bluuebunny/crossref_metadata_2025 huggingface dataset:
Cost transferability problems in economic evaluation as a framework for an European health care and social costs database
Authors: García-Mochón Leticia , Rovira Forns Joan , Espin Jaime
Published: July 2021

This article presents part of the work within Work Package 3 (WP3) of Impact HTA (Improved methods and actionable tools for enhancing HTA), a H2020 EU-funded research project, intended to enhance and promote collaboration in HTA across EU MS. Amongst other objectives, and in close collaboration with WP4, WP3 addressed setting up a multi-country unit-cost database: the European health care and social costs database (EU HCSCD). The purpose of the database is to facilitate the transference of healthcare economic evaluation analyses across countries, jurisdictions and settings. WP3 concentrates on healthcare costs; WP4 on social costs. This paper discusses the state of the art on this topic, building an appropriate conceptual and theoretical framework for Database development. We conducted a broad, but not systematic, literature and gray-literature review (LR), identifying existing practices and problems, and their implications, described in the Results section. We discuss practical implications and draw important conclusions behind the construction, and future evolution, of this database.
C1q/TNF-related protein 4 restores leptin sensitivity by downregulating NF-κB signaling and microglial activation
Authors: Ye Liu , Jia Gongwei , Li Yuejie , Wang Ying , Chen Hong , Yu Lehua , Wu Dandong
Published: July 2021

Objective

C1qTNF-related protein 4 (CTRP4) acts in the hypothalamus to modulate food intake in diet-induced obese mice and has been shown to exert an anti-inflammatory effect on macrophages. Since high-fat diet-induced microglial activation and hypothalamic inflammation impair leptin signaling and increase food intake, we aimed to explore the potential connection between the anorexigenic effect of CTRP4 and the suppression of hypothalamic inflammation in mice with DIO.

Methods

Using an adenovirus-mediated hypothalamic CTRP4 overexpression model, we investigated the impact of CTRP4 on food intake and the hypothalamic leptin signaling pathway in diet-induced obese mice. Furthermore, central and plasma proinflammatory cytokines, including TNF-α and IL-6, were measured by Western blotting and ELISA. Changes in the hypothalamic NF-κB signaling cascade and microglial activation were also examined in vivo. In addition, NF-κB signaling and proinflammatory factors were investigated in BV-2 cells after CTRP4 intervention.

Results

We found that food intake was decreased, while leptin signaling was significantly improved in mice with DIO after CTRP4 overexpression. Central and peripheral TNF-α and IL-6 levels were reduced by central Ad-CTRP4 administration. Hypothalamic NF-κB signaling and microglial activation were also significantly suppressed in vivo. In addition, NF-κB signaling was inhibited in BV-2 cells following CTRP4 intervention, which was consistent with the decreased production of TNF-α and IL-6.

Conclusions

Our data indicate that CTRP4 reverses leptin resistance by inhibiting NF-κB-dependent microglial activation and hypothalamic inflammation.
Interleukin-10 deficiency exacerbates inflammation-induced tau pathology
Authors: Weston Lea L. , Jiang Shanya , Chisholm Devon , Jantzie Lauren L. , Bhaskar Kiran
Published: July 2021

Background

The presence of hyperphosphorylated microtubule-associated protein tau is strongly correlated with cognitive decline and neuroinflammation in Alzheimer’s disease and related tauopathies. However, the role of inflammation and anti-inflammatory interventions in tauopathies is unclear. Our goal was to determine if removing anti-inflammatory interleukin-10 (IL-10) during an acute inflammatory challenge has any effect on neuronal tau pathology.

Methods

We induce systemic inflammation in Il10-deficient (Il10−/−) versus Il10+/+ (Non-Tg) control mice using a single intraperitoneal (i.p.) injection of lipopolysaccharide (LPS) to examine microglial activation and abnormal hyperphosphorylation of endogenous mouse tau protein. Tau phosphorylation was quantified by Western blotting and immunohistochemistry. Microglial morphology was quantified by skeleton analysis. Cytokine expression was determined by multiplex electro chemiluminescent immunoassay (MECI) from Meso Scale Discovery (MSD).

Results

Our findings show that genetic deletion of Il10 promotes enhanced neuroinflammation and tau phosphorylation. First, LPS-induced tau hyperphosphorylation was significantly increased in Il10−/− mice compared to controls. Second, LPS-treated Il10−/− mice showed signs of neurodegeneration. Third, LPS-treated Il10−/− mice showed robust IL-6 upregulation and direct treatment of primary neurons with IL-6 resulted in tau hyperphosphorylation on Ser396/Ser404 site.

Conclusions

These data support that loss of IL-10 activates microglia, enhances IL-6, and leads to hyperphosphorylation of tau on AD-relevant epitopes in response to acute systemic inflammation.
Contraceptive and abortion practices of young Ghanaian women aged 15–24: evidence from a nationally representative survey
Authors: Keogh Sarah C. , Otupiri Easmon , Castillo Philicia W. , Li Naomi W. , Apenkwa Joana , Polis Chelsea B.
Published: July 2021

Background

Young Ghanaian women experience high rates of unmet need for contraception and unintended pregnancy, and face unique barriers to accessing sexual and reproductive health services. This study provides a comprehensive national analysis of young women’s contraceptive and abortion practices and needs.

