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Abstract Heterotopic ossification (HO), often arising in response to traumatic challenges, results from the aberrant osteochondral differentiation of mesenchymal stem cells (MSCs). Nevertheless, the impact of trauma‐induced inflammatory exposure on MSC fate determination remains ambiguous. In this study, the cellular diversity within inflammatory lesions is elucidated, comprising MSCs and several innate and adaptive immune cells. It is observed that quiescent MSCs transition into cycling MSCs, subsequently giving rise to chondrogenic (cMSC) and/or osteogenic (oMSC) lineages within the inflammatory microenvironment following muscle or tendon injuries, as revealed through single‐cell RNA sequencing (scRNA‐seq), spatial transcriptome and lineage tracing analysis. Moreover, these investigations demonstrate that neutrophils and natural killer (NK) cells enhance transition of quiescent MSCs into cycling MSCs, which is also controlled by M1 macrophages, a subpopulation of macrophages can also stimulate cMSC and oMSC production from cycling MSCs. Additionally, M2 macrophages, CD4+ and CD8+ T lymphocytes are found to promote chondrogenesis. Further analysis demonstrates that immune cells promotes the activation of signaling transducers and activators of transcription (STAT) pathway and phosphoinositide 3 (PI3K)/protein kinase B (AKT) pathway in MSC proliferation and osteochondral progenitors’ production, respectively. These findings highlight the dynamics of MSC fate within the inflammatory lesion and unveil the molecular landscape of osteoimmunological interactions, which holds promise for advancing HO treatment.

A virtual environment was developed for PC and Android to be used with a desktop display and the Gear VR, respectively. The goal with it is to measure and enhance the spatial skills of people, because the latter can be achieved by solving simple geometric problems. Originally, this virtual environment consisted only of three such tests, namely the Mental Rotation Test, Mental Cutting Test and Purdue Spatial Visualization Test. Measurements were done in the past with these tests, but now the Heinrich Spatial Visualization Testis also included in the virtual environment. In this paper, its implementation and future measurement plan are presented. [ABSTRACT FROM AUTHOR]

Several works of literature contributed to the web evaluation process in recent years to promote digital inclusion by addressing several accessibility guidelines, methods, processes, and techniques. Researchers have investigated how the web evaluation process could be facilitated by including accessibility issues to obtain an inclusive and accessible solution to improve the user experience and increase user satisfaction. Three systematic literature reviews (SLRs) have been conducted in the context of past research, considering such research focuses. This paper presents a new SLR approach concerning accessibility in the web evaluation process, considering the period from 2010 to 2021. The review of 92 primary studies showed the contribution of publications on different phases of the web evaluation process mainly by highlighting the significant studies in the framework design and testing process. To the best of our knowledge, this is the first study focused on the web accessibility literature reporting the engineering assets for evaluation of new accessible and inclusive web-based solutions (e.g., websites). Besides, in this study, we aim to provide a new direction to the web designers and developers with an updated view of process, methods, techniques, tools, and other crucial aspects to contribute to the accessible process enrichment, as well as depict the gaps and challenges that may be worthy to be investigated in the future. The findings of this SLR introduce a new dimension in web accessibility research on determining and mitigating the research gap of web accessibility issues for web designers, developers, and other practitioners., Competing Interests: Conflict of interestThe authors declare that there is no conflict of interest., (© The Author(s) 2023.)

Road traffic injuries are one of the primary reasons for death, especially in developing countries like Bangladesh. Safety in land transport is one of the major concerns for road safety authorities and other policymakers. For this reason, contributory factors identification associated with crashes is necessary for reducing road crashes and ensuring transportation safety. This paper presents an analytical approach to identifying significant contributing factors of Bangladesh road crashes by evaluating the road crash data, considering three different severity levels (non-fetal, severe, and extremely severe). Generally, official crash databases are compiled from police-reported crash records. Though the official datasets are focusing on compiling a wide array of attributes, an assorted number of unreported issues can be observed that demands an alternative source of crash data. Therefore, this proposed approach considers compiling crash data from newspapers in Bangladesh which could be complimentary to the official crash database. To conduct the analysis, first, we filtered the useful features from compiled crash data using three popular feature selection techniques: chi-square, Two-way ANOVA, and Regression analysis. Then, we employed three machine learning classifiers: Decision Tree, Random Forest, and Naïve Bayes over the extracted features. A confusion matrix was considered to evaluate the proposed model, including classification accuracy, sensitivity, and specificity. The predictive machine learning model, namely, Random Forest using Label Encoder with chi-square and Two-way ANOVA feature selection process, seems the best option for crash severity prediction that provides high prediction accuracy. The resulting model highlights nine out of fourteen independent features as responsible factors. Significant features associated with crash severities include driver characteristics (gender, license type, seat belts), vehicle characteristics (vehicle type), road characteristics (road surface type, road classification), environmental conditions (day of crash occurred, time of crash), and injury localization. This outcome may contribute to improving traffic safety of Bangladesh., (© 2022. The Author(s).)

