bluuebunny/crossref_metadata_2025 huggingface dataset:
Ecotourism Potential: A Bibliometric Review
Authors: SHI Shanshan , LI Mi , XI Jianchao
Published: December 2023

Ecotourism potential is a fundamental research effort needed to promote sustainable regional tourism development, and scholars have paid greater attention to it in recent years, which has led to an increase in the publication of literature on this important and widely recognized topic. However, there is still no clear picture of the development direction of research on ecotourism potential. To address this issue, this study attempts to provide a comprehensive analysis of the existing research state in this field. This paper presents a more detailed review of ecotourism potential, a bibliometric analysis of 949 articles selected from 1,027 publications retrieved from the Web of Science Core Collection database, and a systematic descriptive and network analysis of the bibliometric data using the Biblioshiny tool. Here are some interesting findings: (1) research on the ecotourism potential in the academy started in 1992, with a rapid growth in the number of publications after 2013, with an overall interdisciplinary character and the emergence of a research community represented by Milcu, Balmford, Gallagher, and others; (2) ecotourism, conservation, tourism, management, and biodiversity are high-frequency keywords in this field, revealing the main research directions; (3) the development and evolution of research focus are mainly on three aspects: wildlife and biodiversity conservation, nature-based tourism and environmental values, and the modes and contributions of community participation. Future research should focus on the scientific references of ecotourism potential for promoting regional sustainable development. This paper sheds some light on the comprehensive bibliometric studies on ecotourism potential and improves our understanding of the evolution of this academic discourse theme over the last three decades.
A Virtual Reality Scene Taxonomy: Identifying and Designing Accessible Scene-Viewing Techniques
Authors: Franz Rachel L. , Junuzovic Sasa , Mott Martez
Published: December 2023

Virtual environments (VEs) afford similar interactions to those in physical environments: individuals can navigate and manipulate objects. Yet, a prerequisite for these interactions is being able to view the environment. Despite the existence of numerous scene-viewing techniques (i.e., interaction techniques that facilitate the visual perception of virtual scenes), there is no guidance to help designers choose which techniques to implement. We propose a scene taxonomy based on the visual structure and task within a VE by drawing on literature from cognitive psychology and computer vision, as well as virtual reality (VR) applications. We demonstrate how the taxonomy can be used by applying it to an accessibility problem, namely limited head mobility. We used the taxonomy to classify existing scene-viewing techniques and generate three new techniques that do not require head movement. In our evaluation of the techniques with 16 participants, we discovered that participants identified tradeoffs in design considerations such as accessibility, realism, and spatial awareness, that would influence whether they would use the new techniques. Our results demonstrate the potential of the scene taxonomy to help designers reason about the relationships between VR interactions, tasks, and environments.
Between Rhetoric and Reality: Real-world Barriers to Uptake and Early Engagement in Digital Mental Health Interventions
Authors: Jardine Jacinta , Nadal Camille , Robinson Sarah , Enrique Angel , Hanratty Marcus , Doherty Gavin
Published: December 2023

Digital mental health interventions (DMHIs) have potential to provide effective and accessible care to entire populations, but low client uptake and engagement are significant problems. Few prior studies explore the lived experiences of non-engagers, because reaching this population is inherently difficult. We present an observational inquiry into the barriers to sign-up and early use of a DMHI, along with reasons for initial interest in the DMHI. We collected 205 online questionnaire responses and 20 interviews from self-referring participants across four healthcare ecosystems in the UK and US. Questionnaire results revealed that uncertainty about DMHI usefulness and usability were the main barriers to uptake, whereas forgetting about it, not finding time for it and not finding it useful were the main barriers to early engagement. Participants reported multiple reasons for considering the DMHI, reflecting the contextual, subjective nature of mental health. Our thematic analysis generated themes around (1) the need for human connection, (2) the impact of self-stigma on help-seeking, (3) the lack of knowledge around DMHIs and psychological therapy, (4) the desire for personally relevant care, and (5) the fluctuating, perennial nature of mental health. We discuss implications for DMHI design, implementation and future research, as well as transdisciplinary opportunities.
RSPP: Restricted Static Pseudo-Partitioning for Mitigation of Cross-Core Covert Channel Attacks
Authors: Kaur Jaspinder , Das Shirshendu
Published: December 2023

Cache timing channel attacks exploit the inherent properties of cache memories: hit and miss time along with the shared nature of the cache to leak secret information. The side channel and covert channel are the two well-known cache timing channel attacks. In this article, we propose Restricted Static Pseudo-Partitioning (RSPP), an effective partition-based mitigation mechanism that restricts the cache access of only the adversaries involved in the attack. It has an insignificant impact of only 1% in performance, as the benign processes have access to the full cache and restrictions are limited only to the suspicious processes and cache sets. It can be implemented with a maximum storage overhead of 1.45% of the total Last-Level Cache (LLC) size. This article presents three variations of the proposed attack mitigation mechanism: RSPP, simplified-RSPP (S-RSPP) and corewise-RSPP (C-RSPP) with different hardware overheads. A full system simulator is used for evaluating the performance impact of RSPP. A detailed experimental analysis with different LLC and attack parameters is also discussed. RSPP is also compared with the existing defense mechanisms effective against cross-core covert channel attacks.
Conditional GrÖbner Basis: GrÖbner Basis Detection with Parameters
Authors: Nagasaka Kosaku , Oshimatani Ryo
Published: December 2023