Methods

In 2018, we conducted a nationally representative survey of women aged 15–49, including 1039 women aged 15–24. We used descriptive statistics, multivariable logistic and multinomial regression to compare young versus older (25–49 year-old) women’s preferred contraceptive attributes, reasons for discontinuing contraception, quality of counseling, use of Primolut N-tablet, method choice correlates, and friends’ and partners’ influence. We also examined youth’s self-reported abortion incidence, abortion methods, post-abortion care, and barriers to safe abortion.

Results

Among Ghanaian 15–24 year-olds who had ever had sex, one-third (32%) were using contraception. Compared to older women, they had higher desires to avoid pregnancy, lower ever use of contraception, more intermittent sexual activity, and were more likely to report pregnancies as unintended and to have recently ended a pregnancy. Young contraceptors most commonly used condoms (22%), injectables (21%), withdrawal (20%) or implants (20%); and were more likely than older women to use condoms, withdrawal, emergency contraception, and N-tablet. They valued methods for effectiveness (70%), no risk of harming health (31%) nor future fertility (26%), ease of use (20%), and no effect on menstruation (19%). Infrequent sex accounted for over half of youth contraceptive discontinuation. Relative to older women, young women’s social networks were more influential on contraceptive use. The annual self-reported abortion rate among young women was 30 per thousand. Over half of young women used abortion methods obtained from non-formal providers. Among the third of young women who experienced abortion complications, 40% did not access treatment.

Conclusions

Young people’s intermittent sexual activity, desire for methods that do not harm their health, access barriers and provider bias, likely contribute to their greater use of coital-dependent methods. Providers should be equipped to provide confidential, non-discriminatory counseling addressing concerns about infertility, side effects and alternative methods. Use of social networks can be leveraged to educate around issues like safe abortion and correct use of N-tablet.
Labor migration is associated with lower rates of underweight and higher rates of obesity among left-behind wives in rural Bangladesh: a cross-sectional study
Authors: Sznajder Kristin K. , Wander Katherine , Mattison Siobhan , Medina-Romero Elizabeth , Alam Nurul , Raqib Rubhana , Kumar Anjan , Haque Farjana , Blumenfield Tami , Shenk Mary K.
Published: July 2021

Background

Among Bangladeshi men, international labor migration has increased ten-fold since 1990 and rural to urban labor migration rates have steadily increased. Labor migration of husbands has increased household wealth and redefined women’s roles, which have both positively and negatively impacted the health of wives “left behind”. We examined the direct and indirect effects of husband labor migration on chronic disease indicators and outcomes among wives of labor migrants.

Methods

We collected survey, anthropometric, and biomarker data from a random sample of women in Matlab, Bangladesh, in 2018. We assessed associations between husband’s migration and indicators of adiposity and chronic disease. We used structural equation modeling to assess the direct effect of labor migration on chronic disease, undernutrition, and adiposity, and the mediating roles of income, food security, and proportion of food purchased from the bazaar. Qualitative interviews and participant observation were used to help provide context for the associations we found in our quantitative results.

Findings

Among study participants, 9.0% were underweight, 50.9% were iron deficient, 48.3% were anemic, 39.6% were obese, 27.3% had a waist circumference over 35 in., 33.1% had a high whole-body fat percentage, 32.8% were diabetic, and 32.9% had hypertension. Slightly more women in the sample (55.3%) had a husband who never migrated than had a husband who had ever migrated (44.9%). Of those whose husband had ever migrated, 25.8% had a husband who was a current international migrant. Wives of migrants were less likely to be underweight, and more likely to have indicators of excess adiposity, than wives of non-migrants. Protection against undernutrition was attributable primarily to increased food security among wives of migrants, while increased adiposity was attributable primarily to purchasing a higher proportion of food from the bazaar; however, there was a separate path through income, which qualitative findings suggest may be related to reduced physical activity.

Conclusions

Labor migration, and particularly international labor migration, intensifies the nutrition transition in Bangladesh through increasing wealth, changing how foods are purchased, and reducing physical activity, which both decreases risk for undernutrition and increases risk for excess adiposity.
Development of in-house fully residual deep convolutional neural network-based segmentation software for the male pelvic CT
Authors: Hirashima Hideaki , Nakamura Mitsuhiro , Baillehache Pascal , Fujimoto Yusuke , Nakagawa Shota , Saruya Yusuke , Kabasawa Tatsumasa , Mizowaki Takashi
Published: July 2021

Background

This study aimed to (1) develop a fully residual deep convolutional neural network (CNN)-based segmentation software for computed tomography image segmentation of the male pelvic region and (2) demonstrate its efficiency in the male pelvic region.

Methods

A total of 470 prostate cancer patients who had undergone intensity-modulated radiotherapy or volumetric-modulated arc therapy were enrolled. Our model was based on FusionNet, a fully residual deep CNN developed to semantically segment biological images. To develop the CNN-based segmentation software, 450 patients were randomly selected and separated into the training, validation and testing groups (270, 90, and 90 patients, respectively). In Experiment 1, to determine the optimal model, we first assessed the segmentation accuracy according to the size of the training dataset (90, 180, and 270 patients). In Experiment 2, the effect of varying the number of training labels on segmentation accuracy was evaluated. After determining the optimal model, in Experiment 3, the developed software was used on the remaining 20 datasets to assess the segmentation accuracy. The volumetric dice similarity coefficient (DSC) and the 95th-percentile Hausdorff distance (95%HD) were calculated to evaluate the segmentation accuracy for each organ in Experiment 3.

