Extremity Disorders Research Articles

Intrarater reliability test of the ISOmetric power device—A new instrument for assessment of isometric force in six directions of wrist motion

Study DesignDescriptive reliability study. IntroductionA well-functioning wrist requires sufficient range of motion accompanied by adequate strength in every movement and direction—factors that are not regularly measured simultaneously in patients with wrist problems today. The ISOmetric Power device (ISOP) is a new instrument that measures isometric wrist force in all six directions of motion, but its intrarater reliability in a healthy population has not yet been evaluated. Purpose of the StudyThe purpose of this study was to perform an intrarater reliability test of the ISOP in healthy participants. MethodsThirty-two healthy study participants (16 women/16 men; mean age 38.3 years; SD 6.5) were included. With a standardized testing protocol, the three planes of wrist motion— wrist flexion/extension, radial/ulnar deviation, pro/supination—were measured at one time interval (T1) and repeated after one week (T2). The results were analyzed using the intraclass correlation coefficient (ICC). A paired-samples t-test was also performed to determine if a statistically significant difference (P < .05) existed between the first and the second test values. Measurements with Jamar Dynamometer were performed at both time intervals, for internal control of measurement intrarater reliability. ResultsExcellent correlations (ICC: 0.90-0.99) were found for all test-retests performed. The lowest value (ICC: 0.90) was seen for supination and the highest value (ICC: 0.99) for flexion of the left hand. No statistically significant differences were found in any of the pairs (P > .05) in terms of test-re-test, which additionally strengthen the correlation between the first and second test values. DiscussionContrary to the Jamar Dynamometer, the ISOP is not designed for measuring grip strength, but for assessing the isometric muscle force in flexion, extension, pronation, supination, and radial and ulnar deviation. A systematic review has reported a moderate to strong correlation between isometric strength and dynamic performances. Thus, the ISOP is a more complete and applicable instrument for evaluating the functional strength in different directions in the upper extremity. ConclusionsThe ISOmetric Power device shows excellent intrarater reliability and is proposed to be a possible valuable wrist strength assessment tool to aid in both diagnostics and outcome measures of wrist and upper extremity disorders.

A survey on the awareness, accessibility and funding for augmentative and alternative communication services and devices in Saudi Arabia

Purpose To develop and distribute a survey to obtain information on the awareness, accessibility and funding for augmentative and alternative communication (AAC) services and devices within the Kingdom of Saudi Arabia (KSA). Method The survey targeted three groups of people which included individuals with disabilities and their families, healthcare providers such as medical doctors and nurses and the third group included community members. Survey preparation and administration were performed online via a survey website in order to access a wide range of participants across KSA. Results Results revealed different awareness levels for AAC among the three groups (χ 2 = 45.053, p < .001) with healthcare providers showing a higher degree of awareness compared to the remaining two groups. Moreover, AAC services and devices were found to be accessible within KSA, with no differences in obtaining AAC services and devices among different regions (χ 2 = 14.204, p = .164). Conclusion Although numerous AAC users were able to obtain AAC devices, they identified barriers including a lack of sufficient awareness of the importance, associated expenses, funding constraints and a lack of Arabization of AAC devices. Implications for Rehabilitation Augmentative and alternative communication (AAC) methods allow individuals with communication difficulties to interact and socialize with those around them. The general authority of statistics in Saudi Arabia has shown that Saudi Arabia has an increased number of individuals suffering from severe to extreme communication disorders compared to other countries around the world. Consequently, the need for AAC in Saudi Arabia cannot be underestimated. This study demonstrates the importance of the awareness of AAC among different stakeholders in Saudi Arabia including AAC users, healthcare providers and community members so that individuals with communication problems can receive maximum benefit from AAC. Given that most healthcare providers in Saudi Arabia are prescribing non-tech and low-tech AAC methods indicates the importance of training on AAC for healthcare providers serving patients with communication disorders.

