bluuebunny/crossref_metadata_2025_split huggingface dataset:
Level of technical efficiency and associated factors among health centers in East Gojjam Zone, Northwest Ethiopia: an application of the data envelopment analysis
Authors: Lamesgen Anteneh , Mengist Belayneh , Mazengia Elyas Melaku , Endalew Bekalu 
Published: March 2024

Abstract
Background
Besides the scarcity of resources, inefficient utilization of available health service resources has been the bottleneck to deliver quality health services in Ethiopia. However, Information regarding the efficiency of health service providers is limited in the country. Health service managers and policy makers must be well informed about the efficiency of health service providers and ways of using limited resources efficiently to make evidence-based decisions. This study aimed to assess the level of technical efficiency and associated factors among health centers in East Gojjam Zone, Northwest Ethiopia.

Methods
A facility-based cross-sectional study was conducted among 27 randomly selected health centers in East Gojjam zone, Northwest Ethiopia, from October 30, 2022, to April 30, 2023. Using an interviewer-administered questionnaire and document review checklist, health centers’ data was collected and entered to Epi-Data version 4.6. The data was exported to Microsoft office excel and Stata version 14 for analysis. A two-stage output-oriented data envelopment analysis with a variable return to scale assumption was employed to determine the level of technical efficiencies. Finally, the tobit regression model was applied to identify the associated factors at 5% level of significance.

Results
In this study, 59.3% of the health centers were technically efficient. The mean technical efficiency score of the health centers was 0.899 ± 0.156. Inefficient health centers could provide more 22, 433 outpatient visits, 1,351 family planning visits, 155 referral services, 206 skilled deliveries and 385 fully vaccinations of children if they were technically efficient as their peer health centers for the same year. From the tobit regression, the catchment population and number of administrative staffs were statistically significant determinants of the technical efficiency of health centers.

Conclusions
The mean technical efficiency of the health centers in East Gojjam zone, Northwest Ethiopia was high. However, nearly half of the health centers were technically inefficient, which indicates the exitance of a space for further improvements in the productivity of these health centers. Employing excess number administrative staffs (above the optimal level) should be discouraged and selecting appropriate sites where the health centers to be constructed (to have large catchment population coverage) could improve the productivity of health centers.
Harm reduction behaviours and harm experiences of people who use 3,4-methylenedioxymethamphetamine (MDMA) in Aotearoa New Zealand
Authors: Whelan Jai , Noller Geoff , Ward Ryan D. 
Published: March 2024

Abstract
Background
3,4-Methylenedioxymethamphetamine (MDMA) is drug of high prevalence in Aotearoa New Zealand and is the primary drug analysed by legal drug checking services. We aimed to address the gap in literature pertaining to MDMA-related harm reduction behaviour and harm experiences within the country.

Methods
An online survey was used to assess the harm reduction behaviours (e.g., limiting consumption, planning use, seeking information) of people who use MDMA, in addition to their use of reagent testing and the major national drug checking and harm reduction service, KnowYourStuffNZ.

Results
In total, 915 people completed the survey (60.7% females, aged 18–65, median = 24, IQR = 20–28). Frequency of various MDMA-related harm reduction behaviours differed, although these were carried out relatively frequently by most participants. Those who reported experiencing harm (physical, psychological, spiritual, social) from MDMA, or another drug presumed to be MDMA, reported less frequent harm reduction behaviours than non-harmed consumers. Reagent testing of MDMA had been conducted by 42.3% of the sample. Approximately 27% of the sample had used KnowYourStuffNZ services. Of KnowYourStuffNZ clients, 95.9% reported learning about harm reduction, and 53.3% reported changing their behaviour because of the service. Reasons for not using the KnowYourStuffNZ service were primarily lack of availability in local area (32.8%) or at relevant events (51.8%), and lack of concern with substance quality (29.8%). MDMA harm was reported by 14.4% of the sample, whilst reported harm was more common from consumption of presumably non-MDMA substances, self-reported as being mistaken for MDMA. Harm was primarily physical or psychological. Potential MDMA dependence was apparent in 6.9% of the sample.

