bluuebunny/crossref_metadata_2025 huggingface dataset:
Saudi Billing System: designing a standardized health insurance billing system in Saudi Arabia to support a national health system transformation
Authors: Reka Husein , Mazevska Deniza , Pearse Jim , Maghrabi Abdullah Al , Young Susan E. , Ghamdi Shabab Al
Published: November 2023

Background The Saudi health transformation program entails a comprehensive reform of all health system functions. One of the pillars of this reform is the health care financing transformation. The Council of Health Insurance (CHI) aims to bring more transparency and understanding of case-mix through the introduction of patient classification and data standardization. Until recently, the private health insurance sector was using a variety of in-house non-standardized billing codes that impeded transparency and a value-based health care (VBHC) financing model. This study enabled the introduction of standardized billing codes known as the Saudi Billing System (SBS).
Methods We reviewed and assessed several patient classification and billing systems as part of the assessment phase, followed by data collection from eighty health care providers and the three largest health insurance companies, resulting in more than two million patient encounters for data analysis. A representative sample of 36,299 patient records were re-coded. Coding was undertaken using the Australian Classification of Health Interventions (ACHI) 10th Edition. Codes were assigned based on assessment by clinical coders using an established methodology and followed by an audit to confirm the assigned code or assign an alternative code where the coding could not be adequately completed by the initial coder.
Results 75% of records were mapped to an existing ACHI code, leaving 25% being a partial match, an approximate match or other (1%, 22% and 2% respectively). As part of this process, the original ACHI codes were modified, and additional codes were added, ensuring full compatibility with billing practices. We named the new code set the Saudi Billing System (SBS). As a result of this work, we created an additional 1,774 codes, bringing the total SBS code set to 7,947 codes (30% increase from ACHI 10th Edition).
Conclusions Patient classification and standardized billing systems are critical for transparency in providing health care and financing. Working within the existing national patient classification mandate and clinical coding standards required innovative ways to adapt these systems to a private health insurance market (specificity, familiarity, existing license with modification rights and ability to build fee schedule), to address the requirements of a reformed and more value-based insurance market.
Current mandated patient classification systems are a good basis for adaptation to serve the needs of the overall health care transformation in the country and a building block towards more transparency and VBHC.
Case Report:Sarcoidosis with Peripheral neuropathy
Authors: Li Jing , Yang Sha-Sha , Xue Min , Zhang Mei
Published: November 2023

Background:Peripheral neuropathy is a broad term that encompasses various disorders of the peripheral nervous system. This includes granulomatous neuropathy and non- granulomatous small fiber neuropathy (SFN). The most prevalent clinical manifestations of granulomatous neuropathy are distal symmetric polyneuropathy and asymmetric polyradiculoneuropathy. Common causes of peripheral neuropathy include glycometabolic disturbance, infection, inflammation, and intoxication. However, cases of sarcoidosis are rare.
Case Presentation: A 58-year-old female driving instructor with no previous medical history presented to the hospital with initial numbness in her left foot, followed by numbness and weakness in her right foot and both feet. A month later, she experienced bilateral numbness below the wrist. The patient underwent a lumbar puncture and further testing for auto-antibodies in both the cerebrospinal fluid (CSF) and serum. The results showed negative findings for seventeen antibodies related to peripheral neuropathy and Anti-MAG antibody. Enhanced chest CT revealed multiple swollen lymph nodes in the neck, mediastinum, and bilateral hilar area. Ultrasonography also confirmed enlarged lymph nodes in the bilateral supraclavicular, subclavian region, and mediastinum. Electromyography (EMG) and Nerve conduction studies (NCS) indicated asymmetric motor and sensory polyneuropathy. Additionally, the histological examination of a supraclavicular lymph node revealed characteristic non-caseating granulomas (NCG).
Conclusion:This case report highlights the potential of peripheral neuropathy as a clinical manifestation of sarcoidosis. It emphasizes the importance of considering sarcoidosis as a possible diagnosis in patients presenting with peripheral neuropathy, thereby contributing to increased knowledge and reducing the risk of misdiagnosis.
Mapping the immunopeptidome of seven SARS-CoV-2 antigens across common HLA haplotypes
Authors: Braun Asolina , Rowntree Louise , Huang Ziyi , Pandey Kirti , Thuesen Nikolas , Li Chen , Petersen Jan , Littler Dene , Raji Shabana , Nguyen Thi , Lange Emma Jappe Lange Jappe , Persson Gry , Klausen Michael Schantz , Kringelum Jens , Chung Shan Zou , Croft Nathan , Faridi Pouya , Ayala Rochelle , Rossjohn Jamie , Illing Patricia , Scull Katherine , Ramarathinam Sri , Mifsud Nicole , Kedzierska Katherine , Sørensen Anders , Purcell Anthony
Published: November 2023

