bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ripple Effects Mapping: Capturing the Wider Impacts of Systems Change Efforts in Public Health
Authors: Nobles James , Wheeler Jessica , Dunleavy-Harris Kirsty , Holmes Richard , Inman-Ward Alan , Potts Alexandra , Hall Jennifer , Redwood Sabi , Jago Russell , Foster Charlie 
Published: November 2021

Abstract
Background: Systems approaches are currently being advocated and implemented to address complex challenges in Public Health. These approaches work by bringing multi-sectoral stakeholders together to develop a collective understanding of the system, and then to identify places where they can leverage change across the system. Systems approaches are unpredictable, where cause-and-effect cannot always be disentangled, and unintended consequences – positive and negative – frequently arise. Evaluating such approaches is difficult and new methods are warranted.
Methods: Ripple Effects Mapping (REM) is a qualitative method which can capture the wider impacts, and adaptive nature, of a systems approach. Using a case study example from the evaluation of a physical activity systems approach in Gloucestershire, we: a) introduce the adapted REM method; b) describe how REM was applied in the example; c) explain how REM outputs were analysed; d) provide examples of how REM outputs were used; and e) describe the strengths, limitations, and future uses of REM based on our reflections.
Results: Ripple Effects Mapping is a participatory method that requires the active input of programme stakeholders in data gathering workshops. It produces visual outputs (i.e., maps) of the programmes activities and impacts, which are mapped along a timeline to understand the temporal dimension of systems change efforts. The REM outputs from our example were created over several iterations, with data collected every 3-4 months, to build a picture of activities and impacts that have continued or ceased. Workshops took place both in person and online. An inductive content analysis was undertaken to describe and quantify the patterns within the REM outputs. Detailed guidance related to the preparation, delivery, and analysis of REM are included in this paper.
Conclusion: REM may help to advance our understanding and evaluation of complex systems approaches, especially within the field of Public Health. We therefore invite other researchers, practitioners and policymakers to use REM and to continuously evolve the method to enhance its application and practical utility.
TNF-α Impairs Pericyte-Mediated Cerebral Microcirculation via the NF-κB/iNOS Axis After Experimental Traumatic Brain Injury
Authors: Zheng Shaorui , Wang Cheng , Lin Long , Mu Shuwen , Liu Haibing , Hu Xiaofang , Chen Xiangrong , Wang Shousen 
Published: November 2021

Abstract
Background
Secondary structural and functional abnormalities of the neurovascular unit are important pathological mechanisms following traumatic brain injury (TBI). The tumor necrosis factor α (TNF-α)/nuclear factor-κB (NF-κB) pathway regulates neuroinflammation and oxidative damage, which may act as triggers for pathological processes after TBI. However, the role of TNF-α/NF-κB in pericyte-mediated cerebral microcirculation are currently unknown.
Methods
We assessed the activity and mechanisms of the TNF-α/NF-κB signaling axis on pericyte-mediated microcirculation using the mouse controlled cortical impact model and BV2 cells. Immunofluorescent staining and western blot analysis were used to detect activation of the TNF-α/NF-κB signaling pathway and the expression of inducible nitric oxide synthase (iNOS) to evaluate the effects of the TNF-α specific inhibitor infliximab (IFX). Modified neurological severity scores, Garcia test, Nissl staining, and TUNEL staining were employed to determine the neuroprotective effects of IFX supplementation. The relative blood flow values in the capillary areas surrounding the impinging lesion were observed by Laser speckle contrast imaging. The impact of IFX on pericyte markers was assessed to evaluate whether pericyte damage was dependent on the TNF-α/NF-κB/iNOS axis to gain further insight into the mechanisms underlying the development of the microcirculation disturbance after TBI.
Results
Microglia were activated after TBI, and the expression of NF-κB, iNOS, a disintegrin and metalloproteinase 17, inflammatory factors, and free radicals increased around the injury areas. After lipopolysaccharide treatment, the expression of TNF-α and downstream NF-κB/iNOS in BV2 cells was significantly upregulated. Pharmacological inhibition of TNF-α via IFX significantly reduced NF-κB p65 phosphorylation and nuclear translocation and downregulated iNOS expression. Meanwhile, we found that specific inhibition of TNF-α reversed pericyte marker loss, and improved pericyte function and cerebral microcirculation perfusion after TBI, which could attenuate inflammation and oxidative damage, reduce neuronal cell damage and apoptosis, and play a neuroprotective role.
Conclusion
The results of this study suggested that microglia activated and released TNF-α after TBI, which promoted neuroinflammation and oxidative stress by activating downstream NF-κB/iNOS signals, and this led to pericyte-mediated disturbance of the cerebral microcirculation, which may be one of the vital mechanisms of secondary injury in TBI.
Protective Mechanism of Qi-Dan-Dihuang Decoction in Diabetic Kidney Disease Based on Network pharmacology
Authors: Kuang Liuyan , You Yanting , Qi Jieying , Zhou Xinghong , Chen Jieyu , Ji Shuai , Wang Min , Cheng Jingru , Kwan Hiu Yee , Jiang Pingping , Sun Xiaomin , Luo Ren , Zhao Xiaoshan 
Published: November 2021

