bluuebunny/crossref_metadata_2025 huggingface dataset:
A local-to-global emissions inventory of macroplastic pollution
Authors: Velis Costas , Cottom Joshua , Cook Ed
Published: October 2023

Negotiations for a Global Treaty on plastic pollution1 will shape policy on plastics production, use, and waste management for the coming decades. Parties will require a detailed baseline of waste flows and plastic emission sources at high resolution to enable identification of pollution hotspots and their causes2. Nationally aggregated waste management data can be distributed to smaller scale to identify generalised points of plastic accumulation and source phenomena3-11. However, it is challenging to use this type of spatial allocation to assess the conditions under which emissions take place12,13. To this, we developed a novel methodology for a global macroplastic waste inventory; creating an explanatory framework that combines conceptual modelling of emission mechanisms with measurable activity data. Using machine learning and probabilistic material flow analysis we identify hotspots worldwide (50,072 municipalities) from five land-based plastic waste emission sources. We estimate global plastic waste emissions at 52.5 million metric tonnes (Mt), of which 57% wt. are open burned. Highest contributions: India (9.7 Mt), Nigeria (3.5 Mt), and Indonesia (3.0 Mt). Uncollected waste is the dominant emissions source across Global South. This detailed evidence baseline can inform Treaty negotiations and help develop national and sub-national waste management action plans and source inventories.
Effect of sewage sludge and digestate from anaerobic fermentation as soil additives on the nutritional status and accumulation of non-essential elements in plants with different nutrition strategies
Authors: Zaffar Nazia , Peiter Edgar , Schirmer Dominic , Samarska Alla , Lovynska Viktoriia , Wiche Oliver
Published: October 2023

We explored how sewage sludge and digestate as a soil amendment impact the availability of non-essential elements to plants with different nutrition strategies. Four species were cultivated on soil or soil amended with sewage sludge and digestate: the specialized Ni hyper-accumulator Alyssum murale, the P-efficient Mn accumulator Lupinus albus, the P-inefficient metal accumulator Fagopyrum esculentum and the excluder species Carthamus tinctorius. Shoot accumulation of essential (P, Mg, Fe, Mn, Zn, Ni) and non-essential elements (As, Cd, Pb, Ge, Ga, rare earth elements: REE) was evaluated together with changes of labile element concentrations in soil. Shoot metal(loid) contents decreased in the order F. esculentum > C. tinctorius, L. albus > A. murale. Both treatments improved micronutrient supply in all species; however, shoot P only increased in sewage sludge-treated plants. Both treatments increased the concentrations of labile As, Ge, Ga and REE in soil, while labile Cd was exclusively higher when sewage sludge was added. The digestate treatment did not increase soil–plant transfer of the elements, except Ga in F. esculentum. However, the addition of sewage sludge increased shoot Cd contents in all species. Moreover, F. esculentum responded with a higher accumulation of Ga and L. albus accumulated more As and REE, while shoot accumulation remained unchanged in other species. Our findings suggest species-specific differences in the utilization of labile element pools that most likely derive from altered rhizosphere chemistry, where processes related to element acquisition depend on the plant's nutritional status.
Epidemiological disease burden and annual, nationwide health insurance treatment cost of female infertility based on real-world health insurance claims data in Hungary
Authors: Pónusz-Kovács Dalma , Csákvári Tímea , Sántics-Kajos Luca Fanni , Elmer Diána , Pónusz Róbert , Kovács Bettina , Várnagy Ákos , Kovács Kálmán , Bódis József , Boncz Imre
Published: October 2023

Background:Infertility affects more than 50 million couples worldwide, resulting in a significant burden on individuals and society. Its prevalence ranges from 8-12% among developed countries. The growing number of patients poses an increasing challenge to the healthcare system and its funding. Our quantitative, descriptive, and cross-sectional study aims to analyze the prevalence and annual nationwide health insurance treatment cost of female infertility in Hungary in 2019.
Methods: We used claims data obtained from the Hungarian National Health Insurance Fund Administration (NHFIA). The number of patients, total and age-specific prevalence, annual health insurance expenditure, and the distribution of costs by age group were evaluated. Infertility was determined according to the World Health Organization International Classification of Diseases codes (N.97.0, N97.1, N97.2, N97.3, N97.4, N97.8, N97.9) and the utilization of each healthcare service type. During the study descriptive statistics, correlation analysis and ANOVA were used.
Results: In 2019, the NHIFA spent a total of 7.2 billion HUF (22.2 million EUR) on female infertility treatment in Hungary. The most significant costs were related to inpatient care (4.1 billion HUF, 12.7 million EUR). The highest number of patients and prevalence (33,151 women, 650.4 per 100,000 women) were found in outpatient care. In inpatient care, the prevalence is substantially lower (206.7 per 100,000 women). Female infertility, regardless of its type, mainly affects patients in the 30-39 age group (number of patients: 18,156 women). The average annual health insurance expenditure per capita was 1,083 EUR.
Conclusions: Reproductive health education, prevention, and medical screening play an inevitable role in the early stages of reproductive life to reduce the risk of infertility and decrease the costs of treatment.
Sustainable Biodiesel Production via Chlorella vulgaris and Tetraselmis chuii in food-based brewery Industrial Wastewater
Authors: Hussain Syed Babar , Shah Syed Muhammad Usman , Nosheen Asia , Mumtaz Saqib
Published: October 2023

