bluuebunny/crossref_metadata_2025 huggingface dataset:
Influence of geometric parameters of crankshaft-planetary reducer on cyclograph of work of contact pairs
Authors: Niekhoroshykh M.V. , Yanchevskyi Ihor
Published: October 2022

Background. Crank-planetary reducers (CPR) have a number of advantages: compactness, high load capacity, high structural rigidity, to name a few. At the same time, there is no regulated methodology for their kinematic and force calculation, which limits theirdevelopment and mass production. The creation of effective methods for calculating these reducers to improve their performance at the design stage is of great practical importance.Objective. The aim of this work is to develop an analytical method for calculating the angle of pressure and the contact force in contact pairs “satellite hole – pin of output link” of the CPR depending on the angle between the cranks of its crankshaft (V-shaped),number of satellites and number of pins. Based on the developed method, check the possibility of designing a CPR with arbitrary values of these parameters and investigate their impact on the cyclogram of contact pairs and the associated maximum value of contact force, taking into account the nonlinearity of materials’ deformation.Methods. At the first stage, based on the formulas of analytical geometry, the possibility of theoretical implementation of CPR with an arbitrary value of the angle between the crankshaft cranks, the number of satellites and the number of pins of the output link is shown.The values of pressure angles in the contact pairs “satellite hole – pin of output link” are analysed and on the basis of the received results the cyclogram of work of leading pairs is calculated. In the second stage, using the principle of possible displacements, the formula for calculating the contact force in the leading contact pairs is written as a function of the input shaft rotation angle. When calculating thecontact force, a nonlinear model of material deformation was used.Results. An analytical method for constructing a cyclogram of the contact pairs of a CPR and the contact forces calculation was developed depending on the geometric parameters of the reducer. The possibility of theoretical implementation of reducers with arbitrary value of the angle between the crankshaft cranks, the number of satellites and the number of output link’s pins is shown Conclusions. The dependence of the contact force is obtained as a rotation angle function, the number of satellites and the numberof source pins. With a constant number of simultaneously active leading contact pairs and, accordingly, a uniform load transfer between them, the law of change in the contact force per cycle is similar to parabolic. Otherwise, the change in the contact force per cycle is quite complex. The obtained results can be used in the refined calculation of the efficiency of the CPR and in making various design decisions at the design stage
What Motivates Companies to Take the Decision to Decarbonise?
Authors: Buettner Stefan M. , König Werner , Vierhub-Lorenz Frederick , Gilles Marina
Published: October 2022

Already more than 140 countries consider or have pledged to reach net-zero emission targets by 2050 or earlier and the share of global emissions falling into an emission pricing scheme has steeply increased over the past three years. Even where there are no direct implications for industry (yet), there is a series of subtle pressure points driving an increasing number of companies across the globe to work towards climate neutrality and pledging ambitious emission reduction goals. This article sheds light on the pressure points, the subtle triggers, the underlying considerations as well as the hoped-for benefits for industrial companies from achieving net-zero emissions. The observations and ideas presented in this paper are derived from quantitative data obtained via the Energy Efficiency Index of German Industry (EEI) and qualitative data. Not only societal, work force, supply chain and investor expectations play a large role, but also many strategic considerations which have the potential to make the company more resilient and profitable, particularly in time of crisis. Those companies that do not move towards decarbonisation, on the other hand, may face a costly late-mover disadvantage. This piece uncovers subtle interconnections, helping stakeholders from industry and beyond to grasp opportunities and challenges ahead.
Splash Page with Music
Authors: Boer Sam
Published: October 2022

Music: "Aether" (excerpt) by The Necks. Used by permission.
Cover art by Henrik Donnestad, courtesy of Unsplash.
How do grain coats prevent formation of quartz overgrowths?
Authors: Walderhaug Olav , Porten Kristin W.
Published: October 2022

Examination of grain coats of chlorite, illite, detrital clay, microquartz, and siderite in deeply buried sandstones from the Norwegian continental shelf by scanning electron microscopy shows that the quartz surfaces beneath the grain coats are covered by tiny quartz outgrowths bounded by planar crystal faces. These very small euhedral quartz outgrowths also occur in gaps in the coats where there is no physical barrier to impede their continued growth into adjacent macropores, but such outward growth and expansion into the intergranular pore space was observed only where the gaps in the coats are larger than around 5 μm. We suggest that the inability of euhedral quartz outgrowths smaller than a certain size to grow through grain coats and form large pore-filling quartz overgrowths is a consequence of the increased solubility of micron-sized crystals compared to larger crystals. Due to surface energy effects, the smallest crystals of a mineral are unable to grow at conditions that do not prevent growth of larger crystals of the same mineral. This is a general thermodynamic effect that becomes important for tiny crystals with a large surface-to-volume ratio and is expressed quantitatively by the Ostwald-Freundlich equation. The reason microscopic outgrowths can develop on the quartz grain surfaces in the first place is probably that the initial pre-euhedral growth stages are able to grow at slightly lower silica supersaturations than euhedral outgrowths. Continued growth at the low supersaturations prevalent in most sandstones may consequently depend upon the outgrowths reaching a euhedral shape after they are larger than a critical size. Outgrowths nucleated in gaps in the grain coats smaller than around 5 μm develop planar crystal faces before they have attained the critical size because there is not enough space for larger euhedral outgrowths to form in these smaller gaps. The outgrowths nucleated in the smallest openings are therefore unable to grow through the grain coats and reach the adjacent pore space despite free access to the adjacent macropores. Grain coats can therefore prevent quartz cementation without being continuous at the microscopic scale.
Quantifying Grid Resilience Against Extreme Weather Using Large-Scale Customer Power Outage Data
Authors: Zhu Shixiang , Yao Rui , Xie Yao , Qiu Feng , Qiu Yueming (Lucy) , Wu Xuan
Published: October 2022

