic Cardiomyopathy
No full textDiabetic cardiomyopathy (DCM) is a distinct myocardial complication of diabetes mellitus, characterized by structural and functional cardiac alterations independent of hypertension and coronary artery disease. Its pathogenesis is complex and multifactorial, with oxidative stress recognized as a central mechanism that interacts with metabolic dysregulation, mitochondrial dysfunction, and chronic inflammation. This chapter synthesizes evidence from experimental and clinical studies to examine the role of antioxidant-associated trace elements in the development and management of DCM. Eight essential trace elements—iron, zinc, copper, selenium, iodine, manganese, molybdenum, and chromium—are highlighted for their involvement as cofactors of key antioxidant enzymes, including superoxide dismutase, catalase, and glutathione peroxidase. Disturbances in the homeostasis of these elements weaken antioxidant defenses, increase reactive oxygen and nitrogen species, and accelerate myocardial injury, whereas adequate levels enhance antioxidant activity, preserve mitochondrial function, reduce inflammation, and limit adverse cardiac remodeling. The dual role of trace elements as both inducers and protectors underscores their importance in understanding DCM pathogenesis and highlights their potential as therapeutic modulators. Future strategies should focus on defining optimal micronutrient ranges, developing evidence-based supplementation protocols, and integrating trace element management with conventional treatments to reduce the burden of diabetic cardiomyopathy
ENGAGE: Analyzing the value of virtual reality in a patient-centric immersive learning program in myasthenia gravis for healthcare professionals
No full textBackground: Myasthenia gravis (MG) is a chronic autoimmune neuromuscular disease characterized by muscle weakness that can significantly impact patients’ lives. Recent patient-led research highlighted a disconnect between healthcare professionals (HCPs) and patients, emphasizing the need for effective and empathetic patient–HCP dialogue and shared decision-making (SDM). The power of virtual reality (VR) to increase empathy and provide impactful learning experiences has been established. This outcome evaluation assessed the ability of VR to improve HCPs’ knowledge, attitudes and empathy in MG, aiming to strengthen patient–HCP communication and facilitate SDM.
Methods: The ENGAGE educational pilot program comprised a needs assessment, a VR-based intervention and an outcome evaluation. Content for the VR intervention was developed using a patient-centric approach integrating patient and HCP voices. The VR module simulated “a day in the life of Julia,” a virtual patient with MG, allowing HCPs to experience MG symptoms and their impact on a patient’s life. The experience was implemented in hospital-based workshops. The outcome evaluation included surveys assessing Moore’s Levels 2–4, the Theoretical Domains Framework (TDF), and SDM, and was supplemented by semi-structured interviews. Quantitative and qualitative data were analyzed using SPSS Statistics and thematic analysis, respectively.
Results: Eighty-seven HCPs completed the VR experience across 12 workshops. Sixty HCPs participated in the outcome evaluation survey, and 10 participated in interviews. HCPs reported high satisfaction with the immersive learning, citing its relevance and ease of use. Based on survey responses, HCPs’ most important learnings were a “better understanding of the impact of MG on patients’ lives” (n/N = 46/60) and “developing empathy for how a patient with MG might feel” (n/N = 37/60). HCPs expressed commitment to changing their practice. Quantitative analysis revealed significant improvements in most TDF domains and SDM post-intervention, with the TDF domain “beliefs about capabilities” emerging as the strongest predictor of SDM.