Conclusions
The findings highlight potential targets for harm reduction education and interventions and emphasize the need for greater availability of readily accessible drug checking services in Aotearoa New Zealand.
A usability study on mobile EMG-guided wrist extension training in subacute stroke patients-MyoGuide
Authors: Lin Hao-Ping , Xu Yang , Zhang Xue , Woolley Daniel , Zhao Lina , Liang Weidi , Huang Mengdi , Cheng Hsiao-ju , Zhang Lixin , Wenderoth Nicole 
Published: March 2024

Abstract
Background
Effective stroke rehabilitation requires high-dose, repetitive-task training, especially during the early recovery phase. However, the usability of upper-limb rehabilitation technology in acute and subacute stroke survivors remains relatively unexplored. In this study, we introduce subacute stroke survivors to MyoGuide, a mobile training platform that employs surface electromyography (sEMG)-guided neurofeedback training that specifically targets wrist extension. Notably, the study emphasizes evaluating the platform’s usability within clinical contexts.

Methods
Seven subacute post-stroke patients (1 female, mean age 53.7 years, mean time post-stroke 58.9 days, mean duration per training session 48.9 min) and three therapists (one for eligibility screening, two for conducting training) participated in the study. Participants underwent ten days of supervised one-on-one wrist extension training with MyoGuide, which encompassed calibration, stability assessment, and dynamic tasks. All training records including the Level of Difficulty (LoD) and Stability Assessment Scores were recorded within the application. Usability was assessed through the System Usability Scale (SUS) and participants’ willingness to continue home-based training was gauged through a self-developed survey post-training. Therapists also documented the daily performance of participants and the extent of support required.

Results
The usability analysis yielded positive results, with a median SUS score of 82.5. Compared to the first session, participants significantly improved their performance at the final session as indicated by both the Stability Assessment Scores (p = 0.010, mean = 229.43, CI = [25.74–433.11]) and the LoD (p < 0.001; mean: 45.43, CI: [25.56–65.29]). The rate of progression differed based on the initial impairment levels of the patient. After training, participants expressed a keen interest in continuing home-based training. However, they also acknowledged challenges related to independently using the Myo armband and software.

Conclusions
This study introduces the MyoGuide training platform and demonstrates its usability in a clinical setting for stroke rehabilitation, with the assistance of a therapist. The findings support the potential of MyoGuide for wrist extension training in patients across a wide range of impairment levels. However, certain usability challenges, such as donning/doffing the armband and navigating the application, need to be addressed to enable independent MyoGuide training requiring only minimal supervision by a therapist.
Evaluation of the learning curve and complications in unilateral biportal endoscopic transforaminal lumbar interbody fusion: cumulative sum analysis and risk-adjusted cumulative sum analysis
Authors: Guo Wenlong , Ye Jingyao , Li Tong , Yu Yang , Fan Xiaohong 
Published: March 2024

Abstract
Purpose
To evaluate the learning curve and complications in unilateral biportal endoscopic transforaminal lumbar interbody fusion (ULIF) using the Cumulative Sum (CUSUM) analysis and Risk-adjusted Cumulative Sum (RA-CUSUM) analysis.

Methods
This study retrospectively analyzed 184 consecutive patients who received ULIF in our hospital, including 104 males and 80 females. CUSUM analysis and RA-CUSUM analysis were used to evaluate the learning curve of ULIF based on the operation time and surgical failure rate, respectively. All postoperative complications were defined as surgical failure. Variables of different phases were compared based on the learning curve.

