bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence and factors associated with knee osteoarthritis among middle-aged and elderly individuals in rural Tianjin: a population-based cross-sectional study
Authors: Ji Shuqing , Liu Li , Li Jiwei , Zhao Guohua , Cai Yana , Dong Yanan , Wang Jinghua , Wu Shengguang
Published: April 2023

Background

The prevalence of osteoarthritis has been investigated in many countries and regions. Considering the wide differences in ethnicity, socioeconomic status, environmental factors, and lifestyle patterns, our study aimed to report the prevalence of knee osteoarthritis (KOA) and its associated factors in rural areas of Tianjin.

Methods

This population-based cross-sectional study was conducted between June and August 2020. KOA was diagnosed according to the 1995 American College of Rheumatology criteria. Information on participants’ age, years of education, BMI, smoking and drinking status, sleep quality, and frequency of walking were collected. Multivariate logistic regression analysis was used to analyze factors influencing KOA.

Results

This study included 3924 participants (1950 male and 1974 female); the mean age of all participants was 58.53 years. In total, 404 patients were diagnosed with KOA, and the overall prevalence of KOA was 10.3%. The prevalence of KOA was higher in women than in men (14.1% vs. 6.5%). The risk of KOA in women was 1.764 times higher than that in men. The risk of KOA increased following the increasement of age. There was higher risk of KOA in participants who walked frequently than in participants who walked infrequently (OR = 1.572); in participants with overweight than in participants with normal weight (OR = 1.509), in participants with average sleep quality (OR = 1.677) and those with perceived poor sleep quality (OR = 1.978), respectively, than participants with satisfactory sleep quality, and in postmenopausal women than in non-menopausal women (OR = 4.12). The risk of KOA in participants with an elementary level was lower (0.619 times) than participants with illiteracy. In addition, the results of gender subgroup analysis showed that in male, age, obesity, frequent walking and sleep quality were independent factors associated with KOA; while in female, age, BMI, education level, sleep quality, frequent walking and whether menopausal were independent factors associated with KOA (P < 0.05).

Conclusion

The results of our population-based cross-sectional study showed that sex, age, educational level, BMI, sleep quality, and frequent walking were independent influencing factors for KOA, and the influencing factors for KOA differed between the sexes. In order to reduce the disease burden of KOA and the harm to the health of middle-aged and elderly people, the risk factors related to the control of KOA should be identified as much as possible.

Trial registration: ChiCTR2100050140.
Coordinating smoking cessation treatment with menstrual cycle phase to improve quit outcomes (MC-NRT): study protocol for a randomized controlled trial
Authors: Zawertailo Laurie , Kabir Tina , Voci Sabrina , Tanzini Elise , Attwells Sophia , Malat Liliana , Veldhuizen Scott , Minian Nadia , Dragonetti Rosa , Melamed Osnat C. , Mei-Dan Elad , Selby Peter
Published: April 2023

Background

Women experience greater difficulty achieving smoking abstinence compared to men. Recent evidence suggests that hormonal fluctuations during different phases of the menstrual cycle can contribute to lower smoking abstinence rates following a quit attempt among women. However, these findings are limited by small sample sizes and variability among targeted smoking quit dates. This clinical trial aims to clarify whether targeting the quit date to the follicular or luteal phase of the menstrual cycle can improve smoking abstinence.

Methods

Participants will enroll in an online smoking cessation program providing nicotine replacement therapy (NRT) and behavioral support. We will randomize 1200 eligible individuals to set a target quit date: (1) during the mid-luteal phase, (2) during the mid-follicular phase, or (3) 15–30 days after enrollment with no regard to the menstrual cycle phase (usual practice). Participants will receive a 6-week supply of combination NRT consisting of a nicotine patch plus their choice of nicotine gum or lozenge. Participants will be instructed to start using NRT on their target quit date. Optional behavioral support will consist of a free downloadable app and brief videos focusing on building a quit plan, coping with cravings, and relapse prevention, delivered via e-mail. Smoking status will be assessed via dried blood spot analysis of cotinine concentration at 7 days, 6 weeks, and 6 months post-target quit date.

Discussion

We aim to overcome the limitations of previous studies by recruiting a large sample of participants and assigning target quit dates to the middle of both the follicular and luteal phases. The results of the trial can further elucidate the effects of the menstrual cycle on smoking cessation outcomes and whether it is beneficial to combine menstrual cycle phase timing strategies with accessible and low-cost NRT.

Trial registration

ClinicalTrials.gov NCT05515354. Registered on August 23, 2022.
Design of a stable ethanologenic bacterial strain without heterologous plasmids and antibiotic resistance genes for efficient ethanol production from concentrated dairy waste
Authors: Pasotti Lorenzo , De Marchi Davide , Casanova Michela , Frusteri Chiacchiera Angelica , Cusella De Angelis Maria Gabriella , Calvio Cinzia , Magni Paolo
Published: April 2023

