bluuebunny/crossref_metadata_2025_split huggingface dataset:
Glabridin Hypnosis in Zebrafish Larvae Is Associated With Effects on Multiple Anesthetic Target Receptors
Authors: Avancha Aneesh , Hoyt Helen , Bhave Kieran , Medeiros Madyson , Cho Daniel , Brown Lauren E. , Fernández González Davinia , Porco John A. , Forman Stuart A. 
Published: November 2024

BACKGROUND:

R-Glabridin is a major flavonoid of licorice (Glycyrrhiza glabra) root and known to modulate GABAA receptors, which are targets of many clinical hypnotics. However, R-glabridin hypnotic activity has not been reported in animals.

METHODS:
Inverted photomotor responses (IPMRs) were used to assess the hypnotic effects of natural R-glabridin and synthetic R/S-glabridin in wild-type zebrafish larvae and transgenic larvae lacking functional GABAA receptor β3 subunits (β30/0). Two-electrode voltage-clamp electrophysiology in Xenopus oocytes heterologously expressing ion channels quantified the effects of R-glabridin on wild-type and mutated human α1β3γ2L GABAA receptors, NR1B/NR2A N-methyl-D-aspatate (NMDA) receptors, and α4β2 neuronal nicotinic (nnACh) receptors.

RESULTS:
IPMRs in wild-type zebrafish larvae identified R/S-glabridin as an inhibitor (IC50 = 7.5 µM; 95% confidence interval [CI], 5.9–9.3 µM) that was about half as potent as R-glabridin (IC50 = 4.4. µM; 95% CI, 3.6–5.4 µM). In β30/0 zebrafish larvae, R-glabridin inhibited IPMRs with IC50 = 7.5 µM (95% CI, 5.6–10.0 µM). Electrophysiologic studies revealed that R-glabridin directly activated and positively modulated α1β3γ2L GABAA receptors. Modulation was significantly reduced by α1L232W and β3N265M mutations in the β+/α- transmembrane intersubunit sites where etomidate binds, but not by 5 other point mutations in 4 other transmembrane modulator binding sites. NMDA and nnACh receptors were inhibited by R-glabridin.

DISCUSSION/CONCLUSIONS:
Our findings in zebrafish larvae indicate that IPMR inhibition by R-glabridin is more potent than S-glabridin and that β3-containing GABAA receptors contribute significantly to this behavioral effect. Molecular studies show that R-glabridin modulates at least 3 known anesthetic-sensitive ion channels, suggesting that it is a multimodal hypnotic.
Amitav Ghosh's Historical Genre Fictions
Authors: Darling Noelle 
Published: November 2024

Abstract
This article situates Amitav Ghosh—as both critic and novelist—in relation to the contemporary genre turn, as a means of questioning the logical distinctions undergirding ideas of literariness. Readers of Ghosh tend to cast the overtly science-fictional The Calcutta Chromosome: A Novel of Fevers, Delirium and Discovery as a generic anomaly in his otherwise historical realist oeuvre. Against such automatic delineations, this article argues that Ghosh's 1995 work is not such an outlier when we break down the multiple genres at play within novels across his career, and how their interactions produce effects that have been mistakenly attributed to one or other isolated genre. In The Calcutta Chromosome and the Ibis trilogy (case studies that seem generically distant), critical representations of globalization are developed through recourse to speculative genre frames for archival contents, with the effect of estranging historical continuity, collectivity, and narrative conventions. Attending to ambivalent deployments of genre allows for more precise identification of how contemporary novels formally construct and confuse their own world-building effects, and how critics categorize texts and attribute political-critical impact to them.
Effectiveness of percutaneous key lesion endoscopic lumbar decompression for the treatment of lumbar spinal stenosis in octogenarian patients
Authors: Yang Chien-Tung , Hung Cheng-Che , Wu Chih-Ying , Chiu You-Pen , Guo Jeng-Hung , Ji Hui-Ru , Chiu Cheng-Di 
Published: November 2024

Introduction
With increasing life expectancy, degenerative lumbar spinal stenosis (LSS) has become a common problem in the geriatric population. LSS reduces the quality of life, limits daily activities, and requires therapeutic aids. We share our experiences of treating octogenarian patients with LSS with key lesion percutaneous single portal endoscopic unilateral laminotomy and bilateral decompression (sEndo-ULBD).

