bluuebunny/crossref_metadata_2025_split huggingface dataset:
Data Analysis on Medical Service Utilization and Out-of-Pocket Spending Among Near-Poor National Health Insurance Members in South Korea
Authors: Park Sooyeol 
Published: December 2020

Abstract
Background: The near poor, a low income population which is excluded from the Republic of Korea's Medical Aid (MA) program, experiences insufficient use of medical services and high out-of-pocket (OOP) spending due to insufficient coverage by the country's National Health Insurance (NHI). This study aims to examine medical utilization, OOP spending, and occurrence of catastrophic health expenditures (CHE) among the near poor compared to MA beneficiaries and other NHI members.Methods: A cross-sectional study was conducted drawing upon a nationally representative dataset based on the 2018 Korea Welfare Panel Study (KOWEPS). We classified people into MA beneficiaries, the near-poor population below 50% of the median income threshold, and other NHI members above the 50% median income threshold. Using propensity score matching between MA beneficiaries and the near poor and between the near-poor group and the group of those above the poverty line, this study examined medical utilization, OOP spending, and the occurrence of CHE among the study groups. Results: The findings suggest that MA beneficiaries make greater use of outpatient services compared to the near poor, but other uses of medical services were not significantly different among the study groups. However, OOP spending and occurrence of CHE were significantly higher in the near-poor group compared to the other two groups. Conclusion: We found that the near-poor group was the most vulnerable group in these terms among the Korean population. Health policy needs to take into account the vulnerability of the near-poor population.
Identifying the signature of prospective motor control in children with autism
Authors: Cavallo Andrea , Romeo Luca , Ansuini Caterina , Battaglia Francesca , Nobili Lino , Pontil Massimiliano , Panzeri Stefano , Becchio Cristina 
Published: December 2020

Abstract
Failure to develop prospective motor control has been proposed to be a core phenotypic marker of autism spectrum disorders (ASD). However, whether genuine differences in prospective motor control permit discriminating between ASD and non-ASD profiles over and above individual differences in motor output remains unclear. Here, we combined high precision measures of hand movement kinematics and rigorous machine learning analyses to determine the true power of prospective movement data to differentiate children with autism and typically developing children. Our results show that while movement is unique to each individual, variations in the kinematic patterning of sequential grasping movements genuinely differentiate children with autism from typically developing children. These findings provide quantitative evidence for a prospective motor control impairment in autism and indicate the potential to draw inferences about autism on the basis of movement kinematics.
Assessing the Efficacy of A Marine Reserve to Protect Sharks With Differential Habitat Use
Authors: Peñaherrera-Palma Cesar , Hobday Alistair , Hearn Alex , Espinoza Eduardo , Shillinger George , Ketchum James , Klimley A. , Frusher Stewart , Fischer G. , Semmens Jayson 
Published: December 2020

Abstract
Spatial management through the implementation of marine protected areas is one strategy to limit the extraction of sensitive marine species. Understanding the area used by marine life is thus a key step towards the evaluation of the management framework and efficacy of a protected area. To provide information of the protective coverage of the Galapagos Marine Reserve (GMR), we assessed the habitat utilization distribution (UD) of hammerhead and blacktip sharks in the GMR. Fifteen hammerhead sharks and 27 blacktip sharks were tagged with SPOT and SPLASH satellite tags in the north and south-central regions of the GMR between 2007 and 2012. Our results show nearly 90% of hammerhead shark’s UD was enclosed by the reserve boundary during the cold season (June-October), yet this decreased to only ~30% with the advent of the warm season (December-April). Conversely, blacktip sharks’ UD was 100% enclosed by the reserve boundaries in all seasons. Season and depth were the most important environmental parameters defining the UD of hammerhead sharks; whilst year and eddy kinetic energy were the most important parameters for blacktip sharks. These findings suggest the size of the GMR may be effective for blacktip sharks but seasonally effective for hammerhead sharks.
OnionMHC: A Deep Learning Model for Peptide - HLA-A*02:01 Binding Predictions using both Structure and Sequence Feature Sets
Authors: Saxena Shikhar , Animesh Sambhavi , Fullwood Melissa , Mu Yuguang 
Published: December 2020

