bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influencing Factors of Hospitalization Expenditures in Patients with Budd-Chiari Syndrome
Authors: Liu Xinyu , Liu Yitian , Huang Mengqin , Zhou Jingjing , Wu Wenjian , Tan Zaixiang 
Published: October 2023

Abstract
Objective Thousands of Budd-Chiari syndrome (BCS) cases are reported in Jiangsu, Shandong, Anhui, and other places in China. It is of great significance to investigate and analyze BCS cases in high-incidence areas. The study aims to understand factors associated with hospitalization expenditures for patients with BCS.
Methods In this retrospective study from January 1, 2013, to December 31, 2020, we included 1748 patients from a tertiary hospital. Influencing factors associated with BCS hospitalization expenditures were evaluated by multiple linear regression model analyses.
Results Medicare began to have an effect on hospitalization expenditures when the patient's overall costs reached ￥15,000 or more and contributed more when the expenses were between ￥15,000 and ￥29,999. The length of stay in hospital for BCS did not always have an effect on total costs, but rather exerted an effect at the lowest (<￥15,000) and highest (>￥45,000) levels. In contrast, the type of surgery was associated with cost increase only at the lowest total cost level. Complications and discharge cure were the same and had an impact intermittently.
Conclusions To continuously reduce the hospitalization expenditures of BCS patients, this study suggests improving the health insurance system, shortening the length of hospital stay, controlling the types of surgery performed, and so on.
The discrepancy of antemortem clinical diagnosis and postmortem autopsy diagnosis of lung pathologies in under-five deaths and the reasons for discrepancies: a case series analysis
Authors: Leulseged Haleluya , Rees Chris A. , Alemu Addisu , Barr Beth A. Tippett , Dheressa Merga , Asefa Nega 
Published: October 2023

Abstract
Background: Diagnostic autopsy is the most reliable approach to definitively ascertain the cause of death and evaluate the accuracy of antemortem clinical diagnoses. Identifying diagnostic discrepancies is vital to understand common gaps in antemortem clinical diagnoses and modify antemortem diagnostic approaches to increase the accuracy of clinical diagnosis. The objective of this study was to determine the frequency of diagnostic discrepancies between antemortem clinical diagnoses and postmortem autopsies on lung pathologies and to understand reasons for diagnostic discrepancies among cases included in Child Health and Mortality Prevention Surveillance (CHAMPS) in Ethiopia.
Methods: A clinical case series study of deaths among children under-five in the CHAMPS study at three sites in Ethiopia between October 2019 and April 2022 was conducted. The antemortem clinical diagnoses and postmortem pathological diagnoses of the lung were compared for each case. Two senior physicians assessed the findings for both agreement and disagreement. The McNemar’s test was used to assess for statistically significant differences between antemortem and postmortem diagnoses.
Results: Seventy-five cases were included (73.3% male). Over half (54.7%) died between the 1st and 7th day of life. Sepsis (66.7%), pneumonia (6.7%), and meconium aspiration syndrome (5.0%) were the most common immediate causes of death. Half (52%) of cases were correctly diagnosed antemortem. The magnitude of diagnostic discrepancy was 35% (95% CI: 20%-47%). The most common contributing factors to diagnostic discrepancy were gaps in knowledge (22/75, 35.5%) and problems in consultation and teamwork (22/75, 35.5%).
Conclusions: Misdiagnoses were common among young children who died with positive lung pathology findings. In-service education initiatives and multidisciplinary collaboration are needed to mitigate high rates of diagnostic discrepancies among young children to potentially prevent future deaths.
Cryptococcus albidus fungemia and meningitis in very preterm newborn: case report and review of the literature
Authors: Aljehani Sameera Mohmmed , Zaidan Tasneem Ibraheem A , AlHarbi Noora Obaid , Alharbi Shurooq 
Published: October 2023

