bluuebunny/crossref_metadata_2025_split huggingface dataset:
Design of a phosphor-converted LED based lighting system considering both the lighting and color uniformity
Authors: Yan Jinren 
Published: June 2021

AbstractIn this work, a scheme of combining an aspheric reflector and a primary packaging freeform lens in phosphor-converted lighting-emitting diode (pc-LED) based lighting system design was developed. In contrast to most of previous works in which the color and illumination uniformity of the pc-LED lighting systems were improved one by one, the developed scheme can improve both indicators simultaneously. To demonstrate the feasibility of the developed design scheme, an initially designed pc-LED optical model, with an average correlated color temperature (CCT) of about 5000 K, was constructed as the light source of the illumination system. The key ingredient to the color uniformity of the illumination system was investigated at first, and then several instances with the cut-off angle ranging from 40 to 60 degrees were further discussed. Detailed analysis shows: for each case, the CCT variation decreases from over 4000 K to smaller than 300 K and the illumination uniformity increases from a very low level to better than 80% on the target region.
Acceptance and completion of rifapentine-based TB preventive therapy (3HP) among people living with HIV (PLHIV) in Kampala, Uganda—patient and health worker perspectives
Authors: Semitala Fred C. , Musinguzi Allan , Ssemata Jackie , Welishe Fred , Nabunje Juliet , Kadota Jillian L. , Berger Christopher A. , Katamba Achilles , Kiwanuka Noah , Kamya Moses R. , Dowdy David , Cattamanchi Adithya , Katahoire Anne R. 
Published: June 2021

Abstract
Background
A 12-dose, once-weekly regimen of isoniazid and rifapentine (3HP) is effective in preventing tuberculosis (TB) among people living with HIV (PLHIV). We sought to identify potential barriers to and facilitators of acceptance and completion of 3HP treatment from the perspective of people living with HIV (PLHIV) and health workers in a routine HIV care setting in Kampala, Uganda.

Methods
We conducted semi-structured interviews with 25 PLHIV and 10 health workers at an HIV/AIDS clinic in Kampala, Uganda. For both groups, we explored their understanding and interpretations of TB and TB preventive therapy (TPT), and perceptions about social and contextual factors that might influence the willingness of PLHIV to initiate and complete 3HP. We analyzed the data using an inductive thematic approach and aligned the emergent themes to the Behavior Change Wheel framework to identify sources of behavior and targeted behavior change interventions.

Results
Facilitators of acceptance and completion of 3HP treatment among PLHIV were fear of contracting TB, awareness of being at risk of getting TB, willingness to take TPT, trust in health workers, and the perceived benefits of directly observed therapy (DOT) and self-administered therapy (SAT) 3HP delivery strategies. Barriers included inadequate understanding of TPT, fear of potential side effects, concerns about the effectiveness of 3HP, and the perceived challenges of DOT or SAT. Among health workers, perceived facilitators included knowledge that TB is a common cause of mortality for PLHIV, fear of getting TB, and trust in the health workers by PLHIV, the advantages of once-weekly 3HP dosing, and the benefits of DOT and SAT 3HP delivery strategies. Health worker-reported barriers for PLHIV included inadequate understanding of TB and benefits of TPT, TB-associated stigma, potential side effects pill burden, and challenges of DOT and SAT 3HP delivery strategies. Lack of experience in the use of digital technology to monitor patient care was identified as a health worker-specific barrier. Identified intervention functions to address the facilitators or barriers included education, persuasion, environmental restructuring, enablement, and training.

Conclusions
Using a formative qualitative and comprehensive theoretical approach, we identified key barriers, facilitators, and appropriate interventions, including patient education, enhancing trust, and patient-centered treatment support that could be used to optimize the delivery of 3HP to PLHIV in our setting. These interventions are likely generalizable to other clinical interventions in similar populations in sub-Saharan Africa and other TB high-burden settings.
Intact Fasting Insulin Identifies Nonalcoholic Fatty Liver Disease in Patients Without Diabetes
Authors: Bril Fernando , McPhaul Michael J , Kalavalapalli Srilaxmi , Lomonaco Romina , Barb Diana , Gray Meagan E , Shiffman Dov , Rowland Charles M , Cusi Kenneth 
Published: June 2021

