bluuebunny/crossref_metadata_2025_split huggingface dataset:
Determinants of Primary Healthcare Services Access by National Health Insurance Fund Capitated Members in Uasin Gishu County, Kenya
Authors: Were Barbara , Mwangi Eunice , Muiruri Lillian 
Published: April 2024

Abstract

Purpose
The study identifies provision of primary healthcare services using the capitated health model as a prerequisite for promoting positive healthcare outcomes for a country’s population. However, capitated members have continued to face challenges in accessing primary healthcare services despite enrolment in the National Health Insurance Fund (NHIF). This study sought to determine if variables such as patient knowledge of the NHIF benefit package, NHIF Premium Payment processes, selecting NHIF capitated health facilities, and NHIF Communication to citizens’ influences access to primary healthcare services.
Method
A cross-sectional analytical research design was adopted. Data was collected from patients who were using NHIF cards, who were drawn from health facilities. Data was collected using a structured questionnaire where some of the questions were rated using the Likert scale to enable the generation of descriptive statistics. Data was analysed using descriptive and inferential statistics which was conducted with the aid of SPSS version 25. Bivariate analysis was conducted utilizing Chi-square to facilitate the comparison of the independent and the dependent variables. Data was presented in tabular formats where each of the specific objectives was used as parameters of interest to the study.
Results
The study found that four independent variables (Patient knowledge of NHIF Benefit Package, NHIF Premium Payment processes, Selecting NHIF capitated Health Facility, and NHIF Communication to citizens) were significant predictors of access to capitated healthcare
services with significance values of .001, .001, .001 and .001 respectively at 95% significance level.
Conclusions
The study found that familiarity with the NHIF benefit package significantly influenced NHIF capitated members' access to primary healthcare services in Uasin Gishu County. While most members were aware of their healthcare entitlements, there's a need for increased awareness regarding access to surgical services and dependents' inclusion. Facility selection also played a crucial role, influenced by factors like freedom of choice, NHIF facility selection rules, facility appearance, and proximity to members' homes. NHIF communication positively impacted access, with effective communication channels aiding service accessibility. Premium payment processes also significantly linked with service access, influenced by factors such as payment procedures, premium awareness, payment schedules, registration waiting periods, and penalties for defaults. Overall, patient knowledge, NHIF communication, premium payment processes, and facility selection all contributed positively to NHIF capitated members' access to primary healthcare services in Uasin Gishu County.
Inferring Bladder Cancer Evolution from Mucosal Field Effects by Whole-Organ Spatial Mutational, Proteomic, and Metabolomic Mapping
Authors: Czerniak Bogdan , Lee Sangkyou , Jung Sung Yun , Kus Pawel , Bondaruk Jolanta , Lee June , Jaksik Roman , Putluri Nagireddy , Dinh Khanh , Cogdell David , Chen Huiqin , Wang Yishan , Chen Jiansong , Nevai Neema , Dinney Colin , Mendelsohn Cathy , McConkey David , Behringer Richard , Guo Charles , Wei Peng , Kimmel Marek 
Published: April 2024

Abstract
Multi-platform mutational, proteomic, and metabolomic spatial mapping was used on the whole-organ scale to identify the molecular evolution of bladder cancer from mucosal field effects. We identified complex proteomic and metabolomic dysregulations in microscopically normal areas of bladder mucosa adjacent to dysplasia and carcinoma in situ. The mutational landscape developed in a background of complex defects of protein homeostasis which included dysregulated nucleocytoplasmic transport, splicesome, ribosome biogenesis, and peroxisome. These changes were combined with altered urothelial differentiation which involved lipid metabolism and protein degradations controlled by PPAR. The complex alterations of proteome were accompanied by dysregulation of gluco-lipid energy-related metabolism. The analysis of mutational landscape identified three types of mutations based on their geographic distribution and variant allele frequencies. The most common were low frequency α mutations restricted to individual mucosal samples. The two other groups of mutations were associated with clonal expansion. The first of this group referred to as β mutations occurred at low frequencies across the mucosa. The second of this group called γ mutations increased in frequency with disease progression. Modeling of the mutations revealed that carcinogenesis may span nearly 30 years and can be divided into dormant and progressive phases. The α mutations developed gradually in the dormant phase. The progressive phase lasted approximately five years and was signified by the advent of β mutations, but it was driven by γ mutations which developed during the last 2–3 years of disease progression to invasive cancer. Our study indicates that the understanding of complex alterations involving mucosal microenvironment initiating bladder carcinogenesis can be inferred from the multi-platform whole-organ mapping.
Evaluating the Impact of Common Clinical Confounders on Performance of Deep-Learning based Sepsis Risk Assessment
Authors: Chaganti Shikha , Singh Vivek , Gent Alisdair Edward , Kamaleswaran Rishikesan , Kamen Ali 
Published: April 2024