For a given finite polynomial set, finding a monomial order such that the given set is already a GrÖbner basis for the ideal generated by the given set with respect to the found monomial order is called
GrÖbner basis detection
(GBD) problem and there is also its simpler version, called
structural GrÖbner basis detection
(SGBD) problem. In this short communication, we give algorithms to solve these problems for polynomials with parameters on their coefficients.
Sex-specific increases in myostatin and SMAD3 contribute to obesity-related insulin resistance in human skeletal muscle and primary human myotubes
Authors: Saxena Gunjan , Gallagher Sean , Law Timothy D. , Maschari Dominic , Walsh Erin , Dudley Courtney , Brault Jeffrey J. , Consitt Leslie A.
Published: December 2023

Obesity is considered a main risk factor for the development of insulin resistance and type 2 diabetes. The present study utilizes in vivo and in vitro experiments in human skeletal muscle to demonstrate for the first time that females are inherently more susceptible to myostatin-induced insulin resistance, which is further enhanced with obesity due to increased myostatin and SMAD3 expression.
Integrative Multi-omics Analysis Reveals Different Metabolic Phenotypes Based on Molecular Characteristics in Thyroid Cancer
Authors: Kim Yoo Hyung , Yoon Sang Jun , Kim Mina , Kim Hwan Hee , Song Young Shin , Jung Jin Woo , Han Dohyun , Cho Sun Wook , Kwon Sung Won , Park Young Joo
Published: December 2023

Purpose:

Thyroid cancer metabolic characteristics vary depending on the molecular subtype determined by mutational status. We aimed to investigate the molecular subtype-specific metabolic characteristics of thyroid cancers.

Experimental Design:

An integrative multi-omics analysis was conducted, incorporating transcriptomics, metabolomics, and proteomics data obtained from human tissues representing distinct molecular characteristics of thyroid cancers: BRAF-like (papillary thyroid cancer with BRAFV600E mutation; PTC-B), RAS-like (follicular thyroid cancer with RAS mutation; FTC-R), and ATC-like (anaplastic thyroid cancer with BRAFV600E or RAS mutation; ATC-B or ATC-R). To validate our findings, we employed tissue microarray of human thyroid cancer tissues and performed in vitro analyses of cancer cell phenotypes and metabolomic assays after inducing genetic knockdown.

Results:

Metabolic properties differed between differentiated thyroid cancers of PTC-B and FTC-R, but were similar in dedifferentiated thyroid cancers of ATC-B/R, regardless of their mutational status. Tricarboxylic acid (TCA) intermediates and branched-chain amino acids (BCAA) were enriched with the activation of TCA cycle only in FTC-R, whereas one-carbon metabolism and pyrimidine metabolism increased in both PTC-B and FTC-R and to a great extent in ATC-B/R. However, the protein expression levels of the BCAA transporter (SLC7A5) and a key enzyme in one-carbon metabolism (SHMT2) increased in all thyroid cancers and were particularly high in ATC-B/R. Knockdown of SLC7A5 or SHMT2 inhibited the migration and proliferation of thyroid cancer cell lines differently, depending on the mutational status.

Conclusions:

These findings define the metabolic properties of each molecular subtype of thyroid cancers and identify metabolic vulnerabilities, providing a rationale for therapies targeting its altered metabolic pathways in advanced thyroid cancer.
Supplementary Figure S5 from Spatial and Temporal Mapping of Breast Cancer Lung Metastases Identify TREM2 Macrophages as Regulators of the Metastatic Boundary
Authors: Yofe Ido , Shami Tamar , Cohen Noam , Landsberger Tomer , Sheban Fadi , Stoler-Barak Liat , Yalin Adam , Phan Truong San , Li Baoguo , Monteran Lea , Scharff Ye'ela , Giladi Amir , Elbaz Miriam , David Eyal , Gurevich-Shapiro Anna , Gur Chamutal , Shulman Ziv , Erez Neta , Amit Ido
Published: December 2023

Cell-cell interactions among immune cells vary within metastatic lung tissues.
Supplementary Figure S4 from Spatial and Temporal Mapping of Breast Cancer Lung Metastases Identify TREM2 Macrophages as Regulators of the Metastatic Boundary
Authors: Yofe Ido , Shami Tamar , Cohen Noam , Landsberger Tomer , Sheban Fadi , Stoler-Barak Liat , Yalin Adam , Phan Truong San , Li Baoguo , Monteran Lea , Scharff Ye'ela , Giladi Amir , Elbaz Miriam , David Eyal , Gurevich-Shapiro Anna , Gur Chamutal , Shulman Ziv , Erez Neta , Amit Ido
Published: December 2023

Progression to lung metastasis is associated with infiltration by unconventional immune cell subtypes.
Supplementary Figure S2 from Spatial and Temporal Mapping of Breast Cancer Lung Metastases Identify TREM2 Macrophages as Regulators of the Metastatic Boundary
Authors: Yofe Ido , Shami Tamar , Cohen Noam , Landsberger Tomer , Sheban Fadi , Stoler-Barak Liat , Yalin Adam , Phan Truong San , Li Baoguo , Monteran Lea , Scharff Ye'ela , Giladi Amir , Elbaz Miriam , David Eyal , Gurevich-Shapiro Anna , Gur Chamutal , Shulman Ziv , Erez Neta , Amit Ido
Published: December 2023