In recent decades, the weather around the world has become more irregular and extreme, often causing large-scale extended power outages. Resilience - the capability of withstanding, adapting to, and recovering from a large-scale disruption - has become a top priority for the power sector. However, the understanding of power grid resilience still stays on the conceptual level mostly or focuses on particular components, yielding no actionable results or revealing few insights on the system level. This study provides a quantitatively measurable definition of power grid resilience, using a statistical model inspired by patterns observed from data and domain knowledge. We analyze a large-scale quarter-hourly historical electricity customer outage data and the corresponding weather records, and draw connections between the model and industry resilience practice. We showcase the resilience analysis using three major service territories on the east coast of the United States. Our analysis suggests that cumulative weather effects play a key role in causing immediate, sustained outages, and these outages can propagate and cause secondary outages in neighboring areas. The proposed model also provides some interesting insights into grid resilience enhancement planning. For example, our simulation results indicate that enhancing the power infrastructure in a small number of critical locations can reduce nearly half of the number of customer power outages in Massachusetts. In addition, we have shown that our model achieves promising accuracy in predicting the progress of customer power outages throughout extreme weather events, which can be very valuable for system operators and federal agencies to prepare disaster response.
A Feasibility (pilot) Mixed Methods Study of an Innovative Non-Pharmacological Breath-Based Yoga and Social Emotional Intervention Program in an At-Risk Youth Sample in London, Canada
Authors: vasudev akshya , Ionson Emily , Sathiaselan Janani , Thatipalli Anurag , Chauhan Aman , Watt Christine , Sukhera Javeed , Speechley Mark , Forchuk Cheryl
Published: October 2022

Background: Various service provision models for youth at risk of homelessness have been researched and implemented, including access to housing, physical and mental health resources, etc. However, even with these interventions we remain unaware regarding how best to manage symptoms of depression and anxiety and the rate of drug use in these populations primarily because of lack of feasibility data.
Methods: This paper presents the results of a mixed-methods study in London, Canada, that examined the feasibility of implementing a biopsychosocial intervention, SKY Schools, in at-risk youth aged between 16-25 (n=49). The study also recorded qualitative responses about the program’s usefulness from the perspective of the service users. The SKY Schools intervention consisted of social-emotional learning combined with Sudarshan Kriya Yoga, a standardized yoga-based breathing exercise routine. The intervention program was divided into two phases; an active learning phase and a reinforcement phase.
Results: The results demonstrated that it is feasible to conduct a definitive trial in this population due to a high retention rate (61.2%) and overall positive feedback.
Conclusions: Future researchers may consider the feedback received when designing a randomized control trial to further assess efficacy and tolerability.
Trial Registration: Trial registration: Clinicaltrials.gov, Identifier NCT02749240. Registered April 22, 2016, https://clinicaltrials.gov/ct2/show/NCT02749240
Remote Detection of a Lunar Granitic Batholith at Compton-Belkovich
Authors: Siegler Matthew , Fang Jianqing , Lehman-Franco Katelyn , Andrews-Hanna Jeffrey , Economos Rita , Clair Michael St. , Million Chase , III James Head , Glotch Timothy , White Mackenzie
Published: October 2022

Granites are nearly absent in the Solar System outside of Earth. Achieving granitic compositions in magmatic systems requires multi-stage melting and fractionation, which also increase radiogenic element concentrations. Water and plate tectonics facilitate these processes on Earth, aiding in remelting. Although these drivers are absent on the Moon, small granite samples have been found, but details of their origin and the scale of systems they represent are unknown. We report microwave-wavelength measurements of an anomalously hot geothermal source that is best explained by the presence of a ~50 km diameter granitic system below the thorium-rich, farside feature known as Compton-Belkovich. Passive microwave radiometry is sensitive to the integrated thermal gradient to several wavelengths depth. The 3-37 GHz antenna temperatures of the Chang’E 1 and 2 microwave instruments allow us to measure peak heat flux of ~184 mWm^-2; ~20 times higher than the average lunar highlands. The surprising magnitude and geographic extent of this feature imply an Earth-like, evolved granitic system larger than believed possible on the Moon, especially outside of the Procellarum region. Furthermore, these methods are generalizable: similar uses of passive radiometric data could vastly expand our knowledge of geothermal processes on the Moon and other planetary bodies.
Histological, Haematological, and thyroid hormones toxicity of oral exposure to CuO/ZnO core/shell nanoparticles in female rats
Authors: Mohammed Raghad S. , Aadim Kadhim A. , Ahmed Khalid A.
Published: October 2022