Results

In Experiment 1, the median DSC for the prostate were 0.61 for dataset 1 (90 patients), 0.86 for dataset 2 (180 patients), and 0.86 for dataset 3 (270 patients), respectively. The median DSCs for all the organs increased significantly when the number of training cases increased from 90 to 180 but did not improve upon further increase from 180 to 270. The number of labels applied during training had a little effect on the DSCs in Experiment 2. The optimal model was built by 270 patients and four organs. In Experiment 3, the median of the DSC and the 95%HD values were 0.82 and 3.23 mm for prostate; 0.71 and 3.82 mm for seminal vesicles; 0.89 and 2.65 mm for the rectum; 0.95 and 4.18 mm for the bladder, respectively.

Conclusions

We have developed a CNN-based segmentation software for the male pelvic region and demonstrated that the CNN-based segmentation software is efficient for the male pelvic region.
Effects of an attachment-based parent intervention on mothers of children with autism spectrum disorder: preliminary findings from a non-randomized controlled trial
Authors: Kubo Nobuyo , Kitagawa Megumi , Iwamoto Sayaka , Kishimoto Toshifumi
Published: July 2021

Background

Caregivers of children with autism spectrum disorders (ASD) often experience difficulties in responding appropriately to the needs of those children, who typically express attachment in distinct and nonconventional ways. This highlights the need for an attachment-based approach targeted at caregivers of children with ASD. Circle of Security Parenting (COSP), an attachment-based parenting program, is designed to increase caregivers’ sensitivity to children’s attachment needs. The aim of this study was to provide verification of the effectiveness of COSP in mothers of children with ASD.

Methods

This study was a non-randomized controlled trial. Sixty mothers of children with ASD aged 4–12 were recruited. Twenty mothers received the COSP intervention, while 40 did not. The characteristics of children in the control group were matched with those of the intervention group. To evaluate the outcomes of the intervention, changes in parental self-efficacy and mental health were assessed using the Tool to Measure Parenting Self-Efficacy (TOPSE) and the General Health Questionnaire-30 (GHQ-30). The children’s improvement in emotional and behavioral problems was assessed from the mothers’ perspective using the Child Behavior Checklist (CBCL). Both groups completed the assessments in parallel. Evaluations were compared between baseline (T1) and 6-month follow-up (T2).

Results

Scores for self-efficacy and mental health of mothers and behavior of children were significantly improved from T1 to T2 in the intervention group, but not in the control group. Participants’ mental health was markedly worsened in the control group.

Conclusion

This study demonstrated that the COSP program for mothers of children with ASD improved their parental self-efficacy and mental health, and reduced their subjective sense of difficulties related to their children’s behaviors. Our findings support the effectiveness of the attachment-based program for mothers of children with ASD, providing the groundwork for further studies of the attachment-based intervention for children with ASD and their families. Future studies with larger samples and randomization are also needed for direct evaluation of the improvement of children's attachment security, and for exploration of the synergistic relationship between various family support strategies and COSP.

Trial Registration This trial was registered with the University Hospital Medical Information Network Clinical Trial Registry (No. UMIN000039574)
The impact of a structured handover checklist for intraoperative staff shift changes on effective communication, OR team satisfaction, and patient safety: a pilot study
Authors: Nasiri Ebrahim , Lotfi Mojgan , Mahdavinoor Seyyed Muhammad Mahdi , Rafiei Mohammad Hossein
Published: July 2021

Objective

Handover without a structured format is prone to the omission of information and could be a potential risk to patient safety. We sought to determine the effect of a structured checklist on the quality of intraoperative change of shift handover between scrubs and circulars.

Methods

We conducted a control intervention study on operating room wards of two teaching hospitals from 20 Feb to 21 Nov 2020. This research was conducted in three stages as follows: assessing the current situation (as a group before the intervention), performing the intervention and evaluating the effect of using a checklist on handover quality after the intervention in two groups: with and without checklist. We examined the quality of handover between scrub and circular personnel in terms of handover duration and quality, omission of information and improvement in OR staff satisfaction.

Results

A total of 120 handovers were observed and evaluated. After intervention in the group using the checklist, the percentage of information omission in surgical report was decreased from 19.5 to 12.1% between scrubs (P < 0.00) and from 16.8 to 14.1% between circulars (P < 0.03). Also, in the role of scrub, the mean overall score of handover process quality was significantly higher after the intervention (x̄ = 7 ± 1.5) than before it (x̄ = 6.5 ± 0.9) (p < 0.02). In the role of circulating, despite the positive effect of overall score checklist, no significant difference was observed (p < 0.08). The use of checklist significantly increased the handover duration between scrubs (p < 0.03) and circulars (p < 0.00). The overall mean percentage of handover satisfaction increased from 67.5% before the intervention to 85.5% after the intervention (p < 0.00).

