bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health economic evaluation alongside randomised clinical trial of a health behaviour intervention to manage type 2 diabetes in Nepal
Authors: Dahal Padam Kanta , Ademi Zanfina , Rawal Lal , Mahumud Rashidul Alam , Paudel Grish , Karmacharya Biraj , Sakamoto Haruka , Sugishita Tomohiko , Vandelanotte Corneel 
Published: December 2024

Abstract
Background
Prevention of type 2 diabetes is becoming an urgent public health concern in low and middle-income countries (LMICs). However, there is currently no evidence of a cost-effective approach of health behaviour interventions from community settings in low-income countries like Nepal. Therefore, this study aimed to assess the within-trial economic evaluation of a health behaviour intervention compared with usual care for managing type 2 diabetes in a community setting in Nepal.

Methods
We randomly assigned 30 clusters comprising 481 patients with type 2 diabetes of which 15 to a health behaviour intervention (n = 238 patients) and 15 to the usual care (n = 243 patients). Patients in the intervention group received community health workers-led intensive training for diabetes self-management along with regular phone calls and ongoing support from peer supporters. Costs, quality-adjusted life years (QALYs) and incremental cost-effectiveness ratio (ICER) as costs per QALYs gained were assessed after 6-month from a healthcare system perspective. Probabilistic sensitivity analysis was conducted using 10,000 Monte Carlo simulations to assess the impact of uncertainty of cost-effectiveness analysis under the threshold of three times gross domestic product (GDP) per capita for Nepal (i.e., US $4,140).

Results
Over the 6-month, the intervention yielded an incremental cost of US $28.55 (95% CI = US $21.26 to US $35.84) per person and an incremental QALYs of 0.0085 (95% CI = -0.0106 to 0.0275) per person. The ICER associated with the health behaviour intervention was US $3,358.82 (95% CI = US $-2005.66 to US $3,974.54) per QALY gained, which was below the estimated threshold, indicating a cost-effective approach with a net monetary benefit of US $6.64 (95% CI = US $-22.62 to US $78.01). Furthermore, the probabilistic sensitivity analysis consisting of 10,000 Monte Carlo simulations indicates that the intervention being cost-effective at the given threshold was 89.63%.

Conclusions
Health behaviour interventions in community settings are a cost-effective approach to manage type 2 diabetes, offering good value for money. However, more studies focused on long-term follow-up across diverse setting of LMICs should be warranted to assess the maximum impact of such interventions.

Trial registration
Australia and New Zealand Clinical Trial Registry (ACTRN12621000531819) Registered on 6th May 2021.
Metastasis-associated lung adenocarcinoma transcript 1 overexpression in testis contributes to idiopathic non-obstructive azoospermia via repressing ETS variant transcription factor 5
Authors: Wei Lei , Feng Zonggang , Dou Qian , Li Pengfen , Zhao Xinghua , Hao Bin 
Published: December 2024

AbstractMetastasis-associated lung adenocarcinoma transcript 1 (MALAT1), is a long non-coding RNA localized in the cell nucleus, known for its multifunctional roles, including potential involvement in spermatogenesis. This study investigates the mechanism by which MALAT1 dysregulation contributes to the pathogenesis of idiopathic non-obstructive azoospermia (iNOA). We analyzed MALAT1 levels in two gene expression profiling datasets comprising patients with obstructive azoospermia (OA) who have normal spermatogenesis and 13 patients with iNOA. The dysregulation of MALAT1 along with the expression levels of its negatively correlated genes were confirmed in a larger cohort of 24 OA patients and 38 iNOA patients. We examined the effects of MALAT1 overexpression in primary human spermatogonial stem cells (SSCs) and Sertoli cells. Additionally, we assessed DNA methylation, as well as levels of H3K27me3 and H3K27Ac level near the etv5 promoter region using ChIP-qPCR. We observed that MALAT1 was overexpressed in testes of iNOA patients with its levels negatively correlating with six spermatogenesis related genes and positively correlated with three others. Overexpression of MALAT1 in SSCs repressed proliferation and induced apoptosis while also suppressing ETS variant transcription factor 5 (ETV5) expression by promoting H3K27 tri-methylation of the ETV5 promoter. Overexpression of MALAT1 in Sertoli cells did not induce apoptosis but impaired their cell supporting function. In conclusion, MALAT1 overexpression in SSCs contributes to the pathogenesis of iNOA via downregulating ETV5 expression and promoting cell apoptosis.
Treatment Versus Observation in Early Gestational Diabetes Mellitus: A Systematic Review and Meta-analysis of Randomized Controlled Trials
Authors: Bhattacharya Saptarshi , Nagendra Lakshmi , Dutta Deep , Kamrul-Hasan A B M 
Published: December 2024

Abstract

Purpose
Early gestational diabetes mellitus (eGDM) refers to elevated blood glucose levels not meeting the criteria for overt diabetes before 20 weeks gestation. Observational studies link eGDM to adverse outcomes, but randomized controlled trial (RCT) evidence on early intervention benefits remains inconclusive. To address this, we performed a systematic review and meta-analysis (SRM) of RCTs on this subject.

