bluuebunny/crossref_metadata_2025_split huggingface dataset:
Skilled Lactation Support Using Telemedicine in the Neonatal Intensive Care Unit
Authors: Leong Melanie , Obaid Maria , Ramos Maria Fernandez , Eichenberger Regina , John Annamma , Krumholtz-Belkin Patricia , Roeder Tina , Parvez Boriana 
Published: November 2023

Abstract
NICU mothers face unique challenges in initiating and sustaining breastfeeding. Previous studies have focused on outpatient breastfeeding support. We conducted a retrospective study of breastfeeding outcomes before and after implementing telelactation. Pre-Telemedicine (PTM) mothers received in-person support by NICU lactation consultants, while Telemedicine (TM) mothers received solely telemedicine consults after maternal discharge. Exclusive breastmilk feeding at discharge increased in the TM group. Notably, babies in the TM cohort who were fed any formula on admission experienced significant improvement in exclusive breastmilk feeding at discharge, and those whose mothers received at least one NICU lactation consult had the greatest improvement in exclusive breastfeeding rates at discharge. This study is the first to validate the use of telemedicine as a means of maintaining access to skilled lactation support in the NICU when in-person consults are not feasible. Incorporating telemedicine can ensure access and continuity of skilled lactation support, and sustain breastfeeding rates.
Turbulent Growth: Business Dynamism and Aggregate Productivity
Authors: Massari Filippo 
Published: November 2023

Abstract
Turbulence is the process of endogenous reallocation of resources (e.g., jobs) across firmsdue to entry, exit, and churning (movements within the firm-size distribution). This paperformulates a model of turbulent endogenous growth built on the insight that the forces thatdrive aggregate productivity growth also drive turbulence because the two are manifestationsof a single underlying process: profit-driven competition for market share through innovation.When firms increase their technological knowledge, they gain market share by loweringtheir relative price, thus reducing the marginal value of further gains in market share. Thisleads to the emergence of diminishing returns in relative terms.Therefore, incentives to innovate decline in relative size, all else constant, generating churning endogenously as mean-reversion. This mechanism delivers a stationary, non-degenerate,and endogenous firm-size distribution dependent on R&D. Meanwhile, constant returns to thecumulative factor (technological knowledge) drive a trendless aggregate growth rate determined by R&D. Endogenous entry and exit entail selection effects that shape the characteristicsof the firm population, and generate a firm life cycle, affecting R&D, thus growth.
(JEL: E19, L11, O14, O31, O41)
Development of a Shared Digital Decision Aid for HPV Vaccination in French General Practice: A Pragmatic Study
Authors: Hagiu Dragos-Paul , Tron Arthur , Zuo Minghui , Ecollan Marie , Pinot Juliette , Rossignol Louise , Partouche Henri , Gilberg Serge , Bel Josselin Le , Gauchet Aurélie , Gagneux-Brunon Amandine , Michel Morgane , Mueller Judith E. , Thilly Nathalie , Bruel Sébastien 
Published: November 2023

Abstract
Background: Human papillomaviruses (HPV) are responsible for the most common sexually transmitted infection in the world and persistent infection of oncogenic types is associated with an increased risk of cancers. This infection could be prevented by vaccination. However, in a time of vaccine hesitancy, the decision to get vaccinated or to have a child vaccinated is the result of a complex process and decision aids are tools that may be of help in this context.
Objective: The aim of this article is to present the development of a shared decision aid for HPV vaccination in France, destined to be used during general practice consultations.
Methods: In order to develop the shared decision aid, we followed the steps recommended by the International Patient Decision Aids Standard (IPDAS), i.e. scoping and defining the objectives, assembling the steering group, designing (carrying out two focus groups and a narrative review of the literature) and testing in a alpha test phase (carrying out three focus groups and 11 individual interviews). The tool was co-constructed with adolescents, parents and general practitioners.
Results: We created an online shared decision aid which included the definition of HPV, epidemiological data, the mode of contamination, the different locations of the disease, the development of cancer, the importance of Pap smears, the effectiveness of the vaccination as well as the possible side effects. The various focus groups as well as individual interviews made it possible to determine the values ​​and expectations of patients and physicians thus improving the decision aid. This development also made it possible to confirm an existing need for this type of tool for both patients and physicians.
Conclusions: We have developed a shared decision aid that could help general practitioners communicate about HPV vaccination and get more patients vaccinated. The impact of its use during the consultation will be evaluated on criteria such as the resolution of the decision-making conflict and ultimately on the vaccination coverage, as part of the PrevHPV study.
Safety of Bubble Nasal Intermittent Positive Pressure Ventilation (NIPPV) versus Bubble Nasal Continuous Positive Airway Pressure (NCPAP) in preterm infants with respiratory distress
Authors: John Stephen , Garg Mehak , Muttineni Mounika , Brearley Ann , Rao Praveen , Bhandari Vineet , Slusher Tina , Murki Srinivas 
Published: November 2023

