bluuebunny/crossref_metadata_2025 huggingface dataset:
Associations between cumulative biological risk and subclinical atherosclerosis in middle- and older-aged South Asian immigrants in the United States
Authors: Talegawkar Dr. Sameera , Jin Yichen , Kandula Dr. Namratha , Kanaya Dr. Alka
Published: April 2023

Introduction

The aim of this study was to investigate associations between cumulative biological risk and subclinical atherosclerosis in South Asian immigrants.

Methods

Data from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study, including 844 participants at baseline (mean age=56 [standard deviation=9] years, 46% women). A cumulative biological risk score was derived using 9 biomarkers across cardiovascular, immune and metabolic systems with possible score range 0-9. Common and internal carotid artery intima media thickness (CIMT) and coronary artery calcium (CAC) were used as indicators of subclinical atherosclerosis.

Results

Higher cumulative biological risk score were significantly associated with higher common and internal CIMT and higher odds of CAC at baseline. The odds of new CAC after 5 years of follow-up was 31% higher per 1 point increase in cumulative biological risk score, and higher cumulative biological risk was also associated with CAC progression.

Conclusions

Among South Asian immigrants, cumulative biological risk was directly associated with subclinical atherosclerosis and its progression.
Differences in the Age of Diagnosis of Diabetes in Asian Subgroups: Analysis of Data from the National Health Interview Survey (NHIS) 2006-2018
Authors: Bhatt Rishab , Ingle Shreya , Sackpraseuth Ashley , Venkatraman Siddharth , Sharp Nora , Chung Dr. Sukyung , Long Jin , Palaniappan Dr. Latha , Srinivasan Dr. Malathi
Published: April 2023

Asians have been shown to have a 60% higher prevalence of diabetes than Non-Hispanic Whites (NHWs), with the risk being substantially worse for Asian Indians and Filipinos. The age of diagnosis of diabetes for these subgroups can be a critical indicator of health disparities and may explain the difference in prevalence.
Why We Need Preventative Cancer Screening Processes for High-Risk Populations
Authors: Soh Jennifer , Hwang Joo Ha
Published: April 2023

Gastric cancer has become a severe health disparity amongst East Asian populations residing in the US. While high-risk communities and clear risk factors have been identified, little has been done to improve the gastric cancer rates for East Asian Americans. This op-ed and commentary by Dr. Joo Ha Hwang, Chair of the Asian American Stomach Cancer Disparity Task Force, tells the story of the reality of gastric cancer for high-risk populations and illustrates the dire need for national guidelines to advance early gastric cancer detection practices in the US.
Mercury in Dried Market Fish of Hong Kong and San Francisco: Human Health Implications
Authors: Vallentyne Dan , Zhao Ziyang , Yung Lee Tak , McGuire David
Published: April 2023

Asian, Asian Pacific Islanders, and Asian American residents of San Francisco have higher exposure to mercury and the associated health risks associated with methylmercury toxicity from fish consumption than other demographics across the United States. Due to their higher annual fish consumption, Hong Kong Chinese residents have elevated  risks to methylmercury exposure. Objectives: We investigate samples of dried market fish from San Francisco and from Hong Kong as potential sources of mercury contamination in fish commonly consumed by Asian and Asian American residents. Methods: We analyze 81 samples of dried market fish from San Francisco and Hong Kong for mercury concentration using Inductively Coupled Plasma Emission Spectrograph and Processing Cold Vapor Atomic Fluorescence Spectrometry. We binned into market categories, trophic level, and habitat type for statistical analysis. Results: No significant difference was observed in the mercury levels of samples between San Francisco and Hong Kong (p-value = 0.47). Dried samples did show higher rates of mercury than wet samples reported by the FDA. Data from dried market fish samples also show evidence of bioaccumulation: the concentration of toxins in higher trophic levels of fish (p-value < 0.01). Eliminating apex predators, nearly all samples of fish from both locations and from lower trophic levels had levels below the lowest health advisory thresholds of 0.5 ppm methylmercury by weight. Discussion: Dried fish samples from markets in San Francisco and Hong Kong showed mercury levels with the potential to exceed guidelines set by the EPA and the EFSA, but consumption rates are lacking to know if this threshold is actually being exceeded by consumers. We make recommendations regarding the health risks of dried market fish and of consuming or avoiding fish from certain trophic groups.
Elevated Risk for Cardiovascular Disease in Diasporic South Asians
Authors: Ramanathan Amrita Laxshmy , Palaniappan Latha , Vora Nirali , Ivey Susan Lee
Published: April 2023