Engineering sustainable bioprocesses that convert abundant waste into fuels is pivotal for efficient production of renewable energy. We previously engineered an Escherichia coli strain for optimized bioethanol production from lactose-rich wastewater like concentrated whey permeate (CWP), a dairy effluent obtained from whey valorization processes. Although attractive fermentation performances were reached, significant improvements are required to eliminate recombinant plasmids, antibiotic resistances and inducible promoters, and increase ethanol tolerance. Here, we report a new strain with chromosomally integrated ethanologenic pathway under the control of a constitutive promoter, without recombinant plasmids and resistance genes. The strain showed extreme stability in 1-month subculturing, with CWP fermentation performances similar to the ethanologenic plasmid-bearing strain. We then investigated conditions enabling efficient ethanol production and sugar consumption by changing inoculum size and CWP concentration, revealing toxicity- and nutritional-related bottlenecks. The joint increase of ethanol tolerance, via adaptive evolution, and supplementation of small ammonium sulphate amounts (0.05% w/v) enabled a fermentation boost with 6.6% v/v ethanol titer, 1.2 g/L/h rate, 82.5% yield, and cell viability increased by three orders of magnitude. Our strain has attractive features for industrial settings and represents a relevant improvement in the existing ethanol production biotechnologies.
FTO-mediated m6A demethylation of pri-miR-3591 alleviates osteoarthritis progression
Authors: Liu Wengang , Jiang Tao , Zheng Wei , Zhang Jiayuan , Li Anan , Lu Chao , Lin Zhaowei
Published: April 2023

Objectives

Increasing evidence have demonstrated the N6-methyladenosine (m6A) plays critical roles in osteoarthritis (OA) progression, but the role of m6A in OA has not been completely illuminated. Herein, we investigated the function and underlying mechanism of m6A demethylase fat mass and obesity-associated protein (FTO) in OA progression.

Materials and methods

The FTO expression was detected in mice OA cartilage tissues and lipopolysaccharide (LPS)-stimulated chondrocytes. Gain-of-function assays was used to evaluate the role of FTO in OA cartilage injury in vitro and in vivo. The miRNA-sequencing, RNA-binding protein immunoprecipitation (RIP), luciferase reporter assay, and in vitro pri-miRNA processing assays were conducted to confirm that FTO modulated the pri-miR-3591 process in an m6A-dependent manner and then the binding sites of miR-3591-5p with PRKAA2.

Results

FTO was outstandingly downregulated in LPS-stimulated chondrocytes and OA cartilage tissues. FTO overexpression enhanced the proliferation, suppressed apoptosis, and decreased degradation of extracellular matrix in LPS-induced chondrocytes, whereas FTO knockdown contributed to the opposite effects. In vivo animal experiments showed that FTO overexpression markedly alleviated OA mice cartilage injury. Mechanically, FTO-mediated m6A demethylation of pri-miR-3591 leaded to a maturation block of miR-3591-5p, which relieved the inhibitory effect of miR-3591-5p on PRKAA2 and then promoted the increase of PRKAA2, thereby alleviating OA cartilage damage.

Conclusions

Our results attested that FTO alleviated the OA cartilage damage by mediating FTO/miR-3591-5p/PRKAA2 axis, which provided fresh insights into the therapeutic strategies for OA.
Outbreak investigations after identifying carbapenem-resistant Pseudomonas aeruginosa: a systematic review
Authors: Büchler Andrea C. , Shahab Selvi N. , Severin Juliëtte A. , Vos Margreet C. , Voor in ’t holt Anne F.
Published: April 2023

Background

Carbapenem-resistant Pseudomonas aeruginosa (CRPA) are a serious cause of healthcare-associated infections. Part of the infection prevention and control measures are outbreak investigations (OI) of patients, healthcare workers (HCW), and the environment after identifying a CRPA in order to identify carriers and environmental reservoirs, so that targeted actions can be taken to prevent further transmission. However, little is known on when and how to perform such OI. Therefore, this systematic review aims to summarize OI performed after detection of CRPA in the endemic and epidemic hospital setting.

Main text

Articles related to our research question were identified through a literature research in multiple databases (Embase, Medline Ovid, Cochrane, Scopus, Cinahl, Web of Science, and Google Scholar) until January 12, 2022 (Prospero registration number CRD42020194165). Hundred-twenty-six studies were included. In both the endemic and the epidemic setting, a median number of two out of seven predefined components of OI were identified. In the endemic setting, the most frequent component of OI was screening of the environment (28 studies, 62.2%). In the epidemic setting, screening of the environment (72 studies, 88.9%), and screening of patients during hospitalization (30 studies, 37%) were most frequently performed. Only 19 out of 126 studies (15.1%) reported screening of contact patients, and 37 studies reported screening of healthcare workers (HCW, 29.4%).

Conclusion

Due to probable underreporting of OI in the literature, the available evidence for the usefulness of the individual components of OI is scarce. This could lead to inhomogeneous performance of OI after detection of CRPA in the healthcare setting, and with this, potential under- or overscreening. While we could show evidence for the usefulness for environmental screening in order to identify the mode of transmission, evidence for HCW screening is scarce and might not lead to the identification of modes of transmission. Further studies are needed to better understand CI in different settings and, finally, develop guidance on when and how to best perform OI.
Flexible electric vehicle charging and its role in variable renewable energy integration
Authors: Xu Robert , Seatle Madeleine , Kennedy Christopher , McPherson Madeleine
Published: April 2023

