bluuebunny/crossref_metadata_2025 huggingface dataset:
Analisis Faktor-Faktor Yang Mempengaruhi Perilaku Konsumen Dalam Mengkonsumsi Rokok Obat Sehat Tentrem Di Kabupaten Ponorogo
Authors: Wicaksono Langgeng Satriya Aji , Hanifuddin Iza
Published: March 2024

I

In Indonesia, there are many cigarette consumers, and entrepreneurs, especially those engaged in cigarette products. The large number of cigarette consumers is a business opportunity that has the potential to continue to grow. This can be seen from the increasing number of new cigarette brands launched in the market and supported by many people who smoke. The desire to consume Cigarettes, Healthy Medicine, and be Peaceful, can be influenced by various factors, such as culture. In this case, it is more cultural; social factors it is more to the group. The personal aspect is more to the lifestyle; psychological factors tend to motivation and belief. This study aims to analyze some of these factors on consumer behavior, which in this case is the consumer of Healthy Medicine Cigarettes Tentrem. This research was conducted in Ponorogo Regency. The research subjects are consumers of Healthy Medicine Cigarettes Tentrem. This study uses several consumer respondents of Healthy Medicine Cigarettes Tentrem as samples. The study used data obtained from interviews. The data obtained will then be analyzed between theory and data in the field. The study results show that these factors influence consumer consumption of Tentrem Healthy Medicine Cigarettes.
Analisis Manajemen Risiko Pembiayaan Kepemilikan Rumah Syariah di Griya As-Sakinah Madiun
Authors: Qurrota A'yun Qonita , Masykuroh Ely , Prasetiyo Luhur
Published: March 2024

The application of the concept of convenience triggers risks in Sharia KPR financing, such as problems with financing, cancellation of financing, delays in payment of material debts, delays in handing over buildings, and the risk of differences in land size. This qualitative field research aims to identify risks analyze the risk assessment of Sharia home ownership financing, the factors causing risk, and the risk management process in Sharia home ownership financing at Griya As-Sakinah PT Housing. Sabab Podho Moro Madiun. The data collection techniques used are observation, interviews, and documentation techniques. Researchers interviewed the developer (Director, Marketing Manager, Development Manager, Marketing Staff, Financial Administration Staff, Warehouse Administration Staff, and Engineering Team) and 3 (three) Griya As-Sakinah PT Housing users. Sabab Podho Moro Madiun. This research uses data analysis with an inductive method. The research results show Sharia house ownership financing at Griya As-Sakinah PT Housing. Sabab Podho Moro Madiun experiences several risks, namely financing risk, liquidity risk, operational risk, and compliance risk. Risk assessment of Sharia home ownership financing at Griya As-Sakinah PT Housing. Sabab Podho Moro Madiun is ranked 4th, namely high-fair—factors causing financing risks at Griya As-Sakinah Housing PT. Sabab Podho Moro Madiun comes from the developer (internal management processes, HR, and cash flow), and factors from the user (profitability, prospects, character, capacity, and user condition). The process of implementing risk management in PT. Sharia homeownership financing. Sabab Podho Moro has not fully implemented the risk management stages. The developer prioritizes the concept of flexibility and the principle of kinship towards users.
Analisis Hukum Responsif terhadap Pembatasan Usia Pernikahan terhadap Hak Perempuan di Indonesia
Authors: Niamatin Nilna , Hanifuddin Iza , Maulidia Rohmah
Published: March 2024

This descriptive qualitative study with a literature study approach aims to explore the "marriage age limit" in perspective and categorization in the typology of responsive law. The main material object is "limiting the age of marriage" as a legal norm following legislation (Law 1 of 1974 Ps. 7 Paragraphs 1 and 2). The formal object is ideas, ideas, and arguments that support or reject the idea of the article a quo. The analysis uses a responsive legal theory approach, an epistemological and axiological study of the review of the limitation of the age of marriage as a statutory norm applicable in Indonesia. The results show that: 1) The situation of child marriage because it is allowed to marry at the age of 16 (Article 7 paragraph (1) of Law 1 of 1974) results in the guarantee of women's constitutional rights being violated. These violations include the right to education, health, and growth and development, guaranteed protection by the 1945 Constitution. Applying legal norms needs to balance the protection of children and human rights. 2) The scope of the case includes the right to make life choices and the right to the growth and development of children—the synergy of all parties to educate the community about the adverse effects of early marriage. Provide access to quality health and education services for children so that they can grow and develop properly and ensure the law can effectively increase the prevention of child marriage cases.
Peran Gronjong Wariti dalam Mewujudkan Pemberdayaan Masyarakat Desa Mejono: Sebuah Tinjauan Kualitatif
Authors: Alistasari Nanda , Fadilah Adin
Published: March 2024