Materials and methods
Nine octogenarian patients who underwent sEndo-ULBD between January 2021 and July 2022 were prospectively enrolled in this study. Their visual analogue score (VAS), Oswestry Disability Index (ODI), disc height, spondylolisthesis, lumbar lordotic angle, lumbar scoliotic angle, and spinal canal area before and after sEndo-ULBD were followed up for more than six months.

Results
The VAS score was significantly reduced three months after the operation (p < 0.05). The postoperative ODI scores of all patients improved relative to their preoperative scores; this difference became significant in the third month after the operation (p < 0.05). Index-level disc height did not significantly change after the operation. Spondylolisthesis, lumbar lordotic angle, and lumbar scoliotic angle showed no significant curve progression. The spinal canal area increased markedly after sEndo-ULBD (p <0.05), with no known surgery-related complications.

Conclusions
Key lesion sEndo-ULBD was an appropriate, safe, and effective treatment for octogenarian patients suffering from degenerative LSS. With an average follow-up of over one year, we did not find any significant progression in spinal curvature or instability. sEndo-ULBD is an ideal alternative to aggressive fusion fixation lumbar surgery for managing degenerative LSS in octogenarian patients with functional disability.
Modeling the health and economic implications of adopting a 1-dose 9-valent human papillomavirus vaccination program in adolescents in low/middle-income countries: An analysis of Indonesia
Authors: Daniels Vincent , Saxena Kunal , Patterson-Lomba Oscar , Gomez-Lievano Andres , At Thobari Jarir , Durand Nancy , Myers Evan 
Published: November 2024

Background
Recent evidence suggests that 1 dose of the human papillomavirus (HPV) vaccine may have similar effectiveness in reducing HPV infection risk compared to 2 or 3 doses.

Objective
To evaluate the public health impact and cost-effectiveness of implementing a 1-dose or a 2-dose program of the 9-valent HPV vaccine in a low- and middle-income country (LMIC).

Methods
We adapted a dynamic transmission model to the Indonesia setting, and conducted a probabilistic sensitivity analysis using distributions reflecting the uncertainty in levels and durability of protection of a 1-dose that were estimated under a Bayesian framework incorporating 3-year vaccine efficacy data from the KEN SHE trial (base-case) and 10 year effectiveness data from the India IARC study (alternative analysis). Scenarios included different coverage levels targeted at girls-only, or girls and boys. Costs and benefits were computed over 100 years from a national single-payer perspective.

Results
Depending on the coverage and target population, the median number of cancer cases avoided in 2-dose programs ranged between 600,000–2,100,000, compared to 200,000–600,000 in 1-dose programs. The 1-dose programs are unlikely to be cost-effective compared to 2-dose programs even at low willingness-to-pay (WTP) thresholds. The girls-only 2-dose program tends to be cost-effective at lower WTP thresholds, particularly in scenarios with high coverage, dose price and discount rate, while the girls and boys 2-dose program is cost-effective at higher WTP thresholds. In the alternative analysis, 1-dose programs have higher probability of being cost-effective compared to the base-case, particularly for low WTP thresholds (less than 0.5 GDP) and for high coverage, dose price and discount rate.

Conclusion
Adoption of 1-dose programs with 9-valent vaccine in an LMIC resulted in more vaccine-preventable HPV-related cancer cases than 2-dose programs. The 2-dose programs were more likely to be cost-effective than 1-dose programs for a wide range of WTP thresholds and scenarios.
Screening and treatment practices for iron deficiency in anaemic pregnant women: A cross-sectional survey of healthcare workers in Nigeria
Authors: Babah Ochuwa Adiketu , Beňová Lenka , Hanson Claudia , Abioye Ajibola Ibraheem , Larsson Elin C. , Afolabi Bosede Bukola 
Published: November 2024

Background
Iron deficiency anaemia in pregnancy is a significant contributor to maternal and perinatal morbidity and mortality globally. Despite international and national guidelines for its screening and treatment, knowledge and prescription practices of healthcare providers vary.

Aim
To determine maternal healthcare workers’ screening and treatment practices for iron deficiency in anaemic pregnancy women in two states in Nigeria.

Methodology
This cross-sectional study sampled maternal healthcare workers from 84 randomly selected public health facilities in Lagos and Kano States. Data on methods of diagnosis and prescription practices for iron deficiency anaemia were collected using a self-administered questionnaire. Means and percentages were reported using probability weights, and a comparison of practices of anaemia treatment between doctors and nurses/midwives was done using Chi-square test or Fishers exact.