Advancements in nanomedicine helped scientists design a new class of nanoparticles known as hybrid nanoparticles (core/shell) for diagnostic and therapeutic purposes. An essential requirement for the successful use of nanoparticles in biomedical applications is their low toxicity. Therefore, toxicological profiling is necessary to understand the mechanism of nanoparticles. The current study aimed to assess the toxicological potential of CuO/ZnO core/shell nanoparticles with a size of 30 nm in Albino female rats. In vivo toxicity was evaluated by oral administration of 0, 5, 10, 20, and 40 (mg/L) of CuO/ZnO core/shell nanoparticles to a female rate for 30 consecutive days. The toxicological evaluation revealed significant (p < 0.01) alteration in white blood cells (WBC) at a 5 (mg/L) dose. Also, increase in red blood cells (RBC) at 5, 10 (mg/L) doses, while hemoglobin (Hb) levels and hematocrit (HCT) increased at all doses. This maybe indicates that the CuO/ZnO core/shell nanoparticles stimulated the rate of blood corpuscle generation. The anaemia diagnostic indices (mean corpuscular volume MCV and mean corpuscular haemoglobin MCH) remained unchanged throughout the experiment for all the doses tested 5, 10, 20, and 40 (mg/L). Significant (p < 0.01) growth retardation in all groups treated due to rats' infection by Hyperthyroidism induced by thyroxine (T4) level increase. The histological examination indicates that the low concentrations of CuO/ZnO core/shell nanoparticles are safe for desired biomedical applications.
Association of multi-heavy metals exposure and lung function in a typical rural cohort of Northwest China
Authors: Zheng Ling , Yu Yunhui , Tian Xiaoyu , He Li , Shan Xiaobing , Niu Jingping , Yan Jun , Luo Bin
Published: October 2022

Background
Heavy metal exposure is associated with decreased lung function, but the relationship between metals co-exposure and lung function in rural areas of northwest China remains unclear. Therefore, the purpose of this study is to explore the effects of single or co-exposure of heavy metals on lung function in a rural cohort of northwest China.
Methods
All participants were recruited from the Dongdagou-Xinglong (DDG-XL) rural cohort of Gansu province. Urine levels of 10 common heavy metals were detected, including cobalt (Co), nickel (Ni), molybdenum (Mo), cadmium (Cd), stibium (Sb), copper (Cu), zinc (Zn), mercury (Hg), lead (Pb) and manganese (Mn). The lung function was detected by measuring percentages of predicted forced vital capacity (FVC%) and forced expiratory volume in one second (FEV1%) as well as the ratio of FEV1/FVC. We also analyzed the association between heavy metals and pulmonary ventilation dysfunction (PVD). Restricted cubic spline, logistic regression, linear regression and bayesian kernel machine regression (BKMR) were used to analyze the relationship between heavy metals exposure and lung function.
Results
Finally, a total of 382 participants were included in this study with the average age of 56.69 ± 7.32 years, 82.46% of them used solid fuels for heating and cooking. Logistic regression analysis showed that higher concentration of Hg, Mn, Sb and lower Mo may be risk factors for PVD. And linear regression showed that FEV1% and FVC% were negatively correlated with Sb, Hg, Mn, but positively correlated with Mo. Through BKMR model, we found the lung function decreased with the increase of heavy metals concentration. In addition, Hg and Mn made an enormous contribution to the decline of lung function. Simultaneously, subgroup analyses showed that the males, the people with BMI ≥ 24kg/m2 and used solid fuels showed a higher risk of PVD when exposed to Co, Zn and Hg.
Conclusions
This study found that heavy metals exposure were associated with impairment of lung function regardless of single exposure or co-exposure, particularly for Hg and Mn.
Identifying Clinical Features, Frailty and Treatment Responses of Late-onset Axial Spondiloarthritis
Authors: Bayrak esra dilsat
Published: October 2022

Background: Axial Spondyloarthritis (axSpA) is a chronic inflammatory disease of sacroiliac joints and spine and affects patients in second and third decades of life. However, the incidence of this group of diseases has increased in advanced age.
Objectives: The aim of this study is to broaden the current knowledge about late onset axSpA and compare clinical features with early-onset patients.
Methods: A total of 123 axSpA patients (42 late-onset axSpA, 81 early-onset axSpA) recruited in the study. Patients with symptoms began after 50 years or older were classified as late-onset axSpA. Patients baseline clinical and radiological findings, HLA B27 status, CRP results were recorded. Disease activity was measured by BASDAI index. To assess frailty in late-onset patients, CSF scale was used. Late-onset axSpA patients were reevaluated for frailty after 6 months of treatment.
Results: Female gender was predominant in late-onset axSpA (n:35/42). 57,1%patients were nr-axSpA. Late-onset patients had higher frequency of female gender (p:0,000), peripheral arthritis (p:0,000) and cervical vertebrae involvement (p: 0,002 ) compared with early-onset axSpA patients. NSAIDs response was similar (p:0,572). Median CSF score is 5 at presentation and 3 at month 6 in late-onset axSpA. Patients who received anti-TNF therapy had higher improvement in CSF scores (p:0.003).
Conclusion: AxSpA is very common in general population and has an increasing incidence among elderly patients. Delay in the diagnosis and treatment of late-onset patients leads to serious deterioration in daily life activities. Late-onset patients should be included in clinical trials and epidemiological studies.
Traditional Chinese medicine inpatient lung cancer treatment costs in China: a nationwide study
Authors: Nie hanlin , Han Zhaoran , Nicholas Stephen , Maitland Elizabeth , Huang Zhengwei , Chen Sisi , Tuo Zegui , Ma Yong , Shi Xuefeng
Published: October 2022

