bluuebunny/crossref_metadata_2025 huggingface dataset:
Male refractory hypospadias with sexual reversal: a case report
Authors: Zhao Jianfeng , Chen Gang , Chen Jun , Qian Le
Published: November 2023

Background

Hypospadias is one of the most prevalent urogenital malformations in clinic. However, some hypospadias may have a more complex disorder of sex development. Usually, hypospadias in these patients is severe. Among them, the 46,XX male sex reversal syndrome is a rare disorder of sex development, and this may be the main reason for this type of hypospadias being difficult to repair.

Case presentation

We present a Han nationality 19-year-old male with failure of repeated repair of hypospadias. No sperm was found on semen analysis. Lingual mucosal graft was carried out for this patient. It still did not succeed after using lingual mucosal graft repair. Karyotype analysis of this patient confirmed 46,XX karyotype.

Conclusion

Hypospadias with 46,XX male sex reversal syndrome is hard to repair. Chromosome karyotype examination in patients with hypospadias is suggested. Genetic testing is recommended. In the future, further research is needed on the pathogenesis of disease and how to treat and prevent it.
Induced pluripotent stem cells modulate the Wnt pathway in the bleomycin-induced model of idiopathic pulmonary fibrosis
Authors: Bayati Paria , Taherian Marjan , Soleimani Mansoureh , Farajifard Hamid , Mojtabavi Nazanin
Published: November 2023

Background

The Wnt signaling pathway has been implicated in the pathogenesis of fibrotic disorders and malignancies. Hence, we aimed to assess the potential of the induced pluripotent stem cells (IPS) in modulating the expression of the cardinal genes of the Wnt pathway in a mouse model of idiopathic pulmonary fibrosis (IPF).

Methods

C57Bl/6 mice were randomly divided into three groups of Control, Bleomycin (BLM), and BLM + IPS; the BLM mice received intratracheal instillation of bleomycin, BLM + IPS mice received tail vein injection of IPS cells 48 h post instillation of the BLM; The Control group received Phosphate-buffered saline instead. After 3 weeks, the mice were sacrificed and Histologic assessments including hydroxy proline assay, Hematoxylin and Eosin, and Masson-trichrome staining were performed. The expression of the genes for Wnt, β-Catenin, Lef, Dkk1, and Bmp4 was assessed utilizing specific primers and SYBR green master mix.

Results

Histologic assessments revealed that the fibrotic lesions and inflammation were significantly alleviated in the BLM + IPS group. Besides, the gene expression analyses demonstrated the upregulation of Wnt, β-Catenin, and LEF along with the significant downregulation of the Bmp4 and DKK1 in response to bleomycin treatment; subsequently, it was found that the treatment of the IPF mice with IPS cells results in the downregulation of the Wnt, β-Catenin, and Lef, as well as upregulation of the Dkk1, but not the Bmp4 gene (P values < 0.05).

Conclusion

The current study highlights the therapeutic potential of the IPS cells on the IPF mouse model in terms of regulating the aberrant expression of the factors contributing to the Wnt signaling pathway.
Efficient and privacy-preserving multi-agent systems for smart city carpooling with k-regret queries and differential privacy
Authors: Chen Fei , Zhang Xinjian , Ning Bo , Yang Chao , Jia Xiao
Published: November 2023

Multi-Agent Systems are characterized by the presence of multiple independent agents and find diverse applications. In the context of smart cities, MAS is employed in traffic management to enhance operational efficiency, optimize resource utilization, and improve the quality of life for residents. This research paper focuses on the design of a multi-agent intelligent scheduling system, where passengers, vehicles, and carpooling platforms serve as intelligent agents. The primary objective of passengers is to identify suitable shared vehicles based on criteria such as waiting time, budget constraints, and willingness to carpool. Vehicles, on the other hand, organize their schedules based on passenger demands and designated routes. The carpooling platform takes into account resource allocation priority and optimization problems to ensure the efficient operation of the system. To address the issue of vehicle ordering,k-regret queries are utilized, while passenger preferences provide insight into determining loss factors. To safeguard privacy, differential privacy techniques and a random response mechanism are employed when dealing with multiple passenger queries. Furthermore, a direction-preserving insertion verification method is implemented to mitigate computational complexity. The effectiveness and efficiency of the proposed approach are validated through experimentation.
A global bibliometric and visualized analysis of the status and trends of gastroparesis research
Authors: Li Meng , Gao Ning , Wang Shaoli , Guo Yufeng , Liu Zhen
Published: November 2023

Background

Gastroparesis has a substantial impact on the quality of life but has limited treatment options, which makes it a public health concern. No bibliometric studies on gastroparesis have been published thus far. Thus, this article aims to summarize and analyze research hotspots to provide a reference for clinical researchers.

Materials and methods

Gastroparesis-related research articles were searched in the Web of Science Core Collection (WOSCC), and relevant information was extracted after screening. A total of 1033 documents were analyzed with the bibliometric method using Microsoft Excel, Citespace, and VOSviewer.

Results

Overall, our search retrieved 1033 papers contributed by 966 research institutions from 53 countries. Since 1980, publications in this field have increased rapidly. United States (n = 645) and Temple University (n = 122) were the most productive country and institution, respectively. Parkman, with 96 publications, was the most prominent author.

