bluuebunny/crossref_metadata_2025_split huggingface dataset:
A low resource simulation-based training package leads to increased knowledge and skill retention post Basic Emergency Obstetric and Neonatal Care in rural Tanzania; A stepped- wedge research design Short Title: BEmONC simulation-based training package leads to skill retention in Tanzania
Authors: Matovelo Dismas , Brenner Jennifer L. , Singhal Nalini , NettelAguirre Alberto , Ndaboine Edgar , Shabani Girles , Subi Leonard , Sigalet Elaine 
Published: March 2024

Abstract

Background: The Basic Emergency Obstetric and Neonatal Care (BEmONC) training program merges core modules from Helping Mothers Survive and Helping Babies Survive training programs to improve obstetrical and newborn outcomes. The duration of BEmONC training varies between facilities and countries. Longer term low dose high frequency practice has been shown to prevent skill decay in both Helping Mothers Survive and Helping Babies Survive literature. A recent program evaluation of BEmONC training with extensive changes to infrastructure in rural Tanzania links training with improve obstetric and neonatal outcomes. This study sought to document skill and knowledge outcomes after disseminating a low resource focused simulation package.
Methods: A stepped-wedge research design was used to test the intervention: the simulation package. Participants were midwives/nurses, clinical officers, and medical officers from two hospitals and four Health Centres in Mwanza Region, Tanzania. Facilities were purposely assigned to one of the two clusters. The intervention had three components: (1) 5-day BEmONC workshop, (2) peer to peer facility-based simulation practice using peer cards and (3) clinical mentorship. Cluster A and Cluster B attended the 5-day BEmONC workshop. Cluster A was supported with the component two and three post workshop. Cluster B received these components after the 6-month assessment. Knowledge and skill were analyzed at baseline, post workshop, at 6 months and at 12 months using the r core statistics; p-values < 0.05 were considered statistically significant.
Results: Cluster A (n=7) and Cluster B (n=8) participants demonstrated significant knowledge and skill improvements post-initial workshop. At 6 months, Cluster A aggregate skill scores were significantly higher than Cluster B, who showed skill decay. At 12 months, aggregate skill scores between Cluster A and Cluster B were similar.
Conclusion: The simulation package was feasible and effective for improving baseline skill, and retaining skill sets at 6 and 12 months. This is the first study to pilot the newly developed essential care for labor and birth module. This approach provides a low resource education option for improving healthcare provider abilities to provide quality care. More research is needed to link low resource initiatives with clinical outcomes.
Causal interactions between ENSO and the North Tropical Atlantic
Authors: Le Thanh , Bae Deg-Hyo 
Published: March 2024

Abstract

The global climate is impacted by several major climate modes including the North Tropical Atlantic mode (NTA) and the El Niño–Southern Oscillation (ENSO). Although NTA and ENSO are suggested to have connections, there is uncertainty regarding the causal relationship between these climate modes. While previous works focused on the correlation between NTA and ENSO, causal analyses accounting for the influence of other tropical climate modes are lacking. Here we investigate the causal links between ENSO and NTA using outputs from high-resolution climate model simulations and reanalysis data. Our results suggest robust causal effects of ENSO on NTA and provide insights on the unstable impacts of NTA on ENSO. We observe high consistency between reanalysis data and the models in mimicking the impacts of ENSO on North Tropical Atlantic region. Specifically, most models (14 over 20) and reanalysis data revealed that ENSO is very unlikely to have no causal impacts on NTA. However, there is diverse response of the tropical Pacific to NTA between reanalysis data and the models. While reanalysis data indicates possible impacts of NTA on ENSO and sea surface temperature over the equatorial Pacific, the majority of models (18 over 20) suggest that the NTA is likely to have no causal effects on ENSO. Hence, the models may underestimate the causal effects of NTA on ENSO, implying that better representation of NTA variability and NTA-ENSO causal connections in the models may improve the predictability of ENSO variations.
The mutational burden in os odontoideum patients
Authors: Tian Yinglun , Gao Guodong , Fan Dongwei , Xue Shenglin , Gao Qiyue , Zhang Cheng , Xu Nanfang , Wang Shenglin 
Published: March 2024

