bluuebunny/crossref_metadata_2025_split huggingface dataset:
The use of cost-effectiveness analysis for health benefit package design – should countries follow a sectoral, incremental or hybrid approach?
Authors: Baltussen Rob , Surgey Gavin , Vassall Anna , Norheim Ole F. , Chalkidou Kalipso , Siddiqi Sameen , Nouhi Mojtaba , Youngkong Sitaporn , Jansen Maarten , Bijlmakers Leon , Oortwijn Wija 
Published: October 2023

Abstract
Background
Countries around the world are increasingly rethinking the design of their health benefit package to achieve universal health coverage. Countries can periodically revise their packages on the basis of sectoral cost-effectiveness analyses, i.e. by evaluating a broad set of services against a ‘doing nothing’ scenario using a budget constraint. Alternatively, they can use incremental cost-effectiveness analyses, i.e. to evaluate specific services against current practice using a threshold. In addition, countries may employ hybrid approaches which combines elements of sectoral and incremental cost-effectiveness analysis - a country may e.g. not evaluate the comprehensive set of all services but rather relatively small sets of services targeting a certain condition. However, there is little practical guidance for countries as to which kind of approach they should follow.

Methods
The present study was based on expert consultation. We refined the typology of approaches of cost-effectiveness analysis for benefit package design, identified factors that should be considered in the choice of approach, and developed recommendations. We reached consensus among experts over the course of several review rounds.

Results
Sectoral cost-effectiveness analysis is especially suited in contexts with large allocative inefficiencies in current service provision and can, in theory, realize large efficiency gains. However, it may be challenging to implement a comprehensive redesign of the package in practice. Incremental cost-effectiveness analysis is especially relevant in contexts where specific new services may impact the sustainability of the health system. It may potentially support efficiency improvement, but its focus has typically been on new services while existing inefficiencies remain unchallenged. The use of hybrid approach may be a way forward to address the strengths and weaknesses of sectoral and incremental analysis areas. Such analysis may be especially useful to target disease areas with suspected high inefficiencies in service provision, and would then make good use of the available research capacity and be politically rewarding. However, disease-specific analyses bear the risk of not addressing resource allocation inefficiencies across disease areas.

Conclusions
Countries should carefully select their approach of cost-effectiveness analyses for benefit package design, based on their decision-making context.
Extra-anatomical left common carotid and subclavian artery bypass followed by aortic arch replacement with frozen elephant trunk
Authors: Suzuki Ryo , Akita Masafumi , Miyazaki Suguru , Shimano Ryo 
Published: October 2023

Abstract
Background
Total arch replacement (TAR) using a frozen elephant trunk (FET) allows for simultaneous treatment of the aortic arch and descending aortic pathology via median sternotomy. In addition, an extra-anatomical bypass performed between the left common carotid artery (CCA) and subclavian artery (SCA) prior to TAR allowed further proximalisation of the FET prosthesis, facilitated distal anastomosis of the TAR and spared the demanding left subclavian artery (LSA) anastomosis in the deep thorax. We investigated the efficacy of this debranching-first technique, followed by TAR using a frozen elephant trunk, as a two-stage operation for extensive thoracic aortic aneurysms in high-risk patients.

Methods
Forty-nine consecutive patients with diffuse degenerative aneurysms from the aortic arch to the descending aorta or chronic aortic dissection who underwent left common carotid to subclavian artery bypass followed by TAR using a frozen elephant trunk and subsequent thoracic endovascular aortic repair between 2016 and 2021 were analysed. The baseline characteristics and clinical outcomes were assessed. The estimated overall survival, 5-year aortic event-free survival, and aortic reintervention rates were analysed.

Results
The average European System for Cardiac Operative Risk Evaluation (EuroSCORE II) was 4.7 ± 2.5. The operative mortality rate was 4.1%, with no paraplegia events. The estimated 5-year overall survival, cumulative aortic-related mortality rates were 76.8% and 2%, respectively. The estimated 5-year overall cumulative aortic reintervention rate, including the intended intervention, was 31.3%. The estimated 5-year cumulative rate of non-intended reintervention was 4.5%.

