bluuebunny/crossref_metadata_2025 huggingface dataset:
Studies of the outer-off-midplane lower hybrid wave launch scenario for plasma start-up on the TST-2 spherical tokamak
Authors: Tsujii N. , Ejiri A. , Ko Y. , Peng Y. , Iwasaki K. , Lin Y. , Shinohara K. , Watanabe O. , Jang S. , Hidano T. , Shirasawa Y. , Tian Y. , Adachi F. , Moeller C.P.
Published: May 2024

Establishment of an efficient central solenoid (CS) free tokamak plasma start-up method may lead to an economical fusion reactor. CS-free start-up using lower hybrid (LH) waves has been studied on the TST-2 spherical tokamak. Plasma current of about a quarter of CS-driven discharges has been obtained fully non-inductively using the outer-midplane and top LH launchers. Recently, an outer-off-midplane LH launcher was developed to achieve higher plasma current by optimizing for core absorption and minimal fast electron losses. Using the (outer-)off-midplane launcher, fully non-inductive plasma current start-up up to about 8 kA was achieved. Coupled ray-tracing and Fokker–Planck simulation was performed on equilibria reconstructed with an extended MHD model. It was found that the experimentally observed plasma current was in reasonable agreement with the numerical simulation. The simulation predicted appreciable orbit losses for the off-midplane launcher driven discharge at the present parameters, which was consistent with the experimentally observed x-ray radiation characteristics. The simulation showed that the current density was saturated for the present off-midplane launcher discharges and higher density and higher LH power was necessary to achieve higher plasma current.
Creating negative ion beams from neutral gases using a negative hydrogen ion source
Authors: Paul A. , Melanson S. , Junginger T. , Dehnel M.
Published: May 2024

A typical method to produce negative ion beams uses alkali vapour as a medium for a double charge exchange to convert incident positive (1+) beams to negative (1-) beams. Alkali vapours pose a problem in ion production as they are flammable, explosive and cause vacuum surface contamination. Thus, it is advantageous to use non-metallic vapours for charge exchange as it will prevent hazards and the contamination of vacuum surfaces and targets in which the negative ion beams are incident upon. In this paper we will describe and demonstrate the process of creating negative ion beams by impinging a 15 keV to 30 keV beam from D-Pace's TRIUMF licenced H- volume-cusp ion source (1 mA to 15 mA) onto a volume of non-metallic neutral gas (X) resulting in a single or two-step charge exchange: H- + X → H + X- or H- + X → H + X + e → H + X-. The newly created X- ion beams will be accelerated by a (1 to 20) kV electrostatic accelerator and passed through a mass spectrometer system to separate the primary H- beam from the X- beam. The two gases studied are He and H2 and we will present the magnitude of the resultant beam currents after being separated from the incident H- beam by the mass spectrometer system.
A method of three-dimensional muon imaging using cosmic ray ground array
Authors: Song Sichen , Liu Jia , He Huihai
Published: May 2024

Cosmic ray muon imaging technology is an effective
non-destructive imaging technique. It is currently used to survey
the internal structure of large-scale objects such as active
volcanoes, pyramids, and some buildings. Additionally, it is used to
detect high-Z materials in scenarios such as border security,
nuclear reactor monitoring, and container inspection. All
applications of cosmic ray muons require a detector to reveal and
measure the flux or angular variations of muons. However, detectors
may have specific characteristics for each application depending on
the detection requirements.

Unlike single-point track detectors, we propose using ground array
detectors to investigate how ground array detection technology can
be used for 3D reconstruction of objects. We use ground array
detection technology for simulation studies and apply the Iterative
Correction Algorithm (ICA) to reconstruct two-dimensional
projections and obtain three-dimensional images of density
distribution. We have also addressed the convergence problem and
analyzed and optimized some parameters that may affect the detection
results. The advantages of using ground arrays include their ability
to simultaneously measure the transmittance flux data of muons in
different directions, achieve multi-angle detection, and have a
large field of view, enabling the collection of sufficient data for
more accurate detection results.

To verify the feasibility of our new method, we conducted a simple
experimental validation on a cylindrical cement building located in
the Large High Altitude Air Shower Observatory (LHAASO). By
comparing the experimental results with the cement building in the
array, we found that their shape structure and density information
are basically consistent, demonstrating the effectiveness of our
method.
Tackling the focal shift effect for metalenses
Authors: Ali Farhan , Yazdaanpanah Ramin , Aksu Serap
Published: May 2024

We present a theoretical analysis aimed at comprehending and mitigating the focal shift phenomenon in planar dielectric metalenses. To conduct this analysis, we introduce metalens designs consisting of silicon and germanium nanoblocks on a calcium fluoride substrate, operating in the mid-IR frequency range. The lensing performance of these metalenses is investigated using the finite-difference time-domain method, and they operate at wavelengths of 3 and 4 µm with a polarization conversion efficiency close to unity. Our findings indicate a strong correlation between the focal shift phenomena on dielectric metalenses and the numerical aperture (NA), revealing that increasing the Fresnel number is not always an effective approach to minimizing the focal shift. In contrast to previous studies, we define a critical NA, independent of the lens size, where the focal shift reaches a minimum, resulting in a symmetric focal intensity distribution and ultimately yielding a better-performing metalens. We demonstrate that for NAs greater than the determined critical value, a positive focal shift is observed on planar metalenses, diverging from the conventional negative shift predicted by existing models. Additionally, we show that by selecting a metalens within a specific NA range and with smaller diameters, high focusing efficiencies can be achieved. The focusing efficiency of the studied metalenses is measured as high as 70%, marking one of the best values reported for the IR range to date. These results serve as a guide for improving the agreement between experimental and designed metalens features, enhancing their practical applications.
The dynamical degrees of rational surface automorphisms
Authors: Kim Kyounghee
Published: May 2024