Background. Traditional Chinese Medicine (TCM) has long been a widely recognized medical approach and has been covered by China’s basic medical insurance schemes to treat lung cancer. But there was a lack of nationwide research to illustrate the impact of the use of TCM on lung cancer patients’ economic burden in mainland China. Therefore, we conduct a nationwide study to reveal whether the use of TCM could increase or decrease the medical expenditure of lung cancer inpatients in mainland China. Methods This is a 7-year cross-sectional study from 2010 to 2016. The data is a random sample of 5% from lung cancer claims data records of Chinese Urban Employee Basic Medical Insurance (UEBMI) and Urban Resident Basic Medical Insurance (URBMI). Mann-Whitney test was used to compare inpatient cost data with positive skewness. Ordinary least squares regression analysis was performed to compare the total TCM users’ hospitalization cost with TCM nonusers’, to examine whether TCM use is the key factor inducing relatively high medical expenditure. Result. A total of 47,393 lung cancer inpatients were included in this study, with 38,697 (81.7%) of them at least using one kind of TCM approach. The per inpatient medical cost of TCM users was RMB18,798 (USD2,830), which was 65.2% significantly higher than that of TCM nonusers (P < 0.001). The medication cost, conventional medication cost, and nonpharmacy cost of TCM users were all higher than TCM nonusers, illustrating the higher medical cost of TCM users was not induced by TCM only. With confounding factors fixed, there was a positive correlation between TCM cost and conventional medication cost, nonpharmacy cost (Coef. = 0.283 and 0.211, all P < 0.001), indicting synchronous increase of TCM costs and conventional medication cost for TCM users. Conclusion. The use of TCM could not offset the utilization of conventional medicine, demonstrating TCM mainly played a complementary role but not an alternative role in the inpatient treatment of lung cancer, a joint Clinical Guideline that could balance the use of TCM and Conventional medicine should be developed for the purpose of reducing economic burden for lung cancer inpatients.
Awareness and Care for my Autistic Traits (ACAT) program for adolescents with autism spectrum disorders: a multicenter randomized controlled trial
Authors: Oshima Fumiyo , Mandy William , Seto Mikuko , Hongo Minako , Tsuchiyagaito Aki , Hirano Yoshiyuki , Sutoh Chihiro , Guan Siqing , Nitta Yusuke , Ozawa Yoshihito , Kawasaki Yohei , Ohtani Toshiyuki , Masuya Jiro , Takahashi Noriko , Sato Noriyuki , Nakamura Shizuka , Nakagawa Akiko , Shimizu Eiji
Published: October 2022

Background: This study examined whether a combination of the Awareness and Care for my Autistic Traits (ACAT) program and treatment-as-usual (TAU) is more effective than only TAU in increasing the understanding of autistic attributes, reducing treatment stigma, and improving mental health and social adaptation among adolescents with autism spectrum disorder (ASD) and their parents/guardians.
Methods: Forty-nine adolescents and their parents/guardians were randomly assigned to either a combination of ACAT and TAU (COMB) group or only TAU group. The COMB group received six weekly 100-min ACAT sessions while the TAU group received no additional intervention. The primary outcome was the change in the understanding of autistic attributes (Autism Knowledge Quiz-Child: AKQ-C), administered to autistic adolescents from pre-to post-intervention. The secondary outcomes included the change in AKQ-parent version (AKQ-P) administered to their parents/guardians, treatment stigma, improving mental health, and social adaptation among autistic adolescents and their parents/guardians. All measures except for the self-rating scales were scored by asessors blind to the group assignment.
Results: The individuals (both autistic adolescents and their parents/guardians) in the COMB group, showed an increased score of the AKQ-C and AKQ-P than did those in the TAU group. Autistic adolescents in the COMB group also demonstrated reduced treatment-related stigma and behavioral problems than those in the TAU group, while there were no group differences in the change in social adaptation. For parents/guardians, there were no group differences in the change in treatment-related stigma, mental health, adaptive skills, or attitudes toward their children.
Conclusions: The results suggest that the ACAT could be an effective treatment modality for both autistic adolescents and their parents/guardians to increase the understanding of autistic attributes. The ACAT may positively affect self-understanding, reduce treatment stigma, and stabilize behavioral issues for autistic adolescents, but it may not effectively reduce treatment barriers or improve mental health for parents/guardians. Further research should consider whether additional support for parents/guardians could be beneficial.
Trial registration: Registration number - UMIN000029851 and date of registration - 06/01/2018.
Conceptual Design of the Optical System of the 6.5m Wide Field MUltiplexed Survey Telescope with Excellent Image Quality
Authors: Zhang Yifan , Jiang Haijiao , Shectman Stephen , Yang Dehua , Cai Zheng , Shi Yong , Huang Song , Lu Lu , Zheng Yamin , Kang Shaonan , Mao Shude , Huang Lei
Published: October 2022