Websites content accessibility guidelines (WCAG) ensure that websites should be perceivable, understandable, navigable, and interactive. During the SARS-CoV-2 pandemic, the importance of accessible websites and online content grew throughout the world. Therefore, in this study, we examined COVID-19-related official government websites. This research covered 21 government websites, with 13 websites from European countries and 8 websites from Asian countries, to evaluate their accessibility following WCAG 2.0 and WCAG 2.1 guidelines. The overall goal of this study was to identify the frequent accessibility problems that might help the website owners to identify the shortcomings of their websites. The target websites were evaluated in two steps: in step-1, evaluation was performed through four automatic web accessibility testing tools such as Mauve++, Nibbler, WAVE, and WEB accessibility tools; in step-2, evaluation went through human observation, such as system usability testing and expert testing. The automatic evaluation results showed that few of the websites were accessible; a significant number of websites were not accessible for people with disabilities. In addition, system usability testing found some complexity in website organization, short explanations, and outdated information. The expert testing suggested improving the color of the websites, organization of links, buttons, and font size. This study might be helpful for associated authorities to improve the quality of the websites in the future.

Background and Objective: Daily activities such as shopping and navigating indoors are challenging problems for people with visual impairment. Researchers tried to find different solutions to help people with visual impairment navigate indoors and outdoors., Methods: We applied deep learning to help visually impaired people navigate indoors using markers. We propose a system to help them detect markers and navigate indoors using an improved Tiny-YOLOv3 model. A dataset was created by collecting marker images from recorded videos and augmenting them using image processing techniques such as rotation transformation, brightness, and blur processing. After training and validating this model, the performance was tested on a testing dataset and on real videos., Results: The contributions of this paper are: (1) We developed a navigation system to help people with visual impairment navigate indoors using markers; (2) We implemented and tested a deep learning model to detect Aruco markers in different challenging situations using Tiny-YOLOv3; (3) We implemented and compared several modified versions of the original model to improve detection accuracy. The modified Tiny-YOLOv3 model achieved an accuracy of 99.31% in challenging conditions and the original model achieved an accuracy of 96.11 %., Conclusion: The training and testing results show that the improved Tiny-YOLOv3 models are superior to the original model., Competing Interests: Declaration of Competing Interest None declared., (Copyright © 2021. Published by Elsevier B.V.)

Background: Physical activity mobile apps may encourage patients with cancer to increase exercise uptake, consequently decreasing cancer-related fatigue. While many fitness apps are currently available for download, most are not suitable for patients with cancer due to the unique barriers these patients face, such as fatigue, pain, and nausea., Objective: The aim of this study is to design, develop, and perform alpha testing of a physical activity mobile health game for hematopoietic stem cell transplant (HSCT) patients. The ultimate future goal of this project is to motivate HSCT patients to increase physical activity and provide them with a safe and fun way to exercise., Methods: A mobile health game called Walking Warrior was designed as a puzzle game where tiles are moved and matched. Walking Warrior interfaces with an open-source step counter and communicates with a central online MySQL database to record game play and walking performance. The game came to fruition after following an iterative process model with several prototypes. Game developers and bone marrow transplant nurses were recruited to perform an expert usability evaluation of the Walking Warrior prototype by completing a heuristic questionnaire and providing qualitative suggestions for improvement. Experts also made qualitative recommendations for improvements on speed, movement of tiles, appearance, and accuracy of the step counter. We recruited 5 additional usability evaluators who searched for and compared 4 open-source step counter programs, then qualitatively compared them for accuracy, robustness, cheat proofing, ease of use, and battery drain issues. Patient recruitment is planned at a later stage in this project. This paper only describes software design, development, and evaluation, rather than behavioral evaluation (ie, impact on physical activity), which is the long-term goal of this project., Results: Internal consistency and the instrument's reliability evaluation results from 1 clinical expert and 4 technical experts were deemed excellent (Cronbach α=.933). A hierarchical cluster analysis of the questionnaire item responses for similarity/dissimilarity among the experts indicated that the two expert groups were not clustered into two separate groups in the dendrogram. This indicates that the item responses were not affected by profession. Factor analyses indicate that responses from the 40-item questionnaire were classified into five primary factors. The associated descriptive statistics for each of these categories were as follows (on a scale of 1 to 5): clarity and ease (median 4; mean 3.7, SD 0.45), appropriateness (median 4; mean 3.7, SD 0.49), game quality (median 3.5; mean 3.3, SD 0.42), motivation to walk (median 3; mean 3.1, SD 0.58), and mental effort (median 3.5; mean 3.1, SD 1.27)., Conclusions: The evaluation from experts and clinicians provided qualitative information to further improve game design and development. Findings from the expert usability evaluation suggest the game's assets of clarity, ease of use, appropriateness, quality, motivation to walk, and mental effort were all favorable. This mobile game could ultimately help patients increase physical activity as an aid to recovery., (©Shannon Cerbas, Arpad Kelemen, Yulan Liang, Cecilia Sik-Lanyi, Barbara Van de Castle. Originally published in JMIRx Med (https://med.jmirx.org), 13.04.2021.)

