bluuebunny/crossref_metadata_2025_split huggingface dataset:
Poor glycemic control and its associated factors among children with type 1 diabetes mellitus in Harar, eastern Ethiopia: A cross-sectional study
Authors: Habteyohans Betelhem Demeke , Hailu Betre Shimelis , Meseret Fentahun , Mohammed Ahmed , Berhanu Yeshi , Alemu Ayichew , Tolosa Gadissa , Keneni Mulualem , Desalew Assefa 
Published: September 2023

Abstract
Background
Poor glycemic control increases the risk of acute metabolic derangements and long-term consequences, which are the main causes of morbidity and mortality. Maintaining adequate glycemic control is challenging for children with diabetes, particularly in resource-limited settings. There is a paucity of data on the magnitude of poor glycemic control and its predisposing factors in Ethiopian particularly in this study setting. Hence, we aimed to assess the magnitude of poor glycemic control and its associated factors among children and adolescents with type 1 diabetic mellitus in Jugol and Hiwot Fana Compressive Specialized University Hospitals in Harar, eastern Ethiopia.

Methods
A facility-based cross-sectional study was conducted among 231 children and adolescents with type 1 diabetes mellitus in Jugol and Hiwot Fana Compressive Specialized University Hospitals. Participants were included consecutively in the follow-up clinic from November 15, 2022 to January 15, 2023. Data were collected through an interviewer-administered structured questionnaire and a review of medical records. A binary logistic regression model with an adjusted odds ratio (aOR) and a 95% confidence interval (CI) was used to identify the factors associated with poor glycemic control. Statistical significance was set at p < 0.05.

Result
A total of 231 children and adolescents with type 1 diabetes mellitus were included. The magnitude of poor glycemic control was 166 (71.9%) with 95% CI 66.0–77.7%). In multivariable analysis, the age of the child (aOR = 0.19, 95% CI: 0.05–0.83), education of the caregiver (aOR = 4.13;95% CI: 1.82–9.46), meal frequency less than three (aOR = 3.28; 95% CI: 1.25–8.62), and consumption of forbidden foods (aOR = 3.17; 95% CI: 1.21–8.29) were factors significantly associated with poor glycemic control.

Conclusion
Two-thirds of participants had poor glycemic control. There was a statistically significant association between the age of the child, education of the caregiver, meal frequency, and forbidden foods with poor glycemic control. To improve glycemic control, diabetes education on meal use and selection should be conducted during follow-up along with parent education.
Handling students’ misbehaviors in crowded classrooms: the nursing faculty members’ experiences
Authors: Salarvand Shahin , Niknejad Reyhaneh , Gyasi Razak M. 
Published: September 2023

Abstract
Introduction
The ability of teachers to organize classes and manage the behavior of their students is critical in achieving positive educational outcomes. The aim of this study was to explain the experiences of nursing faculty members in managing disruptive behaviors in the classroom.

Methods
The study adopted descriptive explanatory qualitative study design and provided an avenue to explain the experiences of nursing faculty members in managing disruptive behavior in the classroom Participants were included via the purposive sampling. In-depth and semi-structured interviews were used to collect data. The content analysis presented by Graneheim and Lundman was used to analyze the data. The present study utilized four strength criteria, including credibility, confirmability, transferability, and dependability.

Results
The finding were presented using five themes that emerged from 350 open codes, including managing disruptive behavior in the classroom, guiding the disruptive student, trying to increase learning, and making the class more interesting, setting the rules and regulations of the class with sub-categories.

Conclusions
Participants cited strategies that they enabled to understand the cause of misbehavior and implement strategies to modify students’ misbehaviors by creating a safe and healthy climate to nurture effective learning by students.
Procedure code overutilization detection from healthcare claims using unsupervised deep learning methods
Authors: Suesserman Michael , Gorny Samantha , Lasaga Daniel , Helms John , Olson Dan , Bowen Edward , Bhattacharya Sanmitra 
Published: September 2023

Abstract
Background
Fraud, Waste, and Abuse (FWA) in medical claims have a negative impact on the quality and cost of healthcare. A major component of FWA in claims is procedure code overutilization, where one or more prescribed procedures may not be relevant to a given diagnosis and patient profile, resulting in unnecessary and unwarranted treatments and medical payments. This study aims to identify such unwarranted procedures from millions of healthcare claims. In the absence of labeled examples of unwarranted procedures, the study focused on the application of unsupervised machine learning techniques.

Methods
Experiments were conducted with deep autoencoders to find claims containing anomalous procedure codes indicative of FWA, and were compared against a baseline density-based clustering model. Diagnoses, procedures, and demographic data associated with healthcare claims were used as features for the models. A dataset of one hundred thousand claims sampled from a larger claims database is used to initially train and tune the models, followed by experimentations on a dataset with thirty-three million claims. Experimental results show that the autoencoder model, when trained with a novel feature-weighted loss function, outperforms the density-based clustering approach in finding potential outlier procedure codes.

Results
Given the unsupervised nature of our experiments, model performance was evaluated using a synthetic outlier test dataset, and a manually annotated outlier test dataset. Precision, recall and F1-scores on the synthetic outlier test dataset for the autoencoder model trained on one hundred thousand claims were 0.87, 1.0 and 0.93, respectively, while the results for these metrics on the manually annotated outlier test dataset were 0.36, 0.86 and 0.51, respectively. The model performance on the manually annotated outlier test dataset improved further when trained on the larger thirty-three million claims dataset with precision, recall and F1-scores of 0.48, 0.90 and 0.63, respectively.

