bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chemical Profiling of Shen-Wu-Yi-Shen Tablets Using UPLC-Q-TOF-MS/MS and Its Quality Evaluation Based on UPLC-DAD Combined with Multivariate Statistical Analysis
Authors: Mei Yudan , Hu Yumei , Tao Xiaoqian , Shang Jing , Qian Mengyu , Suo Fengtai , Li Jifeng , Cao Liang , Wang Zhenzhong , Xiao Wei 
Published: January 2024

Abstract
Shen-Wu-Yi-Shen tablets (SWYST) is a traditional Chinese medicine prescription used for treating chronic kidney disease (CKD). This study aims to characterize the constituents in SWYST and evaluate the quality based on the quantification of multiple bioactive components. SWYST samples were analyzed with ultra-high-performance liquid chromatography quadrupole time-of-flight mass spectrometry (UPLC-Q-TOF-MS) and a data-processing strategy. As a result, 215 compounds in SWYST were unambiguously identified or tentatively characterized, including 14 potential new compounds. Meanwhile, strategies based on characteristic fragments for rapid identification were summarized, indicating that the qualitative method is accurate and feasible. Notably, the glucose esters of laccaic acid D-type anthraquinone were first found and their fragmentation patterns were described by comparing that of O-glycoside isomers. Besides, based on comparisons of the cleavage ways of mono-acyl glucose with different acyl groups or acylation sites, differences in fragmentation pathways between 1,2-di-O-acyl glucose and 1,6-di-O-acyl glucose were proposed for the first time and verified by reference substances. In addition, a validated UPLC-DAD was established for the determination of 11 major bioactive components related to treatment of CKD (albiflorin, paeoniflorin, 2,3,5,4′-tetrahydroxy-stilbene-2-O-β-d-glucoside (TSG), 1-O-galloyl-2-O-cinnamoyl-β-d-glucose, emodin-8-O-β-d-glucoside, chrysophanol-O-β-d-glucoside, aloe-emodin, rhein, emodin, chrysophanol and physcion). Moreover, TSG and 1-O-galloyl-2-O-cinnamoyl-β-d-glucose were found as the quality markers related to the origins of SWYST based on multivariate statistical analysis. Conclusively, the findings in this work provide a feasible reference for further studies on quality research and mechanisms of action in treating CKD.
Sexual and Gender Minorities’ Vaccine Uptake and Behavioral Change in Response to the Mpox Outbreak in the United States: August 2022 Through November 2022
Authors: Grov Christian , Zohra Fatima , Mirzayi Chloe , Stief Matthew , D’Angelo Alexa B , Dearolf Michelle , Westmoreland Drew A , Carneiro Pedro , Nash Denis , Carrico Adam W 
Published: January 2024

Abstract

Background
In the summer of 2022, the United States faced a nationwide outbreak of mpox, with cases concentrated in sexual and gender minorities who have sex with men. Understanding rates of mpox vaccine uptake and concomitant behavioral change is essential to guide the implementation of targeted public health responses to the potential reemergence of mpox.

Methods
Between August 2022 and November 2022, 8551 individuals recruited via geosocial networking apps completed a brief survey that assessed mpox vaccine uptake, intentions to get a mpox vaccine, and behavioral change.

Results
In August, 17.4% of participants reported having received at least 1 dose of the mpox vaccine. By November, this prevalence estimate was 35.0%. Black participants were significantly less likely to be vaccinated, and vaccine hesitancy increased among Black participants over time. Among those who had not yet received a vaccination, the intention to get vaccinated decreased over time. We observed trends that coincided with the evolving outbreak, such as decreased worry about mpox and less engagement in risk reduction behaviors over time.