Background: Positive results can be obtained through game-based learning, but children with physical disabilities have fewer opportunities to participate in enjoyable physical activity. Because intelligent serious games can provide personalized learning opportunities, motivate the learner, teach 21st-century skills, and provide an environment for authentic and relevant assessment, they may be used to help children and adolescents with different kinds of learning disabilities to develop social and cognitive competences., Objective: The aim of the study was to produce and evaluate a suite of intelligent serious games based on accessible learning objectives for improving key skills, personal development, and work sustainability among children with learning difficulties., Methods: We conducted this research between 2016 and 2018, with pupils aged 11 to 12 years with learning disabilities who were integrated into the mainstream educational system. We used a 4-step methodology to develop learner creativity and social competences: (1) needs analysis, (2) development of learning content, (3) development of intelligent serious games, and (4) a usability evaluation focusing on the research questions and hypothesis. This was based on an initial teachers' evaluation, using a survey, of students using 2 of the games, where the main goal was to determine user motivation and initiative and to improve the games and the evaluation process. The initial evaluation was followed by a pilot evaluation, which was performed for all proposed games, in all partner countries., Results: In an initial evaluation with 51 participants from Slovenia consisting of a pretest, followed by intelligent serious game intervention and concluding with a posttest, we observed statistically significant improvement in social and cognitive competences measured by tests. Based on these findings and observations, we improved the games and evaluation process. In the pilot test, conducted in all participating countries on a sample of 93 participants, the mean score on the teachers' observation form on the pretest (before students began using the intelligent serious games) was 3.9. In the posttest, after students had used intelligent serious games, the mean score was 4.1., Conclusions: We focused on developing and evaluating intelligent serious games for persons with learning disabilities, particularly for students with disabilities who are integrated into the mainstream educational system. Such games provide an opportunity for personalized learning and should be tailored to ensure that every learner can achieve the highest standard possible. However, we recommend that the games be adapted based on the students' needs and capabilities and a specially developed curriculum. The collected feedback showed that (1) children with learning disabilities need appropriately developed intelligent serious games, and (2) intelligent serious games, and the pertaining didactic methodology, should be based on an interoperable curriculum, so that teachers and trainers can use them. The student survey confirmed improvements in all aspects., (©Andrej Flogie, Boris Aberšek, Metka Kordigel Aberšek, Cecilia Sik Lanyi, Igor Pesek. Originally published in JMIR Serious Games (http://games.jmir.org), 16.04.2020.)

