bluuebunny/crossref_metadata_2025_split huggingface dataset:
Establishment and application of rural domestic sewage treatment evaluation system based on analytic hierarchy process
Authors: Chen Peng , Yu Zhiyuan , Deng Youhua , Li Shanghui , Zhu Dongfeng , Zhang Tao , Xu Dong 
Published: December 2023

AbstractAlthough numerous rural domestic sewage treatment facilities are constructed with the aim of improving the rural environment, the actual treatment effect is still difficult to evaluate. In this study, an evaluation system of rural domestic sewage treatment was established based on the analytic hierarchy process (AHP) model and a county in Zhejiang Province was selected as an example for empirical analysis. According to the results, planning issues have the greatest impact on rural sewage treatment, accounting for 56.8%, while equipment issues, personnel issues and management issues account for 27.3%, 9.7% and 6.2%, respectively. Also, the results demonstrated that terminal planning, location selection, treatment process selection and construction design should be paid attention to among the 11 secondary indicators. The establishment of the evaluation system clarifies the different influencing factors and weights during the operation of the completed facilities, which is conducive to the scientific and effective management of sewage treatment.
On the logarithmic derivative of characteristic polynomials for random unitary matrices
Authors: Ge Fan 
Published: December 2023

AbstractLet be a random unitary matrix of size , distributed with respect to the Haar measure on . Let be the characteristic polynomial of . We prove that for close to the unit circle, can be approximated using zeros of very close to , with a typically controllable error term. This is an analogue of a result of Selberg for the Riemann zeta‐function. We also prove a mesoscopic central limit theorem for away from the unit circle, and this is an analogue of a result of Lester for zeta.
The Cheeger problem in abstract measure spaces
Authors: Franceschi Valentina , Pinamonti Andrea , Saracco Giorgio , Stefani Giorgio 
Published: December 2023

AbstractWe consider nonnegative ‐finite measure spaces coupled with a proper functional that plays the role of a perimeter. We introduce the Cheeger problem in this framework and extend many classical results on the Cheeger constant and on Cheeger sets to this setting, requiring minimal assumptions on the pair measure space perimeter. Throughout the paper, the measure space will never be asked to be metric, at most topological, and this requires the introduction of a suitable notion of Sobolev spaces, induced by the coarea formula with the given perimeter.
A quantitative Hasse principle for weighted quartic forms
Authors: Flores Daniel 
Published: December 2023

AbstractWe derive, via the Hardy–Littlewood method, an asymptotic formula for the number of integral zeros of a particular class of weighted quartic forms under the assumption of nonsingular local solubility. Our polynomials satisfy the condition that . Our conclusions improve on those that would follow from a direct application of the methods of Birch. For example, we show that in many circumstances the expected asymptotic formula holds when and .
Expedition 5300: limits of human adaptations in the highest city in the world
Authors: Champigneulle Benoit , Brugniaux Julien V. , Stauffer Emeric , Doutreleau Stéphane , Furian Michael , Perger Elisa , Pina Alessandra , Baillieul Sébastien , Deschamps Blandine , Hancco Ivan , Connes Philippe , Robach Paul , Pichon Aurélien , Verges Samuel 
Published: December 2023

AbstractExposure to chronic hypobaric hypoxia imposes a significant physiological burden to more than 80 million humans living above 2500 m throughout the world. Among them, 50 000 live in the world's highest city, La Rinconada, located at 5000–5300 m in southern Peru. Expedition 5300 is the first scientific and medical programme led in La Rinconada to investigate the physiological adaptations and altitude‐related health issues in this unique population. Dwellers from La Rinconada have very high haemoglobin concentration (20.3 ± 2.4 g/dL; n = 57) and those with chronic mountain sickness (CMS) exhibit even higher concentrations (23.1 ± 1.7 g/dL; n = 150). These values are associated with large total haemoglobin mass and blood volume, without an associated iron deficit. These changes in intravascular volumes lead to a substantial increase in blood viscosity, which is even larger in CMS patients. Despite these large haematological changes, 24 h blood pressure monitoring is essentially normal in La Rinconada, but some results suggest impaired vascular reactivity. Echocardiography revealed large right heart dilatation and high pulmonary arterial pressure as well as left ventricle concentric remodelling and grade I diastolic dysfunction. These changes in heart dimension and function tend to be more severe in highlanders with CMS. Polygraphy evaluations revealed a large reduction in nocturnal pulse oxygen saturation (median SpO2 = 79%), which is even more severe in CMS patients who also tended to show a higher oxygen desaturation index. The population of La Rinconada offers a unique opportunity to investigate the human responses to chronic severe hypoxia, at an altitude that is probably close to the maximum altitude human beings can permanently tolerate without presenting major health issues.
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Determination of the Bow Winding Material’s Nature from the Burial Ground of the Scythian Time Saryg-Bulun (Central Tuva)
Authors: Loboda A. Yu. , Pozhidaev V. M. , Busova V. S. , Malakhov S. N. , Kilunovskaya M. E. , Semenov V. A. , Tereschenko E. Yu. , Yatsishina E. B. 
Published: December 2023

