bluuebunny/crossref_metadata_2025 huggingface dataset:
Constructing A Business Model for Islamic Digital Pension Fund: Depth Think Case Study from INTERDAP and Malaysia
Authors: Huda Fahmi Alamil , Kurnia Andiyani
Published: April 2023

The objective of this paper is to redesign the Indonesian pension fund’s business model, management system, and new strategies to balance adequate profits, affordability, and sustainable programs. Consider the Malaysian pension system and adapt the INTERDAP application used by PT. Angkasa Pura II. Through this qualitative case study, we applied the foundations of the Triangle Sharia Justice Ecosystem (TSJE); Sharia, digitized the system, and supported green investment in the long run. By modeling the business strategy, facilitating the business model and supplier relationship management, and creating mutually beneficial management among stakeholders. The study found that Malaysia’s pension system has an investment purpose. Indonesia, on the other hand, provides pension loans only based on previously agreed cumulative contributions. Malaysia encourages people across the country to save on severance funds. The pension system is still managed conventionally. Malaysia requires a pension contribution of 23% of the employee’s base salary, while Indonesia requires only 3%. This will affect the contribution of pension funds to the GDP. Malaysia’s pension fund accounts for 60% of GDP. Besides, Indonesia is at only 6.03%. Another view is, to become a developed country, pension funds need to reach 60% of GDP by 2045. Because 42% of the total supply of funds in the infrastructure sector comes from pension funds. The practical implications of this study are access to information, security, and transparency in the management of pension funds through a digital system supervised by the Sharia Regulator (BPS) and the Indonesian government’s efforts to realize that supports the green economy This study integrates the foundations of the TSJE about pension funds management. The limitation of the research study is that more detailed studies and methods are needed to analyze this study. It is expected that this TSJE system will be applied further.
Predicting the risk of heatstroke: Development of a highly accurate model
Authors: Nemoto Mio , Hirabayashi Satoshi , Sato Seisho , Fujii Akihiro , Nojiri Hidetoshi , Ihara Tomohiko
Published: April 2023

High temperatures in urban areas, caused by global climate change and urban heat island intensification, have led to an increase in the number of people experiencing heat-related illnesses, the most serious of which is heatstroke. To help prevent heatstroke, an accurate model that predicts dangerous conditions should be developed to take preventive action. This study aimed to compare three methods for predicting heatstroke risk: multiple regression analysis, a generalized additive model, and time-stratified case-crossover analysis (TC). Susceptibility to heatstroke is likely to depend on year-wise trends and sensitivity to training data; however, most previous models have only tested a limited amount of training data. In this study, we investigated the optimal number of years to use as training data. The error-influencing factors in the training data were identified by comparing the errors of each method. The TC errors were the smallest (p <0.01) and were much less sensitive to the training data than the others. All three methods tended to decrease in accuracy when data from three to four years after the most recent were included. As a result, a highly accurate risk model, robust to training data, was developed using the odds ratios produced by TC with low sensitivity to training data, which was impossible with previous models. This modeling approach is universally applicable and can be used to make urban areas safer in the future.
Evaluation of the recovery rate and prevention of hospitalization among covid-19 outpatients: a randomized clinical trial comparing N-acetylcysteine with Bromhexine
Authors: Ghayour Anahita Eslami , Nazari Sasan , Keramat Fariba , Shahbazi Fatemeh
Published: April 2023

Objectives: Due to the referral of COVID-19 patients to outpatient centers in the early stages, the aim of the present study is to compare the effect of N-acetylcysteine and Bromhexine on the recovery rate and prevention of hospitalization in outpatients with COVID-19
Methodology: This study was conducted from April 2022 to September 2022. First, PCR-confirmed COVID-19 patients were divided into tree groups, one of these groups received N-acetylcysteine while the other received bromhexine and One of these groups did not receive any medication. The patients were followed up on the seventh and fourteenth days of the disease in terms of the duration of changes in oxygen saturation and recovery. The hospitalization and death of the patients were also evaluated after one month.
Results: Out of 225 studied patients, oxygen saturation was increased by 1.33% in the third visit of the patients who received N-acetylcysteine compared to their first visit. This percentage was 1.19% in the patients who received bromhexine.29.77% of the patients were admitted to the hospital and 70.23% of them had no history of hospitalization within 14 day and their mortality rate was 9.33% in control group and it was zero in both groups of patients who received drug.
Conclusions: The results of this study showed that early initiation of Bromhexine and N-acetylcysteine can effectively reduce the hospitalization rate and mortality and shorten the duration of hospitalization.
Clinical trial code: IRCT20220302054167N1 and ethics code: IR.UMSHA.REC.1400.957
Effects of program enrollment in a digital multiple health behavior change intervention on clinical outcomes
Authors: Dzubur Eldin , Yu Jessica Samantha , Hoffman Julia E , Painter Stefanie , Dama Sravanthi , James Roberta , Liu Hau
Published: April 2023