Uptake of electric vehicles is accelerating as governments around the world aim to decarbonize transportation. However, swift and widespread electric vehicle (EV) adoption will require some degree of controlled charging to mitigate the adverse impacts of electric vehicle adoption. Simulating the interaction between transportation and power requires new modelling tools with operational detail and spatial-temporal granularity. This analysis evaluates the potential benefits of utility-controlled charging (UCC) with the objective of reducing variable renewable energy (VRE) curtailment in decarbonized power systems using a framework that links travel and power system models using an intermediate charging model. Results show that the addition of VRE generation infrastructure shows the most impact on electricity system operating emissions and costs, but EV charging plays a significant role as well. Within EV charging strategies, UCC charging decreases emissions by 7% compared to uncontrolled charging. UCC is proven to be most effective in the summer due to higher electric vehicle fuel economy. Finally, the type of VRE generation infrastructure on the grid may have implications for siting of EV charging infrastructure due to the typical temporal peaks of wind and solar energy. These findings demonstrate how the use of distinct but linked travel and power sector models can be deployed to reduce multi-sector emissions and costs.
Upregulation of carbonic anhydrase 1 beneficial for depressive disorder
Authors: Cheng Ke , Wang Yue , He Yong , Tian Yu , Li Junjie , Chen Chong , Xu Xingzhe , Wu Zhonghao , Yu Heming , Chen Xiangyu , Wu Yili , Song Weihong , Dong Zhifang , Xu Huatai , Xie Peng
Published: April 2023

Carbonic Anhydrase 1 (CAR1) is a zinc-metalloenzyme that catalyzes the hydration of carbon dioxide, and the alteration of CAR1 has been implicated in neuropsychiatric disorders. However, the mechanism underlying the role of CAR1 in major depressive disorder (MDD) remains largely unknown. In this study, we report the decreased level of CAR1 in MDD patients and depression-like model rodents. We found that CAR1 is expressed in hippocampal astrocytes and CAR1 regulates extracellular bicarbonate concentration and pH value in the partial hilus. Ablation of the CAR1 gene increased the activity of granule cells via decreasing their miniature inhibitory postsynaptic currents (mIPSC), and caused depression-like behaviors in CAR1-knockout mice. Astrocytic CAR1 expression rescued the deficits in mIPSCs of granule cells and reduced depression-like behaviors in CAR1 deficient mice. Furthermore, pharmacological activation of CAR1 and overexpression of CAR1 in the ventral hippocampus of mice improved depressive behaviors. These findings uncover a critical role of CAR1 in the MDD pathogenesis and its therapeutic potential.
Effect of vacancies and edges in promoting water chemisorption on titanium-based MXenes
Authors: Marquis Edoardo , Benini Francesca , Anasori Babak , Rosenkranz Andreas , Righi Maria Clelia
Published: April 2023

The functionality of two-dimensional (2D) transition metal carbides and nitrides (MXenes) in technological applications greatly depends on their wettability. For instance, MXenes’ layer stability against degradative oxidation is notably reduced when stored in aqueous solutions, leading to the transformation into oxides. In this work, we study water adsorption on Ti-based MXenes by ab initio calculations. The energy gains for the molecular adsorption on Tin+1XnT2 is evaluated as a function of the termination (T = F, O, OH, mixture), the carbon/nitrogen ratio (X = C, N), the layer thickness (n) and water coverage. MXenes’ hydrophilicity tends to increase due to the presence of defects as vacancies and flake edges. We demonstrate that physical adsorption occurs through hydrogen bonding on both defect-free layers and layers containing C/N or Ti atomic vacancies, with –OH terminations providing the strongest interactions (0.40–0.65 eV). In contrast, strong water chemisorption is observed on surfaces with a single termination vacancy (0.60–1.20 eV), edges (0.75–0.85 eV), and clusters of defects (1.00–1.80 eV). We verified that the presence of undercoordinated Ti atoms on the surface is the key factor in promoting H2O chemisorption, i.e., the degradative oxidation.

Graphical Abstract
Examining how social networks influence women and under-represented minority students’ pursuit of engineering in university: when, who, and how?
Authors: Wao Hesborn , Kersaint Gladis , Smith Chrystal A. S. , Campbell-Montalvo Rebecca , Puccia Ellen , Skvoretz John , Martin Julie P. , Lee Reginald , MacDonald George
Published: April 2023

Background

Women and under-represented minority (URM) students continue to be under-represented in STEM and earn the lowest proportion of undergraduate engineering degrees. We employed a mixed methods research approach grounded in social capital theory to investigatewhenthey first consider pursuing engineering as a college degree major,whoinfluences this decision, andhowthe influence occurs. First, we surveyed 2186 first-year undergraduate students entering engineering programs at 11 universities in the U.S. during the fall of 2014. Next, we interviewed a subsample of 55 women and URM students.

Results

Survey findings indicated that women were more likely than men to consider pursuing engineering while in high school, before admission into college, or while in college rather than considering it earlier in their education. Black and Latinx students were more likely than white students to consider pursuing engineering after high school. In addition, Black and Latinx students were more likely than white students to identify a school counselor (rather than a family member) as having the most influence on their engineering academic and career decisions. In interviews, women and URM students provided examples of influential people who connected their aptitude and enthusiasm for mathematics, science, and problem-solving to engineering, explained the benefits of being an engineer, and provided advice about engineering academic and career pathways.