Conclusions

Research hotspots in gastroparesis can be summarized into four domains: innovation in diagnostic modalities, change of oral therapeutic agents, choice of surgical interventions, and pathological mechanisms. Future research on gastroparesis should focus on the quality of life of patients, diagnostic techniques, pyloromyotomy, and transpyloric stent placement.
Women empowerment and food-nutrition security in Sierra Leone: The Gender Model Family approach
Authors: Ayamga Joseph Awimboora , Ayawine Alice , Ayentimi Desmond Tutu
Published: November 2023

Background

This research is conducted in the context of an integrated food security and nutrition project implemented by the Social Enterprise Development Foundation (SEND Sierra Leone) and Agro Forestry Farmers Association (AFFA) in rural Kenema and Pujehun Districts. This paper presents a qualitative ‘baseline’ action-learning research on the impact of the Gender Model Family (GMF) approach on women empowerment and the effects on enhanced outcomes along the agriculture-nutrition pathway. Qualitative data were collected using in-depth face-to-face interviews and focused group discussion (FGD) from the GMF beneficiaries.

Results

Linking Agriculture, Natural Resource Management and Nutrition (LANN) has nutrition security as its aim, and the project objectives and indicators focus on nutrition, not gender—however, this ‘baseline’ action-learning research recognized that gender is a major underlying factor. The evidence suggests that the GMF approach fosters women empowerment and enhances outcomes in food and nutrition security as there has been a change in social rules about men taking part in domestic household work and women involvement in family decision-making.

Conclusions

Given that women play crucial roles as administrators of household food and nutrition security, empowering them is intimately related to the consolidation of household food systems, improves nutrition intake and the fight against food-nutrition insecurity in rural Africa.
Immune checkpoint inhibitors for multiple myeloma immunotherapy
Authors: Liu Zhaoyun , Xu Xintong , Liu Hui , Zhao Xianghong , Yang Chun , Fu Rong
Published: November 2023

Multiple myeloma (MM) is related to immune disorders, recent studys have revealed that immunotherapy can greatly benefit MM patients. Immune checkpoints can negatively modulate the immune system and are closely associated with immune escape. Immune checkpoint-related therapy has attracted much attention and research in MM. However, the efficacy of those therapies need further improvements. There need more thoughts about the immune checkpoint to translate their use in clinical work. In our review, we aggregated the currently known immune checkpoints and their corresponding ligands, further more we propose various ways of potential translation applying treatment based on immune checkpoints for MM patients.
Accelerating Pneumococcal Conjugate Vaccine introductions in Indonesia: key learnings from 2017 to 2022
Authors: Athiyaman Anithasree , Herliana Putri , Anartati Atiek , Widyastuti Niken , Yosephine Prima , Tandy Gertrudis , Karolina Sherli
Published: November 2023

Despite high pneumococcal disease and economic burden in Indonesia and interest to introduce pneumococcal conjugate vaccine (PCV), there were challenges in establishing a comprehensive strategy to accelerate and enable the introduction in country in the early 2010s. Starting in 2017, Clinton Health Access Initiative and partners supported the government of Indonesia with evidence-based decision-making and implementation support for introducing PCV into the routine immunization program. Indonesia has since accelerated PCV roll out, with nationwide reach achieved in 2022. On the path to PCV introduction, several challenges were observed that impacted decision making on whether and on how to optimally roll out PCV, resulting in significant introduction delays; including (1) a complex country context with a devolved government structure, fragmented domestic funding streams, and an imminent transition out of major immunization donor (Gavi) support; (2) strong preference to use domestically sourced products, with limited experience accessing global pooled procurement mechanism including for vaccines; and (3) concerns around programmatic feasibility and sustainability. This case study documents key insights into the challenges experienced and how those were systematically addressed to accelerate new vaccine introduction in Indonesia, with support from local and global stakeholders over time. The learnings would be beneficial for other countries yet to introduce critical new vaccines, in particular those with similar archetype as Indonesia e.g., middle-income countries with domestic manufacturing capacity and/or countries recently transitioning out of Gavi support.
Risk of avoidant/restrictive food intake disorder in patients with inflammatory bowel disease: predictive value of disease phenotype, disease activity and food literacy
Authors: Yin Tingting , Tu Wenjing , Li Yiting , Yang Min , Huang Lina , Zhang Sumin , Xu Guihua
Published: November 2023

Background

Avoidant/Restrictive Food Intake Disorder (ARFID) is a newly described eating disorder. Adequate levels of food literacy allow individuals to have adequate food choices. This study aimed to assess the prevalence of ARFID and the level of food literacy in patients with inflammatory bowel disease (IBD) and to analyse the correlation between ARFID and food literacy.

Method

This cross-sectional study screened for ARFID and assessed food literacy levels in patients with IBD attending four tertiary hospitals in China. ARFID risk was measured using the Nine Item Avoidant/Restrictive Food Intake Disorder Screen (NIAS). Food literacy was assessed using the Food Literacy Evaluation Questionnaire (Chinese version, FLEQ-Ch).The relationship between individual NIAS scores and food literacy variables was analysed to assess which food literacy aspect is positively or negatively associated with NIAS scores. Stepwise linear regression analysis was performed to identify the possible predictors of NIAS scores in patients with IBD.

