bluuebunny/crossref_metadata_2025_split huggingface dataset:
Aortic valve sclerosis is not a benign finding but progressive disease associated with poor cardiovascular outcomes
Authors: Seo Jeong Hun , Chun Kwang Jin , Lee Bong-Ki , Cho Byung-Ryul , Ryu Dong Ryeol 
Published: November 2024

Abstract
Background
Aortic valve sclerosis (AVS) shares risk factors with atherosclerosis. However, the relationship between AVS progression with cardiovascular (CV) risk has not been researched. This study investigates CV outcomes according to progression of AVS.

Methods
This study included 2,901 patients with AVS (irregular leaflet thickening and peak aortic jet velocity < 2 m/sec) who underwent serial echocardiograms at least 1 year apart during 2011–2020. The primary outcome was defined as CV death, myocardial infarction, stroke, or revascularization.

Results
During a median follow-up period of 3.9 years, 439 of 2,901 AVS patients (15.1%) progressed to mild or greater aortic stenosis. Patients with progression were older and more likely to have atrial fibrillation than those without. In a stepwise regression, age (odds ratio [OR] per 1-year increase, 1.04; 95% confidence interval [CI], 1.01–1.07), peripheral artery disease (OR, 9.07; 95% CI, 3.12–26.4), and left ventricular mass index (OR per 1-g/m2 increase, 1.01; 95% CI, 1.00–1.02) were associated with AVS progression. Over a median of 6.3 years, the primary outcome occurred in 858 of 2,901 patients (29.6%). Patients with progression had higher frequency of CV death, myocardial infarction, stroke, or revascularization than those without progression (P < 0.0001). In Cox proportional hazards regression, AVS progression (hazard ratio, 1.33; 95% CI, 1.10–1.61) was a significant determinant of CV mortality.

Conclusions
The progression to aortic stenosis in AVS patients is an independent risk factor for CV mortality. These findings suggest that patients with AVS progression may benefit from stricter CV risk monitoring.
Decision Making in Information Security Investments: Impact of System Vulnerability and Investment Timing on Resource-Sharing Platforms
Authors: Zhao Hui , Wu Yong , Jin Zhijie 
Published: November 2024

This study distinguishes enterprises into high- and low-type categories based on enterprise value and cost efficiency, examining their strategic behaviors in three investment timing games: move simultaneously, the high-type enterprise moves first, and the low-type enterprise moves first. By comparing the three games, we find that both types of enterprises would always exert more effort in the sequential game than in the simultaneous game, and the later-move advantage makes both types of enterprises prefer to become the follower in the game. We also find that the enhanced cost efficiency advantage or enterprise value gap possessed by the high-type enterprise would widen the effort gap between the two types of enterprises, and enhance the low-type enterprise’s incentive to be the follower. Moreover, the existence of system vulnerability not only causes both types of enterprises to reduce their security effort that generates free-riding behaviors but also can first discourage and then encourage enterprises from moving in advance. We further propose a liability-based mechanism to tackle the free-riding problem. We reveal an exact optimal liability coefficient, whether in the simultaneous or sequential game and find that the high-type enterprise should undertake more compensation when its dominant position becomes more obvious and the low-type enterprise could therefore undertake decreased liability. Last, we extend the model to multiple enterprises and show that the results are robust. Funding: This work was supported by the Shanghai Science and Technology Development Foundation [Grant 24692107700]; the Humanities and Social Science Fund of Ministry of Education of China [Grant 23YJA630100]; Fundamental Research Funds for the Central Universities; DHU Distinguished Young Professor Program; and the Shanghai Social Science Foundation [Grant 2022ZGL009]. Supplemental Material: The online appendix is available at https://doi.org/10.1287/deca.2024.0190 .
An Improved Combinatorial Benders Decomposition Algorithm for the Human-Robot Collaborative Assembly Line Balancing Problem
Authors: Huang Dian , Mao Zhaofang , Fang Kan , Fu Enyuan , Pinedo Michael L. 
Published: November 2024