Abstract
Background: In the pediatric and neonatal age groups, infections from non-neoformans Cryptococcusspecies, notably Cryptococcus albidus, are rarely observed and isolated. C. albidus is an emerging fungal infection that causes severe diseases in immunosuppressed patients; furthermore, it has rarely been reported to cause diseases in immunocompetent patients. Several cases have been described in adults who were severely immunosuppressed. Importantly, the clinical syndromes in these reported cases encompass fungemia, meningitis, keratitis, and pulmonary and cutaneous infections. Individuals at risk include neutropenic patients, those with indwelling intravenous devices, those on prolonged steroid or antibiotic use, and those with impaired immune systems and prematurity. The susceptibility of preterm infants with low birth weight to infections, particularly fungal ones, remains a significant concern. This report presents a rare case of fungemia and meningitis due to Cryptococcus albidus in a preterm neonate, emphasizing the clinical significance and potential implications for future treatment and management.. This report aims to alert physicians of the rarity of C. albidus infections in pediatric patients and to review the clinical significance, pathology, treatment, and outcomes.
Case Presentation: We report the first case of C. albidus fungemia and meningitis in low-birth-weight preterm infants. Notably, the patient was admitted for lifesaving treatment from the Alleith Hospital due to prematurity. The blood culture grew C. albidus, which was sensitive to liposomal agents. The patient showed improvement following a six-week treatment regimen with liposomal amphotericin B at a dosage of 5 mg/kg body weight, notably without the inclusion of 5-fluorocytosine, and experienced no sequelae.
Conclusions: This case report underscores the importance of early diagnosis and appropriate antifungal treatment for managing rare fungal infections in vulnerable populations, such as preterm infants. Moreover, it highlights the need for improved diagnostic platforms and comprehensive management protocols for uncommon pathogens in neonatal settings.
Nutrient metabolism in ranging tropical dairy cows supplemented with multi-nutrient blocks with varying inclusion of Moringa stenopetala leaves
Authors: Worku Ketema , Janssens Geert 
Published: October 2023

Abstract
The formulation of multi-nutrient blocks (MNB) based on low-cost and locally available browse feed resources can be a valid feeding strategy in Sub-Saharan Africa, where inadequate feed supply, both in quality and quantity, is a major constraint. We evaluated the four different inclusion percentage (M-0%, M-25%, M-35%, and M-45%) of Moringa stenopetala leaf powder to multi-nutrient blocks on their change on blood metabolite of dairy cows under practical, ranging conditions. Multi-nutrient blocks with four inclusion rates of M. stenopetala leaves were applied as complementary feed for free ranging dairy cows. The study was performed on 24 free ranging dairy cows reared around Arba Minch town in the Southern Ethiopian Rift Valley. Blood samples were collected from the jugular vein of dairy cows both before and after supplementation. Plasma glucose, beta hydroxy butyrate (BHB), urea, creatinine, triglycerides, and non-esterified fatty acids (NEFA) concentration was quantified spectrophotometrically. Dried serum spots were subject to quantitative electrospray tandem mass spectrometry to estimate changes in nutrient metabolism based on selected carnitines. Based on these measurements, the milk yield and body condition score were increased during the period of multi-nutrient block supplementation. During the supplementation period, the cows got higher plasma glucose, triglyceride, and urea concentrations and lower concentrations of BHB, NEFA, and creatinine. From the metabolite profiles, a more efficient nutrient use could be concluded. Although no clear dose-response relationship was observed, the highest inclusion of the M. stenopetala leaves in the multi-nutrient blocks gave the best performance. This outcome supports the idea of implementing M. stenopetala based multi-nutrient blocks on tropical smallholder farms that are not easily accessible to conventional extension services.
Mechanism of Corrosion Behavior Between Pb-rich Phase and Cu-rich Structure of High Sn-Pb Bronze Alloy in Neutral Salt Spray Environment
Authors: Zhou Herong , Wang Xiuyuan , Song Jialiang , Fan Zhiheng , Zhang LiMing , Shi Jingrui , Chen Jiachang , Xiao Kui 
Published: October 2023

Abstract
The corrosion behavior and corrosion mechanism of the Pb-rich phase and Cu-rich structure of the Sn-Pb bronze alloy in a high-chloride and high-humidity environment were studied. The phase
composition of the bronze alloy was analyzed by observing the metallographic and EPMA element distribution, the potential of the microstructure was characterized by SKPFM. The corrosion products and morphology results after electrochemical and neutral salt spray tests were analyzed. The results showed that the matrix structure of bronze material was composed of Pb-rich phase and Cu-rich structure (α(I) phase and (δ+α(II)) eutectoid). During the corrosion process, the rich Pb phase preferentially corroded as the anode and diffused towards the surroundings, while the rich Cu structure served as the cathode. In the rich-Cu structure, compared with δ, the α phase was used as the anode. The corrosion products on the alloy surface mainly included Cu2O, PbCO3, and Cu2(OH)3Cl. As the corrosion gradually deepened along the depth of α phase, the galvanic couple effect between α phase and δ phase and the “oxygen concentration cell” effect gradually increased.
Barriers and Facilitators to Primary Care Management of Type 2 Diabetes in China: A Mixed Methods Study
Authors: Tao Xuanchen , Mao Limin , Zhang Puhong , Ma Xinyan , Liang Zhenyu , Sun Kaige , Peiris David 
Published: October 2023