Results
The CUSUM analysis showed the cutoff point for ULIF was 29 cases, and the RA-CUSUM analysis showed the cutoff point for ULIF was 41 cases. Operating time and hospital stay were significantly decreased as the learning curve progressed (P < 0.05). Visual analogue score (VAS) and Oswestry disability index (ODI) at the last follow-up were significantly lower than preoperatively. At the last follow-up, a total of 171 patients reached intervertebral fusion, with a fusion rate of 92.9% (171/184). A total of eleven complications were observed, and RA-CUSUM analysis showed that the incidence of complications in the early phase was 17.07% and in the late phase was 2.6%, with a significant difference (P < 0.05).

Conclusion
ULIF is an effective minimally invasive lumbar fusion surgical technique. But a learning curve of at least 29 cases will be required to master ULIF, while 41 cases will be required to achieve a stable surgical success rate.
Investigation of the appropriate viscosity of fibrinogen in repairing pleural defects using ventilation and anchoring in an ex vivo pig model
Authors: Fukuda Akihiro , Hashimoto Masaki , Takegawa Yoshitaka , Kondo Nobuyuki , Hasegawa Seiki 
Published: March 2024

Abstract
Objective
Our previous study revealed that the viscosity of fibrinogen could influence the effectiveness of ventilation and anchoring (V/A) methods for controlling air leakages. Here, we examined the association between the viscosity of fibrinogen and effectiveness using an ex vivo pig model.

Methods
The fibrin glue used in this study was BOLHEAL® (KM Biologics Co., Ltd., Kumamoto, Japan). We prepared three types of fibrinogen with different viscosities (higher and lower than normal), including one without additives. Using an ex vivo pig model, a pleural defect was made, and the defect was repaired using three different viscosities of fibrinogen through the V/A method. We measured the rupture pressure at the repair site (N = 10) and histologically evaluated the depth of fibrin infiltration into the lung parenchyma at the repair sites.

Results
The median rupture pressure was 51.5 (40–73) cmH2O in Group 1 (lower viscosity), 47.0 (47–88) cmH2O in Group 2 (no change in viscosity), and 35.5 (25–61) cmH2O in Group 3 (higher viscosity). There was no statistically significant difference between Groups 1 and 2 (p = 0.819), but the rupture pressure was significantly higher in Group 2 than in Group 3 (p = 0.0136). Histological evaluation revealed deep infiltration of fibrin into the lung parenchyma in Groups 1 and 2, but no such infiltration was observed in the higher-viscosity group.

Conclusions
The results of this experiment suggested that the V/A method using fibrin glue containing low-viscosity fibrinogen was more effective in controlling air leakage due to pleural defects.
A prognostic model for Schistosoma japonicum infection-associated liver hepatocellular carcinoma: strengthening the connection through initial biological experiments
Authors: Sheng Shuyan , Chen Bangjie , Xu Ruiyao , Han Yanxun , Mao Deshen , Chen Yuerong , Li Conghan , Su Wenzhuo , Hu Xinyang , Zhao Qing , Lowe Scott , Huang Yuting , Shao Wei , Yao Yong 
Published: March 2024

Abstract
Background
Numerous studies have shown that Schistosoma japonicum infection correlates with an increased risk of liver hepatocellular carcinoma (LIHC). However, data regarding the role of this infection in LIHC oncogenesis are scarce. This study aimed to investigate the potential mechanisms of hepatocarcinogenesis associated with Schistosoma japonicum infection.

Methods
By examining chronic liver disease as a mediator, we identified the genes contributing to Schistosoma japonicum infection and LIHC. We selected 15 key differentially expressed genes (DEGs) using weighted gene co-expression network analysis (WGCNA) and random survival forest models. Consensus clustering revealed two subgroups with distinct prognoses. Least Absolute Shrinkage and Selection Operator (LASSO) and Cox regression identified six prognostic DEGs, forming an Schistosoma japonicum infection-associated signature for strong prognosis prediction. This signature, which is an independent LIHC risk factor, was significantly correlated with clinical variables. Four DEGs, including BMI1, were selected based on their protein expression levels in cancerous and normal tissues. We confirmed BMI1's role in LIHC using Schistosoma japonicum-infected mouse models and molecular experiments.