Result

A total of 372 IBD subjects completed the NIAS and FLEQ-Ch. The overall mean NIAS scores for the IBD cohort was 28.16 ± 8.03 (p < 0.01), and of the 372 participants, 123 (32.5%) had positive ARFID risk scores (≥ 10 NIAS-picky eating, ≥ 9 NIAS-poor appetite, and ≥ 10 NIAS-fear of negative consequences).The NIAS scores were inversely associated with food literacy levels (β =  − 0.299; p < 0.01).Disease phenotype, disease activity, and food literacy in patients with IBD provided valuable predictive insights for avoiding positive outcomes in ARFID.

Conclusion

This study shows that the risk of ARFID in the cohort of patients with IBD is associated with their inadequate food literacy levels. Therefore, this study supports the notion that patients with IBD should be assessed for food literacy regardless of whether they are currently diagnosed with ARFID. Specifically, for early identification of those at risk for ARFID in IBD, disease phenotype, disease activity, and food literacy should be routinely considered in clinical practice.The food literacy awareness of patients must be investigated and improved to predict the risk occurrence of ARFID and encourage healthy eating behaviour.
Installation of the developing nephron in the fetal human kidney during advanced pregnancy
Authors: Minuth Will W.
Published: November 2023

Background

The kidneys of preterm and low birth weight babies reflect vulnerability, since several noxae can evoke the termination of nephron formation. This again leads to oligonephropathy with severe consequences for health in the later life. While the clinical parameters have been intensely investigated, only little is known about the initial traces left by the noxae. For the fetal human kidney, solely the lack of basophilic S-shaped bodies and the reduction in width of the nephrogenic zone were registered. It is not known in how far also the involved progenitor cells, the earlier nephron stages, the collecting duct (CD) ampullae, and the local interstitium are collaterally harmed.

Aim

The interstitium at the forming nephron is heterogeneously structured. Thereby, it fulfills quite different mastering and integrative tasks. Since data dealing with the installation of a nephron is not available, the microanatomical features were recorded.

Results

The microscopic specimens show that the installation of the transient stages of nephron anlage is not synchronized. Instead, it is controlled within a nephrogenic compartment of the nephrogenic zone. It starts near the renal capsule by positioning the nephrogenic niche so that the nephrogenic progenitor cells face the epithelial progenitor cell at the tip of a CD ampulla. Then, the induced nephrogenic progenitor cells assimilate in the pretubular aggregate. While its medial part remains opposite the head of the CD ampulla, at its proximal end, the primitive renal vesicle is formed. Only a part of it separates to stick to the section border between the head and conus of the CD ampulla. This marks the link with the future connecting tubule at the distal pole of the extending renal vesicle. Meanwhile, the proximal pole is mounted next to the connecting tubule of an earlier developed nephron. The resulting two-point mounting serves a common elongation of the conus at the CD ampulla and the medial aspect of the comma-shaped body. In the S-shaped body, it supports to defoliate the arising glomerulus and to link it with the perforating radiate artery at its deep lateral aspect.

Conclusions

The investigation depicts that the installation is an interactive process between the stages of nephron anlage and its structural neighbors. A special meaning has the interjacent interstitium. It is vital for the positioning, shaping, and physiological integration. Due to its special location, this is mainly exposed to noxae.
Modelling the associations between academic engagement, study process and grit on academic achievement of physical education and sport university students
Authors: Tannoubi Amayra , Quansah Frank , Magouri Iteb , Chalghaf Nasr , Bonsaksen Tore , Srem-Sai Medina , Hagan John Elvis , Handrianto Ciptro , Azaiez Fairouz , Bragazzi Nicola Luigi
Published: November 2023

Objective

The present study examined the impact of academic engagement, study processes, and grit on the academic achievement of physical education and sport university students.

Methods

An internet-based survey recruited 459 university students aged 19–25 years (M = 21 ± 1.3) in physical education and sports (PES) to fill out questionnaires on Physical Education-Study Process Questionnaire (PE-SPQ), Physical Education-Grit (PE-Grit), academic engagement (A-USEI), and Grade Point Average (GPA). A path analysis was carried out to understand variable relationships.

Results

Data from each variable exhibited symmetrical and normal distribution, as indicated by the skewness and kurtosis values. The model’s fit indices showed sufficient Comparative Fit Index (CFI = 0.92), Tucker-Lewis Index (TLI = 0.90), Goodness of Fit Index (GFI = 0.99) and Normed Fit Index (NFI = 0.90) and showed acceptable levels. The results indicated a statistically significant positive impact of engagement (β = 0.299, p < 0.001) and study processes (β = 0.397, p < 0.001) on academic achievement. However, the effect of grit on achievement was non-significant.

Conclusions

Academic engagement as well as study processes are two important factors predicting academic achievement while grit seems to be not a major predictor. Hence, physical education and sport faculty and university administrators should prioritize student engagement as a determinant of academic outcomes by reforming or redesigning physical education and sport curriculum modules that can facilitate engagement.
CDKN2A/B deletions are strongly associated with meningioma progression: a meta-analysis of individual patient data
Authors: Wach Johannes , Basaran Alim Emre , Arlt Felix , Vychopen Martin , Seidel Clemens , Barrantes-Freer Alonso , Müller Wolf , Gaunitz Frank , Güresir Erdem
Published: November 2023