Abstract
Background: Qi-Dan-Dihuang Decoction (QDD) has been used for treating diabetic kidney disease (DKD), but the mechanisms are poorly understood. The aim of this study is to reveal the therapeutic effects and the mechanism of QDD in ameliorating DKD by network pharmacology, in vivo, and in vitro studies.Methods: The effect of QDD on body weight, fast blood glucose, oral glucose tolerance test (OGTT), 24 h urinary protein (24hU-Pro), serum creatinine (Scr), blood urea nitrogen (BUN), and pathological evaluation in kidney were investigated in vivo using C57BLKS/J db/db mice. The main active compounds of QDD, compound-disease interaction targets, and related processes and pathways were discerned by network pharmacology analysis through Chinese Medicine Systems Pharmacology Database (TCMSP) and TCM Database@Taiwan. The protein-protein interaction (PPI) network were established through STRING database. GO and KEGG pathway were used for analysis processes and pathways. Then Western blot was used to verified the predicted results. Finally, cell viability, wound healing and mainly pathway protein expression were detected in vitro using renal tubular epithelial cells HK-2 and NRK-52E cells.Results: Although QDD treatment showed no significant difference in FBG and AUC of OGTT, but had significant reduction in Scr level in C57BLKS/J db/db mice. Histopathologic results showed that QDD ameliorated the expansion of mesangial area, thickened membranes of Bowman’s capsules and basement membrane of glomerular capillaries, renal tubular epithelial cells vacuolar degeneration and reversed the glomerular and tubulointerstitial in C57BLKS/J db/db mice. For network pharmacology analysis of QDD, 143 active compounds related to 274 possible targets in QDD obtained and 117 compound-disease interaction targets were screened out combining with Genecards database. 18 key targets was excavated through network topological analysis. GO and KEGG pathway enrichment analysis showed that compound-disease interaction targets were significantly enriched in processes and pathways that are closely related to DKD. Western blot results showed that QDD significantly attenuated EMT-related proteins, p-NF-κb, IL-1β, IL-18, p-p38MAPK/p38MAPK, p-AKT/AKT, and p-mTOR/ mTOR protein expressions. Treatment with QDD could alleviate cell viability damaged, EMT process, p-NF-κb, IL-1β, IL-18, p-p38MAPK/p38MAPK, p-AKT/AKT and p-mTOR/ mTOR protein expressions by high D-gulcose.Conclusions: This study provides convincing evidence suggest that QDD protects renal fibrosis of DKD, by regulating EMT in RTECs and inflammatory response through p38MAPK and AKT/mTOR signaling pathways.
A Method for Mill Monitoring Based on Inter-insert Periodic Correlation Using Singular Value Decomposition (SVD)
Authors: ZHU Xiaowen , Girardin François , Antoni Jérôme 
Published: November 2021

Abstract
This paper introduces a method to monitor the wear of end milling tools in real-time production based on inter-insert periodic correlation. The aim is to detect abnormal behavior of the cutter as early as possible to prevent severe tool failure and subsequent losses. The approach takes advantage of the angular domain to segment the signal in periodic cycles of the same angular duration, which are then amenable to correlation analysis. An ordered separability index with latent correlation characteristics is proposed to assess the current operating state of the tool. A series of simulations with existing experimental data are run to test the feasibility of the proposed index and to calculate the corresponding confidence interval. This approach has a high potential to form an efficient tool condition monitoring system. Compared to the traditional teach-in method, this method is more independent of the cutting conditions (changes of velocity or direction) and has no requirement for a trial cut, making the method useful for small batch production and can reduce the rate of false alarms.
Modelling Spatial Pattern of Anemia and Malnutrition Co-occurrence Among Under-five Children in Ethiopia: A Bayesian Geostatistical Approach
Authors: Egbon Osafu Augustine , Balechew Asrat Mekonnen , Bogoni Mariella Ananias 
Published: November 2021