Abstract

Machine learning based early identification of sepsis in the Emergency department remains a challenging problem, primarily due to the lack of a gold standard for sepsis diagnosis and the corresponding labels required as part of training. In this work, we present a deep learning based predictive model to enable early identification of patients at risk of developing sepsis based on data from the first 24 hours of admission. The predictive model is based on the existing routine blood test results commonly performed on patients CBC (Complete Blood Count), CMP (Comprehensive Metabolic Panel), and Lipid panel, together with vitals, age and sex. To address the challenge of label uncertainty as a part of training process, we explore two different definitions, namely, Sepsis-3 and Adult Sepsis Event and analyze the advantages and drawbacks of each in the context of patient clinical parameters and comorbidities. We particularly analyze the influence of the ground truth label quality on the performance of the overall deep learning system. We see that the model is able to identify patients in the first 24 hours with 83.7% sensitivity and 80% specificity. Our findings underscore the limitations of using individual labels for sepsis and emphasize the superiority of ensemble classifiers based on multiple heterogeneous labels, in the identification of patients with sepsis. The variable performance of the model across different sub-cohorts with specific clinical conditions underscores the need for tailored approaches in sepsis diagnosis, particularly when dealing with patients with confounding comorbidities.
An evaluation of psychometric properties and utility of the Hope Index (HI): A systematic review and meta-analysis protocol
Authors: Dambi Jermaine Matewu , Shava Beatrice Kudzaishe , Mashunye Thandiwe , Dzapasi Lloyd , Mazarura Mutsa , Chibanda Dixon 
Published: April 2024

Abstract
Background: There has been an exponential increase in the number of positive psychological interventions, including hope interventions to foster well-being and decrease the huge burden of mental conditions. Consequently, there has also been an upsurge in the number of hope outcome measures. The Hope Index (HI) is extensively used, but the evidence of the psychometric performance of the is fragmented. This systematic review and meta-analysis aim to critically appraise the psychometric properties of Hope Index.
Methods/design: Two independent and blinded reviewers will search articles in PubMed, Scopus, Web of Science, CINAHL, PsychINFO, ProQuest Dissertations, and Google Scholar. Thereafter, three independent reviewers will then screen the retrieved articles. The risk of bias across studies will then be evaluated using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. The quality of the psychometric properties will be rated using a pre-set criterion and, after that, synthesised using the modified Grading of Recommendations Assessment, Development, and Evaluation (GRADE) checklist.
Discussion: The proposed systematic review will appraise the collective evidence of the psychometric robustness of the HI. The review will also assist in identifying psychometrics that may require further evaluation and make recommendations on the feasibility and utility of the HI.
Systematic Review Registration: PROSPERO pending.
Clinical significance of a panel tests in evaluating central nervous system infections
Authors: Jiang Fang , Yu WenJun , Jiao Xiaoyang , Si Mengya , Wang Xuehua 
Published: April 2024