Most COVID-19 vaccines have been designed to elicit immunity against the SARS-CoV-2 Spike protein. However, the repeated occurrence of new strains harbouring Spike protein mutations demonstrates ready immune evasion by the SARS-CoV-2 virus and the pressing need to develop more broadly targeting COVID-19 vaccines. To facilitate this, we used mass spectrometry to identify immunopeptides that are derived from seven structural and non-structural SARS-CoV-2 proteins that are relatively conserved across viral strains (N, E, Nsp1, Nsp4, Nsp5, Nsp8, Nsp9) and presented by prevalent Human Leukocyte Antigen (HLA) class I and class II molecules. Two different B-lymphoblastoid cell lines were chosen to map immunopeptidomes covering some of the major HLA types across the global human population. We used DNA plasmid transfection and direct antigen delivery approaches to sample different antigens. We found 248 unique HLA class I and HLA class II bound peptides with 71 derived from N, 12 from E, 28 from Nsp1, 19 from Nsp4, 73 from Nsp8 and 45 peptides derived from Nsp9. Over half of the viral peptides are reported for the first time. T cell responses were tested for 56 of the detected peptides and we show robust CD8+ and CD4+ T cell responses against several peptides from the N, E and Nsp9 proteins. Results from this study will aid the development of next-generation COVID vaccines targeting epitopes from across a number of SARS-CoV-2 proteins.
Development and validation of a nomogram for predicting sepsis-associated encephalopathy in ICU patients
Authors: Jin Jun , Zeng Mian , Zhou Qingshan , Yu Lei
Published: November 2023

Background: Sepsis-associated encephalopathy (SAE) is associated with systemic inflammation caused by sepsis. It is estimated that a majority of sepsis patients develop severe acute effects (SAE) during their stay in the intensive care unit (ICU), and a significant number of survivors have persistent cognitive impairment even after they have recovered from the illness. The aim of this study was to develop a useful predictive nomogram for patients with ICU sepsis and screen for SAE risk factors.
Methods: We conducted a retrospective cohort study using the Medical Information Mart for Intensive Care IV (MIMIC-IV) database, defining SAE as a Glasgow Coma Scale (GCS) score of ≤15 or delirium. We randomly divided patients into training and validation cohorts, and used least absolute shrinkage and selection operator (LASSO) regression modeling to optimize feature selection. The independent risk factors were determined through a multivariable logistic regression analysis, and a prediction model was built. Nomogram performance was evaluated using the area under the receiver operating characteristic curve (AUC), calibration plots, Hosmer-Lemeshow test, decision curve analysis (DCA), net reclassification improvement (NRI) and integrated discrimination improvement (IDI).
Results: Among 4476 sepsis patients screened, 2781 (62.1%) developed SAE. In-hospital mortality was higher in the SAE group than in the non-SAE group (9.5% vs 3.7% p<0.001). A number of variables were screened, such as the patient's age, gender, BMI on the first day of admission, the mean arterial pressure, the body temperature, the platelet count, the sodium level, and the use of midazolam. The variables that were assessed encompassed the patient's age, gender, BMI upon admission, initial mean arterial pressure, body temperature, platelet count, sodium level, utilization of midazolam, and SOFA score. These were used to construct and validate a nomogram. Comparisons between the nomogram's AUC, NRI, IDI, and DCA with those of the conventional SOFA score in conjunction with delirium revealed superior performance. The nomogram's calibration plots and the results of the Hosmer-Lemeshow test indicated accurate calibration. Enhanced NRI and IDI values demonstrated that our scoring system surpassed traditional diagnostic approaches. Furthermore, the DCA curve indicated favorable clinical applicability of the nomogram.
Conclusion: This study identified independent risk factors for the development of SAE in sepsis patients and used them to construct a predictive model. The findings of this study can provide a clinical reference for the early diagnosis of SAE in patients.
Genetic confounding in health disparities research
Authors: Gupta Sonali , Sharma Shivam , Jordan I. King , Mariño-Ramírez Leonardo
Published: November 2023

Background
Health disparities are defined as health differences that adversely affect socially disadvantaged populations, and health disparities research is focused primarily on social and environmental determinants of health. We hypothesized that unmeasured genetic differences between population groups are likely to be a major source of hidden confounding for observational studies of health disparities.
Results
Our study cohort consisted of 26,912 UK Biobank participants from Asian, Black, and White ethnic groups. We analyzed outcomes for 1,536 diseases and discovered numerous health disparities that affect socially disadvantaged Asian and Black UK ethnic groups. We modeled outcomes for the top twenty Asian-White and Black-White health disparities using genetic and socioenvironmental risk factors to test for genetic confounding. We found that genetic diversity and differences in socioenvironmental risk factors are correlated between UK ethnic groups and demonstrate how genetic confounding can lead to spurious associations between social disadvantage and genetically influenced disease disparities. Specifically, inclusion of genetic data in disease risk models attenuates the effect of socioeconomic deprivation (SED) on most of the top health disparities, including spurious associations of SED with sickle cell disease and skin cancer. Moreover, comparisons of disease models with SED alone versus models with SED and genetic data together indicate that all the top health disparities analyzed here are more accurately modeled when genetic confounders are included.
Conclusions
Our results support an integrated approach to health disparities research that incorporates genetic, social, and environmental data whenever possible.
High transmission of endemic human coronaviruses before and during the COVID-19 pandemic in adolescents in Cebu, Philippines
Authors: Joseph Janet O. , Ylade Michelle , Daag Jedas Veronica , Aogo Rosemary , Crisostomo Maria Vinna , Mpingabo Patrick , Premkumar Lakshmanane , Deen Jacqueline , Katzelnick Leah
Published: November 2023