Diasporic South Asians, individuals of South Asian descent who live outside their country of origin or heritage, are at a higher risk of developing cardiovascular diseases than the general population in many countries, including the United States. South Asians are also at elevated risk for specific cardiovascular risk factors, including Type 2 diabetes, obesity, metabolic syndrome, hypertension, dyslipidemia, and central distribution of fat (including visceral fat). The MASALA Study, a longitudinal cohort study of South Asians in the United States, found significantly elevated ectopic adiposity, increased insulin resistance, increased inflammatory markers, and decreased insulin sensitivity. To prevent cardiovascular disease, physicians and other medical providers must focus on mitigating known risks, including hypertension, diabetes, tobacco use, low physical activity levels, central obesity, coronary artery calcium (CAC), poor diet, and psychosocial factors. To proactively address these risks for South Asians, we must further educate healthcare providers, as well as advocate on behalf of South Asian people to ensure they have their blood pressure, cholesterol, and fasting glucose levels checked even if their BMI is normal or they follow a vegetarian diet. It is also essential to undertake culturally tailored outreach in specific South Asian communities to create educational materials regarding healthy behavior and lifestyle changes, including in languages needed by the most recent immigrants. Future research must include race, ethnicity, and native country of origin to better characterize the risk of stroke and heart attack and the impact of interventions among diasporic South Asian subgroups.
Immigrant Status and Oral Health Disparities among Asian Americans in the United States
Authors: Han Chengming
Published: April 2023

OBJECTIVES: To explore the roles of household language, foreign-born status, and citizenship on disparities in dental care, and oral health status among Asians in the U.S.

METHODS: Based on the National Health and Nutrition Examination Survey (NHANES) 2011-2018, the author applied weighted nested logistic regression to describe the effects of household language, foreign-born status, and citizenship on dentist visits and self-rated oral health. Weighted negative binomial regression was used to explore the effects of immigrant status on the number of missing teeth. Socioeconomic status and demographic characteristics were controlled for.  

RESULTS: Asians who do not speak English at home present 1.428 times higher likelihood of irregular dentist visits, and 1.487 times higher self-rated fair/poor oral health. Respondents with no citizenship are more likely (OR=1.752) to present irregular dentist visits. Foreign-born Asians present more missing teeth (OR=1.361) than their U.S.-born counterparts.

CONCLUSIONS: Despite the fact that Asians are often regarded as “model minorities” and/or “successful immigrants”, those with lower immigrant statuses illustrated higher risk for irregular dentist visits and disadvantaged oral health status.
Determinants of colorectal cancer screening among South Asian Americans
Authors: Mukherjea Arnab , Shariff-Marco Salma , Yang Juan , Tseng Winston , Palaniappan Latha , Li Jun , Ivey Susan L. , Somsouk Ma , Gomez Scarlett Lin
Published: April 2023

Background: Colorectal cancer screening rates among South Asian Americans are among the lowest of U.S. population groups. Few population-based studies have examined determinants of screening in this population. The purpose of this study was to identify factors associated with colorectal cancer screening among South Asian Americans.

Methods: Data from the 2001-2009 California Health Interview Survey and multivariable logistic regression were used to examine determinants of being non-adherent with colorectal cancer screening recommendations. Independent variables include sociodemographic and healthcare access measures.

Results: Overall, 49% of 459 South Asians were non-adherent to screening recommendations. Characteristics associated with non-adherence were absence of flu shot, absence of doctor visits, sole use of non-English language at home, and <40% life spent in US. In the multivariable model, screening non-adherence was associated with <40% life in US (odds ratio (95% confidence interval) 3.0 (1.4-6.5)), use of non-English at home (2.8 (1.0-7.8)), and no flu shot (2.5 (1.3-4.8)). Obese (BMI > 27.5 kg/m2) versus normal weight patients were less likely to be non-adherent (0.4 (0.2-0.9)).

Conclusions: Length of time in the US and language spoken at home rather than English proficiency were associated with non-adherence to colorectal cancer screening, reflecting the importance of acculturation and retention of cultural values. Health conditions and behaviors reflecting more proactive healthcare utilization may reinforce the importance of provider recommendations and perceived efficacy of health prevention. Qualitative research would inform cultural tailoring necessary to improve colorectal cancer screening rates among the rapidly growing South Asian American population.
A review of the role of cultural practices, values, and norms in type II diabetes treatment for Chinese immigrants
Authors: Ormiston Cameron
Published: April 2023

Although Type II diabetes (T2D) prevalence in US Chinese immigrants continues to rise, gaps in research and clinical care persist. These gaps are largely due to generalizations of the Asian immigrant population, barriers within biomedical culture, and a lack of culturally sensitive treatment plans. Little attention is paid to the unique sociocultural factors and contexts within each subpopulation, such as family influences or traditional medicine approaches. After an analysis of available literature, folk interpretations of disease, the family unit, and cultural food practices were found to be significant influences on T2D treatment. As they navigate their treatment, Chinese immigrants grapple with issues such as the stigmatization of insulin, the importance of providing food as care, and family well-being and harmony. Understanding how and why these elements of PVN affect T2D treatment is crucial to tailoring medical care to the needs of Chinese immigrant communities.
Bone stress injuries
Authors: Hoenig T , Tenforde AS , Hirschmüller A , Cassel M , Rolvien T , Hollander K
Published: April 2023

