bluuebunny/crossref_metadata_2025_split huggingface dataset:
Integrated behavioral health implementation and chronic disease management inequities: an exploratory study of statewide data
Authors: Buchanan Gretchen J. R. , Berge Jerica M. , F. Piehler Timothy 
Published: August 2024

Abstract
Background
People with diabetes, vascular disease, and asthma often struggle to maintain stability in their chronic health conditions, particularly those in rural areas, living in poverty, or racially or ethnically minoritized populations. These groups can experience inequities in healthcare, where one group of people has fewer or lower-quality resources than others. Integrating behavioral healthcare services into primary care holds promise in helping the primary care team better manage patients’ conditions, but it involves changing the way care is delivered in a clinic in multiple ways. Some clinics are more successful than others in fully integrating behavioral health models as shown by previous research conducted by our team identifying four patterns of implementation: Low, Structural, Partial, and Strong. Little is known about how this variation in integration may be related to chronic disease management and if IBH could be a strategy to reduce healthcare inequities. This study explores potential relationships between IBH implementation variation and chronic disease management in the context of healthcare inequities.

Methods
Building on a previously published latent class analysis of 102 primary care clinics in Minnesota, we used multiple regression to establish relationships between IBH latent class and healthcare inequities in chronic disease management, and then structural equation modeling to examine how IBH latent class may moderate those healthcare inequities.

Results
Contrary to our hypotheses, and demonstrating the complexity of the research question, clinics with better chronic disease management were more likely to be Low IBH rather than any other level of integration. Strong and Structural IBH clinics demonstrated better chronic disease management as race in the clinic’s location became more White.

Conclusions
IBH may result in improved care, though it may not be sufficient to resolve healthcare inequities; it appears that IBH may be more effective when fewer social determinants of health are present. Clinics with Low IBH may not be motivated to engage in this practice change for chronic disease management and may need to be provided other reasons to do so. Larger systemic and policy changes are likely required that specifically target the mechanisms of healthcare inequities.
Social disparities in access and quality of consultation in outpatient care in Germany
Authors: von dem Knesebeck Olaf , Lüdecke Daniel , Klein Jens 
Published: August 2024

Abstract
Background
Overall, research on social determinants of access and quality of outpatient care in Germany is scarce. Therefore, social disparities (according to sex, age, income, migration background, and health insurance) in perceived access and quality of consultation in outpatient care (primary care physicians and specialists) in Germany were explored in this study.

Methods
Analyses made use of a cross-sectional online survey. An adult population sample was randomly drawn from a panel which was recruited offline (N = 2,201). Perceived access was assessed by waiting time for an appointment (in days) and travel time to the practice (in minutes), while quality of consultation was measured by consultation time (in minutes) and quality of communication (scale of four items, Cronbach’s Alpha 0.89).

Results
In terms of primary care, perceived access and quality of consultation was worse among women compared to men. Estimated consultation time was shorter among people with statutory health insurance compared to privately insured respondents. Regarding specialist care, people aged 60 years and older reported shorter waiting times and better quality of communication. Lower income groups reported lower quality of communication, while perceived access and quality of consultation was worse among respondents with a statutory health insurance. Variances explained by the social characteristics ranged between 1% and 4% for perceived access and between 3% and 7% for quality of consultation.

Conclusion
We found social disparities in perceived access and quality of consultation in outpatient care in Germany. Such disparities in access may indicate structural discrimination, while disparities in quality of consultation may point to interpersonal discrimination in health care.
Analysis of intracellular communication reveals consistent gene changes associated with early-stage acne skin
Authors: Deng Min , Odhiambo Woodvine O. , Qin Min , To Thao Tam , Brewer Gregory M. , Kheshvadjian Alexander R. , Cheng Carol , Agak George W. 
Published: August 2024