Homozygous CDKN2A/B deletion has been associated with an increased risk of recurrence in meningiomas. However, the evidence is confined to a limited number of studies, and the importance of heterozygous CDKN2A/B deletions remains insufficiently investigated. Hence, the present meta-analysis reconstructs individual patient data (IPD) and reconstructs the probabilities of progression-free survival (PFS) stratified by CDKN2A/B status. IPD of PFS rates were extracted from published Kaplan–Meier plots using the R package IPDfromKM in R studio (RStudio, Boston, MA, USA). Reconstructed Kaplan–Meier Plots of the pooled IPD data were created. One-stage and two-stage meta-analyses were performed. Hazard ratios (HR) were used as effective measures. Of 181 records screened, four articles with 2521 participants were included. The prevalence of homozygous CDKN2A/B deletions in the included studies was 0.049 (95% CI 0.040–0.057), with higher tumor grades associated with a significantly greater proportion of CDKN2A/B deletions. The reconstructed PFS curves for the pooled cohort showed that the median PFS time of patients with a CDKN2A/B wild-type status, heterozygous or homozygous CDKN2A/B deletion was 180.0 (95% CI 145.7–214.3), 26.1 (95% CI 23.3–29.0), and 11.00 (95% CI 8.6–13.3) months, respectively (p < 0.0001). Both hetero- or homozygous CDKN2A/B deletions were significantly associated with shortened time to meningioma progression. One-stage meta-analysis showed that hetero- (HR: 5.5, 95% CI 4.0–7.6, p < 0.00001) and homozygous CDKN2A/B deletions (HR: 8.4, 95% CI 6.4–11.0, p < 0.00001) are significantly associated with shortened time to meningioma progression. Multivariable Cox regression analysis of progression in a subgroup with available covariates (age, sex, WHO grade, and TERT status) and also two-stage meta-analysis confirmed and validated the results of the one-stage analysis that both heterozygous and homozygous CDKN2A/B deletions are of prognostic importance. Further large-scale studies of WHO grade 2 and 3 meningiomas are needed to validate the importance of heterozygous CDKN2A/B deletions with consideration of established factors.
A quantitative evaluation model of ancient military defense efficiency based on spatial strength—take Zhejiang of the Ming Dynasty as an example
Authors: Wang Yinggang , Tan Lifeng , Zhang Zao , Liu Huanjie , Liu Jiayi , Zhang Yukun , Mu Mengqi
Published: November 2023

In the study of the defense capacity of ancient military settlements, most existing studies have evaluated the defense capacity of citadels qualitatively from a historiographical perspective. There are fewer quantitative studies on defense efficiency in a specific regional context. This paper takes the coastal defense citadels system of Zhejiang in the Ming Dynasty of China as the research object. It adopts a combination of digital historical data mining and quantitative research to study the defense efficiency of the military defense area in Zhejiang in the Ming Dynasty. This paper first analyzes the defense pattern of Zhejiang's sea defense citadels system in the Ming Dynasty. It determines the control points of defense groups, quantifies the defense group area with a Voronoi diagram, and classifies and assigns the entropy value to the deployment data of guard forts in historical data. Finally, the assigned forces are superimposed on the defense area to obtain the quantified defense efficiency of each defense group, and the defense results are verified. This paper innovatively proposes an "area-force" perspective. It introduces spatial segmentation and quantitative research methods to study the defense efficiency of a specific regional defense group system in ancient times. It proves that this method is feasible and can be applied to the study of other ancient military defense areas. It also expands the scientific perspective of ancient military fortification systems, which can contribute to systematically preserving ancient military settlement heritage on a larger scale.
Multiple angiosarcomas of both breasts: a case report
Authors: Matsuda Ryota , Saimura Michiyo , Anan Keisei , Katsuyama Kento , Tahara Yuki , Kurata Kanako , Horioka Kohei , Nakamoto Mitsuhiro , Koga Kenichiro , Mitsuyama Shoshu , Sato Eiichi , Wakamatsu Shinichi , Tamiya Sadafumi
Published: November 2023

Background

Primary angiosarcomas of the breast are rare and highly aggressive. We herein report a rare case of multiple angiosarcomas detected concurrently in both breasts.

Case presentation

A 49-year-old woman visited a doctor after noticing a lump in her right breast. At that time, mammography and ultrasonography revealed no abnormal findings in either breast. She was referred to our hospital 5 months later, because screening mammography had revealed a focal asymmetric density in her right breast. Ultrasonography showed ill-defined hyper- and hypo-echoic lesions in both breasts. Magnetic resonance imaging disclosed five heterogeneously enhanced masses (5.8 cm in maximum diameter) in the right breast and six enhanced masses (approximately 1–3 cm in diameter) in the left breast. Histological examination of core needle biopsies revealed proliferation of irregularly shaped vascular channels lined by atypical endothelial cells throughout the adipose tissue and lobules of the breasts, leading to a diagnosis of well-differentiated angiosarcoma. The lesions were assumed to be primary angiosarcomas, because she had neither a history of breast surgery nor of radiation therapy. She underwent bilateral mastectomies and postoperative chest wall irradiation. Computed tomography 11 weeks after the surgery revealed multiple, small, subcutaneous nodules in the chest wall that were suspected of being angiosarcoma metastases. We started chemotherapy (weekly paclitaxel 80 mg/m2), which achieved shrinkage of these nodules within 2 months.