Bone stress injuries, commonly referred to as stress reactions or stress fractures, are caused by overuse and are prevalent conditions in athletes. These injuries are often seen in sports with high cumulative skeletal loading such as running, athletics, gymnastics, basketball, cricket, or soccer. The main injury pathophysiology is an imbalance between bone microdamage formation and its removal and replacement. A detailed medical history and clinical examination are important for diagnosis, with magnetic resonance imaging representing the gold standard for radiographic confirmation. Treatment and return-to-sport decisions should be individualized and based on injury location, severity, aspects of sports participation, and patient preferences. Initial management includes activity modification, protected weight-bearing, immobilization, optimizing nutrition (caloric intake, dietary calcium, and vitamin D supplementation), and in a few cases surgery. Following initial treatment, progressive loading and return-to-activity are initiated. Overall, a high rate of return-to-sports can be expected. Numerous risk factors that alter bone loading or bone health have been described and their identification is a crucial step towards prevention of future injury.
Use of combined shockwave therapy and platelet-rich plasma injection for management of chronic plantar fasciitis in runners: two case reports
Authors: Jarnagin JJ , McCormac KM , McInnis KC , Borg-Stein J , Tenforde AS
Published: April 2023

Plantar fasciitis is one of the most common causes of foot and heel pain in adults. Extracorporeal shockwave therapy (ESWT) and platelet-rich plasma (PRP) have each been described as effective treatments for plantar fasciitis; however, the combined use has not been adequately described. This report characterizes successful return to sport in two runners with plantar fasciitis who were treated with ESWT combined with PRP. Patient-reported outcomes were measured using the Foot and Ankle Ability Measure (FAAM). A 69-year-old female had 8 months of pain refractory to physical therapy (PT). A 73-year-old male presented with recent onset of 3 weeks of symptoms. Both runners had exam findings of plantar fasciitis and MRI confirmation. Each elected to complete ESWT along with PT using a foot core program and met functional improvements for both sport and ADL subscales of FAAM after initial ESWT treatment. However, each runner had worsening pain when attempting to run and both elected to proceed with a single leukocyte-poor PRP injection combined with ESWT. This allowed for successful return to running. Both cases highlight how combined ESWT and PRP with a foot core PT progression may be effective in managing plantar fasciitis in running athletes.
L’appel au visuel dans le Mozi 墨子
Authors: Ghiglione Anna
Published: April 2023

Cette réflexion souligne l’importance de l’hypotypose dans le Mozi d’un point de vue argumentatif et gnoséologique. Les moïstes se prévaudraient de cette figure de rhétorique afin de montrer le bien-fondé de leurs doctrines, en formulant des descriptions frappantes et énergiques de faits réels ou d’événements imaginaires. La force illocutoire de l’hypotypose est par exemple exploitée afin de critiquer la guerre offensive et de prôner les croyances relatives aux esprits ainsi que la modération dans les rites funéraires. Il est à noter que le figural et le conceptuel forment une dyade dynamique plutôt qu’une dichotomie rigide. Ces considérations pourraient apporter un nouvel éclairage sur la question de savoir si la pensée chinoise ancienne est imagée.
Human DUX4 and mouse Dux interact with STAT1 and broadly inhibit interferon-stimulated gene induction
Authors: Spens Amy E , Sutliff Nicholas A , Bennett Sean R , Campbell Amy E , Tapscott Stephen J
Published: April 2023

DUX4 activates the first wave of zygotic gene expression in the early embryo. Mis-expression of DUX4 in skeletal muscle causes facioscapulohumeral dystrophy (FSHD), whereas expression in cancers suppresses IFNγ induction of major histocompatibility complex class I (MHC class I) and contributes to immune evasion. We show that the DUX4 protein interacts with STAT1 and broadly suppresses expression of IFNγ-stimulated genes by decreasing bound STAT1 and Pol-II recruitment. Transcriptional suppression of interferon-stimulated genes (ISGs) requires conserved (L)LxxL(L) motifs in the carboxyterminal region of DUX4 and phosphorylation of STAT1 Y701 enhances interaction with DUX4. Consistent with these findings, expression of endogenous DUX4 in FSHD muscle cells and the CIC-DUX4 fusion containing the DUX4 CTD in a sarcoma cell line inhibit IFNγ induction of ISGs. Mouse Dux similarly interacted with STAT1 and suppressed IFNγ induction of ISGs. These findings identify an evolved role of the DUXC family in modulating immune signaling pathways with implications for development, cancers, and FSHD.
School absenteeism among students in Germany, Japan, Sweden, and the United Kingdom:
Authors: Fredriksson Ulf , Rasmusson Maria , Backlund Åsa , Isaksson Joakim , Kreitz-Sandberg Susanne
Published: April 2023