Conclusion: Our study found that the immersive VR intervention effectively increased HCP empathy, knowledge and attitudes in MG care. The program’s patient-centric design ensured content relevance. These findings suggest that VR-based learning is a valuable tool for medical education and the improvement of SDM, particularly in rare diseases like MG
‘It's already set in my mind’: Investigating the acculturation of secondary school pupils aspiring to teach physical education
No full textThe occupational socialisation of physical education (PE) teachers has received limited scholarly attention in the UK, and even less is known about the influence of acculturation on their ideological preconceptions of PE teaching. Most research investigating PE teachers’ acculturation has relied on the retrospective accounts of PE teacher education (PETE) students or in-service teachers, what we call reflection-on-acculturation. Understanding the pre-existing ideological orientations that prospective recruits bring to PETE is vital for the disruption of conservative practice. Given that PE in England exceeded recruitment targets for trainee teachers in 2023/24 and 2024/25, establishing how these preconceptions are formed is increasingly important. Therefore, this study aimed to investigate the acculturation of prospective pre-service PE teachers while they are still in secondary school, and how it has shaped their perceptions of PE before formal recruitment into PETE. We call this reflection-in-acculturation. Data were generated through focus groups (N = 9) with secondary school pupils aspiring to become PE teachers (N = 62) from eight different secondary schools in the North of England. Data were analysed using reflexive thematic analysis and principles of collaborative qualitative analysis. Findings suggest that acculturation is profoundly influential to prospective recruits’ ideological preconceptions. Far from being ‘blank slates’, the prospective recruits had developed strong anticipatory ideas about, and fixed ideological preconceptions of, what PE teaching is or should be. We recommend that PETE programmes facilitate prolonged opportunities for recruits to critically reflect on their experiences, potentially disrupting and unlearning detrimental orientations developed during acculturation
Social media fatigue in nursing students: the role of self-control, social comparison, and fear of missing out
No full textBackground
The rapid expansion of social media has been accompanied by increasing reports of psychological and physical fatigue among users. Nursing students may be particularly vulnerable due to their high academic workload, clinical stress, and constant reliance on digital communication. This study aimed to examine the roles of self-control, social comparison, and fear of missing out (FoMO) in predicting social media fatigue among nursing students.
Methods
In this cross-sectional study, 223 nursing students from Guilan University of the Medical Science were recruited through convenience sampling. Validated instruments were used, including the Brief Self-Control Scale, the Iowa–Netherlands Comparison Orientation Measure, the FoMO Scale, and the Social Media Fatigue Scale. Data were analyzed using Pearson correlation and stepwise multiple regression in SPSS version 26 and the significant level was set at 0.05.
Results
Social media fatigue was negatively correlated with self-control (r = − 0.394, P < 0.001) and positively correlated with social comparison orientation (r = 0.320, P < 0.001) and fear of missing out (r = 0.480, P < 0.001). In the regression model, FoMO (β = 0.56, P < 0.001), self-control (β = − 0.39, P < 0.001), and social comparison in the ability dimension (β = 0.19, P = 0.048) were significant predictors of social media fatigue.
Conclusion
The findings indicate that Low self-control, high FoMO, and frequent ability-based comparisons were associated with higher levels of social media fatigue. Nursing curricula could incorporate digital self-regulation workshops, FoMO awareness training, and mindful technology-use guidelines to help reduce social media fatigue
A Comparative Assessment of Capsule Formulations Based on Amorphous Solid Dispersion and Salt Formation of Indomethacin
No full textBackground: Indomethacin (IND) is a nonsteroidal anti-inflammatory drug (NSAID) that belongs to the BCS class II and exhibits poor dissolution in the GIT fluids. Solid dispersion (SD) and salt formation (SF) are two acceptable and widely used approaches for dissolution enhancement.
Objective: The aim of the present study is to formulate and in vitro evaluate capsules from IND-Soluplus® SD and IND sodium SF, and compare the dissolution profile of the formulated capsules with pure IND.
Methods: Both IND SD and SF were prepared by the solvent evaporation method and characterized for their production yield, drug content, in vitro release, solid state characterization, and stability studies. Capsules were prepared by manual filling into hard gelatin capsules with IND SD and IND SF used as a source for the active ingredient, lactose or mannitol as diluent, and three types of super disintegrants: croscarmellose sodium, crospovidone, and sodium starch glycolate. The prepared capsules were tested for flow properties, weight variation, content uniformity, disintegration time, and in vitro dissolution test.
Results: The solvent evaporation method successfully produced IND SD and SF with high production yield and drug content, which were above 95%. Solid state characterization revealed complete amorphization of IND in the SD without any incompatibility, while it was in its crystalline state in SF. Both IND SD and SF were stable during the storage period with minor changes in drug content and drug release. The results showed proper flow properties with acceptable results for the weight variation test (all around 500 mg since it is a size 0 capsule), capsule content uniformity (98-99 %), and disintegration time (4-9 min). The disintegration of hard gelatin capsules is impacted by the type of disintegrant used, with superior performance of crospovidone (4 min) and croscarmellose sodium (5.3 min) compared to sodium starch glycolate (7.1-7.4 min). IND solid dispersion showed an enhanced dissolution (100% within 45 min) compared to the pure IND capsules (less than 50% within 45 min) and IND SF (100% within 45 min). Also, the dissolution of IND SD capsules containing crospovidone was superior to those containing croscarmellose sodium and sodium starch glycolate.
Conclusions: Indomethacin SD proved its efficacy in enhancing the dissolution of IND compared to pure IND capsules and IND SF