Background.
SARS-CoV-2, the causative agent of COVID-19, is a betacoronavirus belonging to the same genus as endemic human coronaviruses (hCoVs) OC43 and HKU1 and is distinct from alpha hCoVs 229E and NL63. In a study of adolescents in the Philippines, we evaluated the seroprevalence to hCoVs, whether pre-pandemic hCoV immunity modulated subsequent risk of SARS-CoV-2 infection, and if SARS-CoV-2 infection affected the transmission of the hCoVs.
Methods.
From 499 samples collected in 2021 and screened by SARS-CoV-2 receptor binding domain (RBD) enzyme-linked immunosorbent assay (ELISA), we randomly selected 59 SARS-CoV-2 negative and 61 positive individuals for further serological evaluation. We measured RBD and spike antibodies to the four hCoVs and SARS-CoV-2 by ELISA in samples from the same participants collected pre-pandemic (2018–2019) and mid-pandemic (2021), before COVID-19 vaccination.
Results.
We observed over 72% seropositivity to the four hCoVs pre-pandemic. Binding antibodies increased with age to 229E and OC43, suggesting endemic circulation, while immunity was flat across ages for HKU1 and NL63. During the COVID-19 pandemic, antibody level increased significantly to the RBDs of OC43, NL63, and 229E and spikes of all four hCoVs in both SARS-CoV-2 negative and positive adolescents. Those aged 12–15 years old in 2021 had higher antibodies to RBD and spike of OC43, NL63, and 229E than adolescents the same age in 2019, further demonstrating intense transmission of the hCoVs during the pandemic.
Conclusions.
We observe a limited impact of the COVID-19 pandemic on endemic hCoV transmission. This study provides insight into co-circulation of hCoVs and SARS-CoV-2.
The Impact of Acupuncture on The Brain Function of Patients With Mild to Moderate Depressive Disorders: A Study Protocol
Authors: Yang Bin , Miao Runqing , Wang Tianyu , Zhu Fengya , Li Wuyu , Liu Yang , Wu Jie
Published: November 2023

Introduction:
Depressive disorders are common mental disease that significantly impact the daily lives of those affected. Acupuncture has shown promising therapeutic effects in the treatment of depressive disorders, but its underlying mechanisms remain unclear. This study aims to evaluate the therapeutic effects of acupuncture on mild to moderate depressive disorders and its influence on the brain function of patients with mild to moderate depressive disorders.
Methods
This study plans to recruit 118 participants, who will be randomly allocated to either the acupuncture group or the sham acupuncture group in a 1:1 ratio. Both groups will undergo 8 weeks of treatment, consisting of three sessions per week, with each session lasting for 30 minutes. A follow-up period of 3 months will be conducted after the treatment. Assessments will be conducted at weeks 0, 8, 12, 16, and 20 in this study. The primary outcome measure will be self-rating depression scale (SDS), while secondary outcome measures will include the self-rating anxiety scale (SAS), quality of life scale (SF-36), traditional Chinese medicine syndrome score, symptom elimination rate and functional near-infrared spectroscopy (fNIRS) brain imaging.
Discussion
While acupuncture has been confirmed to have a certain degree of therapeutic efficacy in the treatment of depressive disorders, research on the mechanisms underlying acupuncture's treatment of depression remains limited, particularly with regards to its impact on the brain function of individuals with depression. This study aims to explore both the clinical effectiveness and treatment mechanisms of acupuncture for depressive disorders, with a specific focus on its influence on brain function. This research endeavors to provide new insights into the potential of acupuncture as a therapeutic approach for the treatment of depression in the future.
Oral Microbiota and Porphyromonas Gingivalis Kgp Genotypes Altered in Parkinson’s Disease with Mild Cognitive Impairment
Authors: Li Dongcheng , Ren Tengzhu , Li Hao , Huang Mingdi , Chen Jiaxin , He Qishan , Lv Wei , Liu Hailing , Xu Renshi , Zhang Xiong
Published: November 2023

Cognitive impairment (CI) is a common complication of the non-motor symptoms in Parkinson’s disease (PD), including PD with mild cognitive impairment (PD-MCI) and PD dementia. Recent studies reported the oral dysbiosis in PD and CI, respectively. Porphyromonas gingivalis (P. gingivalis), a pathogen of oral dysbiosis, play an important role in PD, whose lysine-gingipain (Kgp) could lead to AD-type pathologies. No previous study investigated the composition of oral microbiota and role of P. gingivalisin PD-MCI. This study aimed to investigates the differences of oral microbiota composition, P. gingivalis copy number, and Kgp genotypes among PD-MCI, PD with normal cognition(PD-NC) and periodontal status-matched control (PC) groups. The oral bacteria composition, the copy number of P. gingivalisand the Kgp genotypes in gingival crevicular fluid from PD-MCI, PD-NC, and PC were analyzed using 16S ribosomal RNA sequencing, quantitative real-time PCR, and MseⅠ restriction. We found that the structures of oral microbiota in PD-MCI group were significantly different compared to that in PD-NC and PC group. The relative abundances of Prevotella, Lactobacillus, Megasphaera, Atopobium and Howardella were negatively correlated with cognitive score. Moreover, there was a significant difference of Kgp genotypes among the three groups. The predominant Kgp genotypes of P. gingivalis in the PD-MCI group was primarily Kgp Ⅱ, whereas in the PD-NC group was mainly Kgp Ⅰ. The Kgp Ⅱ correlated with lower MMSE and MoCA scores, suggested that PD-CI may be related to Kgp genotypes Ⅱ.
Why are star dunes rarely recognised in the rock record?
Authors: Bristow Charles , Duller Geoff
Published: November 2023