Abstract

Aim
The FilmArray ME Panel is an emerging diagnostic method for detecting multiple pathogens in cerebrospinal fluid (CSF). We evaluated the clinical significance of the FilmArray ME Panel in the diagnosis of central nervous system (CNS) infection.
Methods
CSF specimens of 130 patients with suspected CNS infection were analyzed, along with clinical and laboratory parameters.
Results
patients shared some clinical symptoms at presentation, including fever, headache, altered mental status, and focal neurologic deficits. In a total of 130 patients, pathogens were detected in 22 cases, which included eight bacterial infections, and fourteen viral infections. The predominant bacteria detected in CSF were Streptococcus pneumonia, while the most common virus was enterovirus. The FilmArray ME panel had a better coincidence rate with PCR for viral detection, but had higher sensitivity compared with conventional bacterial detection.
Conclusions
the FilmArray ME Panel provides rapid diagnosis that benefits enabling patients to be promptly treated, improving the effectiveness of treatment.
Paeonia ostii ‘Feng Dan’ plant regeneration through direct organogenesis and direct meristematic nodule culture
Authors: fan Chengcheng , li kexin , Xu Li , deng zhijun , deng shiming , Li jitao , mou jiaolin 
Published: April 2024

Abstract

Tissue culture is preferred for solving the shortcoming of low efficiency in terms of conventional propagation ways in tree peony, an economically important woody plant in China with various purposes. However, callus differentiation is hard to obtain during in vitro regeneration. Meristematic nodule (MN) is a favorable way capable of overcoming this problem, but possesses a lengthy process. Direct organogenesis excluding the callus step is needed to simplify the procedure. This study firstly presented a protocol of direct organogenesis and direct MNs induction and differentiation using cotyledon explant for in vitro regeneration of P.ostii ‘Feng Dan’. The highest direct MNs induction rate (41.67%) and frequency of direct organogenesis (DO) (66.67%) was achieved under the following procedure. The explants were pretreated in dedifferentiation induction medium (DIM) [Murashige and Skoog (MS) medium with 2.27 µMthidiazuron (TDZ)+5.37 µM α-naphthylacetic acid (NAA)] for 10 days, and then the cotyledons without callus induced were transferred to differentiation medium (DM) [Woody plant medium (WPM) containing 2.02 µM N-(2-chloro-4-pyridyl)-N-phenylurea (CPPU)+2.27 µM TDZ and 4.04 µM CPPU+4.54 µM TDZ] respectively, with 6 subcultures, 90 days in total. The regenerated shoots rooted and transplanted successfully. Histological study conﬁrmed the process of DO and direct MNs induction, and revealed that shoots and MNs were originated from increased division of meristematic cell under cortical tissue, as well as from actively divided meristematic cells around vascular center. Moreover, shoots regenerated through MNs differentiation were originated from the epidermal and subepidermal cells. This study is an innovation and supplement in the field of in vitro regeneration in tree peony, and will be conductive to clonal micropropagation, fundamental studies of developmental biology and genetic transformation.
Identifying and validating the prognosis and potential significance of Mitophagy related genes in breast cancer
Authors: Zhao Hejia , Chen Yanjun , Feng Zihao , Qin Yifei , Lin Yan , Luo Jianting , Chen Sijin 
Published: April 2024

Abstract

Background
Breast cancer (BC) is a common malignant tumor with high incidence and mortality rates. Mitophagy refers to a selective form of autophagy that is believed to be closely related to the occurrence and progression of BC. Identifying the mitophagy-related sites associated with BC can help us gain a deeper understanding of the underlying mechanisms of BC, laying the foundation for early diagnosis and effective treatment of BC.
Method
Firstly, we collected RNA seq expression data of BC from the GEO database and conducted differential analysis. The differential expression sites were intersected with mitophagy related sites from the GeneCards database to obtain BC related mitophagy genes. Then, K-M survival analysis and ROC diagnosis and treatment effectiveness analysis were performed to identify prognostic biomarkers of BC. Secondly, based on the expression of mitophagy related sites and survival status, we divided BC patients into high-risk and low-risk subgroups, and conducted immune infiltration and GSEA analysis on different subgroups to understand the potential impact of mitophagy on BC. Finally, IHC images based on the HPA database were used to validate the protein expression of BC prognostic biomarkers.
Result
Through dual validation of K-M survival analysis and ROC diagnosis-treatment efficacy analysis, we ultimately identified 9 mitophagy-related prognostic biomarkers for BC, and found their expression was significantly upregulated in BC tissues. In addition, the results showed that the degree of immune infiltration in the low-risk subgroup was considered higher than that in the high-risk subgroup.
Conclusion
This study unveiled the prognosis, degree of tissue immune infiltration, and significant pathway enrichment levels of mitophagy and BC, and identified 9 prognostically related biomarkers; this has laid the foundation for the development of early diagnostic methods and in-depth research on the pathogenesis of BC in the future.
Multi-layer Security and Power Efficiency Improvement with Blockchain Technology and NB-IoT
Authors: Mohammed Chand Pasha , Jha Sudan , Chopra Shakti Raj , Arora Krishan , Kumar Rakesh , Pradhan Nihar Ranjan 
Published: April 2024

