bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cost-effectiveness analysis of digital therapeutics for home-based cardiac rehabilitation for patients with chronic heart failure: model development and data analysis
Authors: Liu Tianyi , Zhan Yiyang , Chen Silei , Zhang Wenhong , Jia Jian 
Published: November 2023

Abstract
Background
In recent years, numerous guidelines and expert consensus have recommended the inclusion of digital technologies and products in cardiac rehabilitation. Digital therapeutics (DTx) is an evidence-based medicine that uses digital means for data collection and monitoring of indicators to control and optimize the treatment, management, and prevention of disease.

Objective
This study collected and reviewed real-world data and built a model using health economics assessment methods to analyze the potential cost-effectiveness of DTx applied to home-based cardiac rehabilitation for patients with chronic heart failure. From the perspective of medical and health decision-makers, the economic value of DTx is evaluated prospectively to provide the basis and reference for the application decision and promotion of DTx.

Methods
Markov models were constructed to simulate the outcomes of DTx for home-based cardiac rehabilitation (DT group) compared to conventional home-based cardiac rehabilitation (CH group) in patients with chronic heart failure. The model input parameters were clinical indicators and cost data. Outcome indicators were quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs). The robustness of the evaluation methods and results was tested using sensitivity analyses. Clinical indicators, cost data, and health utility values were obtained from real-world data, including clinical study data, published literature, and public website information.

Results
The Markov model simulated a time span of 10 years, with a cycle set at one month, for 120 cycles. The results showed that the per capita cost of the CH group was 38,442.11 CNY/year, with a QALY of 0.7196 per person per year. The per capita cost of the DT group was 42,300.26 CNY/year, with a QALY of 0.81687 per person per year. The ICER per person was 39,663.5 CNY/QALY each year, which was below the willingness-to-pay threshold of 85,698 CNY (China's GDP per capita in 2022).

Conclusions
DTx for home-based cardiac rehabilitation is an extremely cost-effective rehabilitation option compared with conventional home-based cardiac rehabilitation. DTx for home-based cardiac rehabilitation is potentially valuable from the perspective of healthcare decision-makers.
Immune checkpoint analysis in ear cancer
Authors: Klein M. , Polgart E. , Hallermann C. , Schulze H. J. , Hölzle F. , Wermker K. 
Published: November 2023

Abstract
Background
Among cutaneous squamous cell carcinomas, the ear (ecSCC) is one of the most common sites. Loco regional lymph node metastasis is found in six to eleven percent of cases, corresponding to increased metastasis compared to other sites. The aim of this study was to test the markers PD-L1, PD-1, CD4, CD8, and FoxP3 for suitability as prognostic predictive markers.

Methods
Sixty-four patients with ecSCC were included in this study. The expression of immunohistochemical markers (PD-L1, PD-1, CD4, CD8, FOXP3) was correlated with retrospective clinic pathological parameters (lymph node metastasis, distant metastasis, lymph node metastasis during follow-up, disease progression, disease-specific death).

Results
There was a correlation between increased disease specific death and a weak Foxp3 (p = 0.003) or reduced CD8 (p = 0.04). A PD-L1 expression > 1% was found in 39.1% of patients.

Conclusion
The investigated markers (CD4, CD8, FoxP3, PD-1, PD-L1) seem overall rather inappropriate for prognostic evaluation in ecSCC. Only the correlation of disease specific death with CD8 or FoxP3 seems to be worth testing in larger collectives.
Efficacy of Cal-Cemex as bone substitute for tibial plateau fractures
Authors: Pizzoli Andrea , Bondi Manuel , Piotto Laura , Tartaglia Nicola , Saracino Michele , Vyrva Oleg 
Published: November 2023

Abstract
Background
Various factors influence treatment and outcomes in tibial plateau fractures. Bone defects are among them. Many materials have been proposed to address this problem: allograft, bone–cements and various bone substitutes (BSM). Cal-Cemex (β-tricalciophosphate and polymethylmethacrylate) is a new hybrid bi-component BSM. A retrospective multicenter study was conducted based on the clinical experience of three European Hospitals, to demonstrate its clinical effectiveness, versatility and safety.

Materials and Methods
From December 2016 to March 2022, 45 displaced tibial plateau fractures were treated with internal fixation and augmentation using Cal-Cemex. The average age was 55.9 years. According to Schatzker classification, we included 13 type II, 24 type III, 3 type V and 4 type VI fractures. The postoperative follow-up (FU) consisted of clinical and radiological examinations at 6 and 12 weeks and 1 year after surgery. A CT scan was performed preoperatively and 1 year after surgery. Full weight bearing was permitted after less than 6 weeks. Clinical data were collected from patient charts, while functional data were evaluated using the Rasmussen knee function score, the KOOS score and the Hospital for Special Surgery knee rating score (HSS), to evaluate the range of motion, axis and functionality of the knee.

