bluuebunny/crossref_metadata_2025 huggingface dataset:
THE MEDIUM-TERM RESULTS OF ARTHROSCOPIC HIP SURGERY COMPARED WITH PHYSIOTHERAPY AND ACTIVITY MODIFICATION FOR THE TREATMENT OF FEMOROACETABULAR IMPINGEMENT SYNDROME: A MULTICENTRE RANDOMIZED CONTROLLED TRIAL
Authors: Palmer Antony , Fernquest Scott , Logishetty Kartik , Rombach Ines , Harin Alice , Mansour Ramy , Dijkstra Paul , Andrade Tony , Dutton Susan , Glyn-Jones Sion
Published: May 2024

The primary treatment goal for patients with femoroacetabular impingement syndrome, a common hip condition in athletes, is to improve pain and function. In selected patients, in the short term following intervention, arthroscopic hip surgery is superior to a pragmatic NHS- type physiotherapy programme. Here, we report the three-year follow-up results from the FemoroAcetabular Impingement Trial (FAIT), comparing arthroscopic hip surgery with physiotherapy in the management of patients with femoroacetabular impingement (FAI) syndrome.

Two-group parallel, assessor-blinded, pragmatic randomised controlled study across seven NHS England sites. 222 participants aged 18 to 60 years with FAI syndrome confirmed clinically and radiologically were randomised (1:1) to receive arthroscopic hip surgery (n = 112) or physiotherapy and activity modification (n = 110). We previously reported on the hip outcome score at eight months. The primary outcome measure of this study was minimum Joint Space Width (mJSW) on Anteroposterior Radiograph at 38 months post randomisation. Secondary outcome measures included the Hip Outcome Score and Scoring Hip Osteoarthritis with MRI (SHOMRI) score.

Minimum Joint Space Width data were available for 101 participants (45%) at 38 months post randomisation. Hip outcome score and MRI data were available for 77% and 62% of participants respectively. mJSW was higher in the arthroscopy group (mean (SD) 3.34mm (1.01)) compared to the physiotherapy group (2.99mm (1.33)) at 38 months, p=0.017, however this did not exceed the minimally clinically important difference of 0.48mm. SHOMRI score was significantly lower in the arthroscopy group (mean (SD) 9.22 (11.43)) compared to the physiotherapy group (22.76 (15.26)), p-value <0.001. Hip outcome score was higher in the arthroscopy group (mean (SD) 84.2 (17.4)) compared with the physiotherapy group (74.2 (21.9)), p-value < 0.001).

Patients with FAI syndrome treated surgically may experience slowing of osteoarthritisprogression and superior pain and function compared with patients treated non- operatively.
FAIRER PRIORITISATION OF THOSE WAITING FOR PRIMARY HIP ARTHROPLASTY: RESULTS FROM THE PRIORITISATION OF THOSE AWAITING HIP AND KNEE ARTHROPLASTY (PATHWAY) STUDY
Authors: Farrow Luke , Clement Nick , Meek Dominic
Published: May 2024

Given the prolonged waits for hip arthroplasty seen across the U.K. it is important that we optimise priority systems to account for potential disparities in patient circumstances and impact. We set out to achieve this through a two-stage approach. This included a Delphi-study of patient and surgeon preferences to determine what should be considered when determining patient priority, followed by a Discrete Choice Experiment (DCE) to decide relative weighting of included attributes.

The study was conducted according to the published protocol ([https://boneandjoint.org.uk/article/10.1302/2633-1462.310.BJO-2022-0071](https://boneandjoint.org.uk/article/10.1302/2633-1462.310.BJO-2022-0071)). The Delphi study was performed online over 3 rounds with anonymous ranking and feedback. Included factors were voted as either Consensus in, Consensus out, or No Consensus• following an established scoring criterion. A final consensus meeting determined the prioritisation factors (and their levels) to be included in the DCE. The DCE was then conducted using an online platform, with surgeons performing 18 choice sets regarding which merited greater priority between two hypothetical patients. Results were collated and analysed using multinomial logit regression analysis (MNL).

For the Delphi study there were 43 responses in the first round, with a subsequent 91% participation rate. Final consensus inclusion was achieved for Pain; Mobility/Function; Activities of Daily Living; Inability to Work/Care; Length of Time Waited; Radiological Severity and Mental Wellbeing. 70 individuals subsequently contributed to the DCE, with radiological severity being the most significant factor (Coefficient 2.27 \[SD 0.31\], p<0.001), followed by pain (Coefficient 1.08 \[SD 0.13\], p<0.001) and time waited (Coefficient for 1-month additional wait 0.12 \[SD 0.02\], p<0.001). The calculated trade-off in waiting time for a 1-level change in pain (e.g., moderate to severe pain) was 9.14 months.

These results present a new method of determining comparative priority for those on primary hip arthroplasty waiting lists. Evaluation of potential implementation in clinical practice is now required.
THE NATIONAL PROSTHETIC HIP DISLOCATION (PHD) STUDY
Authors: Afzal Sadia , Sephton Benjamin , Wilkinson Hannah , Hodhody Ghazal , Ammori Mohannad , Kennedy James , Hoggett Lee , Board Tim
Published: May 2024

Total Hip Arthroplasty (THA) and Hip Hemiarthroplasties (HA) are successful, cost-effective procedures that improve quality of life. Dislocation is a well recognised complication with a significant health and economic burden. We aim to establish the current management practices across the United Kingdom (UK) for Prosthetic Hip Dislocations (PHD). Our definition of a PHD includes; THA, HA and revision THA.