Abstract

To increase the level of safety, precision, and openness of narrow-band IoT combined with blockchain. NB- IoT revolutionizes seamless connectivity for IoT devices in 3Gpp released 15, enabling long battery life and widespread coverage, its low-power consumption, enhanced penetration capabilities, promising a scalable and robust infrastructure for the future with integration of Blockchain technology presents a decentralized, immutable ledger system that ensures transparent and secure transactions across various industries, fostering trust without intermediaries and reducing fraud risks significantly. Its cryptographic principles and distributed nature empower industries by enabling traceability, enhancing data integrity, and revolutionizing traditional processes of supply chain management, our approach provides distributed data authentication while simultaneously creating a layer-based blockchain with NB- IoT proposing in this paper 16 QAM OFDM modulation technique optimizing Bit Error rate (BER), Symbol Error rate (SER), and Frame Error rate (FER) signal to noise ratio (SNR) at the maximum power of 25db using MAT Lab simulation graphical results in multi-layer, double-layer, and single-layer. Our mathematical model for optimizing business activities carried out at every stage of the intelligent supply chain facilitates revenue sharing among the entities of producers, distributors, and re-sellers who make up the proposed blockchain system and NB-IoT as it incorporates with additional traceability and review functions, it is the optimal solution for safe transportation of intelligent supply chain management.
Evaluating the prediction performances of artificial neural network, nearest neighbor, and CART algorithms for body weight in Sujiang pigs using morphological measurements
Authors: Ergin Malik , Koskan Ozgur 
Published: April 2024

Abstract

The objective of this study was to evaluate machine learning algorithms for predicting body weight in Sujiang pigs. Sujiang pigs originated from the Duroc and Jiangquhai blood lines to improve both the growth rate and lean percentage of native breeds. K nearest neighbor, decision tree (CART), and artificial neural network algorithms were used to predict body weight (BW) using morphological traits such as body length (BL), body height (BH), chest circumference (CC), hip width (HW), and backfat thickness (BFT). The age of the pigs (180±5) was also included as a nominal predictor. For this purpose, all morphological measurements taken from 365 Sujiang pigs in a previous study were used. In total, 219 individual measurements were obtained after data preprocessing. In the Sujiang pig dataset, BW had a significantly positive and high linear relationship with BH (0.66), BL (0.72), CW (0.81), HW (0.84), and CC (0.88) (p < 0.01). Overall, the ANN algorithm outperformed the KNN and DT algorithms in this pig dataset according to the goodness of fit criteria of R2 = 0.91 and RMSE = 3.1. Nevertheless, the KNN algorithm also demonstrated good predictions on the test dataset (R2 = 0.86 and RMSE = 3.57). In the ANN algorithm, several training algorithms were compared, such as the Levenberg‒Marquardt algorithm, Bayesian regularization, and scaled conjugate gradient. In addition, the number of neurons in the hidden layer was manipulated to 2, 3, or 4. All training algorithms yielded similar results. However, when the predictor variables were CC, HW, BL, and BH, the Levenberg–Marquardt network had a superior ability to predict body weight in Sujiang pigs, with R2 = 0.89 and RMSE = 3.05. Furthermore, when BL measurements were not included in the model, the model’s predictive ability decreased by approximately 6%. According to the results, the use of Levenberg‒Marquardt and Bayesian Regularization in the ANN algorithm could help to improve breeding strategies. The traits determined to be the best predictors of BW in Sujiang pigs via the ANN algorithm can be used as indirect selection criteria in the future. However, this study suggested that different age stages, breeds, and traits should be considered in the model to accurately predict BW.
Comparative content analysis of national health strategies before and after COVID-19: a systematic policy analysis among OECD and BRICS countries
Authors: Song Jialu , Zhu Ziqi , Li Qi , Chen Ying , Wang Zhebin , Zhou Shuduo , Xu Ming , Zheng Zhi-Jie 
Published: April 2024

