bluuebunny/crossref_metadata_2025_split huggingface dataset:
Do public health expenditures affect maternal and child health in Madagascar?
Authors: Razakamanana Marilys Victoire , Andrianatoandro Voahirana Tantely , Ramiandrisoa Tiarinisaina Olivier 
Published: October 2023

Abstract
Background
Previous studies have argued that the relationship between health expenditures and health outcomes is more significant among the poor than the non-poor. However, public spending alone does not improve health status. Quality of governance is considered not only as an important determinant of health outcomes but also of the efficiency of public expenditure on health. In low-income countries, barriers to quality service provision can be observed, which may explain the effects of health expenditures. Therefore, this paper aims to identify the relationship between health expenditures and maternal and child mortality in Madagascar and the potential bottlenecks in the flow of funds for maternal and child health.

Methods
Using panel data, fixed and random effect models for the 22 regions of Madagascar over the period 2010 to 2017 were used. Then bottlenecks related to the flow of funds for maternal and child health were identified.

Results
The results reveal that, on the one hand, funding for maternal health, mainly constituted by equipment endowments for health facilities, significantly contributes to the improvement of maternal health (-0.35; p-value = 0.00). On the other hand, child health financing, often realized through transfers of funds to the health system, does not affect children’s health (0.22; p-value = 0.88). The bottleneck analysis illustrates that the transferred funds can suffer from delay or misappropriation and only few parts reach beneficiaries.

Conclusions
Equipment endowments contributed more to health improvement and would be more effective than monetary financing.
Physiological effects of high-flow nasal cannula oxygen therapy after extubation: a randomized crossover study
Authors: Basoalto Roque , Damiani L. Felipe , Jalil Yorschua , Bachmann María Consuelo , Oviedo Vanessa , Alegría Leyla , Valenzuela Emilio Daniel , Rovegno Maximiliano , Ruiz-Rudolph Pablo , Cornejo Rodrigo , Retamal Jaime , Bugedo Guillermo , Thille Arnaud W. , Bruhn Alejandro 
Published: October 2023

Abstract
Background
Prophylactic high-flow nasal cannula (HFNC) oxygen therapy can decrease the risk of extubation failure. It is frequently used in the postextubation phase alone or in combination with noninvasive ventilation. However, its physiological effects in this setting have not been thoroughly investigated. The aim of this study was to determine comprehensively the effects of HFNC applied after extubation on respiratory effort, diaphragm activity, gas exchange, ventilation distribution, and cardiovascular biomarkers.

Methods
This was a prospective randomized crossover physiological study in critically ill patients comparing 1 h of HFNC versus 1 h of standard oxygen after extubation. The main inclusion criteria were mechanical ventilation for at least 48 h due to acute respiratory failure, and extubation after a successful spontaneous breathing trial (SBT). We measured respiratory effort through esophageal/transdiaphragmatic pressures, and diaphragm electrical activity (ΔEAdi). Lung volumes and ventilation distribution were estimated by electrical impedance tomography. Arterial and central venous blood gases were analyzed, as well as cardiac stress biomarkers.

Results
We enrolled 22 patients (age 59 ± 17 years; 9 women) who had been intubated for 8 ± 6 days before extubation. Respiratory effort was significantly lower with HFNC than with standard oxygen therapy, as evidenced by esophageal pressure swings (5.3 [4.2–7.1] vs. 7.2 [5.6–10.3] cmH2O; p < 0.001), pressure–time product (85 [67–140] vs. 156 [114–238] cmH2O*s/min; p < 0.001) and ΔEAdi (10 [7–13] vs. 14 [9–16] µV; p = 0.022). In addition, HFNC induced increases in end-expiratory lung volume and PaO2/FiO2 ratio, decreases in respiratory rate and ventilatory ratio, while no changes were observed in systemic hemodynamics, Troponin T, or in amino-terminal pro-B-type natriuretic peptide.

Conclusions
Prophylactic application of HFNC after extubation provides substantial respiratory support and unloads respiratory muscles.
Trial registration January 15, 2021. NCT04711759.
Effective infection prevention and control measures in long-term care facilities in non-outbreak and outbreak settings: a systematic literature review
Authors: Bloch Nando , Männer Jasmin , Gardiol Céline , Kohler Philipp , Kuhn Jacqueline , Münzer Thomas , Schlegel Matthias , Kuster Stefan P. , Flury Domenica 
Published: October 2023

Abstract
Background
Healthcare-associated infections in long-term care are associated with substantial morbidity and mortality. While infection prevention and control (IPC) guidelines are well-defined in the acute care setting, evidence of effectiveness for long-term care facilities (LTCF) is missing. We therefore performed a systematic literature review to examine the effect of IPC measures in the long-term care setting.