Abstract
Background: Anemia and Malnutrition among under-five children are one of the major challenges to public health in Ethiopia. While anemia is responsible for delayed child development and growth, malnutrition is associated with the high infant mortality rate in Ethiopia. Method: This study aims to determine the socioeconomic, demographic, and geographical risk factors that simultaneously increase the co-occurrence of anemia and malnutrition among under-five children in Ethiopia. Geostatistical data was obtained from the Ethiopia Demographic and Health Survey for 2011 and 2016. A Bayesian hierarchical linear mixed model was adopted using the stochastic partial differential equation to estimate the spatial pattern of the co-occurrence of anemia and malnutrition in Ethiopia. Result: The findings revealed that gender, maternal education, number of children under five, birth order, preceding birth, contraceptive use, vaccination, marital status, birth weight, diarrhea, and fever are significant risk factors of the co-occurrence of anemia and malnutrition. The findings also reveal the vulnerability of under-five children to the co-occurrence of anemia and malnutrition within the first twenty months after birth and young maternal age. Regarding the geographical aspect, this study found a geographical disparity in the prevalence of anemia and malnutrition in Ethiopia. The highest burden of the co-occurrence of anemia and malnutrition lies in the Northern Gambela, Western Oromia, Northeast Benishangul-gumuz, Central and Northern Amhara, Southern Afar, and parts of Somali. Conclusion: These findings could be utilized by policymakers and intervention programs to simultaneously tackle and contain the prevalence of both anemia and malnutrition. For cost-effective intervention, policies and programs that improve individual-level risk factors of parents and caregivers are a more promising approach to tackle high prevalent regions than the ones on the children and should be considered as an utmost priority in the country.
Plastome Phylogenomics and Historical Biogeography of Aquatic Plant Genus Hydrocharis (Hydrocharitaceae)
Authors: Li Zhi-Zhong , Lehtonen Samuli , Gichira Andrew W. , Martins Karina , Andrey Efremov , Wang Qing-Feng , Chen Jin-Ming 
Published: November 2021

Abstract
Background
Hydrocharis L. and Limnobium Rich. are small aquatic genera, including three and two species, respectively. The taxonomic status, phylogenetic relationships and biogeographical history of these genera have remained unclear, owing to the lack of Central African endemic H. chevalieri from all previous studies. We sequenced and assembled plastomes of all three Hydrocharis species and Limnobium laevigatum to explore the phylogenetic and biogeographical history of these aquatic plants.
Results
All four newly generated plastomes were conserved in genome structure, gene content, and gene order. However, they differed in size, the number of repeat sequences, and inverted repeat borders. Our phylogenomic analyses recovered non-monophyletic Hydrocharis. African species H. chevalieri was fully supported as sister to the rest of the species, and L. laevigatum was nested in Hydrocharis as a sister to H. dubia. Hydrocharis-Limnobium initially diverged from the remaining genera at ca. 53.3 Ma, then began to diversify at ca. 30.9 Ma. The biogeographic analysis suggested that Hydrocharis probably originated in Europe and Central Africa.
Conclusion
Based on the phylogenetic results, morphological similarity and small size of the genera, the most reasonable taxonomic solution to the non-monophyly of Hydrocharis is to treat Limnobium as its synonym. The African endemic H. chevalieri is fully supported as a sister to the remaining species. Hydrocharis mainly diversified in the Miocene, during which rapid climate change may have contributed to the speciation and extinctions. The American species of former Limnobium probably dispersed to America through the Bering Land Bridge during the Miocene.
Adaptive Fixed-time Control for Nonlinear Systems Against Time-varying Actuator Faults
Authors: Mei Yu , Wang Jing , Park Ju H. , Shi Kaibo , Shen Hao 
Published: November 2021