The microalgae Chlorella vulgaris and Tetraselmis chuii offer several attractive attributes as an aquaculture feed. Biomass production of T. chuii and C. vulgaris is relatively expensive because it requires high operation and substrate cost. Use of food industry waste is one of the promising solutions to reduce the substrate cost. In this research the impact of diverse concentration was filtered and centrifuged, food wastewater (FWW) was scrutinized as an alternative intermediate for microalgal bioremediation, lipid yield and cell growth. Both the tested species C. vulgaris and T. chuii showed highest lipid accumulation and cell growth at 75% level of food-based industrial wastewater with the maximum specific growth rate (0.27 d− 1), maximum biomass formation rate (0.1–0.18 gL− 1 d− 1) and lipid content (33.80 ± 0.88–35.04 ± 2.05%) respectively. The microalgal cells not only improved with food wastewater feeding but the level of COD (80.97–66.17%), BOD (81.13–66.81%), TN (55.88–22.06%) and certain heavy metals like zinc (99.72–99.52%), manganese (72.09–65.17%), nickel (50.68–34.41%), NO3N (50.68–42.59%), ferric (57.14–65.71%), cadmium (83.51–86.64%), lead (48.83–97.21%) and arsenic (55.13–55.00%) were also efficiently removed from food wastewater (FWW) at different diluted concentrations. C18:0/C18:1 was obtained as the major fatty acids in lipid which showed a vast potential of ADW007 for biodiesel fabrication and instantaneous bioremediation procedure using FWW.
Antagonistic effects of Beauveria bassiana against seed-borne fungi of cowpea (Vigna unguiculata)
Authors: Pachoute Julner , Santos Gil Rodrigues dos , de Souza Danival José
Published: October 2023

Cowpea is cultivated worldwide as a source of protein, but various factors limit its yield. Besides climatic challenges and pest attacks, farmers face pathogens to keep crop productivity. Fungi stood out among its main pathogens. They are generally transmitted by seeds and spread over a long distance through infected seeds. In this sense, this study aimed to assess the diversity of seed-borne fungi associated with cowpea and evaluate the antagonistic effect of B. bassiana on the phytopathogen fungi in vivo and in vitro. A seed health test was performed using the blotter test method. The isolated phytopathogens were molecularly identified and submitted to Koch's postulates. Antagonistic effects of B. bassiana against the pathogens were tested in vitro using the paired culture method and in vivo by inoculating the plant in greenhouse conditions. According to the seed health test result, besides saprophytes (Aspergillus, Penicillium, Rhizopus, Mucor), three pathogens fungi were identified (Fusarium sp., Alternaria aff. burnsii, Epicoccum sp.). In the antagonistic tests and in vitro assays, B. bassiana showed greater growth inhibition of Fusarium sp. isolate JP1. Alternaria burnsii isolate JP2 was inhibited from 18,54 to 35,67% and Epicoccum sp from 22,73 to 25,23%. The inoculation of the plants with B. bassiana reduced Fusarium symptoms to 58,33%, Alternaria aff. burnsii to 40,08%, Epicoccum sp. to 22,22%. This report is the first to isolate Epicoccum sp. in cowpea seed in Brazil and its inhibition by B. bassiana.
The effects of cGAS-Sting pathway on bone mineral density
Authors: Liu Lifei , Tong Xiaoyang , Huang Mei , Zhu Chenyu , Chen Xi , Yuan Yu , Bennett Samuel , Xu Jiake , Zou Jun
Published: October 2023

The cGAS-Sting pathway plays an essential role in a variety of pathological processes, such as inflammation, infection and cancer. It has recently been found to affect bone metabolism, but the exact role is not well understood. We studied the effect of both cGAS gene KO and Sting gene KO mice on bones, and assessed the effects of Sting gene in osteoclast differentiation and osteoblast and formation in vivo. This study found that Sting KO mice but not in cGAS KO mice exhibited a decreased BV/TV and Tb.N, as evident by the micro CT analyses. At the cellular level, Sting deficiency was revealed to promote osteoclastogenesis and inhibit osteoblastogenesis, accompanied with increased phosphorylation of p-38 in osteoclasts and decreased phosphorylation of β-Catenin in bone marrow stromal cells (BMSCs). Our study showed that the absence of cGAS gene had no significant effect on bone density, whereas Sting gene deficiency reduced bone formation in mice, which provides a possible new target for the treatment of osteoporosis.
Use and Cost of Healthcare Services Among Patients with Moderate-to-Severe Osteoarthritis of Hip/Knee with Inadequate Analgesia: Findings from two United States Health Systems
Authors: Lu Yi , Ganz Michael L , Robinson Rebecca L , Zagar Anthony J , Huse Samuel , Hartrick Craig T , Johnston Beth , Dorling Patricia , Thakkar Sheena , Berger Ariel
Published: October 2023