Methods
We systematically searched PubMed and Cochrane libraries for articles evaluating the effect of IPC measures in the LTCF setting since 2017, as earlier reviews on this topic covered the timeframe up to this date. Cross-referenced studies from identified articles and from mentioned earlier reviews were also evaluated. We included randomized-controlled trials, quasi-experimental, observational studies, and outbreak reports. The included studies were analyzed regarding study design, type of intervention, description of intervention, outcomes and quality. We distinguished between non-outbreak and outbreak settings.

Results
We included 74 studies, 34 (46%) in the non-outbreak setting and 40 (54%) in the outbreak setting. The most commonly studied interventions in the non-outbreak setting included the effect of hand hygiene (N = 10), oral hygiene (N = 6), antimicrobial stewardship (N = 4), vaccination of residents (N = 3), education (N = 2) as well as IPC bundles (N = 7). All but one study assessing hand hygiene interventions reported a reduction of infection rates. Further successful interventions were oral hygiene (N = 6) and vaccination of residents (N = 3). In outbreak settings, studies mostly focused on the effects of IPC bundles (N = 24) or mass testing (N = 11). In most of the studies evaluating an IPC bundle, containment of the outbreak was reported. Overall, only four articles (5.4%) were rated as high quality.

Conclusion
In the non-outbreak setting in LTCF, especially hand hygiene and oral hygiene have a beneficial effect on infection rates. In contrast, IPC bundles, as well as mass testing seem to be promising in an outbreak setting.
Active sediment transport along trench axis: insights from X-ray fluorescence core scanning and magnetic analysis of marine sediments in the southwestern Ryukyu Trench
Authors: Hsiung Kan-Hsi , Kanamatsu Toshiya , Ikehara Ken , Murayama Masafumi , Yamamoto Yuhji 
Published: October 2023

AbstractThe southwestern Ryukyu Trench is an ideal place for investigating sediment transport from the Taiwan mountain belt to the Ryukyu Trench floor. To study the characteristics of trench turbidites and sediment transport along the trench, we utilize two piston cores: KR1518-PC04/PL04 at the southwestern end of Ryukyu Trench and YK1501-PC14/PL14 in the trench floor. We also collect two push cores, YK1611-6K1467MG and 6K1467MR, from undisturbed seabed surface to observe lithology. Our analysis reveals that the lithology of the cores shows homogeneous gray mud layers intercalated with very-thin fine sand layers, which we interpret as hemipelagites intercalated with very-thin turbidites. We identify 60 turbidites (0.3–4.0 cm thick) from YK1501-PC14 and 36 turbidites (0.9–4.2 cm thick) from KR1518-PC04. Based on observation from YK1501-PC14, most turbidites, which were less than 1 cm in thickness, displayed planar and sharp bottom contacts. The turbidite thickness of YK1501-PC14 (6448 m water depth) is thinner than that of KR1518-PC04 (6147 m water depth) in general. Through X-ray fluorescence core scans (ITRAX), we distinguished trench turbidites by elemental patterns and accurately determined the depths of every very-thin turbidite. Most hemipelagites from YK1501-PC14 and KR1518-PC04 show similar ITRAX profiles, indicating a similar source of the sediments. ITRAX analysis also revealed five intervals in high-Ca mud in YK1501-PC14, suggesting another potential source from the Ryukyu forearc. Anisotropy of Magnetic Susceptibility (AMS) results show that both YK1501-PC14/PL14 and KR1518-PC04/PL04 exhibit an oblate fabric indicating a normal sedimentary condition. Magnetic signatures showed the presence of pyrrhotite, supporting evidence that Taiwan-sourced sediments can be transported up to ~ 250 km by turbidity currents and spread from the Taiwan Island to the Ryukyu Trench floor. This study improves our understanding of Ryukyu Trench turbidites and provides valuable insights into active sediment transport along the southwestern Ryukyu Trench.
A preclinical platform for assessing long-term drug efficacy exploiting mechanically tunable scaffolds colonized by a three-dimensional tumor microenvironment
Authors: De Vlieghere Elly , Van de Vijver Koen , Blondeel Eva , Carpentier Nathan , Ghobeira Rouba , Pauwels Jarne , Riemann Sebastian , Minsart Manon , Fieuws Charlotte , Mestach Johanna , Baeyens Ans , De Geyter Nathalie , Debbaut Charlotte , Denys Hannelore , Descamps Benedicte , Claes Kathleen , Vral Anne , Van Dorpe Jo , Gevaert Kris , De Geest Bruno G. , Ceelen Wim , Van Vlierberghe Sandra , De Wever Olivier 
Published: October 2023