Results
The average FU was 42.8 months. CT scans taken at 1 year demonstrated a good surface osteointegration without radiolucent lines or osteolysis with good evidence of interdigitation and even bone ingrowth. At 1-year FU, the mean Rasmussen score was 24.7, the mean KOOS score was 90.7 and the mean HSS was 89.9 and the average full weight-bearing period 34.9. No patients had hardware failure or fracture secondary displacement.

Discussion
Cal-Cemex combines biological features and good mechanical performances. It guarantees biocompatibility and osteoconductivity, although it is not fully reabsorbable; β-tricalciophosphate component gives macro- and microporosity that allow fluids to penetrate inside the material, to stimulate bone ingrowth.

Conclusions
The study suggests that Cal-Cemex is an option for tibial plateau fractures, where augmentation and support are necessary for early full weight bearing. The absence of major complications, ease of application, the possibility to cut and perforate this material support its extensive use in bone augmentation for trauma cases.
SHMT2 regulates esophageal cancer cell progression and immune Escape by mediating m6A modification of c-myc
Authors: Qiao Zhe , Li Yu , Cheng Yao , Li Shaomin , Liu Shiyuan 
Published: November 2023

Abstract
Background
In recent years, the role of altered cellular metabolism in tumor progression has attracted widespread attention. Related metabolic enzymes have also been considered as potential cancer therapeutic targets. Serine hydroxymethyltransferase 2 (SHMT2) has been reported to be upregulated in several cancers and associated with poor prognosis. However, there are few studies of SHMT2 in esophageal cancer (EC), and the related functions and mechanisms also need to be further explored.

Methods
In this study, we first analyzed SHMT2 expression in EC by online database and clinical samples. Then, the biological functions of SHMT2 in EC were investigated by cell and animal experiments. The intracellular m6A methylation modification levels were also evaluated by MeRIP. Linked genes and mechanisms of SHMT2 were analyzed by bioinformatics and rescue experiments.

Results
We found that SHMT2 expression was abnormally upregulated in EC and associated with poor prognosis. Functionally, SHMT2 silencing suppressed c-myc expression in an m6A-dependent manner, thereby blocking the proliferation, migration, invasion and immune escape abilities of EC cells. Mechanistically, SHMT2 encouraged the accumulation of methyl donor SAM through a one-carbon metabolic network, thereby regulating the m6A modification and stability of c-myc mRNA in a METTL3/FTO/ALKBH5/IGF2BP2-dependent way. In vivo animal experiments also demonstrated that SHMT2 mediated MYC expression by m6A-methylation modification, thus boosting EC tumorigenesis.

Conclusion
In conclusion, our data illustrated that SHMT2 regulated malignant progression and immune escape of EC cell through c-myc m6A modification. These revealed mechanisms related to SHMT2 in EC and maybe offer promise for the development of new therapeutic approaches.
Influence of cyber-victimization and other factors on depression and anxiety among university students in Bangladesh
Authors: Rahman Tareq , Hossain Md. Mahin , Bristy Nurun Nahar , Hoque Md. Zahidul , Hossain Md. Moyazzem 
Published: November 2023

Abstract
Background and objectives
Cyber-victimization is closely linked with mental health problems such as anxiety, depression, etc., and has become a growing concern among university students in Bangladesh. In the era of globalization, smart gadgets, the internet, and other online resources are readily available, and these tools and devices have now become the primary method for cyberbullying. The authors aim to explore the impacts of cyber-victimization and other factors on anxiety and depression among university students in Bangladesh.

Methods
The primary data for this cross-sectional study were collected using a well-structured questionnaire. This study employs three widely used scales such as cyberbullying inventory, general anxiety disorder-7 (GAD-7), and patient health questionnaire-9 (PHQ-9). Descriptive statistics and multivariable logistic regression analyses are carried out to identify the factors associated with depression and anxiety among university students in Bangladesh.

Results
Findings depict that the prevalence of depression and anxiety among university students was 52.5% and 44.0%, respectively. Depressed respondents were considerably more likely to have difficulty sleeping (p < 0.001), spend more time on social media (p = 0.002), have suicidal thoughts (p < 0.001), and have a high cyber-victimization score (p < 0.001) compared to non-depressed respondents. In comparison with non-anxious respondents, anxious respondents were significantly more likely to: have sleeping difficulties (p < 0.001); spend more time on social media (p = 0.031); have suicidal thinking (p < 0.001); and have a comparatively high cyber-victimization score (p < 0.001). Multivariable logistic regression analysis identified that a one-unit increase in the cyber-victimization score results in a 1.24 times higher chance of experiencing depression (AOR: 1.24, 95% CI 1.17–1.31, p < 0.001), and a one-unit increase in the cyber-victimization score results in a 1.23 times higher chance of experiencing anxiety (AOR: 1.23, 95% CI 1.17–1.30, p < 0.001).

