bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adherence to integrated management of childhood illness (IMCI) guidelines by community health workers in Kano State, Nigeria through use of a clinical decision support (CDS) platform
Authors: McLaughlin Megan , Metiboba Loveth , Giwa Aisha , Femi-Ojo Olufunke , Ravi Nirmal , Mahmoud Nasir Mamoud , Mount-Finette Ezra , Langle-Chimal Ollin , Abbas Dina , Finette Barry 
Published: August 2024

Abstract
Background
The World Health Organization (WHO) Integrated Management of Childhood Illness (IMCI) guidelines established in 1992 to decrease preventable under-five child morbidity and mortality, was adopted by Nigeria in 1997. Over 20 years later, while under-five child mortality remains high, less than 25% of first level facilities have trained 60% of community health workers (CHW) who care for sick children with IMCI. This study investigated the impact in CHWs overall adherence to IMCI guidelines, particularly for critical danger signs, as well as usability and feasible following the implementation of THINKMD’s IMCI-based digital clinical decision support (CDS) platform.

Methods
Adherence to IMCI guidelines was assessed by observational and digital data acquisition of key IMCI clinical data points by 28 CHWs, prior, during, and post CDS platform implementation. Change in IMCI adherence was determined for individual CHW and for the cohort by analyzing the number of IMCI data points acquired by each CHW per clinical evaluation. Consistency of adherence was also calculated by averaging the percentage of total evaluations each data point was observed. Usability and acceptability surveys were administered following use of the CDS platform.

Results
THINKMD CDS platform implementation notably enhanced the CHWs’ ability to capture key IMCI clinical data elements. We observed a significant increase in the mean percentage of data points captured between the baseline period and during the CDS technology implementation (T-test, t = -31.399, p < 0.016, Holm-Bonferroni correction, two-sided), with the mean values going from 30.7% to 72.4%. Notably, even after the completion of the technology implementation phase, the mean percentage of IMCI elements captured by CHWs remained significantly elevated compared to the baseline, with a 26.72 percentage point increase (from 30.7% to 57.4%, T-test, t = -15.779, p < 0.05, Holm-Bonferroni correction, two-sided). Usability and feasibility of the platform was high. CHWs reported that the CDS platform was easy to learn and use (93%) and enabled them to identify sick children (100%).

Conclusion
These results demonstrate that utilization of a digital clinical decision support tool such as THINKMD’s IMCI based CDS platform can significantly increase CHW adherence to IMCI guidelines over paper-based utilization, increase clinical quality and capacity, and improve identification of key danger signs for under-five children while being highly accepted and adopted.
EpCAM-targeted betulinic acid analogue nanotherapy improves therapeutic efficacy and induces anti-tumorigenic immune response in colorectal cancer tumor microenvironment
Authors: Dutta Debasmita , Al Hoque Ashique , Paul Brahamacharry , Park Jun Hyoung , Chowdhury Chinmay , Quadir Mohiuddin , Banerjee Soumyabrata , Choudhury Arghadip , Laha Soumik , Sepay Nayim , Boro Priyanka , Kaipparettu Benny Abraham , Mukherjee Biswajit 
Published: August 2024

Abstract
Background
Betulinic acid (BA) has been well investigated for its antiproliferative and mitochondrial pathway-mediated apoptosis-inducing effects on various cancers. However, its poor solubility and off-target activity have limited its utility in clinical trials. Additionally, the immune modulatory role of betulinic acid analogue in the tumor microenvironment (TME) is largely unknown. Here, we designed a potential nanotherapy for colorectal cancer (CRC) with a lead betulinic acid analogue, named as 2c, carrying a 1,2,3-triazole-moiety attached to BA through a linker, found more effective than BA for inhibiting CRC cell lines, and was chosen here for this investigation. Epithelial cell adhesion molecule (EpCAM) is highly overexpressed on the CRC cell membrane. A single-stranded short oligonucleotide sequence, aptamer (Apt), that folds into a 3D-defined architecture can be used as a targeting ligand for its specific binding to a target protein. EpCAM targeting aptamer was designed for site-specific homing of aptamer-conjugated-2c-loaded nanoparticles (Apt-2cNP) at the CRC tumor site to enhance therapeutic potential and reduce off-target toxicity in normal cells. We investigated the in vitro and in vivo therapeutic efficacy and anti-tumorigenic immune response of aptamer conjugated nanotherapy in CRC-TME.