Abstract
Background: Diabetes mellitus has surged to become a global health emergency. The prevalence of type 2 diabetes (T2DM) in China is over 10%, affecting around 114 million people. Despite the inclusion of T2DM in the National Basic Public Health Service Program (NBPHSP), most people with T2DM experience challenges in achieving optimal management targets. This study aimed to identify barriers and facilitators of diabetes management from the perspectives of primary health care (PHC) service providers and recipients.
Methods: This mixed-methods study was conducted in Shijiazhuang City, Hebei Province, China. A quantitative PHC facility survey was conducted in all administrative districts and qualitative in-depth interviews were conducted in one district with government officials, medical staff, patients with T2DM, and their family members. Interviews were thematically analyzed, and findings were synthesized using Michie’s COM-B theory.
Results: A total of 197 village/community level PHC facilities and 66 township/street level PHC facilities answered the survey, and 42 in-depth interviews were conducted. The primary facilitators stemmed from the NBPHSP policy, which standardized the basic infrastructure, medical equipment (99% equipped with blood pressure measuring devices and glucometers), and medication for the PHC facilities, provided training on NCD prevention and control (95% received training workshops), and compensated the healthcare workers based on the quantity of public health service they provided. However, we found that PHC providers have become ensnared in a detrimental cycle characterized by inadequate capacity, overwhelming workloads, insufficient income, limited career development opportunities, and challenges in attracting young talents. Although all covered by the national medical insurance schemes, patients experienced capability constraints primarily driven by low education levels, advanced age, low health literacy, and a proliferation of misinformation. These factors influenced patients’ motivation to be actively engaged in care and contributed to inertia to intensify treatment and achieve their clinical management goals.
Conclusion: This study identifies several major barriers from the perspectives of both PHC providers and patients with T2DM. Our findings suggest there are substantial opportunities to strengthen the NBPHSP, including improving the capacity and the income level of the PHC providers, attracting and retaining skilled health workers in rural areas, supporting patients to improve their health literacy and take a more active role in their health care, and improving access to high-quality care through digital health approaches.
Trial registration: ClinicalTrials.gov (record NCT02726100, 03/22/2016).
The SGLT2 inhibitor Empagliflozin promotes post-stroke functional recovery in diabetic mice
Authors: Vercalsteren Ellen , Karampatsi Dimitra , Buizza Carolina , Nyström Thomas , Klein Thomas , Paul Gesine , Patrone Cesare , Darsalia Vladimer 
Published: October 2023

Abstract
Type-2 diabetes (T2D) worsens stroke recovery, amplifying post-stroke disabilities. Currently, there are no therapies targeting this important clinical problem. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are potent glucose-lowering drugs for the treatment of T2D that also efficiently reduce cardiovascular death and heart failure. In addition, SGLT2i facilitate several processes implicated in stroke recovery. However, the potential efficacy of SGLT2i to improve stroke recovery in T2D has not been investigated. Therefore, we determined whether a post-stroke intervention with the SGLT2i Empagliflozin could improve stroke recovery in T2D mice. T2D was induced in C57BL6J mice by 8 months of high-fat diet feeding. Hereafter, animals were subjected to transient middle cerebral artery occlusion and treated with vehicle or the SGLTi Empagliflozin (10 mg/kg/day) starting from 3 days after stroke. Stroke recovery was assessed using the forepaw grip strength test. To identify potential mechanisms involved in the Empagliflozin-mediated effects, several metabolic parameters were assessed. Additionally, neuronal survival, neuroinflammation, neurogenesis and cerebral vascularization were analyzed using immunohistochemistry/quantitative microscopy. Empagliflozin significantly improved stroke recovery in association with lowered glycemia, increased serum levels of fibroblast growth factor-21 (FGF-21), and the normalization of T2D-induced aberration of parenchymal pericyte density. The global T2D-epidemic and the fact that T2D is a major risk factor for stroke are drastically increasing the number of people in need of efficacious therapies to improve stroke recovery. Our data provide a strong incentive for the potential use of SGLT2i for the treatment of post-stroke sequelae in T2D.
Rapid visual detection of bovine viral diarrhea virus (BVDV) using recombinase polymerase amplification with SYBR Green I
Authors: Jiang Lingling , Wang Pu , Zhang Gang , Niu Xiaoxia , Liu Qiang , Zhang Sinong , Li Yong 
Published: October 2023