AbstractA comprehensive understanding of the intricate cellular and molecular changes governing the complex interactions between cells within acne lesions is currently lacking. Herein, we analyzed early papules from six subjects with active acne vulgaris, utilizing single-cell and high-resolution spatial RNA sequencing. We observed significant changes in signaling pathways across seven different cell types when comparing lesional skin samples (LSS) to healthy skin samples (HSS). Using CellChat, we constructed an atlas of signaling pathways for the HSS, identifying key signal distributions and cell-specific genes within individual clusters. Further, our comparative analysis revealed changes in 49 signaling pathways across all cell clusters in the LSS— 4 exhibited decreased activity, whereas 45 were upregulated, suggesting that acne significantly alters cellular dynamics. We identified ten molecules, including GRN, IL-13RA1 and SDC1 that were consistently altered in all donors. Subsequently, we focused on the function of GRN and IL-13RA1 in TREM2 macrophages and keratinocytes as these cells participate in inflammation and hyperkeratinization in the early stages of acne development. We evaluated their function in TREM2 macrophages and the HaCaT cell line. We found that GRN increased the expression of proinflammatory cytokines and chemokines, including IL-18, CCL5, and CXCL2 in TREM2 macrophages. Additionally, the activation of IL-13RA1 by IL-13 in HaCaT cells promoted the dysregulation of genes associated with hyperkeratinization, including KRT17, KRT16, and FLG. These findings suggest that modulating the GRN-SORT1 and IL-13-IL-13RA1 signaling pathways could be a promising approach for developing new acne treatments.
Validation of an AI-based solution for breast cancer risk stratification using routine digital histopathology images
Authors: Sharma Abhinav , Lövgren Sandy Kang , Eriksson Kajsa Ledesma , Wang Yinxi , Robertson Stephanie , Hartman Johan , Rantalainen Mattias 
Published: August 2024

Abstract
Background
Stratipath Breast is a CE-IVD marked artificial intelligence-based solution for prognostic risk stratification of breast cancer patients into high- and low-risk groups, using haematoxylin and eosin (H&E)-stained histopathology whole slide images (WSIs). In this validation study, we assessed the prognostic performance of Stratipath Breast in two independent breast cancer cohorts.

Methods
This retrospective multi-site validation study included 2719 patients with primary breast cancer from two Swedish hospitals. The Stratipath Breast tool was applied to stratify patients based on digitised WSIs of the diagnostic H&E-stained tissue sections from surgically resected tumours. The prognostic performance was evaluated using time-to-event analysis by multivariable Cox Proportional Hazards analysis with progression-free survival (PFS) as the primary endpoint.

Results
In the clinically relevant oestrogen receptor (ER)-positive/human epidermal growth factor receptor 2 (HER2)-negative patient subgroup, the estimated hazard ratio (HR) associated with PFS between low- and high-risk groups was 2.76 (95% CI: 1.63–4.66, p-value < 0.001) after adjusting for established risk factors. In the ER+/HER2- Nottingham histological grade (NHG) 2 subgroup, the HR was 2.20 (95% CI: 1.22–3.98, p-value = 0.009) between low- and high-risk groups.

Conclusion
The results indicate an independent prognostic value of Stratipath Breast among all breast cancer patients, as well as in the clinically relevant ER+/HER2- subgroup and the NHG2/ER+/HER2- subgroup. Improved risk stratification of intermediate-risk ER+/HER2- breast cancers provides information relevant for treatment decisions of adjuvant chemotherapy and has the potential to reduce both under- and overtreatment. Image-based risk stratification provides the added benefit of short lead times and substantially lower cost compared to molecular diagnostics and therefore has the potential to reach broader patient groups.
Open total talus dislocation without concomitant malleoli fracture: a case report
Authors: Lamichhane Sameer , Maharjan Rajiv , Thapa Pramesh , Dhakal Binit , Dhungana Amit 
Published: August 2024

Abstract
Background
Total talus dislocation without ankle (malleoli) fracture is a very rare injury with prevalence of only 0.06% of all dislocations and only 2% of talar injuries, and are usually associated with common complications such as infection, avascular necrosis, and posttraumatic arthritis. The treatment usually involves debridement, reduction, stabilization of the ankle joint, and primary or secondary closure of the wound.

Case presentation
We present the case of a 40-year-old South Asian woman who was involved in an accident. She was rushed to our hospital, whereby subsequent examination revealed an open total talus dislocation with the talus being exposed in its entirety from a contaminated wound in the medial side. Furthermore, radiograph confirmed total talus dislocation without concomitant malleoli fracture. She was immediately taken to the operating theater whereby debridement and immediate reduction was performed under anesthesia, and the ankle was stabilized with external fixator for about 6 weeks. She is now able to bear weight on the affected ankle with minimal tolerable pain and has normal range of motion of the ankle.