Abstract
Background
Os odontoideum(OO) is a rare bone malformation at the craniovertebral junction, the presence of which can lead to potential instability of atlantoaxial joints. The cause, prevalence and treatment of OO are still controversial. But the congenital factors are likely to be the main causes according to the current literature reports and the clinical characteristics of OO patients. To further explore the pathogenesis of OO, we conducted this study.
Methods
We consecutively recruited 25 OO patients from 2021 to 2023. The clinical manifestation and concomitant deformities were analyzed and whole-exome sequencing(WES) was performed. And the variants in OO patients were compared using genetic burden analysis with 79 normal population as controls.
Results
Combined with the P-value and OR value of the final data, CDC27(P = 0.002,OR = 5.08),FRG1BP(P = 0.004,OR = 5.59),TRIM8(P = 0.02,OR = 4.58) and CEP250(P = 0.005,OR = 7.78) were singled out as possible correlated gene with OO.
Conclusion
Our study firstly presented an exome-sequenced cohort and highlighted four novel rare variants associated with OO patients through genetic burden analysis. The results provided further evidence for potential oligogenic inheritance of OO.
Integrative analysis of transcriptome and target metabolites uncovering flavonoid biosynthesis regulation of changing petal colors in Nymphaea ‘Feitian 2’
Authors: Zhou Xian , Wu Qian , Wang Xiaohan , Wei Haohui , Zhang Huijin , Wang Liangsheng 
Published: March 2024

Abstract

Background
Nymphaea (waterlily) is known for its rich colors and role as an important aquatic ornamental plant globally. Nymphaea atrans and some hybrids, including N. ‘Feitian 2,’ are more appealing due to the gradual color change of their petals at different flower developmental stages. The petals of N. ‘Feitian 2’ gradually change color from light blue-purple to deep rose-red throughout flowering. The mechanism of the phenomenon remains unclear.
Results
In this work, flavonoids in the petals of N. ‘Feitian 2’ at six flowering stages were examined to identify the influence of flavonoid components on flower color changes. Additionally, six cDNA libraries of N. ‘Feitian 2’ over two blooming stages were developed, and the transcriptome was sequenced to identify the molecular mechanism governing petal color changes. As a result, 18 flavonoid metabolites were identified, including five anthocyanins and 13 flavonols. Anthocyanin accumulation during flower development is the primary driver of petal color change. A total of 12 differentially expressed genes (DEGs) in the flavonoid biosynthesis pathway were uncovered, and these DEGs were significantly positively correlated with anthocyanin accumulation. Six structural genes were ultimately focused on, as their expression levels varied significantly across different flowering stages. Moreover, 104 differentially expressed transcription factors (TFs) were uncovered, and three MYBs associated with flavonoid biosynthesis were screened. The qRT-PCR results were generally aligned with high-throughput sequencing results.
Conclusions
This research offers a foundation to clarify the mechanisms underlying changes in the petal color of waterlilies.
Mental Well-being and Perception of Loneliness Among Men in Poland
Authors: Dziedzic¹ Beata , Kobos¹ Ewa , Przylepa² Katarzyna , Idzik¹ Anna 
Published: March 2024

Abstract

Background: Mental well-being is defined as subjective well-being, characterized by an emotional and cognitive evaluation of one's life that leads to high life satisfaction and low levels of negative emotions. It is estimated that in Poland in 2017, 2.4% of men suffered from depression. Research findings confirm that individuals with a high sense of loneliness often face mental health issues. Loneliness is a predictor of the likelihood of depression, anxiety, and suicidal thoughts. The aim of this study was to assess the mental well-being in a group of men in Poland.
Methods: The study was conducted on a representative sample of 438 men who completed a survey through an online portal using the Computer-Assisted Web Interviewing (CAWI) technique. The Hospital Anxiety and Depression Scale (HADS-M) and the UCLA Loneliness Scale (R-UCLA) were used to assess mental well-being. The average age of the participating men was 45.61±15.64 years.
Results: On the HADS-M scale, participants scored an average of 13.91±9.35 points. Anxiety disorders were identified in 21.91% of the participants on the anxiety subscale, and depressive disorders in 12.55% on the depression subscale. On the loneliness scale, participants scored an average of 40.50±10.78 points. A moderately high and very high sense of loneliness was found in 21.00% and 2.30% of the participants, respectively.
Conclusions : In this study, one fifth of the participants experienced anxiety disorders, and every tenth man showed depressive disorders. Every fifth man experienced a moderately high sense of loneliness. The main predictor of depression symptoms and higher levels of loneliness was the poor financial situation of the participants and a lack of financial decisiveness.
Immune Checkpoint Inhibitors and Pericardial Disease: A Systematic Review
Authors: Mudra Sarah E. , Rayes Danny L , Agrawal Ankit , Kumar Ashwin K. , Li Jason Z. , Njus Meredith , McGowan Kevin , Kalam Kazi A. , Charalampous Charalampos , Schleicher Mary , Majid Muhammad , Syed Alveena , Yesilyaprak Abdullah , Klein Allan 
Published: March 2024