Results
Of the 467 maternal healthcare workers surveyed (232 from Lagos, 235 from Kano), 40.0% were doctors, 54.0% nurses or midwives and 6.0% community health extension workers. In the sample, 27.6% always and 58.7% sometimes screened anaemic pregnant women for iron deficiency; among these, 84.7% screened using complete blood count. Oral iron for treatment of iron deficiency anaemia was prescribed by 96.9%. Intravenous iron for treatment was prescribed by 30.2%, but by only by 18.6% as first-line drug (as iron dextran by 69.3% and as iron sucrose by 31.5% of intravenous iron prescribers). Commonest reasons for low usage of intravenous iron were cost and need for venepuncture. Fifty-three percent of maternal healthcare workers’ prescribed iron supplements for anaemia during concomitant infection, with the prescription practice similar among doctors versus nurse/midwives (p = 0.074).

Conclusion
We found suboptimal levels of screening for iron deficiency among anaemic pregnant women. Iron deficiency anaemia in pregnancy is almost exclusively treated with oral iron by maternal healthcare workers in the two Nigerian states, similarly between doctors and nurses/midwives. Further research into potential reasons for low screening for iron deficiency and low use of intravenous iron are needed.
Prediction of breast cancer Invasive Disease Events using transfer learning on clinical data as image-form
Authors: Fanizzi Annarita , Bove Samantha , Comes Maria Colomba , Di Benedetto Erika Francesca , Latorre Agnese , Giotta Francesco , Nardone Annalisa , Rizzo Alessandro , Soranno Clara , Zito Alfredo , Massafra Raffaella 
Published: November 2024

Background and objective
Detecting patients at high risk of occurrence of an Invasive Disease Event after a first diagnosis of breast cancer, such as recurrence, distant metastasis, contralateral tumor and second tumor, could support clinical decision-making processes in the treatment of this malignancy. Though several machine learning models analyzing both clinical and histopathological information have been developed in literature to address this task, these approaches turned out to be unsuitable for describing this problem.

Methods
In this study, we designed a novel artificial intelligence-based approach which converts clinical information into an image-form to be analyzed through Convolutional Neural Networks. Specifically, we predicted the occurrence of an Invasive Disease Event at both 5-year and 10-year follow-ups of 696 female patients with a first invasive breast cancer diagnosis enrolled at IRCCS “Giovanni Paolo II” in Bari, Italy. After transforming each patient, represented by a vector of clinical information, to an image form, we extracted low-level quantitative imaging features by means of a pre-trained Convolutional Neural Network, namely, AlexNET. Then, we classified breast cancer patients in the two classes, namely, Invasive Disease Event and non-Invasive Disease Event, via a Support Vector Machine classifier trained on a subset of significative features previously identified.

Results
Both 5-year and 10-year models resulted particularly accurate in predicting breast cancer recurrence event, achieving an AUC value of 92.07% and 92.84%, an accuracy of 88.71% and 88.82%, a sensitivity of 86.83% and 88.06%, a specificity of 89.55% and 89.3%, a precision of 71.93% and 84.82%, respectively.

Conclusions
This is the first study proposing an approach which converts clinical information into an image-form to develop a decision support system for identifying patients at high risk of occurrence of an Invasive Disease Event, and then defining personalized oncological therapeutic treatments for breast cancer patients.
ABO-identical versus incompatible platelet transfusion in patients with intracranial hemorrhage
Authors: Dunn Lauren K. , Venner Emily , Nguyen Matthew , Trejo Jose Perdomo , Holley Zachary , Naik Bhiken I. , Khan Jenna , Mazzeffi Michael 
Published: November 2024

Background
Patients with spontaneous and traumatic intracranial hemorrhage (ICH) are frequently transfused platelets to treat thrombocytopenia, platelet function defects, and reverse antiplatelet drugs. ABO-identical platelet transfusion has been suggested to lead to higher post-transfusion platelet increments compared to major-ABO incompatible transfusion. We hypothesized that patients who received ABO-identical transfusion would have higher post-transfusion platelet increments and superior neurologic outcomes.

Methods
Adults with traumatic or non-traumatic ICH from January 1st 2018 to December 31st 2022 were identified using electronic medical records and international classification of disease (ICD)-10 codes. Patients were excluded if they lacked a platelet count within 24 hours before and within 24 hours after transfusion or if they received multiple platelet transfusions before their platelet count was remeasured. After stratification by ABO-identical, ABO-major incompatible, and ABO-minor incompatible transfusion, post transfusion increments were compared, as were clinical outcomes.