Abstract

Background
Long-term drug evaluation heavily relies upon rodent models. Drug discovery methods to reduce animal models in oncology may include three-dimensional (3D) cellular systems that take into account tumor microenvironment (TME) cell types and biomechanical properties.

Methods
In this study we reconstructed a 3D tumor using an elastic polymer (acrylate-endcapped urethane-based poly(ethylene glycol) (AUPPEG)) with clinical relevant stiffness. Single cell suspensions from low-grade serous ovarian cancer (LGSOC) patient-derived early passage cultures of cancer cells and cancer-associated fibroblasts (CAF) embedded in a collagen gel were introduced to the AUPPEG scaffold. After self-organization in to a 3D tumor, this model was evaluated by a long-term (> 40 days) exposure to a drug combination of MEK and HSP90 inhibitors. The drug-response results from this long-term in vitro model are compared with drug responses in an orthotopic LGSOC xenograft mouse model.

Results
The in vitro 3D scaffold LGSOC model mimics the growth ratio and spatial organization of the LGSOC. The AUPPEG scaffold approach allows to test new targeted treatments and monitor long-term drug responses. The results correlate with those of the orthotopic LGSOC xenograft mouse model.

Conclusions
The mechanically-tunable scaffolds colonized by a three-dimensional LGSOC allow long-term drug evaluation and can be considered as a valid alternative to reduce, replace and refine animal models in drug discovery.

Graphical Abstract
A case report of bilateral lateral ventricle calcified pseudoneoplasm of the neuraxins
Authors: Qiao Xiaolong , Chen Yinan , Ji Ying , Niu Chaoshi , Cheng Chuandong 
Published: October 2023

Abstract
Background
Calcifying pseudoneoplasm of the neuraxis (CAPNON) is indeed a rare central nervous system lesion that can occur in central nervous system (CNS). Due to its infrequency and limited literature reports, it is challenging to diagnose and manage CAPNON.

Case presentation
In this intriguing study, we embarked on a quest to uncover the story of a 16-year-old girl who experienced bothersome headaches. Through advanced imaging techniques like computed tomography (CT) and magnetic resonance imaging (MRI), we glimpsed a delicate calcified growth within the lateral ventricles’ posterior horn. Motivated by our unwavering commitment to solving mysteries, we embarked on a surgical journey that not only freed the young patient from her ailment but also shed light on the true nature of her puzzling adversary—a remarkable CAPNON.

Conclusions
For patients with CAPNON who have multiple or non-respectable lesions, the primary goal is to alleviate symptoms. After alleviating the symptoms with partial resection, close monitoring of any residual lesions is essential. If there is no evidence for disease progression, a strategy of continued close observation is appropriate.
Monitoring spatiotemporal changes of urban surface water based on satellite imagery and Google Earth Engine platform in Dhaka City from 1990 to 2021
Authors: Hossain Md. Jakir , Mahmud Md. Munir , Islam Sheikh Tawhidul 
Published: October 2023

Abstract
Background
This study focuses on Dhaka City and its impact on urban surface water. Cities, ecosystems, and agriculture need surface water. It is crucial for water resource planning and environmental preservation. The primary aim is to study how urbanization has affected surface water in Dhaka City over 30 years using satellite imagery.

Methods
The study analyzed three decades of urban surface water shifts using Landsat 5 TM and Landsat 8 OLI/TIRS satellite imagery and Google Earth Engine (GEE) with JavaScript code for water ratio index detection. To investigate water level changes, field observation surveys and secondary data analysis were conducted. This integrated methodology simplified surface water data extraction and analysis, making remote sensing easier and allowing cloud-based satellite data processing.