AbstractContextPatients with nonalcoholic fatty liver disease (NAFLD) are characterized by insulin resistance and hyperinsulinism. However, insulin resistance measurements have not been shown to be good diagnostic tools to predict NAFLD in prior studies.ObjectiveWe aimed to assess a newly validated method to measure intact molecules of insulin by mass spectrometry to predict NAFLD.MethodsPatients underwent a 2-hour oral glucose tolerance test (OGTT), a liver magnetic resonance spectroscopy (1H-MRS), and a percutaneous liver biopsy if they had a diagnosis of NAFLD. Mass spectrometry was used to measure intact molecules of insulin and C-peptide.ResultsA total of 180 patients were recruited (67% male; 52 ± 11 years of age; body mass index [BMI] 33.2 ± 5.7 kg/m2; 46% with diabetes and 65% with NAFLD). Intact fasting insulin was higher in patients with NAFLD, irrespective of diabetes status. Patients with NAFLD without diabetes showed ~4-fold increase in insulin secretion during the OGTT compared with all other subgroups (P = 0.008). Fasting intact insulin measurements predicted NAFLD in patients without diabetes (area under the receiver operating characteristic curve [AUC] of 0.90 [0.84-0.96]). This was significantly better than measuring insulin by radioimmunoassay (AUC 0.80 [0.71-0.89]; P = 0.007). Intact fasting insulin was better than other clinical variables (eg, aspartate transaminase, triglycerides, high-density lipoprotein, glucose, HbA1c, and BMI) to predict NAFLD. When combined with alanine transaminase (ALT) (intact insulin × ALT), it detected NAFLD with AUC 0.94 (0.89-0.99) and positive and negative predictive values of 93% and 88%, respectively. This newly described approach was significantly better than previously validated noninvasive scores such as NAFLD-LFS (P = 0.009), HSI (P &lt; 0.001), and TyG index (P = 0.039).ConclusionIn patients without diabetes, accurate measurement of fasting intact insulin levels by mass spectrometry constitutes an easy and noninvasive strategy to predict presence of NAFLD.
Rescue of Cell Surface Expression and Signaling of Mutant Follicle-Stimulating Hormone Receptors
Authors: Hanyroup Sharika , Anderson Ross C , Nataraja Selvaraj , Yu Henry N , Millar Robert P , Newton Claire L 
Published: June 2021

Abstract
Mutations in G protein-coupled receptors (GPCRs) underlie numerous diseases. Many cause receptor misfolding and failure to reach the cell surface. Pharmacological chaperones are cell-permeant small molecules that engage nascent mutant GPCRs in the endoplasmic reticulum, stabilizing folding and “rescuing” cell surface expression. We previously demonstrated rescue of cell surface expression of luteinizing hormone receptor mutants by an allosteric agonist. Here we demonstrate that a similar approach can be employed to rescue mutant follicle-stimulating hormone receptors (FSHRs) with poor cell surface expression using a small-molecule FSHR agonist, CAN1404. Seventeen FSHR mutations described in patients with reproductive dysfunction were expressed in HEK 293T cells, and cell surface expression was determined by enzyme-linked immunosorbent assay of epitope-tagged FSHRs before/after treatment with CAN1404. Cell surface expression was severely reduced to ≤18% of wild-type (WT) for 11, modestly reduced to 66% to 84% of WT for 4, and not reduced for 2. Of the 11 with severely reduced cell surface expression, restoration to ≥57% of WT levels was achieved for 6 by treatment with 1 µM CAN1404 for 24 h, and a corresponding increase in FSH-induced signaling was observed for 4 of these, indicating restored functionality. Therefore, CAN1404 acts as a pharmacological chaperone and can rescue cell surface expression and function of certain mutant FSHRs with severely reduced cell surface expression. These findings aid in advancing the understanding of the effects of genetic mutations on GPCR function and provide a proof of therapeutic principle for FSHR pharmacological chaperones.
Inhibition of miR-29 Activity in the Myeloid Lineage Increases Response to Calcitonin and Trabecular Bone Volume in Mice
Authors: Shin Bongjin , Hrdlicka Henry C , Delany Anne M , Lee Sun-Kyeong 
Published: June 2021