The induced action on the Picard group of a rational surface automorphism with positive entropy can be identified with an element of the Coxeter group associated to

E
n

,
n
≥
10

E_n, n\ge 10

diagram. It follows that the set of dynamical degrees of rational surface automorphisms is a subset of the spectral radii of elements in the Coxeter group. This article concerns the realizability of an element of the Coxeter group as an automorphism on a rational surface with an irreducible reduced anticanonical curve. For any unrealizable element, we explicitly construct a realizable element with the same spectral radius. Hence, we show that the set of dynamical degrees and the set of spectral radii of the Coxeter group are, in fact, identical. This has been shown by Uehara [Ann. Inst. Fourier (Grenoble) 66 (2016), pp. 377–432] by explicitly constructing a rational surface automorphism. This construction depends on a decomposition of an element of the Coxeter group. Our proof is conceptual and provides a simple description of elements of the Coxeter group, which are realized by automorphisms on anticanonical rational surfaces.
Performing Pastoral Care Through Letters
Authors: Searle Alison
Published: May 2024

For Puritan ministers in early modern England and Scotland, pastoral care required attending to the intellect, body, and emotions of their parishioners. Frequent changes in civil and ecclesiastical governance, such as the reintroduction of Episcopalianism in Scotland under James I and the Act of Uniformity in England following Charles II’s restoration, meant that Puritan ministers were often unable to continue their pastoral vocation within the state church. This was the case for the Scottish Covenanter, Samuel Rutherford (c. 1600–1661), who was exiled from his parish of Anwoth to Aberdeen in 1630 for nonconformist activities. Similarly, in 1660, Richard Baxter (1615–91) was unwilling to subscribe to the new English church settlement following the Restoration and thus had to leave his successful Interregnum ministry in Kidderminster. Through a close reading of selected surviving correspondence, this chapter assesses how Rutherford and Baxter continued to exercise pastoral care by writing letters to a diverse range of correspondents.
Spiritual Inwardness, Religious Antiformalism, and Puritan Polemic in Paradise Lost
Authors: Loewenstein David
Published: May 2024

This chapter argues that the radical Puritan poet of Paradise Lost is more conflicted in his responses to Restoration culture and state religion than commentators have suggested. Defiant in his convictions, he continues to engage vigorously in religious controversy, while also expressing the impulse to withdraw inwardly from ‘a World perverse’ (11.701) in which the righteous few find themselves under assault for daring to ‘utter Odious truth’ (704) and for rejecting a religious culture of ‘outward Rites and specious formes’ (12.534). Tensions in the poem, including its radical Puritan polemicism in relation to its increasing spiritual inwardness, give us a more genuine sense of Milton’s complex, creative, and diverse responses to the sharp religious conflicts and trauma generated by the Restoration settlement and its attempt to impose the state church, with its forms and rituals, upon all Puritans.
Doubly robust proximal synthetic controls
Authors: Qiu Hongxiang , Shi Xu , Miao Wang , Dobriban Edgar , Tchetgen Tchetgen Eric
Published: May 2024

To infer the treatment effect for a single treated unit using panel data, synthetic control (SC) methods construct a linear combination of control units’ outcomes that mimics the treated unit’s pre-treatment outcome trajectory. This linear combination is subsequently used to impute the counterfactual outcomes of the treated unit had it not been treated in the post-treatment period, and used to estimate the treatment effect. Existing SC methods rely on correctly modeling certain aspects of the counterfactual outcome generating mechanism and may require near-perfect matching of the pre-treatment trajectory. Inspired by proximal causal inference, we obtain two novel nonparametric identifying formulas for the average treatment effect for the treated unit: one is based on weighting, and the other combines models for the counterfactual outcome and the weighting function. We introduce the concept of covariate shift to SCs to obtain these identification results conditional on the treatment assignment. We also develop two treatment effect estimators based on these two formulas and generalized method of moments. One new estimator is doubly robust: it is consistent and asymptotically normal if at least one of the outcome and weighting models is correctly specified. We demonstrate the performance of the methods via simulations and apply them to evaluate the effectiveness of a pneumococcal conjugate vaccine on the risk of all-cause pneumonia in Brazil.
If We Know What Works, Why Aren't We Doing It?
Authors: Spencer Margaret , Tarleton Beth , Collings Susan , McIntyre Gillian , Turney Danielle
Published: May 2024