Conclusions

Encouraging earlier consideration of engineering majors, such as during middle school, could allow women and URM students time to take requisite courses and take advantage of college preparatory programming. Likewise, universities can engage in intentional efforts to identify women and URM students with engineering interests and provide guidance. Such efforts should also include connecting them with other women and URM students in engineering. In addition, universities should support K-12 and university personnel in offering advice that can influence students’ decision to declare an engineering major, which could help recruit more women and URM students into engineering.
The 25‐year experience of over‐the‐top ACL reconstruction plus extra‐articular lateral tenodesis with hamstring tendon grafts: the story so far
Authors: Zaffagnini Stefano , Lucidi Gian Andrea , Macchiarola Luca , Agostinone Piero , Neri Maria Pia , Marcacci Maurilio , Grassi Alberto
Published: April 2023

This article presents with an evidence based approach, the kinematical rationale, biological evidence and the long term results of the “Over‐The‐Top” anterior cruciate ligament reconstruction with lateral plasty technique. This surgery was developed more than 25 years ago at the Rizzoli Institute by professor Marcacci and Zaffagnini and it is still widely performed in many orthopedic center worldwide.
Current trends in graft choice for anterior cruciate ligament reconstruction – part I: anatomy, biomechanics, graft incorporation and fixation
Authors: Runer Armin , Keeling Laura , Wagala Nyaluma , Nugraha Hans , Özbek Emre Anil , Hughes Jonathan D. , Musahl Volker
Published: April 2023

Graft selection in anterior cruciate ligament (ACL) reconstruction is critical, as it remains one of the most easily adjustable factors affecting graft rupture and reoperation rates. Commonly used autografts, including hamstring tendon, quadriceps tendon and bone‐patellar‐tendon‐bone, are reported to be biomechanically equivalent or superior compared to the native ACL. Despite this, such grafts are unable to perfectly replicate the complex anatomical and histological characteristics of the native ACL. While there remains inconclusive evidence as to the superiority of one autograft in terms of graft incorporation and maturity, allografts appear to demonstrate slower incorporation and maturity compared to autografts. Graft fixation also affects graft properties and subsequent outcomes, with each technique having unique advantages and disadvantages that should be carefully considered during graft selection.
Simultaneous real-time analysis of tear film optical quality dynamics and functional visual acuity in dry eye disease
Authors: Pan An-Peng , Ma Yunjing , Hu Ruilin , Cao Xuejiao , Wu Yifen , Zhou Kaijing , Tu Ruixue , Shao Xu , Chen Shihao , Yu A-Yong
Published: April 2023

Background

To assess the effect of tear film instability in dry eye disease (DED) by measuring visual performance and tear film optical quality in a simultaneous real-time analysis system.

Methods

Thirty-seven DED participants and 20 normal controls were recruited. A simultaneous real-time analysis system was developed by adding a functional visual acuity (FVA) channel to a double-pass system. Repeated measurements of FVA and objective scatter index (OSI) were performed simultaneously with this system under blink suppression condition for 20 s. Patient-reported symptoms was evaluated using the Ocular Surface Disease Index (OSDI) questionnaire. Mean FVA, mean OSI, and visual acuity break-up time were defined. The OSI maintenance ratio was calculated as an evaluation index to assess the difference between dynamic OSI changes and baseline OSI. The visual maintenance ratio was also calculated in the same way.

Results

Moderate correlations were noted between mean OSI and FVA-related parameters (mean FVA, visual maintenance ratio, visual acuity break-up time: 0.53, − 0.56, − 0.53, respectively,P < 0.01 for all). Moderate to high correlations were noted between OSI maintenance ratio and FVA-related parameters (mean FVA, visual maintenance ratio, visual acuity break-up time: − 0.62, 0.71, 0.64, respectively, allP < 0.01). The metrics derived from the simultaneous real-time analysis system were moderately correlated with the patient-reported symptoms and the visual acuity break-up time possessed the highest correlation coefficients with OSDI total, ocular symptoms, and vision-related function (− 0.64, − 0.63, − 0.62, respectively,P < 0.01). The OSI-maintenance ratio alone appeared to exhibit the best performance of the metrics for the detection of DED with sensitivity of 95.0% and specificity of 83.8% and the combinations of FVA parameters and OSI parameters were valid and can further improve the discriminating abilities.

Conclusions

OSI-related metrics were found to be potential indicators for assessing and diagnosing DED which correlated with both subjective visual performance and patient-reported symptoms; the FVA-related metrics were quantifiable indicators for evaluating visual acuity decline in DED.

Trial registration number:Chinese Clinical Trial Registry, ChiCTR2100051650. Registered 29 September 2021,https://www.chictr.org.cn/showproj.aspx?proj=134612
Primary observations of EVO ICL implantation for high myopia with concave iris
Authors: Zhang Zhe , Niu Lingling , Liu Tingting , Shen Yang , Shang Jianmin , Zhao Jing , Wei Ruoyan , Zhou Xingtao , Yao Peijun
Published: April 2023

Purpose

To investigate the morphological changes of concave iris in myopic patients after EVO implantable collamer lens (ICL) implantation.

Methods

EVO ICL candidates with posterior bowing iris were observed using ultrasound biometric microscopy (UBM) in this prospective nonrandomized observational study. Forty patients were enrolled, with 20 patients in the concave iris group and the other 20 patients in the control group. None of the patients underwent laser peripheral iridotomy. All patients received preoperative and postoperative examinations, which included uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), subjective manifest refraction and intraocular pressure. UBM was used to observe iris curvature (IC), irido-corneal angle (ICA), posterior chamber angle (PCA), iris-lens contact distance (ILCD), iris-zonule distance (IZD) and ciliary process length (CPL). Anterior chamber angle pigment was observed by gonioscopy. The preoperative and postoperative data were analyzed using SPSS.