Conclusions

Early diagnosis, immediate initiation of local and systemic therapies, and intensive follow-up are important in improving the prognosis of angiosarcomas.
Nutritional status of flexitarians compared to vegans and omnivores - a cross-sectional pilot study
Authors: Bruns Anja , Nebl Josefine , Jonas Wiebke , Hahn Andreas , Schuchardt Jan Philipp
Published: November 2023

Background

In the Western world, there has been a notable rise in the popularity of plant-based, meat-reduced flexitarian diets. Nevertheless, there is insufficient data on the nutritional status of individuals following this dietary pattern. The aim of this study was to investigate the intake and endogenous status of various nutrients in a healthy German adult study population consisting of flexitarians (FXs), vegans (Vs) and omnivores (OMNs).

Methods

In this cross-sectional study, dietary intake of 94 non-smoking adults (32 FXs, 33 Vs, 29 OMNs) between 25 and 45 years of age was assessed using 3-day dietary records. In addition, blood samples were collected to determine different endogenous nutrient status markers.

Results

32%, 82% and 24% of the FXs, Vs, and OMNs respectively reported using dietary supplements. In the FXs, intake of total energy as well as macronutrients and most micronutrients were within the reference range. FXs had higher intakes of fiber, retinol-equ., ascorbic acid, folate-equ., tocopherol-equ., calcium, and magnesium compared to OMNs. However, cobalamin intake in FXs (2.12 µg/d) was below the reference (4 µg/d). Based on 4cB12, 13% of FXs showed a cobalamin undersupply [< -0.5 to -2.5] compared to 10% of OMNs, and 9% of Vs. The median 25(OH)D serum concentrations in FXs, Vs and OMNs were 46.6, 55.6, and 59.6 nmol/L. The prevalence of an insufficient/deficient vitamin-D status [< 49.9 nmol 25(OH)D/L] was highest in FXs (53%), followed by Vs (34%) and OMNs (27%). In FXs and Vs, the supplement takers had better cobalamin and vitamin-D status than non-supplement takers. Anemia and depleted iron stores were found only occasionally in all groups. In women, the prevalence of pre-latent iron deficiency and iron deficiency was highest in FXs (67%) compared to Vs (61%) and OMNs (54%).

Conclusion

Our findings indicated that all three diets delivered sufficient amounts of most macro- and micronutrients. However, deficiencies in cobalamin, vitamin-D, and iron status were common across all diets. Further studies are needed to investigate the nutrient supply status and health consequences of meat-reduced plant-based diets. The study was registered in the German Clinical Trial Register (number: DRKS 00019887, data: 08.01.2020).
Individual and community level factors for modern contraceptives utilization among reproductive aged women in Amhara region, Mixed effect multi-level modeling, Data from Mini-EDHS, 2019
Authors: Bizuneh Fassikaw Kebede , Bizuneh Tsehay Kebede , Masresha Seteamlak Adane , Yayeh Berihun Mulu
Published: November 2023

Background

Modern contraceptive has been identified as a key strategy to control unintended pregnancy, protect the health of the mother and child, and promote women wellbeing. Despite this and increasingly wider availability of modern contraceptives, however, there are still high levels of unmet need for birth interspacing and contraceptive use in Amhara regions. This study aimed to identify factors associated with the enhancing of modern contraceptives utilization among reproductive aged women in Amhara region, using a mixed effects multilevel modeling data from mini-EDHS 2019.

Methods

A community-based cross-sectional study was conducted among 711(wt = 100%) samples of reproductive-aged women. The data were interviewed by trained data collectors using a semi-structured questionnaire for the final mini-EDHS 2019 data set. A multilevel binary logistic regression model was fitted to identify the enhancing factors for modern contraceptive utilization Adjusted Odds Ratio (AOR) with 95% Confidence Intervals (CI) was used to identify factors associated with utilization.

Result

The median age of the participants was 31 with (IQR ± 13) years. The overall modern contraceptive utilization was 42.3% (95%CI: 38.7; 46.1). Individual and community factors accounted for 21.4% of the variation in modern contraceptive utilization at the cluster level. Being age 25 years (AOR = 12.99; 95%CI: 4.5–37.2), 26–35 years (AOR = 8.8, 95%CI: 3.25- 24), 36–45 years (AOR = 5.6, 95%CI: 2.2–16.2), being married (AOR = 4.2, 95%CI: 2.21–6.97), educated women (AOR = 11.6, 95%CI: 3.22–40.4), and being middle-economic class (AOR = 3.03; 95%CI: 1.87–4.91) were identified as individual enhancing factors. Whereas, being urban resident (AOR = 5.19; 95%CI: 5.19: 41.7) and having media exposure (AOR = 1.5; 95%CI: 1.58–3.7) were community-level enhancing factors for modern contraceptive utilization.

Conclusion

Compared to earlier studies, in Amhara region, a lower prevalence rate of modern contraceptive utilization was reported. The variation in utilization at the cluster level, 21.4%, was attributed to individual and community-level factors. Healthcare providers should prioritize raising awareness about contraceptive side effects to encourage new users and decrease the number of individuals who discontinue contraceptive methods.
Impact of tardive dyskinesia on patients and caregivers: a survey of caregivers in the United States
Authors: Jain Rakesh , Ayyagari Rajeev , Goldschmidt Debbie , Zhou Mo , Finkbeiner Stacy , Leo Sam
Published: November 2023

Background

Tardive dyskinesia (TD) has a multidimensional impact on patients with TD and, as importantly, their caregivers. An online survey was developed and administered to assess patient and caregiver burden of TD. Survey participants were unpaid caregivers for patients with diagnoses of TD and schizophrenia, bipolar disorder, and/or major depressive disorder. Overall, 162 caregivers rated the 7-day impact of TD on the physical, psychological, and social functioning of patients and the impact of TD on these domains in their own lives and in their professional lives.