High rates of child removal from parents with learning disabilities persist despite substantial evidence that parents with learning disabilities can provide their children with satisfactory care given appropriate support. Child welfare interventions disproportionality based on disability status presents a compelling social issue deserving urgent attention. Co-operative inquiry was used to analyse attitudinal and structural barriers that perpetuate inequitable treatment of parents with learning disabilities and their children, drawing on policy and practice examples from Australia and the UK. Bacchi’s ‘What is the problem represented to be?’ approach to social policy issues was used to answer the question: if we know what works to support parents with learning disabilities, why aren’t we doing it? This commentary contends that the pervasive representation of parents with learning disabilities as inherently deficient in the requisite skills (‘parenting capacity’) needed for safe caregiving has been difficult to shift due to systematic ableism. Neoliberal policies stigmatise a need for support (‘dependence’) as an individual failing and recast assessments of long-term support needs as an unsustainable burden on support services/systems. We conclude that for outcomes to change for parents with learning disabilities and their children a social model of child protection that addresses attitudinal and structural barriers and is based on principles of interdependence, relationality, and ethics of care is required.
The readiness potential and the soul: what happens when you resect their seat in the brain?
Authors: Sjöberg Rickard L
Published: May 2024

Libet’s demonstration that activity in the supplementary motor area precedes conscious decision making is widely considered to have put the final nail in the coffin of dualism. Neurosurgeon Rickard Sjöberg argues that SMA resections show that Libet’s findings are in fact irrelevant to the neuroscientific discussion about free will.
Unemployment: a hidden source of wage inequality?
Authors: Mooi-Reci Irma , Liao Tim F
Published: May 2024

Although unemployment plays a central role in the emergence of labour market disparities, rarely any studies have linked its dynamics with the overall level of wage inequality. This study addresses this gap by assessing how unemployment is associated with both between- and within-group wage disparities. Hypotheses derived from labour market theories are tested using comprehensive longitudinal data from the Dutch OSA Labour Supply Panel spanning 1985–2008. Results from newly developed variance function panel regression models demonstrate that wages of previously unemployed workers are both lower and more dispersed compared to the wages of continuously employed workers. We also found that wage disparities were more pronounced among previously unemployed men than women. The results also demonstrate the usefulness of the variance function panel regression as a method for analyzing sources that drive wage inequality within persons and over time.
Swimming and water safety delivery for newly arrived Australians
Authors: Kiss Beáta , Calverley Hannah L M , Duke Charlotte , Baker Shayne , Matthews Bernadette L
Published: May 2024

In Victoria, Australia, culturally and linguistically diverse communities are more than twice as likely to drown than their Australian-born counterparts. One explanation is the lack of feasible, community-led approaches to water safety and swimming education. A community engagement framework was used to develop and implement a 5-day pool program to teach swimming and water safety to newly arrived migrant children attending an English language school in Victoria. Socio-cultural needs of the predominantly Afghan cohort were incorporated through in-language consultation with parents who requested males and females be educated separately. Participants were assessed against Victorian aquatic competency benchmark standards at pre- and post-program, however, there was no expectation to achieve these competencies within the 5 days due to a lack of prior aquatic exposure. Independent and paired samples t-tests determined changes in skills, including by sex and number of lessons attended. Forty-one participants completed all assessments. Excluding lifesaving skills, there was a significant increase in total competency attainment overall from pre- to post-program (p < 0.001), and for each competency (p’s ≤ 0.002)—predominantly knowledge and rescue skills. Improvements were mostly recorded among males, demonstrating that females may require more specialized support to achieve similar outcomes. Improvements in rescue skills and knowledge indicate the program’s effectiveness in increasing newly arrived migrant children’s awareness of, and exposure to, foundations of safe aquatic behaviours. Future programs tailored to newly arrived migrant communities should consider implementing water familiarization activities as a stepping stone to engagement with structured swimming and water safety education.
CIP-stabilized virtual elements for diffusion-convection-reaction problems
Authors: Beirão da Veiga L , Lovadina C , Trezzi M
Published: May 2024

The Virtual Element Method (VEM) for diffusion-convection-reaction problems is considered. In order to design a quasi-robust scheme also in the convection-dominated regime, a Continuous Interior Penalty approach is employed. Due to the presence of polynomial projection operators, typical of the VEM, the stability and the error analysis requires particular care—especially in treating the advective term. Some numerical tests are presented to support the theoretical results.
Toward IR’s “Fifth Debate”: Racial Justice and the National Interest in Classical Realism
Authors: Karkour Haro , Rösch Felix
Published: May 2024

This article addresses growing calls for a fifth debate on international relations’ (IR) “race amnesia.” The central argument is two-fold. First, contrary to conventional wisdom, racial justice was not omitted in “orthodox” scholarship—in particular Morgenthau’s realism. On the contrary, classical realists repeatedly critiqued the lack of racial justice throughout their careers. Second, racial justice was not only a concern for Morgenthau but also integral to his conception of the national interest, particularly in the Vietnam War. To Morgenthau, the national interest failed in Vietnam because the United States failed to define its purpose at home. Fundamental to its purpose was the question of racial justice. Morgenthau’s conception of the national interest has an enduring impact on contemporary realist scholarship. This scholarship engages with issues that are relevant to postcolonial IR, such as the pursuit of primacy in the War on Terror, the backlash in the form of Trumpism, and the Black Lives Matter protests. Morgenthau’s work provides the intellectual roots that sustain these arguments. For a fifth debate on race in IR to materialize, it is thus this neglected dimension in Morgenthau’s writing that postcolonial scholarship needs to engage with.
Practicing deliberation in challenging speech cultures: the role of metadiscourse
Authors: Manosevitch Idit , Friedman Elie , Sprain Leah
Published: May 2024