Methods
We searched electronic databases to identify RCTs comparing early treatment vs observation for eGDM. The primary neonatal outcomes analyzed were large-for-gestational age (LGA) and macrosomia. The primary maternal outcome was pregnancy-related hypertension. Secondary neonatal outcomes included neonatal respiratory distress (NRD), neonatal intensive-care unit admission, small-for-gestational age, cord-blood C-peptide ≥90th percentile, and neonatal hypoglycemia. Secondary maternal outcomes were cesarean section (CS), emergency CS, labor induction, preeclampsia, and preterm birth.

Results
Seven RCTs involving 4427 pregnancies were analyzed. The studies differed in their timing and methods of inclusion. Six studies used a combination of lifestyle and pharmaceutical interventions, while 1 relied solely on lifestyle modifications. Early treatment did not reduce LGA [odds ratio (OR) 0.84; 95% confidence interval (CI) 0.53-1.32; P = .44], macrosomia (OR 0.68; 95% CI: 0.43-1.06; P = .09), or pregnancy-related hypertension (OR 1.04; 95% CI: 0.68-1.57; P = .87). Among the secondary outcomes, only NRD was significantly reduced in the treatment arm (OR 0.52; 95% CI: 0.34-0.80; P = .003). However, sensitivity analysis, omitting the lifestyle-only study, demonstrated a lower risk of macrosomia with early intervention (OR 0.55; 95% CI: 0.34-0.91; P = .02).

Conclusion
The SRM demonstrates early intervention does not improve most pregnancy outcomes, except NRD. Sensitivity analysis, excluding the lifestyle-only study, additionally revealed a reduction in macrosomia. The findings must be interpreted cautiously due to the variability in study designs. Replication in well-designed multicenter trials is required before clinical application.
Pseudo-endocrine Disorders: Recognition, Management, and Action
Authors: McDermott Michael T 
Published: December 2024

Abstract
“Pseudo-endocrine disorders” refer to proposed conditions that have never been scientifically proven to exist but, due to widespread misinformation available on the internet and other media, are relatively commonly diagnosed and treated with equally unproven and sometimes dangerous treatments. Adrenal fatigue is a nonexistent condition that supposedly results from adrenal exhaustion and atrophy due to chronic stress and has been promoted as a potential explanation for a variety of symptoms. Testing consists of nonvalidated online surveys and salivary cortisol profiles while treatment is not evidence-based at best and can be dangerous. Wilson's syndrome and reverse T3 syndrome are also nonexistent conditions that supposedly result from impaired T4 to T3 conversion and competition of excess reverse T3 with T3 for T3 receptors. Testing involves measurement of axillary temperature and treatment consists of T3 therapy, often at very high and dangerous doses. Hypogonadism (“low T”) is frequently diagnosed in “men's health” clinics and other venues without actual hormone testing or further evaluation and is often treated with supraphysiologic testosterone therapy that suppresses endogenous gonadal testosterone and sperm production, leads to a lifelong need for testosterone therapy, and may have numerous other harmful effects. Low-dose naltrexone (LDN) therapy has been proposed as a treatment for multiple disorders including autoimmune conditions and other disorders resulting from aberrant immune mechanisms, but there is no valid evidence that LDN has any benefits. Management of patients with pseudo-endocrine disorders must involve careful listening, patient education, healthy lifestyle measures, and honesty, encouragement, and compassion.
Two new vertebrate prey species in the diet of the agouti, Dasyprocta punctata, recorded in the highlands of Costa Rica
Authors: Mora José Manuel , Castrillo Trejos Andrey , Méndez Vargas Esteban , Castro Arias Rony , López Lucía I. 
Published: December 2024