Lung metastases and primary tumors exhibit divergent immune landscapes.
FIGURE 6 from Monitoring Glucocorticoid Receptor in Plasma-derived Extracellular Vesicles as a Marker of Resistance to Androgen Receptor Signaling Inhibition in Prostate Cancer
Authors: Gentile Emanuela , Hahn Andrew W. , Song Jian H. , Hoang Anh , Shepherd Peter D. A. , Ramachandran Sumankalai , Navone Nora M. , Efstathiou Eleni , Titus Mark , Corn Paul G. , Lin Sue-Hwa , Logothetis Christopher J. , Panaretakis Theocharis
Published: December 2023

Monitoring changes in GR signaling in patients with localized hormone naïve disease treated with ADT. A, Preoperative trial NCT03279250 Clinical data and PSA concentration at BL and after 6 months of treatments (6 months). B, PSA and steroid levels in plasma, PSA (****, P <0.0001), testosterone (****, P <0.0001). C, Steroid levels in plasma cortisol (**, P = 0.0045). D, GR expression in RNA from EVs transcriptome analysis at BL and after 6 months of treatment. Patients were divided in two different groups bases on upregulation >0.5 or downregulation <0.5 of GR expression. Differential GR expression in GR− and GR+ groups from transcriptome analysis in plasma-derived EVs: GR+ (*, P = 0.0125). E, GR expression in tissues collected from patient's prostatectomy after therapy. IHC images from selected patients GR− and GR+ and IHC quantification of all GR+ and GR− patients with ImageJ.
FIGURE 5 from Monitoring Glucocorticoid Receptor in Plasma-derived Extracellular Vesicles as a Marker of Resistance to Androgen Receptor Signaling Inhibition in Prostate Cancer
Authors: Gentile Emanuela , Hahn Andrew W. , Song Jian H. , Hoang Anh , Shepherd Peter D. A. , Ramachandran Sumankalai , Navone Nora M. , Efstathiou Eleni , Titus Mark , Corn Paul G. , Lin Sue-Hwa , Logothetis Christopher J. , Panaretakis Theocharis
Published: December 2023

Effect of GR inhibitor in combination with ENZA on ENZA-resistant tumors. Schema and treatment planning for in vivo experiment with LNCaP cells subcutaneous injected in NOD SCID mice; ENZA-R group was treated with COMBO (enzalutamide± mifepristone) between 21 and 28 days. A, Longitudinal analysis of ENZA-R (14 days vs. BL, *, P = 0.0246; end vs. BL, **, P = 0.0045; 14 days vs. end, **, P = 0.0078) and COMBO (Enzalutamide± Mifepristone; 14 days vs. BL, **, P = 0.0096; end vs. BL, *, P = 0.0385) from BL to 14 days until the end of the experiment (56 days) in LNCaP in vivo experiment. B, Final tumor growth analysis in LNCaP in vivo experiment (COMBO vs. VEHICLE, **, P = 0.0029). C, Comparison of GR expression for ENZA-R and COMBO mice in LNCaP in vivo experiment (ENZA-R vs. BL, ****, P ≤0.0001; COMBO vs. ENZA-R, **, P = 0.0077; COMBO, *, P = 0.0103). D, IHC images and quantification of GR expression between ENZA-S, ENZA-R, and COMBO groups, in MDA PCa 322-2-6a in vivo experiment. (ENZA-R vs. ENZA-S, *, P = 0.0456; quantification with ImageJ software). E, qRT-PCR results of GR for ENZA-S and ENZA-R and COMBO in plasma-derived EVs (ENZA-R vs. ENZA-S, ****, P ≤0.0001; COMBO vs. ENZA-R, ***, P = 0.0003) and tumors tissues in MDA PCa 322-2-6a in vivo experiment (ENZA-R vs. ENZA-S, **, P = 0.0045; COMBO vs. ENZA-R, *, P = 0.0277; COMBO vs. ENZA-S, *, P = 0.0196).
Data from Monitoring Glucocorticoid Receptor in Plasma-derived Extracellular Vesicles as a Marker of Resistance to Androgen Receptor Signaling Inhibition in Prostate Cancer
Authors: Gentile Emanuela , Hahn Andrew W. , Song Jian H. , Hoang Anh , Shepherd Peter D. A. , Ramachandran Sumankalai , Navone Nora M. , Efstathiou Eleni , Titus Mark , Corn Paul G. , Lin Sue-Hwa , Logothetis Christopher J. , Panaretakis Theocharis
Published: December 2023

Abstract
Disease progression following androgen ablation was shown to be associated with upregulation of the glucocorticoid receptor (GR). Longitudinal monitoring of GR expression in circulating extracellular vesicles (EV) may reflect changes in the tumor cell and facilitates detection of acquired resistance. We utilized LNCaP, LREX cells and a patient-derived xenograft, MDA PDX 322-2-6a, for in vitro and in vivo experiments. Plasma-derived EVs were isolated from patients with localized high-risk prostate cancer undergoing androgen ablation. The mRNA levels of GR in EVs and their responsive genes were detected by transcriptome analysis, qRT-PCR and the protein levels by Western blot analysis. We detected changes in GR expression at mRNA and protein levels in EVs derived from LNCaP and LREX cells in in vitro studies. In in vivo experiments, LNCaP and the PDX MDA 322-2-6a–bearing mice were treated with enzalutamide. GR levels in plasma-derived EVs were increased only in those tumors that did not respond to enzalutamide. Treatment of mice bearing enzalutamide-resistant tumors with a GR inhibitor in combination with enzalutamide led to a transient pause in tumor growth in a subset of tumors and decreased GR levels intracellular and in plasma-derived EVs. In a subgroup of patients with high-risk localized prostate cancer treated with androgen signaling inhibition, GR was found upregulated in matching tissue and plasma EVs. These analyses showed that GR levels in plasma-derived EVs may be used for monitoring the transition of GR expression allowing for early detection of resistance to androgen ablation treatment.
Significance:
Longitudinal monitoring of GR expression in plasma-derived EVs from patients with prostate cancer treated with androgen signaling inhibitors facilitates early detection of acquisition of resistance to androgen receptor signaling inhibition in individual patients.
A multimodal biometric database and case study for face recognition based deep learning
Authors: Kadhim Ola Najah , Hasan Abdulameer Mohammed
Published: December 2023