Abstract

Background
We aimed to evaluate the National Health Policies, Strategies and Plans (NHPSPs) of the Organization for Economic Cooperation and Development (OECD) and BRICS before and after the COVID-19 pandemic to explore nations' commitment to strengthen their health systems in defense of health threats and analyze the specific changes.
Methods
We systematically searched NHPSP documents from the WHO document repository and official governmental websites. Data was then extracted using a standardized extraction template. A coding framework was inductively developed to sort qualitative responses into categories, with frequencies calculated and weighting evaluated, followed by organizing underlying content into subthemes.
Results
The search yielded 154 documents, with 36 retained after screening, encompassing 14 OECD countries and 3 BRICS countries. The most predominant theme was prevention (88.9% pre-pandemic, 99.4% post-pandemic), which was addressed as a primary theme in 26 included NHPSPs. After the COVID-19 pandemic, 6 out of 14 analyzed themes saw higher occurrences, among which infection prevention and control (22.2–50.0%) and resilience to health crisis (22.2–44.4%) increased most significantly. Themes mainstreamed in post-pandemic NHPSPs included prevention (94.4%), health research and technology (61.1%), and One Health (66.7%). Primary healthcare emerged as the most concerned subtheme under prevention. Notably, OECD countries displayed more increased occurrences of themes (13 out of 14) or increased emphasis on themes with similar occurrences before and after COVID-19, while BRICS countries only differed in infection control. The two sets of countries also varied in subthemes and action plans under the same primary theme.
Conclusion
Many countries are endeavoring to move towards more robust health systems by optimizing NHPSPs, yet only about half of OECD and BRICS countries have introduced new NHPSPs after COVID-19. We hope our findings attract attention to the necessity of global health system reforms and provide other countries with actionable recommendations for NHPSP formulation.
Effect of temperature and body size on anterior and posterior regeneration in Hermodice carunculata (Polychaeta, Amphinomidae)
Authors: TOSO Andrea , Mammone Marta , Rossi Sergio , Piraino Stefano , Giangrande Adriana 
Published: April 2024

Abstract

In recent years, population outbreaks of the annelid Hermodice carunculata (Polychaeta, Amphinomidae) are recurrently detected along the coastal zone of the Salento peninsula (Southern Italy), with impacts on marine benthic ecosystems. Annelida are renowned for their remarkable regeneration potential, enabling them to reform lost body parts by asexual reproduction processes. A handful of studies have reported posterior regeneration of H. carunculata, but anterior regeneration and asexual reproduction have not been fully explored. In this study, we investigated the capacity of H. carunculata collected in shallow coastal areas (Ionian Sea, 40°08'26.9" N 17°58'44.1" E) to regenerate anterior body parts under different temperature conditions (22 and 14°C) and considering two different body sizes (~ 4 g and 25 g). In addition, histological analysis and lipid analyses were carried out to detect changes in the reproductive cycle and lipid storage during ongoing regeneration. The results suggest that small and large-sized specimens of H. carunculata can regenerate efficiently anterior body parts in 12–20 weeks post amputation (wpa) when kept at 22°C. Small-sized worms kept at 14°C regenerated slower but died in 24wpa before regenerating a mouth, while large-sized worms kept at 14°C were affected by a 100% mortality during blastema formation. In addition, lipid extraction analyses show that H. carunculata can regenerate during extended periods of starvation by de novo synthesizing lipid reserves and regeneration in H. carunculata does not negatively impact the reproductive cycle, as gametogenesis occurs also during the regenerative processes.