Results
The study demonstrates that the amount of surface water in cities is going down, from 36.23 km2 in 1990 to 5.83 km2 in 2021, which is an enormous decrease. This means that about 20 square kilometers, or 45 percent of the water's surface, have been lost in the last 30 years. The main reasons for the drop are unplanned expansion of cities, accelerated real estate development, and more trade and economic activities in the study area.

Conclusions
The GEE algorithms provide useful insights into surface water's maximum and minimum extent, enabling appropriate planning and management. These findings aid Dhaka City's water resource management and environmental protection.
Efficient genome editing in grapevine using CRISPR/LbCas12a system
Authors: Ren Chong , Gathunga Elias Kirabi , Li Xue , Li Huayang , Kong Junhua , Dai Zhanwu , Liang Zhenchang 
Published: October 2023

AbstractClustered regularly interspaced short palindromic repeats (CRISPR) /Cas12a system, also known as CRISPR/Cpf1, has been successfully harnessed for genome engineering in many plants, but not in grapevine yet. Here we developed and demonstrated the efficacy of CRISPR/Cas12a from Lachnospiraceae bacterium ND2006 (LbCas12a) in inducing targeted mutagenesis by targeting the tonoplastic monosaccharide transporter1 (TMT1) and dihydroflavonol-4-reductase 1 (DFR1) genes in 41B cells. Knockout of DFR1 gene altered flavonoid accumulation in dfr1 mutant cells. Heat treatment (34℃) improved the editing efficiencies of CRISPR/LbCas12a system, and the editing efficiencies of TMT1-crRNA1 and TMT1-crRNA2 increased from 35.3% to 44.6% and 29.9% to 37.3% after heat treatment, respectively. Moreover, the sequences of crRNAs were found to be predominant factor affecting editing efficiencies irrespective of the positions within the crRNA array designed for multiplex genome editing. In addition, genome editing with truncated crRNAs (trucrRNAs) showed that trucrRNAs with 20 nt guide sequences were as effective as original crRNAs with 24 nt guides in generating targeted mutagenesis, whereas trucrRNAs with shorter regions of target complementarity ≤ 18 nt in length may not induce detectable mutations in 41B cells. All these results provide evidence for further applications of CRISPR/LbCas12a system in grapevine as a powerful tool for genome engineering.
Graphical Abstract
Diabetic Neuropathies
Authors: Elafros Melissa A. , Callaghan Brian C. 
Published: October 2023

ABSTRACT

OBJECTIVE
This article provides an up-to-date review of the diagnosis and management of the most common neuropathies that occur in patients with diabetes.

LATEST DEVELOPMENTS
The prevalence of diabetes continues to grow worldwide and, as a result, the burden of diabetic neuropathies is also increasing. Most diabetic neuropathies are caused by hyperglycemic effects on small and large fiber nerves, and glycemic control in individuals with type 1 diabetes reduces neuropathy prevalence. However, among people with type 2 diabetes, additional factors, particularly metabolic syndrome components, play a role and should be addressed. Although length-dependent distal symmetric polyneuropathy is the most common form of neuropathy, autonomic syndromes, particularly cardiovascular autonomic neuropathy, are associated with increased mortality, whereas lumbosacral radiculoplexus neuropathy and treatment-induced neuropathy cause substantial morbidity. Recent evidence-based guidelines have updated the recommended treatment options to manage pain associated with distal symmetric polyneuropathy of diabetes.

ESSENTIAL POINTS
Identifying and appropriately diagnosing the neuropathies of diabetes is key to preventing progression. Until better disease-modifying therapies are identified, management remains focused on diabetes and metabolic risk factor control and pain management.
Amyotrophic Lateral Sclerosis and Other Motor Neuron Diseases
Authors: Izenberg Aaron 
Published: October 2023

ABSTRACT

Objective
This article reviews the clinical spectrum of amyotrophic lateral sclerosis (ALS), its variant presentations, and the approach to diagnosis and management. This review includes a detailed discussion of current and emerging disease-modifying therapies and the management of respiratory and bulbar manifestations of disease. An updated review of ALS genetics and pathophysiology is also provided. This article also touches on several other important motor neuron diseases.