Background
Accurate estimates of costs specific to persons with moderate-to-severe hip and/or knee osteoarthritis who experience inadequate analgesia are difficult to obtain, and are likely to be substantial. To address this issue, this study compared use and cost of healthcare services among patients with moderate-to-severe hip/knee osteoarthritis and inadequate response to ≥ two pain-related medications (“cases”) vs. other patients with hip/knee osteoarthritis (“comparators”).
Methods
This retrospective cohort study used healthcare claims data obtained from two integrated delivery networks: Henry Ford Health and Reliant Medical Group. Patients with hip/knee osteoarthritis, aged ≥ 18 years as of their first hip/knee osteoarthritis diagnosis, and with no evidence of malignancy at any time during the study period (2014–2018) were identified. Patients were stratified into cases and comparators using a previously developed machine-learning algorithm. Inverse probability weights were used to balance the distribution of baseline characteristics between cases and comparators. Use and cost of osteoarthritis-related and all-cause healthcare services were assessed.
Results
The sample included 12,801 (84.7%) cases and 2,318 (15.3%) comparators. Except for emergency department visits and osteoarthritis-related pharmacotherapies, weighted rates of other types of healthcare services use were higher for cases, especially osteoarthritis-related hospitalizations (36.4 vs. 9.6 per 100 patient-years) and non-physician visits (103.8 vs. 45.8 per 100 patient-years). Mean adjusted 12-month cumulative costs for both osteoarthritis-related and all-cause healthcare services were substantially higher for cases than comparators ($7,477 vs. $1,606, p < 0.01 and $16,950 vs. $11,113, p = 0.02, respectively).
Conclusions
Use of a previously validated machine-learning algorithm improves the ability to identify cases, without the need for chart review or primary data collection. Case patients used more healthcare services and incurred higher healthcare costs than other patients with hip/knee osteoarthritis, with the difference in cumulative adjusted total costs of OA-specific healthcare services increased over the follow-up period. These findings illustrate the importance of understanding and estimating the economic burden and unmet needs of more severe forms of hip/knee osteoarthritis. Our study highlights the need of considering both disease severity and treatment response profiles when treating OA.
In vivo reactive astrocyte imaging using [18F]SMBT-1 in tauopathy and familial Alzheimer’s disease mouse models - a multitracer study
Authors: Kong Yanyan , Xie Fang , Wang Xiuzhe , Zuo Chuantao , Huang Qi , Shi Kuangyu , Rominger Axel , Xiao Jianfei , Li Ming , Wu Ping , Yang Yunhao , Guan Yihui , Ni Ruiqing
Published: October 2023

Background:
Reactive astrocytes play important roles in the development of Alzheimer’s disease (AD) and primary tauopathies. Here, we aim to investigate the relationship between reactive astrocytes, tau and amyloid beta, microgliosis and glucose metabolism by using multitracer imaging in widely used tauopathy and familial AD mouse models.
Results:
Positron emission tomography (PET) imaging using [18F]SMBT-1 (monoamine oxidase-B), [18F]florbetapir (amyloid-beta), [18F]PM-PBB3 (tau), [18F]DPA-714 (translocator protein) and [18F]fluorodeoxyglucose (FDG) was carried out in 3- and 7-month-old rTg4510 tau mice, 5×FAD familial AD mice and aged-matched wild-type mice. We found increased regional [18F]SMBT-1, [18F]DPA-714 uptake, and hypoglucose metabolism in the brains of 7-month-old rTg4510 mice with tau accumulation as well as in 7-month-old 5×FAD mice with higher amyloid-beta and tau accumulation compared to age-matched wild-type mice.
Conclusion:
In summary, these findings provide in-vivo evidence for reactive astrocytes, microglial activation, and cerebral hypoglucose metabolism in animal models of tauopathy and familial AD.
Measurement of diaminoxidase (DAO) during low-histamine or ordinary diet in patients with and without histamine intolerance
Authors: odijk Jenny van , Weisheit Adina , Ekerljung Linda , Rentzos Georgios
Published: October 2023

Quantification of diamine oxidase (DAO) concentrations within the serum has been proposed as an adjunctive diagnostic modality for the evaluation of histamine intolerance (HIT). Limited empirical data exist concerning the influence of dietary patterns on DAO levels. In the context of a prospective study employing a crossover design, 18 individuals diagnosed with HIT were randomized to initiate either a low histamine diet (LHD) or a conventional mixed diet (MXD). Serum DAO concentrations were measured at the commencement of the study and following each dietary phase. A control group underwent analogous DAO assessments without imposition of dietary constraints. Throughout the period of histamine-restricted dietary intervention, discernible distinctions in alterations of DAO levels failed to manifest in comparison to alterations observed during the MXD phase. Specifically, among the cohort, 10 of the 18 patients exhibited elevated DAO values subsequent to the LHD regimen, while the remaining eight displayed either reduced or unchanging DAO levels. The prevalence of elevated DAO levels in the LHD group did not differ significantly from that observed in the control group during the MXD phase. Additionally, during the LHD phase, patients reported a significant reduction in gastrointestinal and cutaneous symptoms. This prospective investigation underscores the enduring utility of a histamine-restricted diet, coupled with structured dietary reintroduction, as an efficacious diagnostic approach for individuals presenting with suspected food-related histamine hypersensitivity. Notably, measurement of DAO levels appears to furnish only a limited capacity to discern dietary-induced fluctuations. Notwithstanding, the dynamics of DAO alteration do not appear to exhibit a discernible association with specific dietary patterns, a finding consistent across both patient and control groups.
Meta-analysis of the effects of carbon nanoparticles on parathyroid glands during thyroid papillary carcinoma surgery
Authors: wu xiaoyong , zhang jiayi , yan xuemin , Wang yuexin , wen jinxu
Published: October 2023