Abstract
Bovine diarrhea virus (BVDV) is considered to be the most common pathogen of severe diarrhea in cattle worldwide, with clinical manifestations of fever, diarrhea, ulcers, and abortions, which cause significant economic losses to the cattle industry. The establishment of an efficient, rapid and sensitive assay suitable for field conditions is conducive to the early detection of pathogens and the implementation of relevant treatments. Recombinase polymerase amplification (RPA) is a novel nucleic acid amplification method that has been widely used in the diagnosis of infectious diseases. In this paper, an RPAS assay for recombinase polymerase amplification combined with SYBR Green I was developed for the rapid detection of BVDV. The assay was completed at a constant temperature of 37℃ for 25 min, and the minimum detection limit of RPA was 1×101 copies/µL for gel electrophoresis. Under sunlight, the minimum detection limit of BVDV RPAS visualization was 1×109 copies/µL; Under UV, the minimum detection limit of BVDV RPAS was 1×105 copies/µL. The assay has no cross-reactivity with other viruses causing bovine gastrointestinal and respiratory tract viruses. Clinical samples had equal BVDV RPA, RPAS, and PCR detection thresholds, and SYBR Green I visualization was evident. In conclusion, the BVDV-RPAS established in this study, with high sensitivity and specificity, has the potential to be used as a powerful tool for BVD prevention and control.
MARCH5 promotes autophagy through interaction with P62 leading to malignant progression of hepatocellular carcinoma
Authors: CAI Xin , GAO Jie , YAN Zhiping , ZHANG Huapeng , ZHANG Shuijun , GUO Danfeng 
Published: October 2023

Abstract
Dysregulated MARCH5 expression and impaired autophagy have been reported separately in some cancers. However, their relationship has not been explored in hepatocellular carcinoma (HCC). Here, we present evidence that MARCH5 promotes autophagy by interacting with p62 to mediate its ubiquitylation for subsequent degradation and thus contributes to cancer proliferation, invasion, and migratory migration. Our clinical data showed that MARCH5 was overexpressed in HCC patients and patients with high MARCH5 expression had poorer prognosis and higher recurrence rate after tumor resection. In addition, we found that overexpression of MARCH5 significantly promoted tumor cell growth and EMT-mediated invasion and migration of HCC cells, while knockdown of MARCH5 suppressed the malignant phenotype of tumor cells. Moreover, overexpression of MARCH5 significantly induced autophagy and increased autophagic flux. Mechanistically, MARCH5 was negatively correlated with P62 expression at the protein level rather than at transcriptional level, and MARCH5 induced autophagy through promoting the degradation of p62 induced by ubiquitination modification demonstrating by shortened the half-life of p62, which contributed to the malignant progression of HCC.
Genome-wide detection of selection signatures in Jianli pigs reveals novel cis-regulatory haplotype for two-end black coat color
Authors: Xu Zhong , Wu Junjing , Zhang Yu , Qiao Mu , Zhou Jiawei , Feng Yue , Li Zipeng , Sun Hua , Lin Ruiyi , Song Zhongxu , Zhao Haizhong , Li Lianghua , Chen Nanqi , Li Yujie , Oyelami Favour Oluwapelumi , Peng Xianwen , Mei Shuqi 
Published: October 2023