Conclusions
Despite a 2-fold increase in mpox vaccine uptake between August 2022 and November 2022 in sexual and gender minorities who have sex with men, disparities in vaccine uptake were observed among Black participants. Findings will guide the implementation of public health responses to the potential reemergence of mpox and other viral infectious diseases (eg, meningitis) with a specific focus on optimizing vaccine uptake in Black communities.
Histopathological myocardial changes in patients with severe aortic stenosis referred for surgical valve replacement: a cardiac magnetic resonance correlation study
Authors: Abecasis João , Lopes Pedro , Maltes Sergio , Santos Rita Reis , Ferreira António , Ribeiras Regina , Andrade Maria João , Uva Miguel Sousa , Gil Victor , Félix Ana , Ramos Sancia , Cardim Nuno 
Published: January 2024

Abstract

Aims
Myocardial fibrosis (MF) takes part in left ventricular (LV) remodelling in patients with aortic stenosis (AS), driving the transition from hypertrophy to heart failure. The structural changes that occur in this transition are not fully enlightened. The aim of this study was to describe histopathological changes at endomyocardial biopsy (EMB) in patients with severe AS referred to surgical aortic valve replacement (AVR) and to correlate them with LV tissue characterization from pre-operative cardiac magnetic resonance (CMR).

Methods and results
One-hundred fifty-eight patients [73 (68–77) years, 50% women] were referred for surgical AVR because of severe symptomatic AS, with pre-operative CMR (n = 143) with late gadolinium enhancement (LGE), T1, T2 mapping, and extracellular volume fraction (ECV) quantification. Intra-operative septal EMB was obtained in 129 patients. MF was assessed through Masson’s Trichrome histochemistry. Immunohistochemistry was performed for both inflammatory cells and extracellular matrix (ECM) characterization (Type I Collagen, Fibronectin, Tenascin C). Non-ischaemic LGE was present in 106 patients (67.1%) [median fraction: 5.0% (2.0–9.7)]. Native T1 was above normal [1053 ms (1024–1071)] and T2 within the normal range [39.3 ms (37.3–42.0)]. Median MF was 11.9% (6.54–19.97), with predominant type I collagen perivascular distribution (95.3%). Sub-endocardial cardiomyocyte ischaemic-like changes were identified in 45% of EMB. There was no inflammation, despite ECM remodelling expression. MF quantification at EMB was correlated with LGE mass (P = 0.008) but not with global ECV (P = 0.125).

Conclusion
Patients with severe symptomatic AS referred for surgical AVR have unspecific histological myocardial changes, including signs of cardiomyocyte ischaemic insult. ECM remodelling is ongoing, with MF heterogeneity. These features may be recognized by comprehensive CMR protocols. However, no single CMR parameter captures the burden of MF and histological myocardial changes in this setting.
Clinical and prognostic implications of left ventricular dilatation in heart failure
Authors: Kasa Gizem , Teis Albert , Juncà Gladys , Aimo Alberto , Lupón Josep , Cediel German , Santiago-Vacas Evelyn , Codina Pau , Ferrer-Sistach Elena , Vallejo-Camazón Nuria , López-Ayerbe Jorge , Bayés-Genis Antoni , Delgado Victoria 
Published: January 2024

Abstract

Aims
To assess the agreement between left ventricular end-diastolic diameter index (LVEDDi) and volume index (LVEDVi) to define LV dilatation and to investigate the respective prognostic implications in patients with heart failure (HF).

Methods and results
Patients with HF symptoms and LV ejection fraction (LVEF) &lt; 50% undergoing cardiac magnetic resonance were evaluated retrospectively. LV dilatation was defined as LVEDDi or LVEDVi above the upper normal limit according to published reference values. Patients were followed up for the combined endpoint of cardiovascular death or HF hospitalization during 5 years. A total of 564 patients (median age 64 years; 79% men) were included. LVEDDi had a modest correlation with LVEDVi (r = 0.682, P &lt; 0.001). LV dilatation was noted in 84% of patients using LVEDVi-based definition and in 73% using LVEDDi-based definition, whereas 20% of patients displayed discordant definitions of LV dilatation. During a median follow-up of 2.8 years, patients with both dilated LVEDDi and LVEDVi had the highest cumulative event rate (HR 3.00, 95% CI 1.15–7.81, P = 0.024). Both LVEDDi and LVEDVi were independently associated with the primary outcome (hazard ratio 3.29, 95%, P &lt; 0.001 and 2.8, P = 0.009; respectively).