Conclusion

The implementation of a new structured handover checklist had a positive impact on improving the quality of communication between the surgical team, reducing the information omission rate and increasing the satisfaction.
Brief comments on three existing approaches for managing neonates at risk of early-onset sepsis
Authors: Vaccina E. , Luglio A. , Ceccoli M. , Lecis M. , Leone F. , Zini T. , Toni G. , Lugli L. , Lucaccioni L. , Iughetti L. , Berardi A.
Published: July 2021

Background

Growing concerns regarding the adverse effects of antibiotics during the first days of life and the marked reduction in the incidence of early-onset sepsis (EOS) are changing the clinical practice for managing neonates at risk of EOS. Strategies avoiding unnecessary antibiotics while promoting mother-infant bonding and breastfeeding deserve to be considered.

Main body

We compare strategies for managing newborns at risk of EOS recommended by the American Academy of Pediatrics, which are among the most followed recommendations worldwide. Currently three different approaches are suggested in asymptomatic full-term or late preterm neonates: i) the conventional management, based on standard perinatal risk factors for EOS alone, ii) the neonatal sepsis calculator, a multivariate risk assessment based on individualized, quantitative risk estimates (relying on maternal risk factors for EOS) combined with physical examination findings at birth and in the following hours and iii) an approach entirely based on newborn clinical condition (serial clinical observation) during the first 48 h of life.

We discuss advantages and limitations of these approaches, by analyzing studies supporting each strategy. Approximately 40% of infants who develop EOS cannot be identified on the basis of maternal RFs or laboratory tests, therefore close monitoring of the asymptomatic but at-risk infant remains crucial. A key question is to know what proportion of babies with mild, unspecific symptoms at birth can be managed safely without giving antibiotics.

Conclusions

Both neonatal sepsis calculator and serial clinical observation may miss cases of EOS, and clinical vigilance for all neonates is essential There is a need to assess which symptoms at birth are more predictive of EOS, and therefore require immediate interventions, or symptoms that can be carefully reevaluated without necessarily treat immediately the neonate with antibiotics. Studies comparing strategies for managing neonates are recommended.
Angiotensin-converting enzyme inhibitor for post-transcatheter aortic valve implantation patients: study protocol for a multicenter randomized, open-label blinded endpoint control trial
Authors: Liao Yan Biao , Xia Congying , Cheng Yiheng , Li Qiao , Wei Xin , Ou Yuanweixiang , Chen Fei , Li Yijian , Liu Qi , Xiong Tianyuan , Zhao Zhengang , Peng Yong , Wei Jiafu , Feng Yuan , Chen Mao
Published: July 2021

Background

With the expanded utilization of transcatheter aortic valve implantation (TAVI) to younger and lower surgical risk patients with severe aortic stenosis (AS), optimal medical therapy after TAVI procedure has become the main concern. Renin-angiotensin system inhibitors (RASi) are widely utilized in the area of cardiovascular disease including heart failure and myocardial infarction and revealed the ability to reverse left ventricular (LV) remodeling. Interests have, thus, been drawn in investigating whether the prescription of RASi after the TAVI procedure can prevent or reverse cardiac remodeling and improve long-term clinical outcomes. No recommendation regarding the prescription of RASi after TAVI is proposed yet due to the lack of evidence from randomized controlled trials, especially in the Chinese population. We, therefore, designed this randomized controlled trial to explore the effect of adding fosinopril to standard care in patients who underwent a successful TAVI procedure on the LV remodeling.

Methods

A total of 200 post-TAVI patients from seven academic hospitals across China will be recruited and randomized with a ratio of 1:1 to receive standard care or standard care plus fosinopril. Follow-up visits will take place at 30 days, 3 months, 6 months, 12 months, and 24 months from randomization to assess the clinical symptoms, any adverse events, cardiac function, and quality of life. Cardiac magnetic resonance will be performed at baseline and repeated at the 24-month follow-up visit to assess LV remodeling.

Discussion

This study will provide evidence regarding medical therapy for AS patients who underwent TAVI and filling the gap in the Chinese population.

Trial registration

Chinese Clinical Trial Registry ChiCTR2100042266. Registered on 17 January 2021
Emergency teleradiological activity is an epidemiological estimator and predictor of the covid-19 pandemic in mainland France
Authors: Crombé Amandine , Lecomte Jean-Christophe , Banaste Nathan , Tazarourte Karim , Seux Mylène , Nivet Hubert , Thomson Vivien , Gorincour Guillaume
Published: July 2021

Background

COVID-19 pandemic highlighted the need for real-time monitoring of diseases evolution to rapidly adapt restrictive measures. This prospective multicentric study aimed at investigating radiological markers of COVID-19-related emergency activity as global estimators of pandemic evolution in France. We incorporated two sources of data from March to November 2020: an open-source epidemiological dataset, collecting daily hospitalisations, intensive care unit admissions, hospital deaths and discharges, and a teleradiology dataset corresponding to the weekly number of CT-scans performed in 65 emergency centres and interpreted remotely. CT-scans specifically requested for COVID-19 suspicion were monitored. Teleradiological and epidemiological time series were aligned. Their relationships were estimated through a cross-correlation function, and their extremes and breakpoints were compared. Dynamic linear models were trained to forecast the weekly hospitalisations based on teleradiological activity predictors.