This national study builds on our regional pilot study and records one of the largest datasets of Prosthetic Hip Dislocation management within the UK.

A trainee-led collaborative; the North West Orthopaedic Research Collaborative (NWORC). Conducted a retrospective audit, registered as Quality Improvement (QI) projects, collected data from 38 hospital trusts across the UK.

Data was collected on patient-related factors, inpatient management, and outpatient follow up of each PHD episode between January and July 2019. Primary outcome measured definitive management, in the form of revision surgery or the consideration for this through a referral pathway.

A total of 673 (THA 504, Revision THA 141, HA 28) patients were included with a total of 740 dislocation episodes. Mean age was 75.6 years with female to male ratio 2:1. The majority of PHDs were a result of a low energy mechanism (98.7%) and presented over 6 months post index procedure (80.5%). Over half (53.8%) attended with a first or second time dislocation. Only 29.9% patients received onward revision referral; whereas 70.1% followed diverse management patterns, including local non-arthroplasty and primary arthroplasty surgeon follow-ups. Revision THAs had higher rates of referral for revision (p<0.001) compared to primary THA and HA dislocations.

A high number of PHDs present across the UK, with under a third receiving definitive management plans. This variation increases the economical burden to the National Health Service, highlighting the need for national guidance to manage these complex patients.
THE IMPACT OF SOCIOECONOMIC STATUS ON OUTCOMES FROM TREATMENT FOR FEMOROACETABULAR IMPINGEMENT
Authors: Green Justin , Khanduja Vikas , Malviya Ajay
Published: May 2024

There is little known about how patient socioeconomic status impacts clinical outcomes in hip preservation surgery. The aim of this study was to evaluate the relationship between indices of multiple deprivation, funding provider (NHS Funded or Private Funded) and clinical outcomes following surgery for femoroacetabular impingement (FAI)

The study analysed the data of 5590 patients recorded in the NAHR who underwent primary hip arthroscopic treatment for FAI between November 2013 and July 2023. Records were matched to the UK National index of multiple deprivation using the lower layer super output area. Using iHOT12 score, patient reported outcome measures were analysed at base line and 1 year following surgery.

2358 records were matched to LLSOA deciles. Between the lowest (most deprived) 3 deciles and the highest (least deprived) the average baseline iHOT12 score was 28.98 (n=366) and 35.33 (n=821). The proportion of patients receiving treatment through NHS funding compared to independent funding for the most deprived, 292 (90%) 37 (10%) respectively compared to the least deprived 515 (70%) and 244 (30%) respectively. At 1year, iHOT12 scores for each group were 51.64 (29.1 SD) compared to 61.5 (28.06 SD) respectively.

The study demonstrates that patients from lower socioeconomic backgrounds had poorer baseline and one-year post-surgery iHOT12 scores compared to those from higher socioeconomic strata. Furthermore, a higher reliance on NHS funding was observed among the most deprived, while more affluent patients predominantly opted for private funding. These findings underscore the significant influence of socioeconomic status on both the quality of healthcare received and recovery outcomes in hip preservation surgery, calling attention to the need for more equitable healthcare solutions.
Fiber Optic Sensor Based WIM System Innovation for Implementing Zero Over Dimension Overload
Authors: Hidayah Fatimah Nur , Atmoko Nugroho Tri
Published: May 2024

Vehicles loaded with Over Dimension Overload (ODOL) cause damage to road infrastructure, traffic accidents, and endanger crossing transportation. ODOL vehicles also contribute to the death of people. This research focuses on characterizing the effect of moving loads on fiber optic light loss. Problem-solving approach through the optical fiber macrobending method. This research aims to be implemented in the WIM system concept. Macrobending comes from the weights contained in the body dump. The types of loading carried out are static and dynamic. Under dynamic loading, the speed variation is 0.1 m/s, 0.2m/s, and 0.3 m/s. The research results show that the greater the loading value, the greater the attenuation value of the optical fiber. This research applies to all three speed variations of the dummy dump truck, both front and rear wheels. Apart from that, the best sensitivity value is found at a speed variation of 0.1 m/s. The value is 2.029. This data can be used as a reference for the most recommended speed when a loaded vehicle passes through a fiber optic sensor-based WIM system.
A spin current detecting device working in the drift-diffusion and degenerate regimes
Authors: Miah Muhammad Idris , Islam Md. Torikul , Atiq Shahid , Kityk Iwan , Gray Evan , Chawdhury Nazia , Chowdhury Mohammed Haque , Mamun AA
Published: May 2024

A semiconductor-based device working in the spin drift-diffusion regime and for probing the injected or generated spin current was considered.  The electric field effects on spin transport were analysed. A drift-diffusion equation for spin density was derived and contributions to the spin current were examined. By referring to the techniques of the spin current injection and generation, expressions for the spin current and spin-induced transverse Hall voltage arising from the injected or generated spin-polarized current were derived. The spin current and Hall voltage in dependences of the external electric field and temperature in the degenerate regime were studied. The device operated on the basis of with no external magnetic fields gives a voltage probe of the spin-induced Hall effect. Finally, a way of enhancing the spin current was explored.
LEVANTAMENTO DA QUANTIDADE DE AGROTÓXICOS UTILIZADOS NAS COLHEITAS DAS REGIÕES METROPOLITANAS DE FEIRA DE SANTANA - 2022
Authors: Eduardo de Almeida Silva Filho  , Gean Claudio de Souza Santana
Published: May 2024