Abstract
Introduction:
Despite the growing use of immune checkpoint inhibitors (ICI) in cancer treatment, data regarding ICI-associated pericardial disease are primarily derived from case reports and case series. ICI related pericardial disease can be difficult to diagnose and is associated with significant morbidity. We conducted a systematic review to further characterize the epidemiology, clinical presentation, and outcomes of this patient population.
Methods:
A search of four databases resulted in 31 studies meeting inclusion criteria. Patients >18 years old who presented with ICI mediated pericardial disease were included. Intervention was medical + surgical therapy and outcomes were development of cardiac tamponade, morbidity, and mortality.
Results:
Thirty- eight patients across 31 cases were included. Patients were majority male (72%) with a median age of 63. Common symptoms included dyspnea (59%) and chest pain (32%), with 41% presenting with cardiac tamponade. Lung cancer (81%) was the most prevalent, and Nivolumab (61%) and Pembrolizumab (34%) were the most used ICIs. Pericardiocentesis was performed in 68% of patients, and 92% experienced symptom improvement upon ICI cessation. Overall mortality was 16%.
Discussion:
This study provides the most comprehensive analysis of ICI-mediated pericardial disease to date. Patients affected were most commonly male with lung cancer treated with either Nivolumab or Pembrolizumab. Diagnosis may be challenging in the setting of occult presentation with normal EKG and physical exam as well as delayed onset from therapy initiation. ICI-associated pericardial disease demonstrates high morbidity and mortality, as evidenced by a majority of patients requiring pericardiocentesis.
Female patients with end-stage renal failure treated by hemodialysis had a low mortality rate and small patient number compared to male patients: 5-year follow-up study in Japan
Authors: Takagi Kuniyasu , Kishi Takuya , Goto Taku , Yamanouchi Kohei , Yoshikawa Kazuhiko , Imamura Tomohiro , Nakayama Shiki , Akiyoshi Yuichiro , Onozawa Koji , Takamori Ayako , Fujimoto Kazuma 
Published: March 2024

Abstract

Background:
This study aimed to evaluate gender differences in patient characteristics in maintenance hemodialysis in Takagi Hospital and, in particular, to evaluate gender differences in adverse events, gastrointestinal bleeding, and bone fractures during longitudinal follow-up period.
Methods:
This study included 151 patients undergoing maintenance hemodialysis for end-stage renal failure at Takagi Hospital, a regional core hospital in Japan, in December 2017. All the patients were followed up for five years or until mortality with monitoring in outpatient care. All patients were divided into a female group of 61 and a male group of 90. Patient characteristics and events were evaluated in the electronic medical record including gastrointestinal bleeding and bone fractures diagnosed and treated in Takagi Hospital. Gastrointestinal bleeding was diagnosed by endoscopy. Upper bone fractures included humeral fractures and radius fractures, and lower bone fractures were femoral neck fractures and vertebral compression fractures.
Results:
The patient number was small in females, which was due to the origin of renal failure with less frequency of diabetes mellitus (P < 0.02). Mortality rate was significantly less in females (P < 0.03) of younger generations less than 75 years old (P < 0.014). Multivariate analysis indicated a decrease in diabetes mellitus (odd ratio: 2.3, 95% confidence interval: 1.1-4.8, P = 0.03) and less mortality in those younger than 75 years old (odd ratio: 0.2, 95% confidence interval: 0.1-0.8, P = 0.02) were independent characterized factors in females. Regarding adverse severe events during five years, gastrointestinal bleeding and mortality due to bleeding were not different between females and males. Bone fractures were high in females (females: 34.4% vs. males: 18.9%; P < 0.03), whereas the mortality rate of bone fractured patients was markedly high in males (females: 28.6% vs males: 76.5%; P = 0.003). The increase in mortality rate in males was in patients with lower body bone fractures (P = 0.006).
Conclusions:
Diabetes mellitus-induced end-stage renal failure was less common in females. The mortality rate during hemodialysis was lower in females, especially in patients less than 75 years old. Lower body bone fractures exacerbated mortality more frequently in males compared to females.
Boosting Manufacturing Efficiency through Coopetition: A Quantitative Analysis
Authors: Silva Agostinho da , Cardoso Antonio 
Published: March 2024