Results

A total of 100,018 CT-scans were included over 36 weeks, and 19,133 (19%) performed within the COVID-19 workflow. Concomitantly, 227,677 hospitalisations were reported. Teleradiological and epidemiological time series were almost perfectly superimposed (cross-correlation coefficients at lag 0: 0.90–0.92). Maximal number of COVID-19 CT-scans was reached the week of 2020-03-23 (1 086 CT-scans), 1 week before the highest hospitalisations (23,542 patients). The best valid forecasting model combined the number of COVID-19 CT-scans and the number of hospitalisations during the prior two weeks and provided the lowest mean absolute percentage (5.09%, testing period: 2020-11-02 to 2020-11-29).

Conclusion

Monitoring COVID-19 CT-scan activity in emergencies accurately and instantly predicts hospitalisations and helps adjust medical resources, paving the way for complementary public health indicators.
Magnetic resonance imaging for deep infiltrating endometriosis: current concepts, imaging technique and key findings
Authors: Lorusso Filomenamila , Scioscia Marco , Rubini Dino , Stabile Ianora Amato Antonio , Scardigno Doriana , Leuci Carla , De Ceglie Michele , Sardaro Angela , Lucarelli Nicola , Scardapane Arnaldo
Published: July 2021

Endometriosis is an estrogen-dependent chronic disease affecting about 10% of reproductive-age women with symptoms like pelvic pain and infertility. Pathologically, it is defined by the presence of endometrial tissue outside the uterine cavity responsible for a chronic inflammatory process. For decades the diagnosis of endometriosis was based on surgical exploration and biopsy of pelvic lesions. However, laparoscopy is not a risk-free procedure with possible false negative diagnosis due to an underestimate of retroperitoneal structures such as ureters and nerves. For these reasons nowadays, the diagnosis of endometriosis is based on a noninvasive approach where clinical history, response to therapy and imaging play a fundamental role. Trans-vaginal ultrasound and magnetic resonance imaging are suitable for recognizing most of endometriotic lesions; nevertheless, their accuracy is strictly determined by operators’ experience and imaging technique. This review paper aims to make radiologists aware of the diagnostic possibilities of pelvic MRI and familial with the MR acquisition protocols and image interpretation for women with endometriosis.
Impactful factors and research design in CRISPR-edited stem cell research from top 10 highly cited articles
Authors: Widjaya Michael Anekson , Lee Shin-Da , Ho Yuh-Shan
Published: July 2021

Our objective in this review was to determine (1) impactful research articles about CRISPR-edited stem cells, (2) factors that affected CRISPR method performance in stem cell, and (3) research design related to CRISPR-edited stem cells. Screening research papers of related topic was carried out by using the Science Citation Index Expanded (SCIE) database of the Clarivate Analytics Web of Science Core Collection updated. We screened impactful CRISPR/Cas9-edited stem cells based on total citation until 2020. The result showed the title “RNA-guided human genome engineering via Cas9” was the highest citation in stem cell research using the CRISPR method with total citation 4789 from Web of Science Core Collection until 2020. It became the most influenced paper because this was the first research using CRISPR method for modifying human cells. On the other hand, cell type, CRISPR/Cas9 delivery, and gene target affected CRISPR/Cas9 performance in stem cells. The more complex the cell structure, the more difficult for CRISPR/Cas9 to mutate the host cells. This problem could be solved by modifying the CRISPR/Cas9 delivery by liposome and SaCas9 modification. Another way was using ribonucleoprotein (RNP) as a delivery method. Then, double gene target was more difficult to execute than single gene target. Although it is difficult, CRISPR/Cas9 had the capability to target any genome region from promoter until intron. Research design used a combination of dry lab and wet lab. The dry lab is usually used for sequence analysis and gRNA design. The wet lab which consisted of in vitro and in vivo was used for gene characterization. In particular, colony selection, DNA analysis, and sequencing were important parts for in vitro research design, while DNA analysis and sequencing were crucial parts for in vivo research design. We hoped these findings could give researchers, investor, and students a guideline to conduct CRISPR-edited stem cells in the future.
Chondromalacia patellae: current options and emerging cell therapies
Authors: Zheng Weitao , Li Hanluo , Hu Kanghong , Li Liming , Bei Mingjian
Published: July 2021

Chondromalacia patellae (CMP), also known as runner’s knee, typically occurs in young patients, which is characterized by anterior knee pain (AKP) that is associated with visible changes in patellar cartilage. The initial pathological changes include cartilage softening, swelling, and edema. CMP is caused by several factors, including trauma, increased cartilage vulnerability, patellofemoral instability, bony anatomic variations, abnormal patellar kinematics, and occupation hazards. CMP may be reversible or may progress to develop patellofemoral osteoarthritis. Quadriceps wasting, patellofemoral crepitus, and effusion are obvious clinical indications. Additionally, radiological examinations are also necessary for diagnosis. Magnetic resonance imaging (MRI) is a non-invasive diagnostic method, which holds a promise in having the unique ability to potentially identify cartilage lesions. Modalities are conventionally proposed to treat cartilage lesions in the PF joint, but none have emerged as a gold standard, neither to alleviated symptoms and function nor to prevent OA degeneration. Recently, researchers have been focused on cartilage-targeted therapy. Various efforts including cell therapy and tissue emerge for cartilage regeneration exhibit as the promising regime, especially in the application of mesenchymal stem cells (MSCs). Intra-articular injections of variously sourced MSC are found safe and beneficial for treating CMP with improved clinical parameters, less invasiveness, symptomatic relief, and reduced inflammation. The mechanism of MSC injection remains further clinical investigation and is tremendously promising for CMP treatment. In this short review, etiology, MRI diagnosis, and treatment in CMP, especially the treatment of the cell-based therapies, are reviewed.
Model order reduction for gas and energy networks
Authors: Himpe Christian , Grundel Sara , Benner Peter
Published: July 2021

