bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stepped care for depression at integrated chronic care centers (IC3) in Malawi: study protocol for a stepped-wedge cluster randomized controlled trial
Authors: McBain Ryan K. , Mwale Owen , Ruderman Todd , Kayira Waste , Connolly Emilia , Chalamanda Mark , Kachimanga Chiyembekezo , Khongo Brown David , Wilson Jesse , Wroe Emily , Raviola Giuseppe , Smith Stephanie , Coleman Sarah , Kelly Ksakrad , Houde Amruta , Tebeka Mahlet G. , Watson Samuel , Kulisewa Kazione , Udedi Michael , Wagner Glenn 
Published: September 2021

Abstract
Background
Malawi is a low-income country in sub-Saharan Africa that has limited resources to address a significant burden of disease—including HIV/AIDS. Additionally, depression is a leading cause of disability in the country but largely remains undiagnosed and untreated. The lack of cost-effective, scalable solutions is a fundamental barrier to expanding depression treatment. Against this backdrop, one major success has been the scale-up of a network of more than 700 HIV clinics, with over half a million patients enrolled in antiretroviral therapy (ART). As a chronic care system with dedicated human resources and infrastructure, this presents a strategic platform for integrating depression care and responds to a robust evidence base outlining the bi-directionality of depression and HIV outcomes.

Methods
We will evaluate a stepped model of depression care that combines group-based Problem Management Plus (group PM+) with antidepressant therapy (ADT) for 420 adults with moderate/severe depression in Neno District, Malawi, as measured by the Patient Health Questionnaire-9 (PHQ-9) and Mini-International Neuropsychiatric Interview (MINI). Roll-out will follow a stepped-wedge cluster randomized design in which 14 health facilities are randomized to implement the model in five steps over a 15-month period. Primary outcomes (depression symptoms, functional impairment, and overall health) and secondary outcomes (e.g., HIV: viral load, ART adherence; diabetes: A1C levels, treatment adherence; hypertension: systolic blood pressure, treatment adherence) will be measured every 3 months through 12-month follow-up. We will also evaluate the model’s cost-effectiveness, quantified as an incremental cost-effectiveness ratio (ICER) compared to baseline chronic care services in the absence of the intervention model.

Discussion
This study will conduct a stepped-wedge cluster randomized trial to compare the effects of an evidence-based depression care model versus usual care on depression symptom remediation as well as physical health outcomes for chronic care conditions. If determined to be cost-effective, this study will provide a model for integrating depression care into HIV clinics in additional districts of Malawi and other low-resource settings with high HIV prevalence.

Trial registration
ClinicalTrials.govNCT04777006. Registered on 1 March, 2021
Improving sustainable hydrogen production from green waste: [FeFe]-hydrogenases quantitative gene expression RT-qPCR analysis in presence of autochthonous consortia
Authors: Arizzi M. , Morra S. , Gilardi G. , Pugliese M. , Gullino M. L. , Valetti F. 
Published: September 2021

Abstract
Background
Bio-hydrogen production via dark fermentation of low-value waste is a potent and simple mean of recovering energy, maximising the harvesting of reducing equivalents to produce the cleanest fuel amongst renewables. Following several position papers from companies and public bodies, the hydrogen economy is regaining interest, especially in combination with circular economy and the environmental benefits of short local supply chains, aiming at zero net emission of greenhouse gases (GHG). The biomasses attracting the largest interest are agricultural and urban green wastes (pruning of trees, collected leaves, grass clippings from public parks and boulevards), which are usually employed in compost production, with some concerns over the GHG emission during the process. Here, an alternative application of green wastes, low-value compost and intermediate products (partially composted but unsuitable for completing the process) is studied, pointing at the autochthonous microbial consortium as an already selected source of implementation for biomass degradation and hydrogen production. The biocatalysts investigated as mainly relevant for hydrogen production were the [FeFe]-hydrogenases expressed in Clostridia, given their very high turnover rates.

Results
Bio-hydrogen accumulation was related to the modulation of gene expression of multiple [FeFe]-hydrogenases from two strains (Clostridium beijerinckii AM2 and Clostridium tyrobutyricum AM6) isolated from the same waste. Reverse Transcriptase quantitative PCR (RT-qPCR) was applied over a period of 288 h and the RT-qPCR results showed that C. beijerinckii AM2 prevailed over C. tyrobutyricum AM6 and a high expression modulation of the 6 different [FeFe]-hydrogenase genes of C. beijerinckii in the first 23 h was observed, sustaining cumulative hydrogen production of 0.6 to 1.2 ml H2/g VS (volatile solids). These results are promising in terms of hydrogen yields, given that no pre-treatment was applied, and suggested a complex cellular regulation, linking the performance of dark fermentation with key functional genes involved in bio-H2 production in presence of the autochthonous consortium, with different roles, time, and mode of expression of the involved hydrogenases.