Background:
Multiple health behavior change interventions (MHBCIs) are successful for changing maladaptive behaviors related to individual chronic conditions (CC), but less is known about MHBCIs in the context of managing multiple CC. This study examined effects of enrollment on clinical outcomes in multiple remote monitoring programs, including diabetes (DM), hypertension (HTN), and weight loss (WL). 
Methods:
Participants were adults enrolled in at least one of three programs for DM, HTN, and WL with an optional mental health (MH) component; identified as “at-risk” at baseline ((A1c ≥7%, HTN ≥130/80, or BMI≥30 kg/m2); with ≥ 1 month of data available over a 12-month evaluation period. Outcomes consisted of mean blood glucose (BG), systolic blood pressure (SBP), and percent WL. Data were aggregated to the month level and mixed-effects models tested the effects of multiple program enrollment and the supplemental effect of MH enrollment on outcomes. All models controlled for demographics, time on program, baseline disease status, and engagement. 2,818 adults (55% female) were included, with mean age of 53 years (SD=10.0).  
Results:
A significant interaction was shown between time on program and multiple program enrollment for DM (B=-0.48, SE=0.29) and HTN (B=-0.42, SE=0.12) (z=-3.57, z=-3.89; ps<0.001, respectively). Each program enrollment in addition to DM was associated with a 5.8 mg/dL reduction in BG, and each program enrollment in addition to HTN was associated with a 4.8 mmHg reduction in SBP. Significant interactions were found for time on program and MH enrollment for DM (B=-1.25, SE=0.29), HTN (B=-0.81, SE=0.19), and WL (B=-0.15, SE=0.03) (z=-4.36, z=-4.25, and z=-5.27; ps<0.001, respectively). Additional enrollment in MH was associated with a reduction of 15 mg/dL in blood glucose, of 9.6 mmHg in SBP, and 1.8% WL. 
Conclusions:
Findings support the success of MHBCIs in management of CC and emphasize the supplemental effect a MH program has on improving outcomes.
Deep Learning Model for Inverse Design of Semiconductor Heterostructures with Desired Electronic Band Structures
Authors: Pimachev Artem , Neogi Sanghamitra
Published: April 2023

First-principles modeling techniques have shown remarkable success in predicting electronic band structures of materials. However, the computational costs make it challenging to use them for predicting band structures of semiconductor heterostructures, that show high variability of atomic structures. We propose a machine learning-assisted first-principles framework that bypasses expensive computations and predicts band structures from the knowledge of atomic structural features. Additionally, the framework directly connects modeling results and experimental data. For example, it accepts images obtained with angle-resolved photoemission spectroscopy as input and predicts the corresponding atomic structures. The framework leverages the physical relationship between atomic environments and bands. We demonstrate the framework using silicon/germanium based superlattices and heterostructures. Once trained on silicon-based systems, the framework can even predict band structures of gallium arsenide thin films. The physics-informed framework establishes an approach to expedite the design and discovery of complex materials with desired band structures, going beyond combinatorial approaches.
Maternal BMI Changes from the Prepregnancy to Postpartum Period are Associated with Postpartum Cardiometabolic Risk Factors: A Longitudinal Study
Authors: Zhang Huafan , Niu Jianmin , Wu Linlin , Wu Xiaoxia , Chen Yixuan , Tian Fu-Ying , Yin Aiqi , Hu Fengqiao , Tong Jianing , Huang Xuna , Wan Yanmei Wan
Published: April 2023

Purpose
To investigate the associations between the total body mass index(BMI) change at 3 or 4 years postpartum compared to the prepregnancy and cardiometabolic risk factors.
Methods
This longitudinal study included 1305 participants. Based on the total postpartum BMI changes, they were divided into < 0 units, 0-1.7 units, and > 1.7 units groups using the interquartile range. Multiple linear regression models were used to analyze the associations.
Results
Compared to the reference group, there was a progressive increase in the βcoefficient (βcoef) of homeostasis model assessment of insulin resistance (HOMA-IR) of cardiometabolic risk in the following groups: the ‘0-1.7 units’ group with the ‘high prepregnancy BMI + high gestational weight gain (GWG) trajectory’ [βcoef 0.33; 95% confidence intervals (CI): 0.22, 0.44)] or the ‘very high prepregnancy BMI + very high GWG trajectory’ [0.66; (0.45, 0.88)] and the ‘>1.7 units’ group with the ‘normal prepregnancy BMI + normal GWG trajectory’ [0.33; (0.22, 0.44)], the ‘high prepregnancy BMI + high GWG trajectory’ [0.54; (0.41, 0.67)] or the ‘very high prepregnancy BMI + very high GWG trajectory’ [0.97; (0.79, 1.15)]. However, the ‘<0 units’ group with the ‘low prepregnancy BMI + low GWG trajectory’ [0.13; (0.06, 0.21)] and the ‘0-1.7 units’ group with the ‘low prepregnancy BMI + low GWG trajectory’ [0.08; (0.03, 0.13)] had higher high-density lipoprotein cholesterol (HDL-C) level than the reference group.
Conclusion
Women with a postpartum weight gain > 1.7 units are positively associated with cardiometabolic risk factors, especially those with a high prepregnancy BMI and high GWG. Conversely, women with a postpartum weight loss > 0 units have negative association with cardiometabolic risk factors.
Utilization of low glycemic index foods and associated factors among diabetes mellitus patients in Debre Markos referral and Finote Selam hospitals, Northwest Ethiopia, 2019
Authors: Dessie Zelalem , Temesgen Habtamu , Zeleke Haymanot , Andualem Habtamu
Published: April 2023