Conclusions
Open total talus dislocation without concomitant malleoli fracture is a rare injury. Reduction of the talus in combination with complete wound debridement potentially successfully avoids infection, provides early revascularization preventing avascular necrosis, and preserves the normal ankle anatomy.
Metis: a python-based user interface to collect expert feedback for generative chemistry models
Authors: Menke Janosch , Nahal Yasmine , Bjerrum Esben Jannik , Kabeshov Mikhail , Kaski Samuel , Engkvist Ola 
Published: August 2024

AbstractOne challenge that current de novo drug design models face is a disparity between the user’s expectations and the actual output of the model in practical applications. Tailoring models to better align with chemists’ implicit knowledge, expectation and preferences is key to overcoming this obstacle effectively. While interest in preference-based and human-in-the-loop machine learning in chemistry is continuously increasing, no tool currently exists that enables the collection of standardized and chemistry-specific feedback. is a Python-based open-source graphical user interface (GUI), designed to solve this and enable the collection of chemists’ detailed feedback on molecular structures. The GUI enables chemists to explore and evaluate molecules, offering a user-friendly interface for annotating preferences and specifying desired or undesired structural features. By providing chemists the opportunity to give detailed feedback, allows researchers to capture more efficiently the chemist’s implicit knowledge and preferences. This knowledge is crucial to align the chemist’s idea with the de novo design agents. The GUI aims to enhance this collaboration between the human and the “machine” by providing an intuitive platform where chemists can interactively provide feedback on molecular structures, aiding in preference learning and refining de novo design strategies. integrates with the existing de novo framework REINVENT, creating a closed-loop system where human expertise can continuously inform and refine the generative models.Scientific contributionWe introduce a novel Graphical User Interface, that allows chemists/researchers to give detailed feedback on substructures and properties of small molecules. This tool can be used to learn the preferences of chemists in order to align de novo drug design models with the chemist’s ideas. The GUI can be customized to fit different needs and projects and enables direct integration into de novo REINVENT runs. We believe that can facilitate the discussion and development of novel ways to integrate human feedback that goes beyond binary decisions of liking or disliking a molecule.
Transient motion classification and segment analysis of diffusive trajectories of G proteins and coupled-receptors in a living cell
Authors: Stanislavsky Aleksander A. , Weron Aleksander 
Published: August 2024

AbstractThe molecular movement in single particle tracking (SPT) experiments shows a crucial role of diffusion in many biological processes such as signaling, cellular organization, transport mechanisms, and more. The SPT analysis detects not only classical Brownian motion but diffusion with other features. These include directed diffusion and confined motion. The behavior remains a challenging problem for several reasons. Due to the action of many physical processes, random trajectories of cellular molecules are segmented in different diffusive modes. Often their study requires sophisticated algorithms for the analysis of statistical properties. In this paper we consider the segment analysis for trajectories of G proteins and coupled-receptors in living cells. Their movement is often transient and switches among free diffusion, confined diffusion, directed diffusion, and immobility. Moreover, the confined segments can have both Gaussian and non-Gaussian statistics. The types of alternation of diffusive modes along the trajectories of G proteins and coupled-receptors are analyzed.
TRIM5 inhibits the replication of Senecavirus A by promoting the RIG-I-mediated type I interferon antiviral response
Authors: Li Huizi , Xie Zhenxin , Lei Xiaoling , Chen Ming , Zheng Tingting , Lin Cunhao , Ning Zhangyong 
Published: August 2024