The tourist attraction in Mejono Village is the Gronjong Wariti Tourism, founded by the community in 2017. The existence of this tourist attraction cannot be separated from the role of residents who care about their environment, as well as being committed to inviting residents to make it happen. This research aims to determine the Gronjong Wariti tourist attraction in Mejono Village, Plemahan Subdistrict, Kediri Regency, and the role of the Gronjong Wariti tourist attraction in empowering the people of Mejono Village, Plemahan Subdistrict, Kediri Regency. This research uses a qualitative approach with a descriptive research type. The data collection procedures used were interviews, observation, and documentation. Data analysis is done by reducing data, presenting data, drawing conclusions, and verifying. Checking the validity of the data is carried out by extending observations, persistence of observations, and triangulation. The results of this research are as follows: (1) Gronjong Wariti is a water tourist attraction that utilizes river water flow. Based on the classification of tourist attractions, Gronjong Wariti Tourism is a tourist attraction and special interest attraction because it opens visits to the public who want to visit this tourist attraction. This place has a lot of entertainment, from amusement rides to stalls selling traditional market snacks to a karaoke place. (2) The Gronjong Wariti tourist attraction empowers the community because it involves all the people of Mejono Village, namely at least 75 families in the community around the river. The involvement of all the people of Mejono Village has an impact on realizing the goals of community empowerment, namely institutional improvement, business improvement, income improvement, environmental improvement, life improvement, and community improvement.
Utilização de geotecnologias na identificação da precariedade urbana para regularização fundiária
Authors: Stanganini Fabio , Melo Livia , Leonelli Gisela , Molina Junior Vitor
Published: March 2024

Neste artigo, tem-se como objetivo demonstrar a capacidade das ferramentas de geoprocessamento, incluindo imagens oriundas de diversos sistemas sensoriais, em contribuir para a caracterização, tanto sincrônica como diacrônica, de regiões que demandam regularização fundiária. Através da aplicação das ferramentas de geoprocessamento alinhado com produtos aerofotogramétricos na avaliação urbanística, busca-se demonstrar a presença e a progressão da ocupação informal periférica na cidade de Ribeirão Preto, no interior do estado de São Paulo. Este cenário é empregado como exemplo emblemático do fenômeno de favelização observado em cidades de porte médio no interior paulista.
Photocatalytic degradation of Congo red dye with cobalt-doped manganese aluminium ferrite nanoparticles
Authors: Yasar Muhammad , Noreen Fozia
Published: March 2024

Water pollution caused by the discharge of dyes is a serious environmental problem worldwide.Cobalt-doped manganese aluminium ferrite CoXMn1-XAl0.2Fe1.8O4 (X=0,0.2) nanoparticles synthesized via the sol-gel combustion technique exhibited excellent photocatalytic activity for Congo Red dye degradation under visible light irradiation. Comprehensive materials characterization revealed their structural, optical, morphological, and electronic properties. XRD reveals a cubic spinal ferrite structure, FTIR shows cobalt incorporation, SEM shows nanoparticle morphology, EDX confirms stoichiometric composition, and BET analysis reveals a high surface area. Cobalt incorporation tunes the optical bandgap from 2.8 to 2.5 eV, enabling visible light absorption (UV-DRS). Dielectric and conductivity measurements confirm semiconductor behaviour and indicate cobalt doping introduces additional charge carriers. Cobalt-doped manganese aluminium ferrite exhibited excellent Congo Red dye photodegradation efficiency of 99.9% under normal conditions of pH 7, catalyst dose of 100 mg/L, and dye concentration of 10 ppm following first-order kinetics. Scavenger test observed Hydroxyl and superoxide radicals degrade dyes. Cobalt doping facilitates charge dynamics, narrowing the bandgap and enhancing interfacial charge transfer, leading to superior photocatalytic performance. Cobalt-doped ferrite nanoparticles are reusable. Cobalt-doped manganese aluminium ferrite is an efficient and stable photocatalyst for wastewater treatment.
A TOPSIS-based improved weighting approach with evolutionary computation
Authors: Zeydan Mithat , Güngör Murat , Urazel Burak
Published: March 2024

Although optimization of weighted objectives is ubiquitous in production scheduling, the literature concerning the determination of the weights used in these objectives is scarce. Authors usually suppose that weights are given in advance, and focus on the solution methods for the specific problem at hand. However, weights directly affect optimality, and are of utmost importance in any practical scheduling problem. In this study, we propose a new TOPSIS-based weighting approach for single machine scheduling problem. First, factor weights to be used in customer evaluation are determined by fuzzy covariance matrix adaptation evolutionary strategy (FCMAES). Next, customers (jobs) are sorted using the technique for order of preference by similarity to ideal solution (TOPSIS), by means of which job weights are obtained. Finally, taking these weights as an input, a total weighted tardiness minimization problem is solved by using mixed-integer linear programming to find a suitable job sequence. Real data collected from a textile company of Turkey was employed. Results was compared with Fuzzy Genetic Algorithm (FGENETIC). FCMAES objective function value as 822.69 was obtained better than FGENETIC value as 817.24. This combined methodology may help companies make robust schedules not based purely on subjective judgment, find the best compromise between customer satisfaction and business needs, and thereby ensure profitability in the long run.
Infrared and visible image fusion based on modal feature enhancement with global attention and dynamic convolutional reconstruction
Authors: meng wang , Xia Guo , Haipeng Liu
Published: March 2024

Visible and infrared image fusion (VIF) for obtaining foreground salient information has strong application potential and made substantial progress based on deep neural networks. However, it remains difficult to resolve the feature degradation and spatial detail loss in the feed-forward process of the existing deep networks. In this paper, we propose an input modality-independent feature analysis-reconstruction fusion network to solve the above problems. In the feature extraction stage, a feed-forward feature enhancement module (DFEM) is embedded to explicitly enhance the infrared and visible modal salient features, respectively.Also, an attention template based on global correlation is constructed for converging different channel feature mappings to obtain a consistent fusion representation. Afterwards,dynamic convolution is used to adaptively construct a convolutional kernels in terms of the current input to generate the fused image.Additionally , a perceptual loss function is added into the encoder training to further preserve the semantic information in the fused features for reference-free image scenarios. Subjective and multiple objective evaluations Additionally,using the TNO and RoadScene datasets show that the proposed method outperforms existing fusion baseline models, with the greater average measurements of EN, MI, QAB/F and SCD. Moreover, the fusion results maintain the visible background texture as well as the infrared salient target contrast better.
Effects of formaldehyde stress on electron transport and reactive oxygen species in moss Racomitrium japonicum L.
Authors: Li Wanting , Ma Siqi , Chen Qunlong , Qiu Haiyan , Tang Yunlai , Ren Peng , Tang Hao , Yang Xiaoping , Huang Renhua , Lu Yunmei , Chen Ke
Published: March 2024