Star dunes are the tallest dunes on Earth and are amongst the largest and most spectacular dynamic landforms. Although they are widespread in modern sandy deserts star dunes are rarely recognised in the rock record probably due to a lack of suitable models. This stratigraphic study of a star dune in the Sahara Desert shows that the dune has developed recently and grown rapidly to create a 100 m high dune within the past thousand years. At the base of the dune there is a period of around eight thousand years that appears to lack sand accumulation, probably due to stabilization of the dunes during the African humid period (AHP). The star dune accumulation post-dates the end of the AHP. We present a new model for the structure of a star dune based on a geophysical and geochronological investigation. Individual structural features in star dunes are similar to those from linear or barchanoid dunes, likely leading to misidentification in the rock record, but the suite of features we describe will permit identification of star dunes in future studies of the rock record.
Identification and Experimental Validation of Genes Associated with Programmed Cell Death in Dendritic Cells of the Thyroid Tissue in Hashimoto's Thyroiditis
Authors: Yang Dongyu , Wang Xichang , Sun Ying , Shao Ying , Shi Xiaoguang
Published: November 2023

Introduction:
Hashimoto's thyroiditis (HT) is a chronic autoimmune disorder. Being antigen-presenting cells, dendritic cells induce various types of programmed cell death (PCD), resulting in immune disorders. This study aimed to identify genes associated with various PCD pathways in dendritic cells within the thyroid tissue of HT patients.
Methods
We downloaded the single-cell RNA-sequencing dataset HRA001684 from the National Genomics Data Center (NGDC) database to calculate the area under the curve (AUC) scores for PCD-related genes. We obtained the mRNA sequencing datasets GSE138198 and HRA001684 from Gene Expression Omnibus and NGDC, respectively. Differentially expressed genes (DEGs) were identified by comparing the normal and HT groups in GSE138198 and HRA001684. The intersection of these DEGs with PCD-related genes led to the identification of 17 PCDDEGs.
Results
The AUC scores showed that dendritic cells exhibited significantly high levels of necroptosis, ferroptosis, pyroptosis, autophagy, and PANoptosis and expressed six PCDDEGs: TNFAIP3, CYBB, PTPN6, STAT1, TGFB1, and NLRP3. These genes displayed an AUC > 0.8 for HT in the GSE29315, GSE138198, and HRA001684 datasets and clinical thyroid samples, confirming their diagnostic accuracy. Moreover, their expression was positively correlated with the serum levels of thyroid peroxidase and thyroglobulin antibodies. Finally, all PCDDEGs were inversely associated with thyroid follicular epithelial cells.
Discussion
These findings suggest that dendritic cells play a crucial role in mediating PCD within the thyroid tissues of HT patients. Moreover, TNFAIP3, CYBB, PTPN6, STAT1, TGFB1, and NLRP3 may crucially contribute to the pathogenesis of HT through PCD pathways.
Diagnostic Efficiency of Myocardial Work Indexes in Determining Myocardial Viability in Patients With Acute St-elevation Myocardial Infarction (Stemi): a Diagnostic Test Study.
Authors: CUEVAS LUIS FERNANDO MORENO , ZERTUCHE DIANA ROMERO , MARQUEZ HORACIO GARCIA , RODRIGUEZ ERICK SANCHEZ , GUZMAN GABRIELA RODRIGUEZ , DUARTE SILVIA KARINA MARMOLEJO , CUENCA JESSICA JOCELYN AMADOR , MONTECINOS ALEJANDRO BECERRIL GONZALEZ , RUIZ LUIS ANTONIO MORENO
Published: November 2023

Purpose
To describe the diagnostic accuracy of myocardial work indices to identify myocardial viability in patients with STEMI and LVEF < 45%.
Methods
We studied 49 patients with STEMI and an ejection fraction < 45%. All of them underwent a myocardial viability study with cardiovascular magnetic resonance (CMR) using late gadolinium enhancement (viable tissue was defined as the presence of late enhancement < 50% of the myocardial thickness). At the same time, myocardial work indices were measured to identify the best cutoff point to determine viability, using CMR as the gold standard. We generated ROC curves and then calculated the sensitivity, specificity, and predictive values.
Results
Global constructive work had the best accuracy in the diagnosis of viability (AUC: 0.96. Specificity: 79%. Sensitivity: 97%, for a cutoff point > 786 mmHg%), compared with the Global Work Index (AUC: 0.96 Specificity: 91% Sensitivity: 79% at cutoff point > 664 mmHg%) and Global Myocardial Efficiency (AUC: 0.83 Specificity: 89% Sensitivity: 64% at a cutoff point > 75%); moreover, GCW was better than global longitudinal strain and biplanar ejection fraction of the left ventricle.
Conclusion
Myocardial work indices can detect viable myocardial tissue in patients with STEMI and left ventricular dysfunction with an acceptable degree of diagnostic accuracy.
A synchronous atmosphere-cryosphere-land response to climate on the northern Antarctic Peninsula since the mid-Holocene
Authors: Evangelista Heitor , Verkulich Sergei , Mavlyudov Bulat , Echer Mariza P. , Licinio Marcus Vinicius , Dercon Gerd , García-Rodríguez Felipe , Neto Arthur A. , Kusch Stephanie , Abuchacra Rodrigo C. , Oaquim Anna B.J. , Gonçalves Sérgio J. , Pushina Zinaida , Shimizu Marília H , Heiling Maria , Slaets Johanna , Resch Christian , Castillo Alejandra , Gruber Roman
Published: November 2023