Background
Entire populations are at risk of diseases such as diabetes. There is also limiting resources in Ethiopia to control hyperglycemia because of limited catastrophic expenditure for chronic diseases. Due to the importance of balancing blood glucose level in diabetes, low/ few glycemic foods are important to moderate blood glucose in diabetes patients.
Objectives
To assess the utilization of low glycemic index foods and associated factors among diabetes mellitus patients at Debre Markos referral and Finote Selam hospitals, Northwest Ethiopia, 2019.
Methods
Institution based cross-sectional study design was conducted. A systematic random sampling technique was used to select study participants. The data was coded and entered to Epi Data version 3.1 and exported to statistical package for social science (SPSS) version 25 for analysis. Binary logistic regression model was used for analysis. The adequacy of the final model was checked using Hosmer and Lemeshow goodness of fit test and an assumption of Binary Logistic Regression such as no multi-co linearity was checked. Both bivariable and multivariable analysis were conducted. Those variables that showed significant association at P < 0.25 were included to multivariable analysis. Variables that showed significant association at P < 0.05 with 95% CI was declared statistically significant factors of utilization of low glycemic index foods.
Results
A total of 416 diabetic patients were participated in this study with response rate of 98.5%. Among the study participants, 8.9% (95%CI: 6.3, 11.5) of the participants had good utilization of low glycemic index foods. In this study ≤ 3 Km distance from market [AOR: 3.851(95%CI: 1.262, 11.745)], informal education [AOR: 2.509 (95%CI: 1.178, 5.344)], alcohol consumption [AOR, 3.911(1.599, 9.567)], and good knowledge on low glycemic index foods [AOR: 3.354(1.091, 10.309)] were factors associated with utilization of low glycemic index foods.
Conclusion and Recommendations:
The magnitude of utilization of low glycemic index foods among diabetes mellitus patients attending follow up care service at Debre Markos referral and Finote Selam hospitals was found to be low. Distance to the market, educational status, practice of alcohol consumption, and knowledge on low glycemic index foods were found to be statistically significant with utilization level of low glycemic index foods.
Percutaneous Kyphoplasty for Osteoporotic Vertebral Compression Fractures With or Without Trauma
Authors: Wang Huazheng , Zhang Linlin , Liu Peng , Jing Chengnan , Yang Peng , Yang Shaofeng , Gan Minfeng
Published: April 2023

(1) Background: The study aims to compare the efficacy of percutaneous kyphoplasty (PKP) in the treatment of osteoporotic vertebral compression fractures (OVCFs) with or without trauma.
(2) Methods: Patients with OVCFs who have been treated with PKP from January 2020 to September 2020 were retrospectively analyzed and divided into trauma and non-trauma groups according to whether they had a clear history of trauma before onset. Before and after surgery, the two groups' oswestry dysfunction index (ODI), visual pain simulation score (VAS), vertebral kyphosis angle (Cobb angle), anterior height of damaged vertebrae, middle height of damaged vertebra, the rate of restoration of the damaged vertebra's anterior height, the rate of restoration of the damaged vertebra's middle height, and bone cement leakage rate were compared.
(3) Results: There were several significant differences in VAS or ODI scores between the two groups before , immediately after, and one year after surgery (p> 0.05). The Cobb angle and the rate of bone cement leakage were significantly lower in the non-trauma group compared to the trauma group (p< 0.05).
(4) Conclusion: Compared to patients with OVCF without trauma, patients with OVCF with trauma undergoing PKP surgery have a relatively high bone cement leakage rate, and the degree of Cobb angle recovery and the correction degree of vertebral kyphosis deformity are relatively good.
Identification of the LNC02362–EFNA5 axis as a Potential Prognosis Biomarker in Hepatocellular Carcinoma via Comprehensive Bioinformatics Analysis
Authors: Liu Yuan , Li Xiang , Li Si-Rou , Shi Jian-Hong , Shen Zhou , Liu Li-Na , Wu Fei-Xiang , Liu Ke-Liang , Ni Yan-Xing , Yang Chao-Ran , Hou Zhi-Yuan , Yang Ji-Hong , Cheng Shu-Jie , Qin Yan , Li Jinghua
Published: April 2023

Background and objectives:
Hepatocellular carcinoma (HCC) is one of the most common malignant tumors with a poor prognosis. Long noncoding RNAs (lncRNAs) are now considered as key gene expression regulators and play important roles in different types of cancer. This study aimed to identify potential lncRNAs and uncover vital molecular mechanisms guiding clinical therapy for HCC.
Methods
Based on four microarray datasets (GSE112613, GSE84004, GSE67260, and GSE101728) from the National Center for Biotechnology Information Gene Expression Omnibus (GEO) database of lncRNAs expression in patients with HCC, quantitative real-time PCR (qRT-PCR), cell transfection, cell proliferation assay, scratch wound healing, transcriptome sequencing, and immunofluorescence assays were used to analyze the clinical value and molecular mechanism of LINC02362 in HCC.
Results
High LINC02362 expression was positively correlated with longer overall survival (OS) and exhibited excellent diagnostic accuracy, suggesting that LINC02362 may inhibit HCC progression. Increased LINC02362 expression in HCC cell lines (Hep 3B and Huh 7) after lentiviral infection, overexpression of LINC02362 inhibits hepatocellular carcinoma cell proliferation, migration and invasion and then transcriptome sequencing was performed. Potential molecular LINC02362 pathways in HCC were determined using ClusterProfiler R package in enrichment analyses. Protein–protein interaction networks (PPI) were used to screen hub genes. PPI networks and OS data confirmed that EFNA5 was a downstream target positively regulated by LINC02362.
Conclusions
The LINC02362–EFNA5 axis appears to inhibit HCC progression; thus, it can be used to diagnose, prognose, and treat HCC.
Anatomy of the Fetal Membranes: Insights from Spinning Disk Confocal Microscopy
Authors: Eichholz Hannah Marie , Cornelis Alissa , Wolf Benjamin , Grubitzsch Hanna , Friedrich Philip , Makky Ahmad , Aktas Bahriye , Käs Josef A. , Stepan Holger
Published: April 2023