As an emerging technology, human-robot collaboration (HRC) has been implemented to enhance the performance of assembly lines and improve the safety of human workers. By integrating the advantages of human workers and collaborative robots (cobots), HRC enables production systems to process tasks consecutively, concurrently, or collaboratively. However, the introduction of cobots also makes the corresponding human-robot collaborative assembly line balancing problem more complex and difficult to solve. To solve this problem, we first propose an enhanced mixed integer program (EMIP) with various enhancement techniques and tighter bounds, and then, we develop an improved combinatorial Benders decomposition algorithm (Algorithm ICBD) with new local search strategies, Benders cuts, and acceleration procedures. To verify the effectiveness of our proposed model and algorithms, we conduct extensive computational experiments, and the results show that our proposed EMIP model is significantly better than the existing mixed integer program model; the percentages of instances that can obtain feasible and optimal solutions are increased from 82.42% to 100% and from 29.17% to 43.5%, respectively, whereas the average gap is decreased from 19.81% to 5.64%. In addition, our proposed Algorithm ICBD can get 100% of feasible solutions and 65.92% of optimal solutions for all of the test instances, and the average gap is only 1.49%. Moreover, compared with existing Benders decomposition methods for this problem, our approach yields comparatively better solutions in notably shorter average computational time when run in the same computational environment. History: Accepted by Andrea Lodi, Area Editor for Design & Analysis of Algorithms–Discrete. Funding: This research was supported by the National Natural Science Foundation Council of China [Grants 72401214, 92167206, 7221101377, 72471169, and 72231005], the Ministry of Education of China [Grant 24YJC630078], and Computation and Analytics of Complex Management Systems (Tianjin University). This research was also supported by the Tianjin Natural Science Foundation Project [Grant 23JCQNJC01900] and the Tianjin Philosophy and Social Science Planning Project [Grant TJGL21-016]. Supplemental Material: The software that supports the findings of this study is available within the paper and its Supplemental Information ( https://pubsonline.informs.org/doi/suppl/10.1287/ijoc.2023.0279 ) as well as from the IJOC GitHub software repository ( https://github.com/INFORMSJoC/2023.0279 ). The complete IJOC Software and Data Repository is available at https://informsjoc.github.io/ .
Exploring variations in the implementation of a health system level policy intervention to improve maternal and child health outcomes in resource limited settings: A qualitative multiple case study from Uganda
Authors: Walugembe David Roger , Plamondon Katrina , Kaharuza Frank , Waiswa Peter , Wylie Lloy , Wathen Nadine , Kothari Anita 
Published: November 2024

Background
Despite growing literature, few studies have explored the implementation of policy interventions to reduce maternal and perinatal mortality in low- and middle-income countries (LMICs). Even fewer studies explicitly articulate the theoretical approaches used to understand contextual influences on policy implementation. This under-use of theory may account for the limited understanding of the variations in implementation processes and outcomes. We share findings from a study exploring how a health system-level policy intervention was implemented to improve maternal and child health outcomes in a resource limited LMIC.

Methods
Our qualitative multiple case study was informed by the Normalization Process Theory (NPT). It was conducted across eight districts and among ten health facilities in Uganda, with 48 purposively selected participants. These included health care workers located at each of the cases, policy makers from the Ministry of Health, and from agencies and professional associations. Data were collected using semi-structured, in-depth interviews to understand uptake and use of Uganda’s maternal and perinatal death surveillance and response (MPDSR) policy and were inductively and deductively analyzed using NPT constructs and subconstructs.

Results
We identified six broad themes that may explain the observed variations in the implementation of the MPDSR policy. These include: 1) perception of the implementation of the policy, 2) leadership of the implementation process, 3) structural arrangements and coordination, 4) extent of management support and adequacy of resources, 5) variations in appraisal and reconfiguration efforts and 6) variations in barriers to implementation of the policy.

Conclusion and recommendations
The variations in sense making and relational efforts, especially perceptions of the implementation process and leadership capacity, had ripple effects across operational and appraisal efforts. Adopting theoretically informed approaches to assessing the implementation of policy interventions is crucial, especially within resource limited settings.
A Phase II, Multicentric, Randomized, Double-Blind, Placebo-Controlled, Proof of Concept Study of Efficacy and Safety of Rifamycin SV-MMX 600 mg Tablets Administered Three or Two Times Daily to Patients With Diarrhea-Predominant Irritable Bowel Syndrome
Authors: Balsiger Lukas Michaja , Santos Javier , Serra Jordi , Piessevaux Hubert , Baert Didier , Storr Martin , Basilisco Guido , Mazzetti Alessandro , Moro Luigi , Gerloni Mara , Longo Luigi , Gentili Alessandra , Tack Jan 
Published: November 2024

INTRODUCTION:
Treatment with nonresorbable antibiotics is effective in diarrhea-predominant irritable bowel syndrome (IBS-D). Multimatrix (MMX) formulations ensure targeted drug delivery to the mid-distal small bowel and colon—traditionally considered the origin of IBS symptoms. To assess the efficacy of rifamycin SV-MMX for the treatment of IBS-D.