Formaldehyde is a common gaseous pollutant from buildings and decorative materials. However, in recent years, increasing concerns have been raised regarding its harmful health in indoor air. Therefore, this study aims to investigate the physiological and photosynthetic response mechanisms of Racomitrium japonicum under formaldehyde stress. R. japonicum was exposed to dynamic fumigation with formaldehyde for 7 days, with each day comprising an 8-h exposure period within a sealed container. The effects on plant structure, pigment content, photosynthetic efficiency, and reactive oxygen species (ROS) generation were assessed. Our findings revealed that formaldehyde stress led to structural damage, reduced pigment content, decreased photosynthetic efficiency, and increased ROS production in R. japonicum. Significantly, distinct stress-response pathways were observed at various formaldehyde concentrations. In response to low and moderate formaldehyde concentrations, R. japonicum activated its antioxidant enzyme system to mitigate ROS accumulation. In contrast, the high-concentration treatment group demonstrated suppressed antioxidant enzyme activity. In response, R. japonicum used non-photochemical quenching and activated cyclic electron flow to mitigate severe cellular damage. This study provides an in-depth understanding of the physiological changes of R. japonicum under formaldehyde stress, elucidating its response mechanisms. The findings provide valuable information for developing effective indoor formaldehyde monitoring and purification methods.
Optimization of Deproteinization and Deacetylation of Shrimp Shell Waste for Chitosan Production Using Fractional Factorial Design (FFD)
Authors: kherbache Atiqa , Youcefi Fatma , Ouided Ouahab Linda , Ouided Dehas , Cherifi Achref
Published: March 2024

Chitosan is deacetylated chitin, the second most common polysaccharide after cellulose. The diverse applications of chitosan are directly linked to the properties of the polymer, which vary depending on the extraction process. This study aimed to investigate the factors that influence the deproteinization and deacandylation of chitin and to elucidate their effect on the residual protein level, the level of deacandylation (DD), and the yield of extracted material. The selected responses were studied using a 25 − 1 fractional factorial design with five factors and two levels of variation. The factors tested were A NaOH concentration, B = reaction time, C temperature, D = Particle size, and E = Solid/Liquid ratio. Using the ANOVA regression equation gives a coefficient of determination R2 = (99.62%, 99.72%, and 99.90%) for the residual protein level, the deacandylation (DD), and yield, respectively, indicating the precision of the predicted model. The minimum of residual proteins and the maximum deacandylation DD% and yield% reached under those conditions corresponds to the concentration of NaOH (20%,40%), temperature (40°C,129.88°C), reaction time (60,15.03min), particle size of (1.00,0.3mm) and Solid/Liquid ratio of (1/15,1/10.02g/ml). After carrying out the validation test, the chitosan obtained presents a yield, ash rate, residual proteins, a DD%, solubility, crystallinity, and a molecular weight of 16.16 ± 0.22, 0.124 ± 0.002, 2.08 ± 0.05%, 87.13 ± 0.16%, 97.02 ± 0.09%, 44.32%, and 107.47 ± 0.44KDa respectively.
MIS-C, inherited metabolic diseases and methylmalonic acidemia: a case report and review of the literature
Authors: Maggio Maria Cristina , Castana Cinzia , Caserta Marina , Fiore Antonella Di , Siciliano Vittoria , Corsello Giovanni
Published: March 2024

Bacground Methylmalonic acidemia (MMA) secondary to mutase deficiency, mut0, is an inborn error of metabolism causing complete enzyme deficiency. Multisystem Inflammatory Syndrome in Children (MIS-C) is a hyperinflammatory syndrome characterized by fever, inflammation, multiorgan impairment that manifests 14–60 days after the SARS-CoV-2 infection in patients aged < 21 years. Case presentation We describe the clinical case of a 2-year-old child with MMA secondary to mutase deficiency, with the documented homozygous mutation c.2179 C > T of MMUT gene, associated to mut0 phenotype. One month after SARS-CoV-2 infection, he presented fever, rash, significant increase of C-reactive protein (CRP), ferritin, triglycerides, (interleukin) IL-6, PRO-BNP, compatible with the diagnosis of MIS-C. He was treated with intravenous immunoglobulins (2gr/Kg), methylprednisolone (2 mg/Kg/day), with rapid clinical improvement. Ten days later, he showed the worsening of clinical conditions, with the recurrence of fever, vasculitic rash with palmoplantar extension, further increase of ferritin (1033 ug/l), IL-6 (146 pg/ml), PRO-BNP (5117 pg/ml), triglycerides, anemia, thrombocytopenia, metabolic acidosis with hyperlactatemia (180 mg/dl), increased urinary methylmalonic acid (200 mmol/mCreat), multiorgan failure. He was treated with sodium bicarbonate, thiamine, coenzyme Q, vitamin C, methylprednisolone and anakinra (2 mg/Kg/day). Three days after the start of anakinra, he showed a significant improvement of clinical and biochemical parameters and defervescence. 20 days later, a sepsis from Staphylococcus Aureus and Candida Albicans required the interruption of anakinra, with the worsening of the clinical and haematological parameters and the exitus. Conclusions Only a few cases of patients with inherited metabolic diseases (IMD) and MIS-C are described. However, to our knowledge, this is the first case of MIS-C in MMA described. The description of these clinical cases is a precious lesson for pediatricians to manage IMD therapeutic emergencies. Anakinra must be considered as a safe treatment of choice in IMD patients with MIS-C. The use of anakinra in patients with a severe form of MMA is safe and can be employed to treat MIS-C, gaining a substantial clinical and biochemical improvement.
Isolation of Bacillus altitudinis 5-DSW with Protease Activity from Deep-Sea Mineral Water and Preparation of Functional Active Peptide Fractions from Chia Seeds
Authors: Jin Hao , Baik Sang-Ho
Published: March 2024