Abstract
Objective Nasal Intermittent Positive Pressure Ventilation (NIPPV) is an effective therapy for infants in respiratory distress. We here report the safety of a novel, low-cost, non-electric bubble NIPPV device in comparison with bubble NCPAP.Study Design: At Paramitha Children’s Hospital (Hyderabad, India), preterm (n = 60) neonates with moderate respiratory distress were pragmatically allocated to bubble NCPAP (5–8 cm H2O) or bubble NIPPV (Phigh 8–12 cm H2O/Plow 5–8 cm H2O) based on staff and equipment availability. Primary outcomes to assess safety included clinically relevant pneumothorax, nasal septal necrosis, or abdominal distention.Results One patient in each arm developed minor nasal septal injury (grade 3 on NCPAP, grade 2 on NIPPV); no patients in either arm developed a clinically significant pneumothorax or abdominal distention.Conclusion The similar rates of nasal septal injury, pneumothorax and abdominal distention suggest that bubble NIPPV has a similar safety profile as bubble NCPAP for preterm infants in respiratory distress.
Radiomics Models of Dynamic Contrast-Enhanced MRI for Evaluation of the Expression Levels of CD3+, CD4+ &amp; CD8+ Tumor-Infiltrating Lymphocytes in Advanced Gastric Carcinoma
Authors: huang huizhen , Li Zhiheng , Wang Dandan , Yang Ye , Jin HongYan , Lu Zengxin 
Published: November 2023

Abstract
Objective
To explore the effectiveness of machine learning classifiers based on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in predicting the expression levels of CD3+, CD4+ and CD8+ tumor-infiltrating lymphocytes (TILs) in patients with advanced gastric cancer (AGC).
Materials and Methods
This study investigated 103 patients with confirmed AGC through DCE-MRI and immunohistochemical staining. Utilizing Omni Kinetics software, radiomics features (Ktrans, Kep, and Ve) were extracted and underwent selection via variance threshold, SelectKBest, and LASSO methods. A logistic regression model was constructed, and 10-fold cross-validation assessed its performance. Immunohistochemical staining was used to evaluate CD3+, CD4+, and CD8+ T-cell expression. A receiver operating characteristic curve was used to calculate the model performance.
Results
Eight radiomics characteristics were used in the CD3 model to produce AUCs of 0.857 (training) and 0.863 (test). The CD4 model used seven characteristics to produce AUCs of 0.867 (training) and 0.817 (test). The CD8 model used six characteristics to attain AUCs of 0.876 (training) and 0.820 (test). Clinical usefulness was verified by a careful decision curve study.
Conclusions
Machine learning classifiers based on DCE-MRI have the potential to accurately predict CD3+, CD4+, and CD8+ tumor-infiltrating lymphocyte expression levels in patients with AGC.
Kinesiophobia is associated with quality of life after total hip arthroplasty: A short-term prospective observational study
Authors: Hidaka Ryo , Tanaka Takeyuki , Hashikura Kazuaki , Oka Hiroyuki , Matsudaira Ko , Matsuda Kenta , Moro Toru , Kawano Hirotaka , Tanaka Sakae 
Published: November 2023