METHODS:
Randomized controlled trial in patients with IBS-D (Rome IV). Patients received rifamycin SV-MMX 600 mg (b.i.d = 1200 mg/d or t.i.d = 1800 mg/d) or placebo for 2 weeks. Primary end point was responder rate in the first treatment week on the full analysis set (FAS). Response was defined as decrease in average abdominal pain ≥ 30% AND ≥50% reduction of days with stool type 6 or 7 based on daily reporting.

RESULTS:
A total of 279 patients were randomized (=ITT), and 264 of were included in the FAS. More patients with rifamycin SV-MMX b.i.d (22/88, 25.00%) met the primary end point than t.i.d (10/81, 12.35%) or placebo (9/95, 9.47%) in both FAS and ITT. Adjusted odds ratio (AOR) for b.i.d. vs placebo was 3.26 (95% confidence interval (CI): 1.39–7.67; P = 0.007) and for t.i.d. vs b.i.d. 0.40 (95% CI: 0.17–0.92; P = 0.031). After treatment, the percentage of monthly global responders was higher in the b.i.d. group vs placebo in the first month (64.2% vs 46.6%, adjusted odds ratio = 2.14 95% CI: 1.15; 4.00; P = 0.0173) and first 2 months.

DISCUSSION:
Rifamycin SV-MMX 600 mg b.i.d. was more effective than placebo and t.i.d. dosing in the first week of treatment. Two months after treatment, rifamycin SV-MMX 600 mg b.i.d. provided more global symptom relief than placebo.
Use of a Two-Gene Methylated DNA Biomarker Assay and Nonendoscopic Balloon for Detection of Barrett Esophagus Among High-Risk Individuals in a Screening Population
Authors: Shaheen Nicholas J. , Othman Mohamed O. , Taunk Jawar , Chang Kenneth J. , Jaganmohan Sathya , Yachimski Patrick S. , Fang John C. , Spataro Joseph S. , Verma Suman , Lee Victoria T. , deGuzman Brian J. , Aklog Lishan 
Published: November 2024

INTRODUCTION:
Barrett esophagus (BE) is the precursor to esophageal adenocarcinoma (EAC). We aimed to assess performance, safety, and tolerability of the EsoGuard (EG) assay on samples collected nonendoscopically with the EsoCheck (EC) device (EG/EC) for BE detection in the intended-use population meeting American College of Gastroenterology guideline criteria (chronic gastroesophageal reflux disease and 3+ additional risk factors).

METHODS:
We performed a prospective, multicenter study (NCT04293458) to assess EG performance (primary endpoint) on cells collected with EC, for detection of BE and EAC using esophagogastroduodenoscopy (EGD) and biopsies as the comparator. Twenty-four sites across the United States and Spain participated. EC safety and usability were assessed as secondary endpoints.

RESULTS:
180 male subjects aged >50 years with chronic gastroesophageal reflux disease met eligibility criteria, of which 163 (90.6%) had EGD and successful EC administration. Mean age was 60.5 years, 34.4% were obese, 56.7% had tobacco history, and 3.9% had a 1st degree relative with BE or EAC. Of 122 samples analyzed, 93 contributed to the primary endpoint analysis. Eight subjects (8.6%) in the Primary Analysis Population had BE on EGD, none with dysplasia. Sensitivity of EG for BE was 87.5% (95% confidence interval [CI] 47.4–99.7), specificity was 81.2% (95% CI 71.2–88.8), positive predictive value was 30.4% (95% CI 13.2–52.9), and negative predictive value was 98.6% (95% CI 92.3–99.96). Mild esophageal abrasions were observed in 1.5%; no serious adverse events were reported.