O consumo de agrotóxico tem se tornado algo preocupante para os seres humanos em geral devido ao vasto número de doenças que são desencadeadas pelo consumo exagerado de certas substâncias presentes nos agrotóxicos e pesticidas.
Saintly Protest: Women Religious, Religious Women, and the Early United Farm Worker Movement
Authors: Heidenreich L.
Published: May 2024

Abstract: While the image of César Chávez graces the face of U.S. postal stamps, less recognized are the women of the United Farm Worker Movement. Yet Catholic women, from the better-known Dolores Huerta to regional organizers like Lupe Anguiano, were critical to the union’s early victories. This article begins the work of excavating the lives and labor of the women religious and religious women of the union, with an emphasis on the activism of Catholic Latinas. When structural changes within the Catholic Church of the mid-to-late twentieth century prompted women to reexamine their faith, they responded by supporting movements, such as the grape strike of 1965–1970, on picket lines, with fasts, and for some, with full-time labor. “Saintly Protest” turns to the grape strike and explores how Catholic women, including women religious, came to support the union, and the dynamic relationship between la cotidiana , their activism, and their faith.
“To Become a Warrior and a Son to My Father”: Aleksandr Aleksandrov’s (Nadezhda Durova) Notes of a Cavalry Maiden (1836) as Transgender Autobiography
Authors: Vaysman Margarita
Published: May 2024

ABSTRACT: Transgender autobiographies have been a subject of narratology since the 1990s. Most of these studies have focused predominantly on twentieth- and, later, twenty-first-century texts, guided by the increasing availability of primary sources and the temporal limitations of transgender history. And yet, as Jay Prosser argued in his influential 1998 work Second Skins: The Body Narratives of Sexuality , “even without the official discourse of sex change, the plot lines of nineteenth- and early twentieth-century transgendered subjects are remarkably consistent with those of contemporary transsexuals” (133). This article expands the chronology and geography of narrato-logical analysis of this genre through reading Notes of a Cavalry Maiden [Zapiski kavalerist-devitsy] (1836) by Aleksandr Aleksandrov (Nadezhda Durova) (1783–1866), a Russian-Ukrainian hero of the Napoleonic wars, as a transgender autobiography. This reading brings into consideration new forms, affects, and narrative structures as constituent elements of trans narratives and has the potential to expand anglophone trans imaginaries past the confines of their current locations and temporalities.
Period measurement of a periodic structure by using a heterodyne grating interferometer
Authors: Hsu Cheng-Chih , Tsai Chen-Ming , Ye Chen-Yu , Chen Pei-Ling , Lee Tzu-Ti , Dai Zhi-Xuan
Published: May 2024

This paper proposes an alternative method for grating period measurement based on heterodyne grating interferometry. The optical configurations for measuring the period of reflection/transmission gratings were demonstrated, and four commercially available gratings were used to evaluate the effectiveness of the proposed method. Based on the phase-lock technique, the grating period could be obtained immediately through the phase wrapped/unwrapped process. Under precise measurement conditions, the grating period measurement error of the proposed method was better than 1 nm, and the grating period difference between product specifications was less than 1%. In addition, the measurement results of the proposed method also exhibited high similarity with optical microscopy measurements.
Frequency multiplexed dual-pulse fiber-optic Φ-OTDR for a fading-free distributed fiber sound sensor
Authors: Jiang Yiluo , Gao Xilun , He Wenping , Shen Yonghang
Published: May 2024

Distributed fiber-optic sensor utilizing optical interference signal detection of the Rayleigh backscattering (RBS) light along the fiber under test (FUT) has greatly progressed over the past 20 years. It can now realize real-time sound signal recovery along the FUT with a good fidelity and high sensitivity. However, the performance of the practical distributed fiber-optic sound sensor is still limited by the fading problem, as invalid spatial channels at unknown positions arise due to the low signal intensity at these positions and the resulting near-zero signal-to-noise ratio (SNR). In this paper, we propose a novel, to the best of our knowledge, fading-free fiber sensor structure by incorporating an acousto-optic frequency shift (AOFS) loop into the light source in a dual-pulse phase optical time domain reflectometry (Φ-OTDR). As a result of stable frequency shifting and feedback within the loop, the loop source can output a high-repetition-rate narrow pulse train consisting of multiple separated frequencies. This pulse train is further shaped into two pulse bursts by an acousto-optic modulator (AOM) and an in-balanced fiber-optic Mach–Zehnder interferometer (MZI). The pulse bursts are then sent into the sensing fiber, while the RBS light is detected using an Avalanche photodiode after an erbium-doped fiber amplifier. The experimental results show that the proposed structure is capable of vibration signal recovery with a good SNR all along the FUT. The fading-free performance is evaluated under different AOFS loop gains, showing significant potential in practical fiber sensor network applications.
Surface-normal illuminated pseudo-planar Ge-on-Si avalanche photodiodes with high gain and low noise
Authors: Fleming Fiona , Yi Xin , Mirza Muhammad M. A. , Jin Xiao , Kirdoda Jaroslaw , Dumas Derek C. S. , Saalbach Lisa , Modak Mrudul , Muir Dave A. S. , Smith Charlie , Coughlan Conor , Tian Qingyu , Millar Ross W. , David John P. R. , Paul Douglas J. , Buller Gerald S.
Published: May 2024