In this study, we successfully isolated Bacillus strains with high protease activity from deep-sea mineral water in Korea and used them to obtain functional peptide fractions from chia seeds. The obtained Bacillus strains showed high similarity of 99% with B. altitude with long rod type (named B. altitudinis 5-DSW) and showed high protease activity at 40°C and 70% of the activity was remained even at 70°C. The defatted chia seed protein (15–50 kDa) was treated with crude protease from B. altitudinis 5-DSW and digested into small peptides below 20kDa. The obtained chia seed peptides showed 3 times and 1.5 times higher antioxidant activity in DPPH and ABTs radical scavenging assays, respectively. Moreover, chia seed peptides showed enhanced AChE inhibitory activity with an IC50 value of 14.48 ± 0.88µg/mL and BChE inhibition activity with IC50 value of 10.90 ± 0.80µg/ml. Our results indicate that the newly isolated B. altitudinis 5-DSW and chia seed protein hydrolysates have potential applications in biotechnology and functional food development, enhancing the nutritional quality and value-added utilization of chia byproducts.
Verifiable measurement-based quantum random sampling with trapped ions
Authors: Eisert Jens , Ringbauer Martin , Hinsche Marcel , Feldker Thomas , Faehrmann Paul , Bermejo-Vega Juani , Edmunds Claire , Postler Lukas , Stricker Roman , Marciniak Christian , Meth Michael , Pogorelov Ivan , Blatt Rainer , Schindler Philipp , Monz Thomas , Hangleiter Dominik
Published: March 2024

Quantum computers are now on the brink of outperforming their classical counterparts. One way to demonstrate the advantage of quantum computation is through quantum random sampling performed on quantum computing devices [1–5]. However, existing tools for verifying that a quantum device indeed performed the classically intractable sampling task are either impractical or not scalable to the quantum advantage regime [1, 6, 7]. The verification problem thus remains an outstanding challenge. Here, we experimentally demonstrate efficiently verifiable quantum random sampling in the measurementbased model of quantum computation [8, 9] on a trappedion quantum processor [10, 11]. We create random cluster states, which are at the heart of measurement-based computing, up to a size of 4 x 4 qubits. Moreover, by exploiting the structure of these states, we are able to recycle qubits during the computation to sample from entangled cluster states that are larger than the qubit register. We then efficiently estimate the fidelity to verify the prepared states—in single instances and on average—and compare our results to cross-entropy benchmarking [1, 12]. Finally, we study the effect of experimental noise on the certificates. Our results and techniques provide a feasible path toward a verified demonstration of a quantum advantage.
Binary Quantum Random Number Generator Based on Value Indefinite Observables
Authors: Svozil Karl , Calude Cristian S.
Published: March 2024

All quantum random number generators based on measuring value indefinite observables are at least three-dimensional because the Kochen-Specker Theorem and the Located Kochen-Specker Theorem are false in dimension two. In this article, we construct quantum random number generators based on measuring a three-dimensional value indefinite observable that generate binary quantum random outputs with the same randomness qualities as the ternary ones: the outputs are maximally unpredictable.
Association between Antibiotic Use and Subsequent Risk of Breast Cancer: A Nationwide Retrospective Cohort Study in South Korea
Authors: Hong Jaeyi , Park Sun Jae , Park Young Jun , Jeong Seogsong , Choi Seulggie , Chang Jooyoung , Kim Hye Jun , Song Jihun , Ko Ahryoung , Kim Su Gyeong , Han Minjung , Cho Yoosun , Kim Ji Soo , Oh Yun Hwan , Son Joung Sik , Park Sang Min
Published: March 2024

Background
Several studies have revealed a possible association between antibiotic use and breast cancer in the Western population of women. However, its association with the Asian population remains unclear.
Methods
Data utilized in this nationwide population-based retrospective cohort study was obtained from the Korean National Health Insurance Service (NHIS) database. The study population consisted of 4,097,812 women who were followed up from January 1, 2007, to December 31, 2019. Cox proportional hazards regression was utilized in order to calculate adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for the risk of breast cancer according to cumulative days of antibiotic use and the number of antibiotic classes used, respectively.
Results
It was discovered that participants who used antibiotics for more than 365 days had a higher risk of breast cancer (aHR, 1.15; 95% CI, 1.09–1.21) in comparison to those who did not use antibiotics. In addition, a correlation was found among participants who utilized five or more classes of antibiotics in which they developed a higher risk of breast cancer (aHR, 1.11; 95% CI, 1.05–1.17) than those who were not antibiotic users.
Conclusions
Our research and findings propose that long-term antibiotic use may be associated with an increased risk of breast cancer when multiple covariates are taken into account. The findings support the epidemiological evidence that long-term use of antibiotics may be associated with the risk of breast cancer and demonstrate the need for further studies to confirm causation and mechanisms.
Alpha-mannosidosis in a 3.5-year-old girl: A case report
Authors: Fornes Samuel Bonilla , Perez Maria Pilar Mendez , Gutierrez Maria Eugenia Sanchez , Gómez Enrique Galán
Published: March 2024