Abstract

Background: Kinesiophobia and pain catastrophizing are key factors that affect outcomes after total knee arthroplasty. However, its impact on outcomes after total hip arthroplasty (THA) remains unclear. This study aimed to determine whether kinesiophobia, assessed by the Tampa Scale for Kinesiophobia (TSK)-11, and pain catastrophizing, assessed by the Pain Catastrophizing Scale (PCS), were associated with quality of life (QOL) at 12 months after THA.
Methods: Ninety consecutively patients were evaluated prospectively at 12 months after THA. QOL scores were assessed by disease-specific QOL (the Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire) and general QOL (the EuroQOL-5 Dimensions), pain intensity was used by Visual Analog Scale, and TSK-11 and PCS were evaluated pre-operative and at 12 months after THA. Each QOL score at 12 months was used for multivariate analysis.
Results: Pain intensity and TSK-11 were independently correlated with the disease-specific and general QOL at 12 months after THA in the multiple regression analysis. PCS was not correlated with each QOL at 12 months after THA.
Conclusions: Kinesiophobia and pain intensity were independently associated with disease-specific and general QOL at 12 months after THA. Higher kinesiophobia and pain intensity were potential factors that lower QOL at 12 months after THA.
Follow-up Neutrophil–Lymphocyte Ratio as a Predictor for Postoperative Pneumonia After Endovascular Treatment in Aneurysmal Subarachnoid Hemorrhage Patients: A Retrospective Analysis
Authors: Huang Xinyue , Guo Xiumei , Gao Wen , Guo Liming , Xiong Yu , Chen Chunhui , Zheng Hanlin , Pan Zhigang , Lin Qingxin , Zheng Shuni , Ke Chuhan , Hu Weipeng , Zheng Feng 
Published: November 2023

Abstract
The association between NLR and postoperative pneumonia (POP) in patients with aneurysmal subarachnoid hemorrhage (aSAH) who underwent endovascular treatment remains poorly understood. Patients with aSAH who underwent endovascular treatment between January 2019 and April 2023 were included. The follow-up endpoint was the presence of POP at 30 days postoperatively. Logistic regression analysis was conducted using POP as the dependent variable. NLR was calculated at admission (NLR1), 24 h after endovascular treatment (NLR2), and 3–7 days after endovascular treatment (NLR3). Four prediction models were constructed: Model 1 (variables with p < 0.05, except for the NLR); Model 2 (Model 1 plus NLR1); Model 3 (Model 1 plus NLR2); and Model 4 (Model 1 plus NLR3). Among the 154 patients with aSAH, POP occurred in 101 (65.6%) patients. Higher NLRs at admission (odds ratio [OR] = 1.08; 95% Confidence Interval [CI] 1.02, 1.16; p = 0.019), 24 h postoperatively (OR = 1.14; 95% CI 1.05, 1.25; p = 0.005) and 3-7days postoperatively (OR = 1.17; 95% CI 1.02, 1.38; p = 0.04) were independently associated with the occurrence of POP. Follow-up NLR may be an independent predictor of POP in aSAH patients treated endovascularly. Elevated NLR at admission, 24 h postoperatively and 3–7 days postoperatively correlated with a high risk for POP.
Rational Combinatorial Targeting by Adapter CAR T Cells (AdCAR-T) Prevents Antigen Escape in Acute Myeloid Leukemia (AML)
Authors: Atar Daniel Bünyamin , Ruoff Lara , Mast Anna-Sophia , Krost Simon , Moustafa-Oglou Moustafa , Scheuermann Sophia , Kristmann Beate , Feige Maximilian , Canak Aysegül , Wolsing Katrin , Schilbach Karin , Zekri Latifa , Ebinger Martin , Nixdorf Daniel , Subklewe Marion , Schulte Johannes , Lengerke Claudia , Werchau Niels , Mittelstaet Joerg , Lang Peter , Handgretinger Rupert , Schlegel Patrick , Seitz Christian Martin 
Published: November 2023