Results

Across physical, psychological, and social domains, most caregivers (82.7%) reported that TD had severe impact on the cared-for patients, and 23.5% reported severe impact of TD in their own lives. Caregivers experienced 46.4% activity impairment, and caregivers who were employed (n = 136) experienced 49.5% overall work impairment because of TD-related caregiving.

Conclusions

These results suggest that TD imposes substantial burden for both caregivers and patients.
Research Note Showing That the Rural Mortality Penalty Varies by Region, Race, and Ethnicity in the United States, 1999–2016
Authors: Rhubart Danielle , Santos Alexis
Published: November 2023

This research note presents a new perspective on the rural mortality penalty in the United States. While previous work has documented a growing rural mortality penalty, there has been a lack of attention to heterogeneity in trends at the intersection of region, race, and ethnicity. We use age-adjusted mortality rates from the Centers for Disease Control and Prevention to examine the rural mortality penalty by region, race, and ethnicity for 1999–2016 (N = 44,792,050 deaths) and stratify by 2006 National Center for Health Statistics metropolitan–nonmetropolitan classifications. We find substantial variation at the intersection of region, race, and ethnicity, revealing heterogeneity in the rural penalty and—in some cases—a rural mortality advantage. For the Black/African American population, the rural mortality penalty is observed only in the South. On the other hand, for Hispanic/Latino populations, a small but persistent rural mortality penalty is present only in the South and the West. There is a rural mortality penalty in all regions for White and American Indian/Alaska Native populations. However, for the latter, there is substantial variation in the magnitude of the penalty by region of residence. This research documents heterogeneous patterns when the rural mortality penalty is analyzed by region, race, and ethnicity in the United States.
The implication of interleukin-2 on the expression of CD56bright, CD56dim, and interferon-γ in patients with systemic lupus erythematosus
Authors: Soelistyoningsih Dwi , Susianti Hani , Kalim Handono , Handono Kusworini , Fajar Jonny Karunia
Published: November 2023

Background: Interleukin-2 (IL-2) stimulation had been reported as having a beneficial impact to the expression of CD56bright, CD56dim, and interferon-γ (IFN-γ) in the case of immunological dysfunction diseases. However, in the case of systemic lupus erythematosus (SLE), the role of IL-2 had never been investigated. The objective of this study was to assess the impact of IL-2 on the expression of CD56bright, CD56dim, and IFN-γ in SLE patients.

Methods: An experimental study was conducted by involving peripheral blood mononuclear cells isolated from six SLE patients. The study consisted of four groups based on IL-2 stimulation: D0 (0U/ml), D1 (50U/ml), D2 (150U/ml), and D3 (250U/ml); and they were then cultured for 72 hours. The levels of CD56bright and CD56dim were measured by FACSMelodyTM, while the levels of IFN-γ were measured using ELISA.

Results: In group D0, D1, D2, and D3; the levels of CD56bright were 57.27±37.27, 241.16±64.41, 256.94±50.95, and 259.37±36.44 x1000 cells/mm3 respectively. Moreover, the levels of CD56dim were 812.85±167.37, 631.98±129.90, 616.42±157.97, and 615.90±155.57 x1000 cells/mm3 respectively. On the other hand, the levels of IFN-γ were 24.01±2.56, 26.09±4.79, 30.11±5.34, and 32.43±7.14 pg/ml respectively. Our analysis elucidated that the administration of IL-2 provided potential impact to the levels of CD56bright, but not to the levels of CD56dim and IFN-γ. Our findings indicated that the increased dosage of IL-2 resulted in a more significant impact on CD56bright.

Conclusions: Our study clarifies that IL-2 provides a beneficial impact on CD56bright expression in SLE patients.
A protocol study on assessment of sleep cycle pattern, quality, and its determinant among Young Adults in an urban area of Wardha.
Authors: Mahobia Alka , Chaudhari Sonali
Published: November 2023

Abstract* Introduction The value of sleep in preserving health and well-being is widely understood, especially among young people. To improve cognitive abilities, especially memory retention, adequate sleep is essential. Inadequate sleep quality and the resulting daytime sleepiness can negatively affect young adults’ physical and cognitive health and performance. Objective To assess the sleep cycle pattern, quality, electronic usage at bedtime, and diet among young adults in an urban area of Wardha. Protocol An observational cross-sectional study will be carried out with young adults to evaluate sleep patterns. Sleep quality and related risk factors will be measured using self-reports by participants. The link between many risk variables and poor sleep quality will be investigated using logistic regression analysis. Study Implication The study will help understand and address sleep quality in young adults. The information gathered in the study can further help serve as data for future research. The understanding of why sleep quality is poor among young adults and how their sleep cycle pattern is disturbed.
Effect of 8 weeks badminton session on cardiovascular and neuromuscular functions among older adults in United Arab Emirates: a quasi-experimental study
Authors: Hazari Animesh , Jalgoum Sondos , Kumar Kandakurti Praveen
Published: November 2023