Conclusions
An applicative outcome of the hydrogenases genes quantitative expression analysis can be foreseen in optimising (on the basis of the acquired functional data) hydrogen production from a nutrient-poor green waste and/or low added value compost, in a perspective of circular bioeconomy.
Characterization of fatty acid desaturases reveals stress-induced synthesis of C18 unsaturated fatty acids enriched in triacylglycerol in the oleaginous alga Chromochloris zofingiensis
Authors: Wu Tao , Yu Lihua , Zhang Yu , Liu Jin 
Published: September 2021

Abstract
Background
The green microalga Chromochloris zofingiensis is capable of producing high levels of triacylglycerol rich in C18 unsaturated fatty acids (UFAs). FA desaturation degree is regulated by FA desaturases (FADs). Nevertheless, it remains largely unknown regarding what FADs are involved in FA desaturations and how these FADs collaborate to contribute to the high abundance of C18 UFAs in triacylglycerol in C. zofingiensis.

Results
To address these issues, we firstly determined the transcription start sites of 11 putative membrane-bound FAD-coding genes (CzFADs) and updated their gene models. Functional validation of these CzFADs in yeast and cyanobacterial cells revealed that seven are bona fide FAD enzymes with distinct substrates. Combining the validated functions and predicted subcellular compartments of CzFADs and the FA profiles of C. zofingiensis, the FA desaturation pathways in this alga were reconstructed. Furthermore, a multifaceted lipidomic analysis by systematically integrating thin-layer chromatography, gas chromatography–mass spectrometry and liquid chromatography–mass spectrometry techniques was conducted, unraveling profiles of polar membrane lipids in C. zofingiensis and major desaturation steps occurring in these lipids. By correlating transcriptional patterns of CzFAD genes and changes of lipids upon abiotic stress conditions, our results highlighted collaboration of CzFADs for C18 UFA synthesis and supported that both de novo FA synthesis and membrane lipid remodeling contributed C18 UFAs to triacylglycerol for storage.

Conclusions
Taken together, our study for the first time elucidated the pathways of C18 FA desaturations and comprehensive profiles of polar membrane lipids in C. zofingiensis and shed light on collaboration of CzFADs for the synthesis and enrichment of C18 UFAs in triacylglycerol.
Impact of molecular surgical margin analysis on the prediction of pancreatic cancer recurrences after pancreaticoduodenectomy
Authors: Sunagawa Yuki , Hayashi Masamichi , Yamada Suguru , Tanabe Hiroshi , Kurimoto Keisuke , Tanaka Nobutake , Sonohara Fuminori , Inokawa Yoshikuni , Takami Hideki , Kanda Mitsuro , Tanaka Chie , Nakayama Goro , Koike Masahiko , Kodera Yasuhiro 
Published: September 2021

Abstract
Background
Pancreatic cancer is one of the lethal cancers among solid malignancies. Pathological diagnosis of surgical margins is sometimes unreliable due to tissue shrinkage, invisible field cancerization and skipped lesions like tumor budding. As a result, tumor recurrences sometimes occur even from the pathologically negative surgical margins.

Methods
We applied molecular surgical margin (MSM) analysis by tissue imprinting procedure to improve the detection sensitivity of tiny cancerous cells on the surgical specimen surface after pancreatoduodenectomy. Surgical specimens were collected from 45 pancreatic cancer cases who received subtotal stomach preserving pancreatoduodenectomy at Nagoya University Hospital during 2017–2019. Quantitative methylation-specific PCR (QMSP) of the original methylation marker panel (CD1D, KCNK12, PAX5) were performed and analyzed with postoperative survival outcomes.

Results
Among 45 tumors, 26 cases (58%) were QMSP-positive for CD1D, 25 (56%) for KCNK12 and 27 (60%) for PAX5. Among the 38 tumors in which at least one of the three markers was positive, CD1D-positive cancer cells, KCNK12-positive cancer cells, and PAX5-positive cancer cells were detected at the surgical margin in 8 cases, 7 cases and 10 cases, respectively. Consequently, a total of 17 patients had at least one marker detected at the surgical margin by QMSP, and these patients were defined as MSM-positive. They were associated with significantly poor recurrence-free survival (p = 0.002) and overall survival (p = 0.005) than MSM-negative patients. Multivariable analysis showed that MSM-positive was the only significant independent factor for worse recurrence-free survival (hazard ratio: 3.522, 95% confidence interval: 1.352–9.179, p = 0.010). On the other hand, a significant proportion of MSM-negative cases were found to have received neoadjuvant chemotherapy (p = 0.019).