West Antarctica plays a pivotal role in sea level rise in projected scenarios with global socioenvironmental and economic consequences. Therefore, describing its recent and past climate history and changes is essential for identifying the main climate controls and past responses. To better understand the climatic sensitivity of this region, we analyzed sedimentary records from newly surveyed proglacial lacustrine profiles dated from the middle Holocene to the present on the North Antarctic Peninsula. We combined atmosphere-glacier-land databases that evidenced a close coupling among these compartments during intense melting events. Our analyses furthermore suggest that a short Neoglacial phase from ∼2,000 kyr BP until the onset of the 20th century was possibly influenced by a combined long-term decline in total solar irradiance, Andean volcanism and ENSO.
Value of glycemic dispersion index in predicting major adverse cardiovascular events in diabetic patients with concomitant acute coronary syndrome
Authors: Shi R , Feng L , Xu WB , Ye D , Luo BB , Liu YM , Cao HY , Tang LT
Published: November 2023

Objective: This investigation aims to assess the predictive value of the glycemic dispersion index (GDI), calculated by incorporating glycated hemoglobin, fasting plasma glucose, and 2-hour postprandial plasma glucose, in predicting major adverse cardiovascular events (MACE) within a 12-month timeframe for diabetic patients with concomitant acute coronary syndrome (ACS).
Methods A total of 3261 diabetic patients diagnosed with ACS were selected from the Department of Cardiology, the Sixth Affiliated Hospital of Kunming Medical University, between January 2016 and July 2022. A thorough screening process was conducted, resulting in the inclusion of 512 patients based on the predefined exclusion criteria. Comprehensive clinical data and laboratory examination indicators were collected for all included patients. Subsequently, a follow-up was carried out for 12 months, with the last follow-up being concluded on July 31, 2023. During this period, the occurrence of MACE was meticulously recorded for each enrolled patient. Based on the GDI calculated for the enrolled patients, they were divided into quartile groups. A comparative analysis was performed to evaluate the clinical data and laboratory indicators among these groups. Additionally, the incidence of MACE in each quartile group was calculated. To further identify the risk factors associated with MACE in diabetic patients with concomitant ACS, COX proportional hazards regression analysis and Kaplan-Meier survival analysis were conducted. Finally, the cumulative risk of MACE over time was compared among the different study groups.
Results The patients included in the study were sorted into four groups, Q1, Q2, Q3, and Q4, according to their GDI levels, from lowest to highest. The respective proportions of MACE in the Q1 to Q4 groups were 10.16%, 12.50%, 15.63%, and 16.41%. GDI, STEMI, TC, TG, LDL, and hs-CRP independently predicted the hazards for MACE in diabetic individuals with ACS. The cumulative risk of MACE over time was considerably more significant in those with a GDI > 4.21 than those with a GDI ≤ 4.21.
Conclusion The elevated GDI is correlated with an augmented risk of MACE in diabetic patients with concomitant ACS, thereby serving as an early indicator for assessing the unfavorable clinical prognosis of patients.
Spatial model of groundwater contamination risks from pit-latrines to 2070: Case Study Malawi
Authors: Hinton Rebekah , Kalin Robert , Kanjaye Modesta , Mleta Prince , Macleod Christopher , Troldborg Mads
Published: November 2023

Pit-latrines are central to achieving SDG6, “clean water and sanitation for all”. Unless safely managed, pit-latrines result in groundwater contamination, which increases morbidity and mortality. Despite this, there have been no long-term spatial projections of future pit-latrine contamination risks. National survey data of over 100,000 water-points and 260,000 pit-latrines in Malawi was used to generate a novel, high-resolution model of pit-latrines from 2020–2070 under 5 population, and 3 sanitation policy, scenarios. The ‘business as usual’ model predicts a three-fold increase in the number of water-points at risk of microbial pit-latrine contamination between 2020–2070, with a seven-fold increase in the highest contamination risks. Current nitrogen loading into pit-latrines is comparable to national fertiliser application. The model predicts 8.2 mega-tonnes of faecal nitrogen will be disposed of into subsequently abandoned pit-latrines between 2020–2070. Guided intervention is necessary to prevent SDG6’s push for sanitation undermining its goal of clean water.
Detection and characterization of Deformed wing virus (DWV) in apiaries with stationary and migratory management in the province of Entre Ríos, Argentina
Authors: Gonzalez Fernanda Noemi , Raticelli Fabricio , Ferrufino Cecilia Gabriela , Fagúndez Guillermina , Rodriguez Graciela Adriana , Miño Samuel , Santos Maria Jose Dus
Published: November 2023

The deformed wing virus (DWV) is a highly prevalent pathogen that affects honeybees and is associated to colony losses. In Argentina, the Entre Rios province possesses a floral diversity that allows beekeepers to perform migratory or sedentary management. The aim of this work was to investigate the effect of both types of management on the prevalence and abundance of DWV and to characterize the DWV variant present in the study area. In migratory apiaries, 86.2% of the colonies gave a detectable result to DWV at the beginning of the season (September 2018), and 62% at the end of the season (April 2019). On the other hand, DWV was detected in 44.12% and 62% of sedentary samples, at the beginning and at the end of the season, respectively. The highest viral loads were obtained from migratory samples collected in September. DWV presence and abundance were associated with migratory management and the time of sampling. The virus was also detected in the brood, mites and pollen from the brood frame. Sequence analysis from migratory and sedentary samples revealed a unique DWV variant (DWV-A). Migratory activity has become a common approach to maximize honey production. However, this practice has negative consequences for colony health and susceptibility to DWV.
Comparison of factors affecting turnover intention by job field in biopharmaceutical industry in Korea: A questionnaire-based study
Authors: Cho Ae-Ryeo , Park Jungtae , Kwon Sun-Hong , Choi Jeong-min , Yu Wonsang Robert , Ha Dongmun , Lee Eui-Kyung
Published: November 2023