Results

The average follow-up period was 13.3 ± 5.3 months. The mean efficacy indices were 1.10 ± 0.13 and 1.07 ± 0.11 (P = 0.58), and the safety indices were 1.19 ± 0.09 and 1.18 ± 0.17 in the control group and the concave iris group (P = 0.93), respectively. The IOP postoperatively were 14.13 ± 2.02 mmHg and 14.69 ± 1.59 mmHg in control and concave iris groups (P = 0.37). Preoperatively, the concave iris group was presented with greater IC (P < 0.0001), longer ILCD (P < 0.0001), wider ICA (P = 0.004), narrower PCA (P = 0.01), and shorter IZD (P = 0.03) than the control group. In the concave iris group, IC, ILCD and ICA were significantly decreased after ICL implantation (P < 0.0001), while PCA and IZD were significantly increased (P = 0.03 and P = 0.04, respectively). Postoperative IC, ILCD, ICA, PCA and IZD were not statistically different between groups (P > 0.05). There was no significant difference in pigment deposition grades between the two groups (P = 0.37).

Conclusion

After EVO ICL implantation, the morphology of concave iris was significantly improved, which may reduce the risk of intraocular pigment dissemination caused by iris concavity. The concave iris has no impact on the safety of EVO ICL surgery during the follow-up.
Protocol for a feasibility randomized controlled trial to evaluate the efficacy, safety and tolerability of N-acetylcysteine in reducing adverse drug reactions among adults treated for multidrug-resistant tuberculosis in Tanzania
Authors: Mpagama Stellah G. , Mvungi Happiness C. , Mbelele Peter M. , Semvua Hadija H. , Liyoyo Alphonce A. , de Guex Kristen Petros , Sloan Derek , Kibiki Gibson S. , Boeree Martin , Phillips Patrick P. J. , Heysell Scott K.
Published: April 2023

Background

Adverse drug reactions (ADRs) frequently occur in patients using second-line anti-tuberculosis medicine for treatment of multidrug resistant tuberculosis (MDR-TB). ADRs contribute to treatment interruptions which can compromise treatment response and risk acquired drug resistance to critical newer drugs such as bedaquiline, while severe ADRs carry considerable morbidity and mortality. N-acetylcysteine (NAC) has shown promise in reducing ADRs for medications related to TB in case series or randomized controlled trials in other medical conditions, yet evidence is lacking in MDR-TB patients. TB endemic settings have limited capacity to conduct clinical trials. We designed a proof-of-concept clinical trial primarily to explore the preliminary evidence on the protective effect of NAC among people treated for MDR-TB with second-line anti-TB medications.

Methods

This is a proof-of-concept randomized open label clinical trial with 3 treatment arms including a control arm, an interventional arm of NAC 900 mg daily, and an interventional arm of NAC 900 mg twice-daily administered during the intensive phase of MDR-TB treatment. Patients initiating MDR-TB treatment will be enrolled at Kibong’oto National Center of Excellence for MDR-TB in the Kilimanjaro region of Tanzania. The minimum anticipated sample size is 66; with 22 participants in each arm. ADR monitoring will be performed at baseline and daily follow-up over 24 weeks including blood and urine specimen collection for hepatic and renal function and electrolyte abnormalities, and electrocardiogram. Sputum will be collected at baseline and monthly thereafter and cultured for mycobacteria as well as assayed for other molecular targets of Mycobacterium tuberculosis. Adverse drug events will be analysed over time using mixed effect models. Mean differences between arms in change of the ADRs from baseline (with 95% confidence intervals) will be derived from the fitted model.

Discussion

Given that NAC promotes synthesis of glutathione, an intracellular antioxidant that combats the impact of oxidative stress, it may protect against medication induced oxidative damage in organs such as liver, pancreas, kidney, and cells of the immune system. This randomized controlled trial will determine if NAC leads to fewer ADRs, and if this protection is dose dependent. Fewer ADRs among patients treated with MDR-TB may significantly improve treatment outcomes for multidrug regimens that necessitate prolonged treatment durations. Conduct of this trial will set the needed infrastructure for clinical trials.

Trial registration

PACTR202007736854169 Registered 03 July 2020
The student migration transition: an empirical investigation into the nexus between development and international student migration
Authors: Weber Tijmen , Van Mol Christof
Published: April 2023

In this paper, we analyze the relationship between development and outgoing international student mobility (ISM) for the years 2003–2018 using data from UNESCO. Starting from migration transition theory, we expect that development and outgoing migration follows an inverted U-shape due to changes in capabilities and aspirations of populations. As predicted, we find that outgoing ISM also follows this pattern. Probing deeper into this finding, we investigated whether students from countries of different levels of development favor different destination countries, focusing on destination countries’ academic ranking, GDP per capita, and linguistic and colonial ties. We find that these destination country characteristics indeed have different effects for students from origin countries with different stages of development, and that these effects cannot simply be reduced to a dichotomy between developed/developing countries. Together, the findings highlight the nonlinearity of ISM processes. In turn this opens up new avenues of research regarding the diversity of international student populations.
Health risk management framework for heavy metals and cyanide in Kwekwe city of Zimbabwe: a mixed-method study protocol
Authors: Ngwenya Sheunesu , Mashau Ntsieni S. , Mhlongo Emmanuel S. , Traoré Afsatou N. , Mudau Azwinndini G.
Published: April 2023

Background

According to WHO, in 2015, over 35% of ischaemic heart disease, the leading cause of death and disability worldwide, and about 42% of strokes, the second largest contributor to global mortality, could have been prevented by reducing or removing exposure to chemical pollutants. Heavy metal and cyanide pollution are prevalent in developing countries, especially in sub-Saharan Africa where the effects of industrial pollutants are more severe, partly due to poor regulation. In Zimbabwe, the mining industry alone contributed to 25% of occupational conditions and injuries in 2020. Therefore, to mitigate these problems, this study seeks to develop a health risk management framework for heavy metals and cyanide pollution in the industrial city of Kwekwe.