School absenteeism is a challenge in many countries. Still, there are few comparisons between countries, which is partly due to a lack of shared definitions of concepts. This article makes use of PISA data to compare self-reported student absenteeism in Germany, Japan, Sweden, and the United Kingdom (UK). Three data sets are used, from 2012, 2015, and 2018. The self-reported absenteeism, which is referred to as truancy in the PISA studies, was measured as having skipped a whole school day at least once in the two full weeks before students completed the PISA student questionnaire.
The results show great variation between the studied countries, from 24.4% in the UK in 2015 to 1.5% in Japan in 2012. The percentage of students who reported having skipped school is much higher in the UK than in the other three countries. The differences between the countries concerning the percentage of students reporting having been absent from school are significant for all years, except between Sweden and Germany in 2015. Germany and the UK have a similar pattern in development, with the highest percentages in 2015, while Sweden and Japan have small (albeit not significant) increases from 2012 to 2018. The UK is the only country where the changes between 2012 and 2015 as well as between 2015 and 2018 were significant.
It is not possible to see any obvious patterns between the countries that might be linked to differences related to their welfare regimes, education systems, or values. To find such patterns, it may be necessary either to include more countries in a study or to conduct more in-depth studies on each country.
An anti-collusion attack defense method for physical layer key generation scheme based on transmission delay
Authors: Wang Xiaowen , Huang Jie , Qi Chunyang , Peng Yang , Zhang Shuaishuai
Published: April 2023

Physical layer security (PLS) is considered one of the most promising solutions to solve the security problems of massive Internet of Things (IoTs) devices because of its lightweight and high efficiency. Significantly, the recent physical layer key generation (PLKG) scheme based on transmission delay proposed by Huang et al. (2021) does not have any restrictions on communication methods and can extend the traditional physical layer security based on wireless channels to the whole Internet scene. However, the secret-sharing strategy adopted in this scheme has hidden dangers of collusion attack, which may lead to security problems such as information tampering and privacy disclosure. By establishing a probability model, this article quantitatively analyzes the relationship between the number of malicious collusion nodes and the probability of key exposure, which proves the existence of this security problem. In order to solve the problem of collusion attack in Huang et al.’s scheme, this article proposes an anti-collusion attack defense method, which minimizes the influence of collusion attack on key security by optimizing parameters including the number of the middle forwarding nodes, the random forwarding times, the time delay measurement times and the out-of-control rate of forwarding nodes. Finally, based on the game model, we prove that the defense method proposed in this article can reduce the risk of key leakage to zero under the scenario of the “Careless Defender” and “Cautious Defender” respectively.
Hybrid coordination for the fast formation building of multi-small-AUV systems with the on-board cameras and limited communication
Authors: Wang Xiaomin , Zhang Xiaohan , Zheng Zhou , Kong Xu
Published: April 2023

Formation building for multi-small-AUV systems with on-board cameras is crucial under the limited communication underwater environment. A hybrid coordination strategy is proposed for the rapid convergence to a leader-follower pattern. The strategy consists of two parts: a time-optimal local-position-based controller (TOLC) and a distributed asynchronous discrete weighted consensus controller (ADWCC). The TOLC controller is designed to optimize the assignation of AUVs’ destinations in the given pattern and guide each AUV to its destination by the shortest feasible distance. The ADWCC controller is developed to direct the AUVs blocked by obstacles to reach their destinations with the information from the perceived neighbors by on-board cameras. The rapidity of the proposed strategy is theoretically discussed. The effectiveness of the proposed algorithm has been verified in the simulation environments in both MATLAB and Blender.
Association of ApoE gene polymorphisms with serum lipid levels and the risk of type 2 diabetes mellitus in the Chinese Han population of central China
Authors: Zeng Yali , Wen Shuang , Huan Lijun , Xiong Liang , Zhong Botao , Wang Pengyun
Published: April 2023

Background

Apolipoprotein E (ApoE) is involved in lipid transformation and metabolism. Although some studies have examined the association between ApoE polymorphisms and the risk of type 2 diabetes mellitus (T2DM), the findings differ depending on the location and population.

Methods

A total of 1,738 participants, including 743 patients with T2DM and 995 controls without T2DM, were enrolled from central China, and ApoE polymorphisms, 388T > C (rs429358) and 526C > T (rs7412), were genotyped. The association between ApoE alleles and T2DM and blood lipid levels was analyzed. Logistic regression analysis was performed to evaluate the interactions between ApoE polymorphisms and various factors, such as age, sex, and prevalence of hypertension in patients with T2DM.

Results

The genotype ɛ3/ɛ4 and ɛ4 alleles of ApoE were associated with T2DM risk in the Chinese Han population in central China. Moreover, in patients with T2DM, participants in the E4 (ɛ3/ɛ4, ɛ4/ɛ4) group had significantly higher lipid profiles than those in the E3 (ɛ3/ɛ3) group, whereas participants in the E2 group (ɛ2/ɛ2, ɛ2/ɛ3) showed lower total cholesterol, low-density lipoprotein cholesterol, and ApoE-A1 levels than those in the E3 (ɛ3/ɛ3) group. The results from the current study may help in understanding ApoE polymorphisms and lipid profiles in the Chinese Han population.
Research on the Integration of Online and Offline Teaching Forms of Ideological and Political Theory Courses in the Context of the COVID-19
Authors: Lan Ming
Published: April 2023