Purpose
The fetal membrane is essential for the maintenance of pregnancy, and its integrity until parturition is critical for both fetal and maternal health. Preterm premature rupture of the membranes (pPROM) is known to be an indicator of preterm birth, but the underlying architectural and mechanical changes that lead to fetal membrane failure are not yet fully understood. The aim of this study was to gain new insights into the anatomy of the fetal membrane and to establish a tissue processing and staining protocol suitable for future prospective cohort studies.
Methods
In this proof of principle study, fetal membranes were collected from both vaginal delivery and cesarean section. Small membrane sections were then fixed, fluorescently stained for nucleic acids, actin, and collagen, and subsequently imaged in three dimensions using a spinning disk confocal microscope.
Results
Four fetal membranes of different types were successfully processed and imaged after establishing a suitable protocol. Cellular and nuclear outlines are clearly visible in all cases, especially in the uppermost membrane layer. Focal membrane (micro)fractures could be identified in several samples.
Conclusion
The presented method proves to be well suited to determine whether and how the occurrence of membrane (micro)fractures and cellular jamming correlates with the timing of membrane rupture and the mode of delivery. In future measurements, this method could possibly be combined with mechanical probing techniques to compare optical and mechanical sample information.
Understanding gender and its intersection with social stratifiers on prevention and care seeking behavior of Lymphatic Filariasis in Nepal
Authors: Arjyal Abriti , Parajuli Ayuska , Kharel Chandani , Barrio Mariam Otmani Del , Baral Sushil C
Published: April 2023

Background: Lymphatic Filariasis (LF), is a debilitating and painful neglected tropical disease and is one of the leading causes of permanent disability. Division of work within and outside the household and everyday practices influenced by sex and gender intersect with other demographics and social stratifiers that influence exposure to LF, which ultimately impact on disease burden. Hence, this study aimed to explore the influence of gender and its intersection with other social stratifiers for the prevention and care seeking behavior of LF in Nepal.Methods: This qualitative study was conducted using in-depth interviews (IDIs) and focus group discussions (FGDs) as methods for data collection in Bardiya district. Total 22 IDIs and 2 FGDs were conducted with purposively selected adult male and female aged ≥18 years, residing in the selected area for over a year. The data collection was conducted between January and March 2020. The study received ethical approval from Nepal Health Research Council (Reg. no. 656/2019) and Ethics Review Committee of WHO, Geneva.Results: Men spend more time outside their household compared to women while fulfilling their roles and responsibilities which was largely determined by what is socially acceptable. Thus, limited men’s access to preventive health services as they often missed mass drug administration (MDA) programme held every year in their community and had limited resources to adopt preventive measures to protect themselves from mosquito bites while travelling. The ability to prevent exposure varied when some did not have adequate bed nets for all family members. Although, women in most cases made decision on the selection, purchase and use of protective methods, it was influenced by the patriarchal and gender norms as they felt their responsibility to take care of the family members and thus prioritized male, children and elderly members of the household in case of limited availability. Gender, marital status, ethnicity and geographical areas intersected and influenced individual’s ability to access source of information. There existed sex and religion wise differences on preference of health facilities.Conclusion: Access to resources, division of work, norms and values and decision-making power alone and its interaction with various social stratifiers shaped peoples’ vulnerability to disease, ability to prevent exposure and response to illness.Trial registration: Not Applicable
Multimedia Display of Wushu Intangible Cultural Heritage Based on Interactive System and Artificial Intelligence
Authors: CUI Jinghui , FU Limin
Published: April 2023

With the rapid development of the information age, various forms of digitalization have facilitated people's various lives, but digitalization has also brought crisis to people. The most obvious is that in the digital era, the original living environment of intangible cultural heritage of martial arts and its traditional development and protection mode have become less and less compatible with the digital era. Therefore, its development is currently facing difficulties, even endangered problems. Based on this phenomenon, this paper combines artificial intelligence technology and interactive system to establish an intelligent multimedia display interactive system for intangible cultural heritage of martial arts. In this system, the martial artist's moving image can be captured by the action image acquisition device, and the collected image sequence can be calculated and analyzed. The system host "remembers" the martial artist's action. The main functions of the system, such as random flow, click and zoom, multi-point movement and printing, are all in the charge of the picture control module; Video playback, full screen display and ring button control functions are mainly completed by the video control module. The experimental results show that the task time of using interactive system to locate visual objects with massive information in icon materials is significantly faster than that of using no interactive highlighting system. Therefore, we can preliminarily determine that the interactive system can improve the performance of target positioning in massive information. In this paper, the interactive system and artificial intelligence technology are applied to the intangible cultural heritage of martial arts, which has played a role in promoting its development.
Application of Internet big data analysis technology based on deep learning in tourism marketing performance evaluation
Authors: Su Xiaoguang , Yin Wei
Published: April 2023