Background
Excessive turnover in the biopharmaceutical industry can negatively impact public health and corporate management. This study aims to determine the difference in turnover intention by job field and compare the factors affecting it.
Methods
An online self-report survey was administered to employees working in the production, sales/marketing, and clinical/regulatory affairs fields of biopharmaceutical companies in Korea from September 1 to October 31, 2020. The questionnaire addressed sociodemographic, constructs but also job, organization, and personal-related factors, as well as turnover intention. The difference in turnover intention by job field was confirmed by using the analysis of variance test. Multivariate regression analysis was performed to identify the factors affecting turnover intention by job field.
Results
A total of 529 employees responded to the questionnaire, and 500 cases were analyzed after discarding 29 cases with missing data. Turnover intention differed according to job field (p < 0.001), and production was the highest. In the production field, the higher both the satisfaction with the supervisor (β = -0.326, p-value = 0.005), the lower the turnover intention. Greater satisfaction with the work scope (β = -0.181, p-value = 0.01), salary (β = -0.169, p-value = 0.005) and corporate culture (β = -0.314, p < 0.001) factors showed low turnover intention for sales/marketing field, and the higher the satisfaction with the work scope (β = -0.350, p-value = 0.035), the lower the turnover intention for clinical/regulatory affairs field.
Conclusions
To reduce the turnover rate in the biopharmaceutical industry, it is necessary to develop policies that align with the unique needs of each job field. Companies should focus on increasing satisfaction with their supervisor for production field, and work scope for sales/marketing and clinical/regulatory affairs fields. Additionally, salary and corporate culture are important factors for sales/marketing field.
Intrapapillary hemorrhage with adjacent peripapillary subretinal hemorrhage of both eyes after Covid-19 infection: a case report
Authors: Wang Yifan , Chen Hong , Yuan Lifei , Fan Yijia , Liang Yilei , Zhang Haiyu , Dang Ziyao , Wang Lifei
Published: November 2023

Background
Intrapapillary hemorrhage with adjacent peripapillary subretinal hemorrhage is commonly observed in myopia with tilted optic disc. It presents with typical features on the fundus and follows a self-limiting course. However, due to its complex etiology, clinicians sometimes lack sufficient understanding of it which can easily lead to misdiagnosis or overtreatment. In this case report, we describe a rare case of intrapapillary hemorrhage with adjacent peripapillary subretinal hemorrhage in both.
Case presentation:
An 18-year-old female who has no past medical history experienced a sudden occlusion of the anterior visual field in the right eye for the past 2 days after a 5-day history of COVID-19 infection. The best corrected visual acuity is 0.5 in the right eye and 0.6 in the left eye. Optical coherence tomography (OCT) showed tilted optic discs in both eyes, bulged nasal optic discs, and the presence of strong reflective material under the parafoveal retina of the optic discs. Fundus fluorescein angiography (FFA) showed subretinal fluorescence occlusion above and nasolateral to the optic disc in the right eye, with hypofluorescence below the optic disc; the subretina below the optic disc was obscured by vitreous hemorrhage; hypofluorescence was seen in the optic disc region of the left eye.COVID-19 antigen was positive. The patient was in the early stage of the third COVID-19 infection when the disease occurred. We speculate that it may be related to it. After 5 months of conservative treatment, the patient's hemorrhage disappeared in both eyes and her best corrected visual acuity returned to normal.
Conclusions
Intrapapillary hemorrhage with adjacent peripapillary subretinal hemorrhage usually occurs in myopia with tilted optic disc. In most patients, the cause of the bleeding is unknown, but it can gradually resolve under clinical observation or conservative treatment.
Evaluation of grape genotypes for seedlessness and other agronomic traits as expressed under subtropical conditions for their potential role as donor parents
Authors: Jadhav Amol Kailas , Singh Sanjay Kumar , Verma Mahendra Kumar , Srivas Manish , Kumar Chavlesh , Mhetre Vishal Balasaheb
Published: November 2023

The present investigation was conducted from 2021 to 2022 in subtropical north India under New Delhi conditions by evaluating 12 grape accessions to assess the phenotypic and genetic variability across various horticultural traits. Notably, the genotypes exhibited significant variations in bunch weight, size, density, and berry traits, such as weight, shape, and seed presence. Seedless grapes, in particular, demonstrated superior bunch weight and size, with bunch weight ranging from 94.10 g (genotype Pearl of Csaba) to 325.67 g (genotype Perlette) and substantial variations in bunch size, too. For berry characteristics, the range extended from 1.37 g (genotype Beauty Seedles) to 3.57 g (genotype Pusa Aditi), with seeded genotypes displaying the largest berries. Physio-chemical analysis indicated that seedless grapes typically had higher total soluble solids (TSS) and acidity, although exceptions existed among the individual genotypes. The new hybrid genotype Pusa Purple Seedless exhibited the highest TSS (19.96 0B), while Beauty seedless had the lowest TSS (16.08 0B), with significant variations in pulp acidity and juice percentage across the genotypes. Based on seed or seed trace fresh weight anaysis, progenies were classified into four classes: completely seedless, semi-seedless, semi-seeded, and completely seeded. These categories were defined by the number of seed remnants per berry (ranging from 0.03 to 2.25), dry matter percentage (ranging from 30.82 to 60.53%), and average fresh seed trace weights (13.10, to 45.40 mg). Additionally, phenotypic and genetic correlations demonstrated positive associations between berry and seed traits with correlation coefficients ranging from r = 0.67 to 0.93 for specific traits. However, some negative correlations (r = -0.21 to -0.90) between berry and bunch size, TSS, Titratable acidity, and juice content were observed with certain traits. Principal Component Analysis identified key traits contributing to genetic diversity, which can be a valuable for seedless breeding programs in sub-tropical regions of India.
Effect of microalgae feed supplementation on growth performance and feeding efficiency of tilapia fry
Authors: Sorokin Boris , Gusev Evgeniy , Namsaraev Zorigto , Emelianova Anna , Patova Elena , Novakovskaya Irina , Vinokurov Vladimir , Kuzmin Denis
Published: November 2023