Germanium-on-Silicon (Ge-on-Si) avalanche photodiodes (APDs) are of considerable interest as low intensity light detectors for emerging applications. The Ge absorption layer detects light at wavelengths up to ≈ 1600 nm with the Si acting as an avalanche medium, providing high gain with low excess avalanche noise. Such APDs are typically used in waveguide configurations as growing a sufficiently thick Ge absorbing layer is challenging. Here, we report on a new vertically illuminated pseudo-planar Ge-on-Si APD design utilizing a 2 µm thick Ge absorber and a 1.4 µm thick Si multiplication region. At a wavelength of 1550 nm, 50 µm diameter devices show a responsivity of 0.41 A/W at unity gain, a maximum avalanche gain of 101 and an excess noise factor of 3.1 at a gain of 20. This excess noise factor represents a record low noise for all configurations of Ge-on-Si APDs. These APDs can be inexpensively manufactured and have potential integration in silicon photonic platforms allowing use in a variety of applications requiring high-sensitivity detectors at wavelengths around 1550 nm.
Heterogeneously integrated silicon-conductive oxide MOSCAP microring modulator array
Authors: Wang Alan , Hsu Wei-Che , Abdolhosseini Saeed , Rong Haisheng , Kumar Ranjeet , Zechmann Bernd
Published: May 2024

In pursuit of energy-efficient optical interconnect, silicon microring modulator (Si-MRM) has emerged as a pivotal device offering an ultra-compact footprint and capability of on-chip wavelength division multiplexing (WDM). This paper presents a 1 × 4 metal-oxide-semiconductor capacitor (MOSCAP) Si-MRM array gated by high-mobility titanium-doped indium oxide (ITiO), which was fabricated by combining Intel's high-volume manufacturing process and the transparent conductive oxide (TCO) patterning with the university facility. The 1 × 4 Si-MRM array exhibits a high electro-optic (E-O) efficiency with Vπ⋅L of 0.12 V⋅cm and achieves a modulation rate of (3×25 + 1×15) Gb/s with a measured bandwidth of 14 GHz. Additionally, it can perform on-chip WDM modulation at four equally spaced wavelengths without using thermal heaters. The process compatibility between silicon photonics and TCO materials is verified by such industry-university co-fabrication for the MOSCAP Si-MRM array and demonstrated enhanced performance from heterogeneous integration.
Bichromatically pumped artificial cnoidal wave breathers in optical microresonators
Authors: Gao Yiran , Dai Jian , Wu Zhonghan , Liu Anni , Zhang Tian , Sun Wei , Liu Junqiu , Xu Kun
Published: May 2024

Breathers are localized structures that undergo a periodic oscillation in their duration and amplitude. Optical microresonators, benefiting from their high-quality factor, provide an ideal test bench for studying breathing phenomena. In a monochromatically pumped microresonator system, intrinsic breathing instabilities are widely observed in the form of temporal dissipative Kerr solitons which only exist in the effectively red-detuned regime. Here, we demonstrate a novel bichromatic pumping scheme to create compulsive breathing microcombs via respectively distributing two pump lasers at the effectively blue- and red-detuned sides of a single resonance. We experimentally discover the artificial cnoidal wave breathers and molecular crystal-like breathers in a photonic chip-based silicon nitride microresonator and theoretically describe their intriguing temporal dynamics based on the bichromatic pumping Lugiato–Lefever equation. In particular, the corresponding breathing microcombs exhibit diverse comb line spacing ranging from 2 to 17 times the free spectral range of the microresonator. Our discovery not only provides a simple yet robust method to harness microcombs with reconfigurable comb line spacing but also reveals a new class of breathing waves in driven dissipative nonlinear systems.
Line-scanning microscopy with laterally symmetric imaging using simultaneous cross-line illumination
Authors: Shen Dan , Li Yafeng , Wang Meng , Han Yutong , Lu Bolin , Gong Hui , Luo Qingming , Yuan Jing
Published: May 2024

Using an on-the-fly scanning scheme, line confocal microscopy can obtain complex structures of large biological tissues with high throughput. Yet, it suffers from lateral imaging asymmetry and thus introduces the potential deformations of the observation results. Here, we propose cross-line illumination microscopy (cLIM) that acquires the imaging data of two perpendicular directions simultaneously through the same objective lens in a line scanning and utilizes two-direction deconvolution fusion to achieve lateral symmetric imaging performance. Imaging fluorescence beads indicates that cLIM reduces lateral resolution asymmetry from 46.1% to 2.5% and improves lateral resolution by 31.0%, compared with traditional line-scanning imaging. Compared with commercial point-confocal microscopy, the cLIM has a 25.84× increase in imaging speed and 1.93× better background-suppressing ability when imaging an 11,306  μm×7783  μm×100  μm mouse kidney slice. We also show the advantages of the cLIM in observing direction-sensitive texture features by imaging a muscular tissue slice. cLIM offers a novel solution to achieve laterally symmetric line-scanning imaging with simple modifications while maintaining high throughput and accuracy for imaging large-scale samples.
Key residues in the VDAC2-BAK complex can be targeted to modulate apoptosis
Authors: Yuan Zheng , van Delft Mark F. , Li Mark Xiang , Sumardy Fransisca , Smith Brian J. , Huang David C. S. , Lessene Guillaume , Khakam Yelena , Jin Ruitao , He Sitong , Smith Nicholas A. , Birkinshaw Richard W. , Czabotar Peter E. , Dewson Grant
Published: May 2024