Background: Alpha-mannosidosis is a rare lysosomal storage disease caused by a deficiency of the enzyme alpha-mannosidase. It manifests as a continuous spectrum of signs and symptoms characterized by dysmorphic features, skeletal abnormalities, delayed psychomotor and speech development, impaired hearing, and psychiatric involvement.
When suspected, alpha-mannosidosis must be confirmed by biochemical and molecular testing, namely, assessment of blood levels of alpha-mannosidase in leukocytes or fibroblasts and Sanger or new-generation sequencing of the MAN2B1 gene. The disease must be diagnosed and treatment started as quickly as possible, since the long-term prognosis for untreated patients is very poor. Enzyme replacement therapy (ERT, human recombinant alpha-mannosidase) has replaced allogenic stem cell transplant as the mainstay of therapy, thus improving disease-related outcomes with, for example, reduced serum oligosaccharide levels, greater functional capacity, and improved quality of life, all with a good safety profile.
Case presentation: We report the seventh case of alpha-mannosidosis in Spain. The patient was a 3.5-year-old girl assessed in the clinical genetics department for developmental retardation and marked dysmorphic features (trigonocephaly, exophthalmos, hypertelorism, and a flat nasal bridge). Radiography revealed shortening and thickening of the long bones, as well as metopic and coronal synostosis. Craniosynostosis was treated with surgery. Assessment of alpha-mannosidase revealed complete absence of enzymatic activity. Genetic analysis revealed the homozygous pathogenic variant of MAN2B1, c.2248C>T, which is associated with alpha-mannosidosis.
Conclusions: ERT is the only currently available pharmacological option for treating children with mild-to-moderate alpha-mannosidosis. Without ERT, patients’ quality of life would be impaired, and their prognosis would worsen significantly.
Optimal Variable Acceptance Sampling Plan under Progressive Type-II Censoring for Mixture Distribution: Applications in Breast Cancer Data
Authors: Mathai Ashlyn Maria , Kumar Mahesh
Published: March 2024

Mixture distributions are widely utilized in various practical problems such as clinical experiments and electronic component life testing. Despite this, the literature does not extensively cover acceptance sampling plans associated with these distributions. In this paper, variable acceptance sampling plans are designed for an exponential-Rayleigh mixture distribution using partially accelerated life tests (PALT). Under progressive type-II censoring schemes with binomial removals, the maximum likelihood estimates (MLEs) of the unknown parameters of the mixture distribution are derived for Arrhenius and linear life-stress relationships. Based on these relationships, optimal variable sampling plans are formulated and plan parameters are determined by solving corresponding optimization problems. The study presents numerical findings, a comparative analysis, and sensitivity assessments. Finally, the practical applicability and relevance of the proposed acceptance sampling plans are demonstrated using real-world datasets of breast cancer patients' records and failure lifetime data from communication transmitter-receivers in a commercial aircraft.
Does a formal referral system work? Case study of a tertiary teaching and referral hospital in Kenya: Pre-posttest study
Authors: Omondi Maxwell Philip
Published: March 2024

Inappropriate utilization of higher-level health facilities and ineffective management of the referral processes in resource-limited settings is increasingly becoming a concern in health care management in developing countries. This is characterized by self-referrals and frequent bypassing of nearest health facilities coupled with low use of formal referral mechanisms. This scenario lends itself to a situation where uncomplicated medical conditions are unnecessarily managed in a high-cost health facility. This compromises the ability and capacity of Kenyatta National Hospital to function as a referral facility as envisioned by Kenya Health Sector Referral Implementation Guidelines of 2014, Kenya 201 constitution and Kenyatta National Hospital legal statue of 1987. On 1st July 2021, Kenyatta National Hospital (KNH) did enforce the national referral guidelines that required patients have a formal referral letter to reduce the number of self-referrals, decongest KNH and allow KNH to function as a referral facility as envisioned by Kenya Health Sector Referral Implementation Guidelines of 2014, Kenya 2010 constitution and KNH legal statue of 1987. The purpose of this study was to analyse the effect of enforcement of national referral guidelines on use of official facility referral letters to KNH.This was a pre-posttest study design. The study was conducted amongst the orthopedic and trauma facility referrals in 2021 with 222 and 246 before and after enforcement of referral guidelines respectively. Data collection was done through data abstraction. Data was analyzed using frequency distribution, pearson chi-square test and logistic regression. The enforcement of the national referral guidelines had no effect on the use of the official written referral letters as per the requirement of the national referral guidelines amongst the orthopedic and trauma admissions at KNH (p = 0.524). Over 80% of facility referrals were young and middle-aged patients before and after enforcement of the referral guidelines with children and elderly representing the minority. Most of the facility referrals had had primary and secondary level of education with admissions. Women, elective patients and those with higher education were more likely to have a written referral letter (p < 0.05). In conclusion, enforcement of the referral guidelines had no effect on use of the official written referral letters to KNH. There is need for capacity building of health care workers on effective referral process by designing and disseminating referral SOPs and standardized documentation for referrals and regular referral review forums to review coordination, encourage accountability and continuous improvement and referral performance monitoring.
The Role of Frontal Pole Cortex and Personalized Feedback in Sustaining Future-Oriented Healthy Dietary Behaviors
Authors: Hosoda Chihiro , Ochiai Ryuji , Hosokawa Kenchi , Nakamura Yuko , Matsuhashi Takuto , Okanoya Kazuo
Published: March 2024