Conclusions
The assessed technique enables a less technically demanding surgery with reasonable outcomes. The estimated 5-year aortic event-free survival and reintervention rates were acceptable, suggesting that multiple stages of alternative open and endovascular interventions, such as this technique, may reduce the morbidity and mortality rates of high-risk patients with diffuse thoracic aortic aneurysm.
UMIN-CTR (University hospital Medical Information Network-Clinical Trial Registry)
https://center6.umin.ac.jp/cgi-open-bin/ctr_e/index.cgi
Clinical registration number: UMIN000051531
Risk of cervical intraepithelial neoplasia grade 3 or more diagnoses for human papillomavirus16/18-positive women by cytology and co-infection status
Authors: Ao Mengyin , Yao Xiaoxi , Zheng Danxi , Gu Xuesai , Xi Mingrong 
Published: October 2023

Abstract
Background
Human papillomavirus (HPV) 16 and 18 cause approximately 70% of cervical cancer cases. The aim of this study was to evaluate whether co-infected with other HPV genotypes will affect the risk of cervical carcinogenesis in HPV16/18 positive-women.

Methods
In this cross-sectional study, cervical cytology and histological classifications from women who tested positive for HPV 16/18 and underwent colposcopy within 6 months, between January 2010 and May 2021 were obtained from West China Second University Hospital of Sichuan University.

Main outcomes and measures
Immediate risk of cervical intraepithelial neoplasia grade 3 or more diagnoses (CIN 3+).

Results
A total of 7940 HPV 16/18-positive women were included, with a median age of 40 years (range 25–84 years). Among them, 2710 (34.1%) were infected with multiple genotypes, 6533 (82.28%) had cytology results and 2116 (26.65%) women were diagnosed with CIN 3+. The effects of HPV 16/18 coinfecting with other HPV on CIN3 + risk varied with specific HPV genotypes. After adjusting for cofactors, compared to single HPV 16 infection, the CIN 3 + risk was significantly reduced in women infected with HPV 16 + other high-risk HPV (hrHPV) [odds ratio (OR) = 0.621, 95% confidence interval (CI) 0.511–0.755], HPV 16 + low-risk HPV (lrHPV) (OR = 0.620, 95% CI 0.436–0.883), and HPV 16 + lrHPVs + other hrHPVs (OR = 0.248, 95% CI 0.157–0.391). The prevalence of CIN 3 + was associated with increased severity of cytologic abnormalities in HPV 16/18-positive women and peaked at cytology HSIL + (89.9% and 82.3%), which held a substantially greater risk than that of NILM (OR = 65.466, 95% CI 50.234–85.316).

Conclusions
In this cross-sectional study of HPV 16/18-positive women, the effects of multiple infection were likely complicated and varied with specific HPV genotypes. The coinfection of HPV 16 and other genotypes of HPV except HPV 18 was associated with decreased CIN 3 + risk. Cytologic results were informative when HPV 16/18 was positive. It might be reasonable to recommend expedited treatment for patients with HPV 16/18 positive and HSIL + cytology in the Chinese population.
N6-methyladenosine methyltransferase KIAA1429 promoted ovarian cancer aerobic glycolysis and progression through enhancing ENO1 expression
Authors: Gan Lijuan , Zhao Shengchao , Gao Yang , Qi Yuwen , Su Min , Wang Anjin , Cai Hongbing 
Published: October 2023

Abstract
Background
Despite improvements in prognosis due to advances in treatment, including surgery, genetic screening, and molecular targeted therapy, the outcomes of ovarian cancer (OC) remain unsatisfactory. Internal mRNA modifications are extremely common in eukaryotes; N6-methyladenosine (m6A) alteration has significant effects on mRNA stability and translation, and it is involved in the pathophysiology of numerous diseases related to cancer.

Methods
Bioinformatics analysis, quantitative real-time polymerase chain reaction and Western blotting were used to detect the expression of vir-like m6A methyltransferase associated (KIAA1429) in OC tissues and cell lines. Several different cell models and animal models were established to determine the role of KIAA1429 in glucose metabolism reprogramming and the underlying molecular mechanism of OC. The mechanism of oncology functional assays, co-immunoprecipitation and a luciferase reporter gene was employed to ascertain how KIAA1429 interacts with important molecular targets.