Abstract
Background:The peptide binding to Major Histocompatibility Complex (MHC) proteins is an important step in the antigen-presentation pathway. Thus, predicting the binding potential of peptides with MHC is essential for the design of peptide-based therapeutics. Most of the available machine learning-based models predict the peptide-MHC binding based on the sequence of amino acids alone. Given the importance of structural information in determining the stability of the complex, here we have utilized both the complex structure and the peptide sequence features to predict the binding affinity of peptides to human receptor HLA-A*02:01. To our knowledge, no such model has been developed for the human HLA receptor before that incorporates both structure and sequence-based features.Results:We have applied machine learning techniques through the natural language processing (NLP) and convolutional neural network to design a model that performs comparably with the existing state-of-the-art models. Our model shows that the information from both sequence and structure domains results in enhanced performance in the binding prediction compared to the information from one domain alone. The testing results in 18 weekly benchmark datasets provided by the Immune Epitope Database (IEDB) as well as experimentally validated peptides from the whole-exome sequencing analysis of the breast cancer patients indicate that our model has achieved state-of-the-art performance.Conclusion: We have developed a deep-learning model (OnionMHC) that incorporates both structure as well as sequence-based features to predict the binding affinity of peptides with human receptor HLA-A*02:01. The model demonstrates state-of-the-art performance on the IEDB benchmark dataset as well as the experimentally validated peptides. The model can be used in the screening of potential neo-epitopes for the development of cancer vaccines or designing peptides for peptide-based therapeutics. OnionMHC is freely available at https://github.com/shikhar249/OnionMHC
Rate of Central Corneal Thickness Changes in Primary Angle Closure Eyes: Long-term Follow-up Results
Authors: Park Hae Min , Choi Jiin , Lee Won June , Uhm Ki Bang 
Published: December 2020

Abstract
Background Central corneal thickness (CCT) and its association with intraocular pressure, which is a pivotal parameter in glaucoma management, has previously been reported. In this study, we intended to investigate the long-term change of CCT in terms of rate in eyes with primary angle closure (PAC). Additionally, we aimed to analyze events that could affect CCT.Methods In this retrospective study, 27 patients with PAC who had a follow-up period of more than five years were evaluated. The rate of CCT changes from baseline was evaluated from the serial CCT measurements over the average follow-up period. The pattern of CCT change rate according to modes of treatment and history of angle closure attack was analyzed using the repeated linear mixed model analysis.Results A total of 52 eyes were enrolled. The CCT reduction rate of the entire study population was − 0.72 ± 0.22 µm/yr (P = 0.001) with statistical significance. The CCT thinning rate of the laser peripheral iridotomy (PI) group was − 0.53 ± 0.25 µm/yr (P = 0.034), that of the surgical trabeculectomy group was − 1.32 ± 0.43 µm/yr (P = 0.002), and it was not statistically significant (P = 0.112). The rate of CCT thinning in patients with a history of acute angle closure attack was − 0.81 ± 0.31 µm/yr (P = 0.009) and that in patients without an attack was − 0.63 ± 0.30 µm/yr (P = 0.001), and it was not statistically significant (P = 0.680). Baseline CCT appeared to be the only significant factor affecting the rate of CCT changes (P < 0.001).Conclusions We found a significant reduction in CCT over a long-time observation period in PAC eyes. We also found that the rates of CCT reduction were not affected by different treatment modalities or acute angle closure attack. The analysis of long-term CCT changes in conjunction with baseline CCT would also be helpful in the clinical evaluation of the PAC patients.
Community structure and metabolic potentials for biofuel production of an ancient beer starter ‘emao' revealed by a whole-metagenome study
Authors: Narzary Diganta , Boro Nitesh , Borah Ashis , Takashi Okubo , Takami Hideto 
Published: December 2020

Abstract
The community structure and functional metabolic modules occurring in ‘emao' – a traditional rice beer starter of ancient origin from north-east India has been unearthed for the first time using shot-gun whole-metagenome sequencing. Emao harbours potential microorganisms for saccharification, lignocellulose degradation, and biofuel production that correlate with probable metabolic functional modules. Eukaryotic microorganisms, especially moulds and yeasts, dominated over the prokaryotes in emao compared to previous metagenomic studies on such traditional starters where the relative abundance of prokaryotes was higher than the eukaryotes. The comprehensive microbial species diversity, community structure, and metabolic modules exhibited in emao would be practical in the formulation of mixed-microbial cultures for biofuel production from plant-based feedstocks.
Low Cerebrospinal Fluid Beta Amyloid1-42 in Patients with Tubercoulous Meningitis
Authors: Stroffolini Giacomo , Guastamacchia Giulia , Audagnotto Sabrina , Atzori Cristiana , Trunfio Mattia , Nigra Marco , Stefano Alessandro Di , Perri Giovanni Di , Calcagno Andrea 
Published: December 2020