Lifestyle-related diseases present a significant health challenge, highlighting the critical need for promoting healthy behaviors, particularly among young adults. The frontal pole cortex (FPC) is known for its role in supporting persistence towards near-term objectives, yet its relevance in fostering long-term health behavior change remains less understood. This study investigates the association between FPC structural integrity and the adoption of sustained health behaviors targeting distant future goals. We engaged fifty participants in a 27-day study, where they provided daily food diaries and mental health assessments. Depending on their dietary analysis, participants received either personalized feedback (PF) or general nutritional feedback (CF). The PF group demonstrated higher engagement in diary completion and notable improvements in nutritional intake and mental well-being, evidenced by a significant decrease in trait anxiety, compared to the CF group. Interestingly, a significant correlation between FPC structural features (cortical thickness, T1-weighted/T2-weighted (T1w/T2w) ratio, and fractional anisotropy (FA)) and diary submission frequency was found exclusively in the CF group. These findings suggest that personalized feedback can effectively enhance dietary habits and mental health by potentially leveraging FPC-related mechanisms that underpin the maintenance of health-related behaviors over the long term.
Machine Learning Derivation of Two Cardiac Arrest Subphenotypes with Distinct Responses to Treatment
Authors: Zhang Weidong , Wu Chenxi , Ni Peifeng , Zhang Sheng , Zhang Hongwei , Zhu Ying , Hu Wei , Diao Mengyuan
Published: March 2024

INTRODUCTION: Cardiac arrest (CA), characterized by its heterogeneity, poses challenges in patient management. This study aimed to identify clinical subphenotypes in CA patients to aid in patient classification, prognosis assessment, and treatment decision-making. METHODS: For this study, comprehensive data were extracted from the Medical Information Mart for Intensive Care IV (MIMIC-IV) 2.0 database. We excluded patients under 16 years old, those not initially admitted to the intensive care unit (ICU), or treated in the ICU for less than 72 hours. A total of 52 clinical parameters relevant to CA patients were selected for analysis. These included demographic data, vital signs, and laboratory parameters. After an extensive literature review and expert consultations, key factors such as temperature (T), sodium (Na), creatinine (CR), glucose (GLU), heart rate (HR), PaO2/FiO2 ratio (P/F), hemoglobin (HB), mean arterial pressure (MAP), platelets (PLT), and white blood cell count (WBC) were identified as the most significant for cluster analysis. Consensus cluster analysis was utilized to examine the mean values of these routine clinical parameters within the first 24 hours post-ICU admission to categorize patient classes. Furthermore, in-hospital and 28-day mortality rates of patients across different CA subphenotypes were assessed using multivariate logistic and Cox regression analysis. RESULTS: After applying exclusion criteria, 719 CA patients were included in the study, with a median age of 67.22 years (IQR: 55.50-79.34), of whom 63.28% were male. The analysis delineated two distinct subphenotypes: Subphenotype 1 (SP1) and Subphenotype 2 (SP2). Compared to SP1, patients in SP2 exhibited significantly higher levels of P/F, HB, MAP, PLT, and Na, but lower levels of T, HR, GLU, WBC, and CR. SP2 patients had a notably higher in-hospital mortality rate compared to SP1 (53.01% for SP2 vs. 39.36% for SP1, P < 0.001). 28-day mortality decreased continuously for both subphenotypes, with a more rapid decline in SP2. These differences remained significant after adjusting for potential covariates (adjusted OR = 1.82, 95% CI: 1.26–2.64, P = 0.002; HR = 1.84, 95% CI: 1.40–2.41, P < 0.001). CONCLUSIONS: The study successfully identified two distinct clinical subphenotypes of CA by analyzing routine clinical data from the first 24 hours following ICU admission. SP1 was characterized by a lower rate of in-hospital and 28-day mortality when compared to SP2. This differentiation could play a crucial role in tailoring patient care, assessing prognosis, and guiding more targeted treatment strategies for CA patients.
Functional characterization of cell wall-associated β-glucanases and peroxidase induced during wheat-Diuraphis noxia inteactions.
Authors: Zondo Siphephelo N.N. , Mohase Lintle , Tolmay Vicki , Mafa Mpho S.
Published: March 2024