Astrophysics and cosmology in the coming decades urgently need a large field-of-view (FOV), highly multiplexed spectroscopic survey telescope satisfying challenging image quality and stability requirements. The 6.5m MUltiplexed Survey Telescope (MUST) proposed by Tsinghua University will be constructed on the Saishiteng Mountain of Northwest China to improve the spectroscopic survey capability of ground-based optical telescopes. In this paper, we demonstrate the conceptual design of the optical system of MUST. MUST will adopt a 6.5m primary mirror, a 2.45m secondary mirror, and a multiple-element widefield corrector (WFC) to ensure excellent image quality with an 80% encircled energy size of image spots less than ~ 0.6 arcsec in diameter for the entire 3° FOV and the whole 50° zenith angle range. Thanks to its compact 6.5m Ritchey-Chretien system and 20000 optical fibers on its Cassegrain focus, MUST will carry out state-of-the-art wide-field spectroscopic surveys with efficiency ~ 19 times higher than the Dark Energy Spectroscopic Instrument (DESI) using a measure proposed by Ellis et al. Upon completion around 2029, MUST will be one of the world's largest and most advanced wide-field spectroscopic survey telescopes and a new essential reference for the future development of wide-field survey telescopes. It will enable significant advances in many fields in astrophysics and cosmology.
Cross-tissue correlations of genome-wide DNA methylation in Japanese live human brain and their blood, saliva, and buccal epithelial tissues
Authors: Nishitani Shota , Isozaki Makoto , Yao Akiko , Higashino Yoshifumi , Yamauchi Takahiro , Kidoguchi Masamune , Kawajiri Satoshi , Tsunetoshi Kenzo , Neishi Hiroyuki , Imoto Hirochika , Arishima Hidetaka , Kodera Toshiaki , Fujisawa Takashi , Nomura Sadahiro , Kikuta Ken-ichiro , Shinozaki Gen , Tomoda Akemi
Published: October 2022

Neuroepigenetics considers genetic sequences and the interplay with environmental influences to elucidate vulnerability risk for various neurological and psychiatric disorders. However, evaluating DNA methylation of brain tissue is challenging owing to the issue of tissue specificity. Consequently, peripheral surrogate tissues were used, resulting in limited progress compared with other epigenetic studies, such as cancer research. Therefore, we developed databases to establish correlations between the brain and peripheral tissues in the same individuals. Four tissues, resected brain tissue, blood, saliva, and buccal mucosa (buccal), were collected from 19 patients (aged 13–73 years) who underwent neurosurgery. Moreover, their genome-wide DNA methylation was assessed using the Infinium HumanMethylationEPIC BeadChip arrays to determine the cross-tissue correlation of each combination. These correlation analyses were conducted with all methylation sites and with variable CpGs, and with when these were adjusted for cellular proportions. For the averaged data for each CpG across individuals, the saliva–brain correlation (r = 0.90) was higher than that for blood–brain (r = 0.87) and buccal–brain (r = 0.88) comparisons. Among individual CpGs, blood had the highest proportion of CpGs correlated to the brain at nominally significant levels (19.0%), followed by saliva (14.4%) and buccal (9.8%). These results were similar to the previous IMAGE-CpG results; however, the correlation analysis between the correlation coefficients of the datasets revealed a relatively low degree of correlation (brain vs. blood: r = 0.27, saliva; r = 0.18, and buccal; r = 0.24). To the best of our knowledge, this is the fourth study in the literature initiating the development of databases for correlations between the brain and peripheral tissues in the same individuals. We present the first database developed from an Asian population, specifically Japanese samples (AMAZE-CpG), which would contribute to interpreting individual epigenetic study results from various Asian populations.
Diagnosis and Management of Keratoconus by Eye Care Practitioners in Kenya
Authors: Rashid Zahra , Moodley Vanessa , Mashige Khathutshelo Percy
Published: October 2022

Background: To explore current eye care practice in keratoconus diagnosis and management in Kenya.
Methods: An online questionnaire was distributed to ophthalmic clinical officers (OCO) and optometrists.
Results: A total of 203 responses were received from 52 OCOs and 151 optometrists with a response rate of 24.4% and 53.5% respectively. The majority reported having access to retinoscopes (88.5%; p=0.48) and slit lamps (76.7; p=0.14). Few practitioners did not have access to a corneal topographer (13.5%; p=0.08) and rigid contact lens (CL) fitting sets (OCOs 5.8%, optometrists 33.8%; p<0.01). One-third did not feel that retinoscopy (38.7%; p=0.21), slit lamp findings (30.3%; p=0.10) and corneal topography (36.6%; p= 0.39) are important investigations in keratoconus diagnosis. Corneal topography was not recommended in two-thirds of patients (59.0%; p=0.33) with vernal keratoconjunctivitis (VKC). The majority counselled against eye rubbing in mild (73.6%; p=0.90) VKC, 52.9% in moderate (p=0.40) and 43.6% in severe (p=0.24) cases. The majority prescribed spectacles in mild (90.2%; p=0.95), 29% (p=0.97) in moderate and 1.9% (p=0.05) in severe cases. When the binocular best corrected visual acuity (BCVA) with spectacles was ≤ 6/18, 76.9% of OCOs and 58.9% of optometrists referred for CLs (p=0.02). When binocular BCVA with CLs dropped to ≤6/18, 83.7% (p=0.18) referred to the ophthalmologist for surgical intervention. Few OCOs fitted rigid CLs (15.4% OCOs, 51.0% optometrists; p=0.01), majority referred to optometrists (82.7% OCOs, 43.7% optometrists; p<0.01). Progression was monitored in 70.1% (p=0.11) of mild, 50.9% (p=0.54) moderate and 25.3% (p=0.31) advanced cases. Few OCOs (15.4%) performed corneal cross-linking (CXL). Keratoconus patients were referred to an ophthalmologist when BCVA dropped (50.4%; p=0.35) and on signs of progression (59.8%; p=0.37). About one-quarter (26.1%; p=0.10) referred for CXL regardless of age and progression, two-thirds (68.5%; p=0.46) when keratoconus was progressing and a few (5.4%; p=0.13) did not know when to refer. Co-management with ophthalmologists was reported by 58.0% (p=0.06) of respondents.
Conclusion: The results of this study highlight the need to map services for keratoconus patients, review current curricula and continuous education priorities for mid-level ophthalmic workers, develop guidelines for the diagnosis and management of keratoconus and improve interdisciplinary collaboration.
CYP24A1 and SLC34A1 mutations in five cases with idiopathic infantile hypercalcemia
Authors: Wang Qiao , Chen Jia-jia , Wei Li-ya , Liu Min , Li Wen-jing , Su Chang , Gong Chunxiu
Published: October 2022

Backgrounds

Idiopathic infantile hypercalcemia (IIH) is a rare hereditary disorder caused by CYP24A1 and SLC34A1 gene mutations. In this study, the clinical manifestations and molecular aspects of five new Chinese patients were investigated.