Abstract
Introduction Tubercolous meningitis (TBM) is an important disease leading to morbidity, disability and mortality that primarily affects children and immune-depressed patients. Specific neuromarkers predicting outcomes, severity and inflammatory response are still lacking. In recent years an increasing number of evidences show a possible role for infective agents in developing neurodegenerative diseases. Methods We retrospectively included 13 HIV-negative patients presenting with meningeal tuberculosis. Lumbar punctures were performed for clinical reasons and CSF biomarkers were routinely available: we analyzed blood brain barrier permeability (CSF to serum albumin ratio, “CSAR”), intrathecal IgG synthesis, (CSF to serum IgG ratio), inflammation (neopterin), amyloid deposition (1-42 β-amyloid), neuronal damage (T-tau, P-tau, 14.3.3) and astrocytosis (S-100 β). Results Patients were 83% male and 67 % Caucasian with a median age of 51 years(24.5-63.5 IQR). Apart from altered CSAR (median value 18.4, 17.1-30.9 IQR), neopterin (14.3 ng/ml, 9.7-18.8) and IgG ratios (15.4, 7.9-24.9) patients showed very low levels of 1-42 β-amyloid in their CSF (348.5 pg/mL,125-532.2). Protein 14.3.3. tested altered in 38.5% cases. T-tau, ptau and S100Beta were in the range of normality. Altered low level of beta amyloid correlated over time with classical TBm findings and altered neuromarkers.Conclusion CSF Biomarkers from patients with TBM were compatible with inflammation, blood brain barrier damage and impairment in beta amyloid metabolism. Aβ1-42 could be tested as a prognostic markers, backing the routine use of available neuromarkers. To our knowledge this is the first case showing such low levels of Aβ1-42 in TBM; its accumulation, drove by neuroinflammation related to infections, can be central in understanding neurodegenerative diseases.
Incentivizing appropriate malaria case management in the private sector: a study protocol for two linked cluster randomized controlled trials to evaluate provider- and client-focused interventions in western Kenya and Lagos, Nigeria
Authors: Woolsey Aaron M , Simmons Ryan A , Woldeghebriel Meley , Zhou Yunji , Ogunsola Oluwatosin , Laing Sarah , Olaleye Tayo , Kipkoech Joseph , Rojas Bomar Mendez , Saran Indrani , Odhiambo Mercy , Malinga Josephine , Ambani George , Kimachas Emmah , Fashanu Chizoba , Wiwa Owens , Menya Diana , Laktabai Jeremiah , Visser Theodoor , Turner Elizabeth L , O’Meara Wendy Prudhomme 
Published: December 2020

Abstract
Background

A large proportion of artemisinin-combination therapy (ACT) anti-malarial medicines is consumed by individuals that do not have malaria. The over-consumption of ACTs is largely driven by retail sales in high malaria-endemic countries to clients who have not received a confirmatory diagnosis. This study aims to target ACT sales to clients receiving a confirmatory diagnosis using malaria rapid diagnostic tests (mRDTs) at retail outlets in Kenya and Nigeria.

Methods

This study comprises two linked four-arm 2x2 factorial cluster randomized controlled trials focused on malaria diagnostic testing and conditional ACT subsidies with the goal to evaluate provider directed- and client-directed interventions. The study will be conducted at two contrasting study sites: a rural region around Webuye in western Kenya and the urban center of Lagos, Nigeria. Clusters are 41 and 48 participating retail outlets in Kenya and Nigeria, respectively. Clients seeking care at participating outlets across all arms will be given the option of paying for a mRDT – at a study-recommended price – to be conducted at the outlet. In the provider-directed intervention arm, the outlet owner receives a small monetary incentive to perform the mRDT. In the client-directed intervention arm, the client receives a free ACT if they purchase an mRDT and receive a positive test result. Finally, the fourth study arm combines both the provider- and client- directed interventions. The diagnosis and treatment choices made during each transaction will be captured using a mobile phone app. Study outcomes will be collected through exit interviews with clients, who sought care for febrile illness, at each of the enrolled retail outlets.