Results
Among 167 patients who received platelet transfusion, 76 (45.5%) received ABO-identical transfusion, 54 (32.3%) received ABO-major incompatible transfusion, and 37 (22.2%) received ABO-minor incompatible transfusion. There were no significant differences in absolute platelet increment between groups. The median increment was 7x109/L for ABO-identical platelets, 10x109/L for ABO-major incompatible platelets, and 11x109/L for ABO-minor incompatible platelets, p = .87. There was no significant difference in the percentage of patients discharged alive with modified Rankin score of 1 or 2 or cerebral performance category 1 or 2 between groups (p = .56 and .39 respectively). After adjusting for confounders in a general linear model there remained no associations between ABO compatibility and platelet increment after transfusion.

Conclusions
Our data support similar efficacy for ABO-identical and ABO-incompatible platelet transfusion in patients with ICH.
Protocol: A mixed-methods study to evaluate implementation and outcomes of U.S. state telemental health policy expansion during the COVID-19 pandemic
Authors: Leung Lucinda B. , Santos Jasmeen J. , Escarce José J. , Ettner Susan L. , Der-Martirosian Claudia , Raja Pushpa , McCourt Alexander D. , Fortney John , McGinty Emma E. 
Published: November 2024

Background
Until the COVID-19 pandemic, it had not been possible to examine the effect of rapid policy changes surrounding telemental health on patient-reported mental health care access, costs, symptoms, and functioning. Sizable variation in telemental health use by patient race-ethnicity, age, and rurality, and in its adoption across healthcare settings, underscores the need to study equitable dissemination and implementation of high-quality telemental health services in the real world. This protocol describes an explanatory sequential mixed-methods study that aims to examine the effects of state telemental health policy expansion on patient-reported mental health outcomes, as well as the policy-to-practice pathway from the perspectives of state leaders, clinicians, and staff who care for underserved patients.

Methods
This study uses legal mapping research methods to characterize the effective dates and specific provisions of telemental health policies (e.g., Medicaid reimbursement, private payer laws, professional licensure requirements) before and during the COVID-19 pandemic in all 50 U.S. states and Washington, D.C. Then, we will examine state factors (e.g., COVID-19 cases, broadband internet access) explaining these telemental health policies using discrete-time hazard models. The primary quantitative analysis employs a difference-in-difference approach to predict effects on outcome measures using a nationally representative survey of individuals. Using the Medical Expenditure Panel Survey, we will examine policy effects on (a) access to, use of, and expenditures related to mental health care and (b) mental health outcomes, functioning, and employment. Finally, qualitative methods will be used to obtain feedback from state leaders, administrators, clinicians, and clinic staff members on how state telemental health policy expansion influenced mental health services delivery during the pandemic, with a focus on improving safety-net care. We will use a positive deviance approach to select key partners from 6 “high” and 6 “low” telehealth expansion states for interviews and focus groups.

Discussion
The overall study goal is to better understand the effect of pandemic-related state policy changes around telehealth on patient-reported mental health care access, costs, symptoms, and functioning. By characterizing variations in telehealth policies and their downstream effects, this mixed-methods study aims to inform equitable dissemination, implementation, and sustainment of high-quality telemental health services.
The association between systemic immune-inflammation index and prostate-specific antigen: Results from NHANES 2003–2010
Authors: Tang Zhongqiu , Li Shaojie , Zeng Mengjun , Zeng Lu , Tang Zhaohui 
Published: November 2024

Purpose
Current research has not extensively explored the correlation between Systemic Inflammatory Index (SII) and prostate-specific antibody (PSA) levels. This study aimed to investigate the relationship between the SII and PSA levels in American males aged > 40 years without prostate cancer.

Methods
Data were obtained from the 2003–2010 National Health and Nutrition Examination Survey (NHANES). Patients without complete SII or PSA data were excluded. Multiple linear regression models were used to investigate the possibility of a linear association between the SII and PSA levels. Fitted smoothed curves and threshold effect analyses were used to characterize the nonlinear relationships.

Results
The study included 5982 male participants over the age of 40 years from the United States. The average SII (mean ± standard deviation) was 562.78 ± 355.60. The mean value of PSA was 1.85 ± 3.24. The results showed that SII exhibited a positive correlation with PSA (β = 0.0005, 95% CI: (0.0002, 0.0007)), and an interaction test indicated that the effects of age, body mass index, hypertension, and diabetes were not significant for this positive correlation between SII and PSA (all P > 0.05). We discovered an inverted U-shaped connection between the SII and PSA with a turning point (K) of 1168.18 by using a two-segment linear regression model. To the left of the turning point, there was a positive connection between SII and PSA (β = 0.0009,95% CI: (0.0006, 0.0012); P < 0.0001).