This qualitative research draws on language and social interaction (LSI) approaches to consider how speech culture shapes the practice of deliberation in a country presumed to be a challenging environment for deliberative practices: Israel. Our analysis examines structured deliberative forums conducted by communication students in Israel, to demonstrate how participants reference, use, and orient to both deliberative democracy discourse and Israeli speech culture in ways that enable them to overcome cultural challenges to doing deliberation. We found that participants utilize metadiscourse to take stances that frame cultural challenges of deliberation, negotiate the tensions between deliberative principles and local speech culture, and creatively integrate local speech norms with deliberation. This research contributes to LSI and Political Communication scholarship, by enhancing practical theory of deliberative democracy. The explication of the role of metadiscourse reframes the relationship between culture and deliberation thereby providing new directions for scholars, practitioners, and educators of deliberative democracy.
Diasporic (Dis)Connections and In-betweennesses: German-Jewish Refugees and Indians in Kenya
Authors: Eppelsheimer Natalie
Published: May 2024

This contribution describes various forms of in-betweenness lived by German-Jewish refugees in transit in colonial Kenya. It examines the multi-layered conditions of interaction between German-Jewish refugees and diasporic Indians as they were experienced by refugees and seeks to bring to the fore some of the complex dynamics within Kenya’s colonial hierarchies. Analysing refugees’ experiences as documented not only in personal letters and official correspondences, but also in autobiographical literary narratives, it puts refugee politics during the National Socialist regime in dialogue with global imperialism and (post)colonialism and shows how heavily immigration policies were impacted not only by race politics in multi-ethnic Kenya, but also by classism.1
Use of Menthol Cigarettes and Accessories Among Youth Who Smoked After the Menthol Cigarette Ban in England and Canada, 2021: Implications for Health Equity
Authors: N Kyriakos Christina , Filippidis Filippos T , East Katherine A , Reid Jessica L , Driezen Pete , Hammond David
Published: May 2024

Introduction

This study examined menthol cigarette use among youth who smoked, after menthol cigarette bans were implemented in England (May 2020) and Canada (October 2017).

Aims and Methods

Cross-sectional data come from 2021 ITC Youth Tobacco and Vaping Survey respondents aged 16–19 who smoked in the past 30 d in England (N = 715) and Canada (N = 419). Adjusted logistic regression models, estimated separately for each country, examined sociodemographic correlates of usually smoking menthol cigarettes (reporting currently most often smoking menthol cigarettes) overall, and by past 30-d use of any menthol accessories (e.g., filters, capsules). Youth reported the cigarette variety they smoked most often, coded as menthol or nonmenthol.

Results

Almost no youth who smoked in the past 30 d reported most often smoking a cigarette variety coded as menthol. However, 34.5% (95% CI: 30.4% to 38.9%) of youth who smoke in England and 30.9% (26.0%–36.3%) in Canada reported usually smoking menthol cigarettes, with greater odds of use among those identifying as black, or other race/ethnicity, respectively, compared to white in England (60.0%, aOR = 3.08, p = .001; 47.4%, aOR = 2.27, p = .011) and Canada (43.6%, aOR = 2.44, p = .046; 51.2%, aOR = 2.92, p = .001). Among those who reported usually smoking menthol cigarettes in England (N = 223) and Canada (N = 108), 71.7% (64.0%–78.2%) and 51.5% (41.1%–61.7%) reported using menthol accessories.

Conclusions

After menthol cigarette bans in England and Canada, approximately one-third of youth who smoked reported usually smoking menthol cigarettes, with disproportionately higher use among those identifying as black and other race/ethnicity. Menthol accessories accounted for most menthol cigarette use. Closing regulatory loopholes is critical to advancing public health equity.

Implications

Use of menthol cigarette accessories (eg, filters, cards, capsules) among youth who smoked was prevalent after implementation of menthol cigarette bans in England and Canada, and there was disproportionately higher use among those who identified as black and any other race/ethnicity. Efforts are therefore required to close regulatory loopholes of menthol cigarette bans. Findings further support countries, such as the United States, proposing menthol cigarette bans which extend coverage to accessories. More comprehensive menthol bans that also restrict accessories are likely to be more effective in reducing flavored tobacco use among young people and in advancing health equity.
Flavored Tobacco Sales Restrictions and Youth E-cigarette Behavior: Impact by Tobacco Retailer Density in Diverse Communities in California
Authors: Dove Melanie S , Gee Kevin A , Tong Elisa K
Published: May 2024

Introduction

Factors that impact flavored tobacco sales restriction (flavor restrictions) effectiveness on youth e-cigarette behavior are unclear. Tobacco retailer density (retailer density) is a health equity issue with greater retailer density in high-minority, low-income areas. We examined the association between flavor restrictions and youth e-cigarette behavior by retailer density across diverse communities in the California Bay Area.