Background Older adults (40-70 years) are the most susceptible age group for developing cardiovascular, and neuromuscular disorders due to a lack of physical activities. The engagement of older adults in physical activities such as badminton can improve their neuromuscular function. Thus, this study aimed to analyze the effects of badminton on cardiovascular & neuromuscular function among older adults with and without non-communicable diseases in the United Arab Emirates. Methods A total of 120 participants were recruited and divided into three groups: Two interventional groups which consisted of participants with non-communicable disease (WCN, N=40), and participants without the non-communicable disease (WICN, n=40), and one non-interventional group (NIC) as healthy control participants. Groups with and without non-communicable diseases engaged in badminton (45-60 minutes per session, thrice a week for two months) as per the specific inclusion and exclusion criteria. Results The findings of the study indicated that there was a significant improvement in cardiovascular and many neuromuscular variables within and between the groups (p≤0.05) with maximum changes in participants with non-communicable diseases. Conclusions Engagement in sports like badminton can help to overcome the non-communicable disease burden. The immediate impact can be seen with the introduction of such interventional sports activities on a larger scale. Since the improvement was seen to be much better in the participants with non- communicable diseases, it could help to reduce the burden of non-communicable diseases. Clinical Trial Registry, India registration REF/2022/02/051455 (08/02/2022)
Evolutionary Algorithm on General Cover with Theoretically Guaranteed Approximation Ratio
Authors: Zhang Yaoyao , Zhu Chaojie , Tang Shaojie , Ran Yingli , Du Ding-Zhu , Zhang Zhao
Published: November 2023

Theoretical studies on evolutionary algorithms have developed vigorously in recent years. Many such algorithms have theoretical guarantees in both running time and approximation ratio. Some approximation mechanism seems to be inherently embedded in many evolutionary algorithms. In this paper, we identify such a relation by proposing a unified analysis framework for a global simple multiobjective evolutionary algorithm (GSEMO) and apply it on a minimum weight general cover problem, which is general enough to subsume many important problems including the minimum submodular cover problem in which the submodular function is real-valued, and the minimum connected dominating set problem for which the potential function is nonsubmodular. We show that GSEMO yields theoretically guaranteed approximation ratios matching those achievable by a greedy algorithm in expected polynomial time when the potential function g is polynomial in the input size and the minimum gap between different g-values is a constant.

History: Accepted by Erwin Pesch, Area Editor for Heuristic Search & Approximation Algorithms.

Funding: This work was supported by National Natural Science Foundation of China [11771013, U20A2068]; Zhejiang Provincial Natural Science Foundation of China [LD19A010001].
Financing Innovative Activity and the Endogeneity of Patenting
Authors: Marquez Robert , Nguyen Thành , Yavuz M. Deniz
Published: November 2023

It is common for lenders to require innovative firms to report all innovations and take actions, such as patenting, to protect their value. However, many future innovations are difficult to verify, making enforcement of such requirements difficult. This creates a tension for firms between protecting their innovations through patenting and creating assets that can be liquidated by a lender when not fully repaid. We show that the endogeneity of the patenting decision introduces an upper bound on the long-term payments that can be credibly promised to a lender, affecting the feasibility of obtaining financing and the terms of financial contracts.

This paper was accepted by David Sraer, finance.
On Proportionally Consistent Solutions to the Divorced-Parents Problem
Authors: Romeijnders Ward , Van Foreest Nicky D. , Wijngaard Jacob
Published: November 2023

When Dutch parents with children divorce, a mediator compiles a matrix with the financial needs of the children and the financial capacities of parents to meet these needs. Moreover, in case parents have children from previous marriages or are prepared to contribute to stepchildren, a bipartite graph shows which parent is financially responsible for which child. The Dutch high court ruled that the final contributions should be proportionally consistent, implying that shortages for children should be prevented if possible and any remaining parental capacities should be proportionally divided among parents responsible for the same child. Finding by hand this proportional solution is difficult for realistic court cases, as these can include several (step)parents and children. The paper on the divorced-parents problem shows that the final unique solution can be found when parents start court cases iteratively and provides efficient algorithms that can deal with large (country-size) networks.
Stochastic Liquidity as a Proxy for Nonlinear Price Impact
Authors: Muhle-Karbe Johannes , Wang Zexin , Webster Kevin
Published: November 2023

For the “In This Issue” column:

Trading costs play a central role in designing and implementing quantitative trading strategies. To quantify trading costs, optimal execution and trading algorithms rely on price impact models, such as the propagator model. Empirically, price impact is concave in trade sizes, leading to nonlinear models for which optimization problems are intractable and even qualitative properties, such as price manipulation, are poorly understood. This paper shows that, in the diffusion limit of small and frequent orders, the nonlinear model converges to a tractable linear model. In this high-frequency limit, a stochastic liquidity parameter approximates the original impact function’s nonlinearity. This allows us to derive simple formulas for optimal trading strategies and sharp conditions on market volumes to rule out price manipulation. A detailed empirical study using high-frequency limit-order data illustrates the practical performance of the theoretical results.
Dual sideband receiver for radio-over-fiber
Authors: Horst Yannik , Blatter Tobias , Kulmer Laurenz , Landolt Leo , Bitachon Bertold Ian , Vukovic Boris , Moor David , Salamin Yannick , Leuthold Juerg
Published: November 2023