Conclusion
The majority of patients with HF and LVEF &lt; 50% present both increased LVEDDi and LVEDVi whereas 20% show discordant linear and volumetric definitions of LV dilatation. Patients with increased LVEDDi and LVEDVi have the worst clinical outcomes suggesting that the assessment of these two metrics is needed for better risk stratification.
Sustaining essential health services in Lao PDR in the context of donor transition and COVID-19
Authors: Kim Eunkyoung , Park Yu Lee , Lo Ying-Ru , Keoprasith Bounserth , Panyakeo Suphab 
Published: January 2024

Abstract
Lao People’s Democratic Republic (Lao PDR) aims at graduating from least developed country status by 2026 and must increase the level of domestic financing for health. This paper examines how the government has prepared for the decline of external assistance and how donors have applied their transition approaches. Adapting a World Health Organization (WHO) framework, reflections and lessons were generated based on literature review, informal and formal consultations and focus group discussions with the Lao PDR government and development partners including budget impact discussion. The government has taken three approaches to transition from external to domestic funding: mobilizing domestic resources, increasing efficiency across programs and prioritization with a focus on strengthening primary health care (PHC). The government has increased gradually domestic government health expenditures as a share of the government expenditure from 2.6% in 2013 to 4.9% in 2019. The Ministry of Health has made efforts to design and roll out integrated service delivery of maternal, newborn, child, and adolescent health services, immunization and nutrition; integrated 13 information systems of key health programs into one single District Health Information Software 2; and prioritized PHC, which has led to shifting donors towards supporting PHC. Donors have revisited their aid policies designed to improve sustainability and ownership of the government. However, the government faces challenges in improving cross-programmatic efficiency at the operational level and in further increasing the health budget due to the economic crisis aggravated during Coronavirus disease 2019 (COVID-19). Working to implement donor transition strategies under the current economic situation and country challenges, calls into question the criteria used to evaluate transition. This criterion needs to include more appropriate indicators other than gross national income per capita, which does not reflect a country’s readiness and capacity of the health system. There should be a more country-tailored strategy and support for considering the context and system-wide readiness during donor transition.
Leveraging global investments for polio eradication to strengthen health systems’ resilience through transition
Authors: Tediosi Fabrizio , Villa Simone , Levison Darcy , Ekeman Ebru , Politi Claudio 
Published: January 2024

Abstract
Since the launch of the Global Polio Eradication Initiative in 1988, more than US$20 billion has been invested globally in polio eradication. The World Health Organization and its partners are currently supporting Member States to transition the functions used to eradicate polio to strengthen their health systems. This study analyses global polio activities through the lens of health systems and the Common Goods for Health (CGH). Polio activities include key health system functions such as surveillance and response systems and immunization, which are essential to maintaining resilient health systems. They also support essential functions such as policy development, planning, training and capacity building, which are often underfunded in many countries. To improve overall resilience, it is critical to continue to integrate these functions into local health systems so that the capacity built through the polio eradication programme can be used for broader public health purposes. It is vital that this integration process be tailored to each country’s unique health system context, rather than using a one-size-fits-all approach. While integration of all polio activities into local health systems is ideal, the transition to domestic financing may be coordinated with other global health financing mechanisms. This would reduce funding fragmentation and transaction costs, and allow for a focus on health system functions as a whole rather than just disease-specific efforts. The transition to domestic financing of polio activities could be staggered, prioritizing the transition to domestic funding for activities with limited global externalities, while seeking longer-term external funding for those that are global CGH.
Understanding China’s shifting priorities and priority-setting processes in development assistance for health
Authors: Guo Bingqing , Fan Victoria , Strange Austin , Grépin Karen Ann 
Published: January 2024