Backgroud：carbon nanoparticles suspension injection is a commonly used lymph node tracer in thyroid tumor surgery. Its effect on the parathyroid gland is still unclear. Therefore, this paper attempted to evaluate the effect of the application of carbon nanoparticles in thyroid cancer surgery on the parathyroid gland by meta-analysis.
Method：Literature retrieved from the Cochrane Library, Embase, PubMed, Sinomed, CNKI and Wanfang databases was reviewed. Retrieved December 1, 2022. The outcome measures included as effective measures were relative risk (RR) and 95% confidence interval (CI). For data analysis, Stata 15.0 software is employed.
Results: A total of 14 studies were included in this meta-analysis. 1117 patients with papillary carcinoma of thyroid were treated with carbon nanoparticles during surgery, and 997 patients were treated with conventional surgery without carbon nanoparticles. The results showed that compared with conventional surgery, the application of nano carbon can reduce the parathyroid gland misincision and reduce the incidence of postoperative hypocalcemia. (RR=0.42,95%CI 0.35-0.5,P < 0.00001).
Conclusions: The use of carbon nanoparticles in the treatment of thyroid papillary carcinoma is advantageous for parathyroid gland protection.
Tannase enzyme (Tannin acyl hydrolase, EC 3.1.1.20 : Source of Gallic acid and various Gallate biproducts) production by Solid state fermentation With Aspergillus niger from fruit and tea wastes and optimization of the process parameters by OVAT and Response Surface Methodology
Authors: Das Sayan , Ghosh Uma , Biswas Prasanta Kr.
Published: October 2023

Biocatalysts are amongst the valuable articles required for urgent need of people and are produced by microbial sources. In general enzymes are manufactured by submerged fermentation. However it is expensive because of its high operating costs. Solid state fermentation (SSF) is a propitious alternative for manufacture of enzyme in a cost effective way. Development of food products with fruits and vegetables propagate peels in enormous quantity as waste.Bioconversion of the waste for enzyme synthesis results several advantages including value addition to the waste, reduction in environmental pollution, simultaneously reducing the production cost of enzyme. The diverse administration of Tannase in food and feed processing, chemical as well as waste treatment makes it one of the most potential enzymes for Industry. The present study reveals the biosynthesis of Tannase enzyme from food wastes such as peels of fruits and vegetables, used tea leaves and wheat bran by SSF applyingAspergillus nigerstrain. As a result of this work Orange peel was found as potential substrate to Tannase producer resulting highest amount of enzyme 0.0037 unit/gm dry solid followed by mango peel and used tea leaves with activity of 0.0035 and 0.0026 u/gds respectively. The ideal condition of fermentation studied by OVAT methodology and highest activity 0.0038 u/gds was observed at 300C temperature, for 9 days of fermentation under static condition by orange peel with hydration of 1:3 w/v. Finally RSM (Response surface methodology) was applied for optimization of parameters to improve tannase yield.
Establish a novel tumor budding-related signature to predict prognosis and guide clinical therapy in colorectal cancer
Authors: Li Qixin , Liu Gaixia , Qiu Quanpeng , Zhang Jiaqi , Li Ruizhe , Zhao Jiamian , She Junjun , Chen Yinnan
Published: October 2023

Tumor budding is a long-established independent adverse prognostic marker for colorectal cancer (CRC), yet assessment of tumor budding was not reproducible. Therefore, development of precise diagnostic approaches to tumor budding is in demand. In this study, we first performed bioinformatic analysis in our single-center CRC patients’ cohort (n = 84) and identified tumor budding-associated hub genes using the weighted gene co-expression network analysis (WGCNA). A machine learning methodology was used to identify hub genes and construct a prognostic signature. Nomogram model was used to identified hub genes score for tumor budding, and the receiver operating characteristic (ROC) curve and calibration plot indicated high accuracy and stability of hub gene score for predicted the prognosis of CRC. The association between budding-associated hub genes and score and prognosis of CRC were further verified in TCGA CRC cohort (n = 342). Then gene set enrichment analysis (GSEA) and gene set variation analysis (GSVA) were applied to explore the signaling pathways related to the tumor budding and validated by immunohistochemistry (IHC) of our clinical samples. Subsequently, immune infiltration analysis demonstrated that there was a high correlation between hub genes score and Macrophages M2 cells infiltrated in tumor tissue. In addition, somatic mutation and chemotherapeutic response prediction were analyzed based on the risk signature. In summary, we established a tumor budding diagnostic molecular model, which can improve tumor budding assessment and provides a promising novel molecular marker for immunotherapy and prognosis of CRC.
Secondary implant stabilization using a modified microplate fixation technique.
Authors: Helal Mohamed Hamdy , Aboushelib Moustafa Nabil
Published: October 2023

Objectives: to enhance initial stability of dental implants placed in compromised bone defects with poor initial stability using a modified fixation technique.
Methods: Two osteotomy defects (6 mm and 4 mm in diameter) were made in the femur of a dog model. Dental implants (4 mm in diameter and 10 mm in length) were placed in the two defects. Microplates were used to enhance the initial stability of the compromised implant placed in the larger defect size without the need for the additional use of a bone graft. A reverse torque test and histomorphometric analysis were performed after eight weeks to assess bone implant contact (n=48).
Results: Both plate and control implants had almost identical bone-to-implant contact ratios, 82.55 ± 0.61 and 82.86 ± 0.69, respectively. The two tested implants had no statistically significant difference in bone implant contact (t=1.155, p=.260) nor reverse torque test (t=1.408, p=.173).
Conclusions: Secondary implant stabilization improved osteointegration of implants suffering from poor initial stability without the need to resort to bone graft or other complicated techniques.
Rope Skipping or Badminton? The Effect of Exercise on Sleep Quality and Fatigue in University Students
Authors: Ye Zixin , Tan Shuyue , Zhu Yingyuan , Fan Jialin
Published: October 2023