La guatusa centroamericana, Dasyprocta punctata, ha sido tradicionalmente considerada un herbívoro, alimentándose principalmente de frutos y semillas. Sin embargo, existen informes de este roedor consumiendo 3 especies de vertebrados: un ratón (en cautiverio), un ave y una lagartija gusano. En este estudio, añadimos 2 nuevas especies de vertebrados a la dieta de la guatusa: 1 ave y 1 mamífero. Llevamos a cabo investigaciones y guiamos tours de historia natural en la región de Monteverde, Costa Rica. Monteverde es bien conocido por sus reservas biológicas y sus actividades de ecoturismo. Los poblados de Monteverde y Santa Elena están situados dentro del Bosque Nuboso Tropical Montano, una franja altitudinal relativamente estrecha con cobertura de nubes frecuente durante gran parte del año. En 2 ocasiones separadas, observamos guatusas depredando especies de vertebrados en Monteverde. El 8 de junio de 2023, vimos a una guatusa adulta con un armadillo de nueve bandas juvenil, Dasypus novemcinctus, en la boca. El 12 de julio de 2024, observamos a otra guatusa persiguiendo y consumiendo 2 polluelos de la codorniz serrana pechinegra, Odontophorus leucolaemus. Estos 2 nuevos ítems de presa sugieren tendencias carnívoras oportunistas de la guatusa. Parece ser que este roedor captura animales jóvenes que no representan una amenaza significativa ni requieren un esfuerzo considerable para ser capturados, ni causan daños colaterales. De esta manera, la guatusa obtiene algunos nutrientes esenciales que no obtiene de su dieta habitual basada en plantas durante tiempos de escasez.
The Sinaloan mastiff bat (Molossus sinaloae) is indeed found in Sinaloa, México
Authors: Renteria osé M. , Rangel-Cota Gerardo , Camargo Issac 
Published: December 2024

Las investigaciones sobre Molossus sinaloae reflejan desafíos en su taxonomía debido a su amplia distribución geográfica. A pesar de que el nombre científico de la especie hace referencia al estado de Sinaloa, México, su presencia en éste ha sido cuestionada, por habitar vegetación xerófila, contrastante con el típico de montaña. En el invierno de 2023, se registraron 2 ejemplares de M. sinaloae en el norte de Sinaloa. Posteriormente, se revisó su taxonomía y se tomaron medidas morfológicas. Se analizaron registros de la presencia del murciélago mastín de Sinaloa en el norte de México comparando registros en bases de datos de colecciones científicas. Nosotros colectamos 2 individuos adultos de M. sinaloae, 1 macho y 1 hembra, en la ciudad de Los Mochis, Sinaloa, México. Estos registros son los más septentrionales jamás documentados para la especie y respaldan una expansión de su rango de distribución de ~ 463 km al norte de su distribución conocida actual. Nuestro análisis de los registros más recientes de la especie en México evidencia que M. sinaloae se distribuye comúnmente en la Planicie Costera del Pacífico. Los nuevos registros reportados sugieren que M. sinaloae no está limitada por barreras geográficas. La importancia biogeográfica de la región Neártica se destaca documentando al murciélago mastín de Sinaloa, que no se había observado en Sinaloa, México, durante casi 90 años.
Lygia Pape at Santa Úrsula: Toward an Affirmative Biopolitics of Artistic Pedagogy in the Brazilian Military Dictatorship
Authors: Svanelid Oscar 
Published: December 2024

EN:This article analyzes the artistic pedagogy of Lygia Pape at Santa Úrsula during the military dictatorship focusing on her commitment to educating her students' senses and social awareness. This draws attention to the biopolitical aspects of Pape's teaching as she engaged her students on a different trajectory than the "authoritarian modernization" propagated by the dictatorship.PT: Este artigo analisa a pedagogia artística de Lygia Pape na Santa Úrsula durante a ditadura militar com foco em seu compromisso com a formação de sentidos e consciência social. Isso chama a atenção para os aspectos biopolíticos do ensino de Pape ao engajar seus alunos em uma trajetória diferente da "modernização autoritária" propagada pela ditadura.
Unified monitoring and telemetry platform supporting network intelligence in optical networks
Authors: Shen Sen , Han Jing , Bardhi Klodian , Li Haiyuan , Yang Ruizhi , Teng Yiran , Yokar Vaigai , Yan Shuangyi , Simeonidou Dimitra 
Published: December 2024