In the context of the epidemic situation, in combination with the actual situation of teachers and students, organize teachers to carry out online teaching in different levels and categories, promote the quality and efficiency of classroom teaching, actively promote the curriculum construction and "cloud teaching+ideological and political" teaching, at the same time, combine the anti-epidemic materials to play the role of ideological and political course ideological guidance and value guidance, enrich and expand the new connotation of ideological and political education. The article expounds the theoretical construction of the offline ideological and political education model for epidemic prevention and control and puts forward the practical content of "five in one" and "ten emphases" based on the actual work, to provide some practical countermeasures and suggestions for the online ideological and political education.
Development of an Electronic Platform for Vocational Skills Training Based on Collective Data Sharing Technology
Authors: Li Chunjie
Published: April 2023

In this paper, data dimensionality reduction and feature extraction are carried out based on the discrete set data, and the set data sharing algorithm and simulation examples are proposed on the decentralized cloud sharing platform. Maslow's Hierarchy of Needs Theory, Constructivist Learning Theory, etc. School-enterprise cooperation to build a "school-in-a-plant", building a multi-functional on-campus training base integrating "integrated teaching, productive practice, product research and development, skills training and appraisal, and technical services"; to improve the overall level of professional development and service capabilities.
Course Ideological and Political Exploration and Practice under Professional Ideological and Political Leadership
Authors: Chunjie Li
Published: April 2023

"Curriculum Ideology and Politics" is an important part of the current ideological and political work in higher education, and science and engineering professional courses have difficulties in the implementation of "Curriculum Ideology and Politics" because they use natural science, engineering technology, etc. as the teaching content. Taking the building materials course as an example, it is an important embodiment of the synergy effect. Promoting the ideological and political construction of courses is an inevitable requirement for colleges and universities to educate people, and it is an important way to build morality and cultivate people. This article first expounds the concept and connotation of curriculum ideology and politics, and then combines the curriculum characteristics of professional courses to give some ways and methods for professional courses to develop curriculum ideology and politics.
Construction and Application of Digital System in the Field of Financial Auditing in Colleges and Universities
Authors: Wei Lu
Published: April 2023

Nowadays, people have entered the digital age, and the development of digital technology has changed the traditional production methods and promoted industrial upgrading. With the continuous deepening of information construction, digital auditing has begun to be widely used in financial auditing. This paper analyzes the current situation of financial auditing under digital conditions and puts forward measures for the effective application of digital auditing in financial auditing based on the current situation. On this basis, this paper expounds the framework and composition of university financial digital platform construction, and then analyzes the specific application methods of university financial digitalization, including financial information digitalization, financial management process digitalization, business digitalization, etc. made some suggestions. Through the research, I hope to provide some help and inspiration for the application of financial digitization in colleges and universities.
Carbon Rights Trading - The Synergistic Impact of Climate Finance and Regional Economic Development on Regional Economy
Authors: Yang Jun
Published: April 2023

Climate finance is a financial solution that has emerged to address climate change and develop a low carbon economy and is a significant trend in the development of modern finance. The article mainly reviews and prospects climate finance related issues. Research has pointed out that from a global perspective, climate finance has emerged with the emergence of global climate change issues and will inevitably develop with the deepening of global efforts to address climate change. Climate change mitigation, adaptation, and marketization of climate friendly technologies will be the three major areas of climate finance support. The financial ecological environment and its various factors in the Beijing Tianjin Hebei region have overall positive effects on economic development, but the effects of each factor vary. The financial ecological environment has a positive promoting effect on the growth of economic aggregates, the tertiary industry, and urbanization, and has a significant impact on the growth of economic aggregates and urbanization. Insufficient support for the primary industry has a negative impact on the growth of the secondary industry.
Clinical Presentations and Operative Management of Non Traumatic Acute Pain Abdomen- A Prospective Interventional Study from Jorhat, Assam, India
Authors: Nath Hemendra Chandra , Doley Debanarayan , Das Nayanjyoti , Acharya Labanya Kumar , Gogoi Sufil
Published: April 2023

Introduction: Non traumatic acute abdominal pain is a very common reason for patients’ visit to the Emergency Department and remains a challenging task for general surgeons in terms of appropriate diagnosis as well as management in a timely manner. Aim: To evaluate the clinical presentations, the operative management and the post-operative outcome of patients presented with non-traumatic acute pain abdomen. Materials and Methods: A hospital-based prospective interventional study was done in 250 patients presenting with non-traumatic acute pain abdomen to the Emergency Department of General Surgery, Jorhat Medical College and Hospital, Jorhat, Assam, India, from June 2021 to May 2022. Demographic profile, detailed history physical examination, operative managements and the outcome were noted. Results: Out of 250 patients with non-traumatic acute pain abdomen who underwent operative intervention, most affected age group was 2nd-4th decade of life, comprising 165 (66%) patients. A total of 167 (66.80%) were males. Most common presenting symptom besides pain abdomen was nausea, seen in 172 (68.80%) cases. Most common clinical sign besides tenderness was abdominal muscle guarding, seen in 220 (88%) cases. Acute appendicitis was the most common aetiology with 129 (51.60%) patients and emergency open appendicectomy was the most common surgical procedure performed. Most common post-operative complication was surgical site infection, seen in 57 (22.80%) cases. Mortality rate was 3.60% (9 deaths). Conclusion: As most acute pain abdomen invariably present with surgical emergency and varied aetiology, the complexity for imparting the most appropriate treatment is increased. Hence, surgeons in the emergency department need to be wellversed in assessing the patients right from taking of proper history, clinical correlation of symptoms to elicitation of signs, assisted with most readily available investigations, to arrive at a prompt diagnosis to provide appropriate surgical intervention at the earliest.
Assessment of the Agroforestry System on Farmers Socioeconomic Status in Azamgarh District, Uttar Pradesh, India
Authors: Kaushal Gyan Shri , Raj A. J. , Kumar Hemant , Khare Neelam , Masih Shalini , Umrao Rajiv
Published: April 2023