Abstract
Over the past two decades, China has become a distinctive and increasingly important donor of development assistance for health (DAH). However, little is known about what factors influence China’s priority-setting for DAH. In this study, we provide an updated analysis of trends in the priorities of Chinese DAH and compare them to comparable trends among OECD Development Assistance Committee (DAC) donors using data from the AidData’s Global Chinese Development Finance Dataset (2000–2017, version 2.0) and the Creditor Reporting System (CRS) database (2000–2017). We also analyse Chinese medical aid exports before and after the start of the COVID-19 pandemic using a Chinese Aid Exports Database. We further explore the potential factors influencing China’s shifting priority-setting processes by reviewing Chinese official documents following Walt and Gilson’s policy analysis framework (context–actors–process–content) and by testing our conjectures empirically. We find that China has become an important DAH donor to most regions if measured using project value, including but not limited to Africa. China has prioritized aid to African and Asian countries as well as to CRS subsectors that are not prioritized by DAC donors, such as medical services and basic health infrastructure. Chinese quarterly medical aid exports almost quintupled after the start of the COVID-19 pandemic. Noticeably, China has allocated more attention to Asia, eye diseases and infectious disease outbreaks over time. In contrast, the priority given to malaria has declined over the same period. Regarding factors affecting priority shifts, the outbreaks of SARS and Ebola, the launch of the Belt and Road Initiative and the COVID-19 pandemic appear to be important milestones in the timeline of Chinese DAH. Unlike stereotypes of China as a ‘lone wolf’ donor, our analysis suggests multilateral processes are influential in informing and setting Chinese DAH priorities.
The impact of shifts in PEPFAR funding policy on HIV services in Eastern Uganda (2015–21)
Authors: Zakumumpa Henry , Paina Ligia , Ssegujja Eric , Shroff Zubin Cyrus , Namakula Justin , Ssengooba Freddie 
Published: January 2024

Abstract
Although donor transitions from HIV programmes are increasingly common in low-and middle-income countries, there are limited analyses of long-term impacts on HIV services. We examined the impact of changes in President’s Emergency Plan for AIDS Relief (PEPFAR) funding policy on HIV services in Eastern Uganda between 2015 and 2021.We conducted a qualitative case study of two districts in Eastern Uganda (Luuka and Bulambuli), which were affected by shifts in PEPFAR funding policy. In-depth interviews were conducted with PEPFAR officials at national and sub-national levels (n = 46) as well as with district health officers (n = 8). Data were collected between May and November 2017 (Round 1) and February and June 2022 (Round 2). We identified four significant donor policy transition milestones: (1) between 2015 and 2017, site-level support was withdrawn from 241 facilities following the categorization of case study districts as having a ‘low HIV burden’. Following the implementation of this policy, participants perceived a decline in the quality of HIV services and more frequent commodity stock-outs. (2) From 2018 to 2020, HIV clinic managers in transitioned districts reported drastic drops in investments in HIV programming, resulting in increased patient attrition, declining viral load suppression rates and increased reports of patient deaths. (3) District officials reported a resumption of site-level PEPFAR support in October 2020 with stringent targets to reverse declines in HIV indicators. However, PEPFAR declared less HIV-specific funding. (4) In December 2021, district health officers reported shifts by PEPFAR of routing aid away from international to local implementing partner organizations. We found that, unlike districts that retained PEPFAR support, the transitioned districts (Luuka and Bulambuli) fell behind the rest of the country in implementing changes to the national HIV treatment guidelines adopted between 2017 and 2020. Our study highlights the heavy dependence on PEPFAR and the need for increasing domestic financial responsibility for the national HIV response.
Managing transitions from external assistance: cross-national learning about sustaining effective coverage
Authors: Shroff Zubin Cyrus , Sparkes Susan P , Paina Ligia , Skarphedinsdottir Maria , Gotsadze George , Zakumumpa Henry , Tang Kun , Perera Prasadini N , Yuan MyMai , Hanson Kara 
Published: January 2024