Background
Fatigue and poor sleep quality are common among university students and can negatively affect their studies, college lives, and physical and mental health. Aerobic exercise has shown promise in mitigating these issues. However, exercise interventions involved in previous studies were often time-consuming. To identify a more efficient approach, we evaluated the effects of 15-day rope skipping and badminton interventions on fatigue and sleep issues. We hypothesized that both badminton and rope skipping would be effective in mitigating fatigue and sleep problems and that the effect of rope skipping would be greater than that of badminton.
Methods
Seventy-six participants’ levels of fatigue and sleep were assessed via five variables, using the Consensus Sleep Diary, the Pittsburg Sleep Quality Index, and the fatigue diary.
Results
Both exercises were effective only in improving perceived fatigue and sleep onset latency. One of the reasons for the nonsignificant results could be that some participants’ sleep was disturbed by roommates sharing the same bedroom.
Conclusions
Short-term rope skipping and badminton can effectively improve the fatigue and sleep quality of university students. In addition, we found that some participants reported being more interested in exercise after the intervention, suggesting that exercise interventions could be used to foster exercise habits.
Differential efficacy of screening modalities for colorectal neoplasms: a systematic review and network meta-analysis of randomized controlled trials
Authors: Ashraf Muhammad Talal , Sohail Affan , Khan Muhammad Khuzzaim Shakeel , Khalid Muhammad Hamza Awais , Aslam Muaaz , Uddin Naseer , Khan Anosh Aslam , Ochani Rohan Kumar , Surani Salim
Published: October 2023

Introduction:
Colorectal cancer (CRC), being a major global health problem and the second most common cancer, leads to more than 550,000 deaths per year globally. CRC usually arises from precancerous growths called adenomas. The investigations, flexible sigmoidoscopy (FS), and colonoscopy can help in detecting high-risk precancerous growths and malignant tumors. Most invasive and high-risk colorectal tumors cause occult bleeding, which can be detected by fecal immunochemical test (FIT) and guaiac fecal occult blood test (gFOBT). All these methods can be used to detect malignancies and benign colorectal tumors in patients at risk of developing cancer. This network meta-analysis aims to compare the effectiveness of gFOBT, FIT, FS and colonoscopy for the early detection of CRC.
Methods: Search was conducted for all randomized controlled trials (RCTs) in relevant databases (1975-2022), assessed the risk of bias, and retrieved data from relevant RCTs. The participants either underwent screening through the above-mentioned techniques or received no screening at all. Participants who did not undergo any screening were tested as a common control for all screening interventions. Primary outcomes were the incidence of CRC, the incidence of high-risk adenoma, all-cause mortality, and CRC-related mortality. Odds ratio (OR) and 95% CI estimates were calculated using the method of Bayesian network meta-analysis.
Results: We identified 11 RCTs involving over one million participants. The reported mean age was 61.87 (45-80) years, and the overall gender distribution was balanced between all the comparison arms. The overall mean prospective follow-up was 8.05 (5.5-11) years after the initial screening was performed. FS offered the greatest reduction in CRC findings [OR = 0.733, 95% CI (0.666, 0.807)] when compared to no screening group. Colonoscopy was associated with a higher detection of CRC as the group had an increased number of high-risk patients [OR = 2.28; 95% CI (1.95, 2.67)]. Biennial FIT is associated with the lowest risk of high-risk adenoma detection [OR = 0.293; 95% CI (0.259,0.330)]. Annual gFOBT is associated with the greatest reduction in the risk of CRC-related mortality [OR 0.757; 95% CI (0.584, 0.977)]. FS is associated with the greatest reduction in the risk of all-cause mortality compared to the no-screening group [OR 0.801; 95% CI (0.772, 0.832)].
Conclusion: Colonoscopy is the most effective screening technique in detecting the incidence of CRC and as well as the incidence of CRC-related mortality. Biennial gFOBT is the most effective non-invasive test and significantly detects the greatest risk of high-risk adenoma development. Sigmoidoscopy is associated with the lowest risk of an all-cause mortality.
Non-COVID-19 deaths in Norway 2020–2022. A population-based cross-sectional register study
Authors: Raknes Guttorm , Fagerås Stephanie Jebsen , Sveen Kari Anne , Júlíusson Pétur Benedikt , Strøm Marianne Sørlie
Published: October 2023