Methods

The convergent parallel mixed-method study design will be utilised. Qualitative and quantitative data will be collected, analysed, and merged in order to inform the development of the risk framework. An analytical cross-sectional survey would be used to determine levels of heavy metals in surface water, soil, and vegetables. Free cyanide will be determined in surface water samples only. The phenomenological qualitative inquiry will be used to investigate health events and risks associated with potentially toxic pollutants (heavy metals and cyanide) to describe or interpret participants' lived experiences. The qualitative and quantitative results will be used to develop and validate the framework to manage identified health risks. For data analysis, statistical analysis will be used in the quantitative study, while thematic analysis will be used in the qualitative study. The study was approved by the University of Venda Ethics Committee (Registration Number FHS/22/PH/05/2306) and the Medical Research Council of Zimbabwe (Approval Number MRCZ/A/2944). All ethical principles will be adhered to throughout the study in accordance with the Helsinki Declaration.

Discussion

While existing risk management frameworks have significantly contributed to human and environmental health protection, novel and comprehensive frameworks need to be developed to counter the ever-dynamic and evolving risks associated with chemical pollutants. If the management framework is successfully developed, it could offer an opportunity for the prevention and control of potentially toxic elements.
Access to parenting leaves for recent immigrants: a cross-national view of policy architecture in Europe
Authors: Duvander Ann-Zofie , Koslowski Alison
Published: April 2023

Parenting leaves play a crucial part in supporting women’s labour force participation as well as men’s participation in infant care. A major question is who has access to such leave policies and earlier research has pointed out large variations in eligibility. This article focuses on the leaves that are available to recently arrived immigrants, parents who are in a specific situation of being in transition between systems. Using information from the database of leave policies, theInternational Review of Leave Policies and Research 2021(leavenetwork.org), we map eligibility and entitlements in Belgium, Germany, Italy, Spain, Sweden and the UK, all countries with tiered systems of parenting leave entitlement as well as relatively large recent immigrant populations. Our findings indicate that the leave policies available to recent immigrants can be patchwork in nature and of a very different generosity to the benefits available to many other parents. In addition, the benefits available to this group are often (even) more gendered and perhaps suggest a fall back to a policy logic of maternalism. We discuss how parenting leave may facilitate (or not) an exit from the early vulnerable stage that many immigrant parents face during the first few years in a new country.
Exploring educational impacts among pre, during and post COVID-19 lockdowns from students with different personality traits
Authors: Zheng Yong , Zheng Shuaiqi
Published: April 2023

The influence of personality traits on educational outcomes has been widely recognized and studied. Research has explored its effects on factors such as student satisfaction, academic anxiety, and dishonesty, particularly during the COVID-19 pandemic. However, there has been a lack of studies comparing the learning behaviors and performance of students with different personality traits during the pre, during, and post-COVID-19 lockdown periods. This study fills this gap by analyzing the differences in academic metrics, such as class grades and assignment submissions, among students with varying personality traits during different lockdown periods. Our research, based on a dataset of 282 graduate students in the USA, identified correlations and patterns between lockdown periods, personality traits, and academic metrics. For example, the class grades and the rate of late submissions were affected by different lockdown periods. Students with lower degree in extraversion and agreeableness made less attempts in assignment submissions. These findings can assist educators in identifying impacted students and developing effective teaching strategies at early stage in future incidents.
Content validation and psychometric evaluation of the Angioedema Quality of Life Questionnaire for hereditary angioedema
Authors: Vanya Magdalena , Watt Maureen , Shahraz Saeid , Kosmas Charlotte E. , Rhoten Stephanie , Costa-Cabral Sara , Mendivil Joan , Devercelli Giovanna , Weller Karsten
Published: April 2023

Background

There is considerable burden of illness in hereditary angioedema (HAE). However, instruments to assess health-related quality of life (HRQoL) in HAE are limited. The Angioedema Quality of Life Questionnaire (AE-QoL) was developed to measure HRQoL in patients with recurrent angioedema; the validity of the AE-QoL in patients with HAE is described.

Methods

To identify disease-related experiences with a focus on the impact of HAE on HRQoL, interviews were conducted with a group of clinician experts and patients with HAE from Canada, France, Germany, Spain, the United Kingdom, and the United States, along with a targeted literature review. Concepts were mapped to the AE-QoL to assess item relevance, interpretation, and conceptual coverage. Cognitive interviews assessed item clarity and relevance. A psychometric validation was performed using data from a phase 3 trial.