Recently, multimodal biometric systems have garnered a lot of interest for the identification of human identity. The accessibility of the database is one of the contributing elements that impact biometric recognition systems. In their studies, the majority of researchers concentrate on unimodal databases. There was a need to compile a fresh, realistic multimodal biometric database, nonetheless, because there were so few comparable multimodal biometric databases that were publically accessible. This study introduces the MULBv1 multimodal biometric database, which contains homologous biometric traits. The MULBv1 database includes 20 images of each person's face in various poses, facial emotions, and accessories, 20 images of their right hand from various angles, and 20 images of their right iris from various lighting positions. The database contains real multimodal data from 174 people, and all biometrics were accurately collected using the micro camera of the iPhone 14 Pro Max. A face recognition technique is also suggested as a case study using the gathered facial features. In the case study, the deep convolutional neural network (CNN) was used, and the findings were positive. Through several trials, the accuracy was (97.41%).
Evaluation of structural failure resistance of glass fiber reinforced concrete beams
Authors: Getachew Yilachew , Assegie Tsehay Admassu , Mohmmad Shaimaa Hadi , Salau Ayodeji Olalekan , Yanhui Liu , Braide Sepiribo Lucky
Published: December 2023

Glass fiber reinforced concrete (GFRC) is a composite material that is widely used in construction due to its high strength and durability. GFRC is made by adding glass fibers to the concrete mix, which increases the tensile strength of the material. This paper evlautes the shear resistance (SR) of sliced glass fiber (30 mm) GFRC beams. The shear resistance of GFRC beams can be significantly improved by adding glass fibers to the concrete mix. However, further research is needed to fully understand the shear behavior of GFRC and to optimize its design for maximum shear resistance. The result indicates that shear fracture glass fiber is a better alternative for increasing a shear resistance input mechanism.
Ocular biometry of snakes of the species Python bivittatus kept in captivity
Authors: Agostinho Inghrid Caroline Coutinho , Martins Jessica Amancio , Balbueno Melina Castilho Souza , Coelho Cidéli de Paula , Martins Júnior Raul
Published: December 2023

During embryological development, the eyelids of snakes fuse and no longer open like in mammals. They become transparent, thus forming spectacles, a transparent structure that covers the eyes. The primary function of these spectacles is to provide a physical barrier to protect the eyes without eyelids. This study aimed to evaluate the ocular biometry of Python bivittatus snakes. Ocular ultrasound examinations were performed on four individuals using the Logic E ultrasound device (GE, United States) with a 10-22 MHz linear probe. Conduction gel was used to make transducer contact with the cornea in these snakes. Images were obtained to evaluate the following measurements: axial length of the eyeball, anterior chamber depth, lens thickness, and vitreous depth. These measurements of intraocular structures were, respectively: 0.05 ± 0.02 cm for corneal thickness in the right eye and 0.04 ± 0.007 cm in the left eye; 0.11 ± 0.04 cm for anterior chamber depth in the right and left eyes; 0.36 ± 0.07 cm for the lens thickness in the right eye and 0.39 ± 0.05 cm in the left eye; 0.35 ± 0.05 for the depth of the vitreous chamber in the right eye and 0.31 ± 0.02 cm in the left eye; and 0.85 ± 0.18 cm for the length of the globe in the axial plane in the right eye and 0.85 ± 0.14 cm in the left eye. Knowledge of snakes’ anatomical and ophthalmological parameters is scarce, and the incidence of eye diseases is still little known, making further studies necessary.
Breaking the Vicious Circle between Discrimination and Homelessness
Authors: Fragkou Roxani , Tsadiras Alexandros
Published: December 2023

Homelessness is without a doubt a global phenomenon, constantly increasing at an alarming rate. Although discourse about homelessness is predominantly linked to discourse about inadequate housing, homelessness does not only amount to a breach of the right to housing, but furthermore constitutes a violation of a broad range of human rights, including non-discrimination. This article discusses how homelessness and discrimination mutually exacerbate and magnify one another, creating a vicious circle. The article places homelessness in a human rights framework, arguing that enhancing the anti-discrimination legislation is an essential component of breaking this vicious circle. In particular, the article suggests acknowledging homelessness as a protected ground under anti-discrimination law, illustrating how expanding the list of protected grounds in anti-discrimination law in Europe is expected to reinforce the effectiveness and coherence of the anti-discrimination legal framework and encourage its implementation, by remedying some of its shortcomings vis-à-vis people experiencing homelessness.
Impossible Representations: Fantasy, Mimesis, and Heteroglossia in Louisiana French Fiction
Authors: Cooper R. Paul
Published: December 2023