BAK and BAX execute intrinsic apoptosis by permeabilising the mitochondrial outer membrane. Their activity is regulated through interactions with pro-survival BCL-2 family proteins and with non-BCL-2 proteins including the mitochondrial channel protein VDAC2. VDAC2 is important for bringing both BAK and BAX to mitochondria where they execute their apoptotic function. Despite this important function in apoptosis, while interactions with pro-survival family members are well characterised and have culminated in the development of drugs that target these interfaces to induce cancer cell apoptosis, the interaction between BAK and VDAC2 remains largely undefined. Deep scanning mutagenesis coupled with cysteine linkage identified key residues in the interaction between BAK and VDAC2. Obstructive labelling of specific residues in the BH3 domain or hydrophobic groove of BAK disrupted this interaction. Conversely, mutating specific residues in a cytosol-exposed region of VDAC2 stabilised the interaction with BAK and inhibited BAK apoptotic activity. Thus, this VDAC2–BAK interaction site can potentially be targeted to either inhibit BAK-mediated apoptosis in scenarios where excessive apoptosis contributes to disease or to promote BAK-mediated apoptosis for cancer therapy.
A multilevel analysis of the determinants of HIV testing among men in Sub-Saharan Africa: Evidence from Demographic and Health Surveys across 10 African countries
Authors: Ijaiya Mukhtar A. , Anibi Adedotun , Abubakar Mustapha Muhammed , Obanubi Chris , Anjorin Seun , Uthman Olalekan A.
Published: May 2024

Sub-Saharan Africa, the epicenter of the HIV epidemic, has seen significant reductions in new infections over the last decade. Although most new infections have been reported among women, particularly adolescent girls, men are still disadvantaged in accessing HIV testing, care, and treatment services. Globally, men have relatively poorer HIV testing, care, and treatment indices when compared with women. Gender norms and the associated concept of masculinity, strength, and stereotypes have been highlighted as hindering men’s acceptance of HIV counseling and testing. Therefore, men’s suboptimal uptake of HIV testing services will continue limiting efforts to achieve HIV epidemic control. Thus, this study aimed to identify individual, neighborhood, and country-level determinants of sub-optimal HIV testing among men in Sub-Saharan African countries. We analyzed demographic and health datasets from surveys conducted between 2016 and 2020 in Sub-Saharan African Countries. We conducted multivariable multilevel regression analysis on 52,641 men aged 15–49 years resident in 4,587 clusters across 10 countries. The primary outcome variable was ever tested for HIV. HIV testing services uptake among men in these ten Sub-Saharan African countries was 35.1%, with a high of 65.5% in Rwanda to a low of 10.2% in Guinea. HIV testing services uptake was more likely in men with increasing age, some form of formal education, in employment, ever married, and residents in relatively wealthier households. We also found that men who possessed health insurance, had some form of weekly media exposure, and had accessed the internet were more likely to have ever received an HIV test. Unlike those noted to be less likely to have ever received an HIV test if they had discriminatory attitudes towards HIV, comprehensive HIV knowledge, recent sexual activity, and risky sexual behavior were positive predictors of HIV testing services uptake among men. Furthermore, men in communities with high rurality and illiteracy were less likely to receive an HIV test. Individual and community-level factors influence the uptake of HIV testing among Sub-Saharan African men. There was evidence of geographical clustering in HIV testing uptake among men at the community level, with about two-thirds of the variability attributable to community-level factors. Therefore, HIV testing programs will need to design interventions that ensure equal access to HIV testing services informed by neighborhood socioeconomic conditions, peculiarities, and contexts.
Reducing non-communicable diseases among Palestinian populations in Gaza: A participatory comparative and cost-effectiveness modeling assessment
Authors: Basu Sanjay , Yudkin John S. , Jawad Mohammed , Ghattas Hala , Hamad Bassam Abu , Jamaluddine Zeina , Safadi Gloria , Ragi Marie-Elizabeth , Ahmad Raeda El Sayed , Vamos Eszter P. , Millett Christopher
Published: May 2024

We sought to assess the effectiveness and cost-effectiveness of potential new public health and healthcare NCD risk reduction efforts among Palestinians in Gaza. We created a microsimulation model using: (i) a cross-sectional household survey of NCD risk factors among 4,576 Palestinian adults aged ≥40 years old in Gaza; (ii) a modified Delphi process among local public health experts to identify potentially feasible new interventions; and (iii) reviews of intervention cost and effectiveness, modified to the Gazan and refugee contexts. The survey revealed 28.6% tobacco smoking, a 40.4% prevalence of hypertension diagnosis (with a 95.6% medication treatment rate), a 25.6% prevalence of diabetes diagnosis (with 95.3% on treatment), a 21.9% prevalence of dyslipidemia (with 79.6% on a statin), and a 9.8% prevalence of asthma or chronic obstructive pulmonary disease (without known treatment). A calibrated model estimated a loss of 9,516 DALYs per 10,000 population over the 10-year policy horizon. The interventions having an incremental cost-effectiveness ratio (ICER) less than three times the GDP per capita of Palestine per DALY averted (<$10,992 per DALY averted)(<$10,992 per DALY averted) included bans on tobacco smoking in indoor and public places [$34 per incremental DALY averted (95% CI: $17, $50)], treatment of asthma using low dose inhaled beclometasone and short-acting beta-agonists [$140 per DALY averted (95% CI: $77, $207)], treatment of breast cancer stages I and II [$730 per DALY averted (95% CI: $372, $1,100)], implementing a mass media campaign for healthier nutrition [$737 per DALY averted (95% CI: $403, $1,100)], treatment of colorectal cancer stages I and II [$7,657 per DALY averted (95% CI: $3,721, $11,639)], and (screening with mammography [$17,054 per DALY averted (95% CI: $8,693, $25,359)]). Despite high levels of NCD risk factors among Palestinians in Gaza, we estimated that several interventions would be expected to reduce the loss of DALYs within common cost-effectiveness thresholds.
Physical activity across midlife and health-related quality of life in Australian women: A target trial emulation using a longitudinal cohort
Authors: Nguyen Binh , Clare Philip , Mielke Gregore I. , Brown Wendy J. , Ding Ding
Published: May 2024