Results

Interviews were conducted with seven clinicians and 40 adult patients. Patients reported 35 unique impacts of HAE on their lives, the most frequent being on work/school, social relationships, physical activities, and emotions, particularly fear/worrying and anxiety. Saturation for these impacts was reached, and all concepts covered in the AE-QoL were reported during the interviews. Patients agreed that the questionnaire items and response options were clear and relevant, and the 4-week recall period was appropriate. The psychometric validation included data from 64 patients. For AE-QoL total scores, excellent internal consistency (Cronbach’s alpha > 0.90), test-retest reliability (intraclass coefficient > 0.80), convergent validity with the Sheehan Disability Scale (r = 0.663), divergent validity with the EQ-5D-5L index (r = 0.292) and EQ-VAS (r = 0.337), and known-groups validity (p < 0.0001; ɳ2 = 0.56) were demonstrated.

Conclusions

Qualitative and psychometric analyses showed that the AE-QoL is a reliable and valid instrument for measuring HRQoL in adult patients with HAE from six countries.
Exploring best-matched embedding model and classifier for charging-pile fault diagnosis
Authors: Wang Wen , Wang Jianhua , Peng Xiaofeng , Yang Ye , Xiao Chun , Yang Shuai , Wang Mingcai , Wang Lingfei , Li Lin , Chang Xiaolin
Published: April 2023

The continuous increase of electric vehicles is being facilitating the large-scale distributed charging-pile deployment. It is crucial to guarantee normal operation of charging piles, resulting in the importance of diagnosing charging-pile faults. The existing fault-diagnosis approaches were based on physical fault data like mechanical log data and sensor data streams. However, there are other types of fault data, which cannot be used for diagnosis by these existing approaches. This paper aims to fill this gap and consider 8 types of fault data for diagnosing, at least including physical installation error fault, charging-pile mechanical fault, charging-pile program fault, user personal fault, signal fault (offline), pile compatibility fault, charging platform fault, and other faults. We aim to find out how to combine existing feature-extraction and machine learning techniques to make the better diagnosis by conducting experiments on realistic dataset. 4 word embedding models are investigated for feature extraction of fault data, including N-gram, GloVe, Word2vec, and BERT. Moreover, we classify the word embedding results using 10 machine learning classifiers, including Random Forest (RF), Support Vector Machine, K-Nearest Neighbor, Multilayer Perceptron, Recurrent Neural Network, AdaBoost, Gradient Boosted Decision Tree, Decision Tree, Extra Tree, and VOTE. Compared with original fault record dataset, we utilize paraphrasing-based data augmentation method to improve the classification accuracy up to 10.40%. Our extensive experiment results reveal that RF classifier combining the GloVe embedding model achieves the best accuracy with acceptable training time. In addition, we discuss the interpretability of RF and GloVe.
Constrained large-eddy simulation of laminar-turbulent transition in compressible channel flows
Authors: Chen Sanmu , Jiang Zhou , Wan Minping , Chen Shiyi
Published: April 2023

An improved approach for constrained large-eddy simulations (CLES) of wall-bounded compressible transitional flows is proposed by introducing an intermittency factor. The improved model is tested and validated with compressible channel flows at various Mach numbers and Reynolds numbers that are transitioning from laminar to turbulent states. The improved model is compared against traditional dynamic Smagorinsky model (DSM) and Direct Numerical Simulations (DNS), where the improved model is in better agreement with DNS results than traditional DSM model, in terms of mean velocity profiles, total Reynolds stress and total heat flux. Therefore, the proposed method can be used to accurately predict the temporal laminar-turbulent transition process of compressible wall-bounded flows.
Effects of kimchi on human health: a scoping review of randomized controlled trials
Authors: Song Eunhye , Ang Lin , Lee Hye Won , Kim Myung-Sunny , Kim You Jin , Jang Daija , Lee Myeong Soo
Published: April 2023

Kimchi is a Korean traditional fermented food which is one of the most popular ethnic fermented foods in Korea and consumed daily. The purpose of this review was to systematically evaluate all prospective clinical studies of kimchi and to estimate the effectiveness of kimchi for health in general. Three English databases, four Korean databases, and two clinical trial registries were searched until November 7, 2022. Two independent reviewers extracted and tabulated the data. The outcomes of this review were any health-related outcomes that studied on kimchi or kimchi-derived probiotics. Eleven randomized controlled trials (RCTs) were included in this review, with 638 participants enrolled in total and 608 participants completing the trials. Most of the included RCTs examined serum lipid profiles and clinical parameters and found that kimchi interventions showed decrease in serum lipids, cholesterols and body fats. Kimchi interventions may be safe and effective treatment option for the treatment of general health, obesity, and irritable bowel syndrome, regardless of the lack of adequate trials. In the future, research that can verify the conflicting results on the health benefits of kimchi should be conducted rigorously to provide the scientific basis for the benefits of kimchi.
Epidemiology of primary and revision total knee arthroplasty: analysis of demographics, comorbidities and outcomes from the national inpatient sample
Authors: Nham Fong H. , Patel Ishan , Zalikha Abdul K. , El-Othmani Mouhanad M.
Published: April 2023

Introduction

Primary total knee arthroplasty (TKA) is a preferred treatment for end-stage knee osteoarthritis. In the setting of a failed TKA, revision total knee arthroplasty (rTKA) acts as a salvage procedure and carries a higher risk compared to primary TKA. Given increased interest in postoperative outcomes from these procedures, a thorough understanding of the demographics, comorbidities, and inpatient outcomes is warranted. This study aimed to report the epidemiological data of demographics, comorbidity profiles and outcomes of patients undergoing TKA and rTKA.