Conclusion
Pancreatic cancer-specific methylation marker panel was established to perform MSM analysis. MSM-positive status might represent microscopically undetectable cancer cells on the surgical margin and might influence the postoperative long-term outcomes.
Generalized proportional fractional integral functional bounds in Minkowski’s inequalities
Authors: Aljaaidi Tariq A. , Pachpatte Deepak B. , Shatanawi Wasfi , Abdo Mohammed S. , Abodayeh Kamaleldin 
Published: September 2021

AbstractIn this research paper, we improve some fractional integral inequalities of Minkowski-type. Precisely, we use a proportional fractional integral operator with respect to another strictly increasing continuous function ψ. The functions used in this work are bounded by two positive functions to get reverse Minkowski inequalities in a new sense. Moreover, we introduce new fractional integral inequalities which have a close relationship to the reverse Minkowski-type inequalities viaψ-proportional fractional integral, then with the help of this fractional integral operator, we discuss some new special cases of reverse Minkowski-type inequalities through this work. An open issue is covered in the conclusion section to extend the current findings to be more general.
Efficacy of combination of venetoclax with azacitidine or chemotherapy in refractory/relapse acute leukemias of ambiguous lineage, not otherwise specified
Authors: Liu Kaiqi , Li Yan , Qiu Shaowei , Zhou Chunlin , Wei Shuning , Lin Dong , Zhang Guangji , Wei Hui , Wang Ying , Liu Bingcheng , Gong Xiaoyuan , Fang Qiuyun , Song Yang , Wang Huijun , Li Chengwen , Li Qinghua , Wu Lihua , Gong Benfa , Liu Yuntao , Wang Jianxiang , Mi Yingchang 
Published: September 2021

AbstractAcute leukemias of ambiguous lineage, not otherwise specified (ALAL-NOS) is a rare type of acute leukemia. Management of relapse/refractory (R/R) patients is still challenging.traditional chemotherapy treatment is not effective. In this paper, we reported 6 R/R patients diagnosed as ALAL-NOS in our hospital, who were treated with venetoclax based treatment (venetoclax combining with azacitidine or chemotherapy). All 6 patients achieved CR. Five of the six patients received allo-HSCT, four patients were still alive in CR until the follow-up day. Our data provide preliminary evidence and show that venetoclax based regimens are effective and safety in patients with R/R ALAL-NOS.
Double defects-induced elastic wave coupling and energy localization in a phononic crystal
Authors: Jo Soo-Ho , Shin Yong Chang , Choi Wonjae , Yoon Heonjun , Youn Byeng D. , Kim Miso 
Published: September 2021

AbstractThis study aims to investigate elastic wave localization that leverages defect band splitting in a phononic crystal with double defects through in-depth analysis of comparison of numerical and experimental results. When more than one defect is created inside a phononic crystal, these defects can interact with each other, resulting in a distinctive physical phenomenon from a single defect case: defect band splitting. For a phononic crystal consisting of circular-hole type unit cells in a thin aluminum plate, under A0 (the lowest antisymmetric) Lamb waves, both numerical simulations and experiments successfully confirm the defect band splitting phenomenon via frequency response functions for the out-of-plane displacement calculated/measured at the double defects within a finite distance. Furthermore, experimental visualization of in-phase and out-of-phase defect mode shapes at each frequency of the split defect bands is achieved and found to be in excellent agreement with the simulated results. Different inter-distance combinations of the double defects reveal that the degree of the defect band splitting decreases with the increasing distance due to weaker coupling between the defects. This work may shed light on engineering applications of a multiple-defect-introduced phononic crystal, including broadband energy harvesting, frequency detectors, and elastic wireless power transfer.
A case report of fibrolamellar hepatocellular carcinoma, with particular reference to preoperative diagnosis, value of molecular genetic diagnosis, and cell origin
Authors: Takahashi Atsushi , Imamura Hiroshi , Ito Ryota , Kawano Fumihiro , Gyoda Yu , Ichida Hirofumi , Yoshioka Ryuji , Mise Yoshihiro , Fukumura Yuki , Sano Katsuhiro , Saiura Akio 
Published: September 2021