Wheat plants infested by Russian wheat aphids (RWA) induce a cascade of defence responses, which include increased activity of β-1,3-glucanase and peroxidase (POD). There is a lack of information regarding β-1,3-glucanase and POD synergistic effects on the plant cell wall modification and characterisation during wheat-RWA infestation. This study aimed to characterise the physicochemical properties of the cell wall-bound POD and β-1,3-glucanase during RWA-wheat interaction. The susceptible Tugela, moderately resistant Tugela Dn1, and resistant Tugela Dn5 cultivars were planted in a glasshouse to a seedling stage before being infested with RWASA2 for 14 days. The findings showed a significant increase in β-1,3-glucanase and POD activities in the infested Tugela Dn5 and Tugela-Dn1 cultivars over the 14 days. However, in the Tugela enzymes were repressed. In addition, it was shown for the first time that β-1,3-1,4-glucanase activity specific toward mixed-linked glucan was significant in the resistant cultivar over 14 days. β-1,3-glucanase, β-1,3-1,4-glucanase and POD displayed optimum at pH 5. β-1,3-glucanase and POD displayed temperature optimum at 40 and 50°C, respectively. However, β-1,3-1,4-glucanase had temperature optimum at 25°C. β-1,3-glucanase and POD had a thermo-stability at 37°C followed by about 80% relative activity at 70°C, but β-1,3-1,4-glucanase displayed thermostability at 25°C and retained more than 75% at 70°C, confirming that β-1,3-1,4-glucanase and β-1,3-glucanase induced in the resistant cultivars cell wall were two different enzymes. Mechanism of actions and oligosaccharide displayed that β-1,3-glucanase was highly active against β-1,3-glucan and required a triose and higher oligosaccharide to be active. Our findings demonstrated cell-wall bound POD and β-1,3-glucanase activities significantly increased in wheat after RWASA2 infestation, revealing they acted synergistically to reinforce the cell wall to deter RWASA2 feeding in resistant cultivars.
WITHDRAWN: Harmonizing Sustainable Transportation: A Comprehensive Hybrid Vehicle Integrating CNG, In-Wheel Motors, and Rooftop Solar Panels for Environmental Excellence.
Authors: KARTHIK MURI
Published: March 2024

The full text of this preprint has been withdrawn, as it was submitted in error. Therefore, the authors do not wish this work to be cited as a reference. Questions should be directed to the corresponding author.
Multiple presentations of pediatric activated PI3K-delta syndrome: a single-center experience in south-central mainland China
Authors: Zhang Liang , Kang Zhijuan
Published: March 2024

Background Activated phosphoinositide 3-kinase delta syndrome causes recurrent respiratory tract infections, lymphoproliferation, autoimmunity, and lymphoma, due to mutations in PI3Kδ subunits, encoded by PIK3CD and PIK3R1, or PTEN, resulting in APDS1, APDS2, and APDS-L subtypes, respectively. Over 400 cases of APDS have been recognized since 2013; however, reports of pediatric patients from China are relatively limited.Methods Herein, individuals diagnosed with APDS by whole-exome sequencing from a single center in China were retrospectively assessed. Demographic characteristics, disease complications, laboratory data, and genetics were reviewed based on medical records.Results Ten, two, and nine patients with APDS1, APDS2, and APDS-L, respectively, were included. All patients with APDS1 had the c.3061G > A mutation in PIK3CD; patients with APDS2 had heterozygous c.1425 + 1G > C and c.1425 + 1G > A mutations in PIK3R1; and of patients with APDS-L, four had c.388C > T, and the other five had c.697C > T, c.1031delA, c.202T > C, c.640C > T, and c.896dupA mutations in PTEN. Recurrent respiratory tract infections were the most common manifestations in all patients. Neurodevelopmental abnormalities were noted in all patients with APDS-L. Bronchiectasis, chronic lymphoproliferation, and autoimmunity were more common in patients with APDS1 and APDS2. Five patients with APDS1 died from complications, including severe bacterial infection, autoimmune disease, renal failure, and lymphoma. Decreased serum IgG levels, increased IgM levels, B cell lymphopenia, and CD4 lymphopenia were predominant immunologic features in patients with APDS1 and APDS2.Conclusions APDS is a combined immunodeficiency with variable clinical manifestations. Patients with APDS1 and APDS2 had more frequent and severe infections than those with APDS-L. Neurodevelopmental delay was common in patients with APDS-L. APDS can be fatal; appropriate management is required to improved patient outcomes.
Genome-wide association study and candidate gene identification for agronomic traits in 182 upward-growing fruits of C. frutescens and C. annuum
Authors: Fu Genying , Yu Shuang , Wu Kun , Yang Mengxian , Altaf Muhammad Ahsan , Wu Zhuo , Deng Qin , Lu Xu , Fu Huizhen , Wang Zhiwei , Cheng Shanhan
Published: March 2024

Pepper agronomic traits serve as pivotal indicators for characterizing germplasm attributes and correlations. Investigating genotypic disparities through phenotypic variations holds significant scientific merit Whole genome resequencing facilitates comprehensive examination of diverse individuals with known references, enabling subsequent differential analyses to pinpoint single nucleotide polymorphisms(SNPs) linked to pepper agrnomic. This study ,conducted a genome-wide association study(GWAS) encompassing 26 agronomic traits in 182 pepper specimens. Rigorous measures, including phylogenetic analysis, population structure analysis, population principal component analysis, kinship analysis, and linkage disequilibrium analysis, were employed to ensure the precision and reliability of GWAS results. The optimal statistical model. Was determined through these analyses. A total of 929 SNPs significantly associated with 26 agronomic traits, were identified, alongside the detection of 519 candidate genes within 100kb region adjacent to these SNPs. Additionally, through gene annotation and expression pattern scrutiny, genes such as SCPL13, extensin-1-like, and DDB1 correlated with fruit traits in Capsicum frutescens and Capsicum annuum were validated via qRT-PCR. This validation provides a robust reference for molecular marker-assisted breeding of pepper agronomic traits, offering both genetic resources and theoretical foundations for future endeavors in molecular marker-assisted breeding for pepper.
Relationship between the level of physical activity and body mass index to the risk of developing blood pressure among overweight and obese young adults in the Northern Emirates city: A cross-sectional study
Authors: Choudhary Naina , Gopal Kumaraguruparan , K Praveenkumar , D Satheeskumar , Hazari Animesh , Muthukrishnan Ramprasad
Published: March 2024