The study investigated that the Socioeconomic status and use of an agroforestry system, 20 farmers from one district, four blocks, and four villages per block were randomly selected. The socioeconomic condition of the agroforestry system in the Azamgarh districts of Uttar Pradesh is based on preliminary study. According to the size of their holdings, the respondents were divided into Palhani, Bilariyaganj, Mehnagar, and Jahanaganj block farmers, and observations were made about their socioeconomic profiles. Farmers ranged in age from middle-aged to elderly; the majority had completed middle school, whereas large farmers were more likely to have completed high school; most of them were nuclear families with semi-cemented or cemented homes and had more than 10 years of expertise in agriculture and agroforestry. Their family sizes ranged from medium to big, or over 5 individuals. In the three categories of farmers, the risk orientation ranged from low to medium; the scientific orientation was of a medium degree. The large farmers were found to be more exposed to the media, and most farmers were found to attend group meetings. Smallholder farmers, especially in developing nations, contribute significantly to local, regional, and economies as a result of socioeconomic and environmental constraints. About 75% of the world's agricultural land is used by smallholders.
Research on Formwork Construction Technology of Railway Bridge
Authors: Hua Qiao De
Published: April 2023

With the continuous development of railway bridge construction, the application of new technology, new technology and new materials is becoming more and more extensive, which puts forward higher requirements for the design and construction of formwork. This article takes railway bridge templates as the research object, and focuses on the technical difficulties in the design and construction of prefabricated and assembled bridge templates for segments. Combined with the currently under construction Zhengzhou to Xuchang railway elevated bridge project, the short line method is used for construction, and the types of railway bridge templates, design and construction techniques of templates are introduced. Combining engineering examples to illustrate the characteristics of template design and construction, this provides a reference for the design and construction of similar bridge templates in the future.
Preclinical In vivo Acute Toxicity Testing of Hyrdoethanolic Extracts of Ficus thonningii Blume (Moraceae) on Wistar Rat Models
Authors: Fokunang Estella Tembe , Ara Ngo Biyiha Marilyn Orlane , Pantaleon Ambassa , Legrand Njinkio Nono Borgia , Bathelemy Ngameni , Charles Fokunang
Published: April 2023

Ficus thonningii (Blume) is a medicinal plant whose biological activity has been demonstrated in the management of peptic ulcers. Unfortunately, little scientific data exists on its toxicity. This is why we studied the acute and subacute oral toxicity profile of the hydro-ethanolic extract of the bark of F. thonningii and the systemic exposure of the bioactive components of the plant.Acute toxicity was assessed by administering a single dose of 2000 mg/kg to 5-week-old rats and observed for 14 days. The subacute toxicity study was performed in 6-week-old rats. Animals were orally treated with a daily dose of 125 mg/kg, 250 mg/kg, 500 mg/kg extract for 28 days. A satellite group of animals received 500 mg/kg per day for 28 days and after discontinuation of treatment they were observed for 14 days. Hematological and blood biochemical parameters, as well as kidney and liver histology, were recorded at the end of each experiment. For acute treatment, administration of a dose of 2000 mg/kg did not induce any critical behavioral changes or deaths. Following subacute dosing, biochemical analysis revealed a slight elevation of liver parameters in the 500mg/kg hydroethanolic extract, while no significant increase was observed for kidney parameters. This study showed that daily administration of Ficus thonningii (Blume) for 28 days resulted in the potential to reverse impairment of liver function.
Excavation of Neolithic pits, later prehistoric structures and a Roman temporary camp along the line of A96 Kintore and Blackburn Bypass, Aberdeenshire
Authors: Alexander Derek , Cowie T , Cressey M , Finlayson B , Holden T , Hunter F
Published: April 2023

Investigation prior to the construction of the bypass revealed features relating to various periods of activity. Pits were identified at several locations containing prehistoric pottery, while the northern and western perimeters of a Roman temporary camp were examined. The foundations of an Iron Age timber structure c. ten metres in diameter were excavated. Extensive excavation around the western entrance of the Roman temporary camp located a concentration of features including a spread of pits containing Neolithic pottery and chipped stone, four later prehistoric structures and Roman/Early Historic field ovens. Twenty-five Neolithic to Early Romano-British radiocarbon dates are reported. Includes separately authored reports on:
Developer-funded fieldwork in Scotland, 1990-2003
Authors: Phillips Tim , Bradley Richard
Published: April 2023