Abstract

Targeting AML by chimeric antigen receptor T cells (CAR-T) has been challenging due to the promiscuous expression of AML-associated antigens on healthy hematopoietic stem and progenitor cells as well as a high degree of inter- and intratumoral heterogeneity. Consequently, we did not yet see dramatic clinical successes, as in B-phenotypic malignancies treated with CD19- or BCMA-directed CAR-T cells. In the present study, we analyzed the inter- and intratumoral heterogeneity of AML-associated antigens in 30 primary pediatric AML samples at single-cell resolution. We identified CD33, CD38, CD371, IL1RAP and CD123 as the most frequently expressed. Notably, high variability was observed not only across the different patient samples but also among leukemic cells of the same patient, which indicates that multiplexed targeting approaches will be needed to target all leukemic cells. To address this need, we utilized our modular Adapter CAR (AdCAR) platform, enabling precise qualitative and quantitative control over CAR-T-cell function. We show highly efficient and target-specific activity for newly generated adapter molecules (AMs) against CD33, CD38, CD123, CD135 and CD371, both in vitro and in vivo. Importantly, we prove that inherent intratumoral heterogeneity in antigen expression translates into antigen escape and therapy failure to monotargeted CAR-T therapy. For the first time, we demonstrate in a PDX model that rational combinatorial targeting by AdCAR-T cells can cure heterogenic disease. In conclusion, we elucidate the clinical relevance of heterogeneity in antigen expression in pediatric AML and present a novel concept for precision immunotherapy by combinatorial targeting utilizing the AdCAR platform.
Playing for Cognition: Investigating the Feasibility and User Experience of a Virtual Reality Serious Game for Cognitive Assessment in Children with Congenital Heart Disease
Authors: de Wouw Charlotte Van , Bousché Eileen , Schooneveld Monique Van , Nijenhuis HP , Huygelier Hanne , Nijboer Tanja , Breur Hans 
Published: November 2023

Abstract
Background
In order to facilitate the development and implementation of innovative technology in clinical practice, it is important to understand the user experience of end-users. Virtual Reality (VR) offers the possibility to assess cognitive functioning in a dynamic environment that simulates real-world situations. The purpose of this cross-sectional study was to investigate the feasibility of a VR Serious Game for cognitive assessment in school-aged children with congenital heart disease (CHD). The sub-aims were two-fold: (1) to objectively evaluate the feasibility of the VR Serious Game in children with CHD in comparison to typically developing (TD) children and (2) to explore the user experience of both groups following their interaction with the VR Serious Game.
Results
A total of 101 children participated in this study; 98 children were included in the final analysis (CHD: n = 54; TD: n = 47). The VR Serious Game appeared feasible for both children with CHD and TD children, with 88% children completing the innovative VR assessment without encountering any issues. There were no discernible differences in completion rates between groups. Children with CHD reported significantly lower scores than TD children on three user experience scales: Engagement, Flow and Presence. Nonetheless, the scores for Engagement and Flow were still considered "moderate to good". Both groups reported minimal adverse physiological reactions.
Conclusions
The findings suggested that the VR Serious Game was feasible for children with CHD and that the user experience was positive. Future research should investigate the effectiveness of the VR Serious Game compared with a conventional or digital NPA, prioritising the development of novel outcome measures that can better estimate and explain the impact of cognitive impairment on daily functioning.
Costs of delivering COVID-19 vaccine in Botswana during the height of the pandemic: A retrospective study
Authors: Vaughan Kelsey , Mokena Onalenna T , Rankgoane-Pono Goabaone , Keetile Moses , Griffiths Ulla Kou 
Published: November 2023

Abstract
Background
The development, distribution and delivery of COVID-19 vaccines following the outbreak of the global coronavirus pandemic in February 2020 is the largest global immunization action in history. To assist with planning and resource mobilization efforts, a global-level model using data from the literature on childhood and adult flu vaccine delivery estimated expected COVID-19 vaccine delivery costs. However, country-level studies were needed to validate these estimates, learn lessons for future pandemics, and plan for future COVID-19 vaccination of priority groups.
Methods
We tested several methodological innovations to estimate total costs and costs per dose of COVID-19 vaccine delivery in Botswana. Costs incurred by all government sectors, parastatals, donors and non-governmental organizations were included. Both fiscal costs (financial outlays) and the value of selected, existing human resources and donated vaccines (economic costs) were included.
Results
Total, fiscal delivery costs of COVID-19 vaccination were estimated at US$49.8 million for a 13-month period, with over half accounting for newly hired human resources. Newly hired staff supported not just vaccine delivery, but also co-ordination and social mobilization efforts. The value of existing human resources redeployed to support COVID-19 vaccination was US$36.6 million. Based on 2.6 million doses delivered, the fiscal and economic delivery cost per dose were US$19 and US$33, respectively. Vaccines were procured and donated at an average price per dose of US$13.46, increasing the economic cost per dose delivered to approximately US$47.
Conclusions
In Botswana, costs were substantially higher than modelled estimates for COVID-19 vaccine delivery and the cost of delivering routine childhood vaccines. This suggests that rolling out a new vaccine to an entire population in the middle of a pandemic requires additional financial investments beyond what has been typical for immunization services in the past.
CO2 emissions prediction from coal used in power plants using univariate and multivariate machine learning models
Authors: Prakash Ankit , Singh Sunil Kumar 
Published: November 2023