Background

There is little long-term causal evidence on the effect of physical activity on health-related quality of life. This study aimed to examine the associations between longitudinal patterns of physical activity over 15 years and health-related quality of life in both the physical and mental health domains, in a cohort of middle-aged Australian women.

Methods and findings

We used data collected at 3-year intervals (1998 to 2019) from 11,336 participants in the Australian Longitudinal Study on Women’s Health (ALSWH) (1946 to 1951 birth cohort). Primary outcomes were the physical (PCS) and mental health component summary (MCS) scores (range from 0 to 100; higher scores indicate higher perceived physical/mental health) from the SF-36 in 2019 (when women aged 68 to 73 years). Using target trial emulation to imitate a randomized controlled trial (RCT), we tested 2 interventions: (1) meeting the World Health Organization (WHO) physical activity guidelines consistently throughout the 15-year “exposure period” (2001 to 2016; when women aged 50–55 to 65–70 years; physical activity assessed every 3 years); and (2) not meeting the guidelines at the beginning of the exposure period but starting to first meet the guidelines at age 55, 60, or 65; against the control of not meeting the guidelines throughout the exposure period. Analysis controlled for confounding using marginal structural models which were adjusted for sociodemographic and health variables and conditions. Consistent adherence to guidelines during the exposure period (PCS: 46.93 [99.5% confidence interval [CI]: 46.32, 47.54]) and first starting to meet the guidelines at age 55 (PCS: 46.96 [99.5% CI: 45.53, 48.40]) were associated with three-point higher PCS (mean score difference: 3.0 [99.5% CI: 1.8, 4.1] and 3.0 [99.5% CI:1.2, 4.8]) than consistent non-adherence (PCS: 43.90 [99.5% CI: 42.79, 45.01]). We found a similar pattern for most SF-36 subscales but no significant effects of the interventions on MCS. The main limitations of the study were that it may not account for all underlying health conditions and/or other unmeasured or insufficiently measured confounders, the use of self-reported physical activity and that findings may not be generalizable to all mid-age women.

Conclusions

Results from the emulated RCT suggest women should be active throughout mid-age, ideally increasing activity levels to meet the guidelines by age 55, to gain the most benefits for physical health in later life.
Autonomous and policy-induced behavior change during the COVID-19 pandemic: Towards understanding and modeling the interplay of behavioral adaptation
Authors: Zozmann Heinrich , Schüler Lennart , Fu Xiaoming , Gawel Erik
Published: May 2024

Changes in human behaviors, such as reductions of physical contacts and the adoption of preventive measures, impact the transmission of infectious diseases considerably. Behavioral adaptations may be the result of individuals aiming to protect themselves or mere responses to public containment measures, or a combination of both. What drives autonomous and policy-induced adaptation, how they are related and change over time is insufficiently understood. Here, we develop a framework for more precise analysis of behavioral adaptation, focusing on confluence, interactions and time variance of autonomous and policy-induced adaptation. We carry out an empirical analysis of Germany during the fall of 2020 and beyond. Subsequently, we discuss how behavioral adaptation processes can be better represented in behavioral-epidemiological models. We find that our framework is useful to understand the interplay of autonomous and policy-induced adaptation as a “moving target”. Our empirical analysis suggests that mobility patterns in Germany changed significantly due to both autonomous and policy-induced adaption, with potentially weaker effects over time due to decreasing risk signals, diminishing risk perceptions and an erosion of trust in the government. We find that while a number of simulation and prediction models have made great efforts to represent behavioral adaptation, the interplay of autonomous and policy-induced adaption needs to be better understood to construct convincing counterfactual scenarios for policy analysis. The insights presented here are of interest to modelers and policy makers aiming to understand and account for behaviors during a pandemic response more accurately.
Effect of senior executives’ overseas experience on corporate green innovation
Authors: Cheng Fangze , Kuang Xin
Published: May 2024

Against the background of increasingly severe environmental problems, green development has gained widespread attention, and green innovation has thus become crucial for enterprises. This study used 2007–2019 data from listed A-share companies in China to evaluate the effect of senior executives’ overseas experience on corporate green innovation. The results showed that senior executives’ overseas experience could promote green innovation in companies. This positive effect was more significant for private enterprises and high-tech enterprises, especially in eastern China. The CEO pay regulation have a significant negative moderating effect on this positive effect. This study enriches upper echelons theory and provides theoretical support for government agencies to accelerate innovative green development strategies. The results can also provide a decision-making basis for governments to formulate policies to promote enterprises’ green development.
Analyzing the nexus between Chinese industrial policy and cross-border M&As
Authors: Dong Zhiyong , Zhu Zhigan , Song Dawei , An Hongyu
Published: May 2024