AbstractBackgroundFibrolamellar hepatocellular carcinoma (FL-HCC) is a liver tumor that occurs almost exclusively in young adults without underlying liver disease. In spite of its distinct clinical characteristics and specific imaging findings, preoperative diagnosis is often difficult due to the extremely low incidence of the tumor. Although FL-HCC shows particular morphological features on H&E-stained tissue sections, differential diagnosis from ordinary HCC, especially the scirrhous variant of HCC, and intrahepatic cholangiocarcinoma needs additional immunohistochemical (IHC) analyses and/or molecular genetic testing.Case presentationA 21-year-old male patient was referred to our hospital for further evaluation of a large liver mass. Abdominal ultrasound examination, contrast-enhanced computed tomography, and magnetic resonance imaging revealed a well-defined hypervascular lobulated liver mass, 11 × 11 cm in diameter, with a central scar and calcification, in segments 5/8. Under the diagnosis of FL-HCC, we carried out extended anterior sectorectomy, including a part of segment 4. On microscopic examination, the tumor was composed of proliferating polygonal cells with abundant eosinophilic granular cytoplasm containing nuclei with vesicular chromatin and enlarged nucleoli, in an abundant stroma. Collagen fibers arranged in a parallel lamellar pattern were seen in the tumor stroma. These findings, together with the results of subsequent IHC analyses using HAS, CK7, and CD 67, we made the diagnosis of FL-HCC, which was further confirmed by detection of theDNAJB1-PRKACAfusion gene in the tumor cells by RT-PCR.ConclusionFL-HCC shows distinct imaging appearances. Although it also has characteristic morphological features, combined use of IHC and/or molecular genetic studies are necessary for the final diagnosis.
Lung transplantation for idiopathic multicentric Castleman disease: potential efficacy and tolerability of a humanized anti-interleukin-6 receptor monoclonal antibody
Authors: Tomioka Yasuaki , Otani Shinji , Tanaka Shin , Shien Kazuhiko , Suzawa Ken , Miyoshi Kentaroh , Yamamoto Hiromasa , Okazaki Mikio , Sugimoto Seiichiro , Yamane Masaomi , Toyooka Shinichi 
Published: September 2021

Abstract
Background
Idiopathic multicentric Castleman disease (iMCD) is a rare polyclonal lymphoproliferative disease caused by the overrepresentation of interleukin-6 (IL-6). Tocilizumab (TCZ) is a humanized monoclonal antibody that binds to the IL-6 receptor and is approved for the treatment of iMCD. The efficacy and tolerability of TCZ in patients with iMCD undergoing lung transplantation (LTx) remain unknown.

Case presentation
We present the case of a 48-year-old iMCD patient with end-stage lung disease (ESLD) who was successfully treated with cadaveric single-LTx. Intravenous TCZ was used to stabilize the iMCD patient every 2 weeks, except for withdrawal immediately after LTx. At 32 month post-transplant, the patient remained asymptomatic without evidence of rejection, development of de novo donor-specific antibody (DSA), and recurrent iMCD in the native lung.

Conclusions
Single-LTx can be a feasible treatment option for ESLD caused by iMCD. TCZ can be used safely and may be beneficial in recipients with iMCD, and TCZ in combination with usual immunosuppression can be helpful in stabilizing iMCD patients pre- and post-LTx.
Urogenital schistosomiasis burden in school-aged children in Tiko, Cameroon: a cross-sectional study on prevalence, intensity, knowledge and risk factors
Authors: Sumbele Irene Ule Ngole , Tabi Doris Bennen , Teh Rene Ning , Njunda Anne Longdoh 
Published: September 2021

Abstract
Background
This study aimed at determining urogenital schistosomiasis (UGS) prevalence, intensity, knowledge and risk factors in school-aged children (SAC) in the new endemic focus of Tiko, Cameroon.

Methods
A cross-sectional study including 389 SAC of both sexes aged 5–15 years was carried out between April and June 2018. A structured questionnaire was used to collect demographic data, clinical and predisposing factors. Urine sample collected was used to detect Schistosoma haematobium eggs by filtration technique and microhaematuria by Heme dipstick COMBI 11. Logistic regression model was used to determine risk factors of UGS.