Results

Four patients showed hypercalcemia, hypercalciuria, decreased PTH and bilateral medullary nephrocalcinosis in early infancy. Their clinical symptoms and biochemical abnormalities improved after intensive hydration, furosemide and oral phosphorus treatment, except one patient needed salmon calcitonin injection. All patients remained bilateral medullary nephrocalcinosis. One patient admitted at 11 years old presented arterial hypertension, hypercalciuria and nephrocalcinosis, but normal serum calcium. She had history of nausea, poor appetite and growing when infancy. Gene analysis showed two have compound heterozygous mutations of CYP24A1, one patient with monoallelic CYP24A1 variant, and two with monoallelic SLC34A1 variant. Four CYP24A1 variants (c.116G > C, c.287T > A, c.476G > A and c.1349T > C) and two SLC34A1 variants (c.1322A > G and c.1697_1698insT) were first reported.

Conclusions

CYP24A1 and SLC34A1 gene mutations are genetic cause of idiopathic infantile hypercalcemia. Monoallelic variant of CYP24A1 or SLC34A1 gene contributes to symptomatic hypercalcemia, hypercalciuria and nephrocalcinosis. Manifestations of IIH are varying with onset age. Hypercalcemia may not the necessarily after infancy and the patients with nephrolithiasis either in older children or adults may consider IIH.
Erectile dysfunction is an indication of impaired central hemodynamic in adults with type 1 diabetes without cardiovascular disease: a pilot study
Authors: Kulecki Michal , Naskret Dariusz , Kaminski Mikolaj , Kasprzak Dominika , Lachowski Pawel , Klause Daria , Kozlowska Maria , Flotynska Justyna , Uruska Aleksandra , Zozulinska-Ziolkiewicz Dorota
Published: October 2022

Arterial stiffness (AS) and non-dipping pattern are early predictors of cardiovascular diseases but are not used in clinical practice. We aimed to assess if the International Index of Erectile Function (IIEF-5) score could be a useful tool to predict AS and non-dipping pattern in subjects with type 1 diabetes (T1DM). The study group consisted of adults with T1DM. Aortic pulse wave velocity (PWV Ao), central systolic blood pressure, and pulse were measured with a brachial oscillometric device (Arteriograph 24). ED was assessed by the IIEF-5. A comparison between the groups with and without ED was performed. Of 34 investigated men with T1DM, 12 (35.3%) suffered from ED. The group with ED had higher mean 24h pulse (77.7 [73.7-86.5] vs 69.9 [64.0-76.8]/min; p=0.04, nighttime PWV Ao (8.1 [6.8-8.5] vs 6.8 [6.1-7.5]m/s; p=0.015) and prevalence of non-dipping SBP Ao pattern (11 [91.7] vs 12 [54.5]%; p=0.027) than individuals without ED. The presence of ED detected a central non-dipping pattern with a sensitivity of 47.8% and a specificity of 90.9%. ED is associated with a central non-dipping pattern, increased AS, and a mean 24h pulse among people with T1DM.
Clinicopathological features and significance of CD26 expression in papillary thyroid carcinoma
Authors: Li Lan , Ding Lu , Zhang Rui , Luo Jin , Fang Jingyi , Zhou Huanhuan , Zhu Zhengpeng
Published: October 2022

Purpose This study aimed to evaluate the potential significance of CD26 expression in papillary thyroid cancer (PTC) tissues and to investigate their relationship with classical clinicopathological characteristics and prognosis. Methods Immunohistochemistry (IHC) staining was used to explore the expression pattern of CD26 in PTC tissues and corresponding adjacent tissues in 86 patients. In addition, we searched GEPIA database to estimate the expression difference of CD26 mRNA in thyroid cancer and normal thyroid tissues, and download the expression bar graph of mRNA and Kaplan Meier curve of CD26 in PTC compared to normal thyroid tissues. Results We found that 89.53% (77/86) of PTC overexpressed CD26, on the contrary, we observed that CD26 was not expressed in normal thyroid tissues adjacent to the tumor. The expression of CD26 was strongly associated with lymph node metastasis (ꭓ2 = 7.59,P = 0.006), tumor size (ꭓ2 = 7.59,P = 0.006) and patients' age (ꭓ2 = 3.95,P = 0.047), but there had no association between CD26 expression and patients' gender, capsular invasion (P > 0.05). Moreover, CD26 mRNA level was extremely low in normal thyroid tissues and significantly increased in thyroid cancer tissues(P < 0.01). Survival analysis presented that the patients with higher CD26 mRNA expression owned lower disease-free survival (DFS) and higher recurrence risk (HR = 1.8,P = 0.048). Conclusion Our data demonstrated that CD26 might be promising biomarkers and therapeutic target for PTC.
The Effectiveness of Educational Intervention based on the Health Action Model (HAM) in Improving Breast Cancer Screening Behaviors
Authors: MAHBOOBIGHAZAANI FAHIMEH , KARIMI MASOUD , AZADBAKHT MOJTABA , GHAHREMANI LEILA
Published: October 2022