To counter the volatile nature of renewable energy sources, gas networks take a vital role. But, to ensure fulfillment of contracts under these circumstances, a vast number of possible scenarios, incorporating uncertain supply and demand, has to be simulated ahead of time. This many-query gas network simulation task can be accelerated by model reduction, yet, large-scale, nonlinear, parametric, hyperbolic partial differential(-algebraic) equation systems, modeling natural gas transport, are a challenging application for model order reduction algorithms.

For this industrial application, we bring together the scientific computing topics of: mathematical modeling of gas transport networks, numerical simulation of hyperbolic partial differential equation, and parametric model reduction for nonlinear systems. This research resulted in the (Model Order Reduction for Gas and Energy Networks) software platform, which enables modular testing of various combinations of models, solvers, and model reduction methods. In this work we present the theoretical background on systemic modeling and structured, data-driven, system-theoretic model reduction for gas networks, as well as the implementation of and associated numerical experiments testing model reduction adapted to gas network models.
Utilization of Completely Recycled Fine Aggregate for Preparation of Lightweight Concrete Partition Panels
Authors: Yang Yibo , Chen Baixi , Zeng Weizhen , Li Yanjun , Chen Qiaohui , Guo Wenying , Wang Hengchang , Chen Yingqin
Published: July 2021

To reduce the cost of lightweight concrete (LWC) partition panels and to address recycling concrete waste, this work utilized completely recycled fine aggregate (CRFA) to replace the natural fine aggregate and ceramsite in the preparation of LWC and LWC partition panels. To this end, an autoclave-free curing process and an air-entraining agent were used to prepare the CRFA-LWC. The workability, compressive strength, drying shrinkage, and pore structure of the CRFA-LWC and the performance of the CRFA-LWC partition panels were then investigated. The results show that the optimal ratio of the CRFA to the cement is 2.2 for the lightweight concrete, and the optimal panel cross section is a rounded rectangular one. All the pores in the CRFA-LWC have a diameter of smaller than 0.17 mm, and the diameter of 89% of them is less than 0.05 mm. In order to satisfy the drying shrinkage requirements stipulated by Chinese code JC/T 169-2016, the CRFA-LWC should be cured for at least 10 days. The economic analysis concludes that the material cost of CRFA-LWC is 40% lower than that of the autoclaved ceramsite concrete. In addition, utilizing CRFA in lightweight concrete can ease the shortage of natural aggregate.
Influence of learning and internship satisfaction on students’ intentions to stay at their current jobs: survey of students participating in Taiwan’s dual education system
Authors: Liu Louis Chih-hung
Published: July 2021

We investigated the effectiveness of Taiwan’s dual education system, referred to as the dual system of vocational training policy (DSVTP) program. By surveying 722 randomly selected respondents participating in the DSVTP program, we examined the effects of students’ satisfaction with their learning and internship in the program on their intentions to stay at their current jobs. We employed structural equation modeling to analyze the associations among factors. Our empirical results revealed positive correlations between learning satisfaction, job involvement, dual system satisfaction, and intentions to stay at the current job. These empirical results also suggested that students participating DSVTP are largely satisfied with this program and would promote them to stay at current job, which in turn helps to alleviate youth unemployment. On the basis of the statistical analysis results, policy implications that could serve as a reference in future reforms of the DSVTP in Taiwan are also discussed.
Pharmacy preparedness in handling COVID-19 pandemic: a sharing experience from a Malaysian tertiary hospital
Authors: Thong Kah Shuen , Selvaratanam Manimegahlai , Tan Chiew Ping , Cheah Meng Fei , Oh Hoey Lin , Lee Pooi Mun , Chew Chii-Chii , Chang Chee-Tao , Lee Jason Choong Yin
Published: July 2021

This commentary shares the experience of a hospital pharmacy department in providing healthcare services during the COVID-19 outbreak in Malaysia. During this pandemic, the medication delivery system is redesigned to minimize contact among patients and the health care providers. Also, the remote medication monitoring system was implemented to deliver pharmaceutical care for inpatients. Communication technology was used to assist the pharmacist in medication counseling. QR codes to access videos demonstrating the use of devices were made available for patients. Pharmacists were also tasked with the procurement of personal protective equipment and medications needed requiring special approval from the Ministry of Health.
Review on self-regulated learning in smart learning environment
Authors: Gambo Yusufu , Shakir Muhammad Zeeshan
Published: July 2021