Methods
After the characterization of nanoengineered aptamer conjugated betulinic acid nanotherapy, we evaluated therapeutic efficacy, tumor targeting efficiency, and anti-tumorigenic immune response using cell-based assays and mouse and rat models.

Results
We found that Apt-2cNP improved drug bioavailability, enhanced its biological half-life, improved antiproliferative activity, and minimized off-target cytotoxicity. Importantly, in an in vivo TME, Apt-2cNP showed promising signs of anti-tumorigenic immune response (increased mDC/pDC ratio, enhanced M1 macrophage population, and CD8 T-cells). Furthermore, in vivo upregulation of pro-apoptotic while downregulation of anti-apoptotic genes and significant healing efficacy on cancer tissue histopathology suggest that Apt-2cNP had predominantly greater therapeutic potential than the non-aptamer-conjugated nanoparticles and free drug. Moreover, we observed greater tumor accumulation of the radiolabeled Apt-2cNP by live imaging in the CRC rat model.

Conclusions
Enhanced therapeutic efficacy and robust anti-tumorigenic immune response of Apt-2cNP in the CRC-TME are promising indicators of its potential as a prospective therapeutic agent for managing CRC. However, further studies are warranted.

Graphical abstract
Socioeconomic benefits associated with bats
Authors: Aggrey Siya , Rwego Innocent B. , Sande Eric , Khayiyi Joyce D. , Kityo Robert M. , Masembe Charles , Kading Rebekah C. 
Published: August 2024

Abstract
Background
While bats are tremendously important to global ecosystems, they have been and continue to be threatened by loss of habitat, food, or roosts, pollution, bat diseases, hunting and killing. Some bat species have also been implicated in the transmission of infectious disease agents to humans. While One Health efforts have been ramped up recently to educate and protect human and bat health, such initiatives have been limited by lack of adequate data on the pathways to ensure their support. For instance, data on the role of bats in supporting different components of human welfare assets would be utilized as a stepping stone to champion conservation campaigns. Unfortunately, these data are limited and efforts to synthesize existing literature have majorly focused on few components human welfare leaving other important aspects.

Methods
Here, we analyze benefits associated with bats in the context of welfare economics considering all the asset components. We surveyed scientific and gray literature platforms utilizing particular keywords. We then classified these values using integrated approaches to understand different values across human welfare assets of “health,” “material and immaterial assets,” “security or safety” and “social or cultural or spiritual relations”.

Results
We found 235 papers from different countries indicating that bats play fundamental roles in supporting human welfare. These benefits were more prevalent in Asia and Africa. In terms of the use of bats to support welfare assets, bats were majorly utilized to derive material and immaterial benefits (n = 115), e.g., food and income. This was followed by their use in addressing health challenges (n = 99), e.g., treatment of ailments. There was a similarity in the benefits across different regions and countries.

Conclusion
These results indicate potential opportunities for strengthening bat conservation programs. We recommend more primary studies to enhance understanding of these benefits as well as their effectiveness in deriving the perceived outcomes.
Semi-field evaluation of electrocuting eave tubes for the control of endophagic mosquitoes in south-east Tanzania
Authors: Shirima Ruth S. , Katusi Godfrey C. , Mmbando Arnold S. , Fanuel Gracious , Aslanis Dimitrios , Kadam Suhas , Lonji Clement Tshidibi , Sylvester Haruna A. , Lluberas Manuel , Okumu Fredros O. , Knols Bart G. J. , Kaindoa Emmanuel W. 
Published: August 2024

Abstract
Background
Eave spaces are major entry points through which malaria vectors enter houses. Interventions that target mosquitoes at the eaves have recently been developed. However, most of these interventions are based on insecticides for which resistance has been reported. Here we evaluated the efficacy of mosquito electrocuting eave tubes (MEETs) against Anopheles gambiae sensu stricto (An. gambiae s.s.) and Anopheles funestus s.s. under semi-field conditions.

Methods
Experiments were conducted in two semi-field chambers, each containing one experimental hut. Six electrocuting eave tubes were installed in each hut to assess their impact on laboratory-reared An. gambiae s.s. and An. funestus s.s.. Each species was assessed separately over 10 nights by releasing 200 unfed females per night into each chamber. One volunteer slept in each hut from 7 p.m. to 5 a.m. Mosquitoes were collected indoors and outdoors using mouth and Prokopack aspirators.

Results
The placement of MEETs significantly reduced the nightly An. gambiae s.s. indoor and outdoor biting, by 21.1% and 37.4%, respectively. Indoor-biting An. funestus s.s. were reduced by 87.5% while outdoor-biting numbers of An. funestus s.s. declined by 10.4%.