Modern Louisiana French fiction remains in scant supply. Modern Louisiana French fiction remains in scant supply, largely as a result of the dwindling number of French speakers. Even during the nineteenth century, French writers faced the same problems Louisiana French writers face today, how to model artistically a fading linguistic reality. This article argues that mimesis in Louisiana French fiction is impossible because there no longer exists a rich linguistic reality to use as a model. Despite this, Louisiana French fiction uses techniques from fantasy literature to bring that reality to life.
Interview: Faust in Three Languages, or How to Translate Goethe without Knowing German
Authors: Wanner Adrian , Astrakhan Vadim
Published: December 2023

Vadim Astrakhan is a Russian immigrant to the United States who has made a name for himself as a translator and performer of songs by Soviet bard Vladimir Vysotsky. While his previous translations were all from Russian, Astrakhan’s latest project is an English verse rendition of Goethe’s Faust. Astrakhan does not know German. He begins by running Goethe’s original text through Google Translate. He then collates the result with various existing English-language versions of Faust as well as the canonical Russian verse translation by Boris Pasternak (published 1953), which was his main inspiration for putting Faust into rhymed English verse. Adrian Wanner, a professor of Russian and comparative literature at Penn State and a native speaker of German, discusses with Astrakhan what prompted him to translate Goethe’s tragedy. The conversation touches on Astrakhan’s use of English and Russian sources and his methodology and goals as a translator, including the crucial importance he ascribes to bringing to life the music and humor of Goethe’s original for a contemporary American theatrical audience.
Neotypification of the sweet tabaiba, Euphorbia balsamifera (Euphorbiaceae)
Authors: FERRER-GALLEGO P. PABLO , RIINA RICARDA
Published: December 2023

N/A
Blocking Events in East Antarctica: Impact on Precipitation and their Association with Large-Scale Atmospheric Circulation Modes
Authors: Wang Sai , Ding Minghu , Liu Ge , Li Guancheng , Chen Wen
Published: December 2023

This study, utilizing ERA5 data from 1979 to 2021, identifies a prevalent occurrence of blocking events in East Antarctica, particularly in the region extending from Wilkes Land to Dronning Maud Land. The genesis of these blocking highs is typically facilitated by the intensification of Rossby waves within the circumpolar westerlies. By classifying the circulation patterns causing the blocking events, the blocking events in East Antarctica are divided into five categories. On the western flank of the blocking high, we observe the transportation of warm and humid air into inland Antarctica, instigating regional snowfall. High precipitation levels are observed in different regions based on the specific location of the blocking high. We also demonstrate that the contribution of atmospheric blockings to total annual precipitation and extreme precipitation events increases from coastal to inland. Over the East Antarctic plateau, the blockings are responsible for at least 15% of total accumulated snowfall and 30% of extreme precipitation events. Finally, we find a significant relationship between the interannual variability in East Antarctic blocking frequency and the phase variability of the Southern Annular Mode (SAM). A positive phase of the SAM inhibits an increase in blocking frequency, while a negative phase favors an increase. However, the two Pacific–South American patterns (PSA-1 and PSA-2), characterized by wave trains originating in the tropical Pacific that extend across the Southern Hemisphere extratropics, do not significantly influence the interannual variability in East Antarctic blocking frequency.
Simulation of the hexagonal 3D braiding process for stent preforms
Authors: Ding Caihong , Gu Xin , Lu Chenyu
Published: December 2023

Due to the complex braiding process and long development cycle of the hexagonal three-dimensional braided stent, a MatLab based computer-aided braiding method for a stent is proposed to speed up the development process. First, an oblique coordinate system for the chassis and a polar coordinate system for the chassis unit are constructed, respectively, precisely to coordinate the carrier’s movements on the chassis. Subsequently, an iterative formula delineating the trajectory of the carrier is introduced. The formula effectively translates the entire braiding process into the positional coordinates of the carrier on the chassis and the yarn heights on the mandrel during different stages. Based on the specific characteristics of the braiding process and the stent’s structure, the stent is divided into pressing and twisting sections. The interwoven pattern for both the pressing and twisting sections is determined by establishing the basic tiling form, solving the yarn interwoven sequence, judging the interwoven type and computing the number of kinks. Finally, while considering the stent's dimensional parameters and the interwoven pattern of the yarn, the spatial curve equations for the yarns in both the pressing and the twisting sections are formulated. By concatenating these equations for each section, the three-dimensional trajectory equations and a comprehensive solid model of the stent are successfully derived. Through a rigorous comparative analysis of dimensions and the braiding pattern between the three-dimensional solid model and the physical stent preform, the accuracy and fidelity of the model generated through the implementation of computer-aided braiding technology are verified.
A case of lower limb ulcer caused by hydroxyurea in treating primary thrombocytosis
Authors: Shi Yulan , Wu Zhoupeng
Published: December 2023

Hydroxyuria is a common medication for treating blood system diseases, but ulcers in the lower limbs caused by this medication are often rare and not often suspected. We reported an elderly patient with lower limb ulcers caused by hydroxyurea treatment for primary thrombocytosis. When hydroxide is used, close observation of skin lesions and prompt handling of any skin disruption should prevent ulcers.
Expectations Regarding Reciprocity of Flows of Intergenerational Support in China: Does Gender or Birth Order Matter?
Authors: Tang Zequn , Wang Ning , Evandrou Maria , Falkingham Jane
Published: December 2023