Despite the increasing use of the self-regulated learning process in the smart learning environment, understanding the concepts from a theoretical perspective and empirical evidence are limited. This study used a systematic review to explore models, design tools, support approaches, and empirical research on the self-regulated learning process in the smart learning environment. This review revealed that there is an increasing body of literature from 2012 to 2020. The analysis shows that self-regulated learning is a critical factor influencing a smart learning environment’s learning process. The self-regulated learning components, including motivation, cognitive, metacognitive, self-efficiency, and metacognitive components, are most cited in the literature. Furthermore, self-regulated strategies such as goal setting, helping-seeking, time management, and self-evaluation have been founded to be frequently supported in the literature. Besides, limited theoretical models are designed to support the self-regulated learning process in a smart learning environment. Furthermore, most evaluations of the self-regulated learning process in smart learning environment are quantitative methods with limited mixed methods. The design tools such as visualization, learning agent, social comparison, and recommendation are frequently used to motivate students’ learning engagement and performance. Finally, the paper presents our conclusion and future directions supporting the self-regulated learning process in the smart learning environment.
A cross sectional study of non-medical use of prescription opioids and suicidal behaviors among adolescents
Authors: Wright Nate , Ramirez Marizen R.
Published: July 2021

Background

Non-medical use of prescription opioids (NMUPO), defined as taking an opioid in a manner or dose other than prescribed, taking someone else’s, or for the feelings that it produces, has been reported by 5 to 20% of adolescents, and is associated with a two fold increase in suicidal behaviors among adolescents. Adolescents with long-term health problems (LTHP) have poorer mental health and may seek NMUPO for pain relief that is not obtained through standard care. For this study, we measured the association between NMUPO and suicidal behaviors, and further assessed effect modification by LTHP hypothesizing the association between NMUPO and suicidal behaviors was stronger for adolescents with LTHP.

Findings

For students with LTHP, 13.5% reported suicide ideation, while 8.0% of students without LTHP reported suicide ideation. For suicide attempt, 4.4% of students with LTHP reported a suicide attempt, while 2.1% of students without LTHP reported a suicide attempt. The proportion of students who reported suicide ideation and attempts increased with higher occasions of NMUPO. Adjusted logistic regression models found increased odds of suicide ideation (OR (95% CI): 1–5 occasions: 2.3 (2.0–2.6); > 6 occasions: 2.7 (2.2–3.8)) and suicide attempts (OR (95% CI): 1–5 occasions: 3.2 (2.7–3.7); > 6 occasions: 4.1 (3.1–5.3)) for students who reported NMUPO. An interaction term for NMUPO and LTHP was then added to the models. Effect modification was not present on the multiplicative scale. On the additive scale, evidence of effect modification was observed: higher risk was indicated for students with LTHP versus no LTHP for both suicide ideation (Predicted risk (95%CI): > 6 occasions NMUPO, LTHP: 0.24 (0.18–0.29); No LTHP: 0.16 (0.13–0.18)) and attempt (Predicted risk (95%CI): 1–5 occasions NMUPO, LTHP: 0.08 (0.07–0.10); No LTHP: 0.05 (0.05–0.06); > 6 occasions NMUPO, LTHP: 0.11 (0.07–0.15); No LTHP: 0.06 (0.05–0.08)).

Conclusions

The results affirmed that NMUPO is associated with suicidal behaviors among adolescents. A pattern also emerged of higher risk of suicidal behaviors for those with LTHP who reported NMUPO. Areas of further inquiry should explore chronic medical or pain conditions as possible modifying pathways that could exacerbate the effects of NMUPO on suicidal behaviors specific to an adolescent population.
Technical note: rectangular femoral tunnel for anterior cruciate ligament reconstruction using a new ultrasonic device: a feasibility study
Authors: Seil Romain , Mouton Caroline , Jacquet Christophe
Published: July 2021

Purpose

The goal of this preliminary report was to show the use of novel Ultrasound (US) technology for anterior cruciate ligament (ACL) reconstruction surgery and evaluate its feasibility for the creation of a rectangular femoral bone tunnel during an arthroscopic procedure in a human cadaver model.

Methods

Two fresh frozen human cadaver knees were prepared for arthroscopic rectangular femoral tunnel completion using a prototype US device (OLYMPUS EUROPA SE & CO. KG). The desired rectangular femoral tunnel was intended to be located in the femoral anatomical ACL footprint. Its tunnel aperture was planned at 10 × 5 mm and a depth of 20 mm should be achieved. For one knee, the rectangular femoral tunnel was realized without a specific cutting guide and for the other with a 10 × 5 mm guide. One experienced orthopedic surgeon performed the two procedures consecutively. The time for femoral tunnel completion was evaluated. CT scans with subsequent three-dimensional image reconstructions were performed in order to evaluate tunnel placement and configuration.

Results

In the two human cadaver models the two 10 × 5x20mm rectangular femoral tunnels were successfully completed and located in the femoral anatomical ACL footprint without adverse events. The time for femoral tunnel completion was 14 min 35 s for the procedure without the guide and 4 min 20 s with the guide.