AbstractThe miR-29-3p family (miR-29a, miR-29b, miR-29c) of microRNAs is increased during receptor activator of nuclear factor kappa-B ligand (RANKL)-induced osteoclastogenesis. In vivo, activation of a miR-29-3p tough decoy inhibitor in Cre recombinase under the control of the lysozyme 2 promoter-expressing cells (myeloid lineage) resulted in mice displaying enhanced trabecular and cortical bone volume because of decreased bone resorption. Calcitonin receptor (Calcr) is a miR-29 target that negatively regulates bone resorption. CALCR was significantly increased in RANKL-treated miR-29-decoy osteoclasts, and these cells were more responsive to the inhibitory effect of calcitonin on osteoclast formation. Further, cathepsin K (Ctsk), which is critical for resorption, was decreased in miR-29-decoy cells. CALCR is a Gs-coupled receptor and its activation raises cAMP levels. In turn, cAMP suppresses cathepsin K, and cAMP levels were increased in miR-29-decoy cells. siRNA-mediated knock-down of Calcr in miR-29 decoy osteoclasts allowed recovery of cathepsin K levels in these cells. Overall, using a novel knockin tough decoy mouse model, we identified a new role for miR-29-3p in bone homeostasis. In RANKL-driven osteoclastogenesis, as seen in normal bone remodeling, miR-29-3p promotes resorption. Consequently, inhibition of miR-29-3p activity in the myeloid lineage leads to increased trabecular and cortical bone. Further, this study documents an interrelationship between CALCR and CTSK in osteoclastic bone resorption, which is modulated by miR-29-3p.
Formation of Nanoporous Gold Film on Ti by Anodization in Oxalic Acid
Authors: Nishio Kazuyuki , Udagawa Yuta 
Published: June 2021

Abstract
A nanoporous gold (NPG) film was formed on a Ti sheet or sputter-deposited thin Ti film by the anodization of a thin gold film on the Ti substrates in oxalic acid. A remarkably low anodic current of the Ti sheet compared with that of the Al sheet indicates that Ti is a stable substrate for the NPG film formed by the anodization. It is also confirmed that the preanodization of the Ti sheet significantly improves the adhesion of the NPG film to Ti. By increasing the anodic potential, NPG film was formed on sputter-deposited thin Ti film with a thickness of 130 nm.
A first radiotherapy application of functional bulboclitoris anatomy, a novel female sexual organ-at-risk, and organ-sparing feasibility study
Authors: Marshall Deborah C , Ghiassi-Nejad Zahra , Powers Allison , Reidenberg Joy S , Argiriadi Pamela , Ru Meng , Dumane Vishruta , Buckstein Michael , Goodman Karyn , Blank Stephanie V , Schnur Julie , Rosenstein Barry 
Published: June 2021

Objective: The bulboclitoris (clitoris and vestibular bulbs) is the primary organ responsible for female sexual arousal and orgasm. Effects of radiotherapy on the bulboclitoris are unknown, as its structure/function has yet to be described in radiotherapy, and it overlaps only partially with the external genitalia structure. Our aim was to: describe bulboclitoris structure, function and delineation; compare volume of and dose delivered to the bulboclitoris vs external genitalia; and, compare bulboclitoris-sparing IMRT (BCS-IMRT) to standard IMRT (S-IMRT) to determine reoptimization feasibility. Methods: Our expert team (anatomist, pelvic radiologist, radiation oncologist) reviewed bulboclitoris anatomy and developed contouring guidance for radiotherapy. 20 female patients with anal cancer treated with chemoradiation were analyzed. Sexual organs at risk (OARs) included the external genitalia and the bulboclitoris. Volumes, dice similarity coefficients (DSCs) and dose received using S-IMRT were compared. Plans were reoptimized using BCS-IMRT. Dose–volume histograms (DVHs) for PTVs and all OARs were compared for BCS-IMRT vs S-IMRT. Results: Bulboclitoris structure, function and delineation are described herein. The bulboclitoris occupies 20cc (IQR:12–24), largely distinct from the external genitalia (DSC <0.05). BCS-IMRT was superior to S-IMRT in reducing the dose to the bulboclitoris, with the greatest reductions in V30 and V40, with no significant changes in dose to other OARs or PTV 1/V95. Conclusion: The bulboclitoris can be contoured on planning imaging, largely distinct from the external genitalia. Compared with S-IMRT, BCS-IMRT dramatically reduced dose to the bulboclitoris in anal cancer planning. BCS-IMRT might safely reduce sexual toxicity compared with standard approaches. Advances in knowledge: The structure and function of the bulboclitoris, the critical primary organ responsible for female sexual arousal and orgasm, has yet to be described in the radiotherapy literature. Structure, function and delineation of the bulboclitoris are detailed, delineation and bulboclitoris-sparing IMRT were feasible, and sparing reduces the dose to the bulboclitoris nearly in half in female patients receiving IMRT for anal cancer, warranting further clinical study.
The association of meniscal body height with knee structural changes in middle-aged and elderly patients with symptomatic knee osteoarthritis
Authors: Liu Yao , Du Guiying 
Published: June 2021