Results
The overall prevalence of UGS was 37.0% (CI 32.4–41.9) and 32.6% (CI 28.2–37.5) were positive by egg excretion while 24.4% (CI 20.4–28.9) by haematuria. S. haematobium egg excretion and haematuria were significantly higher in males (P = 0.016; P = 0.049) and children 12–15 years old (P = 0.009; P = 0.002), respectively. The mean number of eggs per 10 mL of urine was 77.6 (10.2) and ranged from 2 to 400. The proportion of light intensity of infection was higher (67.7%, CI 59.2–75.2) with no significant differences by sex, age and residence. However, the older children were more heavily infected when compared to the younger children, who had more of light infection. Overall, the mean knowledge score 1.42 (CI 1.32–1.51) on a scale of 6, was poor and the proportion of good knowledge of the disease (23.14%, CI 19.2–27.6) was low. Stream water contact (AOR = 4.94; P = 0.001) was the only significant risk factor identified.

Conclusion
Urogenital schistosomiasis is of public health concern among SAC in Tiko, Cameroon. Most participants have poor knowledge about the disease, hence education on vector-borne diseases and the avoidance of stream water contact should be implemented.
Panitumumab Plus Fluorouracil and Folinic Acid Versus Fluorouracil and Folinic Acid Alone as Maintenance Therapy in RAS Wild-Type Metastatic Colorectal Cancer: The Randomized PANAMA Trial (AIO KRK 0212)
Authors: Modest Dominik Paul , Karthaus Meinolf , Fruehauf Stefan , Graeven Ullrich , Müller Lothar , König Alexander Otto , Fischer von Weikersthal Ludwig , Caca Karel , Kretzschmar Albrecht , Goekkurt Eray , Haas Siegfried , Kurreck Annika , Stahler Arndt , Held Swantje , Jarosch Armin , Horst David , Reinacher-Schick Anke , Kasper Stefan , Heinemann Volker , Stintzing Sebastian , Trarbach Tanja 
Published: September 2021

PURPOSE The randomized PANAMA trial investigated the efficacy of panitumumab (Pmab) when added to maintenance therapy with fluorouracil and folinic acid (FU/FA) in patients with RAS wild-type metastatic colorectal cancer. METHODS Following first-line induction therapy with six cycles of FU/FA and oxaliplatin plus Pmab, responding patients (stable disease or partial or complete remission) were randomly assigned (1:1, open-label) to maintenance treatment with either FU/FA plus Pmab or FU/FA alone. The primary objective was to demonstrate superiority of progression-free survival (PFS, time from random assignment until progression or death) in favor of FU/FA plus Pmab with a hazard ratio (HR) of 0.75, a power of 80%, and a significance level of 10%. Secondary end points included overall survival, objective response rate of maintenance therapy, and toxicity. Survival end points were analyzed by the Kaplan-Meier method and compared by log-rank test and Cox regressions. Dichotomous variables were compared by Fisher's exact test; odds ratios were indicated when appropriate. The trial is registered with ClinicalTrials.gov ( NCT01991873 ). RESULTS Overall, 248 patients were randomly assigned and received maintenance therapy with either FU/FA plus Pmab (125 patients) or FU/FA alone (123 patients). At data cutoff, with 218 events (of 218 needed), PFS of maintenance therapy was significantly improved with FU/FA plus Pmab (8.8 months v 5.7 months; HR, 0.72; 80% CI, 0.60 to 0.85; P = .014). Overall survival (event rate 54%) numerically favored the FU/FA plus Pmab arm (28.7 months v 25.7 months; HR, 0.84; 95% CI, 0.60 to 1.18; P = .32). Objective response rates were 40.8% in patients receiving FU/FA plus Pmab versus 26.0% in patients receiving FU/FA alone (odds ratio, 1.96; 95% CI, 1.14 to 3.36; P = .02). The most frequent Common Terminology Criteria for Adverse Event grade ≥ 3 event during maintenance therapy was skin rash (7.2%). CONCLUSION In RAS wild-type metastatic colorectal cancer, maintenance therapy with FU/FA plus Pmab induced a significantly superior PFS compared with FU/FA alone. If active maintenance therapy is aspired following induction therapy with FU/FA and oxaliplatin plus Pmab, FU/FA plus Pmab appears to be the most favorable option.
Experimental quasi-1D capillary-wave turbulence
Authors: Ricard Guillaume , Falcon Eric 
Published: September 2021

Abstract
Wave turbulence in quasi-1D geometry is usually not investigated experimentally since low-order resonant wave interactions are theoretically prohibited. Here, we report on the first observation of unidirectional capillary-wave turbulence on the surface of a fluid in a canal. We also show that five-wave interactions are the lowest-order resonant process subsisting at small scales, and are thus probably the one generating such quasi-1D capillary wave turbulence. We show that the wave spectrum is compatible with the corresponding dimensional analysis prediction. The main assumptions of weak turbulence theory are also verified experimentally. Quasi-1D wave turbulence could be thus highlighted in other fields of wave turbulence.