Graded response model fit, measurement invariance and (comparative) precision of the Dutch-Flemish PROMIS\xae Upper Extremity V2.0 item bank in patients with upper extremity disorders

BackgroundThe Dutch-Flemish PROMIS® Upper Extremity (DF-PROMIS-UE) V2.0 item bank was recently developed using Item Response Theory (IRT). Unknown for this bank are: (1) if it is legitimate to calculate IRT-based scores for short forms and Computerized Adaptive Tests (CATs), which requires that the items meet the assumptions of and fit the IRT-model (Graded Response Model [GRM]);(2) if it is legitimate to compare (sub) groups of patients using this measure, which requires measurement invariance; and (3) the precision of the estimated patients’ scores for patients with different levels of functioning and compared to legacy measures. Aims were to evaluate (1) the assumptions of and fit to the GRM, (2) measurement invariance and (3) (comparative) precision of the DF-PROMIS-UE v2.0.MethodsCross-sectional data were collected in Dutch patients with upper extremity disorders. Assessed were IRT-assumptions (unidimensionality [bi-factor analysis], local independence [residual correlations], monotonicity [coefficient H]), GRM item fit, measurement invariance (absence of Differential Item Functioning [DIF] due to age, gender, center, duration, and location of complaints) and precision (standard error of IRT-based scores across levels of functioning). To study measurement invariance for language [Dutch vs. English], additional US data were used. Legacy instruments were the Disability of the Arm, Shoulder and Hand (DASH), the QuickDASH and the Michigan Hand Questionnaire (MHQ).ResultsIn total 521 Dutch (mean age ± SD = 51 ± 17 years, 49% female) and 246 US patients (mean age ± SD = 48 ± 14 years, 69% female) participated. The DF-PROMIS-UE v2.0 item bank was sufficiently unidimensional (Omega-H = 0.80, Explained Common Variance = 0.68), had negligible local dependence (four out of 1035 correlations > 0.20), good monotonicity (H = 0.63), good GRM fit (no misfitting items) and demonstrated sufficient measurement invariance. Precise estimates (Standard Error < 3.2) were obtained for most patients (7-item short form, 88.5%; standard CAT, 91.3%; and, fixed 7-item CAT, 87.6%).The DASH displayed better reliability than the DF-PROMIS-UE short form and standard CAT, the QuickDASH displayed comparable reliability. The MHQ-ADL displayed better reliability than the DF-PROMIS-UE short form and standard CAT for T-scores between 28 and 50. For patients with low function, the DF-PROMIS-UE measures performed better.ConclusionsThe DF-PROMIS-UE v2.0 item bank showed sufficient psychometric properties in Dutch patients with UE disorders.

THEMES AND PERSPECTIVES IN OFFICE ERGONOMICS: IMPLICATION FOR SAFETY, HEALTH AND WORKERS’ PRODUCTIVITY IN KATSINA STATE LOCAL GOVERNMENT OFFICES IN NIGERIA

Issues concerning ergonomics have become central to office occupational safety and health due to the prevalence of work-related musculo-skeletal disorders which cause worker discomfort, disability, and loss of productivity. In Nigeria, upper extremities disorders such as wrist pains, pains in the upper back region, shoulder pains, ulna neuropathy, neck disorders, and eye syndrome are common epidemics among typists, secretaries, computer users and other related office jobs with negative socio-economic consequences. The purpose of this paper is to present the result of an investigation of the current office ergonomic situation of Katsina State Local Government offices in Nigeria with its implication for workers’ safety, health, and overall productivity. The methodology adopted is the qualitative strategy of inquiry using 210 questionnaires with a section having open-ended questions designed to ask respondents to speak their minds concerning the nature of ergonomic facilities of their offices, nature of office work policy (ergonomic policy) and their level of ergonomic awareness. Using thematic network analysis, the responses from that section of the questionnaire were organized into themes, patterns, and categories based on three deductive themes (ergonomic facilities, ergonomic policy, and ergonomic awareness) as key concepts in the investigation. From the analysis of the responses, it was found that the ergonomic scenario of Local Government offices in the Katsina State of Nigeria in terms of office facilities, office ergonomic (work) policy and level of ergonomic awareness are poor and that workers are exposed to the dangers of work-related musculo-skeletal disorders and other related occupational diseases. Despite the fact that the study area for this research was Local Government Offices in Katsina State, Nigeria, the findings and implications are relevant to other government offices in the country. Therefore, the conclusion of this study is that the office environment of Katsina State Local Governments in Nigeria needs to be improved for the general safety, health and overall productivity of the workers.