Abstract
Small and Medium-sized Enterprises (SMEs) are crucial to Europe's economy, yet they face significant challenges within global supply chains, primarily due to efficiency deficits. Despite their important role in employment, innovation, and wealth generation, these enterprises struggle to compete on a global scale. Recognizing the potential of coopetition - strategic collaboration among competitors - as a means to enhance efficiency, this study explores its impact within the Portuguese Ornamental Stone industry, a critical sector for the national economy. Employing a case study methodology in an IoT-enabled coopetition network, it is documented a substantial improvement in manufacturing efficiency (38.41%), alongside increases in efficiency consistency (20.68%), labor productivity (61.59%), and raw material yield (31.65%). These findings not only validate the efficacy of coopetition in overcoming the efficiency challenges faced by SMEs but also highlight specific areas for further enhancement, such as labor productivity consistency. This research contributes to filling the empirical gap in understanding coopetition's role in SME efficiency and sets the stage for future inquiries into optimizing and expanding coopetition networks. It underscores the necessity for comprehensive strategies to implement coopetition practices, providing a blueprint for SMEs to thrive in the competitive landscape of global digital supply chains.
NeuroInsight: A Revolutionary Self-Adaptive Framework for Precise Brain Tumor Classification in Medical ImagingUsing Adaptive Deep Learning
Authors: Arora Sonia , Mishra Gouri Sankar 
Published: March 2024

Abstract

This study presents a robust framework for the classification of brain tumors, beginning with meticulous data curation from 233 patients. The dataset comprises a diverse range of T1-weighted contrast-enhanced images, encompassing meningioma, glioma, and pituitary tumor types. Rigorous organization, pre-processing, and augmentation techniques are applied to optimize model training. The proposed self-adaptive model incorporates a cutting-edge algorithm, leveraging Adaptive Contrast Limited Histogram Equalization (CLAHE) and Self-Adaptive Spatial Attention. CLAHE enhances grayscale images by tailoring contrast to the unique characteristics of each region. The Self-Adaptive Spatial Attention, implemented through an Attention Layer, dynamically assigns weights to spatial locations, thereby enhancing sensitivity to critical brain regions. The model architecture integrates transfer learning models, including DenseNet169, DenseNet201, ResNet152, and InceptionResNetV2, contributing to its robustness. DenseNet169 serves as a feature extractor, capturing hierarchical features through pre-trained weights. Model adaptability is further enriched by components such as batch normalization, dropout, layer normalization, and an adaptive learning rate strategy, mitigating overfitting and dynamically adjusting learning rates during training. Technical details, including the use of the Adam optimizer and softmax activation function, underscore the model's optimization and multi-class classification capabilities. The proposed model, which amalgamates transfer learning and adaptive mechanisms, emerges as a powerful tool for brain tumor detection and classification in medical imaging. Its nuanced comprehension of brain tumor images, facilitated by self-adaptive attention mechanisms, positions it as a promising advancement in computer-aided diagnosis in neuroimaging. Leveraging DenseNet201 with a self-adaptive mechanism, the model surpasses previous methods, achieving an accuracy of 94.85%, precision of 95.16%, and recall of 94.60%, showcasing its potential for enhanced accuracy and generalization in the challenging realm of medical image analysis.
Efficiency of diffusion MRI ADC values with shear wave elastography in kidney transplanted patients
Authors: Karaküçük Seda Nida , Güngör Özkan , Menzilcioğlu Mehmet Sait , Karaküçük Selim , Doğan Adil 
Published: March 2024