Background: Obesity affects both adults and children all over the world and it is a major causative factor for diabetes, cardiovascular disease, different types of cancer, and even death. Therefore, this study aimed to assess the level of PA and BMI to the risk of developing high BP among overweight and obese young adults.
Methodology: The study was carried out in the Thumbay Medi-city Northern Emirates, Ajman, UAE. Approval was obtained from the Institutional Review Board (CoHS, GMU (IRB-COHS-STD-110-JUNE-2023).
Results: Out of 206 participants, 139 were overweight and 67 were obese. Further, 89 were found to have high normal BP, 93 normal BP, and 24 were found to have optimal blood pressure. The mean GPA scores were 322.8±62.28 in overweight individuals and 301.17±49.05 in obese individuals. Furthermore, among overweight and obese participants there is a weak correlation between PA & BMI (r=0.06, p= 0.88) and (r=0.15, p= 0.44) and the BP and BMI (r=0.18, p= 1.02) and (r= 0.16, p= 0.90) were found.
Conclusion: Although PA, BMI, and BP are assumed to be related variables leading to various non-communicable diseases the present study showed a weak correlation between the level of PA and BMI to the risk of developing BP among overweight and obese young adults in the Northern Emirates.
Deficiency of SDHC promotes metastasis by reprogramming fatty acid metabolism in colorectal cancer
Authors: Ding Zhuoyu , Wei Yiyi , Dai Jingping , Pan Chaomin , Yang Li , Li Qingyuan , Zhang Yue , Yan Qun , Wu Changjie , Li Aimin , Liu Side , Lan Zhixian , Wang Xinke
Published: March 2024

Background
Several studies have demonstrated a strong correlation between impaired Succinate dehydrogenase (SDH) function and the advancement of tumors. As a subunit of SDH, succinate dehydrogenase complex subunit C (SDHC) has been revealed to play tumor suppressive roles in several cancers, while its specific role in colorectal cancer (CRC) still needs further investigation.
Methods
The effects of SDHC on the metastasis of CRC cells were evaluated both in vitro and in vivo. To reveal the mechanisms underlying SDHC, drug screening and RNA sequencing were carried out. Molecular and biological experiments were conducted to uncover the mechanisms of dysregulated lipid accumulation caused by SDHC.
Results
Downregulation of SDHC was found to be closely associated with a poor prognosis in CRC. SDHC knockdown promoted CRC metastasis both in vitro and in vivo. Through drug screening and Gene set enrichment analysis, it was discovered that SDHC downregulation was positively associated with the fatty acid metabolism pathways significantly. The effects of SDHC silencing on metastasis were reversed when fatty acid synthesis was blocked. Subsequent experiments revealed that SDHC silencing activated the PI3K/AKT signaling axis, leading to lipid accumulation by upregulating the expression of aldehyde dehydrogenase 3 family member A2 (ALDH3A2) and reduction of fatty acid oxidation rate by suppressing the expression of acyl-coenzyme A oxidase 1 (ACOX1) and carnitine palmitoyltransferase 1A (CPT1A).
Conclusions
SDHC deficiency could potentially enhance CRC metastasis by modulating the PI3K/AKT pathways and reprogramming lipid metabolism.
Factors Associated with Skilled Birth Attendance Utilization Among Women in Enderta District, Tigray, Northern Ethiopia
Authors: Hailesslassie Brhanu , Gebrezigabiher Tesfay , Hailu Kebede
Published: March 2024

Background
Ensuring skilled birth attendance utilization combined with emergency obstetric care could prevent 80% of maternal deaths of which 99% occur in low-and middle-income countries (LMICs). Skilled birth attendants assist in identifying treatable birth complications and thereby saving lives. However, utilization of skilled birth attendance has remained low in LMICs, including Ethiopia and the study area. Hence, this study aimed to assess the magnitude and factors associated with skilled birth utilization among women aged 15–49 years in Enderta District, Northern Ethiopia
Methods
Community-based cross-sectional study was conducted on 434 women aged 15–49 years who gave birth from September 2010 to August 2011. Primary data were collected using pretested close-ended structured questionnaire. The collected data was checked for completeness before being entered into the SPSS software for analysis. The data was then loaded into SPSS version 16 to recode, clean, and recheck missing data values, as well as prepare for descriptive and inferential analysis to investigate factors related to skilled birth attendant utilization.
Results
Response rate of the studied women was 100%. Only11.5% of the women had skilled birth attendance during their recent delivery; and this was overall significantly associated (P = 0.001) with variables include: educational status of (women, husband, children), income, distance to health facility, having health post nearby to village, frequency of visits from HEWs/health workers, advice during antenatal care, access to maternal health information, unfavorable perception toward health workers and health facilities. The inferential findings of the logistic regression model with the predictors were statistically significant [X2 = 259.731(df = 24, n = 434) and P = 0.001]. Moreover, the Hosmer-Lemeshow test provided evidence of well fitted of the predictors (X2= 2.078, p = 0.979).
Conclusion
Skilled birth attendance utilization in the study district is low as that of the Ethiopian Demographic and Health Surveys 2011 report for Ethiopia and Tigray; and it was lagging behind more than 7 times to achieve skilled birth attendance utilization target of the 5th MDG. Factors associated with low skilled birth attendance utilization need to be addressed at demand and supply side.