Conclusion
In the population of men over 40 years old without prostate cancer, SII and PSA exhibited a non-linear relationship. Specifically, there was a positive correlation between SII and PSA levels when the SII value was < 1168.18.
Reference values for respiratory muscle strength and maximal voluntary ventilation in the Brazilian adult population: A multicentric study
Authors: Araújo Palomma Russelly Saldanha , Fonseca Jéssica Danielle Medeiros da , Marcelino Ana Aline , Moreno Marlene Aparecida , Dornelas de Andrade Arméle de Fátima , Yañez Matias Otto , Torres-Castro Rodrigo , Resqueti Vanessa Regiane , Fregonezi Guilherme Augusto de Freitas 
Published: November 2024

Aim
To determine reference values and propose prediction equations for respiratory muscle strength, maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), and endurance by means of maximal voluntary ventilation (MVV) in healthy Brazilian adults.

Methods
Anthropometric data, level of physical activity, pulmonary function, and respiratory muscle strength and maximal voluntary ventilation of 243 participants (111 men and 132 women) aged 20 to 80 years were assessed at three cities in the southeast and northeast region of Brazil.

Results
Mean maximal respiratory pressures and MVV were higher in men (MIP = 111.0 ± 28.0; MEP = 149.6 ± 40.3; MVV = 150.6 ± 35.2) than in women (MIP = 87.9 ± 17.6; MEP = 106.7 ± 25.2; MVV = 103.4 ± 23.2; all p < 0.05). Based on regression models, the following prediction equations were proposed for men: MIP = 137–0.57 (age), R2 = 0.13, standard error of estimate (SEE) = 26.11; MEP = 179.9–0.67 x (age), R2 = 0.08, SEE = 38.54; and MVV = 206.3–1.18 x (age), R2 = 0.36, SEE = 28.08. Prediction equations were also proposed for women: MIP = 107.3–0.4 x (age), R2 = 0.16, SEE = 16.10; MEP = 127.4–0.43 x (age), R2 = 0.08, SEE = 24.09; and MVV = 146.3–0.86 x (age), R2 = 0.42, SEE = 17.56.

Conclusion
Reference values for MIP, MEP, and MVV were determined in healthy Brazilian adults. Results from different Brazilian regions provided adequate prediction equations considering an ethnically heterogeneous population.
The state of iodine deficiency in Kyrgyzstan: Insights from studies of knowledge, attitudes and practices
Authors: Chyngyshpaeva Yulia , Dzhaliev Zhokhongir , Derbishalieva Zhyparkul , Ibrahim Muiz , Lucero-Prisno Don Eliseo III , Dzhusupov Kenesh 
Published: November 2024

Objective
This study aimed to assess the knowledge, attitudes, and practices (KAPs) regarding iodine deficiency among the population of Kyrgyzstan, with a focus on pregnant women, and to correlate these factors with the urinary iodine concentration (UIC).

Methods
A cross-sectional study was conducted using structured questionnaires and urine sample analysis to evaluate iodine status. A multistage stratified sampling method ensured a representative sample from both urban and rural areas. Descriptive statistics were used to summarize demographic characteristics and KAP variables, whereas chi-square tests and multivariate logistic regression analysis were used to identify predictors of KAP outcomes.

Results
The study included 690 participants, with balanced representation from both urban and rural areas. The mean knowledge score was moderate, with significant gaps in the understanding of iodine deficiency. The participants generally had positive attitudes toward iodine intake but exhibited suboptimal practices, especially in rural areas. Pregnant women demonstrated greater knowledge, but fewer practical behaviors related to iodine intake. Compared with rural participants, urban participants had higher UIC levels, indicating better iodine nutrition. Multivariate regression analysis revealed that residence, knowledge, attitudes, and practices significantly influenced UIC levels.

Conclusion
Despite existing iodization programs, significant gaps remain in the knowledge and practices related to iodine intake, particularly in rural areas. This study highlights the need for targeted public health interventions to improve iodine nutrition and reduce the burden of iodine deficiency disorders in Kyrgyzstan. Enhancing public health education, improving the accessibility and affordability of iodized salt, and regularly monitoring the iodine status are essential strategies for addressing these issues.