Silibinin prevents depression-like behaviors in a single prolonged stress rat model: the possible role of serotonin

BackgroundPost-traumatic stress disorder (PTSD) is an extreme mood disorder that occurs after experiencing extreme stress, and patients with this disorder are known to accompany with symptoms of depression, anxiety, and memory impairments. Silibinin (SIL) is a natural polyphenolic flavonoid and is the main active ingredient of silymarin, which is primarily extracted from the milk thistle. Although some studies have assessed the properties of this flavonoid, the potential of SIL as a treatment for PTSD patients and its mechanisms of action have yet to be fully elucidated.MethodsAfter exposure to a model of single prolonged stress (SPS), the open field test (OFT) and forced swimming test (FST), were used to investigate the effects of SIL on anxiety- and depression-like symptoms in male rats. The rats received of SIL (25, 50, and 100 mg/kg) for 14 days following exposure to SPS.ResultsAdministration of SIL significantly improved anxiety-like behaviors in the OFT, depression-like behaviors in the FST, and freezing behavior in fear conditioning test. SIL also increased levels of serotonin in the hippocampus (Hipp) and amygdala, and enhanced expression of tryptophan hydroxylase-1 mRNA in the Hipp. The administration of SIL also inhibited SPS-induced decreases dopamine levels and increases norepinephrine levels in the Hipp.ConclusionsTaken together, the present findings suggest that SIL can be a useful therapeutic ingredient for the treatment of trauma stress-associated symptoms, including PTSD-induced anxiety and depression caused by PTSD.

Votive Reliefs of Lower Extremities Disorders: A Brief Review.

The purpose of this paper is to present a series of votive reliefs from Graeco-Roman antiquity related to disorders of the lower extremities, in order to comprehend the importance of anatomical offerings as gifts of gratitude to healing gods such as Asclepius. The selected offerings cover disorders such as varicose vein disease and deformities of the lower limbs and provide significant information on medical treatments in ancient Greece, as well as the importance of religious practices in the healing process.

Robustness of Optical Response for Self‐Assembled Plasmonic Metamaterials with Morphological Disorder and Surface Roughness

AbstractBottom‐up fabrication of metallized biotemplated nanostructures to form specific plasmonic nanoresonators holds promise as a means of achieving large‐scale optical metamaterials. However, in contrast to top‐down methods, the stochastic growth of self‐assembled nanoresonators is prone to significant disorder and surface roughness, which naturally raise an important question about the robustness of their resonant properties in terms of structural imperfections. An aggregated‐random‐sphere model is developed to mimic the nucleated growth of metallized DNA origami assembly, leading to meta‐atoms with realistic, experimentally observed morphological disorder and surface roughness. Using the well‐known split‐ring‐resonator (SRR) motif as an example, the resonant properties of meta‐atoms under different levels of roughness are investigated and a strong tolerance of optical response against morphological disorder is revealed. It is found that in SRRs, even with dramatic roughness introduced, the expected resonances are still observed, despite broadening line shapes compared to ideal smooth structure. Only for extreme disorder, which causes drastic segmentation of SRRs, does the resonant response disappear. The demonstrations are very encouraging for the prospects of bottom‐up fabrication toward versatile functional metamaterials and metadevices.