In recent years, machine-learning (ML) applications have generated considerable interest and shown great potential in optimizing optical network management, such as quality of transmission estimation, traffic prediction, and resource allocation. However, these applications often require large datasets for training, inference, and updating, while network operators are generally reluctant to disclose their data due to privacy concerns and the sensitivity of operational information. Most open-source datasets typically lack transparency regarding network specifics, such as topology details and device configurations, making data acquisition and ML model training more difficult. In response, this paper presents a unified monitoring and telemetry platform that leverages distributed and centralized time-series databases on InfluxDB, a Kafka-based telemetry pipeline, and advanced ML applications. The separation of distributed and centralized databases improves data management flexibility and scalability. The Kafka-based telemetry pipeline ensures high-throughput, low-latency data streaming with end-to-end latency under 0.05 s through optimized partitioning. Additionally, integrating Kafka and InfluxDB allows for real-time data visualization from multiple sources, improving transparency and supporting real-time data streaming for network applications. By implementing this advanced telemetry and ML architecture, network operators can build a more intelligent, responsive, and resilient optical network infrastructure.
Passive temperature-compensated fiber Fabry-Perot magnetic field sensor
Authors: Chen Xiaoli , Wu Shengnan , Li Nan , Liu Liu , He Sailing 
Published: December 2024

A passive temperature-compensated magnetic field sensor based on the material thermal-optics effect has been proposed. The proposed structure is easy to fabricate, consisting of only two single-mode optical fibers adhered to a magnetostrictive rod and the Fabry-Perot (FP) cavity filled with polydimethylsiloxane (PDMS). Benefitting from the negative thermal-optics coefficient of PDMS, the temperature cross-sensitivity of the sensor decreased from 351.02 pm/°C to 12.59 pm/°C, while exhibiting a high magnetic field sensitivity of 160.66 pm/mT@38.47-61.52 mT. The proposed sensor avoids complex control systems, composite structures, and bulky packaging. This feature effectively compensates for temperature influences during magnetic field detection, making it an ideal candidate for stable magnetic field sensors in practical applications.
Self-injection locked laser via a hollow-core fiber Fabry–Perot resonator
Authors: Feng Zitong , Ding Meng , Komanec Mateˇj , Zvánovec Stanislav , Zhong Ailing , Poletti Francesco , Marra Giuseppe , Slavík Radan 
Published: December 2024

In a hollow-core fiber (HCF), light propagates through an air/vacuum core rather than a solid material, resulting in a low thermo-optic coefficient and ability to handle high powers. Here, we demonstrate a laser locked to a hollow-core fiber reference, which thanks to the low HCF thermal sensitivity, shows long-term stability an order of magnitude better than compact commercially available low-noise lasers. The laser frequency variation within ±600  kHz was measured over 50 h. The stability of our proof-of-concept laser is ensured via a strong self-injection ratio of −15  dB, enabled by the high-power handling and low loss of the hollow-core fiber’s resonator. Moreover, our results show appealing performance parameters, including a fractional frequency stability of 4×10−13 at 1 s averaging time and a Lorentzian component of the linewidth of 0.2 Hz.
Hematological and immunological profiles of podoconiosis patients in West Gojjam Zone, Ethiopia: A comparative cross-sectional study
Authors: Atnaf Aytenew , Oakes Ryan , Scodari Bruno T. , Desta Kassu , Taye Bineyam , Tsegaye Aster 
Published: December 2024

Background
Podoconiosis is a geo-chemically induced, non-infectious, familial, chronic lymphedema of the legs that occurs among barefoot people in rural, farming communities with extreme poverty. Despite a growing body of research surrounding the disease, the pathogenesis of the disease is relatively unknown. This study aims to investigate the immunological and hematological profiles of individuals affected by podoconiosis in comparison to healthy controls.

Methodology/Principal findings
A comparative cross-sectional study was conducted in West Gojjam Zone of Ethiopia involving adult individuals clinically diagnosed with podoconiosis (n = 53) and healthy controls (n = 67) from the same area. A survey was conducted to gather information on sociodemographic, lifestyle characteristics, and clinical features of the disease. About nine ml whole blood samples were collected for hematological and immunological testing, which included IL-4, TNF-α, IL-6, IL-17, IL-10, TGF β and IFN-γ. Overall, we observed significant differences in hematological parameters between individuals with podoconiosis and healthy controls. Specifically, we found a notable reduction in white blood cell count, with an adjusted mean difference (AMD) of -1.15 (95% CI: -2.09 to -0.21; p = 0.017). Additionally, the differential white blood count showed a decrease in absolute neutrophils (AMD = -3.42, 95% CI: -4.15 to -2.69; p < 0.001) and absolute eosinophils (AMD = -0.20, 95% CI: -0.37 to -0.03; p = 0.019). Conversely, we noted an increase in absolute lymphocytes (AMD = 0.98, 95% CI: 0.50 to 1.46; p < 0.001) and monocytes (AMD = 0.54, 95% CI: 0.22 to 0.85; p = 0.001). However, we didn’t observe a significant difference in cytokine profile between podoconiosis patients and healthy controls