Marketing through the network is the basic marketing method in the information age. It has certain marketing value, and its position has gradually become stable. It has become the mainstream marketing method, especially praised by the tourism industry, which has injected fresh blood into this field. As the development of tourism market is dynamic, businesses will consider the needs of tourists when paying attention to its development process, so as to design performance evaluation criteria for tourism marketing. Under this research background, this paper has completed the Internet marketing performance evaluation system for the tourism market by introducing big data analysis technology and in-depth learning technology. This system can effectively evaluate the actual development of the tourism industry, and the system design comprehensively considers the 360-degree performance appraisal and balanced integral models. Based on the actual tourism data of a certain place, this study summarizes some additional evaluation indicators, thus improving the evaluation model and laying the foundation for the introduction of data and model construction process of AHP. According to the principle of maximum membership, the following experimental results can be obtained: due to the poor performance evaluation results of a scenic spot, its membership is the largest. It can be seen from this that the Internet marketing performance evaluation system for the tourism market has practical application value and can effectively analyze market performance. This paper improves the performance evaluation system by introducing in-depth learning and big data analysis technology into the tourism market performance analysis.
Protective effects and mechanisms of auricular vagus nerve stimulation in the alleviation of acute ischemic cerebral injury in mice
Authors: Chang Cher-Chia , Liou Kuo-Tong , Wang Yea-Hwey , Hsu Chih-hung , Shen Yuh-Chiang , Yen Jiin-Cherng
Published: April 2023

Stroke is a major cause of death and long-term disability. Although numerous treatments have shown neuroprotective effects in animal models of ischemic stroke, their clinical efficacy and safety remain to be further investigated. Previous studies have indicated that vagus nerve stimulation (VNS) may reduce cerebral damage in ischemic stroke, but the specific mechanisms by which VNS achieves this effect in murine cerebral ischemic stroke injury are unclear. In this study, an animal model was designed to investigate the therapeutic effects and mechanisms of auricular vagus nerve stimulation (aVNS) in mice with acute ischemic stroke induced by middle cerebral artery occlusion (MCAO) and reperfusion injury. We focused particularly on the involvement of α4-nicotinic acetylcholine receptor (α4-nAChR) and the molecular signaling pathways mediated by aVNS. Mobility of the animals after acute ischemic stroke, infarct volume, and expression of neuroprotective and damaging factors were analyzed to understand the therapeutic effect and protective mechanism of aVNS on ischemic stroke. Our findings demonstrate that aVNS treatment improved mobility and reduced cerebral infarct volume after acute ischemic stroke. Additionally, administration of α4-nAChR antagonists reversed the protective effects of aVNS on ischemic stroke. Our mechanistic investigations revealed that aVNS mediates protective effects against acute ischemic stroke by reducing inflammatory and apoptotic factors, while enhancing neuronal regeneration factors, through activation of α4-nAChR and the GSK3β/β-catenin pathway. Our results provide clear evidence supporting the use of aVNS as a neuroprotective treatment for ischemic stroke in mice.
The relationship between serum Resolvin D1, NLRP3, cytokine levels, and adolescents with first-episode medication-naïve major depressive disorder
Authors: Guo Jiamei , Zhang Tanwei , Chen Wanjun , Tan Jianyu , Li Xiao , Zheng Anhai , Fu Yixiao , Qiu Tian
Published: April 2023