Aims and Methods

We analyzed data from the California Healthy Kids Survey using a difference-in-differences (DID) strategy. We compared pre- and post-policy changes in e-cigarette access and use one-year post-implementation among high school students in the Bay Area with a flavor restriction (n = 20 832) versus without (n = 66 126). Separate analyses were conducted for students in cities with low and high retailer density, with a median cutoff of 3.3 tobacco retailers/square mile.

Results

Students with high retailer density were more likely to identify as a minority and have parents with lower education. Among students with low retailer density, flavor restrictions were associated with 24% lower odds in the pre- to post-policy increase in ease of access relative to unexposed students (DID = 0.76, 95% CI: 0.58, 0.99). Among students with high retailer density, flavor restrictions were associated with 26% higher odds in ease of access (DID: 1.26, 95% CI: 1.02, 1.56) and 57% higher odds of current use (DID = 1.57, 95% CI: 1.31, 1.87).

Conclusions

Flavor restrictions had positive impacts on youth e-cigarette access in low, but not high retailer density cities. From a health equity perspective, our results underscore how flavor restrictions may have uneven effects among vulnerable groups.

Implications

In diverse communities in the California Bay Area, our results suggest a protective association between flavored tobacco sales restrictions and youth access to e-cigarettes in low, but not high tobacco retailer density cities one-year post-implementation. These results underscore how flavor restrictions may have uneven effects, and when implemented in high retailer density areas, may disproportionately place already vulnerable groups at heightened exposure to e-cigarette use and access. In high retailer density areas, additional tobacco control efforts may need to be included with flavor restriction implementation, such as increased education, youth prevention and cessation programs, policies to reduce tobacco retailer density, or stronger tobacco retailer enforcement or compliance monitoring.
Come for the Tobacco, Stay for the Flavor: Flavored Cigarillo–Use Trajectories Among Young Adult Sexual Gender Minority Women
Authors: Osborn Catherine , Pike Moore Stephanie , Koopman Gonzalez Sarah , Quisenberry Amanda , Klein Elizabeth , Trapl Erika
Published: May 2024

Introduction

The purpose of this research was to identify how young adult sexual gender minority (SGM) women who use cigarillos may respond to cigar flavor restrictions.

Aims and Methods

Young adults aged 21–28 years in the United States who currently use cigarillos were recruited between October 2020 and April 2021 to participate in an online survey. Due to high prevalence of cigarillo use among individuals who identify as sexual and/or gender minority (SGM) women, their (n = 192) flavored tobacco-use behaviors and anticipated responses to cigarillo flavor restrictions were compared to cisgender heterosexual (CisHet) women (n = 110). Logistic regression was used to model cigarillo cessation and product-switching behaviors (flavored and unflavored).

Results

SGM women were significantly less likely to report the use of flavor at the initiation of cigarillo use (61.7% vs. 86.1%) but were no different in current flavor use compared to CisHet women, with more than 80% of all women using any flavor. SGM women were 2.36 times as likely to say they would discontinue using cigarillos if flavors were unavailable. Among those who would continue using cigarillos, SGM women were 4.53 times as likely to endorse switching to an unflavored tobacco product but had the same likelihood of saying they would switch to flavored product compared to CisHet women.

Conclusions

Flavor restriction policies may not reduce the initiation of cigarillos among SGM women and may elicit differential cigarillo use and tobacco product substitution by SGM identity. Flavor restriction policies should be coupled with targeted cessation resources to address potential remaining disparities.

Implications

SGM US women have a unique cigarillo-use trajectory. These women are more likely to initiate cigarillos without flavor and then later integrate it into their behavior. National cigar flavor restrictions are expected to have a greater impact decreasing cigarillo initiation among CisHet women and decreasing current cigarillo use among SGM women. However, for those who would continue using unflavored cigarillos, SGM women may remain at risk for nicotine dependence due to increased product substitution. SGM women should be prioritized for cessation resources to reduce tobacco-use disparities leading up to and following the implementation of cigar flavor restrictions.
Neighborhood Inequities in Tobacco Product Descriptors, Washington, DC, 2018–2019
Authors: Kong Amanda Y , Westneat Susan C , Anesetti-Rothermel Andrew , van de Venne Judy G , Debnam Charles , Ribisl Kurt M , Cohn Amy M , Rose Shyanika W
Published: May 2024

Background

The tobacco industry uses product descriptors to communicate reduced harm and increase appeal. This cross-sectional study assessed store-level racial, ethnic, and socioeconomic inequities in the distribution of retail tobacco product descriptors in a convenience sample of retailers in Washington, DC.

Methods

Young adults (n = 146) who did not currently use tobacco reported real-time store visits over 14 days. Trained data collectors took high-resolution photographs of all tobacco (including e-cigarette) marketing in each store (n = 96) participants visited. We coded text descriptors on tobacco product advertisements and displays into descriptor categories (eg, fruit, sweet, concept). We fit multilevel models to examine relationships between store neighborhood census tract-level racial, ethnic, and socioeconomic characteristics and tobacco product descriptors in stores. As a supplementary analysis, we used geospatial methods to model predicted patterns of descriptors at the census tract level.

Results

Stores located in census tracts with the highest versus lowest percentage of Black residents had a greater count of fruit, sweet or dessert, alcohol, and concept descriptors (p < .05), similar to findings from the geospatial approach. Adjusted models also indicated some inequities in stores in census tracts with higher percentages of Hispanic or Latino residents for fruit, alcohol, and concept descriptors; however, tract-level models showed opposite results for concept flavors.