A dual sideband reception scheme for radio-over fiber (RoF) links is introduced. It is shown that the new receiver can increase the performance of noise-limited systems by up to 3 dB (2.97 dB in a lab back-to-back experiment). The receiver scheme exploits the fact that current RoF links do not realize their full potential. This is because in typical RoF receivers, the radio-frequency (RF) signals are mapped back to the optical domain by means of electro-optical modulator. In this process energy typically is lost as only one of the two generated sidebands is subsequently used. The suggested receiver exploits the signal of both sidebands. The receiver scheme was subsequently tested in a full optical-RF-optical transmission link at RF carrier frequencies of 228 GHz over a free-space channel spanning distances of 1400 m for symbol rates of up to 48 Gbaud 4 QAM. Here, we could achieve SNR improvements of up to 2.6 dB.
Fraunhofer diffraction at the two-dimensional quadratically distorted (QD) grating
Authors: Liu Yuewei , Liu Zhengkun , Hénault François , Ortiz Antonio , Frain Monique , Feng Yan
Published: November 2023

A two-dimensional (2D) mathematical model of quadratically distorted (QD) grating is established with the principles of Fraunhofer diffraction and Fourier optics. A discrete sampling method is applied for finding a numerical solution of the diffraction pattern of QD grating. An optimized working phase term, which determines the balanced energies and high efficiency of multi-plane images, can be obtained by the bisection algorithm. To confirm the analytical approach described above, the results have been compared with those obtained using a classical numerical model based on Fraunhofer diffraction theory and a fast Fourier transform (FFT) algorithm. The results show that our analytical approach allows the precise design of QD grating and improves the optical performance of simultaneous multi-plane imaging system. An optical setup based on our well-designed QD grating has been appended to the camera port of a commercial microscope, and some preliminary microscopy images have been successfully obtained. Further upgrade of our analytical model is in progress to improve the image quality and promote the applications.
Tunable ultra-wideband graphene-based filter with a staggered structure
Authors: Feng Yuncai , Huang Zhengyang , Zhang Xiaomin , Qiu Tianhui
Published: November 2023

We present a tunable ultra-wideband band-stop filter utilizing graphene with a straightforward staggered structure. The transmission spectrum has been meticulously analyzed using the effective-index-based transfer matrix method (EIB-TMM). The results demonstrate that the filtering properties can be precisely tailored by manipulating the Fermi energy level of graphene. Importantly, we have successfully achieved a remarkable ultra-wideband stopband by optimizing the staggered parameters. Our exploration of redefining the staggered structure through adjustments to three critical parameters has revealed a crucial role in expanding bandwidth. This investigation deepens our understanding of how nonperiodic structures can effectively broaden bandwidth and holds great promise for the prospective design of ultra-wideband band-stop devices.
Design and fabrication of large-mode-area multicore chalcogenide fiber with low bending loss
Authors: Zhang Min , Li Ningzhe , Jia Jinsheng , Xiao Feng , Jiao Kai , Wang Xiange , Bai Shengchuang , Zhao Zheming , Zhang Peiqing , Dai Shixun , Nie Qiuhua , Shen Xiang , Wang Rongping , Wang Xunsi
Published: November 2023

Multicore fiber (MCF) has a larger mode-area (LMA) compared to traditional single-core fiber, making it easy to get a mode area of more than 3000 µm2 with an optimized MCF structure. Here, a fine-structured 19-core fiber based on chalcogenide glass was fabricated using a combined method involving extrusion, drilling, and rod-in-tube for the first time. The fiber has a minimum transmission loss of 1.8 dB/m at 6.7 µm. When the bending radius exceeds 6 cm, a low bending loss of about 0.6 dB appears, and the experimental data are in good agreement with the simulation results. In addition, the supermode characteristics of the 19-core fiber are analyzed from both perspectives of simulation and experiment, and these results are perfectly in good agreement. We believe it opens a new way to develop high-power and bend-resisting fiber with such kind of multicore structure.
Deep learning-assisted light sheet holography
Authors: Asoudegi Nima , Dorrah Ahmed H. , Mojahedi Mo
Published: November 2023

In a novel approach to layer-based holography, we propose a machine learning-assisted light sheet holography–an optimized holography technique which projects a target scene onto sheets of light along the longitudinal planes (i.e. planes perpendicular to the plane of the hologram). Using a convolutional neural network in conjunction with superposition of Bessel beams, we generate high-definition images which can be stacked in parallel onto longitudinal planes with very high fidelity. Our holography system provides high axial resolution and excellent control over the light intensity along the optical path, which is suitable for augmented reality and/or virtual reality applications.
Zero-optical-distance mini-LED backlight with light-guiding microstructure lens for extra-thin, large-area notebook LCDs
Authors: Ye Zhi Ting , Chen Yen Lung , Chiu Chang Che , Hu Chia Chun
Published: November 2023

Mini–light-emitting diode (Mini-LED) backlight units (BLUs) in combination with high dynamic range technology can reduce energy and ensure high contrast and luminance. However, the number of LEDs used in mini-LED BLUs is considerably larger than the number of partitions in local dimming, resulting in low cost effectiveness. We proposed a design combining edge-light mini-LEDs and light-guiding microstructure lenses to reduce the number of light sources required in displays considerably. A 16-inch prototype was produced for experiments. The length, width, and thickness of the liquid crystal display module were 351.87, 225.75, and 1.709 mm, respectively. For edge-light mini-LEDs with a pitch of 8.6 mm, the average luminance was 18,836 nits for an input power of 22.5 watts, the uniformity was 85%, the uniformity merit function was 10.13, and the contrast ratio was 60,000:1. Thus, a zero-optical-distance (ZOD) mini-LED backlight for extra-thin, large-area notebook LCDs was produced.