This study investigates the flows of downward intergenerational transfer to adult children of different gender and birth order, and their influence on parental expectations towards old-age care and financial support, using data from the 2015–2016 China Health and Retirement Longitudinal Study (CHARLS). Based on the analytic sample of 1218 parents and 3237 adult children, we found that in multi-child families, sons are more likely to be expected by their parents as future caregivers if both they and their siblings received parental housing support, while it is the case for daughters when only they themselves received parental housing support. Parents’ downward housing support shows a stronger effect on care expectations than on expectations of future financial support. This study contributes to our understanding of intergenerational transfer norms and expectations from parents’ perspective and has important implications for old-age care policies in contemporary China.
Inflammatory bowel disease patients undergoing total hip arthroplasty have higher odds of implant-related complications
Authors: Magruder Matthew L , Parsa Shabnam , Gordon Adam M , Ng Mitchell , Wong Che Hang J
Published: December 2023

Purpose:

This study evaluates whether IBD patients are at increased risk of implant-related complications after THA.

Materials and methods:

A retrospective study from 01 January 2010 to 31 October 31 2020 using an administrative claims database was performed. IBD patients undergoing THA ( n = 11,025), without corticosteroid treatment, were propensity score matched to controls in a 1:5 ratio ( n = 55,121) based on age, sex, and the Charlson Comorbidity Index (CCI). Outcomes evaluated included periprosthetic fracture, aseptic loosening, prosthetic joint infection, and THA revision within 2 years of index procedure. Chi-square analyses were used to compare the matched cohorts. The association of IBD and implant-related complications was evaluated using logistical regression to calculate odds ratios (ORs), 95% confidence intervals (95% CIs), and p-values. A p-value < 0.001 was used as the significance threshold.

Results:

Patients with IBD had a greater incidence and odds of total implant complications (7.03% vs. 3.98%; OR 1.76; p < 0.001) compared with matched controls. IBD patients had significantly higher incidence and odds of developing periprosthetic fracture (0.50% vs. 0.20%; OR 2.46; p < 0.001), THA revisions (2.21% vs. 1.17%; OR 1.91; p < 0.001), aseptic loosening (1.45% vs. 0.84%; OR 1.75; p < 0.001), and prosthetic joint infection (2.87% vs. 1.77%; OR 1.64; p < 0.001).

Conclusions:

Patients with IBD who underwent primary THA had a significantly higher risk of implant-related complications compared to matched controls. Providers should use this study to appropriately assess post-complication risk factors for their patients with IBD.
Interference effect on wind-induced internal pressure between two tall buildings with dominant opening
Authors: Yu Xianfeng , Xie Zhuangning , Liu Muguang
Published: December 2023

For a typical functional space with dominant opening of a high-rise building, the distributions of mean internal pressure interference factor ( IFm) and peak internal pressure interference factor ( IFp) are studied in detail by a series of wind tunnel experiments, and the power spectrum densities are employed to present the energy distribution characteristics of the fluctuating internal pressure. For the case of windward wall opening, shielding effects are dominant for the mean internal pressures, while the peak internal pressures show certain amplification effects when the interfering building is located in the domain of {1.5 < y/b > 3} and the maximum IFp is 1.36. For the case of side wall opening, the mean internal pressures only show amplification effects in parallel arrangements for different breadth ratios ( Br). However, it is not only in the parallel arrangements but also in the oblique arrangements that the peak internal pressures show amplification effects, where the maximum IFp is 1.21 when Br = 1.0 and 1.2. With respect to the height ratio Hr = 0.6, the mean and peak internal pressures have nothing to do with the interfering building for windward wall opening, whereas they are interfered for side wall opening. When Hr = 0.8 and x/ b > 4, even though the values of IFm are less than 1 while the values of IFp are greater than 1 due to the three-dimensional flow effects.
Shame, health literacy and consent
Authors: Lyons Barry , Dolezal Luna
Published: December 2023

This paper is particularly concerned with shame, sometimes considered the ‘master emotion’, and its possible role in affecting the consent process, specifically where that shame relates to the issue of diminished health literacy. We suggest that the absence of exploration of affective issues in general during the consent process is problematic, as emotions commonly impact upon our decision-making process. Experiencing shame in the healthcare environment can have a significant influence on choices related to health and healthcare, and may lead to discussions of possibilities and alternatives being closed off. In the case of impaired health literacy we suggest that it obstructs the narrowing of the epistemic gap between clinician and patient normally achieved through communication and information provision. Health literacy shame prevents acknowledgement of this barrier. The consequence is that it may render consent less effective than it otherwise might have been in protecting the person's autonomy. We propose that the absence of consideration of health literacy shame during the consent process diminishes the possibility of the patient exerting full control over their choices, and thus bodily integrity.
Moderate to Severe Osteoarthritis: What is the Economic Burden for Patients and the Health Care System? Insights from the “PONOS” Study
Authors: Savvari P. , Skiadas I. , Barmpouni M. , Papadakis S. A , Psychogios V. , Pastroudis A.P. , Skarpas G.A. , Tsoutsanis A. , Garofalakis A. , Katsifis G. , Argyropoulou O.D. , Boumpas D. , Menegas D.
Published: December 2023

Objective

To assess the economic burden of moderate to severe osteoarthritis (OA) management for patients and the health care system in Greece.

Design

A noninterventional, cross-sectional, prospective, epidemiological analysis of data from the medical records of patients with moderate to severe OA, recruited in a single visit from 9 sites in Greece. Outcomes included health care resource use (direct/indirect costs) associated with this patient population.