Conclusions

In this convenience sample, fruit, alcohol, sweet/dessert, and concept FTP descriptors were prevalent in stores in neighborhoods with more Black residents demonstrated through two analytic approaches. Surveillance using representative samples of tobacco retailers could improve the ability to track the extent of this inequity.

Implications

We document inequities in the amount of fruit, sweet or dessert, alcohol, and concept flavor descriptors in stores across neighborhoods in Washington, DC. Federal, state, and local regulatory action is needed to reduce inequities in flavored tobacco product availability and marketing, including for concept flavors.
Interventions for Tobacco Prevention and Control in Humanitarian Settings: A Scoping Review
Authors: Gudi Nachiket , Mathias Edlin Glane , Swain Ansuman , Gupta Vanshika , Raj Elstin Anbu , Pattanshetty Sanjay , Zodpey Sanjay , Brand Helmut
Published: May 2024

Introduction

Tobacco usage is an epidemic as statistics point towards smoking as the second leading cause of death. Populations experiencing humanitarian emergencies may experience a higher propensity for tobacco, alcohol, and other substance abuse disorders. This review aimed to map tobacco prevention and control interventions in humanitarian settings.

Aims and Methods

The search for this scoping review was conducted in six databases and supplemented with a gray literature search. Articles were screened at title-abstract and full-text by two pairs of authors, and data was abstracted by three individuals independently. An adapted diffusion of governance framework is used to discuss the findings.

Results

A total of 26 articles were included from the searches conducted in the databases and gray literature. The interventions targeted all age groups. The documents retrieved from the gray literature search were classified as population-based interventions, as they were not restricted to a particular group of individuals. Interventions were delivered at various locations, using different methods and engaging multiple stakeholders. Interventions assessed were grouped into packaging, labeling, and other policy interventions (pricing and taxes).

Conclusions

There are few tobacco prevention and control interventions in the humanitarian context. The diffusion of governance perspective in implementing these interventions in humanitarian settings provides a cue for inter-sectoral cooperation among different stakeholders and disciplines beyond the health sector. Our review recommends exploring complementarity between the demand and supply-side interventions for tobacco control.

Implications

The scoping review has highlighted various tobacco prevention and control efforts in humanitarian settings. The interventions were delivered using various modes, and yet the burden of smoking is higher among the humanitarian population. Further research may use impact evaluation techniques to assess the impact of these interventions to facilitate the re-design of the implementation approach and policy priorities.
Prevalence and Determinants of Stunting-Anemia and Wasting-Anemia Comorbidities and Micronutrient Deficiencies in Children Under 5 in the Least-Developed Countries: A Systematic Review and Meta-analysis
Authors: Dessie Getenet , Li Jinhu , Nghiem Son , Doan Tinh
Published: May 2024

Context

Despite shifting from addressing isolated forms of malnutrition to recognizing its multifaceted nature, evidence on the prevalence and determinants of micronutrient deficiencies, and their coexistence with undernutrition in children under 5, remains insufficient, unsystematic, and incohesive.

Objective

The aim of this systematic review and meta-analysis was to assess the prevalence and determinants of stunting-anemia and wasting-anemia comorbidities and micronutrient deficiencies in children under 5 in the least-developed countries (LDCs).

Data Sources

Electronic searches took place from January 15, 2023, to February 14, 2024, across multiple databases, including PubMed, Embase, Web of Science, SCOPUS, African Index Medicus (AIM), World Health Organization's Institutional Repository for Information Sharing (IRIS), and African Journals Online. The search spanned the years 2000 to 2024, yet it yielded eligible full-text English research articles from only 2005 to 2021 conducted in LDCs. Studies lacking quantitative data on malnutrition types and their determinants were excluded.

Data Extraction

Two independent authors assessed articles for bias and quality using Hoy et al's 10-item scale and Newcastle-Ottawa Scale (NOS) criteria. Prevalence and other details were extracted using a Joanna Briggs Institute Excel template. Authors extracted adjusted odds ratios (aORs) for determinant factors such as sex and vitamin A and iron supplementation.

Data Analysis

The search yielded 6248 articles from 46 LDCs. Sixty-nine articles, with a total sample size of 181 605, met inclusion criteria for the final meta-analysis. Vitamin A deficiency affected 16.32% of children, and iodine deficiency affected 43.41% of children. The pooled prevalence of wasting-anemia and stunting-anemia comorbidity was 5.44% and 19.47%, respectively. Stunting was associated with vitamin A deficiency (aOR: 1.54; 95% CI: 1.01–2.37), and not taking vitamin A supplementation was associated with iron-deficiency anemia (aOR: 1.37; 95% CI: 1.21–1.55).

Conclusion

A significant proportion of children under 5 in LDCs experienced stunting-anemia and wasting-anemia comorbidities and micronutrient deficiencies. This study underscores the urgent need to address factors driving these burdens.