Abstract
Background:Jianli pig, a renowned indigenous breed in China, has the characteristics of a two-end black (TEB) coat color, excellent meat quality, strong adaptability and increased prolificacy. However, there is limited information available regarding the genetic diversity, population structure and genomic regions under selection of Jianli pig. On the other hand, the genetic mechanism of TEB coat color has remained largely unknown.
Results: In this study, the whole genome resequencing of 30 Jianli pigs within a context of 153 individuals representing 13 diverse breeds was performed. The population structure analysis revealed that Jianli pigs have close genetic relationships with the Tongcheng pig breed, their geographical neighbors. Three methods (observed heterozygosity, expected heterozygosity, and runs of homozygosity) implied a relatively high level of genetic diversity and, a low inbreeding coefficient in Jianli compared with other pigs. We used Fst and XP-EHH to detect the selection signatures in Jianli pigs compared with Asian wild boar. A total of 451 candidate genes influencing meat quality (CREBBP, ADCY9, EEPD1 and HDAC9), reproduction (ESR1 and FANCA), and coat color (EDNRB, MITF and MC1R), were detected by gene annotation analysis. Finally, to fine-map the genomic region for the two-end black (TEB) coat color phenotype in Jianli pigs, we performed three signature selection methods between the TEB coat color and no-TEB coat color pig breeds. The current study, further confirmed that the EDNRB gene is a candidate gene for TEB color phenotype found in Chinese pigs, including Jinhua pigs, and the haplotype harboring 25 SNPs was a strong candidate causative mutation that regulates the TEB coat color phenotype by altering enhancer function.
Conclusion: Our results advanced the understanding of the genetic mechanism behind artificial selection, and provided further resources for the protection and breeding improvement of Jianli pigs.
Spectroscopic Studies on Structurally Modified Anthraquinone Azo Hydrazone Tautomer: Theoretical and Experimental Approach
Authors: Shekharagouda Pampapathi , Mamatha G P , Nagaraju G , Krishnamurthy Chethan , Gouthaman Siddan , Al-Asbahi Bandar Ali , Al-Hada Naif Mohammed , Naik Lohit 
Published: October 2023

Abstract
A series of unique four mono-azo substituted anthraquinone analogue were synthesized by using the anthraquinone components in the diazo-coupling technique. The FT-IR, 1H NMR, and HRMS, data were used to confirm the structure of the molecules, and spectroscopic techniques like UV-Vis, and photoluminescence spectroscopy were employed to estimate the photophysical properties of the molecules. The molecular optimized geometry and frontier molecular orbitals were estimated using density functional theory. Further, global chemical reactivity descriptors parameter was theoretically estimated using the value of the highest occupied molecular orbit and lowest unoccupied molecular orbits. The anti-tubercular action of the synthesised dyes were also examined. The results of this biological activity showed that N-isopropyl aniline combined with anthraquinone N-isopropyl aniline had superior anti-tubercular activity when compared to Rifampicin as the standard. As per molecular docking studies, the synthesized compound Q1 showed excellent binding energy (-10.0 kcal/mol) among all compounds against the 3ZXR Protein. These results agreed with our in-vitro anti-TB activity results.
OX40-Ligand Enhances H7N9 Whole Inactivated Virus Vaccine-induced Antibody Responses by Promoting Proliferation of Follicular Helper T Cells and Germinal Centre B Cells
Authors: Li Yingying , Gao Ting , Sun Ming , Wang Yufang , Wang Yong , Tang Ximin 
Published: October 2023

Abstract
The H7N9 avian influenza virus first emerged in eastern China in the spring of 2013 and became epidemic nationwide, causing wide concern worldwide due to its rapid outbreak and spread. Currently, vaccination remains the best way to prevent and control the spread of H7N9 influenza, and adjuvants are indispensable for the development of inactivated vaccines. Therefore, it is of great significance to develop efficient and inexpensive novel H7N9 influenza vaccine adjuvants. In this study, we constructed OX40L/Fc and H7N9 whole inactivated virus (WIV) co-immunized mice model and evaluated the efficacy of OX40L as an immune adjuvant in co-immunized mice. Mice co-immunized with H7N9 WIV + OX40L/Fc produced more T follicular helper cells (Tfh), germinal center (GC) B cells, and plasma cells (PCs) than mice immunized with the vaccine alone. This suggested that OX40L could improve protective antibody responses after co-immunization with H7N9 WIV by affecting T cell-dependent humoral immune responses. Overall, our results reveal that OX40L has a good adjuvant effect on H7N9 WIV vaccine.
Fatal Hemophagocytic Lymphohistiocytosis of unknown origin complicated by Acute Pulmonary Aspergillosis: case report and literature review
Authors: Bossan Gabriel , Randazzo Flavien , Rossi Camelia 
Published: October 2023

Abstract
Hemophagocytic lymphohistiocytosis (HLH) is a rare condition that can have serious consequences for patients. It has a range of possible causes, including primary causes as well as a variety of secondary forms associated with infectious, autoimmune, and neoplastic diseases. Diagnosis can be challenging due to the various clinical presentations of the syndrome, and identifying the underlying cause can be even more difficult. Here, we report the case of a young woman who was diagnosed with HLH rapidly complicated by acute pulmonary aspergillosis, but no specific trigger for the condition was found.