Background: Inflammation has become a critical pathological mechanism of Major Depressive Disorder (MDD). NLRP3 is a critical inflammatory pathway to maintain the immune balance. Recently, evidence showed that Resolvin D1(RvD1) might be a new antidepressant choice due to its protective effects through the inhibition of neuroinflammation. However, whether they have clinical value in the diagnosis and treatment evaluation of adolescent depression was unclear.
Methods: Forty-eight untreated first-episode adolescent patients with moderate to severe major depressive disorder, as well as 30 healthy adolescents (HCs, age and gender-matched), were enrolled for this study. Their ages ranged from 13 to 18 (15.75± 1.36) years. The patients were treated with fluoxetine for 6-8 weeks. HDRS-17 was used to evaluate the severity of depressive symptoms. Venous blood samples were collected at baseline (patients b and HCs) and after treatment (only patients). Serum concentrations of RvD1, NLRP3, IL-1β, IL-18, and IL-4 were measured by enzyme-linked immunosorbent assays (ELISA) pre- and post-fluoxetine treatment.
Results: Serum levels of RvD1 and anti-inflammatory cytokine IL-4 were significantly elevated in adolescents with MDD compared to healthy adolescents, but no significant difference in NLRP3, IL-1β, and IL-18 between the two groups. Meanwhile, RvD1 (positively) and IL-4 (negatively) were correlated with the severity of symptoms (HDRS-17 scores) after adjusting age, gender, and BMI. Interestingly, fluoxetine treatment significantly reduced the serum levels of RvD1, NLRP3, IL-1β, and IL-18 in MDD adolescents but increased the levels of IL-4 relative to baseline. Furthermore, we observed that serum levels of RvD1 might be an excellent distinguishing indicator for depression and healthy adolescents.
Conclusions: Our study is the first to compare RvD1 and NLRP3 between adolescent MDD and HCs. Our findings of reactive increase of RvD1 in adolescent MDD comprised a novel and critical contribution.Our results showed the presence of inflammation resolution unbalanced in adolescents with MDD and indicated that RvD1 might be an ideal biomarker for diagnosing and treating adolescent MDD.
Adjuvant chemotherapy in T3 upper urinary tract urothelial carcinoma: retrospective cohort study
Authors: Chang Yi-Huei , Hsiao Po-Jen , Weng Han-Yu , Tai Ta-Yao , Yeh Hsin-Chih , Lee Hsiang-Ying , Huang Chao-Yuan , Chen Chung-Hsin , Tsai Yao-Chou , Yu Chih-Chin , Tsai Chung-You , Cheng Pai-Yu , Hsueh Thomas Y. , Chiu Allen W. , Jiang Yuan-Hong , Lee Yu-Khun , Chen Yung-Tai , Chuech Leonard S. , Chiang Bing-Juin , Huang Hsu-Che , Chen I-Hsuan Alan , Lin Jen-Tai , Lin Wei Yu , Hu Su-Wei , Fang Jen-Kai , Hsu Hui-Tsung , Chung Chi-Jung , Huang Chi-Ping
Published: April 2023

Background
The benefit of adjuvant chemotherapy was investigated for patients with T3 upper urinary tract urothelial carcinoma (UTUC) who underwent radical nephroureterectomy.
Methods
This is a multicenter retrospective observational study of 482 patients with pathological T3 N0 and Nx UTUC who underwent radical nephroureterectomy with and without adjuvant chemotherapy. The median overall survival (OS), cancer-specific survival (CSS), and disease-free survival (DFS) of patients who received adjuvant chemotherapy were analyzed to determine predictors of patient prognosis.
Results
Of the 482 patients, 140 (29.0%) received adjuvant chemotherapy. Adjuvant chemotherapy showed a benefit only for the median DFS rate (58% vs 49%; p = 0.04). Multivariate analyses revealed that adjuvant chemotherapy improved median DFS (HR 0.537; CI 0.35–0.83; p = 0.005). Surgical margin also significantly influenced median OS (HR 4.038; p < 0.001), CSS (HR 3.926; p < 0.001), and DFS (HR 3.201; p < 0.001).
Conclusions
Adjuvant chemotherapy improved DFS but did not improve OS or CSS in patients with pathological T3 N0 and Nx UTUC.
GenArk: Towards a million UCSC Genome Browsers
Authors: Clawson Hiram , Lee Brian T , Barber Galt P , Casper Jonathan , Diekhans Mark , Fischer Clay , Gonzalez Jairo Navarro , Hinrichs Angie S , Lee Christopher M , Nassar Luis R , Perez Gerardo , Wick Brittney , Schmelter Daniel , Speir Matthew L , Armstrong Joel , Zweig Ann S , Kuhn Robert M , Kirilenko Bogdan M , Hiller Michael , Kent William J , Haussler David , Haeussler Maximilian
Published: April 2023

Interactive graphical genome browsers are essential tools for biologists working with DNA sequences. Although tens of thousands of new genome assemblies have become available over the last decade, accessibility is limited by the work involved in manually creating browsers and curating annotations. The results can push the limits of data storage infrastructure. To facilitate managing this increasing number of genome assemblies, we created the Genome Archive (GenArk) collection of UCSC Genome Browsers from assemblies hosted at NCBI(1). Built on our established assembly hub system, this collection enables fast, on-demand visualization of chromosome regions without requiring a database server. Available annotations include gene models, some mapped through whole-genome alignments, repeat masks, GC content, and others. We also modified our popular BLAT(2) aligner and in-silico PCR to support a large number of genomes using limited RAM. Users can upload additional annotations themselves via track hubs(3) and custom tracks. We can import more annotations in bulk from third-party resources, demonstrated here with TOGA(4) gene models. 2,430 GenArk assemblies are listed at https://hgdownload.soe.ucsc.edu/hubs/ and can be found by searching on the main UCSC gateway page. We will continue to add human high-quality assemblies and for other organisms, we are looking forward to receiving requests from the research community for ever more browsers and whole-genome alignments via http://genome.ucsc.edu/assemblyRequest.html.
Flow hydrodynamics drive effective fish attraction behaviour into slotted fishway entrances
Authors: Farzadkhoo Maryam , Kingsford Richard T , Suthers Iain M. , Felder Stefan
Published: April 2023