Conclusions
MEETs represent a promising tool for controlling mosquitoes at the point of house entry. Further validation of their potential under natural field conditions is necessary. Several advantages over insecticide-based eave tubes are indicated and discussed in this article.

Graphical Abstract
Bank intermediation efficiency and liquidity risk in Egypt: a two-stage non-parametric analyses
Authors: Pasha Rania 
Published: August 2024

AbstractThis is a pioneering study that undertakes a comparative analysis assessing the annual intermediation efficiency of public versus private banks in Egypt. Moreover, liquidity risk is a major threat facing banks in their efforts to sustain financial stability. Thus, this study is the first to model the determinants of liquidity risk in public and private banks in Egypt while examining the impact of banks’ intermediation efficiencies on their liquidity risk levels. The study employs advanced nonparametric econometric approaches on a sample of Egyptian public and private banks from 2014 to 2022. The data envelopment analysis is used in estimating banks’ intermediation efficiency scores, while the quantile regression analysis is applied to examine the impact of bank intermediation efficiency on liquidity risk under different liquidity risk quantiles. The findings indicate that public banks show consistent superiority in terms of their financial intermediation efficiency levels compared to private banks. Moreover, the paper findings demonstrate the negative significant relationship between bank intermediation efficiency and liquidity risk while highlighting the higher significant positive impact of intermediation efficiency on reducing the liquidity risk of banks that are characterized by undertaking high liquidity risk levels. Furthermore, contrary to general assumptions, this study’s findings demonstrate that the significance of micro- and macro-level determinants of a bank’s liquidity risk is dependent on its prevailing liquidity risk level. Hence, the positive impact of equity capital, asset concentration, size, and growth in gross domestic product and the negative effect of asset quality on bank liquidity risk vary under banks’ different liquidity risk quantiles.
Cognitive–behavioural therapy for complex post-traumatic stress disorder
Authors: Rajkumar Beena 
Published: August 2024

SUMMARYComplex post-traumatic stress disorder (CPTSD) was adopted as a new diagnosis in ICD-11. Trauma-focused cognitive–behavioural therapy (CBT) is effective in treating PTSD but with CPTSD being a recently defined diagnosis, the evidence for its effectiveness in that disorder is not as clear, but it is still promising. This article reviews the diagnosis, psychopathology and some key differential diagnoses, and looks at the two CBT approaches that are currently used in clinical practice: the phase-oriented approach and the unimodal approach. The key aims of this article are to clarify the concept of CPTSD, its differentiation from borderline personality disorder and prominent comorbidities, how it develops and how CBT is used to treat it.
Pilot Study of Plasma miRNA Signature Panel for Differentiating Single vs Multiglandular Parathyroid Disease
Authors: Goldfarb Melanie , Bustos Matias A , Moon Jamie , Jackson Katherine , Singer Frederick R , Hoon Dave S B 
Published: August 2024

Abstract

Context
The ability to differentiate sporadic primary hyperparathyroidism (sPHPT) caused by a single parathyroid adenoma (PTA) from multiglandular parathyroid disease (MGD) preoperatively, as well as definitely diagnose sPHPT in difficult patients, would enhance surgical decision-making.

Objective
This work aimed to identify miRNA (miR) signatures for MGD, single- and double-PTA, as well as cell-free miRNA (cfmiR) in plasma samples from patients with single-PTAs to use as biomarkers.

Methods
A total of 47 patients with sPHPT (single-PTA n = 32, double-PTA n = 12, MGD n = 9). Preoperative plasma samples from 16 single-PTA and 29 normal healthy donors (NHDs). All specimens were processed and analyzed for 2083 miRs using HTG EdgeSeq miR whole-transcriptome assay and normalized using DESeq2 to identify differentially expressed (DE) miRs. MiR classifiers were identified using Random Forest. Main outcome measures were receiver operating characteristic curves and areas under the curve.

Results
MiR signatures distinguished normal parathyroid from MGD and PTA as well as MGD from PTA in tissue samples. Common miRs were found in the single-PTA and double-PTAs. Data integration identified a 27-miR signature in single-PTA tissue samples compared to the rest of the tissue samples. In plasma samples analysis, significant cfmiRs were DE in single-PTA patients compared to NHD. Of those, only 9 miRNAs/cfmiRs were found DE both in tissue and plasma samples from patients diagnosed with a single PTA (AUC = 76%).