Abstract
The results of studying the bow-winding material from mound 2, burial 5, at the Saryg-Bulun burial ground (Central Tuva, Russia) of the Aldy-Bel culture dated to the end of the 7th–beginning of the 6th centuries BC are presented. According to the first publication and the assumptions of archaeologists, the winding could be of animal origin; however, in recent years, this argument has been challenged due to similar finds of plant origin. Studies using infrared (IR) spectroscopy and chromatography show that the winding material for the arms of the ancient bow was fish skin.
Does mobile renewal make health insurance more responsive to clients? A case study of the National Health Insurance Scheme in Ghana
Authors: Akweongo Patricia , Gadeka Dominic Dormenyo , Aryeetey Genevieve , Sumboh Jemima , Aheto Justice Moses K , Aikins Moses 
Published: December 2023

BackgroundIn 2018, Ghana’s National Health Insurance Authority (NHIA) introduced a mobile strategy to enhance re-enrolment and improve client knowledge of their entitlements. This study investigated how Ghana’s mobile strategy has influenced the NHIA’s responsiveness to clients in terms of patient rights and entitlements, equity and satisfaction with health services.MethodsWe surveyed people (n=1700) in 6 districts who had renewed their insurance in the previous 12 months, using any strategy (mobile or manual). Multiple regression analysis examined correlation between individual characteristics and renewal modality. Policy documents on the mobile programme’s design and focus group discussions (n=12) on people’s experiences renewing their insurance were analysed thematically.ResultsWhile the mobile platform was designed for mobile National Health Insurance Scheme (NHIS) renewal and to provide information about insurance entitlements, few people surveyed (20%) knew about these informational features. Among those who renewed their NHIS coverage, 58% did so on the mobile renewal platform. Mobile renewal was high among those with tertiary education and those in the higher wealth quintiles. Mobile renewal was considered convenient, but required literacy in English, a phone and a mobile money wallet. For those who lacked some or all of these prerequisites but wanted to use mobile renewal, mobile vendors emerged as valued facilitators.ConclusionThe mobile platform has increased the responsiveness of Ghana’s NHIS through offering clients a more convenient mechanism to renew their insurance policies. It does not, however, eliminate the one month waiting period for activating the card, does not provide prompts to reassure clients of their renewal and does not empower most clients with information on entitlements. To improve the adoption and use of the mobile renewal strategy, the NHIA should publicise the platform’s information-sharing functions and explore formally engaging mobile vendors.
Predictors of outcome in patients with moderate mixed aortic valve disease
Authors: Patel Kush P , McKenna Michael , Thornton George D , Vandermolen Sebastian , Abdulelah Zaid Ali , Awad Wael , Baumbach Andreas , Mathur Anthony , Treibel Thomas A , Lloyd Guy , Mullen Michael J , Bhattacharyya Sanjeev 
Published: December 2023