Psychometric properties of the global rating of change scales in patients with low back pain, upper and lower extremity disorders. A systematic review with meta-analysis

ObjectiveThe purpose of this systematic review was to critically appraise and synthesize the psychometric properties of the Global Rating of Change (GRoC) scales on the assessment of patients with low back pain (LBP), upper extremity and lower extremity disorders. MethodsA search was performed in 4 databases (MEDLINE, EMBASE, CINAHL, SCOPUS) until February 2019. Eligible articles were appraised using Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) checklist and the Quality Appraisal for Clinical Measurement Research Reports Evaluation Form. ResultsThe 8 eligible studies included participants with orthopedic lumbar spine impairments (n = 52,767), patients with work-related musculoskeletal disorders (n = 1944), patients with low back pain (n = 183) and individuals with upper extremity disorders (n = 151). Risk of bias was ranging from “adequate” to “very good” and quality was found excellent for all studies. Based on pooled data, test-retest reliability of 11-item GRoC for patients with low back pain was found excellent ICC = 0.84, 95% CI: 0.65 to 0.94. Test-retest reliability in patients with shoulder pain was found fair to good ICC of 0.62 in a 15-point GRoC scale. Seven studies (n = 7) examined the convergent validity between GRoC and another outcome measure. Minimum important change on the Portuguese version of Global Perceived Effect (GPE) for patients with LBP was 2.5 points out of 11 points. ConclusionsThe current pool of clinical measurement studies indicates that the GRoC has excellent test-retest reliability for patients with low back pain, shoulder pain and with lumbar spine disorders. However, the validity of it as a reference standard in responsiveness studies or as an accurate overall assessment of change has been questioned. While future studies might provide more insight into its measurement properties, this limitation is unlikely to change. Therefore, we suggest that future responsiveness in the studies that want a global indicator measure need to use an additional measure to mitigate recall bias. Prospero registration numberCRD 42020149122.

A novel six-component spinel-structure high-entropy oxide with ferrimagnetic property

An equimolar spinel (Al1/6Co1/6Cr1/6Fe1/6Mn1/6Ni1/6)3O4 high-entropy oxide (HEO) was developed as a novel oxide magnetic material. The as-synthesized nanocrystalline powder of high purity and homogeneity was obtained by a facile solution combustion synthesis method with an average crystalline size of about 12 nm. To prove utility, the magnetic property was measured and the as-synthesized nanocrystalline powder showed ferrimagnetism below the Curie temperature 248 K. The long-range ferrimagnetic behavior can be understood by the quite larger super-exchange interactions due to the extreme chemical disorder in the HEO.

Functional Uncoupling of Pain-Linked Nav1.7/A1632E Dimers Partly Rescues Its Pain-Causing Phenotype

The voltage-gated sodium channel Nav1.7 is essential for an adequate perception of pain in humans and its mutations cause various pain syndromes. The hNav1.7/A1632E mutation leads to a pain syndrome which combines symptoms of erythromelalgia and paroxysmal extreme pain disorder (PEPD). The mutation-induced gating changes include increased persistent current. Using 3D molecular simulations, we show that in hNav1.7/A1632E the inactivation particle (IFM motif) is hindered from binding by steric and hydrophobic mismatch within its binding pocket at the side of the pore module. This phenomenon is well in line with the recently proposed allosteric fast inactivation mechanism, in which the IFM motif no longer occludes the pore by a "hinged lid" mechanism but by binding-induced conformational changes. By using native polyacrylamide gel electrophoresis (PAGE), we show that hNav1.7 dimerizes similar to what has been reported for hNav1.5. Applying a patch-clamp approach, we reveal that the disease-linked persistent current depends on the channel's functional dimerization status. Difopein is an inhibitor of 14-3-3 protein and suggested to functionally uncouple dimerization of hNav1.5. Its co-transfection leads to a significant decrease in hNav1.7/A1632E persistent currents. Thus, channel dimerization seems to support the dramatic increase in the pain-causing persistent current induced by the hNav1.7/A1632E mutation's interference with the allosteric fast inactivation mechanism. We here reveal how functional uncoupling of hNav1.7/A1632E dimers partly rescues the pain-causing molecular phenotype. Our work hence supports the newly described allosteric fast inactivation mechanism and combines it for the first time with sodium channel dimerization, leading to new insights in human pain syndromes.