Conclusions/Significance
The decrease in neutrophil counts among podoconiosis cases compared to healthy controls may provide insight into the potential disease pathogenesis, suggesting the involvement of autoimmune-related mechanisms, as it demonstrates a similar hematological profile to other autoimmune disorders.
Predictors of neonatal mortality among neonates in Tigray regional state, Ethiopia: A cross-sectional study
Authors: Gebrerufael Gebru Gebremeskel , Welegebrial Brhane Gebrehiwot , Teklezgi Mehari Gebre 
Published: December 2024

Background
Since 2015, Ethiopia is committed to lowering the death rate for children under five and it is one of the countries in Sub-Saharan Africa that has accomplished the fourth Millennium Development Goal. However, in Ethiopia, neonatal death has remained a serious public health concern, with greater rates found in Tigray regional state and the predictors aren’t well recognized. The goal of this study was to ascertain the prevalence of neonatal death in the Tigray regional State as well as any relevant risk factors.

Methods
This study performed a secondary data analysis of the 2016 Ethiopia Demographic and Health Survey (EDHS) report. Information was gathered on 716 neonates who were born five years before the survey began. Risk factors for neonatal mortality were thought to include mother and neonate demographics, health, and environmental factors. The study employed multivariable logistic regression model analysis and descriptive statistics to identify significant correlates of neonatal mortality.

Results
In Tigray regional state, the overall prevalence of neonatal mortality was 4.3% (95% CI: 3.06, 6.10). The multivariable logistic regression model analysis revealed that factors such as multiple birth types (AOR = 15.3, 95% CI: 3.54, 65.84), birth order (2–4) (AOR = 4.88, 95% CI: 1.52, 15.7), sex of the neonate (being male) (AOR = 3.75, 95% CI: 1.45, 9.75), home place of delivery (AOR = 7.4, 95% CI: 2.0, 27.6), and neonates born to mothers aged 20–34 years (AOR = 0.23, 95% CI: 0.087, 0.58) were significantly risk factors associated with a higher risk of neonatal mortality rate.

Conclusions
The study recognized the sex of the neonate, birth order, mother’s age, place of delivery, and birth type as potential risk factors for neonatal mortality. The prevalence of neonatal mortality indicated that the neonatal mortality rate in Tigray regional state was higher than the national average. To reduce neonatal mortality, targeted interventions should focus on high-risk groups, such as mothers delivering at home and those with multiple births.
Setting the balance of care for older adults at risk of hospitalization and delayed discharge: A mixed-methods research protocol
Authors: Kuluski Kerry , Jacobson Danielle , Ghazalbash Somayeh , Baek Junhee , Rosella Laura , Mansfield Elizabeth , Sud Abhimanyu , Tang Terence , Guilcher Sara J. T. , Zargoush Manaf 
Published: December 2024

Introduction
Delayed hospital discharge is a persistent care quality issue experienced across health systems worldwide and remains a priority area to be addressed in Canada. Often associated with a decrease in services while waiting to leave the hospital, delayed discharge from hospital can lead to increased frailty, physical and cognitive decline, and caregiver burnout. Optimizing availability of and timely access to community-based health and social care are avenues that could reduce initial admissions to the hospital and length of hospital stay, and facilitate hospital discharges.

Methods
This research will explore the ways in which community resources could be leveraged to potentially avoid hospitalization and delayed hospital discharge for older adults using sequential mixed-methods including co-design. To better understand the characteristics and needs of older adults, the research team will first identify sub-populations of older adults (65 years old or older) at risk of hospitalization and delayed discharge using comprehensive, longitudinal administrative health data. From these health data, risk profiles and personas will be created and then shared with key partners (e.g., older adults, caregivers, healthcare providers, healthcare decision-makers), who will be engaged to identify, leverage, and create targeted care solutions. The barriers and facilitators to the implementation of these care solutions will then be explored.

Discussion
Delayed hospital discharge has been a critical care quality issue across Canada for decades. The current research will provide health system leaders with an approach to better allocate services to older adults in order to avoid delayed hospital discharge and identify gaps in health and social care resources based on the characteristics, needs, and preferences of older adults, their caregivers, and providers.