ObjectivesGrading the severity of moderate mixed aortic stenosis and regurgitation (MAVD) is challenging and the disease poorly understood. Identifying markers of haemodynamic severity will improve risk stratification and potentially guide timely treatment. This study aims to identify prognostic haemodynamic markers in patients with moderate MAVD.MethodsModerate MAVD was defined as coexisting moderate aortic stenosis (aortic valve area (AVA) 1.0–1.5 cm2) and moderate aortic regurgitation (vena contracta (VC) 0.3–0.6 cm). Consecutive patients diagnosed between 2015 and 2019 were included from a multicentre registry. The primary composite outcome of death or heart failure hospitalisation was evaluated among these patients. Demographics, comorbidities, echocardiography and treatment data were assessed for their prognostic significance.Results207 patients with moderate MAVD were included, aged 78 (66–84) years, 56% male sex, AVA 1.2 (1.1–1.4) cm2and VC 0.4 (0.4–0.5) cm. Over a follow-up of 3.5 (2.5–4.7) years, the composite outcome was met in 89 patients (43%). Univariable associations with the primary outcome included older age, previous myocardial infarction, previous cerebrovascular event, atrial fibrillation, New York Heart Association >2, worse renal function, tricuspid regurgitation ≥2 and mitral regurgitation ≥2. Markers of biventricular systolic function, cardiac remodelling and transaortic valve haemodynamics demonstrated an inverse association with the primary composite outcome. In multivariable analysis, peak aortic jet velocity (Vmax) was independently and inversely associated with the composite outcome (HR: 0.63, 95% CI 0.43 to 0.93; p=0.021) in an adjusted model along with age (HR: 1.05, 95% CI 1.03 to 1.08; p<0.001), creatinine (HR: 1.002, 95% CI 1.001 to 1.003; p=0.005), previous cerebrovascular event (85% vs 42%; HR: 3.04, 95% CI 1.54 to 5.99; p=0.001) and left ventricular ejection fraction (LVEF) (HR: 0.97, 95% CI 0.95 to 0.99; p=0.007). Patients with Vmax ≤2.8 m/s and LVEF ≤50% (n=27) had the worst outcome compared with the rest of the population (72% vs 41%; HR: 3.87, 95% CI 2.20 to 6.80; p<0.001).ConclusionsPatients with truly moderate MAVD have a high incidence of death and heart failure hospitalisation (43% at 3.5 (2.5–4.7) years). Within this group, a high-risk group characterised by disproportionately low aortic Vmax (≤2.8 m/s) and adverse remodelling (LVEF ≤50%) have the worst outcomes.
Postdischarge major bleeding, myocardial infarction, and mortality risk after coronary artery bypass grafting
Authors: Björklund Erik , Enström Philip , Nielsen Susanne J , Tygesen Hans , Martinsson Andreas , Hansson Emma C , Lindgren Martin , Malm Carl-Johan , Pivodic Aldina , Jeppsson Anders 
Published: December 2023

ObjectiveTo investigate the incidence and mortality risk associated with postdischarge major bleeding after coronary artery bypass grafting (CABG), and relate this to the incidence of, and mortality risk from, postdischarge myocardial infarction.MethodsAll patients undergoing first-time isolated CABG in Sweden in 2006–2017 and surviving 14 days after hospital discharge were included in a cohort study. Individual patient data from the SWEDEHEART Registry and five other mandatory nationwide registries were merged. Piecewise Cox proportional hazards models were used to investigate associations between major bleeding, defined as hospitalisation for bleeding, with subsequent mortality risk. Similar Cox proportional hazards models were used to investigate the association between postdischarge myocardial infarction and mortality risk.ResultsAmong 36 633 patients, 2429 (6.6%) had a major bleeding event and 2231 (6.1%) had a myocardial infarction. Median follow-up was 6.0 (range 0–11) years. Major bleeding was associated with higher mortality risk <30 days (adjusted HR (aHR)=20.2 (95% CI 17.3 to 23.5)), 30–365 days (aHR=3.8 (95% CI 3.4 to 4.3)) and >365 days (aHR=1.8 (95% CI 1.7 to 2.0)) after the event. Myocardial infarction was associated with higher mortality risk <30 days (aHR=20.0 (95% CI 16.7 to 23.8)), 30–365 days (aHR=4.1 (95% CI 3.6 to 4.8)) and >365 days (aHR=1.8 (95% CI 1.7 to 2.0)) after the event.ConclusionsThe increase in mortality risk associated with a postdischarge major bleeding after CABG is substantial and is similar to the mortality risk associated with a postdischarge myocardial infarction.
Hypertensive disorders of pregnancy and cardiovascular disease risk: a Mendelian randomisation study
Authors: Tschiderer Lena , van der Schouw Yvonne T , Burgess Stephen , Bloemenkamp Kitty W M , Seekircher Lisa , Willeit Peter , Onland-Moret Charlotte , Peters Sanne A E 
Published: December 2023