Results
We identified a series of DEGs that mediate schistosomiasis, the parasitic disease caused by Schistosoma japonicum infection, and hepatocarcinogenesis, and constructed a suitable prognostic model. We analyzed the mechanisms by which these DEGs regulate disease and present the differences in prognosis between the different genotypes. Finally, we verified our findings using molecular biology experiments.

Conclusion
Bioinformatics and molecular biology analyses confirmed a relationship between schistosomiasis and liver hepatocellular cancer. Furthermore, we validated the role of a potential oncoprotein factor that may be associated with infection and carcinogenesis. These findings enhance our understanding of Schistosoma japonicum infection's role in LIHC carcinogenesis.
Sepsis-associated acute kidney injury: recent advances in enrichment strategies, sub-phenotyping and clinical trials
Authors: Legrand Matthieu , Bagshaw Sean M. , Bhatraju Pavan K. , Bihorac Azra , Caniglia Ellen , Khanna Ashish K. , Kellum John A. , Koyner Jay , Harhay Michael O. , Zampieri Fernando G. , Zarbock Alexander , Chung Kevin , Liu Kathleen , Mehta Ravindra , Pickkers Peter , Ryan Abigail , Bernholz Juliane , Dember Laura , Gallagher Martin , Rossignol Patrick , Ostermann Marlies 
Published: March 2024

AbstractAcute kidney injury (AKI) often complicates sepsis and is associated with high morbidity and mortality. In recent years, several important clinical trials have improved our understanding of sepsis-associated AKI (SA-AKI) and impacted clinical care. Advances in sub-phenotyping of sepsis and AKI and clinical trial design offer unprecedented opportunities to fill gaps in knowledge and generate better evidence for improving the outcome of critically ill patients with SA-AKI. In this manuscript, we review the recent literature of clinical trials in sepsis with focus on studies that explore SA-AKI as a primary or secondary outcome. We discuss lessons learned and potential opportunities to improve the design of clinical trials and generate actionable evidence in future research. We specifically discuss the role of enrichment strategies to target populations that are most likely to derive benefit and the importance of patient-centered clinical trial endpoints and appropriate trial designs with the aim to provide guidance in designing future trials.
Zika virus prevention behaviors and knowledge among male partners of pregnant people and lack of condom use as a prevention behavior from the Zika en Embarazadas y Niños (ZEN) prospective cohort study, Colombia
Authors: Sancken Christina L. , Tannis Ayzsa , Amouzou Sandra A. , Burkel Veronica , Carlson Jeffrey M. , Newton Suzanne , Gilboa Suzanne M. , Gonzalez Maritza , Valencia Diana , Tong Van T. , Ospina Martha 
Published: March 2024

Abstract
Objective
Zika virus (ZIKV) infection in pregnancy can cause brain and eye abnormalities and neurodevelopmental sequelae. In the absence of medical countermeasures, behavioral interventions were recommended to prevent mosquito bites and sexual transmission of ZIKV. This report uses data from the Zika en Embarazadas y Niños (ZEN) prospective cohort study in Colombia to describe the knowledge, attitudes, and behaviors (KAB) related to ZIKV prevention in male partners compared to those of their pregnant partners at study enrollment during February 2017–2018.

Results
Most male partners reported wearing protective clothing such as long pants (97.6%) and long sleeves (72.8%), as well as covering ankles and feet (89.1%) to prevent ZIKV infection. When comparing the preventive behavior of condom use between male and pregnant partners, 26 pairs (10.0%) both responded that they performed the behavior. Overall, 25.1% of male partners and 18.9% of pregnant people reported any condom use during the three months before enrolling in ZEN. When comparing other preventive behaviors between male and pregnant partners, the behavior which was most frequently reported by both partners was wearing long pants (85.4%), and the least frequently reported by both partners was using condoms after finding out about a partner’s pregnancy (3.4%).
Revealing the role of SPP1+ macrophages in glioma prognosis and therapeutic targeting by investigating tumor-associated macrophage landscape in grade 2 and 3 gliomas
Authors: Tang Wenshu , Lo Cario W. S. , Ma Wei , Chu Annie T. W. , Tong Amy H. Y. , Chung Brian H. Y. 
Published: March 2024