Background
Causes of death other than COVID-19 seem to contribute significantly to the excess mortality observed during the 2020–2022 pandemic. In this study, we explore changes in non-COVID-19 causes of death in Norway during the COVID-19 pandemic from March 2020 to December 2022.
Methods
We performed a population-based cross-sectional study on data from the Norwegian Cause of Death Registry. All recorded deaths from 1st January 2010 to 31st December 2022 were included. The main outcome measures were the number of deaths and age-standardised death rate (ASMR) per 100000 population from the major cause of death groups in 2020, 2021 and 2022. The predicted number of deaths and ASMRs were forecasted with a 95% prediction interval constructed from a general linear regression model based on the corresponding number of deaths and rates from the preceding ten prepandemic years (2010–2019). We also examined whether there were deviations from expected seasonality in the pandemic period based on prepandemic monthly data from 2010–2019. The cumulative number of deaths and ASMR were estimated based on monthly mortality data.
Results
There was significant excess mortality (number of deaths) in 2021 and 2022 for all causes (3.7% and 14.5%), for cardiovascular diseases (14.3% and 22.0%), and for malignant tumours in 2022 (3.5%). In terms of ASMR, there was excess mortality in 2021 and 2022 for all causes (2.9% and 13.7%), and for cardiovascular diseases (16.0% and 25,8%). ASMR was higher than predicted in 2022 for malignant tumours (2.3%). There were fewer deaths than predicted from respiratory diseases (except COVID-19) in 2020 and 2021, and from dementia in 2021 and 2022. From March 2020 to December 2022, there were cumulatively 3754 (ASMR 83.8) more non-COVID-19 deaths than predicted, of which 3453 (ASMR: 79.6) were excess deaths from cardiovascular disease, 509 (ASMR 4.0) from malignant tumours. Mortality was lower than predicted for respiratory diseases (-1889 (ASMR: -44.3)), and dementia (-530 (ASMR − 18.5)).
Conclusions
There was considerable excess non-COVID-19 mortality in Norway from March 2020 until December 2022, mainly due to excess cardiovascular deaths. For respiratory diseases and dementia, mortality was lower than predicted.
Early Experiences of Low- and Middle-Income Countries with Integration of COVID-19 Vaccination into Health Systems and Routine Health Services
Authors: Belayneh Asalif , Curry Dora Ward , Edwards Amanda , Gallo Kerry , Maguiraga Fodie Fodie , Mounts Anthony , Tupps Cara
Published: October 2023

Background
Vertical and fragmented tactics used in the global introduction of COVID-19 vaccination strained health systems in low- and middle-income countries (LMIC). Global strategy has shifted from achieving short-term coverage goals towards sustainable integration of COVID-19 vaccination into health systems. The COVID-19 Vaccine Implementation Program (CoVIP) examined early experiences of LMIC with COVID-19 vaccine integration, gaining insights to inform policy, decision-making, and financing.
Methods
COVIP surveyed 24 countries to assess COVID-19 vaccination integration occurring between March 2021 and March 2023 among immunization programs, public health campaigns, primary care, and other health services. Countries were surveyed on integration experience and activities across planning and leadership, service delivery, demand generation, vaccine safety, logistics and cold chain, and data management systems. Integration was categorized as structured or opportunistic based on the degree of planning, analysis, and systems change. Formal planning for future integration and monitoring was also assessed.
Results
All surveyed countries had integration experience, and the majority had experience with integrating service co-delivery, planning, demand generation, and vaccine safety. Two-thirds of countries had experience with integrating logistics and cold chain systems; half of countries had integration experience with data management systems. Service delivery integration was frequently opportunistic, and vaccine safety and data systems integration was more structured. Most countries had a formal plan for full or partial integration of COVID-19 vaccine with childhood immunization, primary health care, or other activities. Half had initiated planning and preparation for future integration, and less than a third had an implementation and monitoring plan to assess integration effectiveness.
Conclusions
Data management, logistics, and cold chains are critical health system domains requiring focused investment to support sustainable integration. Integration can be facilitated through expansion of adult immunization programs to better serve at-risk populations throughout the life course. Other key recommendations include evaluating demand dynamics and customizing IEC strategies, addressing knowledge gaps, and leveraging successful partnership and technical assistance models for future vaccine introductions. These findings should inform investment and decision-making to reach high-risk populations, build capacity to respond to future public health emergencies, and increase global health security.
Trial registration:
N/A
Macroscale Patterns of Dissolved Organic Matter Thermodynamic Properties Across Diverse River Systems
Authors: Stegen James , Garayburu-Caruso Vanessa , Sengupta Aditi , Dodds Walter , Fansler Sarah , Chu Rosalie , Danczak Robert , Garcia Marci , Goldman Amy , Graham Emily , Kaufman Matthew , Ren Huiying , Renteria Lupita , Sandborn Daniel , Song Hyun-Seob , Willi Katie , Ross Matt , Torgeson Joshua , Toyoda Jason
Published: October 2023

Thermodynamic properties of dissolved organic matter (DOM) influence river biogeochemistry. Using these properties to predict biogeochemical rates across rivers requires knowledge of how they vary. We employed mass spectrometry to quantify three DOM thermodynamic properties mechanistically linked to microbial respiration and biomass growth. We estimated these properties for each identified molecule in over 500 water and sediment samples from freshwater and saline rivers spanning diverse biomes. DOM thermodynamic properties exhibited continental-scale spatial gradients associated with climate and land-cover. Theory predicts relationships among the three properties. Observed inter-property relationships diverged from these predictions, but were consistent across continents. We infer that while there is variation in DOM thermodynamic properties across rivers--associated with climate and land cover--quantitative shifts in any one property are mechanistically linked to shifts in the other properties, leading to highly constrained inter-property relationships that persist across diverse rivers. Given the broad extent of sampled rivers, we suggest the observed inter-property relationships may hold across all rivers. Models that predict river biogeochemistry via DOM thermodynamic properties can use patterns observed here as inputs and constraints.
Development and Delphi consensus validation of the Medication-Related Fall Screening and Scoring tool.
Authors: Saeed Dima , Carter Gillian , Miller Ruth , Darcy Carmel , Miller Karen , Madden Kevin , McKee Hilary , Agnew Jayne , Crawford Paula , Parsons Carole
Published: October 2023