ObjectiveObservational studies show that hypertensive disorders of pregnancy (HDPs) are related to unfavourable maternal cardiovascular disease (CVD) risk profiles later in life. We investigated whether genetic liability to pre-eclampsia/eclampsia and gestational hypertension is associated with CVD risk factors and occurrence of CVD events.MethodsWe obtained genetic associations with HDPs from a genome-wide association study and used individual participant data from the UK Biobank to obtain genetic associations with CVD risk factors and CVD events (defined as myocardial infarction or stroke). In our primary analysis, we applied Mendelian randomisation using inverse-variance weighted regression analysis in ever pregnant women. In sensitivity analyses, we studied men and nulligravidae to investigate genetic liability to HDPs and CVD risk without the ability to experience the underlying phenotype.ResultsOur primary analysis included 221 155 ever pregnant women (mean age 56.8 (SD 7.9) years) with available genetic data. ORs for CVD were 1.20 (1.02 to 1.41) and 1.24 (1.12 to 1.38) per unit increase in the log odds of genetic liability to pre-eclampsia/eclampsia and gestational hypertension, respectively. Furthermore, genetic liability to HDPs was associated with higher levels of systolic and diastolic blood pressure and younger age at hypertension diagnosis. Sensitivity analyses revealed no statistically significant differences when comparing the findings with those of nulligravidae and men.ConclusionsGenetic liability to HDPs is associated with higher CVD risk, lower blood pressure levels and earlier hypertension diagnosis. Our study suggests similar findings in ever pregnant women, nulligravidae and men, implying biological mechanisms relating to HDPs are causally related to CVD risk.
Effects of flavour and modified risk claims on nicotine pouch perceptions and use intentions among young adults who use inhalable nicotine and tobacco products: a randomised controlled trial
Authors: Vogel Erin A , Tackett Alayna P , Unger Jennifer B , Gonzalez Maria J , Peraza Natalia , Jafarzadeh Nikki S , Page Michelle K , Goniewicz Maciej L , Wong Melissa , Leventhal Adam M 
Published: December 2023

BackgroundAvailability of flavours and potential modified risk tobacco product (MRTP) claims may influence young adults’ (YAs’) perceptions of and intentions to use nicotine pouches (‘pouches’).MethodsYAs aged 21–34 years (N=47,Mage=24.5,SD=3.1) with past-month nicotine/tobacco use (10.6% cigarette-only, 51.1% e-cigarette-only, 38.3% dual use) and no intention to quit were randomised to self-administer four Zyn 3 mg nicotine pouches in a 4 (flavour; within-subjects: smooth, mint, menthol, citrus) × 2 (MRTP claim on packaging; between subjects: present or absent) mixed-factorial design. After self-administering each pouch, participants reported appeal, use intentions and perceived harm compared with cigarettes and e-cigarettes. Three mixed-factorial analysis of variances (ANOVAs) examined main and interactive effects of flavour and MRTP claim on appeal, use intentions and comparative harm perceptions.ResultsMint (M=55.9,SD=26.4), menthol (M=49.7,SD=26.8) and citrus (M=46.6,SD=24.8) flavours were significantly more appealing than smooth (M=37.6,SD=25.4; p<0.001). MRTP claim did not significantly affect product appeal (p=0.376). Use intentions were greater for mint (M=2.6,SD=1.3) and menthol (M=2.0,SD=1.1) flavours than smooth (M=1.8,SD=1.0; p=0.002). Flavour did not affect comparative harm perceptions (p values>0.418). MRTP claims increased use intention (p=0.032) and perceptions of pouches as less harmful than cigarettes (p=0.011), but did not affect perceived harm relative to e-cigarettes (p=0.142). Flavour × MRTP claim interactions were not significant.ConclusionsFlavoured (vs smooth) pouches were more appealing to YAs. MRTP claims reduced perceived harm of pouches compared with cigarettes; however, intentions to switch were low. To protect YAs’ health, regulatory restrictions could target flavours and MRTP claims.
FcγRIIB Is an Immune Checkpoint Limiting the Activity of Treg-Targeting Antibodies in the Tumor Microenvironment
Authors: Knorr David A. , Blanchard Lucas , Leidner Rom S. , Jensen Shawn M. , Meng Ryan , Jones Andrew , Ballesteros-Merino Carmen , Bell Richard B. , Baez Maria , Marino Alessandra , Sprott David , Bifulco Carlo B. , Piening Brian , Dahan Rony , Osorio Juan C. , Fox Bernard A. , Ravetch Jeffrey V. 
Published: December 2023