Abstract
The often-prominent role of external assistance in health financing in low- and middle-income countries raises the question of how such resources can enable the sustained or even expanded coverage of key health services and initiatives even after donor funding is no longer available. In response to this question, this paper analyses the process and outcomes of donor transitions in health—where countries or regions within countries are no longer eligible to receive grants or concessional loans from external sources based on eligibility criteria or change in donor policy. The comparative analysis of multiple donor transitions in four countries—China, Georgia, Sri Lanka and Uganda—identifies 16 factors related to policy actors, policy process, the content of donor-funded initiatives and the broader political-economic context that were associated with sustained coverage of previously donor supported interventions. From a contextual standpoint, these factors relate to favourable economic and political environments for domestic systems to prioritize coverage for donor-supported interventions. Clear and transparent transition processes also enabled a smoother transition. How the donor-supported initiatives and services were organized within the context of the overall health system was found to be critically important, both before and during the transition process. This includes a targeted approach to integrate, strengthen and align key elements of the governance, financing, input management and service delivery arrangements with domestic systems. The findings of this analysis have important implications for how both donors and country policy makers can better structure external assistance that enables sustained coverage regardless of the source of funding. In particular, donors can better support sustained coverage through supporting long-term structural and institutional reform, clear co-financing policies, ensuring alignment with local salary scales and engaging with communities to ensure a continued focus on equitable access post-transition.
Linking climate stressors to ecological processes in ecosystem models, with a case study from the Gulf of Alaska
Authors: Rovellini Alberto , Punt André E , Bryan Meaghan D , Kaplan Isaac C , Dorn Martin W , Aydin Kerim , Fulton Elizabeth A , Alglave Baptiste , Baker Matthew R , Carroll Gemma , Ferriss Bridget E , Haltuch Melissa A , Hayes Adam L , Hermann Albert J , Hernvann Pierre-Yves , Holsman Kirstin K , Liu Owen R , McHuron Elizabeth , Morzaria-Luna Hem Nalini , Moss Jamal , Surma Szymon , Weise Madison T 
Published: January 2024

Abstract
As climate stressors are impacting marine ecosystems and fisheries across the world, ecosystem models that incorporate environmental variables are increasingly used to inform ecosystem-based fisheries management. The assumptions around the mechanistic links between climate stressors and the biological processes in these models are important, but the implications for model outcomes of which stressors are captured and how they affect modeled biological processes are seldom explored. Using a whole-ecosystem model (Atlantis) for the Gulf of Alaska, we explore the effects of capturing physical (increased temperature) and biogeochemical (decreased low trophic level productivity) climate stressors, and disentangle the effects of each stressor on the productivity of forage fish, groundfish, and fish-eating seabirds. We then test the effects of alternative model specifications of temperature-driven habitat determination and bioenergetics. Increased temperature resulted in increased weight-at-age and higher natural mortality, while decreased productivity resulted in decreased weight-at-age and higher natural mortality. Model specification of temperature dependence of movement and spawning influenced model outcomes, and decoupling these processes from temperature led to overly optimistic biomass predictions. As the use of ecosystem models to inform fisheries management becomes more operational, we illustrate that the assumptions around the links between climate stressors and ecological processes influence model outcomes.
Deterministic and stochastic processes generating alternative states of microbiomes
Authors: Hayashi Ibuki , Fujita Hiroaki , Toju Hirokazu 
Published: January 2024

Abstract
The structure of microbiomes is often classified into discrete or semi-discrete types potentially differing in community-scale functional profiles. Elucidating the mechanisms that generate such “alternative states” of microbiome compositions has been one of the major challenges in ecology and microbiology. In a time-series analysis of experimental microbiomes, we here show that both deterministic and stochastic ecological processes drive divergence of alternative microbiome states. We introduced species-rich soil-derived microbiomes into eight types of culture media with 48 replicates, monitoring shifts in community compositions at six time points (8 media × 48 replicates × 6 time points = 2304 community samples). We then confirmed that microbial community structure diverged into a few state types in each of the eight medium conditions as predicted in the presence of both deterministic and stochastic community processes. In other words, microbiome structure was differentiated into a small number of reproducible compositions under the same environment. This fact indicates not only the presence of selective forces leading to specific equilibria of community-scale resource use but also the influence of demographic drift (fluctuations) on the microbiome assembly. A reference-genome-based analysis further suggested that the observed alternative states differed in ecosystem-level functions. These findings will help us examine how microbiome structure and functions can be controlled by changing the “stability landscapes” of ecological community compositions.