Background and Objectives: Children with autism spectrum disorder (ASD) experience challenges with social interactions, a core feature of the disorder. Social skills therapy has been shown to be helpful. Over the past several years, computer-assisted and robot-assisted therapies have been infiltrating the social skills teaching environment. Rapid progress in the field of technology, especially in the robotics area, offers tremendous possibilities for innovation and treatment or even education for individuals with ASD. This paper's purpose is to drive awareness of these innovative interventions in order to support the social lives of children with ASD. The aims of the paper are identifying (1) the types of Information Technology platforms that are being evaluated in computer and robot-assisted therapies for children with ASD; (2) the various disciplines or professions studying and utilizing these computer and robot-assisted social skill therapies; (3) the outcomes being evaluated in each trial; and (4) if results demonstrate benefits to children with autism., Materials and Methods: PubMed, CINAHL, Science Direct, and Web of Science databases were searched for clinical trials published over the past five years. Search terms incorporated the subject intersection of autism, and computer or robot-assisted therapy. Results were mined for pediatric populations only and study designs establishing controlled comparisons., Results: Eighteen unique international studies were identified that utilize robot interventions (11 studies) and serious computer game interventions (seven studies). Most demonstrated promising results in improving outcomes for children with ASD. Study implications reveal a rapidly evolving assistive technology for ASD social skills therapy., Conclusions: These interventions show considerable promise, but more effectiveness and cost effectiveness research of high quality should be carried out with larger numbers of children. Also, further studies are necessary to evaluate these technologies' effectiveness amongst adults with ASD and within unique subsets of the higher functioning autism population.

As the need for sensors increases with the inception of virtual reality, augmented reality and mixed reality, the purpose of this paper is to evaluate the suitability of the two Kinect devices and the Leap Motion Controller. When evaluating the suitability, the authors' focus was on the state of the art, device comparison, accuracy, precision, existing gesture recognition algorithms and on the price of the devices. The aim of this study is to give an insight whether these devices could substitute more expensive sensors in the industry or on the market. While in general the answer is yes, it is not as easy as it seems: There are significant differences between the devices, even between the two Kinects, such as different measurement ranges, error distributions on each axis and changing depth precision relative to distance.

The use of websites to provide patient education is becoming more common. The benefits of a properly executed and effective preoperative patient educational intervention have been shown to result in improved psychological and physical well-being for patients undergoing surgery. The purpose of this pilot study was to determine the usability, utility, and feasibility of a website we created to increase engagement and improve the quality of the preoperative education patients receive in preparation for hip and knee arthroplasty. Eighty patients who met the inclusion criteria were recruited, aged between 40 to 65, among those 52.5% were female, 71.25% were placed for knee replacement, 28.75% for hip replacement. Forty patients were randomly assigned to paper education cohort, 40 to the paper and website education cohort. However, only 19 from each cohort participated in the survey questionnaire. The outcome of interest included qualitative data for patient knowledge, satisfaction, utilities, and usability, which were assessed based on the Perceived Health Website Usability Questionnaire online survey. The paper-based survey contains ten questions using a 7-point Likert scale while the web-based survey contains fourteen questions using the same 7-point Likert scale. Descriptive statistics and independent samples t -tests were used for comparative analysis of usual paper education and website education cohorts; whereby Microsoft Excel data analytics tool was used to compute the results. The Alpha level was set to 0.05 for the statistical results. The result of the study showed no statistically significant differences in both cohorts at the 0.05 level. We hypothesized that both information delivery methods were effective in increasing knowledge and engaging patients to their preoperative educations. According to the survey result for the nursing staff, they believed that the use of the website improved nursing workflow, efficiency, and patient education.

Neurosurgery is a medical specialty that relies heavily on imaging. The use of computed tomography and magnetic resonance images during preoperative planning and intraoperative surgical navigation is vital to the success of the surgery and positive patient outcome. Augmented reality application in neurosurgery has the potential to revolutionize and change the way neurosurgeons plan and perform surgical procedures in the future. Augmented reality technology is currently commercially available for neurosurgery for simulation and training. However, the use of augmented reality in the clinical setting is still in its infancy. Researchers are now testing augmented reality system prototypes to determine and address the barriers and limitations of the technology before it can be widely accepted and used in the clinical setting.

Using basic mathematical operations is not easy for everyone. The AndMaths game for Android devices was developed to help elementary school students to learn these basic mathematical skills in the number ranges of twenties, fifties, hundreds and thousands. The user can freely select the number ranges.

Today, more and more children with Autism Spectrum disorder are diagnosed, which means that around 1% of the population is concerned. Most of the concerned can acquire daily routine tasks by a bit of help and can fit in the society. As Besio et al. said, "…play is an instinctive need for both humans….In children with disabilities, depending on the type of functional limitations, the spontaneity of play is lost and the activity becomes problematic. Children with cognitive and intellectual impairments have a difficulties in communication, social interactions,….Since play is also a window for children's cognitive development, children may be perceived as more developmentally delayed than they actually are, leading to reduce expectations on the part of adults." The aim of the authors was to create an Android based application which helps 6-9 year old children living with Autism Spectrum disorder to learn everyday tasks and acquire everyday routine.