Abstract Senecavirus A (SVA) is an emerging virus that poses a threat to swine herds worldwide. To date, the role of tripartite motif 5 (TRIM5) in the replication of viruses has not been evaluated. Here, TRIM5 was reported to inhibit SVA replication by promoting the type I interferon (IFN) antiviral response mediated by retinoic acid-inducible gene I (RIG-I). TRIM5 expression was significantly upregulated in SVA-infected cells, and TRIM5 overexpression inhibited viral replication and promoted IFN-α, IFN-β, interleukin-1beta (IL-1β), IL-6, and IL-18 expression. Conversely, interfering with the expression of TRIM5 had the opposite effect. Viral adsorption and entry assays showed that TRIM5 did not affect the adsorption of SVA but inhibited its entry. In addition, TRIM5 promoted the expression of RIG-I and RIG-I-mediated IFNs and proinflammatory cytokines, and this effect was also proven by inhibiting the expression of TRIM5. These findings expand the scope of knowledge on host factors inhibiting the replication of SVA and indicate that targeting TRIM5 may aid in the development of new agents against SVA.
Understanding the role of mobility in the recorded levels of violent crimes during COVID-19 pandemic: a case study of Tamil Nadu, India
Authors: Paramasivan Kandaswamy , Jaiswal Saish , Subburaj Rahul , Sudarsanam Nandan 
Published: August 2024

Abstract
Purpose/Goal
This research investigates the potential link between mobility and violent crimes in Tamil Nadu, India, using an empirical study centred on the COVID-19 pandemic waves (2020–2022). The goal is to understand how these events influenced crime, employing a counterfactual approach.

Methods
The study employs the XGBoost algorithm to forecast counterfactual events across different timeframes with varying levels of mobility. The mobility data sources include historical bus and passenger records spanning a decade, along with Google Community Mobility Reports added during the pandemic phases. The foundation for crime analysis is built upon the univariate time series of violent crimes reported as First Information Reports from 2010 to 2022.

Findings
Results indicate a significant correlation between mobility and violent crimes when mobility drops below a specific threshold. However, no such correlation is observed when mobility is above this threshold during the non-pandemic periods. The COVID-19 pandemic had a major impact on people’s and vehicular mobility, especially during the complete lockdown periods of the first two waves, and also affected crime rates.

Conclusions
The decrease in recorded incidents could also be attributed to fewer criminal opportunities. Additionally, this could be due to unfavourable situational factors, such as victims’ limited access to appropriate health and law enforcement agencies to report crimes. Furthermore, frontline services were busy with pandemic-related commitments, which could have contributed to a lack of crime registration even when crimes were committed.
Field measurements of turbulent mixing south of the Lombok Strait, Indonesia
Authors: Susanto R. Dwi , Wei Zexun , Santoso Priyadi Dwi , Wang Guanlin , Fadli Muhammad , Li Shujiang , Agustiadi Teguh , Xu Tengfei , Priyono Bayu , Li Ying , Fang Guohong 
Published: August 2024

AbstractThe Indonesian seas, with their complex passages and vigorous mixing, constitute the only route and are critical in regulating Pacific–Indian Ocean interchange, air–sea interaction, and global climate events. Previous research employing remote sensing and numerical simulations strongly suggested that this mixing is tidally driven and localized in narrow channels and straits, with only a few direct observations to validate it. The current study offers the first comprehensive temporal microstructure observations in the south of Lombok Strait with a radius of 0.05° and centered on 115.54oE and 9.02oS. Fifteen days of tidal mixing observations measured potential temperature and density, salinity, and turbulent energy dissipation rate. The results revealed significant mixing and verified the remotely sensed technique. The south Lombok temporal and depth averaged of the turbulent kinetic energy dissipation rate, and the diapycnal diffusivity from 20 to 250 m are $$\varepsilon$$
ε
= 4.15 ± 15.9) × 10–6 W kg–1 and $$K\rho$$

K
ρ

= (1.44 ± 10.7) × 10–2 m2s–1, respectively. This $$K\rho$$

K
ρ

is up to 104 times larger than the Banda Sea [$$K\rho$$

K
ρ

= (9.2 ± 0.55) × 10–6 m2s–1] (Alford et al. Geophys Res Lett 26:2741–2744, 1999) or the “open ocean” $$K\rho$$