Methods

A retrospective review of NIS registry discharge data from 2006 to 2015 third quarter was performed. This study included adults aged 40 and older who underwent TKA or rTKA. A total of 5,901,057 TKA patients and 465,968 rTKA patients were included in this study. Simple descriptive statistics were used to present variables on demographics, medical comorbidities, and postoperative complications.

Results

A total of 5,901,057 TKA and 465,968 rTKA discharges were included in this study, with an average age of 66.30 and 66.56 years, and the major payor being Medicare, accounting for 55.34% and 59.88% of TKA and rTKA cases, respectively. Infection (24.62%) was the most frequent reason for rTKA, and was followed by mechanical complications (18.62%) and dislocation (7.67%). The most common medical comorbidities for both groups were hypertension, obesity, and diabetes. All types of inpatient complications were reported in 22.21% TKA and 28.78% of rTKA cases. Postoperative anemia was the most common complication in both groups (20.34% vs. 25.05%).

Conclusions

Our data demonstrated a 41.9% increase in patients receiving TKA and 28.8% increase in rTKA from the years 2006 to 2014. The data showed a 22.21% and a 28.78% “complication” rate with TKA and rTKA, with postoperative anemia being the most common complication. The top 3 medical comorbidities were hypertension, obesity, and diabetes for both groups and with increased focus on perioperative optimization, future analyses into preoperative medical optimization, and improved primary arthroplasty protocol may result in improved postoperative outcomes.
Sleep quality among psoriasis patients: excluding the immunosuppressive therapy effect
Authors: Khalaf Ola O. , El-Komy Mohamed M. , Kattaria Dina B. , El-Mesidy Marwa S.
Published: April 2023

Background

Psoriasis is associated with several comorbidities and different psychological disorders including anxiety and depression. Psoriasis may also affect sleep quality and consequently the quality of life. The use of immunosuppressants used in the treatment of psoriasis were also reported to increase insomnia, so the purpose of the study is to assess the quality of sleep and degree of insomnia in patients with psoriasis not on any systemic or immunosuppressive therapy compared to controls and to examine the relation between sleep quality, insomnia with depressive, and anxiety symptoms. One hundred psoriasis cases, not receiving immunosuppressive therapy, and 80 apparently healthy subjects were recruited as controls. We assessed quality of sleep, insomnia and screened for anxiety and depressive symptoms among psoriasis patients and healthy controls; any patient on immunosuppressant therapy was excluded.

Results

Quality of sleep using Pittsburgh Sleep Quality Index, insomnia using Insomnia Severity Index, depression using Beck Depression Inventory, and anxiety using Taylor Anxiety Manifest Scale were statistically significant higher among psoriasis patients than healthy controls all with p value p < 0.001. Depressive symptoms were significantly positively correlated with Pittsburgh Sleep Quality Index (PSQI) global score (p = 0.045) and subjective sleep quality subscale (p = 0.005). Also, BDI scores was significantly positively correlated with insomnia scores as measured by ISI (p = 0.026).

Anxiety symptoms were significantly positively correlated with global score of PSQI (p = 0.004) and its subscale (subjective sleep quality, sleep latency, sleep disturbance, use of medications and daytime dysfunction) and insomnia (p = 0.001).

Conclusions

Abnormal sleep quality and insomnia were detected in patients with psoriasis not using any immunosuppressive or systemic therapy, and this could be due to the psoriasis disease itself or due to the associated anxiety and depression associated with psoriasis. Screening for psychiatric symptoms specially that of depression, anxiety, and sleep among patients with psoriasis is of utmost importance for better quality of life. Thus, collaboration between dermatologists and psychiatrists may show better life quality for these cases and better treatment outcomes.
Serum Interleukin-34 in Psoriatic arthritis patients and its correlation with disease 1 activity, and subclinical atherosclerosis
Authors: Tabra Samar Abdalhamed , Abu-Zaid Mohammed Hassan , Elsharaby Radwa Mahmoud , Maria Dina , ElMiedany Samah
Published: April 2023

Background

Psoriatic arthritis (PsA) is a chronic multi-domains autoimmune inflammatory disorder. Patients with PsA have a significant prevalence of cardiovascular affection. Upregulated Interleukin-34 (IL-34) has been seen in many autoimmune disorders, and also in atherosclerotic plaques. The aim of this observational case–control study was to evaluate the serum levels of il-34 in PsA patients and correlate between its level and disease activity, and subclinical cardiovascular affection.

Results

In this study, there were 70 PsA patients and 70 healthy volunteers, 43 patients were on Methotrexate, 6 on sulfasalazine, while 40 patients were on biological therapy either monotherapy or in combination with DMARDs. There were significant differences between PsA patients and controls in ESR, high sensitivity-CRP, total lipid profile, and IL-34 levels (p < 0.05) while there were no significant differences regarding Echo and ECG results. Also, we found that there was significant elevation in DAPSA score, hs-CRP, IL-34, and cIMT in the active patients when we compared them with inactive patients. IL-34 had significant positive correlations with DAPSA score, hs-CRP, and cIMT (r = 0.654, 0.579, and 0.658 respectively).

Conclusion

Serum interleukin-34 is an important marker in PsA as its levels were elevated in PsA patients and were correlated with disease activity and subclinical cardiovascular affection.