Conclusion
Twenty-seven miRs were consistently found DE in single-PTA tissue and plasma samples. Data integration showed a 9-cfmiR signature with potential clinical utility to preoperatively diagnose sPHPT caused by a single PTA, which could decrease more invasive parathyroid explorations.
Mechanistic divergences of endocytic clathrin-coated vesicle formation in mammals, yeasts and plants
Authors: Johnson Alexander 
Published: August 2024

ABSTRACT
Clathrin-coated vesicles (CCVs), generated by clathrin-mediated endocytosis (CME), are essential eukaryotic trafficking organelles that transport extracellular and plasma membrane-bound materials into the cell. In this Review, we explore mechanisms of CME in mammals, yeasts and plants, and highlight recent advances in the characterization of endocytosis in plants. Plants separated from mammals and yeast over 1.5 billion years ago, and plant cells have distinct biophysical parameters that can influence CME, such as extreme turgor pressure. Plants can therefore provide a wider perspective on fundamental processes in eukaryotic cells. We compare key mechanisms that drive CCV formation and explore what these mechanisms might reveal about the core principles of endocytosis across the tree of life. Fascinatingly, CME in plants appears to more closely resemble that in mammalian cells than that in yeasts, despite plants being evolutionarily further from mammals than yeast. Endocytic initiation appears to be highly conserved across these three systems, requiring similar protein domains and regulatory processes. Clathrin coat proteins and their honeycomb lattice structures are also highly conserved. However, major differences are found in membrane-bending mechanisms. Unlike in mammals or yeast, plant endocytosis occurs independently of actin, highlighting that mechanistic assumptions about CME across different systems should be made with caution.
Muscle Mitochondrial Capacity Is Impaired Immediately Following Maximal Exercise
Authors: DICKINSON CALLIE G. , MENDEZ KRISTIN M. , HOLYFIELD MAKAYLA D. , BATCHELOR NICHOLAS T. , MCCULLY KEVIN K. 
Published: August 2024

ABSTRACT
Mitochondria are essential in supplying energy to skeletal muscle. Near-infrared spectroscopy (NIRS) was developed to noninvasively assess mitochondrial capacity (mV̇O2max) as a rate constant of metabolic recovery after exercise.

Purpose
This study measured the time course mV̇O2max following both maximal and submaximal exercise.

Methods
Healthy male and female participants were tested (n = 12 maximal and n = 8 submaximal exercise). A NIRS device was placed on the left medial gastrocnemius. Participants performed either 1 min of maximal, rapid (~2 Hz), or submaximal (~0.37 Hz) plantar flexion exercise on a custom pneumatic ergometer. mV̇O2max was measured before and immediately after exercise. mV̇O2max measurements consisted of four incomplete recovery curves of muscle metabolism taken after 30 s of electrical muscle stimulation except in the first post-exercise to be consistent with the use of pre-exercise trial. The four recovery curves were collected 50-, 156-, 260-, and 366-s postexercise, each producing an mV̇O2max rate constant.

Results
After maximal exercise, muscle acceleration decreased to 52 ± 18% (P = 0.001) of prevalues. mV̇O2max was reduced from the pre-exercise mean at the first post-trial (2.16 ± 0.44 to 1.21 ± 0.52 min−1, P < 0.001). The fourth trial showed recovery from the first (2.2 ± 0.46 min−1 vs 1.21 ± 0.52 min−1, P < 0.001) and was not significantly different from pre-exercise values (2.2 ± 0.46 vs 2.16 ± 0.44 min−1, P = 0.41). No change in acceleration or mV̇O2max was seen after submaximal exercise (P > 0.05).

Conclusions
The 56.7% reduction in mV̇O2max supports the hypothesis that in young, healthy individuals, a minute of maximal exercise transiently impairs mV̇O2max, which then recovers within 6 min. The NIRS method shows promise in tracking time course changes in mV̇O2max and warrants further investigation of the transient effects of exercise on mV̇O2max.
Assessment of Maximum Heart Rate Prediction Equations in Adults at Low and High Risk of Cardiovascular Disease
Authors: BOULAY PIERRE , GHACHEM AHMED , POIRIER PAUL , SIGAL RONALD J. , KENNY GLEN P. 
Published: August 2024

ABSTRACT

Purpose
Maximum heart rate (HRmax) is commonly used to estimate exercise intensity. Since direct measurement of HRmax is not always practical, prediction equations were developed. However, most equations have not been properly validated in adults at low and high risk of cardiovascular disease (CVD). We sought to: 1) assess the accuracy of commonly used equations to predict HRmax among adults at low and high CVD risk and, 2) determine if SuperLearner (SL) modeling combining base machine algorithms could improve HRmax prediction.