Abstract

Objective In our study, we aimed to evaluate fibrosis using shear wave elastography, a current technique in renal allograft, as well as to evaluate perfusion by including diffusion MR imaging in the same graft, and to provide information about allograft dysfunction with the combined use.Materials and Methods A total of 87 patients, 33 female (age range 17–72 years) and 52 male (age range 15–75 years), were included in the study. In the prospective study, after diffusion MRI of the transplanted kidney, ADC measurements was performed from the renal cortex. At the same time, stiffness was measured with SWE simultaneously from the cortex of the same graft, and the correlation of both methods with the estimated glomerular filtration rate (eGFR) was compared.Results The upper, middle and lower mean elastography values were found to be significantly higher (p < 0.05) and the ADC values were significantly lower (p < 0.05) in the GFR ≤ 60 group compared to the group with eGFR > 60. There was a significant relationship between ADC measurements and the amount of proteinuria, and when the groups with proteinuria < 300 mg and > 300 mg were compared. When ROC analysis was performed for ADC value, AUC = 0.825, two groups could be differentiated with 82.8% sensitivity and 76.8% specificity.Conclusion Shear wave elastography and diffusion MRI can be used successfully in allograft dysfunction. Elastography is prominent in the detection of fibrosis in allograft. ADC values are closely related to the amount of proteinuria.
Design of potent telomerase inhibitors using ligand-based approaches and molecular dynamics simulations studies
Authors: Bajaj Shalini , Murahari Manikant , YC Mayur 
Published: March 2024

Abstract
Telomerase is a well-recognised and a promising target for cancer therapy. In this study, we selected ligand-based approaches to design telomerase inhibitors for the development of potent anticancer agents for future cancer therapy. Till date no telomerase inhibitors have been clinically introduced. To investigate the chemical characteristics required for telomerase inhibitory activity, a ligand-based pharmacophore model of oxadiazole derivatives reported from the available literature was generated using the Schrodinger phase tool. The generated pharmacophore model displayed five features, two hydrophobic and three aromatic rings. This selected pharmacophore hypothesis is validated by screening a dataset of reported oxadiazole derivatives. The pharmacophore model was selected for virtual screening using ZINCPharmer against the ZINC database. The ZINC database molecules with pharmacophoric features similar to the selected pharmacophore model and good fitness score were taken for molecular docking studies. With the pkCSM and SwissADME tools we predicted the pharmacokinetic and toxicity of top ten ZINC database compounds based on docking score, binding interactions and identified two in-silicopotential compounds with good ADME and less toxicity. Then both the hit molecules were exposed to molecular dynamic simulation integrated with MM-PBSA binding free energy calculations using GROMACS tools. The MM-PBSA calculations exhibited that the free binding energy of selected protein-ligand complexes were found stable and stabilized with nonpolar and van der walls free energies. Our study suggests that ZINC82107047 and ZINC8839196 can be used as hit molecules for future biological screening and for discovery of safe and potent drugs as telomerase inhibitors for cancer therapy.
Modulation of the endophytic strain Kosakonia radicincitans UYSO10 proteome by sugarcane roots exudate
Authors: Taulé Cecilia , Lima Analía , Beracochea Martín , Durán Rosario , Battistoni Federico 
Published: March 2024

Abstract

Backgroun: Plant-associated microbiotas play a key role in plant health, growth, and stresses resilience. These microbiotas are considered the second plant genome by expanding its genetic potential. One of the main components of the plant microbiota is the endophytic bacterial communities, which live in the plant's internal tissues. The main sources of this microbiota are the seed and the soil where the plant grows. Particularly, soil bacteria are attracted by different signals present in plant root exudates, to later colonize the rhizoplane and infect internal tissues. Although the colonization and infection processes of endophytic bacteria are well documented, the molecular bases of the mechanisms involved in the plant-endophyte interaction are still poorly understood. Previously it was shown that strain Kosakonia radicincitans UYSO10 promotes the growth of sugarcane plants and was defined as a true endophyte. Moreover, it was demonstrated that the biological nitrogen fixation process is involved in the plant growth promotion observed. The aim of this work is to expand the knowledge about the possible mechanisms involved in the early stages of the interaction between the diazotrophic endophytic strain UYSO10 and sugarcane plants.
Methodology: a proteomic approach was conducted in the strain UYSO10 exposed or not to sugarcane exudates.
Results showed that in the presence of root exudates, strain UYSO10 senses the environment and adapts its proteome to transport and metabolize different nutrients, and to interact with the host plant. These results deepen the knowledge of the potential mechanisms involved in the early stage of plant-bacteria endophyte interaction.