Introduction:
Falls are a significant public health problem and constitute a major cause of injuries and mortality. Risk factors for falls are multifactorial and include medication use.
Aim
To develop a medication-related fall (MRF) screening and scoring tool and to determine its content validity.
Methods
The MRF tool was developed from clinical practice guidelines addressing medication-related problems and additional medications identified by specialist pharmacists across a region of the United Kingdom (Northern Ireland (NI)). Medication classes were categorised according to their ‘potential to cause falls’ as: high-risk (three points), moderate-risk (two points) or low-risk (one point). The overall medication-related falls risk for the patient was determined by summing the scores for all medications. The MRF was validated using Delphi consensus methodology, whereby three iterative rounds of surveys were conducted using SurveyMonkey®. Twenty-two experts from 10 countries determined their agreement with the falls risk associated with each medication on a 5-point Likert scale. Only medications with at least 75% of respondents agreeing or strongly agreeing were retained in the next round.
Results
Consensus was reached for 19 medications/medication classes to be included in the final version of the MRF tool; ten were classified as high-risk, eight as moderate-risk and one as low-risk.
Conclusion
The MRF tool is simple and has the potential to be integrated into medicines optimisation to reduce falls risk and negative fall-related outcomes. The score from the MRF tool can be used to as a clinical parameter to assess the need for medication review and clinical interventions.
Interventions to improve symptomatology in patients with hypothyroidism and persistent symptoms: A systematic review.
Authors: Hidalgo Jessica , Lincango Eddy P , Codova-Madera Sandra , Ruiz-Arellanos Kim , Wenczenovicz Camila , Ponce Oscar J. , Alvarez-Villalobos Neri , Rao Arbaaz , Ospina Naykky M. Singh , Maraka Spyridoula , Acosta Gonzalo J , Brito Juan Pablo
Published: October 2023

Background
Levothyroxine (LT4) monotherapy is the standard treatment for hypothyroidism; however, 10–15% of patients have persistent hypothyroid symptoms despite normalizing thyroid hormone levels with LT4. This study aims to summarize the best available evidence on interventions to improve symptomatology in patients with hypothyroidism and persistent symptoms.
Methods
A systematic search was conducted in March 2022 for randomized controlled trials (RCTs) and observational studies on interventions for adult patients with persistent hypothyroid symptoms despite biochemical euthyroidism on thyroid hormone replacement.
Results
Of 277 articles, seven fulfilled the inclusion criteria. 455 participants were included. Most intervention participants were female (78.6%) with a mean age of 47.5 years. Five clinical trials evaluating ginger (vs. starch), L-carnitine (vs. placebo), combination LT4 and liothyronine (LT3) (vs. LT4 or placebo), and surgery for patients with serum antithyroid peroxidase (TPO Ab) titers greater than 1000 IU/ml (vs. LT4) found inconsistent improvement in hypothyroidism related symptoms and general health. Of these clinical trials, the use of ginger and surgery showed the largest improvements in fatigue scores. One observational study comparing thyroidectomy vs observation found no impact difference on general health. Lastly, another observational study evaluating combination LT4/LT3 (vs. LT4 monotherapy) found improvement in fatigue and QoL. There were 31 (12%) adverse events in the intervention group and 18 (10.8%) in the comparator group.
Conclusions
There is no high-quality evidence supporting any intervention for persistent symptoms in hypothyroidism. Available evidence, limited by the risk of bias, inconsistency, and heterogeneity, suggests that some persistent symptoms, particularly fatigue, could improve with ginger and thyroidectomy.
Trial registry number:PROSPERO (CRD42022318720)
The Invisible Embedded “Values” Within Large Language Models: Implications for Mental Health Use
Authors: Hadar-Shoval Dorit , Asraf Kfir , Mizrachi Yonathan , Haber Yuval , Elyoseph Zohar
Published: October 2023

Values are an integral part of any mental health intervention, profoundly shaping definitions of psychopathology and treatment approaches. As large language models (LLMs) hold promises for mental health applications, it is prudent to evaluate their embedded “values-like” abilities prior to implementation. This study uses Schwartz's Theory of Basic Values (STBV) to quantify and compare the motivational “values-like” abilities underpinning four leading LLMs. The results suggest that Schwartz’s theory can reliably and validly measure “values-like” abilities within LLMs. However, apparent divergence from published human values data emerged, with each LLM exhibiting a distinct motivational profile, potentially reflecting opaque alignment choices. Such apparent mismatches with human values diversity might negatively impact global LLM mental health implementations. The appropriate transparency and refinement of alignment processes may be vital for instilling comprehensive human values into LLMs before this sensitive implementation in mental healthcare. Overall, the study provides a framework for rigorously evaluating and improving LLMs’ embodiment of diverse cultural values to promote mental health equity.
Influence of Spiral Airway Structure Parameters of Dual-Airway Diesel Engine on Airway Performance
Authors: bao guangyuan , he chao , li jiaqiang , liu xueyuan
Published: October 2023