Conclusion

US technology can be used for the creation of a rectangular femoral bone tunnel during an arthroscopic ACL reconstruction procedure. The use of a specific cutting guide can reduce the time for femoral tunnel completion. Additional experience will further reduce the time of the procedure.
The church bridge project focus group results: African American perspectives of weight management programs to improve nutrition and physical activity behaviors
Authors: Lemacks Jennifer L. , Abbott Laurie S. , Greer Tammy , Gunn Renee , Bryant Ashley , Bradford LaShaundrea , Ralston Penny A.
Published: July 2021

Background

The prevalence of obesity is disproportionately high among African Americans in the Southern US. More information is needed about factors that influence participation in nutrition and physical activity programs to promote healthy weight.

Objective

The purpose of this study is to explore the weight management perceptions of young to middle aged adult African Americans.

Methods

The Church Bridge Project intervention participants were recruited for two focus groups. Qualitative data were recorded, transcribed and a thematic content analysis was conducted to identify major themes.

Results

Barriers included technology learning curve/burden and competing priorities. Facilitators included support, limited cost, convenience, and health. Participants perceived the term “weight management” program as overwhelming and defeating.

Conclusion

The Church Bridge Project model confirmed social support and disease prevention as key factors for weight management. Further work should substantiate social support as a key factor to guide minority health efforts.
The membership of parties abroad: a case study of the UK
Authors: Collard Susan , Kernalegenn Tudi
Published: July 2021

Against a long trend decline in the membership of political parties in Western democracies, there has been an unexpected surge in the UK since 2015. Interestingly, this phenomenon has also been observed amongst British expatriates, despite their historically very low levels of engagement. Our paper explores this development using a multi-methods approach to investigate its impact across the three main parties, comparing the relative importance of supply-side and demand-side factors in each case. We show that the creation and development of British parties abroad are the result of two contrasting dynamics: a top-down one, which gives legitimacy and structure and in some cases, resources, and a bottom-up one, which gives purpose but also networks. Our survey of British expatriate party members reveals a diversity of triggers and motivations for membership, making an original contribution to the wider literature on party membership and on the political engagement of emigrants.
Fermented pork fat (Sa-um) and lifestyle risk factors as potential indicators for type 2 diabetes among the Mizo population, Northeast India
Authors: Lalrohlui Freda , Ghatak Souvik , Zohmingthanga John , Hruaii Vanlal , Kumar Nachimuthu Senthil
Published: July 2021

Over the last few decades, Mizoram has shown an increase in cases of type 2 diabetes mellitus; however, no in-depth scientific records are available to understand the occurrence of the disease. In this study, 500 patients and 500 healthy controls were recruited to understand the possible influence of their dietary and lifestyle habits in relation with type 2 diabetes mellitus. A multivariate analysis using Cox regression was carried out to find the influence of dietary and lifestyle factors, and an unpairedttest was performed to find the difference in the levels of biochemical tests. Out of 500 diabetic patients, 261 (52.3%) were males and 239 (47.7%) were females, and among the control group, 238 (47.7%) were males and 262 (52.3%) were females. Fermented pork fat, Sa-um (odds ratio (OR) 18.98), was observed to be a potential risk factor along with tuibur (OR 0.1243) for both males and females. Creatinine level was found to be differentially regulated between the male and female diabetic patients. This is the first report of fermented pork fat and tobacco (in a water form) to be the risk factors for diabetes. The unique traditional foods like Sa-um and local lifestyle habits like tuibur of the Mizo population may trigger the risk for the prevalence of the disease, and this may serve as a model to study other populations with similar traditional practices.
ESRFuzzer: an enhanced fuzzing framework for physical SOHO router devices to discover multi-Type vulnerabilities
Authors: Zhang Yu , Huo Wei , Jian Kunpeng , Shi Ji , Liu Longquan , Zou Yanyan , Zhang Chao , Liu Baoxu
Published: July 2021

SOHO (small office/home office) routers provide services for end devices to connect to the Internet, playing an important role in cyberspace. Unfortunately, security vulnerabilities pervasively exist in these routers, especially in the web server modules, greatly endangering end users. To discover these vulnerabilities, fuzzing web server modules of SOHO routers is the most popular solution. However, its effectiveness is limited due to the lack of input specification, lack of routers’ internal running states, and lack of testing environment recovery mechanisms. Moreover, existing works for device fuzzing are more likely to detect memory corruption vulnerabilities.In this paper, we propose a solution ESRFuzzer to address these issues. It is a fully automated fuzzing framework for testing physical SOHO devices. It continuously and effectively generates test cases by leveraging two input semantic models, i.e., KEY-VALUE data model and CONF-READ communication model, and automatically recovers the testing environment with power management. It also coordinates diversified mutation rules with multiple monitoring mechanisms to trigger multi-type vulnerabilities. With the guidance of the two semantic models, ESRFuzzer can work in two ways: general mode fuzzing and D-CONF mode fuzzing. General mode fuzzing can discover both issues which occur in the CONF and READ operation, while D-CONF mode fuzzing focus on the READ-op issues especially missed by general mode fuzzing.We ran ESRFuzzer on 10 popular routers across five vendors. In total, it discovered 136 unique issues, 120 of which have been confirmed as 0-day vulnerabilities we found. As an improvement of SRFuzzer, ESRFuzzer have discovered 35 previous undiscovered READ-op issues that belong to three vulnerability types, and 23 of them have been confirmed as 0-day vulnerabilities by vendors. The experimental results show that ESRFuzzer outperforms state-of-the-art solutions in terms of types and number of vulnerabilities found.