Methods
A total of 1208 participants (61.6 ± 7.3 yr; 62.7% male) were included. HRmax was measured during a maximal cardiorespiratory exercise test. Predicted HRmax was estimated using the following published equations: Fox, Åstrand, Tanaka, Gelish and Gulati, and a SL model. Bland-Altman analyses as well as performance indicators such as root mean squared error (RMSE) and Lin’s Concordance Correlation Coefficient were performed.

Results
All predicted HRmax-derived equations were positively associated with measured HRmax (women: r = 0.31; men: r = 0.46, P ≤ 0.001) but to a greater extent using a SL model (women: r = 0.47; men: r = 0.59, P ≤ 0.001). Overall, all equations tended to overestimate measured HRmax, with a RMSE which varied between 10.4 and 12.3 bpm. Although the SL model outperformed other equations, with no significant difference between measured and predicted HRmax, RMSE remained high (11.3 bpm). Lack of accuracy was mainly observed among adults with low aerobic fitness and with CVD risk factors, such as obesity, diabetes, and hypertension.

Conclusions
We showed that commonly used equations and the SL model have insufficient accuracy to predict HRmax among adults. The performance of the prediction equations varied considerably according to the population clinical characteristics such as the presence of CVD risk factors or a low aerobic fitness.
Consuming Whey Protein with Added Essential Amino Acids, Not Carbohydrate, Maintains Postexercise Anabolism While Underfed
Authors: GWIN JESS A. , CHURCH DAVID D. , ALLEN JILLIAN T. , WILSON MARQUES A. , CARRIGAN CHRISTOPHER T. , MURPHY NANCY E. , VARANOSKE ALYSSA N. , MARGOLIS LEE M. , WOLFE ROBERT R. , FERRANDO ARNY A. , PASIAKOS STEFAN M. 
Published: August 2024

ABSTRACT

Purpose
Energy deficiency decreases muscle protein synthesis (MPS), possibly due to greater whole-body essential amino acid (EAA) requirements and reliance on energy stores. Whether energy deficit–induced anabolic resistance is overcome with non-nitrogenous supplemental energy or if increased energy as EAA is needed is unclear. We tested the effects of energy as EAA or carbohydrate, combined with an EAA-enriched whey protein, on postexercise MPS (%·h−1) and whole-body protein turnover (g protein·240 min−1).

Methods
Seventeen adults (mean ± SD; age: 26 ± 6 yr, body mass index: 25 ± 3 kg·m−2) completed a randomized, parallel study including two 5-d energy conditions (BAL; energy balance; daily energy requirements (DEF), −30% ± 3% energy requirements) separated by ≥7 d. Volunteers consumed EAA-enriched whey with added EAA (+EAA; 304 kcal, 56 g protein, 48 g EAA, 17 g carbohydrate, 2 g fat; n = 8) or added carbohydrate (+CHO; 311 kcal, 34 g protein, 24 g EAA, 40 g carbohydrate, 2 g fat; n = 9) following exercise. MPS and whole-body protein synthesis (PS), breakdown (PB), and net balance (NET; PS–PB) were estimated postexercise with isotope kinetics.

Results
MPS rates were greater in +EAA (0.083 ± 0.02) than +CHO (0.059 ± 0.01; P = 0.015) during daily energy requirements, but similar during BAL (P = 0.45) and across energy conditions within treatments (P = 0.056). PS rates were greater for +EAA (BAL, 117.9 ± 16.5; daily energy requirements, 110.3 ± 14.8) than +CHO (BAL, 81.6 ± 8.0; daily energy requirements, 83.8 ± 5.9 g protein·240 min−1; both P < 0.001) and greater during BAL than daily energy requirements in +EAA (P = 0.045). PB rates were less in +EAA (8.0 ± 16.5) than +CHO (37.8 ± 7.6 g protein·240 min−1; P < 0.001), and NET was greater in +EAA (106.1 ± 6.3) than +CHO (44.8 ± 8.5 g protein·240 min−1; P < 0.001).

Conclusions
These data suggest that supplementing EAA-enriched whey protein with more energy as EAA, not carbohydrate, maintains postexercise MPS during energy deficit at rates comparable to those observed during energy balance.