Effective fishways rely on attracting fish, utilising the natural rheotactic behaviour of fish to orient into an attraction flow near the entrance. Despite the critical importance of attraction, understanding of the hydrodynamics of vertical slot entrances in relation to fish behaviour remains poor. Herein, hydrodynamic measurements of flows at slotted fishway entrances were experimented with two different designs, two velocities, three water depths, and two fish species, silver perch (Bidyanus bidyanus) and Australian bass (Percalates novemaculeata). Fish behaviours were tracked in relation to hydrodynamic measures of three-dimensional velocity and turbulent kinetic energy (TKE). There were distinct differences in the attraction flow between entrance designs, irrespective of velocity and water depth. Plain slotted entrance produced a more symmetric flow in the centre of the flume, causing fish to approach the entrance by skirting the core of the attraction jet flow and areas of high turbulence. In contrast, streamlined slotted entrance design resulted in an asymmetric attraction flow which guided fish along the wall of the flume, improving attraction for both species. There were clear patterns in swimming trajectories for silver perch, swimming along the sidewalls of the observation zone towards the entrance, but Australian bass were less predictable, using random routes on their way to the slotted entrance. Both species preferred areas of low turbulence (TKE < 0.02 m2/s2) and the asymmetric attraction flow along one of the sidewalls created by the streamlined entrance improved the fish attraction. This work has important implications for design of vertical slotted entrance systems.
Healthcare leaders’ and elected politicians’ approach to support- systems and requirements for complying with quality and safety regulation in nursing homes – A case study
Authors: Magerøy Malin Rosell , Braut Geir Sverre , Macrae Carl , Wiig Siri
Published: April 2023

Background: Healthcare leaders play an important and complex role in managing and handling the dual responsibility of both Health, Safety and Environment (HSE) for workers and quality and safety for patients (QPS). There is a need for investigation into how healthcare leaders and decision makers organize and create support structures to handle these combined responsibilities in practice. The aim of this study was to explore how healthcare leaders and elected politicians organize, control, and follow up the work of HSE and QPS in a Norwegian nursing home context. Moreover, we explore how they interpret, negotiate, and manage the dual responsibility and possible tensions between employee health and safety, and patient safety and quality of service delivery.
Methods: The study was conducted in 2022 as a case study exploring the experience of healthcare leaders and elected politicians in five municipalities responsible for providing nursing homes services in Norway. Elected politicians (18) and healthcare leaders (11) participated in focus group interviews (5) and individual interviews (11). Data were analyzed using inductive thematic analysis.
Results: The analysis identified five main themes explaining how the healthcare leaders and elected politicians organize, control, and follow up the work of HSE and QPS:
1. Establish frameworks and room for maneuver in the work with HSE and QPS.
2. Create good routines and channels for communication and collaboration.
3. Build a culture for a health-promoting work environment and patient safety.
4. Create systems to handle the possible tensions in the dual responsibility between caring for employees and quality and safety in service delivery.
5. Define clear boundaries in responsibility between politics and administration.
Conclusions: The study showed that healthcare leaders and elected politicians who are responsible for ensuring sound systems for quality and safety for both patients and staff, do experience tensions in handling this dual responsibility. They acknowledge the need to create systems and awareness for the responsibility and argue that there is a need to better separate the roles and boundaries between elected politicians and the healthcare administration in the execution of HSE and QPS.
Delivering Medical Leadership Training Through The Healthcare Leadership Academy: A Four Year Analysis
Authors: Zarif Azmaeen , Bandyopadhyay Soham , Miller George , Malawana Johann
Published: April 2023

Background
Formal leadership training has typically been targeted at senior health professionals. The Healthcare Leadership Academy (HLA) was formed in 2016 to provide a leadership programme for students and early-career health professionals. This study analyses the effectiveness of the HLA scholarship programme as an intervention for improving interest in, and preparing scholars for, future leadership roles.
Methods
A mixed methods study using responses from a survey developed to collect data on the effectiveness of the HLA Scholarship program in cultivating leadership development. Questions required either multiple-choice, free-text, ranking or Likert scale (‘strongly agree’, ‘agree’, ‘neither agree nor disagree’, ‘disagree’, ‘strongly disagree) responses. Descriptive statistical analyses and qualitative data coding, management, and analysis were conducted.
Results
70 participants who underwent the course between 2016 and 2020 completed the questionnaire. Nearly all (99%) found that the training provided on the programme had equipped them to be more effective leaders, with 86% of respondents stating that they were more likely to take on leadership roles. Nearly all (97.1%) found the course to be either of good or very good quality. Seven themes were identified from free text responses. They were “improved self-awareness by scholars”, “expectations of the organisation”, “guidance to future careers”, “broadening horizons”, “network development”, and a description of the scholars programme as an “enjoyable and accessible course”.
Conclusions
Healthcare leadership is a non-negotiable component of healthcare delivery in the 21st Century. As healthcare professionals, it is our duty to be effective leaders confident and competent in navigating the increasingly-complex systems within which we operate for the benefit of ourselves, colleagues, and patients. By accounting for known shortcomings and developing ameliorative measures, the HLA Scholarship programme addresses unmet needs in a structured manner to support effective long-term healthcare leadership development.
Unequal distributions of crowdsourced weather data in England and Wales
Authors: Brousse Oscar , Simpson Charles , Poorthuis Ate , Heaviside Clare
Published: April 2023