Abstract
Background
Glioma is a highly heterogeneous brain tumor categorized into World Health Organization (WHO) grades 1–4 based on its malignancy. The suppressive immune microenvironment of glioma contributes significantly to unfavourable patient outcomes. However, the cellular composition and their complex interplays within the glioma environment remain poorly understood, and reliable prognostic markers remain elusive. Therefore, in-depth exploration of the tumor microenvironment (TME) and identification of predictive markers are crucial for improving the clinical management of glioma patients.

Results
Our analysis of single-cell RNA-sequencing data from glioma samples unveiled the immunosuppressive role of tumor-associated macrophages (TAMs), mediated through intricate interactions with tumor cells and lymphocytes. We also discovered the heterogeneity within TAMs, among which a group of suppressive TAMs named TAM-SPP1 demonstrated a significant association with Epidermal Growth Factor Receptor (EGFR) amplification, impaired T cell response and unfavourable patient survival outcomes. Furthermore, by leveraging genomic and transcriptomic data from The Cancer Genome Atlas (TCGA) dataset, two distinct molecular subtypes with a different constitution of TAMs, EGFR status and clinical outcomes were identified. Exploiting the molecular differences between these two subtypes, we developed a four-gene-based prognostic model. This model displayed strong associations with an elevated level of suppressive TAMs and could be used to predict anti-tumor immune response and prognosis in glioma patients.

Conclusion
Our findings illuminated the molecular and cellular mechanisms that shape the immunosuppressive microenvironment in gliomas, providing novel insights into potential therapeutic targets. Furthermore, the developed prognostic model holds promise for predicting immunotherapy response and assisting in more precise risk stratification for glioma patients.

Graphical abstract
Weak-type regularity for the Bergman projection over N-dimensional classical Hartogs triangles
Authors: Li Yi , Wang Mengjiao 
Published: March 2024

AbstractIn this paper, we study the weak-type regularity of the Bergman projection on n-dimensional classical Hartogs triangles. We extend the results of Huo–Wick on the 2-dimensional classical Hartogs triangle to the n-dimensional classical Hartogs triangle and show that the Bergman projection is of weak type at the upper endpoint of $L^{q}$

L
q

-boundedness but not of weak type at the lower endpoint of $L^{q}$

L
q

-boundedness.
The role of renewable energy in the energy–growth–emission nexus in the ASEAN region
Authors: Tran Thao , Bui Hung , Vo Anh The , Vo Duc Hong 
Published: March 2024

Abstract
Background
The Association of Southeast Asian Nations (ASEAN) relies mainly on fossil fuels in their energy supply, leading to higher CO2 emissions, pollution, and further environmental degradation. This paper uses the panel vector autoregressive and the Granger non-causality test in the heterogeneous panels, together with long-run estimation techniques, to examine the dynamic link among energy consumption, economic growth, and carbon emissions with the focus on renewable energy for the ASEAN countries in the past three decades.

Results
The findings from this paper indicate that carbon emissions are associated with energy consumption. In contrast, renewable energy usage reduces CO2 emissions, improving environmental quality. Economic growth is associated with increased energy consumption and carbon emissions in the ASEAN countries. The findings also indicate that the effects of energy consumption on economic growth are more significant than those of renewable energy in ASEAN. When considered together, these findings form a vicious circle regarding the energy–growth–emission nexus for the ASEAN economies. In addition, a bidirectional Granger causality among energy consumption, economic growth, CO2 emissions and renewable energy usage is confirmed.

Conclusions
Renewable energy has emerged as an important viable option for the ASEAN nations to achieve their dual objectives of enhanced economic growth, reduced CO2 emission, leading to improved environmental quality.