Extreme Fermi Surface Smearing in a Maximally Disordered Concentrated Solid Solution.

We show that the Fermi surface can survive the presence of extreme compositional disorder in the equiatomic alloy Ni_{0.25}Fe_{0.25}Co_{0.25}Cr_{0.25}. Our high-resolution Compton scattering experiments reveal a Fermi surface which is smeared across a significant fraction of the Brillouin zone (up to 40% of 2π/a). The extent of this smearing and its variation on and between different sheets of the Fermi surface have been determined, and estimates of the electron mean free path and residual resistivity have been made by connecting this smearing with the coherence length of the quasiparticle states.

Postural stability and functional disorders in patients with loosened hip prosthesis

The number of primary hip arthroplasties is growing every year. One of the most common long complications is the aseptic loosening of the prosthesis leading to serious complications in patients life, pain and following surgeries. In the literature, there is a lack of studies regarding balance impairment in this group of patients, which is why there was a need to conduct the study in order to find possible falling risk factors and simple functional, diagnostic test. The aim of the study was to assess functional state and static balance disorders in patients admitted to orthopaedic department due to loosened hip prosthesis prior to its replacement or removal. The study population were 30 patients (15 women and 15 men) admitted to Orthopaedic Department for diagnosis and treatment of loosened hip prosthesis. Patients' mean age was 71.67 ± 9.21, body height 169.20 ± 8.75 cm, body weight 77.83 ± 12.96 kg. The clinical control group consisted of 30 healthy subjects age-, body height- and weight-matched, without degenerative disorders of lower extremities. Function was assessed with Harris Hip score. The static balance test was conducted in the mornings, in quiet separate room on bi-modular stabilometric platform CQStab2P, registering the movement of centre of foot pressure (COP). Measurements with eyes open and closed showed significant differences in limb loads - the load to the healthy limb was several times greater. Results of tests on the platform with eyes closed showed significantly worse balance in patients group. Their total statokinesiogram path was longer, and their COP sways number was greater. Similarly to the test with eyes open, the load of the healthy limb was much greater. Hip replacement loosening results in significant worsening of balance parameters. Balance assessment could be an additional useful diagnostic tool for hip replacement loosening available for physiotherapists.

Association between upper extremity dysfunction and sleep disturbance in an elderly general population.

Objective:Several upper extremity disorders are associated with sleep disturbance in patient populations. This study evaluated the relation between self-assessment of upper extremity function and sleep disturbance in an elderly general population.Methods:A total of 159 participants (56 men, 103 women, 38–88 years old, mean age of 66.4 years) completed a self-administered questionnaire including items for sex, weight, height, and dominant hand. Upper extremity dysfunction was investigated using Quick Disabilities of the Arm, Shoulder, and Hand of the Japanese Society for Surgery of the Hand. The sleep disturbance severity was evaluated using a Japanese version of the Athens Insomnia Scale. Quality of life was assessed using the EuroQol-5-dimension-3-level, Japanese version. We measured the bilateral hand grip as an indicator of hand muscle function. Statistical tests were applied to clarify the association between upper extremity dysfunction and screening results for sleep disturbance.Results:Of 159 participants, 45 (28.3%) had sleep disturbance as assessed using Japanese version of the Athens Insomnia Scale (11 men and 34 women; mean age of 68.1 years). Japanese version of the Athens Insomnia Scale scores correlated with the EuroQol index; EuroQol visual analog scale; and Quick Disabilities of the Arm, Shoulder, and Hand scores. The Quick Disabilities of the Arm, Shoulder, and Hand score and dominant grip strength of the participants with sleep disturbance were significantly higher than those of the no sleep disturbance group. The EuroQol index score and visual analog scale of those reporting a sleep disturbance were significantly lower than those of the no sleep disturbance group.Conclusion:Self-administered upper extremity health condition as assessed using Quick Disabilities of the Arm, Shoulder, and Hand correlated with sleep disturbance. Our results suggest a link between upper extremity conditions and sleep disturbance.