Latest Developments
A new set of simplified diagnostic criteria may help identify patients at earlier stages of the disease. A coformulation of sodium phenylbutyrate and tauroursodeoxycholic acid has been shown to have a significant benefit on disease progression and survival, leading to approval by regulatory authorities in the United States and Canada. An oral formulation of edaravone and an antisense oligonucleotide to a SOD1 gene variation (tofersen) have also recently been approved by the US Food and Drug Administration (FDA). Phase 3 trials of intrathecal mesenchymal stem cells failed to meet primary end points for efficacy. Updated American Academy of Neurology quality measures for the care of patients with ALS were published in 2023.

Essential Points
There has been continued progress in ALS genetics, diagnosis, and disease-modifying therapies. However, we still lack a definitive biomarker or a treatment that can halt the progression or reverse the course of disease. The evolving understanding of the genetic and pathophysiologic underpinnings of disease offers promise for more effective and clinically meaningful treatments in the future.
Recovery of Shoulder, Elbow, and Forearm Movement After Nerve Reconstruction for Neonatal Brachial Plexus Palsy
Authors: Muhlestein Whitney E. , Chang Kate W.-C. , Justice Denise , Nelson Virginia S. , Brown Susan H. , Saadeh Yamaan S. , Smith Brandon W. 
Published: October 2023

BACKGROUND AND OBJECTIVES:
There is a relative dearth of published data with respect to recovery of upper extremity movement after nerve reconstruction for neonatal brachial plexus palsy (NBPP). This study aimed to demonstrate long-term recovery of active range of motion (AROM) at the shoulder, elbow, and forearm after nerve reconstruction for NBPP and to compare that with patients managed nonoperatively.

METHODS:
We interrogated a prospectively collected database of all patients evaluated for NBPP at a single institution from 2005 to 2020. AROM measurements for shoulder, elbow, and forearm movements were collected at every visit up to 5 years of follow-up and normalized between 0 and 1. We used generalized estimated equations to predict AROM for each movement within local age windows over 5 years and compared the operative and nonoperative cohorts at each age interval.

RESULTS:
In total, >13 000 collected datapoints representing 425 conservatively and 99 operatively managed children were included for analysis. At 5 years, absolute recovery of AROM after nerve reconstruction was ∼50% for shoulder abduction and forward flexion, ∼65% for shoulder external rotation, and ∼75% for elbow flexion and forearm supination, with ∼20% loss of elbow extension AROM. Despite more limited AROM on presentation for the operative cohort, at 5 years, there was no significant difference between the groups in AROM for shoulder external rotation, elbow extension, or forearm supination, and, in Narakas grade 1–2 injury, shoulder abduction and forward flexion.

CONCLUSION:
We demonstrate recovery of upper extremity AROM after nerve surgery for NBPP. Despite more severe presenting injury, operative patients had similar recovery of AROM when compared with nonoperative patients for shoulder external rotation, elbow extension, forearm supination, and, for Narakas grade 1–2 injury, shoulder abduction and forward flexion.
Case Report: Whole lung lavage therapy for pulmonary alveolar proteinosis: a double-edged sword
Authors: Guediri Nouha , Moussa Chirine , Ben Jemia Emna , Rouis Houda , Kwas Hamida , Khouaja Ibtihel , Ghedira Habib , Maalej Sonia 
Published: October 2023

Pulmonary alveolar proteinosis (PAP) is an uncommon disease characterized by the excessive accumulation of lipoprotein material in the alveoli. No uniform treatment existed. However, whole lung lavage (WLL) remains the main treatment. We report the case of a 33-year-old non-smoking man, with no reported history of medical problems, who complained of dyspnea on exertion and cough for over 5 years. A CT scan revealed diffuse pulmonary interstitial infiltrates. Bronchoalveolar lavage was milky. WLL was planned, and the procedure was repeated 70 times and a total of 3,5 liters of saline serum was instilled and 2,8 liters of milky liquid was removed. The operation procedure was interrupted because of acute pulmonary edema. The patient was transferred to the intensive care unit for acute respiratory distress syndrome. He received 3 days of noninvasive ventilation and regression of supplemental oxygen. Faced with the seriousness of the complication it was decided not to perform a third wash and to monitor the patient functionally and radiologically. Currently, after one year of the lung wash the patient is stable functionally and radiologically. We presented a rare complication of a WLL in a patient with PAP. Physicians should evaluate the patient carefully before suggesting WLL, which is an invasive procedure requiring general anesthesia for a pathology that may evolve spontaneously favorably.