DISCUSSION:
This study in the intended-use population suggests that EG/EC is promising for BE screening. While future work is necessary to define its performance characteristics with more precision, this approach may provide a safe, accurate, and well-tolerated nonendoscopic alternative in high-risk patients.
Gastrointestinal health anti-diarrheal mixture relieves spleen deficiency-induced diarrhea through regulating gut microbiota
Authors: Wu Zhengquan , Yao Liuyi , Guo Jun , Xu Zhong , Wang Zhengyan 
Published: November 2024

Abstract
This study evaluated the therapeutic efficacy of the gastrointestinal health anti-diarrheal mixture (GHAM) on diarrhea induced by spleen deficiency, focusing on its modulation of gut microbiota. Using specific pathogen-free Wistar rats, a spleen deficiency model was created through senna leaf gavage. Rats were divided into control, model, positive control, and GHAM treatment groups. After a 14-day treatment, fecal samples were analyzed via 16S rDNA sequencing to assess microbiota alterations. GHAM significantly mitigated diarrhea and enhanced food intake and fecal quality. It increased the abundance of beneficial bacteria, such as Romboutsia and Clostridium_sensu_stricto_1, and decreased the levels of diarrhea-associated bacteria, such as Prevotellaceae and Bacillus, thereby improving microbiota functionality. GHAM’s modulation of gut microbiota structure and function effectively alleviated spleen deficiency-induced diarrhea, positioning it as a potential natural herbal treatment for gastrointestinal ailments. This study lays the groundwork for further exploration of GHAM’s regulatory impact on gut health.
Myriad factors and pathways influencing tumor radiotherapy resistance
Authors: Mi Lanjuan , Zhang Hongquan 
Published: November 2024

Abstract
Radiotherapy is a cornerstone in the treatment of various tumors, yet radioresistance often leads to treatment failure and tumor recurrence. Several factors contribute to this resistance, including hypoxia, DNA repair mechanisms, and cancer stem cells. This review explores the diverse elements that drive tumor radiotherapy resistance. Historically, resistance has been attributed to cellular repair and tumor repopulation, but recent research has expanded this understanding. The tumor microenvironment – characterized by hypoxia, immune evasion, and stromal interactions – further complicates treatment. Additionally, molecular mechanisms such as aberrant signaling pathways, epigenetic modifications, and non-B-DNA structures play significant roles in mediating resistance. This review synthesizes current knowledge, highlighting the interplay of these factors and their clinical implications. Understanding these mechanisms is crucial for developing strategies to overcome resistance and improve therapeutic outcomes in cancer patients.
On implementation of Stickel's key exchange protocol over max-min and max-T semirings
Authors: Alhussaini Sulaiman , Sergeev Sergeĭ 
Published: November 2024

Abstract
Given that the tropical Stickel protocol and its variants are all vulnerable to the generalized Kotov–Ushakov attack, we suggest employing the max-min semiring and, more generally, max-

T

T

semiring where the multiplication is based on a

T

T

-norm, as a framework to implement the Stickel protocol. While the Stickel protocol over max-min semiring or max-

T

T

semiring remains susceptible to a form of Kotov–Ushakov attack, we demonstrate that it exhibits significantly increased resistance against this attack when compared to the tropical (max-plus) implementation.
Crystal structure of 1′,3′-dihydro-2,2′-spirobi[indene]-1,3-dione, C17H12O2
Authors: Wang Lanhua , Liu Qi 
Published: November 2024

Abstract
C17H12O2, monoclinic, P21/c (no. 14), a = 11.0333(13) Å, b = 15.7993(19) Å, c = 7.0619(9) Å, β = 92.302(2)∘, V = 1230.0(3) Å3, Z = 4, R
gt(F) = 0.0420, wR
ref(F
2) = 0.1081, T = 298 K.
Schweigeminute nach Versterben eines Menschen auf der Intensivstation
Authors: Meyer-Natus Theresa , Frick Eckhard , Mächler Ruth 
Published: November 2024

Zusammenfassung
Das Konzept einer einminütigen Schweigeminute nach dem Tod eines Patienten (in der Literatur als „PAUSE“ bekannt) wird in internationalen Studien, vor allem im amerikanischen Raum, als förderlich für das psychische Wohlbefinden des Personals beschrieben (Bartels 2014; Kapoor et al. 2018; Ducar & Cunningham 2019; Welch et al. 2022; Webb et al. aop). Diese Studie zielt darauf ab, die Machbarkeit und Wirkung einer solchen Schweigeminute in München zu untersuchen.
In einem zweistufigen Studiendesign wird zunächst die Bereitschaft des medizinischen Personals zur Einführung der Schweigeminute erfasst (Stufe 1), gefolgt von der clusterrandomisierten Implementierung und Überprüfung der Intervention (Stufe 2). Wir analysieren den Einfluss der Intervention auf die Lebenszufriedenheit und das Work-Engagement.
Die Ergebnisse können Hinweise auf die Machbarkeit und den Nutzen einer Schweigeminute in Deutschland geben und das Potenzial dieser Intervention zur Verbesserung der Lebenszufriedenheit und das Work-Engagement des Intensivpersonals beleuchten.
Design e artesanato: auxílio para o pré desenvolvimento de uma identidade visual
Authors: Pinto Azevedo Luiza , Lopes Damasceno Patrícia 
Published: November 2024