K
ρ

= 0.03 × 10–4 m2s−1 within 2° of the equator to (0.4–0.5) × 10–4 m2s−1 at 50°–70° (Kunze et al. J Phys Oceanogr 36:1553–1576, 2006). Therefore, nonlinear interactions between internal tides, tidally induced mixing, and ITF plays a critical role regulating water mass transformation and have strong implications to longer-term variations and change of Pacific–Indian Ocean water circulation and climate.
Surgical approach for a refractory enterocutaneous fistula by combining laparoscopic surgery and a planned open conversion: a case report
Authors: Hasegawa Makoto , Ogino Takayuki , Sekido Yuki , Takeda Mitsunobu , Hata Tsuyoshi , Hamabe Atsushi , Miyoshi Norikatsu , Uemura Mamoru , Doki Yuichiro , Eguchi Hidetoshi 
Published: August 2024

Abstract
Background
An enterocutaneous fistula (ECF) is defined as an abnormal communication between the gastrointestinal tract and skin. ECFs are rarely encountered in clinical practice, yet are frequently difficult to treat. Few reports exist regarding the surgical techniques for the treatment of an ECF. Therefore, we report a case of refractory ECF with concomitant severe adhesions, in which we performed combined laparoscopic adhesiolysis and planned open conversion.

Case presentation
A 57-year-old female patient underwent a laparotomy for an ovarian cyst in her 20s. At 46 years, adhesiolysis without bowel resection was performed for adhesive small bowel obstruction (SBO). However, her symptoms did not improve. Eighteen days postoperatively, she underwent a reoperation and jejunostomy. An ECF developed post-reoperation; therefore, stoma closure and radical surgery for the ECF were planned. Due to the severe adhesions, only stoma closure was performed, based on intraoperative assessments. The patient was subsequently referred to our hospital. First, skin care around the fistula was provided during an outpatient visit. Appropriate sizing of the stoma pouch was performed, to improve erosions and ulcers. Thereafter, debridement of the perifistula skin and simple closure of the ECF outlet were attempted; however, the ECF recurred shortly thereafter. After 8 years of regular skin care, with the ECF remaining stable, however, manifesting as symptomatic SBO, she underwent laparoscopic adhesiolysis. This procedure was initiated in the epigastric region, where relatively fewer adhesions were anticipated. Post-open conversion, partial resection of the small intestine at four locations, including the fistula site, was performed. Postoperatively, jejunal edema and peristaltic dysfunction, due to narrowing of the superior mesenteric artery occurred. Regular drainage by percutaneous endoscopic gastrostomy was required. However, she improved and was discharged 3 months post-operatively. Three years post-operatively, the ECF and SBO did not recur.

Conclusions
We reported a case of refractory ECF in which we were able to safely perform surgery, by combining laparoscopic adhesiolysis and a planned open conversion. Therefore, the surgical approach used in this case may be an option for securing a safe surgical field, while avoiding collateral damage.
Automated cardiovascular MR myocardial scar quantification with unsupervised domain adaptation
Authors: Crawley Richard , Amirrajab Sina , Lustermans Didier , Holtackers Robert J. , Plein Sven , Veta Mitko , Breeuwer Marcel , Chiribiri Amedeo , Scannell Cian M. 
Published: August 2024

Abstract
Quantification of myocardial scar from late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) images can be facilitated by automated artificial intelligence (AI)-based analysis. However, AI models are susceptible to domain shifts in which the model performance is degraded when applied to data with different characteristics than the original training data. In this study, CycleGAN models were trained to translate local hospital data to the appearance of a public LGE CMR dataset. After domain adaptation, an AI scar quantification pipeline including myocardium segmentation, scar segmentation, and computation of scar burden, previously developed on the public dataset, was evaluated on an external test set including 44 patients clinically assessed for ischemic scar. The mean ± standard deviation Dice similarity coefficients between the manual and AI-predicted segmentations in all patients were similar to those previously reported: 0.76 ± 0.05 for myocardium and 0.75 ± 0.32 for scar, 0.41 ± 0.12 for scar in scans with pathological findings. Bland-Altman analysis showed a mean bias in scar burden percentage of -0.62% with limits of agreement from -8.4% to 7.17%. These results show the feasibility of deploying AI models, trained with public data, for LGE CMR quantification on local clinical data using unsupervised CycleGAN-based domain adaptation.

Relevance statement
Our study demonstrated the possibility of using AI models trained from public databases to be applied to patient data acquired at a specific institution with different acquisition settings, without additional manual labor to obtain further training labels.

Graphical Abstract