Results
We reported that KIAA1429 was overexpressed in OC and predicted a poor prognosis. Functionally, KIAA1429 promoted cell growth by inducing proliferation and inhibiting necrosis. Mechanistically, KIAA1429 promoted tumor progression and glycolysis via stabilizing ENO1 mRNA in a way dependent on m6A. Furthermore, we investigated that the SPI1 transcription factor is the main transcription factor that regulates KIAA1429 transcription in OC.

Conclusion
Our findings revealed that SPI1/KIAA1429/ENO1 signaling is a novel molecular axis and raises awareness of the vital functions of the changes in KIAA1429 and m6A changes in the metabolic reprogramming of OC. These results identified new potential biomarkers and treatment targets for OC.
What is the role of Swiss domestic cats in environmental contamination with Echinococcus multilocularis eggs?
Authors: Furtado Jost Rebecca , Müller Norbert , Marreros Nelson , Moré Gastón , Antoine Loic , Basso Walter , Frey Caroline F. 
Published: October 2023

AbstractBackgroundThe role of the domestic cat as definitive host forEchinococcus multilocularisand thus in environmental contamination with eggs has not yet been entirely resolved. This study aimed to assess the prevalence ofE. multilocularisand other gastrointestinal parasites in Swiss domestic cats and to compare the diagnostic sensitivity of different methods for the detection of intestinal taeniid infection.MethodsFaecal samples from 146 cats were included in the study. Faecal samples only were available from 55 cats; for the other 91 cats, necropsy was performed in addition to faecal sample testing. All (n = 146) faecal samples were analysed by a combined sedimentation/flotation technique (44% ZnCl2) and by the sodium acetate-acetic acid-formalin (SAF) sedimentation technique; when sufficient material was available (n= 121 samples) the Baermann-Wetzel technique was also used. Additionally, all samples were analysed by two coproantigen (copro)-quantitative PCRs (qPCR): (i) a multiplex qPCR able to detect and differentiate betweenE. multilocularis,Echinococcus granulosussensu lato andTaeniaspp./other cestodes (CEST-qPCR) and (ii) anE. multilocularis-specific qPCR (EM-qPCR). Finally, the intestines were examined macroscopically and microscopically for parasite stages at necropsy (n = 91) and using an intestinal scraping technique (IST) (n = 64).ResultsOf the 146 cats examined, 24 (17.1%) were infected by intestinal parasites, namelyHydatigera(syn.Taenia)taeniaeformis(8.9%),Toxocara cati(6.1%),Capillariasp. (3.4%), hookworms (3.4%),Mesocestoides litteratus(1.4%),Giardiasp. (1.4%),Cystoisospora rivolta(1.4%),Cystoisospora felis(0.7%),Toxoplasma gondii(0.7%),Hammondia hammondi(0.7%) andStrongyloidessp. (0.7%). Necropsy and the IST revealed adultH. taeniaeformisin 12 animals, of which eight faecal samples were positive by the CEST-qPCR (sensitivity = 67%) and six samples by the sedimentation/flotation technique (sensitivity = 50%). NoE. multilocularisinfection was detected in the sampled cats. Using Bayesian latent class analysis, the mean posterior prevalence probability was 0.0% (95% confidence interval 0–0.83%) forE. multilocularis.ConclusionsThere was no evidence ofE. multilocularisinfection among the 146 cats examined, suggesting that the prevalence of this parasite is low (< 1%) in the Swiss domestic cat population. Nonetheless, some of the sampled cats were infected by parasites that have rodents as intermediate hosts, demonstrating successful predation by these cats, and some were infected with zoonotic parasites. Cats therefore should not be disregarded as potential hosts forE. multilocularisand other zoonotic parasites.Graphical Abstract
Relative abundance data can misrepresent heritability of the microbiome
Authors: Bruijning Marjolein , Ayroles Julien F. , Henry Lucas P. , Koskella Britt , Meyer Kyle M. , Metcalf C. Jessica E. 
Published: October 2023