The paper is in two parts. The first presents a digest of the prehistoric evidence recovered by developer-funded archaeology between 1990 and 2003 and compares it with the results of projects funded by Historic Scotland. The second reflects on the wider significance of this material in relation to past and present research on Scottish prehistory and its implications for the archaeology of Britain and Ireland.
Prescribing Opioids for Pain
Authors: Ari Mim , Alexander Jason T. , Weyer George
Published: April 2023

This JAMA Clinical Guidelines Synopsis summarizes the Centers for Disease Control and Prevention’s 2022 clinical practice guideline for prescribing opioids for pain.
Association Between a Capitated, Low-cost, County-Based Public Health Insurance Option and Affordable Care Act Premium Growth in California
Authors: Teotia Arjun , Arnold Daniel R. , Scheffler Richard M.
Published: April 2023

Importance

Empirical evidence is needed on how a capitated, risk-based county plan performs as a viable public option in the Affordable Care Act (ACA) Marketplace in California.

Objective

To estimate whether LA Care—a capitated, county-based public option and California’s largest public insurer—was associated with health insurance premium growth in the Los Angeles (LA) regions of Covered California (CC), the ACA exchange in California.

Design, Setting, and Participants

This economic evaluation used ACA silver plan premium data within the 19 CC regions. Difference-in-differences and event study models used data on plan-level premiums from Health Insurance Exchange Compare for years 2014 to 2022 to estimate the association between LA Care and ACA premium growth in LA.

Exposures

The intervention was LA Care becoming the lowest-cost health plan on the ACA exchange in 2018. The treatment group included the East and West LA regions, and the control group included the remaining 17 CC regions.

Main Outcomes and Measures

The main outcome variable was annual premium growth of plans on CC from 2014 to 2022.

Results

Using 504 plan-level observations for 2014 to 2022, ACA premium growth in LA declined by 4.8% after LA Care became the lowest-cost health plan on the exchange in 2018 (coefficient estimate, −0.048; SE, 0.022; 95% CI, −0.093 to −0.002). Savings due to lower premium growth from 2019 to 2022 were calculated to be $345 million, with approximately 70% of the savings ($242 million) going to the federal government.

Conclusions and Relevance

In this economic evaluation, LA Care was associated with lower premium growth of other health insurance plans in the LA regions of CC, with the majority of savings going to the federal government. California could have captured these savings if it had applied for and received a State Innovation Waiver under section 1332 of the ACA. LA Care may be a viable public option with the potential to be expanded across California through the state’s 16 other county-based health plans.
Internal Medicine Resident Perspectives on Virtual Recruitment
Authors: O’Connor Alec B. , McGarry Kelly , Finn Kathleen M. , Harris Linda , Zaas Aimee K.
Published: April 2023

This survey study describes the perceived implications of virtual-only recruitment and the preferred application process for residents and fellows.
Trends in the Prevalence of Stroke Among Community-Dwelling Individuals in the US, 1999-2018
Authors: Andres Wells , Rothstein Aaron , Elser Holly , Sloane Kelly L. , Gottesman Rebecca F. , Kasner Scott E. , Schneider Andrea L. C.
Published: April 2023

This cross-sectional study estimates trends in stroke prevalence representative of the noninstitutionalized civilian population of US adults 20 years and older using data from the 1999 to 2018 National Health and Nutrition Examination Surveys.
Characteristics of Progressive Multifocal Leukoencephalopathy Associated With Sarcoidosis Without Therapeutic Immune Suppression
Authors: McEntire Caleb R. S. , Fletcher Anita , Toledano Michel , Epstein Samantha , White Emily , Tan C. Sabrina , Mao-Draayer Yang , Banks Samantha A. , Aksamit Allen J. , Gelfand Jeffrey M. , Thakur Kiran T. , Anand Pria , Cortese Irene , Bhattacharyya Shamik
Published: April 2023

Importance

Progressive multifocal leukoencephalopathy can occur in the context of systemic sarcoidosis (S-PML) in the absence of therapeutic immune suppression and can initially be mistaken for neurosarcoidosis or other complications of sarcoidosis. Earlier recognition of S-PML could lead to more effective treatment of the disease.

Objective

To describe characteristics of patients with S-PML.

Design, Setting, and Participants

For this case series, records from 8 academic medical centers in the United States were reviewed from 2004 to 2022. A systematic review of literature from 1955 to 2022 yielded data for additional patients. Included were patients with S-PML who were not receiving therapeutic immune suppression. The median follow-up time for patients who survived the acute range of illness was 19 months (range, 2-99). Data were analyzed in February 2023.

Exposures

Sarcoidosis without active therapeutic immune suppression.

Main Outcomes and Measures

Clinical, laboratory, and radiographic features of patients with S-PML.

Results

Twenty-one patients with S-PML not receiving therapeutic immune suppression were included in this study, and data for 37 patients were collected from literature review. The median age of the 21 study patients was 56 years (range, 33-72), 4 patients (19%) were female, and 17 (81%) were male. The median age of the literature review patients was 49 years (range, 21-74); 12 of 34 patients (33%) with reported sex were female, and 22 (67%) were male. Nine of 21 study patients (43%) and 18 of 31 literature review patients (58%) had simultaneous presentation of systemic sarcoidosis and PML. Six of 14 study patients (43%) and 11 of 19 literature review patients (58%) had a CD4+ T-cell count greater than 200/μL. In 2 study patients, a systemic flare of sarcoidosis closely preceded S-PML development. Ten of 17 study patients (59%) and 21 of 35 literature review patients (60%) died during the acute phase of illness. No meaningful predictive differences were found between patients who survived S-PML and those who did not.