Objectives: To investigate whether and how meniscal height is associated with osteoarthritis (OA)-related knee structural changes in symptomatic knee OA. Methods: We studied 106 patients (61 female, aged 40–73 years) with symptomatic knee OA. X-ray was used for Kellgren-Lawrence score. Meniscal body heights and extrusion were measured on coronal sections of intermediate-weighted MRI sequence. Knee structural changes were assessed using the modified whole-organ magnetic resonance imaging score (WORMS). Associations between meniscal body height and knee structural changes were assessed using linear regression analysis. Results: Higher medial meniscal body height was significantly associated with severe medial meniscal lesions (p = 0.001–0.023), medial compartmental cartilage lesions (p = 0.045), patellofemoral compartmental and medial compartmental bone marrow edema patterns (p = 0.001–0.037), anterior cruciate ligament and patellar ligament abnormalities (p = 0.020–0.023), and loose bodies (p = 0.017). However, lateral meniscal body height was negatively correlated with WORMS scores for lateral meniscal lesions (p ≤ 0.018), lateral compartmental cartilage lesions (p ≤ 0.011), and lateral compartmental bone marrow edema patterns (p = 0.038). Conclusion: Higher medial meniscal body height was associated with more severe medial compartment structural abnormalities and patellofemoral bone marrow edema patterns, while lateral meniscal body height was inversely correlated with the severity of lateral compartment structural abnormalities. Advances in knowledge: Our study revealed that meniscal body height was associated with multiple OA-related knee structural changes, which would be beneficial in identifying patients with or at risks for knee OA.
The Problem of Teaching Children of Immigrants in the Russian Federation
Authors: Vinogradova Natalya 
Published: June 2021

The publication proposes to discuss the problem of teaching children of immigrants who have arrived in our country and need to adapt to the new social, linguistic and cultural environment. The principles underlying the organization of education for children of immigrants in the Russian Federation, and the conditions for their education in educational institutions of our country, which were formulated at a meeting of the Council under the President of the Russian Federation for Interethnic Relations on March 30, 2021, are given. The content of the state order of the Ministry of Education of the Russian Federation to the Federal State the budgetary scientific institution “Institute of Education Development
Strategy of the Russian Academy of Education” to study the difficulties faced by children of immigrants in the process of adaptation. The result of the study should be the creation of a set of guidelines for teachers organizing the work of classes in which children of immigrants study.
Management of non-traumatic epistaxis in adults in the emergency department
Authors: Reed Ashley , Barnes Martyn , Howard Caroline 
Published: June 2021

Background/aims Despite epistaxis being a common presentation to emergency departments there is a lack of guidelines, both nationally and internationally, for its management. The authors reviewed the current management of epistaxis and then introduced a new pathway for management to see if care could be improved. The aims were to evaluate the impact of the pathway on reduction of emergency department breaches, emergency ambulance transfers and hospital admissions. Methods The study was an interrupted time series analysis over 29 months and included 903 participants. A pathway for the management of adults with non-traumatic epistaxis was designed and implemented in a university teaching hospital with an emergency department annual attendance rate of 105 495 in 2019–20. Results The pathway led to a 14-minute longer stay in the emergency department, a 5% increase in emergency department breaches, an 8.2% reduction in admissions, a 3.6% reduction in emergency ambulance transfers, a 14.1% increase in nasal cautery and a 3.2% reduction in nasal packing. Conclusions The authors calculate that these results equate to roughly 56 hospital bed days saved, providing better care closer to home for patients, in addition to beneficial knock-on effects for other emergency department and admitted patients.
Burnout within UK surgical specialties: a systematic review
Authors: Balendran B , Bath MF , Awopetu AI , Kreckler SM 
Published: June 2021