Results

A total of 164 patients were included in the analysis: mean age was 70.5 years, and the majority of participants were females (78.7%). The presence of comorbidities was reported by 87.2% of patients, with hypertension being the most frequently reported (53.7%). Paracetamol was the most commonly used analgesic treatment (96%), followed by systemic nonsteroidal anti-inflammatory drugs (NSAIDs) (75%) and opioids (50%). The mean overall annual direct costs per patient was estimated at 1,675.3€, with approximately half incurred by the National Health Insurance Fund, whereas the mean overall annual indirect cost (absenteeism of patients and informal caregivers) was estimated at 3,501.4€. Joint replacement (JR) procedures and paid care were the major drivers of annual direct costs in this patient population (4,326.3€ and 9,360.0€, respectively).

Conclusions

This real-world analysis of direct and indirect costs confirmed the substantial economic burden imposed by moderate to severe OA to the health care system and the patients. Our findings emphasize the need for interventions to enhance disease management, to improve patients’ health outcomes and reduce the global burden of OA on society.
Transforaminal lumbar interbody fusion with a tantalum cage: lumbar lordosis redistribution and sacral slope restoration with a modified posterior technique
Authors: Ferraro Marcello , Puglia Francesco , Della Valle Andrea , Cerbone Vincenzo , Cicatelli Alfonso , Peroni Donata Rita , Cecconi Davide , Misaggi Bernardo , La Maida Giovanni Andrea
Published: December 2023

Background

Transforaminal lumbar interbody fusion (TLIF), a commonly used procedure in spine surgery, has the advantage of a lower incidence of nerve lesions compared to the posterior lumbar interbody fusion (PLIF) technique. The intersomatic arthrodesis has always been carried out with a single tantalum cage normally used for PLIF. Tantalum is a metal that is particularly used in orthopedic surgery. It has a modulus of elasticity similar to marrow and leads to high primary stability of the implant.

Materials and methods

Our study was a retrospective monocentric observational study evaluating clinical and radiological outcomes of tantalum cages in a modified TLIF technique with posterior instrumentation and autologous and/or homologous posterolateral bone grafting. The aim of the study was to evaluate clinical outcomes and the increase in or redistribution of lumbar lordosis. The intersomatic arthrodesis was always carried out with a single tantalum cage normally used for PLIF to reduce the neurological risk. We retrospectively studied 105 patients who were treated with a modified unilateral TLIF approach by two surgeons between 2013 and 2018. We evaluated the Oswestry Disability Index (ODI), Visual Analogue Scale (VAS) for back pain, global lumbar lordosis, lordosis of L4–sacrum, segmental lordosis of functional motion units that underwent arthrodesis, pelvic tilt, pelvic incidence, and the sacral slope in 77 patients. All patients were suffering from grade III or IV Pfirrmann, instability, or foraminal post-laminectomy stenosis and/or grade I–II degenerative spondylolisthesis or low-grade isthmic spondylolisthesis. They had no significant sagittal imbalance, with a sagittal vertical axis (SVA) of < 5 mm. The average follow-up duration was 30 months.

Results

We achieved excellent clinical results, with only four cases of failure (5.2%). Moreover, we noticed a statistically significant redistribution of lumbar lordosis, with an average percentage increase in L4–S1 lordosis equal to 19.9% (P < 0.001), an average increase in the L4–S1/Lumbar lordosis (LL) ratio from 0.53 to 0.63 (P < 0.001), and a mean percentage increase in sacral slope equal to 7.6% (P < 0.001).

Conclusion

Thanks to the properties of tantalum, our modified single-portal TLIF technique is a valid surgical solution to obtain a solid arthrodesis and restore the correct lumbar lordosis distribution while reducing neurological complications and the number of failures.

Level of evidence: 4

Trial registration statement: retrospective observational study, no trial registration.
Analysing cluster randomised controlled trials using GLMM, GEE1, GEE2, and QIF: results from four case studies
Authors: Offorha Bright C. , Walters Stephen J. , Jacques Richard M.
Published: December 2023

Background

Using four case studies, we aim to provide practical guidance and recommendations for the analysis of cluster randomised controlled trials.

Methods

Four modelling approaches (Generalized Linear Mixed Models with parameters estimated by maximum likelihood/restricted maximum likelihood; Generalized Linear Models with parameters estimated by Generalized Estimating Equations (1st order or second order) and Quadratic Inference Function, for analysing correlated individual participant level outcomes in cluster randomised controlled trials were identified after we reviewed the literature. We systematically searched the online bibliography databases of MEDLINE, EMBASE, PsycINFO (via OVID), CINAHL (via EBSCO), and SCOPUS. We identified the above-mentioned four statistical analytical approaches and applied them to four case studies of cluster randomised controlled trials with the number of clusters ranging from 10 to 100, and individual participants ranging from 748 to 9,207. Results were obtained for both continuous and binary outcomes using R and SAS statistical packages.

Results

The intracluster correlation coefficient (ICC) estimates for the case studies were less than 0.05 and are consistent with the observed ICC values commonly reported in primary care and community-based cluster randomised controlled trials. In most cases, the four methods produced similar results. However, in a few analyses, quadratic inference function produced different results compared to the generalized linear mixed model, first-order generalized estimating equations, and second-order generalized estimating equations, especially in trials with small to moderate numbers of clusters.