Numerical simulations of the airflow within the intake system and in-cylinder flow of the D19TCI automotive diesel engine were conducted using Computational Fluid Dynamics (CFD) software. The primary focus of this investigation was to examine the influence of the structural design parameters of the diesel engine's spiral intake manifold on the cylinder's swirl ratio. Through the manipulation of three key structural design parameters of the spiral intake manifold, we explored their impact on the cylinder's swirl ratio. The study utilized the spiral airflow deflection angle (θ), spiral chamber height (H), and eccentricity of the spiral intake manifold (∆a) as the three influential factors, each set at three levels. The swirl ratio and intake volume, representing two essential airflow characteristics, served as the evaluation criteria in an orthogonal experiment and subsequent linear regression analysis.The findings reveal that individually altering the three structural design parameters of the spiral intake manifold to values of -15° for the swirl angle, 6.28 mm for the spiral chamber height, and 3 mm for the eccentricity results in the maximum cylinder swirl ratio. This relationship adheres to the linear regression equation: Swirl Ratio = 0.754 - 0.005Swirl Angle + 0.165Spiral Chamber Height + 0.088*Eccentricity.
Integrative analysis of the role of CCT3 in human pan-cancer
Authors: Lin Shaochong , Zhang Qian , Wu Di , Cheng Yanfei , Yao Yuanqing
Published: October 2023

Increasing evidence revealed that the carcinogenic effects of chaperonin containing CCT3 in multiple tumors, but there is no pan-cancer analysis of CCT3. In this study, we utilized a series of bioinformatics tools to systematically reveal the expression status, prognostic value, methylation level, immune infiltration relevance and functional mechanisms of CCT3 in thirty-three TCGA tumors in an attempt to provide an in-depth and comprehensive view of the role of CCT3 in malignancies. We found that the dysregulation of CCT3 was manifested at multiple levels, such as transcriptome, protein and promoter region methylation status. In general, the upregulation of CCT3 has been widely observed in most tumor tissues compared with normal tissues, which was closely related to the clinical features of patients. We also discovered that the high CCT3 expression indicated poor overall OS and RFS in ACC, CESC and KIRP. CCT3 was significantly correlated with immune infiltrating cells and immune checkpoints in pan-cancer. Several cancer-related pathways and a novel CCT3-related ceRNA network were eventually identified, providing insights for future studies. In summary, the pan-cancer analysis confirmed that CCT3 could be a promising biological target for assessing the prognosis and immunotherapy of cancers.
Evaluating Event Embeddings on Commodity Future Prices
Authors: Steel Benjamin , Ruths Derek
Published: October 2023

Using news text-as-data to predict complex socio-political and economic measures is difficult. Modern pre-training natural language processing techniques can deliver intuitive and sophisticated methods that produce cogent results, but they necessitate arduous initial work before they can be widely applied. Here we show that pre-trained event embeddings allow accessible and powerful latent space modelling for time series data such as market prices. We evaluate commodity futures prediction, such as oil and agricultural futures, using neural time series modelling. We show that event embeddings can outperform sentiment on benchmark socio-economic measures.
Patterns, causes and policy implications of regional differences in COVID-19 mortality in the United States: A secondary analysis of excess mortality estimates
Authors: Stoto Michael A. , Schlageter Samantha , degl’Innocenti Duccio Gamannossi , Zollo Fabiana , Kraemer John D
Published: October 2023

In 2021 the “Red Covid,” narrative emerged: states and counties that are predominantly Republican and/or supported Trump experienced widespread vaccine hesitancy and eventually opposed mask and vaccine mandates. Our analysis of excess mortality quantifies this effect. After the first wave, death rates in the South were more than double those in the Northeast; 45% of deaths were in the South, with 38% of the population. Although there have been many correlational studies of this phenomenon, our analysis uses excess mortality estimates, aggregated by Census region and six pandemic phases, to establish the magnitude of this effect. We show that, if every region had the same mortality rate as the lowest regional rate in each period, more than 418,763 COVID-19 deaths were in this sense "avoidable." The analysis also shows that the U.S. has been a divided nation at almost since the start of the pandemic. We estimate that 198,642 deaths could have been averted during the Summer of 2020 and the Alpha wave, before vaccines were widely available. This strongly suggests that implementation of and adherence to NPIs made a difference. Similarly, while vaccination is a personal choice, as many Republicans argue, our estimates of 221,360 deaths averted after vaccines became available demonstrate the population-level consequences of that choice. Beyond the substantive results, this analysis demonstrates the importance of excess mortality estimates as part of the public health surveillance toolkit. Official mortality counts rely on complete recording of COVID-19 as a cause of death, COVID-19 deaths are under reported for many reasons. Between Jan. 3, 2020 and April 30, 2022, public health officials reported 978,567 COVID-19 deaths in the U.S. According to our calculations, however, the excess mortality associated with COVID-19 totaled 1,335,292, during that period, 37% more COVID-19 deaths than reported. Moreover, the proportion of COVID-19 deaths reported as such varied markedly over time and region, and reporting was generally less complete in the regions and periods with the highest mortality rates. Analyses of recorded COVID-19 deaths, just as of cases, therefore, would attenuate regional differences.