Results

The primary outcome measure is the proportion of all ACTs that are sold to malaria test-positive clients in each study arm. For all secondary outcomes we will evaluate the degree to which the interventions affect purchasing behavior among people seeking care for a febrile illness at the retail outlet.

Conclusions

If our study demonstrates that malaria case management can be improved in the retail sector, it could reduce overconsumption of ACTs and enhance targeting of publicly funded treatment reimbursements, lowering the economic barrier to appropriate diagnosis and treatment for patients with malaria.
Observing UT1-UTC with VGOS
Authors: Haas Rüdiger , Varenius Eskil , Matsumoto Saho , Schartner Matthias 
Published: December 2020

Abstract
We present rst results of UT1-UTC determinations using the VLBI Global Observing System (VGOS). During December 2019 through February 2020 a series of 1 hour long observing sessions were performed using the VGOS stations at Ishioka in Japan and the Onsala twin telescopes in Sweden. The data of this VGOS-B series were correlated, post-correlation processed, and analysed at the Onsala Space Observatory. The derived UT1-UTC results were compared to corresponding results from standard legacy S/X Intensive sessions (INT1/INT2), as well to the nal values of the International Earth Rotation and Reference Frame Service (IERS), provided in IERS Bulletin B. The VGOS-B series achieve 3-4 times lower formal uncertainties for the UT1-UTC results than standard legacy S/X INT series. Furthermore, the root mean square (RMS) agreement with respect to the IERS Bulletin B is 30-40 % better for the VGOS-B results than for the INT1/INT2 results.
Oblique Lumbar Interbody Fusion at the L5-S1 Segment via an Approach Between the Psoas Muscle and the Great Vessels: Technique Note and Case Presentations.
Authors: Li Xigong , Diao Weiyi , Zhang Yuzhu , Wu Junsong , Xing Chunyang , Du Junhua , Chen Bin , Xu Sanzhong 
Published: December 2020

Abstract
Study DesignTechnique note.ObjectivesTo describe our modified oblique lumbar interbody fusion (OLIF) technique in the reconstruction of the L5-S1 segment.Summary of Background DataRecently, OLIF has been generally recognized as an effective procedure in the treatment of various spinal pathologies at L2-L5 segments. However, the usage of OLIF at the L5-S1 segment doesn’t have gained widespread acceptance in spine community. Some authors still concern about the feasibility of OLIF used in lumbosacral fusionMethodsTen consecutive patients underwent L5-S1 interbody fusion using the OLIF technique in our institution. The L5–S1 disc space is approached via one retroperitoneal oblique corridor between the psoas muscle and the great vessels. The discectomy and endplate preparation are performed through a surgical window developed on the anterolateral side of L5-S1 disc. A secondary cage insertion technique is used for safe placement of interbody fusion cages.ResultsOf the 10 patients, 6 were males and 4 were females, with an average age of 55.4±6.8 years. There were 8 single-level and 2 two-level procedures, including 2 at L4–L5 and 10 at L5–S1. Preoperative axial MR images confirmed 1 patient with type I LCIV (left common iliac vein), 6 with type II LCIV and 3 with type III LCIV. The average blood loss was 133.4±88.5 ml, and the average operative times were 153.6±38.3 minutes. Postoperative radiographs examination confirmed all patients obtained a better reconstruction at the lumbosacral junction. Two patients with type III LCIV sustained iliolumbar vein laceration during the exposure, and no other perioperative complications were encountered.ConclusionOur novel OLIF L5-S1 technique is a more feasible procedure of lumbosacral fusion, which shared the common surgical plane with OLIF L2-5, allowing for L2 to S1 reproducible multi-levels interbody fusions via a retroperitoneal oblique corridor between the psoas muscle and the great vessels. Detailed preoperative plan and meticulous intraoperative manipulation are prerequisite for the success of OLIF L5-S1 procedure.
Locoregional Treatment in De Novo Metastatic Breast Cancer: A Retrospective Cohort Study
Authors: Jianna Sun , Lingjun Kong , Nana Feng , Hong Liu , Chongxi Ren 
Published: December 2020