Introduction Burnout is of growing concern within the surgical workforce, having been shown to result in reduced job satisfaction, decreased patient satisfaction and higher rates of medical errors. Determining the extent of burnout and identifying its risk factors within UK surgical practice is essential to ensure appropriate interventions can be implemented to improve mental wellbeing. Materials A systematic search of PubMed, Medline, Embase, PsychINFO and Cochrane databases was performed, following PRISMA guidelines. Studies published between January 2000 and October 2019 that reported prevalence data or risk factors on burnout for surgeons working within the UK and/or the Republic of Ireland were included. Findings Ten papers met the inclusion criteria. The overall prevalence of burnout amongst surgeons in the UK was 32.0% (IQR 28.9–41.0%), with surgical trainees having the highest prevalence (59.0%) of burnout documented for any subgroup. The most common risk factors identified for burnout were younger surgeon age and lower clinical grade. Being married or living with a partner was found to be protective. Conclusions Burnout is highly prevalent in UK surgical specialties, mostly amongst surgical trainees. Targeted pre-emptive interventions based upon relevant risk factors for burnout should be prioritised, at both individual and institutional levels.
Appraisal of the current guidelines for the management of diverticular disease using the Appraisal of Guidelines Research and Evaluation II (AGREE II) instrument
Authors: Gavriilidis P , Askari A , Gavriilidis E , de’Angelis N , Di Saverio S , Wheeler J , Davies RJ 
Published: June 2021

Introduction Diverticular disease is one of the most frequent reasons for attending emergency departments and surgical causes of hospital admission. In the past decade, many surgical and gastroenterological societies have published guidelines for the management of diverticular disease. The aim of the present study was to appraise the methodological quality of these guidelines using the Appraisal of Guidelines Research and Evaluation II (AGREE II) tool. Methods PubMed, Embase, Cochrane Library and Google Scholar databases were searched systematically. The methodological quality of the guidelines was appraised independently by five appraisers using the AGREE II instrument. Findings A systematic search of the literature identified 12 guidelines. The median overall score of all guidelines was 68%. Across all guidelines, the highest score of 85% was demonstrated in the domain ‘Scope and purpose’. The domains ‘Clarity and presentation’ and ‘Editorial independence’ both scored a median of 72%. The lowest scores were demonstrated in the domains ‘Stakeholder involvement’ and ‘Applicability’ at 46% and 40%, respectively. Overall, the National Institute for Health and Care Excellence (NICE) guidelines performed consistently well, scoring 100% in five of six domains; NICE was one of the few guidelines that specifically reported stakeholder involvement, scoring 97%. Generally, the domain of ‘Stakeholder involvement’ ranked poorly with seven of twelve guidelines scoring below 50%, with the worst score in this domain demonstrated by Danish guidelines at 25%. Conclusion Six of twelve guidelines (NICE, American Society of Colon & Rectal Surgeons (ASCRS), European Society of Coloproctology (ESCP), American Gastroenterological Association, German Society of Gastroenterology/German Society for General and Visceral Surgery (German), Netherlands Society of Surgery) scored above 70%. Only three, NICE, ASCRS and ESCP, scored above 75% and were voted unanimously by the appraisers for use as they are. Therefore, use of AGREE II may help improve the methodological quality of guidelines and their future updates.
W-type normal dispersion thulium-doped fiber-based high-energy all-fiber femtosecond laser at 1.7  µm
Authors: Chen Shaoxiang , Chen Yuhao , Liu Kun , Sidharthan Raghuraman , Li Huizi , Chang Chen Jian , Wang Qi Jie , Tang Dingyuan , Yoo Seongwoo 
Published: June 2021

We propose a parabolic W-type thulium-doped fiber for the 1.7 µm high-energy femtosecond pulsed laser. Despite its attractive normal dispersion, the fiber offers high gain in 1.7 µm region thanks to its distributed short-pass filtering effect. With a proper dispersion management in an all-fiber chirped pulse amplification (CPA) scheme, we demonstrate so far the highest pulse energy of 128.0 nJ in a stable pulse of 174 fs in the 1.7–1.8 µm region, which marks above an order of magnitude improvement in pulse energy while exhibiting the shortest pulse duration among fiber-based CPA works at 1.7 µm. Hence, we provide a pathway to an energy scalable and efficient femtosecond laser at 1.7 µm via a compact and elegant all-fiber solution.