Systematic Review Registration

PROSPERO registration no. CRD42023409483.
Inflammatory proteins mediate male erectile dysfunction via plasma metabolites
Authors: Kang Zhen , Zhang Zhuo-Rui , Feng Zhi-Yuan , Dong Long-Shen , Yang Junfeng
Published: May 2024

Background

There are no clear conclusions as to whether inflammatory proteins and plasma metabolites influence erectile dysfunction (ED).

Aim

In this research, we used Mendelian randomization (MR) analysis to discover a causal relationship between inflammatory proteins, plasma metabolites, and ED.

Methods

Raw data with ED, inflammatory proteins, and plasma metabolites were obtained from the MRC IEU OpenGWAS and FinnGen database. After a series of screenings, the remaining single nucleotide polymorphisms were selected as instrumental variables or MR analysis to assess the relationship between genetically predicted inflammatory proteins or plasma metabolites and the pathogenesis of ED.

Outcomes

The relationship between inflammatory factors and ED was fully analyzed and elaborated.

Results

In the inverse variance–weighted method, there exists a significant causal relationship between 4 types of genetically predicted inflammatory proteins and 50 types of plasma metabolites with the incidence of ED. The primary discovery is that 3 inflammatory proteins, fibroblast growth factor 5, interleukin-22 receptor subunit alpha-1, and protein S100-A12, can impact the risk of ED through plasma metabolites.

Clinical Implications

ED metabolites and inflammatory proteins are also closely associated with cardiovascular diseases, warranting further exploration.

Strengths and Limitations

Our analysis is based on a European population, limiting its generalizability, the genome-wide association study dataset for ED has a relatively small number of cases, and we hope for larger genome-wide association study datasets for future validation.

Conclusion

This study has identified that inflammatory proteins can influence ED through plasma metabolites.
A low androgenic state inhibits erectile function by suppressing endothelial glycosides in the penile cavernous tissue of rats
Authors: Zhou Wei , Jiang Jun , Jiang Rui
Published: May 2024

Background

The endothelial glycocalyx is an important barrier that protects the structure and function of endothelial cells. Androgen deficiency is a common factor that causes structural and functional impairment of endothelial cells.

Aim

To investigate changes in the endothelial glycocalyx in the penile corpus cavernosum of the rat with low androgen status and its relationship with erection function.

Methods

Eighteen 10-week-old Sprague-Dawley male rats were randomly divided into 3 groups (n = 6 each): sham operation, castration, and castration + testosterone replacement. The maximum intracavernosal pressure/mean arterial pressure of the penis was measured after modeling for 4 weeks. The expression levels of endothelial nitric oxide synthase (eNOS), phospho-eNOS, syndecan 1, heparanase, and nitric oxide in penile cavernous tissue and the serum levels of heparan sulfate, hyaluronic acid, tumor necrosis factor α, and interleukin 6 were determined. Transmission electron microscopy was used to observe the ultrastructure of the endothelial glycocalyx in penile tissue.

Outcomes

The thickness of the endothelial glycocalyx in the penile corpus cavernosum of castrated rats was significantly lower than that of the control group.

Results

In the castrated rats, the endothelial glycocalyx thickness, syndecan 1 level, ratio of phospho-eNOS to eNOS, nitric oxide level, and maximum intracavernosal pressure/mean arterial pressure (3 V, 5 V) were significantly lower than those in the sham group (P < .05). The expression of heparanase and the serum levels of tumor necrosis factor α and interleukin 6 were significantly higher in the castrated group than in the sham group (P < .05).

Clinical Translation

Upregulating the expression of the endothelial glycocalyx in the penile corpus cavernosum may be a new method for treating erectile dysfunction caused by low androgen levels.

Strengths and Limitations

This study confirms that low androgen status promotes the breakdown of the endothelial glycocalyx. However, further research is needed to determine whether androgens are related to the synthesis of the endothelial glycocalyx.

Conclusion

Low androgen status may suppress the level of nitric oxide in the cavernous tissue of the penis via impairment of the endothelial glycocalyx, resulting in inhibited erection function in rats.
Demographic and Audiological Characteristics of Candidates for Over-the-Counter Hearing Aids in the United States
Authors: Humes Larry E.
Published: May 2024

Objectives:

This report presents descriptive data on the demographic and audiological characteristics of US adults with perceived mild-to-moderate hearing loss, the primary candidates for over-the-counter (OTC) hearing aids.

Design:

The analyses are descriptive and present population-weighted responses for various self-reported demographic and audiological variables for adults with mild or moderate perceived hearing trouble. Results of pure-tone audiometry and immittance measures are also presented. Nationally representative datasets from the National Health and Nutrition Examination Surveys (NHANES) for 2011 to 2012, 2015 to 2016, and 2017 to 2020, the three most recent NHANES datasets with audiological information, were used.

Results:

The NHANES datasets indicated that there are 49.5 million adults in the United States with perceived mild-to-moderate hearing trouble. Results indicated that OTC hearing-aid candidates are most frequently 50 to 69 years of age, married, and identify as non-Hispanic White race/ethnicity. Most of these individuals graduated from high school, had several risk factors for hearing loss, had not had a hearing test in the past 5 years, and had never used hearing aids or assistive listening devices previously. The typical audiometric profile was a bilaterally symmetrical sloping hearing loss with slight to mild hearing loss above 2000 Hz. Group data showed normal immittance measures and absence of otoscopic abnormalities except for the presence of excessive (not impacted) cerumen in about 13% of the OTC hearing-aid candidates.