AbstractBackgroundHost genetics can shape microbiome composition, but to what extent it does, remains unclear. Like any other complex trait, this important question can be addressed by estimating the heritability (h2) of the microbiome—the proportion of variance in the abundance in each taxon that is attributable to host genetic variation. However, unlike most complex traits, microbiome heritability is typically based on relative abundance data, where taxon-specific abundances are expressed as the proportion of the total microbial abundance in a sample.ResultsWe derived an analytical approximation for the heritability that one obtains when using such relative, and not absolute, abundances, based on an underlying quantitative genetic model for absolute abundances. Based on this, we uncovered three problems that can arise when using relative abundances to estimate microbiome heritability: (1) the interdependency between taxa can lead to imprecise heritability estimates. This problem is most apparent for dominant taxa. (2) Large sample size leads to high false discovery rates. With enough statistical power, the result is a strong overestimation of the number of heritable taxa in a community. (3) Microbial co-abundances lead to biased heritability estimates.ConclusionsWe discuss several potential solutions for advancing the field, focusing on technical and statistical developments, and conclude that caution must be taken when interpreting heritability estimates and comparing values across studies.
What if parental love is conditional …? Children’s self-esteem profiles and their relationship with parental conditional regard and self-kindness
Authors: Brueckmann Malin , Teuber Ziwen , Hollmann Jelena , Wild Elke 
Published: October 2023

Abstract
Background
Numerous studies have demonstrated that low, unstable, or contingent self-esteem negatively affects youth development and is linked to adolescent psychopathology. However, most previous studies have applied variable-oriented approaches, and less is known about the natural combination of self-esteem facets in school-aged adolescents, how parental conditional regard affects self-esteem profiles, and how these profiles relate to self-kindness, self-judgement, and life satisfaction.

Methods
By employing a longitudinal person-oriented approach (i.e., latent profile analysis and latent transition analysis) on two-wave longitudinal data from 587 German secondary school students (52.3% female, Mage=13.52 years), this study aims to (1) identify adolescents’ self-esteem profiles based on the level, stability, and contingency of self-esteem; (2) examine the impact of parental conditional regard on the self-esteem profiles explained using self-determination theory; and (3) examine these profiles’ relationship with self-kindness, self-judgement, and life satisfaction.

Results
Four self-esteem profiles were derived: optimal-secure (~ 8%), good (~ 18%), average (~ 36%), and low-insecure (~ 38%). The results reveal a concerningly high proportion as well as a high stability of low-insecure self-esteem (~ 98%) and indicate the strong negative influence of parental conditional regard on the development of optimal-secure self-esteem. Furthermore, the results demonstrate strong correlations between optimal-secure self-esteem, highly developed self-kindness, and high life satisfaction.

Conclusions
Using a longitudinal person-oriented approach, it was possible to identify a group with highly vulnerable self-esteem, characterised by particularly low self-kindness, strong self-judgment, and lower life satisfaction. The findings of this study support the need for prevention and intervention targeting adolescents with low-insecure self-esteem.
A review study on discourse-analytical approaches to language testing policy in the South Korean context
Authors: Shin Dongil , Park Soohyeon , Cho Eunhae 
Published: October 2023

AbstractResearch on language planning and policy (LPP) has transcended beyond enacting government-initiated language policy and progressed towards uncovering inherent power relations. The discourse-analytical approach (DA) effectively captures the relation between texts and other elements of social practices. Therefore, this approach has been adopted to analyze the meaning-making process in ideologies, practices, and different social contexts. The current study expands on previous research and argues that language testing policies (LTP) be explored using the DA because the former is also produced within the discursive practices of intertextual and interdiscursive links among texts (e.g., policy documents and media texts) and social structures. Three empirical contexts are analyzed to demonstrate the need for introducing tests: (1) introducing the National English Ability Test to replace the preexisting English subject test of the College Scholastic Test in Korea to measure speaking, writing, reading, and listening skills; (2) adopting cut-off scores for graduation based on the Test of English for International Communication; and (3) implementing the Test of Proficiency in Korean scores for screening and regulating the flow of immigrants. The results facilitate an understanding of the variability in LTP contexts, thereby contributing to democratic pluralism in the LPP field.
Course and predictors of social security disability insurance in patients with borderline personality disorder over 24 years of prospective follow-up
Authors: Kramer Ueli , Temes Christina M. , Frankenburg Frances R. , Glass Isabel V. , Zanarini Mary C. 
Published: October 2023