Logic is part of our everyday life. However, there are some cases where people have difficulties using deductive reasoning. The aim of this work is to help people with mild intellectual disability or learning disability to learn the basis of logical thinking. We developed an application on Android operating system to improve logical thinking.

Background: Occurrences of strokes often result in unilateral upper limb dysfunction. Dysfunctions of this nature frequently persist and can present chronic limitations to activities of daily living., Methods: Research into applying virtual reality gaming systems to provide rehabilitation therapy have seen resurgence. Themes explored in stroke rehab for paretic limbs are action observation and imitation, versatility, intensity and repetition and preservation of gains. Fifteen articles were ultimately selected for review. The purpose of this literature review is to compare the various virtual reality gaming modalities in the current literature and ascertain their efficacy., Results: The literature supports the use of virtual reality gaming rehab therapy as equivalent to traditional therapies or as successful augmentation to those therapies. While some degree of rigor was displayed in the literature, small sample sizes, variation in study lengths and therapy durations and unequal controls reduce generalizability and comparability., Conclusions: Future studies should incorporate larger sample sizes and post-intervention follow-up measures.

The topic of this article and work was to create an application for movement therapy, which can help the rehabilitation of stroke patients. The application makes it possible to make unique exercises for different patients, adapting to the special personal needs. The developed real time gesture analyzing algorithm works in the background of the application, which has not yet spread on the field of medical devices. I deal with one part of this wide field in my dissertation, with the rehabilitation gesture analyzing. The data received from the Kinect sensor is processed by a location based gesture analyzing algorithm, and the results show that the software is suitable for the improvement of the rehabilitation process. It was a key aspect to create a simple interface. I achieved this with the use of the C# language and WPF technology.

The first step in DNA mismatch repair (MMR) is the recognition of DNA mismatches or nucleotide insertions/deletions (IDLs) by MutS and MutS homologues. To investigate the conformational properties of MutS-mismatch complexes, we used single-molecule fluorescence resonance energy transfer (smFRET) to examine the dynamics of MutS-induced DNA bending at a GT mismatch. The FRET measurements reveal that the MutS-GT mismatch recognition complex is highly dynamic, undergoing conformational transitions between many states with different degrees of DNA bending. Due to the complexity of the data, we developed an analysis approach, called FRET TACKLE, in which we combine direct analysis of FRET transitions with examination of kinetic lifetimes to identify all of the conformational states and characterize the kinetics of the binding and conformational equilibria. The data reveal that MutS-GT complexes can reside in six different conformations, which have lifetimes that differ by as much as 20-fold and exhibit rates of interconversion that vary by 2 orders of magnitude. To gain further insight into the dynamic properties of GT-MutS complexes and to bolster the validity of our analysis, we complemented our experimental data with Monte Carlo simulations. Taken together, our results suggest that the dynamics of the MutS-mismatch complex could govern the efficiency of repair of different DNA mismatches. Finally, in addition to revealing these important biological implications of MutS-DNA interactions, this FRET TACKLE method will enable the analysis of the complex dynamics of other biological systems.

The objective of this study is to test the luminous efficiency functions V(lambda), V'(lambda), V(10)(lambda) and their linear combinations on the basis of a data set gained from a simulated mesopic night-time driving experiment. Another aim is to provide 'real-world' data for the 'X framework' or 'linear combination model', and to find out its limits in a practical situation. Human performance was measured by the reaction time method. Results show that the single parameter of the linear combination of photopic and scotopic luminous efficiency functions can be determined analytically with little variation for a given mesopic background luminance level and a given visual target colour, but the computation leads to considerable deviations comparing all three target colours (red, green and blue) used in the experiment. The conclusion for the given experimental conditions is that the single parameter of the linear combination model has an increasing deviation for lower background luminance levels.

A patient who returned from India with a gastrointestinal disturbance subsequently developed the clinical features of rabies. The diagnosis was confirmed by isolation of rabies virus from saliva and the demonstration of rising titres of rabies antibody. He was treated in an intensive care unit, ventilated mechanically, and given rabies antiserum, but cerebral activity ceased and he died after 22 days. His course was marked by numerous bouts of cardiac arrhythmia including complete heart block. This case indicates the need for vaccination against rabies to be carried out immediately after exposure to a possibly rabid dog since encephalitis develops a fatal outcome may not be prevented even with intensive medical treatment.