Search for novel best-performing starter feed ingredients is one of the main challenges of modern aquaculture industry. The goal of this article was to evaluate the effect of microalgae supplementation enriched with omega-3 polyunsaturated eicosapentaenoic acid and powerful antioxidant fucoxanthin on grows and performance of Red tilapia fry (Oreochromis mossambicus × Oreochromis niloticus). We formulated three experimental diets, using two strains of microalgae from our culture collection – Vischeria magna (Petersen) Kryvenda, Rybalka, Wolf & Friedl SBV-108 (class Eustigmatophyceae), rich with eicosapentaenoic acid and Mallomonas furtiva Gusev, Certnerová, Škaloudová & Škaloud SBV-13 (class Chrysophyceae), rich with fucoxanthin – and their combination. Vischeria magna SBV-108 is a new strain whose biochemical properties and growth characteristics have not been previously studied. Coppens Supreme-15 was used as control diet. The best performing was omega-3 enriched Diet 1 (10% w/w Vischeria magna), that significantly (P < 0.05) overperformed control feed on absolute growth, average growth, specific growth rate, feed conversion rate, protein efficiency ratio, protein productive value and energy productive value. Diet 3 (5% w/w Vischeria magna and 5% w/w Mallomonas furtiva) and Diet 2 (10% w/w Mallomonas furtiva) were not significantly different from control at most parameters. Generally, supplementation of feed with microalgae rich in omega-3 eicosapentaenoic acid significantly improved Red tilapia fry growth parameters and overall feed performance, while supplementation of feed with microalgae rich in antioxidant fucoxanthin was not beneficial compared to control.
Low expression of Elovl6 may involve in fat loss in white adipose tissue of cancer-associated cachexia
Authors: Jin Chenyang , Wang Shuangjie , Sui Xiangyu , Meng Qingyang , Wu Guohao
Published: November 2023

Background: Cancer-associated cachexia (CAC) arises from malignant tumors and leads to a debilitating wasting syndrome. In the pathophysiology of CAC, the depletion of fat performs a significant function. The mechanism of CAC-induced fat loss includes the enhancement of lipolysis, inhibition of lipogenesis, and browning of white adipose tissue (WAT), however, few lipid-metabolic enzymes have been reported to be involved in CAC. This study hypothesized that Elovl6, a critical enzyme for elongation of fatty acids, may involve in fat loss in CAC.
Method: Transcriptome sequencing technology was employed to identify CAC-related genes in the WAT of a CAC rodent model. Then the expression level of Elovl6 and fatty acid composition were analyzed in a large clinical sample. Elovl6 was knocked down in 3T3-L1 mouse preadipocytes to compare with wild-type 3T3-L1 cells treated with tumor cell-conditioned medium.
Result: In the WAT of patients with CAC, a significant decrease in the expression of Elovl6 was found, which correlates with the extent of body mass reduction in a linear relationship. Gas chromatographic analysis revealed an augmentation in palmitic acid (C16:0) and a reduction in linoleic acid (C18:2n6c) content in those tissue samples. Treating with tumor cell-conditioned medium, 3T3-L1 mouse preadipocytes showed a decrease of Elov16, and Elovl6-knockdown cells demonstrated reduced pre-adipocyte differentiation and lipogenesis. Likewise, the knockdown of Elovl6 in 3T3-L1 cells exhibited a significant rise in palmitic acid (C16:0) and a remarkable decrease in oleic acid (C18:1n9c) content.
Conclusion: Overall, the expression of Elovl6 was diminished in the WAT of CAC patients. The decreased expression of Elovl6 might lead to fat loss in CAC by potentially altering the fatty acid composition in adipocytes. These findings suggest that Elovl6 may be used as a valuable biomarker for early diagnosis of CAC, and hold promise as a target for future therapies.
Unravelling the Relationship between Obesity, Density, Accessibility to Public Transport and Green Spaces in Babol City
Authors: Shahmiri Mojtaba Shahabi , Khatami Seyed Mahdi , Javanian Mostafa
Published: November 2023