Abstract
Background
The utilization of Social Security Disability Insurance (SSDI) is frequent in patients with borderline personality disorder (BPD) and may represent a meaningful marker of a patient’s symptom severity, poor psychosocial functioning, and/or inner suffering. Over 24 years of prospective follow-up, the present study aims to describe the course of SSDI and assess the role of clinically relevant predictors.

Methods
A total of 290 inpatients with BPD were interviewed at baseline and 12 consecutive follow-up waves, each separated by two years, after index hospitalization. Included were also 72 inpatients with other personality disorders. Surviving patients were reinterviewed. A series of interviews and self-report measures were used to assess psychosocial functioning and treatment history, axis I and II disorders, and childhood/adult adversity.

Results
Results show that rates of SSDI utilization were relatively stable over 24 years of follow-up (on average, 47.2% of the patients with BPD were on SSDI). Patients with BPD were three times more likely to be on SSDI than patients with other PDs. Patients with BPD displayed flexibility in their usage of SSDI. By 24 years, 46% of patients remitted, out of which 85% experienced recurrence and 50% of the patients had a new onset over time. In multivariate analyses, four variables were found to predict SSDI status in patients with BPD over time. These variables were: age 26 or older, lower IQ, severity of non-sexual childhood abuse, and presence of PTSD.

Conclusions
The results of this study suggest that a combination of a demographic factors, childhood adversity, natural endowment, and comorbidity are significant predictors of receiving SSDI over time. On a group level, there is a relative stability of SSDI usage over time, but on the individual level, the present study found a high fluctuation in receiving SSDI over 24 months of prospective follow-up.
Effective contribution ratio of the molar during sequential distalization using clear aligners and micro-implant anchorage: a finite element study
Authors: Liu Xulin , Wu Junjie , Cheng Yuxun , Gao Jie , Wen Yi , Zhang Yubohan , Luo Houzhuo , Jin Zuolin , Ma Yanning 
Published: October 2023

Abstract
Introduction
This study aims to investigate the biomechanical effects of anchorage reinforcement using clear aligners (CAs) with microimplants during molar distalization. And also explores potential clinical strategies for enhancing anchorage in the sequential distalization process.

Methods
Finite element models were established to simulate the CAs, microimplants, upper dentition, periodontal ligament (PDL), and alveolar bone. In group set I, the 2nd molars underwent a distal movement of 0.25 mm in group set II, the 1st molars were distalized by 0.25 mm after the 2nd molars had been placed to a target position. Each group set consisted of three models: Model A served as the control model, Model B simulated the use of microimplants attached to the aligner through precision cuts, and Model C simulated the use of microimplants attached by buttons. Models B and C were subjected to a series of traction forces. We analyzed the effective contribution ratios of molar distalization, PDL hydrostatic stress, and von Mises stress of alveolar bone.

Results
The distalization of the 2nd molars accounted for a mere 52.86% of the 0.25-mm step distance without any reinforcement of anchorage. The remaining percentage was attributed to the mesial movement of anchorage teeth and other undesired movements. Models B and C exhibited an increased effective contribution ratio of molar distalization and a decreased loss of anchorage. However, there was a slight increase in the undesired movement of molar tipping and rotation. In group set II, the 2nd molar displayed a phenomenon of mesial relapse due to the reciprocal force produced by the 1st molar distalization. Moreover, the efficacy of molar distalization in terms of contribution ratio was found to be positively correlated with the magnitude of force applied. In cases where stronger anchorage reinforcement is required, precision cuts is the superior method.

Conclusions
The utilization of microimplants in conjunction with CAs can facilitate the effective contribution ratio of molar distalization. However, it is important to note that complete elimination of anchorage loss is not achievable. To mitigate undesired movement, careful planning of anchorage preparation and overcorrection is recommended.