Interference of the Carpal Tunnel syndrome symptoms on occupational performance

ABSTRACT BACKGROUND AND OBJECTIVES: The Carpal Tunnel syndrome is characterized as the compression syndrome with the highest incidence in the population, impairing the upper limbs and, consequently, occupational performance. The objective of this study was to identify the symptoms of the compression syndrome and the impact of the disease on upper extremity disorders in relation to occupational performance. METHODS: This is a quantitative study with a descriptive approach, conducted with adults, both male and female, diagnosed with Carpal Tunnel syndrome. There was an initial evaluation to identify pain, edema, paresthesia, sensitivity alteration, and muscle weakness. The Disabilities of the Arm, Shoulder and Hand was used to assess the performance of fine motor activities as well as broader movements that require motor skills. This study used only the part of the instrument that evaluates the severity of symptoms concerning the week before the interview and other implications as pain, discomfort and weakness, difficulty in moving the upper limb, and to sleep. RESULTS: Fifteen adults diagnosed with the Carpal Tunnel syndrome participated in this study (27 affected limbs), being the dominant side the most undermined. The main complaint was pain, with higher intensity at night, followed by paresthesia. The Carpal Tunnel syndrome also compromises occupational performance, especially in activities using hands, and in sleep quality. CONCLUSION: It was noticed that the Carpal Tunnel syndrome interferes with occupational performance, as well as that pain is the main complaint.

Health-related quality of life in patients with diabetic foot ulceration: study protocol for adaptation and validation of patient-reported outcome measurements (PROMs) in Dutch-speaking patients

IntroductionDiabetic foot ulceration (DFU) is a common late-stage complication of diabetes with a large impact on health status and quality of life. Patient-reported outcome measures (PROMs) provide a standardised method...

Structural Fuzziness of the RNA-Organizing Protein SERF Determines a Toxic Gain-of-interaction

The mechanisms by which protein complexes convert from functional to pathogenic are the subject of intensive research. Here, we report how functionally unfavorable protein interactions can be induced by structural fuzziness, i.e., by persisting conformational disorder in protein complexes. We show that extreme disorder in the bound state transforms the intrinsically disordered protein SERF1a from an RNA-organizing factor into a pathogenic enhancer of alpha-synuclein (aSyn) amyloid toxicity. We demonstrate that SERF1a promotes the incorporation of RNA into nucleoli and liquid-like artificial RNA-organelles by retaining an unusually high degree of conformational disorder in the RNA-bound state. However, this type of structural fuzziness also determines an undifferentiated interaction with aSyn. RNA and aSyn both bind to one identical, positively charged site of SERF1a by an analogous electrostatic binding mode, with similar binding affinities, and without any observable disorder-to-order transition. The absence of primary or secondary structure discriminants results in SERF1a being unable to select between nucleic acid and amyloidogenic protein, leading the pro-amyloid aSyn:SERF1a interaction to prevail in the cytosol under conditions of cellular stress. We suggest that fuzzy disorder in SERF1a complexes accounts for an adverse gain-of-interaction which favors toxic binding to aSyn at the expense of nontoxic RNA binding, thereby leading to a functionally distorted and pathogenic process. Thus, structural fuzziness constitutes a direct link between extreme conformational flexibility, amyloid aggregation, and the malfunctioning of RNA-associated cellular processes, three signatures of neurodegenerative proteinopathies.