Conclusion
University students are struggling with cyberbullying, which can lead to depression and anxiety levels. Promoting more cyberbullying awareness is necessary since failing to do so could result in a sustained or increased prevalence of anxiety and depression levels among students, which could have disastrous repercussions.
Enhancement of material attributes of poorly compressible metformin hydrochloride through coprocessing with hydroxypropyl cellulose (HPC-L) using coprecipitation (CPT)
Authors: Chaturvedi Kaushalendra , Pongkulapa Pasaorn , Ding Xiaoyi , Shah Harsh S. , Kiang San , Kadajji Veeran 
Published: November 2023

AbstractCoprocessing involves integration of multiple substances to improve the physical, chemical, mechanical, and biopharmaceutical properties of a material. Coprocessing is a promising technique in the pharmaceutical industry which support both drug substance and drug product processes. When active pharmaceutical ingredients (APIs) are coprocessed with excipients, it can enable direct compression and continuous manufacturing. Hydroxypropyl cellulose (HPC-L), a commonly used excipient in pharmaceutical formulations, can enhance drug stability, solubility, and bioavailability. In this study, we have employed coprecipitation (CPT) to coprocess metformin hydrochloride (MET) with HPC-L, resulting in the formation of agglomerates with improved physical attributes without any risk of polymorphic changes. Acetone/acetonitrile and heptane were used as solvent and antisolvent, respectively. Screening study revealed that the use of a rotor stator helps to control the size of metformin hydrochloride and HPC-L agglomerates (M-CPT) without negatively impacting bulk density and powder flow properties. The CPT agglomerates showed residual solvent levels within the specified ICH limits. Powder rheology results demonstrated a sixfold increase in FFC of M-CPT compared to neat MET. The compressibility, tabletability, compactability, and “In-Die” Heckel analysis data further suggested that the M-CPT agglomerates are directly compressible with no observable changes in the dissolution profile of MET. Overall, this study demonstrates application of CPT approach to tune the physical and mechanical properties, and HPC-L can be used as an excipient of choice for CPT technique to improve the compressibility and flowability of APIs.
Graphical Abstract
Using objective measures to examine the effect of suspect-filler similarity on eyewitness identification performance - Final Registered Report
Authors: McKinley Geoffrey L. , Peterson Daniel J. 
Published: November 2023

AbstractWhen selecting fillers to include in a police lineup, one must consider the level of similarity between the suspect and potential fillers. In order to reduce misidentifications, an innocent suspect should not stand out. Therefore, it is important that the fillers share some degree of similarity. Importantly, increasing suspect–filler similarity too much will render the task too difficult reducing correct identifications of a guilty suspect. Determining how much similarity yields optimal identification performance is the focus of the proposed study. Extant research on lineup construction has provided somewhat mixed results. In part, this is likely due to the subjective nature of similarity, which forces researchers to define similarity in relative terms. In the current study, we manipulate suspect–filler similarity via a multidimensional scaling model constructed using objective facial measurements. In doing so, we test the “propitious heterogeneity” and the diagnostic-feature-detection hypotheses which predict an advantage of lineups with low-similarity fillers in terms of discriminability. We found that filler similarity did not affect discriminability. We discuss limitations and future directions.
An integrated approach to water conservation: fuzzy logic assessment of water tariffs in Abu Dhabi Emirate’s residential sector
Authors: AlHamad Issah M. , Al Hemyari Osamah , Shashati Ahmad , Al Seraihi Hazza , Albahlooli Hamad , Ewim Daniel Raphael Ejike , Al Nuaimi Saeed 
Published: November 2023

Abstract
Background
Abu Dhabi, a part of the United Arab Emirates, is situated in an arid region where water scarcity is a significant concern. The residential sector in Abu Dhabi consumes a large portion of the available water resources, leading to a critical need for effective water management strategies. This study aims to understand the relationship between water tariffs and water consumption in the residential sector in Abu Dhabi. It employs an integrated fuzzy logic model, a form of artificial intelligence, to assess the impact of water tariffs on water consumption. The model includes variables such as water tariffs, the level of water awareness, the level of water behavior, and the level of technology use. The objective of these variables is to evaluate their impact on the water-saving index, which represents the ratio of daily water consumption per capita in Abu Dhabi to the global average.

Results
The findings of this study, based on a survey measuring the level of water awareness, behavior, and technology use, revealed a potential strategy for reducing water consumption in Abu Dhabi’s residential sector. It was observed that increasing water tariffs, while maintaining current levels of water awareness, behavior, and technology use, could lead to a reduction in water consumption. However, it was also found that the impact of further tariff increases on water conservation diminishes after a certain threshold, indicating the necessity of a balanced approach in tariff adjustment. Interestingly, the study also highlights that Abu Dhabi residents demonstrate high levels of water behavior and technology use, indicating a positive trend toward water conservation.