Abstract
Preclinical murine data indicate that fragment crystallizable (Fc)-dependent depletion of intratumoral regulatory T cells (Treg) is a major mechanism of action of anti–CTLA-4. However, the two main antibodies administered to patients (ipilimumab and tremelimumab) do not recapitulate these effects. Here, we investigate the underlying mechanisms responsible for the limited Treg depletion observed with these therapies. Using an immunocompetent murine model humanized for CTLA-4 and Fcγ receptors (FcγR), we show that ipilimumab and tremelimumab exhibit limited Treg depletion in tumors. Immune profiling of the tumor microenvironment (TME) in both humanized mice and humans revealed high expression of the inhibitory Fc receptor, FcγRIIB, which limits antibody-dependent cellular cytotoxicity/phagocytosis. Blocking FcγRIIB in humanized mice rescued the Treg-depleting capacity and antitumor activity of ipilimumab. Furthermore, Fc engineering of antibodies targeting Treg-associated targets (CTLA-4 or CCR8) to minimize FcγRIIB binding significantly enhanced Treg depletion, resulting in increased antitumor activity across various tumor models. Our results define the inhibitory FcγRIIB as an immune checkpoint limiting antibody-mediated Treg depletion in the TME, and demonstrate Fc engineering as an effective strategy to overcome this limitation and improve the efficacy of Treg-targeting antibodies.
Treatment Response, Tumor Infiltrating Lymphocytes and Clinical Outcomes in Inflammatory Breast Cancer–Treated with Neoadjuvant Systemic Therapy
Authors: De Schepper Maxim , Nguyen Ha-Linh , Richard François , Rosias Louise , Lerebours Florence , Vion Roman , Clatot Florian , Berghian Anca , Maetens Marion , Leduc Sophia , Isnaldi Edoardo , Molinelli Chiara , Lambertini Matteo , Grillo Federica , Zoppoli Gabriele , Dirix Luc , Punie Kevin , Wildiers Hans , Smeets Ann , Nevelsteen Ines , Neven Patrick , Vincent-Salomon Anne , Larsimont Denis , Duhem Caroline , Viens Patrice , Bertucci François , Biganzoli Elia , Vermeulen Peter , Floris Giuseppe , Desmedt Christine 
Published: December 2023

Abstract

Inflammatory breast cancer (IBC) is a rare (1%–5%), aggressive form of breast cancer, accounting for approximately 10% of breast cancer mortality. In the localized setting, standard of care is neoadjuvant chemotherapy (NACT) ± anti-HER2 therapy, followed by surgery. Here we investigated associations between clinicopathologic variables, stromal tumor-infiltrating lymphocytes (sTIL), and pathologic complete response (pCR), and the prognostic value of pCR. We included 494 localized patients with IBC treated with NACT from October 1996 to October 2021 in eight European hospitals. Standard clinicopathologic variables were collected and central pathologic review was performed, including sTIL. Associations were assessed using Firth logistic regression models. Cox regressions were used to evaluate the role of pCR and residual cancer burden (RCB) on disease-free survival (DFS), distant recurrence-free survival (DRFS), and overall survival (OS). Distribution according to receptor status was as follows: 26.4% estrogen receptor negative (ER−)/HER2−; 22.0% ER−/HER2+; 37.4% ER+/HER2−, and 14.1% ER+/HER2+. Overall pCR rate was 26.3%, being highest in the HER2+ groups (45.9% for ER−/HER2+ and 42.9% for ER+/HER2+). sTILs were low (median: 5.3%), being highest in the ER−/HER2− group (median: 10%). High tumor grade, ER negativity, HER2 positivity, higher sTILs, and taxane-based NACT were significantly associated with pCR. pCR was associated with improved DFS, DRFS, and OS in multivariable analyses. RCB score in patients not achieving pCR was independently associated with survival. In conclusion, sTILs were low in IBC, but were predictive of pCR. Both pCR and RCB have an independent prognostic role in IBC treated with NACT.

Significance:
IBC is a rare, but very aggressive type of breast cancer. The prognostic role of pCR after systemic therapy and the predictive value of sTILs for pCR are well established in the general breast cancer population; however, only limited information is available in IBC. We assembled the largest retrospective IBC series so far and demonstrated that sTIL is predictive of pCR. We emphasize that reaching pCR remains of utmost importance in IBC.
“Havana Syndrome”: A post mortem
Authors: Bartholomew Robert E , Baloh Robert W 
Published: December 2023

Background: Since 2016, an array of claims and public discourse have circulated in the medical community over the origin and nature of a mysterious condition dubbed “Havana Syndrome,” so named as it was first identified in Cuba. In March 2023, the United States intelligence community concluded that the condition was a socially constructed catch-all category for an array of health conditions and stress reactions that were lumped under a single label. Aims: To examine the history of “Havana Syndrome” and the many factors that led to its erroneous categorization as a novel clinical entity. Method: A review of the literature. Results/Conclusions: Several factors led to the erroneous classification of “Havana Syndrome” as a novel entity including the failure to stay within the limitations of the data; the withholding of information by intelligence agencies, the prevalence of popular misconceptions about psychogenic illness, the inability to identify historical parallels; the role of the media, and the mixing of politics with science.