In recent years, as China experiences economic expansion and its corporations become more global, it has notably become a central hub for cross-border mergers and acquisitions (M&A) on the world stage. The Chinese government, in tandem, leverages these international M&A operations to drive industrial transformation and progress in technology. This research investigates the role of China’s industrial policies in shaping cross-border M&A activities by examining recent instances. Findings indicate that relaxing financial barriers and applying specific industrial tactics bolster companies’ abilities to secure funding, consequently energizing cross-border M&A initiatives. Several firms in these international mergers and acquisitions are intricately connected to political strategies, markedly affecting the formulation of industrial policies. This assertion is corroborated through the analysis of relevant statistical evidence. The study methodically collects and scrutinizes data to quantitatively depict the current landscape and influencing elements of cross-border M&A, thus providing concrete evidence for policy and business strategy formulation.
Quality of life and its associated factors in chronic kidney disease patients undergoing hemodialysis from a Peruvian city: A cross-sectional study
Authors: Machaca-Choque Dana , Palomino-Guerra Guimel , Flores-Cohaila Javier , Parihuana-Travezaño Edgar , Taype-Rondan Alvaro , Gomez-Colque Sujey , Copaja-Corzo Cesar
Published: May 2024

Objective

To assess quality of life and explore its associated factors in a group of patients with chronic kidney disease (CKD) undergoing hemodialysis in Peru.

Methodology

We conducted a cross-sectional analysis of patients with CKD treated at two medical centers in Tacna, Peru; between July and September 2023. We conducted a survey via telephone interviews with eligible patients using the Short Form 36 (SF 36) to assess their quality of life.

Results

Of 257 patients with CKD undergoing hemodialysis, we successfully interviewed 207 (59.9% males, median age: 62 years, median time on hemodialysis: 3.5 years). In the context of the SF-36 assessment, the dimensions with the lowest scores were physical role (mean: 13.9), emotional role (32.2), and physical function (32.4). Regarding the SF-36 summary scores, the average scores were 42.2 in the mental health domain and 32.0 in the physical health domain. In the adjusted model, the physical health domain score was higher in males (β = 2.7) and those with economic self-sufficiency (β = 3.0) and lower in older adults (β = -2.5). The score in the mental health domain was higher in those with a higher level of education (β = 4.1), in those with economic self-sufficiency (β = 3.8), and in those receiving care at one of the centers included (β: 4.2).

Conclusion

Quality of life was affected, particularly in the realms of physical and emotional well-being. Furthermore, both the physical and mental health domains tend to show lower scores among women, older individuals, those lacking economic self-sufficiency, individuals with lower educational levels, and those with comorbidities.
Investigating the nature of prokaryotic genomic island locations within a genome
Authors: Aldaihani Reem , Heath Lenwood S.
Published: May 2024

Horizontal gene transfer (HGT) is a powerful evolutionary force that considerably shapes the structure of prokaryotic genomes and is associated with genomic islands (GIs). A GI is a DNA segment composed of transferred genes that can be found within a prokaryotic genome, obtained through HGT. Much research has focused on detecting GIs in genomes, but here we pursue a new course, which is identifying possible preferred locations of GIs in the prokaryotic genome. Here, we identify the locations of the GIs within prokaryotic genomes to examine patterns in those locations. Prokaryotic GIs were analyzed according to the genome structure that they are located in, whether it be a circular or a linear genome. The analytical investigations employed are: (1) studying the GI locations in relation to the origin of replication (oriC); (2) exploring the distances between GIs; and (3) determining the distribution of GIs across the genomes. For each of the investigations, the analysis was performed on all of the GIs in the data set. Moreover, to void bias caused by the distribution of the genomes represented, the GIs in one genome from each species and the GIs of the most frequent species are also analyzed. Overall, the results showed that there are preferred sites for the GIs in the genome. In the linear genomes, these sites are usually located in the oriC region and terminus region, while in the circular genomes, they are located solely in the terminus region. These results also showed that the distance distribution between the GIs is almost exponential, which proves that GIs have preferred sites within genomes. The oriC and termniuns are preferred sites for the GIs and a possible natural explanation for this could be connected to the content of the oriC region. Moreover, the content of the GIs in terms of its protein families was studied and the results demonstrated that the majority of frequent protein families are close to identical in each section.
Serum klotho associated with thyroid hormone in adults: A population-based cross-sectional research
Authors: Zhang Xia , Liu Xuekui , Li Lin , Zhang Yan , Li Qing , Geng Houfa , Shi Li , Wang Ben , Qiu Qinqin , Yu Tianpei , Sang Yiquan , Wang Liying , Xu Wei , Liang Jun
Published: May 2024

Background and study aim

The klotho protein, a multifunctional protein, has been shown to be associated with a wide range of endocrine diseases and has been linked to thyroid tumourigenesis. However, the relationship between serum klotho levels and thyroid hormones remains poorly understood. This study aimed to explore the correlation between serum klotho levels and thyroid hormones.

Methods

Data was obtained from the NHANES cycles 2007–2008, 2009–2010, and 2011–2012. A total of 4674 participants were recruited for this study. Statistical analysis was using multiple linear regression analyses, and restricted cubic spline plots (RCS) to investigate the association between serum klotho levels and serum levels of thyroid hormones.