Conclusions:

Tens of millions of US adults have perceived mild-to-moderate hearing trouble but have not pursued assistance, either through obtaining a hearing test or acquiring prescription hearing aids.
Assessing Right Ventricle Over Time in Patients on Veno-Venous Extracorporeal Membrane Oxygenation: Insights From Serial Echocardiography
Authors: Isha Shahin , Narra Sai Abhishek , Batool Humera , Jonna Sadhana , Giri Abhishek , Herrmann Olivia , Dyson Amari , Nichols Mick D. , Hannon Rachel , Pham Si , Moreno Franco Pablo , Baz Maher , Sanghavi Devang , Kiley Sean , Waldron Nathan , Pandompatam Govind , Bohman J. Kyle K. , Chaudhary Sanjay , Rosenbaum Drew N. , Guru Pramod K. , Bhattacharyya Anirban
Published: May 2024

Extracorporeal membrane oxygenation (ECMO) is often used in acute respiratory distress syndrome (ARDS) with refractory hypoxemia. There is limited literature highlighting the development of right ventricular (RV) failure while on ECMO. We conducted a retrospective multicenter observational study including 70 patients who were placed on veno-venous (VV)-ECMO for respiratory failure at Mayo Clinic, Jacksonville, and Mayo Clinic, Rochester, between January 2018 and June 2022 and had at least two post-ECMO transthoracic echoes. The primary outcomes were the incidence and progression of RV dysfunction and dilatation. The secondary outcome was in-patient mortality. Among 70 patients in our cohort, 60.6% had a normal RV function at the time of ECMO placement, whereas only 42% had a normal RV function at the second post-ECMO echo. On multinomial regression, a moderate decrease in RV function was associated with ECMO flow (odds ratio [OR] = 2.32, p = 0.001) and ECMO duration (OR = 1.01, p = 0.01). A moderately dilated RV size was also associated with ECMO flow (OR = 2.62, p < 0.001) and ECMO duration (OR = 1.02, p = 0.02). An increasing degree of RV dysfunction was associated with worse outcomes. Our study showed that the increasing duration and flow of VV-ECMO correlated with progressive RV dilatation and dysfunction, which were associated with poor survival.
External validation of a model using health administrative data to predict acetabular fracture probability: Brief report
Authors: Adamczyk Andrew , Kelly Martin James , Kreder Hans , Grammatopoulos George , van Walraven Carl
Published: May 2024

Analyses using population-based health administrative data can return erroneous results if case identification is inaccurate (“misclassification bias”). An acetabular fracture (AF) prediction model using administrative data decreased misclassification bias compared to identifying AFs using diagnostic codes. This study measured the accuracy of this AF prediction model in another hospital. We calculated AF probability in all hospitalizations in the validation hospital between 2015 and 2020. A random sample of 1000 patients stratified by expected AF probability was selected. Patient imaging studies were reviewed to determine true AF status. The validation population included 1000 people. The AF prediction model was very discriminative (c-statistic 0.90, 95% CI: 0.87–0.92) and very well calibrated (integrated calibration index 0.056, 95% CI: 0.039–0.074). AF probability can be accurately determined using routinely collected health administrative data. This observation supports using the AF prediction model to minimize misclassification bias when studying AF using health administrative data.
Total Pancreatectomy With Percutaneous Islet Autotransplant After Remote Islet Processing
Authors: Lewellen Kyle A. , Maatman Thomas K. , House Michael G. , McGreevy Kathleen , Cavaghan Melissa K. , Dorwart Michael R. , Fogel Evan L. , Haste Paul M. , Montero Anne Mary , Roch Alexandra M. , Zyromski Nicholas J.
Published: May 2024

Objectives

Total pancreatectomy with islet autotransplant (TPIAT) is important therapy for select chronic pancreatitis (CP) patients. The specialized technique of islet isolation limits widespread TPIAT use. We hypothesized that remote islet isolation provides satisfactory islet yield and perioperative outcomes.

Methods

A retrospective review of TPIAT patients between 2020 and 2022 was conducted. Islet isolation was performed off-site, with percutaneous intraportal islet autotransplant (IAT) completed the morning following pancreatectomy. Demographics and perioperative outcomes were analyzed.

Results

Fourteen patients underwent TPIAT; median age was 43 (interquartile range, 12.5) years. Operation occurred 7.5 (14.8) years after pancreatitis diagnosis. The most common pancreatitis etiology was genetic (50%). All patients underwent preoperative endoscopic therapy; three underwent prior pancreatectomy. Operative time was 236 (51) minutes; subsequent percutaneous IAT time was 87 (35) minutes. The islet equivalent (IEQ)/kilogram (kg) yield was 3456 (3815) IEQ/kg. Nine patients had positive islet cultures. Two thromboembolic events and one bacteremia occurred. One perihepatic hematoma occurred after percutaneous portal venous access. The median postoperative length of stay was 14.5 days, and five patients (36%) were readmitted within 90 days. All patients were discharged home on insulin. No mortality occurred.

Conclusions

Total pancreatectomy with remote islet isolation provides excellent islet yield for autotransplant and satisfactory perioperative outcomes.