Este artigo é um recorte de um Trabalho de Conclusão de Curso que tem como objetivo auxiliar o designer na etapa de pré desenvolvimento de uma identidade visual para um artesão, tendo por base a metodologia de Design Participativo (BATISTA, 2011). Para alcançar esse objetivo, foi explicitada a relação entre design e artesanato e esclarecido o conceito de identidade visual para um artesão, a partir de de Borges (2011), Sebrae (2014) e Batista (2011). Por fim, apresenta-se uma análise de marcas desenvolvidas para artesãos, na qual se utilizou da técnica de benchmarking (CARLINI, 2004) aliada aos princípios do design. Como resultados foi possível observar que o artesanato é parte indispensável da cultura de um povo, representa suas práticas e costumes, além de influenciar diretamente na economia de um determinado lugar. Também foi possível perceber que identidades visuais desenvolvidas especialmente para artesãos através da metodologia de Design Participativo preza pela participação deste em todas as etapas do processo do desenvolvimento de uma marca.
A sustentabilidade como potencializadora da indissociabilidade entre ensino, pesquisa e extensão
Authors: Natalia Steigleder Clara , Da Fonseca Holz Raquel , Eduardo Silveira Luzardo Javier , Carlos de Oliveira Koglin João , Pinto da Silva Maurício 
Published: November 2024

Este ensaio apresenta a EspecializaçãoGestão para a Sustentabilidade, do Centro de Integração do Mercosul (CIM), refletindo sobre os aspectos teóricos e práticos que nortearam sua formulação. O tema Sustentabilidade é tratado como potencializador da indissociabilidade entre ensino, pesquisa e extensão. A relação universidade - sociedade marca de forma significativa o Curso a partir de três pilares: 1) Sustentabilidade como uma escolha que representa um compromisso do CIM com o desenvolvimento sustentável, tanto nas ações internas, institucionais, como em relação à região em que está inserido; 2) a transversalidade e indivisibilidade dos Objetivos do Desenvolvimento Sustentável no trabalho conjunto das áreas que compõem o CIM, possibilitando uma abordagem complexa do tema da Sustentabilidade; e 3) a dimensão prática que o Curso adquire a partir da compreensão da importância da produção de estudos, pesquisas, políticas e ações de ensino e extensão que promovam a Sustentabilidade nas ações dos agentes públicos e privados.
Saúde e bem estar: Ações extensionistas e seu potencial de transformação de uma SAC urbana utilizada por moradores de Divinópolis MG
Authors: Guimaraes Parreira Adriano , Cunha Tibúrcio Larissa 
Published: November 2024

O acesso à água com qualidade e em abundância é desigual em todo o mundo. No Brasil, cerca de 35 milhões de pessoas não têm acesso à água potável, como alternativa, comunidades em vulnerabilidade hídrica tendem a buscar outros meios de abastecimento como as SAC’s (soluções alternativas coletivas de abastecimento). Em Divinópolis MG há várias SAC’s cuja água é utilizada pela população para consumo próprio sem o devido conhecimento de sua qualidade microbiológica, em sua maioria localizadas em regiões com diferentes níveis de degradação ambiental. Neste sentido, o foco deste trabalho consistiu na realização de intervenções na SAC urbana popularmente conhecida como mina Bela Vista, cuja água é frequentemente coletada pela população local para consumo próprio. As ações envolveram análises laboratoriais periódicas da qualidade microbiológica de amostras de água coletadas naquele manancial, levantamento das condições macroscópicas gerais, reuniões junto a comunidade, autoridades municipais e veículos de comunicação com vistas a melhoria das condições encontradas. Em um ambiente de interação dialógica e buscando transformação social, assegurando vida saudável e bem estar aos usuários, observou-se variação da qualidade microbiológica da água ao longo do período de avaliação, classificação predominantemente ruim da condição macroscópica observada, os quais fundamentaram levantamento de proposições e conquista de acordos com o poder público local com vistas ao cercamento da nascente, instalação de lixeiras assim como a conscientização dos moradores locais quanto ao descarte de lixo e trânsito de animais.