Abstract
The adaptive fixed-time control problem for nonlinear systems with time-varying actuator faults is investigated in this paper. A novel adaptive fixed-time controller is designed via combining the Lyapunov stability theory with the backstepping method. It can be adapted to both system uncertainties and unknown actuator faults. Compared with the existing fault-tolerant control schemes subject to actuator faults, the adaptive fixed-time neural networks control scheme can make sure that the tracking error is convergent in a small neighborhood of the origin within a fixed-time interval, and it does not depend on the original states of the system and actuator faults. In light of the control scheme proposed in this paper, the fixed-time stability of the closed-loop system can be guaranteed by theoretical analysis, and a numerical example is provided to verify the effectiveness of obtained theoretical results.
Trends in the Occurrence and Treatment Outcomes of Tuberculosis in North Shewa Zone of Ethiopia: A 5-Year Retrospective Analysis of Cases at Tarmaber District Health Centers
Authors: Teklesilassia Seble , Gelana Tegenu , Alelign Tilahun 
Published: November 2021

Abstract
Background: Tuberculosis (TB) remain a key global public health concern in Ethiopia. The study aimed at assessing prevalence and treatment outcomes of tuberculosis in the past five years. Methods: A retrospective data were collected from TB registry unit at Debre-Sina and Aremanya health centers from 2014-2018. A total of 221 TB patients who were registered and attended the direct observed treatment (DOTs) service in the health centers included in the study. Data were analyzed using SPSS version 20.Results: Among 221 TB patients, the prevalence of pulmonary TB was 175 (79.2%) of which 35.7% were smear positive, 43.4% were smear negative, 19.9% were with extra pulmonary TB and 0.9% were multidrug resistant. TB was found to be higher in males (52.5%) than females (47.5%). The highest TB cases (62%) occurred in the age group of 15 to 44 years (c2 =26.110, p= 0.002). The occurrence of all forms of TB was higher in urban (56.6%) than in rural settings (43.4%). The incidence of TB/HIV co-infection in the study area was 19% (c2=9.534, p= 0.023). Treatment success was increased from 2014 to 2018 in both health centers; however, TB detection rate was low (45.8%) in the study area. Conclusions: This retrospective study showed a decreasing trend of TB in the last five years. However, the study implies the need to give emphasis on pulmonary TB case detection for its elimination program.
Fidelity and Maintenance of Motivational Interviewing Skills in Diabetes Prevention Program Coaches: A Pilot Study
Authors: Cranston Kaela , Ivanova Elena , Davis Connie , Jung Mary 
Published: November 2021

Abstract
Background: Motivational interviewing is an effective counselling style for changing lifestyle behaviours. Few studies have examined brief motivational interviewing training for non-healthcare practitioners to deliver motivational interviewing-informed health programs. The purpose of this study was to pilot a brief motivational interviewing workshop on non-healthcare practitioners to deliver a community-based diabetes prevention program. Methods: This pilot study used convenience sampling to obtain seven participants naïve to motivational interviewing who wanted to become diabetes prevention program coaches. Participants attended a two-day motivational interviewing workshop, were then shadowed by an expert coach delivering the diabetes prevention program, and finally, were shadowed by an expert coach and received feedback. The primary outcome was whether coaches were able to maintain a level of at least client-centered motivational interviewing skills for the six months post-training, as assessed by the Motivational Interviewing Competency Assessment (MICA). Two independent coders used the MICA to assess a random selection of participants’ audio recordings of interactions between with diabetes prevention program clients. One session for each client in coaches’ first six months post-training was coded. Motivational interviewing-competency scores were generated using MICA scores for six months. Results: Coaches were 25B2 years old, 71% female, and 43% had less than a bachelor’s degree. Mean motivational interviewing-competency was at a level of client-centered (total MICA score of 3.3a0.24) over six months. The majority (71%) of all sessions were client-centered for all of the MICA categories. Conclusions: This pilot study offers preliminary evidence that non-healthcare practitioners attending a brief motivational interviewing training were able to deliver a client-centered level of motivational interviewing in a community-based diabetes prevention program up to six months post-training without the use of any booster training sessions. This suggests that the training used within this study may be sufficient to train future non-healthcare practitioner diabetes prevention program coaches in the community.
Knowledge, Attitude and Practice of ARtificial Intelligence in Emergency and Trauma Surgery, the ARIES Project: An international web-based survey
Authors: De Simone Belinda , Abu-Zidan Fikri M , Gumbs Andrew A , Chouillard Elie , Saverio Salomone Di , Sartelli Massimo , Coccolini Federico , Ansaloni Luca , Collins Toby , Kluger Yoram , Moore Ernest E , Leppaniemi Ari , Litvin Andrej , Mascagni Pietro , Milone Luca , Piccoli Micaela , Abu-Hilal Mohamed , Sugrue Michael , Biffl Walter L , Catena Fausto 
Published: November 2021