Percutaneous Zadek osteotomy for the treatment of insertional Achilles tendinopathy

BackgroundInsertional Achilles tendinopathy (IAT) is a challenging common lower extremity disorder, despite several treatment options described in literature. Open dorsal closing wedge calcaneal osteotomy or Zadek Osteotomy (ZO), for the treatment of the IAT has good clinical results but a high rate of postoperative complications. The purpose of this study is to describe percutaneous ZO for the treatment of the IAT and to evaluate its impact on the clinical and functional postoperative outcomes. MethodsTwenty-six consecutive patients presenting with unilateral IAT refractory to nonoperative measures were treated with percutaneous ZO. Visual Analogue Scale (VAS) and Foot Function Index Score (FFI) were recorded preoperatively and at final follow-up visit (12±3) months. Postoperative complications, satisfaction, and relief of the pain were also recorded. ResultsThe percutaneous ZO showed a significant improvement (p<0.0001) in preoperative to postoperative FFI (from 65±9 to 8±12) and VAS (from 9±1 to 1±2). Two postoperative complications (8%) were observed: a case of symptomatic non-union and hardware pain, both in healthy patients. The overall rate of satisfaction after surgery was (92%). The relief from pain was achieved after an average period of 12 weeks. ConclusionsZO is a safe and effective procedure for the treatment of IAT. The use of a minimally invasive surgical approach is associated with excellent pain reduction (VAS score) and improved clinical function (FFI score). When compared to the open surgical approach, the percutaneous ZO may decrease recovery time and postoperative complications.Level of evidence: III, retrospective case series.

Don DeLillo's Great Jones Street: Commodification and Pandemonium

The future modern condition of humanity is at stake; the market economy rationalizes and mechanizes people; reduces them to objects that consume objects. Material value predominates human value. Meaning is lost; it is equal to the accumulation of tangible objects. The complexity of human condition in the 21st century has become one of the most widely explored topics among scholars, writers, and critics in American literature. Given that DeLillo's character Bucky Wunderlick exemplifies this complexity, this paper proposes to explore Wunderlick’s treatment to commodification imposed upon him by the crowds (audience/masses) and market economy. In this paper, these crowds and the economic system are reduced to the notion of Pandemonium. It denotes chaos, a state of extreme confusion and disorder. My reading of Wunderlick’s commodification in contemporary America grounds on Marx and Engels' definition of the concept. I strengthen my argument with Jean Baudrillard, Guy DeBord, Lucas, and Adorno. On the whole, this study aspires to further expand the understanding of the future plight of human beings in the post-contemporary (my italics) America.

Magnetic frustration control through tunable stereochemically driven disorder in entropy-stabilized oxides

Entropy-stabilized oxides possess a large configurational entropy that allows for the unique ability to include typically immiscible concentrations of species in different configurations. Particularly in oxides, where the physical behavior is strongly correlated to stereochemistry and electronic structure, entropic stabilization creates a unique platform to tailor the interplay of extreme structural and chemical disorder to realize unprecedented functionalities. Here, we control stereochemically driven structural disorder in single crystalline, rocksalt, (MgCoNiCuZn)O-type entropy-stabilized oxides through the incorporation of ${\mathrm{Cu}}^{2+}$ cations. We harness the disorder to tune the degree of glassiness in the antiferromagnetic structure. Structural distortions driven by the Jahn-Teller effect lead to a difference in valence on the Co cation sites, which extends to dilution and disorder of the magnetic lattice. A spin glass model reveals that the fractional spin ordering of the magnetic lattice can be tuned by \ensuremath{\sim}65%. These findings demonstrate entropy-stabilization as a tool for control of functional phenomena.

Varis etiyopatogenezinde lökosit aktivasyonu ile apopitozisin ilişkisi

Aim: Varicose veins are the most common disorders of the lower extremities. The purpose of this study is to investigate the effect of leukocyte activation in the vein wall and apoptosis in the etiopathogenesis of varicose veins.Material and Methods:Forty-six patients with varicose veins were included in the study. High ligation with stripping with or without additional individual ligation and excision was performed for symptoms, complications or cosmetic needs. ELISA was used to measure the serum concentration of caspase-8 and caspase-9.Results: There was a statistically significant difference between the cephalic vein and saphenous vein groups (p=0.04 and p&amp;lt;0.0001 respectively). Conclusion: As a conclusion, the complex pathophysiology underlying varicose veins has yet to be fully defined. It is suggested that both leukocyte activation and dysregulation of apoptosis are associated with susceptibility for varicose vein formation however this argument needs further research.