Due to the high rates of obesity and the lack of research on how the built environment contributes to obesity in Iran, this study aimed to investigate the relationship between density, accessibility to public transport and green spaces, obesity, and related diseases in Babol. Logistic regression was used to analyze data on health indicators such as body mass index (BMI), blood pressure, and diabetes, as well as environmental indicators including population density, residential density, accessibility to bus and taxi stations, the number of stations, the proximity to green spaces, and their proportion. The study found that living in areas with a density of over 120 people per square kilometer reduces the likelihood of being overweight or obese compared to areas with a density of 100 to 120 people. Access to green spaces within a 200-meter radius did not show a significant association with diseases. There was a weak negative relationship between the number of public transportation stations at different distances and body mass index, indicating lower levels of overweight and obesity. Changing from neighborhoods with lower residential densities to higher residential densities reduced the likelihood of developing heart disease and heart disease by about 74% and 44.4%, respectively. The presence of green spaces in neighborhoods had a weak correlation with physical activity and the reduction of obesity and related diseases. Increasing the number of taxi and bus stations from one to three within a 400-meter radius significantly reduced the likelihood of developing high blood pressure by approximately 70% and diabetes by 56.5% within a 200-meter radius. Living within a distance of less than 150 meters from the nearest public transportation station or nodal points was associated with a 51.3% lower probability of developing high blood pressure compared to living within a distance of 300 to 500 meters from public transportation stations.
Tailored Nanofluid Formulations: Enhancing Crude Oil Thermophysical Properties for Improved EOR Processes through MWCNTs and SDS Integration
Authors: Bagheri Hamid , Mousavi Seyed Borhan , Nami Shamin Hosseini , Heris Saeed Zeinali
Published: November 2023

This research delved into the effects of introducing multi-walled carbon nanotubes (MWCNTs) and sodium dodecyl sulfate (SDS) into crude oil with an anionic base, aiming to enhance its thermophysical attributes in the EOR process. The investigation encompassed a range of properties, including interfacial tension, viscosity, density, and electrical conductivity, measured using an LV rheometer with spindle 18. Various ratios of MWCNTs and SDS were mixed with the crude oil to evaluate their impacts. The study uncovered that the 1:1 ratio of MWCNTs to SDS achieved a noteworthy 10% reduction in interfacial tension while minimally affecting viscosity, showing promise for practical applications. Temperature had diverse effects on viscosity and interfacial tension, displaying fluctuating trends. The highest observed result was a substantial 190% viscosity increase at 40°C with a 2:1 ratio, whereas the lowest was a slight − 0.81% density change at 60°C for the 1:1 ratio. Additionally, interfacial tension consistently decreased over time for all ratios at various temperatures, with the most significant reductions observed at 40°C and 60°C, particularly for the 1:2 and 1:1 ratios. Furthermore, adding MWCNTs and SDS led to a remarkable drop in electrical conductivity, indicating a substantial decrease in salt content within the crude oil. However, it was noted that higher MWCNT concentrations might not be cost-effective, emphasizing the importance of optimizing additive ratios for a balance between performance and economic viability. This study highlights the potential of tailored nanofluid formulations to improve the thermophysical properties of crude oil, potentially enhancing extraction and refining processes.
Characteristics and medical practices of hospitalized patients with anti-N-methyl-D-aspartate receptor encephalitis associated with ovarian teratoma in Japan: a retrospective cohort study
Authors: Aoyama Yoko , Kinjo Yasuyuki , Hoshino Kaori , Harada Hiroshi , Ueda Taeko , Kurita Tomoko , Yoshino Kiyoshi , Matsuda Shinya
Published: November 2023

Background
The incidence of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis and the proportion of patients with ovarian teratoma with complications are unclear. The proportion of those who become severely ill and the percentage of those undergoing medical treatment for severe cases are also unknown. Therefore, in this study, we aimed to investigate the characteristics and medical practice of hospitalized patients with ovarian teratomas complicated by NMDAR encephalitis in Japan.
Results
Patients with ovarian teratoma and encephalitis had a lower median age than those without encephalitis. The group with ovarian teratoma complicated with anti-NMDAR encephalitis was more likely to be transported by ambulance and had more transfers from other hospitals than the group without the complication. Among the target hospitalized patients, the 15 − 19 age group had the highest incidence rates. The median age was lower for steroid pulse therapy, intravenous immunoglobulin therapy, and plasma exchange therapy in that order. Additionally, younger patients underwent more invasive treatments.
Conclusion
Anti-NMDAR encephalitis associated with ovarian tumors often occurs in young people in their late teens and 20s, and younger patients are more likely to be severely ill.
Mast cell-derived TSLP triggers an allergic response, thereby suppressing the early stage of melanoma development
Authors: Kim Hee-Yun , Rah So-Young , Kang Ho-Geun , Kim Hyung-Min , Jeong Hyun-Ja
Published: November 2023

An allergic reaction is a hypersensitive immune reaction. Patients with allergic disorders have a lower incidence of certain cancers. Nevertheless, the role and underlying detailed mechanisms of allergic reaction in cancer development remain obscure. We sought to investigate the role of mast cell-mediated allergic reaction in the early stage of melanoma development. B16F10 melanoma-bearing animal models and in vitro models were used to examine the function and precise mechanism of mast cell-mediated allergic reactions in the melanoma development. Here, we revealed that mast cell-mediated allergic reaction caused autophagy and apoptosis in melanoma by raising thymic stromal lymphopoietin (TSLP) levels, resulting in improved survival of tumor control mice. Targeted depletion of TSLP decreased survival in tumor control mice, whereas TSLP injection increased survival through boosting allergic responses. Single-cell RNA sequencing analysis revealed that TSLP decreased the number of melanocytes, increased the number of T cells, and raised the levels of mast cell-derived allergy-promoting factors compared to tumor control. Moreover, TSLP enhanced the immune response and allergic reactions in immunodeficient mice, resulting in the suppression of melanoma development. Coincidently, patients with melanoma had lower serum levels of TSLP than healthy individuals. Furthermore, in vitro stimulation of melanocytes with mast cell-derived TSLP prompted apoptosis of melanoma by inducing the autophagy. Therefore, our findings suggest that mast cell-derived TSLP directly/indirectly suppressed the early stage of melanoma development by enhancing immunity through triggering allergic reactions.