Introduction: Breast cancer is the most common cancer in women. Considering the lack of knowledge about the cause of breast cancer and since all women are susceptible to this disease, training screening behaviors for early diagnosis is essential to reduce the mortality from this disease. Therefore, the present study aimed to determine the effect of training based on the health action model in improving breast cancer screening behaviors in women aged 30 to 69 in Kashan City.Methods: The present study was semi-experimental and the research setting included comprehensive health service centers in Kashan. The statistical population was women aged 30 to 69. A total of 162 women in the same age group were selected to participate in the study by simple random sampling. They were divided into two intervention and control groups. Before the educational intervention, a questionnaire distributed between two groups. The educational package was designed and prepared after analyzing the initial data of the questionnaires. The educational intervention was performed in both virtual (Whatsapp platform) and attendance methods for the intervention group over two months. All participants completed informed consent forms before the study. The questionnaires were distributed and collected in three periods before, three, and six months after the educational intervention. The data was analyzed using SPSS 22 software.Findings: The mean scores of knowledge, perceived susceptibility, severity, barriers, benefits, self-efficacy, subjective norms, skills and behavioral intention related to monthly breast self-examination, clinical examination and mammography, significantly increased in the intervention group compared to the control group three and six months after the intervention. Furthermore, screening behaviors, including monthly breast self-examination, clinical examination and mammography, significantly increased in the intervention group compared to the control group 3 three and six months after the intervention (P<0.05).Conclusion: The research results proved the effectiveness of interventions based on the health action model in promoting breast cancer screening behaviors and the determinants of such behaviors.
Changes in activity of daily living performance and quality of life 3 months after hip fracture surgery may predict 1-year surgical outcomes in Taiwanese older adults: A prospective cohort study
Authors: Yang Tzu-I , Kuo Yi-Jie , Huang Shu-Wei , Chen Yu-Pin
Published: October 2022

Background Hip fracture is a major concern in older adults. It may result in the long-term loss of mobility and self-care ability in patients. Functional status decreases soon after hip fracture surgery but increases gradually thereafter. However, some patients may without strong physical resilience eventually exhibit functional dependence. In this study, we investigated whether short-term postoperative changes in activity of daily living (ADL) performance and quality of life (QoL) can predict the 1-year outcomes of hip fracture surgery in older Taiwanese adults. Methods This prospective cohort study included older adults (≥ 60 years) who underwent hip fracture surgery at a single tertiary medical center in Taiwan between November 2017 and March 2021. We collected baseline data, including the patients’ demographics, Charlson comorbidity index (CCI) scores, and responses to a questionnaire (Short Portable Mental State Questionnaire [SPMSQ]) for dementia screening. Moreover, their scores on the EuroQol-5D questionnaire (for evaluating QoL) and Barthel Index (for assessing ADL performance) were collected at baseline and 3 and 12 months after surgery. Changes in ADL performance and QoL 3 months after surgery were evaluated, and the associations of these parameters (and other potential factors) with 1-year surgical outcomes were investigated. Results We analyzed the data of 318 patients with hip fracture and complete follow-up data regarding ADL performance and QoL 3 and 12 months after surgery. After covariate adjustment, multivariate logistic regression revealed that changes in ADL performance and QoL 3 months after surgery were positively and significantly correlated with 1-year surgical outcomes (p < .001). Furthermore, baseline CCI and SPMSQ scores were independent predictive factors associated with 1-year ADL outcomes (p = .042 and < .001, respectively). Conclusions Short-term functional recovery may help predict long-term ADL and QoL outcomes in older adults. Thus, short-term rehabilitation programs are recommended, particularly within 3 postoperative months, to prevent long-term functional dependence. Our study may serve as a reference for future studies aimed at improving the ADL performance and QoL of older patients after hip fracture surgery.
Assessment of the concentration, enzymatic activity, and health risks of heavy metals in Tilapia and Pangasius raised for human consumption
Authors: Mazed Maria Al , Haque Md. Ayenuddin , Iqbal Md Mehedi , Rana Saifuddin , Ahammad Kabir , Quader Md Fahad Bin , Nahid Sk. Ahmad Al , Ahmed Sk Istiaque
Published: October 2022

Heavy metal contamination of fish is a global safety concern for the consumers. Atomic absorption spectrometry (AAS) was used to measure the concentration of three HMs (As, Pb, and Cr) in two commercially farmed fish species that are widely consumed:Oreochromis niloticus(tilapia) andPangasianodon hypophthalmus(pangasius). This investigation was done to determine whether there was any potential health risk. The concentration of the studied heavy metals was within standard acceptable limits. As, Cr, and Pb had respective mean concentrations of 0.037 ± 0.023 mg/kg, 0.005 ± 0.002 mg/kg and 0.029 ± 0.015 mg/kg in the case of tilapia; and 0.049 ± 0.017 mg/kg, 0.007 ± 0.005 mg/kg and 0.024 ± 0.009 mg/kg, respectively, in the case of pangasius. Hierarchical clustering revealed that As may come through seepage and groundwater, while Cr and Pb are the products of contaminated feeds. ALP and ATPase activity varied significantly amongst the fishes' various organs. However, multiple regression analysis revealed that the current concentration of HMs in tilapia and pangasius was insufficient to predict enzymatic activity except for ALP in pangasius gill. The results of calculations for estimated daily intake (EDI), target hazard quotient (THQ), hazard index (HI), and carcinogenic risk (CR) indices made it abundantly evident that eating the fish under study posed no significant harm to the consumers' health. In conclusion, the contamination level of farmed tilapia and pangasius sold in the study area was within the permissible limit, however regular monitoring is needed to assure safe production.
BMI trajectory in adulthood in relation to cause-specific mortality: a sample of 89,886 adults
Authors: Chiu Po-Wei , Yu Tsung , Kukreti Shikha , Strong Carol
Published: October 2022