Abstract
Aim: We aimed to evaluate the knowledge, attitude and practices in the application of artificial intelligence in the emergency setting among international acute care and emergency surgeons.
Methods: An online questionnaire composed of 30 multiple choice and open-ended questions was sent to the members of the World Society of Emergency Surgery between 29th May and 28th August 2021. The questionnaire was developed by a panel of 11 international experts and approved by the WSES steering committee.
Results: 200 participants answered the survey, 32 were females (16%). 172 (86%) surgeons thought that artificial intelligence will improve acute care surgery. Fifty surgeons (25%) were trained on robotic surgery and can perform it. Only 19 (9.5%) were currently performing it. 126 (63%) surgeons do not have a robotic system in their institution, and for those who have it, it was mainly used for elective surgery. Only 100 surgeons (50%) were able to define different artificial intelligence terminology. Participants thought that artificial intelligence is useful to support training and education (61.5%), perioperative decision making (59.5%), and surgical vision (53%) in emergency surgery. There was no statistically significant difference between males and females in ability, interest in training or expectations of artificial intelligence (p values 0.91, 0.82, and 0.28 respectively, Mann-Whitney U test). Ability was significantly correlated with interest and expectations (p< 0.0001 Pearson rank correlation, rho 0.42 and 0.47 respectively) but not with experience (p = 0.9, rho -0.01)
Conclusions: The implementation of artificial intelligence in the emergency and trauma setting is still in an early phase. The support of emergency and trauma surgeons is essential for the progress of AI in their setting which can be augmented by proper research and training programs in this area.
Multi-proteomic Analysis Revealed Distinct Protein Profiles in Cerebrospinal Fluid of Patients Between Anti-NMDAR Encephalitis NORSE and Cryptogenic NORSE
Authors: Wang Dongmei , Wu Yongming , Pan Yue , Wang Shengnan , Liu Guanghui , Gao Yibo , Xu Kaibiao 
Published: November 2021

Abstract
Background: New-onset refractory status epilepticus (NORSE) caused by anti-N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis and cryptogenic etiologies are various in clinical features. The underlying mechanisms of the diseases have still remained elusive.Methods: 6 patients with anti-NMDAR encephalitis NORSE, 5 with cryptogenic NORSE (C-NORSE), and 5 controls were enrolled. Clinical data, including clinical features, cerebrospinal fluid (CSF) samples, and cranial images were collected. CSF samples were tested for FAIMS based quantitative proteomic analysis, immunome protein microarray, and inflammatory cytokine array. Bioinformatics and immunostaining were used for interpretation and verification.Results: The clinical features of anti-NMDAR encephalitis NORSE and C-NORSE patients were similar to those reported previously. Proteomic analysis revealed that 101 proteins (63 up-regulated and 38 down-regulated) and 56 proteins (42 up-regulated and 14 down-regulated) changed in CSF samples of anti-NMDAR encephalitis NORSE and C-NORSE patients, respectively. The mean fold-change of the up-regulated proteins, namely up-proteomic score in this study, was positively associated with the severity of disease, including ICU stay, mRS score at discharge, and time taken for patients awaking from a coma. The distribution of changed proteins in CSF between the two diseases were quite different. Pathways of humoral immune response, wound healing, and epigenetic regulation of transcription were up-regulated in anti-NMDAR encephalitis NORSE. Pathways of innate and lymphocyte mediated immune response, synaptic functions, ubiquitination, and cell apoptosis were up-regulated in C-NORSE group, suggesting that C-NORSE could undergo neurodegeneration. This was consistent with a mouse model of SE, which showed high ubiquitination and cell apoptosis in CA1 to CA3 regions of hippocampus. Immunome microarray analysis demonstrated high autoantibody targeting 48 proteins in CSF samples of anti-NMDAR encephalitis NORSE. However, in C-NORSE, the reaction was kept at a very low level. Inflammatory cytokine array, unexpectedly, showed no remarkable changes except for decreased level of interleukin-6 (IL-6) in both anti-NMDAR encephalitis NORSE and C-NORSE.Conclusions: The present study suggests that the up-proteomic score of CSF could be a promising indicator for assessment of the severity of anti-NMDAR encephalitis NORSE and C-NORSE. The distinct CSF proteomes imply different pathogenic mechanisms of the two diseases, and immunotherapy strategies as well.