Personal weather stations (PWS) can provide useful data on urban climates by densifying the number of weather measurements across major cities. They do so at a lower cost than official weather stations by national meteorological services. Despite the increasing use of PWS data, little attention has yet been paid to the underlying socio-economic and environmental inequalities in PWS coverage. Using social deprivation, demographic, and environmental indicators in England and Wales, we characterize existing inequalities in the current coverage of PWS. We find that there are fewer PWS in more deprived areas which also observe higher proportions of ethnic minorities, lower vegetation coverage, higher building height and building surface fraction, and lower proportions of inhabitants under 65 years old. This implies that data on urban climate may be of lower quality or more uncertain in particular areas, which may limit the potential for climate adaptation and empowerment in those communities.
How can an inferior competitor be a successful invader?
Authors: Tesfay Yohannes B. , Blaschke Annika , Kreyling Jürgen
Published: April 2023

The invasion of ecosystems by non-native species is recognized as one of the most significant global challenges, particularly in semiarid regions where native biodiversity is already under stress from drought and land degradation. The implicit assumption is that invaders are strong competitors, but a greenhouse pairwise experiment conducted to examine intraspecific and interspecific competition effects of Opuntia ficus-indica, a widespread invader in semiarid ecosystems, with two species native to the highlands of Eritrea, Ricinus communis and Solanum marginatum, revealed that O. ficus-indica is a weak competitor. In direct interaction, the competition in aboveground productivity measured by the logarithmic response ratio for O. ficus-indica was 3.4-fold and 5.9-fold higher than for R. communis and S. marginatum, respectively. Belowground, the native R. communis was facilitated (-1.00 ± 0.69) by O. ficus-indica which itself suffered from high competition. This pattern became even stronger under water shortage, where aboveground competition for S. marginatum decreased 5.7-fold, and for O. ficus-indica, it increased 1.4-fold. Despite being a poor competitor, O. ficus-indica outperformed R. communis and S. marginatum in both aboveground (4.3 and 3.8 times more) and belowground (27 and 2.8 times more) biomass production, respectively. The findings of this study challenge the common interpretation that invasive species are strong competitors and highlight the importance of considering other factors, such as productivity and tolerance limits, when assessing the potential impacts of invasive species on semiarid ecosystems.
Oral health literacy, knowledge and perceptions in a socially and culturally diverse population: a mixed methods study
Authors: King Shalinie , Thaliph Ayesha , Laranjo Liliana , Smith Benjamin J , Eberhard Joerg
Published: April 2023

Background: Poor oral health literacy has been proposed as a causal factor in disparities in oral health outcomes. This study aims to investigate oral health literacy (OHL) in a socially and culturally diverse population of Australian adults visiting a public dental clinic in Western Sydney.
Methods: A mixed methods study where oral health literacy was assessed using the Health Literacy in Dentistry scale (HeLD-14) questionnaire and semi-structured interviews explored oral health related knowledge, perceptions and attitudes. Interviews were analysed using a thematic approach.
Results: A sample of 48 participants attending a public dental clinic in Western Sydney was recruited, with a mean age of 59.9 (SD16.2) years, 48% female, 50% born in Australia, 45% with high school or lower education, and 56% with low-medium OHL. A subgroup of 21 participants with a mean age of 68.1 (SD14.6) years, 40% female, 64% born in Australia, 56% with a high school or lower education, and 45% with low-medium OHL completed the interview. Three themes identified from the interviews included 1) attitudes and perceptions about oral health that highlighted a lack of agency and low prioritisation of oral health, 2) limited knowledge and education about the causes and consequences of poor oral health, including limited access to oral health education and finally 3) barriers and enablers to maintaining good oral health, with financial barriers being the main contributor to low OHL.
Conclusions: Strategies aimed at redressing disparities in oral health status should include improving access to oral health information. The focus should be on the impact poor oral health has on general health with clear messages about prevention and treatment options in order to empower individuals to better manage their oral health.
Cost-effectiveness of the anti-vascular endothelial growth factor intravitreal injection and panretinal photocoagulation for patients with proliferative diabetic retinopathy in South Korea
Authors: Lee Hyeon-Jeong , Cho Songhee , Park Jungeun , Jin Yan , Kim Hyung Min , Jee Donghyun
Published: April 2023

Background: We determined the cost-effectiveness of the anti-vascular endothelial growth factor (VEGF) intravitreal injection versus panretinal photocoagulation (PRP) for patients with proliferative diabetic retinopathy (PDR) in South Korea.
Methods: We simulated four treatment strategies using PRP and the anti-VEGF injection by constructing a Markov model for a hypothetical cohort of 50-year-old PDR patients: (1) PRP only; (2) anti-VEGF injection only; (3) PRP first; and (4) anti-VEGF injection first.
Results: In this cost-effectiveness analysis, compared with only-PRP, the incremental cost-effectiveness ratiowas $95,456 per quality-adjusted life-year (QALY) for PRP first, $34,375 per QALY for anti-VEGF injection first, and $33,405 per QALY for anti-VEGF injection only from a healthcare perspective. From the societal and payer perspective, strategy (2) was more cost-saving and effective than (1). In the probabilistic sensitivity analysis, only-PRP was cost-effective up to the willingness-to-pay (WTP) of about $42,000, while anti-VEGF injection only was cost-effective from a healthcare perspective. From the societal and payer perspectives, regardless of the value of WTP, anti-VEGF injection only was the most cost-effective strategy.
Conclusion: Our results on the cost-effectiveness of the anti-VEGF injection for PDR, alone or in combination with PRP treatment, can be used as important evidence when making medical service decisions.