Abstract

Carbon dioxide (CO2 ) emission has increased rapidly due to the predominant usage of fossil fuels. The energy sector contributes a considerable amount towards the total share that belongs to CO2 emissions worldwide. In this work, we have applied the Multivariate and Univariate variants of time-series, machine learning and deep learning models over the CO2 emissions dataset. The dataset is collected central electricity authority containing the attributes as coal supply information, CO2 emissions, peak demand, and peak met. The performance of the applied models is tested using performance metrics such as RMSPE, MAE, RMSE, MSE, MAPE, SMAPE, and RAE. The dataset is collected from 2005-2021 to perform the test and train, and further, we have forecasted the CO2 emission from 2022-2050 by applying the best performing models. The findings of the work show that autoregression is the best-performing model and obtained the best rank i.e. 1.85 by applying the Friedman ranking. A comparative study is also done over multivariate and univariate analysis.
Cloudy: A Python-based Simulator for Modern Cloud Environments
Authors: Siavashi Ahmad , Momtazpour Mahmoud 
Published: November 2023

Abstract
Cloud computing is a pervasive technology, underpinning numerous modern services. However, understanding and optimizing cloud environments can be complex and challenging, demanding sophisticated simulation tools. Existing cloud simulators, predominantly developed in languages like Java, often lack flexibility, struggle with rapid adaptation to emerging technologies, and can be difficult to integrate with contemporary libraries, especially in Artificial Intelligence (AI) and Linear Programming (LP) domains. To address these limitations , we introduce Cloudy, a Python-based simulator designed to model and simulate modern cloud environments. As Python offers simplicity, readability, and extensive library support, Cloudy provides an easily accessible, yet powerful , tool for comprehensive cloud simulations. It leverages Python's seamless integration with AI and LP libraries for advanced experimentation and supports modern cloud peripherals, such as GPUs. Moreover, Cloudy accommodates various cloud service models, making it highly versatile for different cloud-based scenarios. Compared to the established CloudSim simulator, Cloudy demonstrated a significant reduction in memory usage and simulation time by 15.6x and 2.75x, respectively. This paper offers an in-depth exploration of the Cloudy simulator, its features, and potential applications.
The Combined Anti-Tumor Effects of 5-Fluorouracil and Neurokinin Receptor Inhibitor, Aprepitant, against Colorectal Cancer: In vitro and In vivo Study
Authors: Alalikhan Abbas , Ebrahimi Safieh , Aliee Ali. , Mirzavi Farshad , Hashemy Seyed Isaac 
Published: November 2023

Abstract
Background
Colorectal cancer (CRC) is one of the world's largest health concerns with growing global incidence and mortality. The potential value of the neurokinin-1 receptor as a therapeutic target has been reported in several tumor types, including CRC. Here we examined the potential anti-tumor effects of a clinically approved neurokinin -1 receptor antagonist, aprepitant, alone and its combination with Fluorouracil (5-FU) as a first choice CRC chemotherapeutic drug, in both in vitro and in vivo models of CRC.
Methods
MTT assay was employed for assessing cell proliferation. mRNA expression levels were determined by quantitative real-time PCR (qRT-PCR). Flow cytometric analysis of apoptosis was performed using an Annexin-V/propidium iodide assay kit. We finally conducted an in vivo experiment in a mouse model of CRC to confirm the in vitro antiproliferative activity of aprepitant and 5-FU.
Results
We found that aprepitant and 5-FU significantly reduced CRC cell viability. The combination of drugs exhibited potent synergistic growth inhibitory effects on CRC cells. Moreover, aprepitant and 5-FU induced apoptosis and altered the levels of apoptotic genes (up-regulation of Bax, p53, p53 along with downregulation of Bcl-2). Importantly, the aprepitant-5-FU combination showed a more pronounced impact on apoptosis and associated genes than either of the agents alone. Furthermore, aprepitant reduced tumor growth in vivo and led to significantly longer survival time, and this effect was more prominent when using the aprepitant -5-FU combination.
Conclusions
Collectively, combinatory treatment with aprepitant and 5-FU potentially exerts synergistic growth inhibition and apoptosis induction in CRC, deserving further consideration as a novel strategy for CRC patients.