Conclusion

This paper demonstrates the analysis of cluster randomised controlled trials with four modelling approaches. The results obtained were similar in most cases, however, for trials with few clusters we do recommend that the quadratic inference function should be used with caution, and where possible a small sample correction should be used. The generalisability of our results is limited to studies with similar features to our case studies, for example, studies with a similar-sized ICC. It is important to conduct simulation studies to comprehensively evaluate the performance of the four modelling approaches.
Anti-hepatitis C antibody carriage and risk of liver impairment in rural-Cameroon: adapting the control of hepatocellular carcinoma for resource-limited settings
Authors: Kamga Wouambo Rodrigue , Panka Tchinda Gaelle , Kagoue Simeni Luc Aime , Djouela Djoulako Paule Dana , Yateu Wouambo Clarisse Irene , Tamko Mella Ghislaine Flore , Tchoumi Leuwat Eric Pascal , Bello Djoda , Fokam Joseph
Published: December 2023

Background

The Viral hepatitis elimination by 2030 is uncertain in resource-limited settings (RLS), due to high burdens and poor diagnostic coverage. This sounds more challenging for hepatitis C virus (HCV) given that antibody (HCVAb) sero-positivity still lacks wide access to HCV RNA molecular testing. This warrants context-specific strategies for appropriate management of liver impairment in RLS. We herein determine the association between anti-HCV positivity and liver impairment in an African RLS.

Methods

A facility-based observational study was conducted from July-August 2021 among individuals attending the “St Monique” Health Center at Ottou, a rural community of Yaounde,Cameroon. Following a consecutive sampling, consenting individuals were tested for anti-HCV antibodies, hepatitis B surface antigen (HBsAg) and HIV antibodies (HIVAb) as per the national guidelines. After excluding positive cases for HBsAg and/or HIVAb, liver function tests (ALT/AST) were performed on eligible participants (HBsAg and HIVAb negative) and outcomes were compared according to HCVAb status; with p < 0.05 considered statistically significant.

Results

Out of 306 eligible participants (negative for HBsAg and HIVAb) enrolled, the mean age was 34.35 ± 3.67 years. 252(82.35%) were female and 129 (42.17%) were single. The overall HCVAb sero-positivity was 15.68%(48/306), with 17.86% (45/252) among women vs. 5.55%(3/54) among men [OR (95%CI) = 3.69(2.11-9.29),p = 0.04]. HCVAb Carriage was greater among participants aged > 50 years compared to younger ones [38.46%(15/39) versus 12.36% (33/267) respectively, OR(95%CI) = 4.43(2.11-9.29), p < 0.000] and in multipartnership [26.67%(12/45)vs.13.79%(36/261) monopartnership, OR (95%CI) = 2.27(1.07-4.80),p = 0.03]. The liver impairment rate (abnormal ALT+AST levels) was 30.39%(93/306), with 40.19%(123/306) of abnormal ALT alone. Moreover, the burden of Liver impairment was significantly with aged> 50 versus younger ones [69.23% (27/39) versus 24.72%(66/267) respectively, p < 0.000). Interestingly, the burden of liver impairment (abnormal AST + ALAT) was significantly higher in HCVAb positive (62.5%, 30/48) versus HCVAb negative (24.42%, 63/258) participants, OR: 3.90 [1.96; 7.79], p = 0.0001.

Conclusions

In this rural health facility, HCVAb is highly endemic and the burden of liver impairment is concerning. Interestingly, HCVAb carriage is associated with abnormal liver levels of enzyme (ALT/AST), especially among the elderly populations. Hence, in the absence of nuclei acid testing, ALT/AST are relevant sentinel markers to screen HCVAb carriers who require monitoring/care for HCV-associated hepatocellular carcinoma in RLS.
Using signal-to-cutoff ratios of HIV screening assay to predict HIV infection
Authors: Guo Yin-Feng , Yan Shui-Di , Xie Jia-Wen , Wang Mao , Lin Yi-Qiang , Lin Li-Rong
Published: December 2023

Background

The sensitivity of HIV screening assays often leads to a high rate of false-positive results, requiring retests and confirmatory tests. This study aimed to analyze the capability of signal-to-cutoff (S/CO) ratios of HIV screening assay to predict HIV infection.

Methods

A retrospective study on the HIV screening-positive population was performed at Zhongshan Hospital, Xiamen University, the correlation between HIV screening assay S/CO ratios and HIV infection was assessed, and plotted Receiver Operating Characteristic (ROC) curves were generated to establish the optimal cutoff value for predicting HIV infection.

Results

Out of 396,679 patients, 836 were confirmed to be HIV-infected, with an HIV prevalence of 0.21%. The median S/CO ratios in HIV infection were significantly higher than that in non-HIV infection (296.9 vs. 2.41, P < 0.001). The rate of confirmed HIV infection was increased with higher S/CO ratios in the screening assay. The ROC curve based on the HIV screening assay S/CO ratio achieved a sensitivity of 93.78% and a specificity of 93.12% with an optimal cutoff value of 14.09. The area under the ROC curve was 0.9612. Further analysis of the ROC curve indicated that the S/CO ratio thresholds yielding positive predictive values of 99%, 99.5%, and 100% for HIV infection were 26.25, 285.7, and 354.5, respectively.

Conclusion

Using HIV screening assay S/CO ratio to predict HIV infection can largely reduce necessitating retests and confirmatory tests. Incorporating the S/CO ratio into HIV testing algorithms can have significant implications for medical and public health practices.