Conclusions and Relevance

In this case series, patients with sarcoidosis developed PML in the absence of therapeutic immune suppression, and peripheral blood proxies of immune function were often only mildly abnormal. Systemic sarcoidosis flares may rarely herald the onset of S-PML. Clinicians should consider PML in any patient with sarcoidosis and new white matter lesions on brain magnetic resonance imaging.
Clinical Features Associated With Rate of Fractures in Patients With Systemic Sclerosis: A US Cohort Study
Authors: Rogers Bliss , Famenini Sina , Perin Jamie , Danila Maria I. , Wipfler Kristin , Michaud Kaleb , McMahan Zsuzsanna H.
Published: April 2023

Objective

Systemic sclerosis (SSc) is associated with several specific risk factors for fracture due to the complications of the disease and related medications. The present study was undertaken to examine the relationship between SSc‐associated clinical features and fracture rate in a large US cohort.

Methods

Participants with SSc in FORWARD, The National Databank for Rheumatic Diseases, were included (1998–2019). Age‐ and sex‐matched individuals with osteoarthritis (OA) from the same database were included as comparators. The primary end point was self‐reported major osteoporotic fracture. Cox proportional hazards models were used to study the associations between risk factors and fractures.

Results

The study included 922 individuals (SSc patients, n = 154; OA patients, n = 768). Eighty‐seven percent were female, with a mean age of 57.8 years. Fifty‐one patients developed at least 1 fracture during a median of 4.2 years (0.5–22.0 years) of follow‐up. Patients with SSc had more frequent fractures compared to OA comparators (hazard ratio [HR] 2.38 [95% confidence interval (95% CI) 1.47–3.83]). Among patients with SSc, a higher Rheumatic Disease Comorbidity Index score (HR 1.45 [95% CI 1.20–1.75]) and a higher Health Assessment Questionnaire disability index score (HR 3.83 [95% CI 2.12–6.93]) were associated with more fractures. Diabetes mellitus (HR 5.89 [95% CI 2.51–13.82]) and renal disease (HR 2.43 [95% CI 1.10–5.37]) were independently associated with fracture among SSc patients relative to SSc patients without these comorbidities.

Conclusion

Our findings highlight factors associated with fracture among patients with SSc. Disability as measured by the HAQ DI is a particularly strong indicator of fracture rate in SSc. Improving SSc patients’ functional status, where possible, may lead to better long‐term outcomes.
A new application of the hardware in the loop test of the min–max controller for turbofan engine fuel control
Authors: Davoodi M. , Bevrani H.
Published: April 2023

This article performs a novel hardware test application on the min–max algorithm to control a two‐axis turbofan engine's fuel with a high bypass ratio. In this technique the microcontroller uses a nonlinear model based on the min–max algorithm to control the turbofan's fuel consumption. The min–max control method precisely provides the desired thrust while meeting the engine's physical and operational limitations. By setting the engine's limits appropriately, a surge is prevented from happening due to overheating of the turbine. As a proof of concept, the proposed fuel control algorithm is verified using an Intel Addison's Arduino microcontroller connected to a computer. The implemented hardware is examined by incorporating it into a typical control loop test and monitored via a computer. The achieved results indicate fast time response and algorithm flexibility in simulation modes. The test results confirm the precision and proper implementation of the proposed min–max control algorithm. In addition, the suggested min–max control algorithm can be applied to realize restrictions such as the rotational speed and the outlet pressure of the high‐pressure compressor under the required conditions.
Applicability Analysis of Carbon Fiber Composite Materials for a Novel Lightweight Designing Lap Bar of Amusement Ride
Authors: Liu Ran , Zhang Peng-fei , Shen Gong-Tian , Zhang Yong , Zhou Wei , Xiao Kun-Ming , Li Qing
Published: April 2023

The machinery manufacturing industry, including amusement rides, has made progress in structural lightweight and increasingly using carbon fiber‐reinforced plastics (CFRP) to achieve modest weight savings. The lap bar, as a key force‐bearing component used to restrain passengers, bears the brunt of becoming an important direction for lightweight design. To address this issue, the study analyzes and calculates its stress and deformation based on finite element analysis, and the results show that the CFRP lap bar does not exhibit obvious strain concentration, expected to have a longer service life. On the basis of these studies, the CFRP lap is prepared, and it is found that this substitution leads to a reduction in weight of 66.7%. In addition, three groups of fatigue tests are used to simulate its running state under nuclear load and overload, and acoustic emission (AE) technology is used to monitor it. The results show that there is no obvious damage in the tests of three different stages, and the reliability is strong, which verifies that the selection of carbon fiber materials can meet the requirements of bumpers.