The dynamic change of weight over time had been known as an important factor that impacts mortality risk. The aims of this study were to obtain the heterogeneity of the BMI trajectory throughout the adulthood by gender and age groups; examined the association of the trajectories of BMI and all-cause and cause-specific mortality. The data from the study were obtained from the large prospective cohort study in Taiwan between 1998 and 2019 which was linked to National Death Registry for death information. The participants were stratified into four groups by age and gender and self-reported demographic and measured BMI data were used. Group based trajectory analysis was used to identify distinct trajectories of changes in BMI. Cox proportional hazards model was used to assess the hazard ratio (HR) of all-cause and cause-specific mortality risk. Data were analyzed in April 2020. Complete dataset was obtained from 290279 participants. Four trajectory groups were identified by the pattern of BMI change over time. This study shows that different trajectories are associated with mortality. Finding suggests that mortality risk differs in each trajectory group and in each age and gender stratification. It appears that obesity is a protective factor in cancer-related mortality in female but not in male in group of old age while low-normal weight is a risk factor in respiratory-related mortality in all participants. Our findings can be used to define the appropriate BMI in each age and gender groups and thereby earlier health intervention actions can be taken to avoid mortality.
Clustering of health-related behavior patterns using latent class analysis: Results from a working population of 12,168 Japanese at risk for noncommunicable diseases
Authors: Miki Takahiro , Yamamoto Kojiro , Kanai Masashi , Takeyama Kento , Iwatake Maki , Hagiwara Yuta
Published: October 2022

Background:
Noncommunicable diseases (NCDs) have become a significant global problem. Since health behaviors are associated with NCDs, and it is more effective to characterize populations using a public health population approach and provide specific interventions according to those characteristics, it is useful to examine the formation of clusters of health behavior combinations. Therefore, this study is intended to conduct clustering analysis by health behavior of Japanese people in the working population who are at risk of NCDs, through the use of latent class analysis.
Methods:
Participants were individuals who had not previously been diagnosed with NCDs but were at risk for NCDs. Participants were assessed on the basis of several demographic data and several health behaviors. The clustering study used latent class analysis (LCA) based on health behavior characteristics for individuals at risk of NCDs among the Japanese working population. All statistical analyses were conducted using R (Version 4.0.4) and the “poLCA” package (Version 1.6.0).
Results:
This study’s participants was 12,168. Regarding LCA, the study compared models with one to six latent classes. The five classes were closest to the most appropriate model because of the Bayesian Information Criterion, Akaike Information Criterion, and G^2 values and the more distinguishable cluster characteristics. Cluster 1 was “having healthy lifestyles but disliking hospitals”; Cluster 2 was “women with healthy lifestyle behaviors”; Cluster 3 was “general population”; and Cluster 4 was “middle-aged group in need of lifestyle improvement.” Cluster 5 was “a group of treatment for lifestyle-related diseases.”
Conclusions:
This study reveals more discernible health behavior patterns in a sample of the Japanese population using large real-world data. This may suggest the effectiveness of each distinctive approach in considering a population approach to public health.
Assessing the Utility of Haematological and Non-invasive Fibrotic Indices for Chronic HBV infection Prognosis and Monitoring: A Pilot Study in a Ghanaian Population
Authors: Nyarko Eric NY , Obirikorang Christian , Owiredu W. K.B.A. , Adu Evans Asamoah , Acheampong Emmanuel
Published: October 2022

Objective: Haematological and liver fibrotic markers could be appreciably utilized for effective monitoring of Hepatitis B viral (HBV) infection, thereby increasing patient’s treatment outcome. The objective of this study was to assess the applicability of complete blood count (CBC) and non-invasive liver-fibrotic indices as markers of prognostic outcome and monitoring in HBV infection.
Results: Significant differences in levels of white cell and differentials counts, red blood cell count, hemoglobin indices, and platelet indices were observed between HBV-infected patients (cases) and uninfected persons (controls). Levels of haemoglobin (Hb), total white blood cells (tWBC), neutrophils, monocytes, platelets, and Platelet Distribution width (PDW) were significantly lower (p<0.05) in the cases compared to the controls. Total and indirect bilirubin; De-Ritis ratio, Aspartate transaminase-to-platelet ratio index (APRI) and RDW-to-platelet ratio (RPR) were elevated in cases compared with controls (p-value < 0.05). In a multivariate adjusted model to test the significance of markers, Hemoglobin Index (beta coefficient = -0.876, p-value<0.001), NLR (beta coefficient = -0.839, p-value<0.001), MPV_10000 (beta coefficient = -0.333, p-value<0.001) and Albumin (beta coefficient =-0.059, p-value = 0.014), were associated with HBV infection status. Receiver operative characteristics curve analysis showed Hemoglobin Index (AUC= 0.744) and MPV_10000 (AUC = 0.730) as better prognostic markers for HBV-infection.