Conclusions
This study emphasizes the importance of increasing water awareness among Abu Dhabi residents as a means to foster sustainable water consumption practices. While water tariffs can contribute to reductions in water consumption, the effects tend to decrease beyond a certain point. Therefore, a comprehensive approach involving water tariffs, increased water awareness, and the adoption of water-saving technologies may be the most effective strategy for water conservation. The insights from this study extend beyond Abu Dhabi and offer valuable guidance for addressing water conservation challenges worldwide. It highlights the importance of adopting a multi-faceted approach in water management, and the potential for such strategies to have international relevance in the pursuit of sustainable water consumption.
A deep learning aided differential distinguisher improvement framework with more lightweight and universality
Authors: Liu JiaShuo , Ren JiongJiong , Chen ShaoZhen 
Published: November 2023

AbstractIn CRYPTO 2019, Gohr opens up a new direction for cryptanalysis. He successfully applied deep learning to differential cryptanalysis against the NSA block cipher SPECK32/64, achieving higher accuracy than traditional differential distinguishers. Until now, one of the mainstream research directions is increasing the training sample size and utilizing different neural networks to improve the accuracy of neural distinguishers. This conversion mindset may lead to a huge number of parameters, heavy computing load, and a large number of memory in the distinguishers training process. However, in the practical application of cryptanalysis, the applicability of the attacks method in a resource-constrained environment is very important. Therefore, we focus on the cost optimization and aim to reduce network parameters for differential neural cryptanalysis.In this paper, we propose two cost-optimized neural distinguisher improvement methods from the aspect of data format and network structure, respectively. Firstly, we obtain a partial output difference neural distinguisher using only 4-bits training data format which is constructed with a new advantage bits search algorithm based on two key improvement conditions. In addition, we perform an interpretability analysis of the new neural distinguishers whose results are mainly reflected in the relationship between the neural distinguishers, truncated differential, and advantage bits. Secondly, we replace the traditional convolution with the depthwise separable convolution to reduce the training cost without affecting the accuracy as much as possible. Overall, the number of training parameters can be reduced by less than 50% by using our new network structure for training neural distinguishers. Finally, we apply the network structure to the partial output difference neural distinguishers. The combinatorial approach have led to a further reduction in the number of parameters (approximately 30% of Gohr’s distinguishers for SPECK).
Precipitating factors and outcome of acute asthma attack patients attended to the emergency unit at Cairo University Specialized Pediatric Hospital in 2019 “before COVID era”
Authors: Ahmed Khaled Amin Nasef , Aziz Iman Ali Abd El , Tarek Sara , Fattah Hager Mahmoud Abd El , Behairy Ahmed Said 
Published: November 2023

Abstract
Background
Asthma is a common and potentially serious chronic disease that imposes a substantial burden on patients, their families, and the community.

Objectives
The aim of this study was to find a correlation between precipitating factors of acute asthma attacks of patients attending to emergency departments and different factors such as socioeconomic status.

Methods
The study included patients 2–12 years old of both sexes who were already diagnosed with bronchial asthma coming to ER with acute asthmatic attacks. Data were collected by a questionnaire which includes personal data (name, age, and sex), anthropometric data, score for assessment of socioeconomic status (SES), symptoms of asthmatic attack, risk factors, mode and type of treatment, compliance to treatment, or evaluation of asthma severity and outcome of patients attending to ER.

Results
This study included 170 patients. Males represented 63.5% of the patients. The mean age of the patients was 5.4 ± 2.7 years. Our patients were distributed into the following: 65.9% were low SES, 22.9% were very low SES, and 11.2% were moderate SES. As regards presenting symptoms of the study group, all the patients (100%) presented to ER with cough, while 88.2% of them presented with wheezes, 85.8% presented with dyspnea, 21.2% of them presented with tightness, and only 0.01% presented with cyanosis. As regards precipitating factors of asthma, the most common precipitating factors among our patients causing attending to ER were irritant inhalers (72.4%), passive smoking (60.6%), exercise (70.5%), certain foods (45.3%), upper respiratory tract infection (12.9%), and non-compliance to asthma treatment (85.2%). The most common causes of non-compliance to treatment were family negligence and illiteracy (34.1%) and poor socioeconomic conditions (17.1%). The majority of patients (96.5%) who could be stabilized with medications were discharged, whereas a merged proportion of critically ill patients (3.5%) required ICU admission. However, no deaths were reported.

Conclusion
The most common precipitating factors of our patients that led to more attending to ER in the previous 6 months were exercise, irritant inhalers, and non-compliance to asthma treatment.