Abstract
Background: In an earlier analysis of this cohort study, local therapy based on surgical resection of the primary tumor might confer a survival benefit in women with de novo metastatic breast cancer (dnMBC). Here we report the survival outcomes of locoregional treatment (LRT), focusing on the association of surgical timings and surgical margins with survival in these patients. Methods: The retrospective study included patients with dnMBC in two Chinese tertiary hospitals, between March 1, 2007, and December 31, 2017. Overall survival (OS) was evaluated by means of a stratified log-rank test and summarized with the use of Kaplan–Meier methods. Results: A total of 153 patients were included, of whom 87 underwent LRT and 66 systemic therapy alone (STA). LRT showed a significant OS benefit over STA (HR, 0.47; 95% CI, 0.33 to 0.69; p<.0001). Median OS of LRT group and STA group were 42 months (95% CI, 35.0 to 48.9 months) and 21 months (95% CI, 16.1 to 25.9 months), respectively. The benefit was consistent across most subgroups. The OS of patients undergoing surgery was better than that of patients without surgery (HR, 0.48; 95% CI, 0.33 to 0.70; p=.0001), and there was difference in survival improvement at different surgical timings (surgery before chemotherapy, during chemotherapy and after chemotherapy) (HR, 0.79; 95% CI, 0.65 to 0.95; p=.013). The survival benefit of surgery after chemotherapy was the most, followed by surgery during chemotherapy (Median 56 months, 95% CI, 40.8 to 71.2 months). Moreover, compared with patients with positive margins, the OS of patients with negative margins was significantly improved (HR, 2.35; 95% CI, 1.65 to 3.35; p<.0001), with a median OS of 56 months (95% CI, 45.9 to 66.1 months). Conclusions: Our results suggest that LRT is associated with improved OS in women with dnMBC, and patients who had surgery after or during systemic chemotherapy with negative surgical margins, are expected to benefit more.
Small-molecule HDAC&nbsp;and Akt&nbsp;Inhibitors Suppress Tumor Growth and Enhance Immunotherapy in Multiple Myeloma
Authors: Hirano Mitsuhito , Imai Yoichi , Kaito Yuta , Murayama Takahiko , Sato Kota , Ishida Tadao , Yamamoto Junichi , Ito Takumi , Futami Muneyoshi , Ri Masaki , Yasui Hiroshi , Nojima Masanori , Kamikubo Yasuhiko , Gotoh Noriko , Iida Shinsuke , Handa Hiroshi , Tojo Arinobu 
Published: December 2020

Abstract
Background: Multiple myeloma (MM) patients may undergo relapse and experience resistance to existing therapies. Cereblon (CRBN) is key mediator of the bioactivities of immunomodulatory drugs (IMiDs), including lenalidomide. Moreover, genetic alteration of CRBN is frequently detected in IMiD-resistant patients and considered to contribute to IMiD resistance. Thus, overcoming resistance to drugs, including IMiDs, is expected to improve clinical outcomes. Here, we examined potential mechanisms of a histone deacetylase (HDAC) inhibitor and Akt inhibitor in treatment of relapsed/refractory MM patients.Methods: We established lenalidomide-resistant cells by knocking down or knocking out CRBN in MM cells. Additionally, we derived multi-drug (bortezomib, doxorubicin, or dexamethasone)-resistant cell lines and primary cells from relapsed/refractory MM patients. The effects of HDAC and Akt inhibitors on these drug-resistant MM cells were then observed with a particular focus placed on whether HDAC inhibitors enhance immunotherapy efficacy. We also investigated the effect of lenalidomide on CRBN-deficient cells.Results: HDAC inhibitor suppressed the growth of drug-resistant MM cell lines, and enhanced antibody-dependent cellular cytotoxicity (ADCC) of therapeutic antibodies by upregulating natural killer group 2D (NKG2D) ligands in MM cells. CRBN-deficient cells showed lenalidomide-induced upregulation of glycogen synthase kinase-3 (p-GSK-3) and c-Myc phosphorylation. Meanwhile, HDAC and Akt inhibitors downregulated c-Myc by blocking GSK-3 phosphorylation. HDAC and Akt inhibitors also exhibited synergistic cytotoxic and c-Myc–suppressive effects. Moreover, the dual HDAC and PI3K inhibitor, CUDC-907, exhibited cytotoxic and immunotherapy-enhancing effects for MM cells, including for multi-drug-resistant lines and primary cells including lenalidomide-resistant patients.Conclusions: Combined HDAC and Akt inhibition represents a promising approach for the treatment of relapsed/refractory MM.