Results

In the unadjusted covariate model, ln(klotho) significantly positively correlated with tT3, tT4, fT3, tT4/fT4, and tT3/fT3 (all P<0.01) and negatively correlated with TSH, tT4/tT3, and fT4/fT3 (all P<0.05). Furthermore, tT3, tT4, fT3and tT3/fT3 (P < 0.05) were still significant in the adjusted model. And it is worth noting that there is an approximately L-shaped nonlinear relationship between ln(klotho) and fT3,tT3 with a cut-off point of 6.697 (P-non-linear < 0.05). The stratification analysis showed gender and iodine level differences in the relationship between serum Klotho levels and thyroid hormones.

Conclusion

There is an L-shaped nonlinear relationship between ln(klotho) and fT3, tT3, suggesting that klotho could be involved in the physiological regulation of thyroid function.
Explaining why increases in generic use outpace decreases in brand name medicine use in multisource markets and the role of regulation
Authors: Blankart Katharina E. , Vandoros Sotiris
Published: May 2024

Background

Healthcare systems worldwide face escalating pharmaceutical expenditures despite interventions targeting pricing and generic substitution. Existing studies often overlook unwarranted volume increases in multisource markets due to differential physician perceptions of brand name and generics.

Objective

This study aims to explain the outpacing of generic medicine use over brand name use in multisource markets and assess the regulatory role, specifically examining the impact of reference pricing on volume and intensity increases.

Methods

Analyzing German multisource prescription medicine markets from 2011 to 2014, we evaluate regulatory mechanisms and explore whether brand name and generic medicines constitute separate market segments. Using an Oaxaca-Blinder decomposition approach, we divide the differential in brand name versus generic medicine use rates into market structure and unobserved segment effects.

Results

Generic use rates surpass same-market brand name substitution by 3.87 prescriptions per physician and medicine, on average. Reference pricing mitigated volume increase, treatment intensity and expenditure. Disparities in quantity and expenditure dynamics between brand name and generic segments are partially explained by market structure and segment effects.

Conclusion

Generic medicine use effectively reduces expenditures but contributes to increased net prescription rates. Reference pricing may control medicine use, but divergent physician perceptions of brand name and generics, revealed by identified segment effects, call for nuanced policy interventions.
A unified classification system for HIV-1 5’ long terminal repeats
Authors: Guo Xing , Yu Dan , Liu Mengying , Li Hanping , Chen Mingyue , Wang Xinyu , Zhai Xiuli , Zhang Bohan , Wang Yanglan , Yang Caiqing , Wang Chunlei , Liu Yongjian , Han Jingwan , Wang Xiaolin , Li Jingyun , Jia Lei , Li Lin
Published: May 2024

The HIV-1 provirus mainly consists of internal coding region flanked by 1 long terminal repeats (LTRs) at each terminus. The LTRs play important roles in HIV-1 reverse transcription, integration, and transcription. However, despite of the significant study advances of the internal coding regions of HIV-1 by using definite reference classification, there are no systematic and phylogenetic classifications for HIV-1 5’ LTRs, which hinders our elaboration on 5’ LTR and a better understanding of the viral origin, spread and therapy. Here, by analyzing all available resources of 5’ LTR sequences in public databases following 4 recognized principles for the reference classification, 83 representatives and 14 consensus sequences were identified as representatives of 2 groups, 6 subtypes, 6 sub-subtypes, and 9 CRFs. To test the reliability of the supplemented classification system, the constructed references were applied to identify the 5’ LTR assignment of the 22 clinical isolates in China. The results revealed that 16 out of 22 tested strains showed a consistent subtype classification with the previous LTR-independent classification system. However, 6 strains, for which recombination events within 5’ LTR were demonstrated, unexpectedly showed a different subtype classification, leading a significant change of binding sites for important transcription factors including SP1, p53, and NF-κB. The binding change of these transcriptional factors would probably affect the transcriptional activity of 5’ LTR. This study supplemented a unified classification system for HIV-1 5’ LTRs, which will facilitate HIV-1 characterization and be helpful for both basic and clinical research fields.
Clear aligner’s adverse effects: A systematic review protocol
Authors: Ronchi Lemos Cintia , Ventura Fadel Marianella Aguilar , Polmann Helena , Meller Dias de Oliveira Júlia , Pauletto Patrícia , Miron Stefani Cristine , Flores-Mir Carlos , De Luca Canto Graziela
Published: May 2024

With the growing popularity of clear aligners, more patients have chosen to use them instead of traditional orthodontic braces to correct their malocclusions. Clear aligners offer distinct advantages over conventional fixed braces, such as limited aesthetic impact, the convenience of easily removing them for meals, improved accessibility for brushing and flossing, and a treatment approach that avoids the use of metal, minimizing potential irritation to the cheeks and gums. Manufacturers point out a disadvantage that can be administered in this type of treatment. Still, to our knowledge, a comprehensive review of the published literature assessing the adverse/negative effects of clear aligners has not yet been conducted. A systematic review, with or without meta-analysis, will be performed. The inclusion criteria will be studies involving individuals using clear aligners and reporting potential adverse/negative effects during or after treatment. No restrictions about time or language will be applied. The studies screening will be conducted in two stages. Two independent reviewers will initially evaluate the title and abstract under the eligibility criteria. Subsequently, the same two reviewers will examine the articles’ full text in-depth. The results will be synthesized in the form of a narrative description and incorporate a meta-analysis if justified. Furthermore, we will present details regarding the sample characteristics, intervention, study objectives, methodologies employed, and primary findings. This study aims to investigate the potential adverse effects and their frequency among orthodontic patients wearing clear aligners. Moreover, the outcomes of this review have the potential to illuminate specific inherent limitations of aligner therapy as a comprehensive orthodontic approach.