Conclusions
This study demonstrates the feasibility of leveraging unsupervised, deep-learning methods to identify potential procedure overutilization from healthcare claims.
Immediate initiation of antiretroviral treatment: knowledge, attitudes, and practices among clinic staff in New York City
Authors: Bertolino Daniel , Baim-Lance Abigail , D’Aquila Erica , Coren Freda , Abraham Bisrat 
Published: September 2023

Abstract
Background
Immediate initiation of antiretroviral treatment (iART) is a proven intervention that significantly decreases time to viral suppression and increases patient retention. iART involves starting medication as early as possible, often after a reactive rapid HIV test or re-engagement in care, although it does not have a universal definition. We aimed to understand iART from an implementation science perspective in a wide range of New York City (NYC) clinics providing HIV primary care, including staff knowledge, attitudes, and practices, as well as clinic barriers and facilitators to iART.

Methods
We used a mixed-methods, convergent study design, with a quantitative survey and in-depth interview (IDI), to understand individual-level knowledge, attitudes, and practices, as well as clinic-level barriers and facilitators to iART. We recruited at least one medical and non-medical staff member from a diverse purposive sample of 30 NYC clinics. In quantitative analyses, we used separate binomial logistic regression models to estimate odds ratios (OR) and 95% confidence intervals (95% CI). In qualitative analyses, we used codebooks created by thematic analyses structured using a Framework Model to develop descriptive analytic memos.

Results
Recruited staff completed 46 surveys and 17 IDIs. We found high levels of awareness of the viral suppression and retention in care benefits of iART. Survey respondents more commonly reported medication starts within three to four days of a reactive rapid HIV test rather than same-day initiation. Among survey respondents, compared to medical staff, non-medical staff were more likely to agree that medication should only be initiated after receiving confirmatory HIV test results (OR: 0.2, 95% CI: 0.06–0.8). Additionally, survey respondents from clinics serving a majority people of color were less likely to report iART on the same day as a reactive rapid HIV test (OR: 0.2, 95% CI: 0.02–1.0, p-value < 0.5). IDI results elucidated barriers to implementation, including perceived patient readiness, which potentially leads to added disparities in iART access.

Conclusion
iART has proven benefits and support for its implementation among HIV clinic staff. Our findings indicate that barriers to expanding iART access may be overcome if implementation resources are allocated strategically, which can further progress towards health equity.
Proteomic analysis of ceftazidime and meropenem-exposed Pseudomonas aeruginosa ATCC 9027
Authors: Ngo Hong Loan , Huynh Thuc Quyen , Tran Nguyen Bao Vy , Nguyen Ngoc Hoa Binh , Tong Thi Hang , Trinh Thi Truc Ly , Nguyen Van Dung , Das Prem Prakash , Lim Teck Kwang , Lin Qingsong , Nguyen Thi Thu Hoai 
Published: September 2023

Abstract
Background
Pseudomonas aeruginosa is well known for its intrinsic ability to resist a wide range of antibiotics, thus complicates treatment. Thus, understanding the response of the pathogen to antibiotics is important for developing new therapies. In this study, proteomic response of P. aeruginosa to the commonly used anti-pseudomonas antibiotics, ceftazidime (Caz) and meropenem (Mem) was investigated.

Methods
P. aeruginosa ATCC 9027, an antibiotic-susceptible strain, was exposed to sub-MIC values of antibiotics either Caz or Mem for 14 days to obtain E1 strains and then cultured in antibiotic-free environments for 10 days to obtain E2 strains. Proteomes of the initial and E1, E2 strains were identified and comparatively analyzed using isobaric tags for relative and absolute quantitation (iTRAQ) in cooperation with nano LC–MS/MS. Noted up and down-regulated proteins were confirmed with quantitative reverse transcriptase PCR (qRT-PCR).

Results
Overall, 1039 and 1041 proteins were identified in Caz and Mem-exposed strains, respectively. Upon antibiotic exposure, there were 7–10% up-regulated (Caz: 71, Mem: 85) and down-regulated (Caz: 106, Mem: 69) proteins (1.5-fold change cut-off). For both Caz and Mem, the DEPs were primarily the ones involved in metabolic process, membrane, virulence, protein synthesis, and antibiotic resistance in which proteins involved in antibiotics resistance tended to be up-regulated while proteins involved in protein synthesis and metabolic process were down-regulated. Noted proteins included beta-lactamase AmpC which was up-regulated and OprD which was down-regulated in both the antibiotic-exposed strains. Besides, biofilm formation related proteins TssC1 and Hcp1 in Caz- exposed strains and the membrane/ periplasmic proteins Azu and PagL in Mem-exposed strains were found significantly down-regulated. qRT-PCR results confirmed the expression change of AmpC, Hcp1 and OprD proteins.

Conclusion
Exposure of Pseudomonas aeruginosa to sub-MIC values of Caz and Mem resulted in around 10% change in its proteome. Not only proteins with confirmed roles in antibiotic resistance mechanisms changed their expression but also virulence- associated proteins. Both Caz and Mem response involved up-regulation of AmpC and down-regulation of OprD. While TssC1 and Hcp1 were responsible for Caz response, Azu and PagL were more likely involved in Mem response.
Connexin-43 hemichannels orchestrate NOD-like receptor protein-3 (NLRP3) inflammasome activation and sterile inflammation in tubular injury
Authors: Roger Elena , Chadjichristos Christos E. , Kavvadas Panagiotis , Price Gareth W. , Cliff Chelsy L. , Hadjadj Safia , Renciot Jessy , Squires Paul E. , Hills Claire E. 
Published: September 2023

Abstract
Background
Without a viable cure, chronic kidney disease is a global health concern. Inflammatory damage in and around the renal tubules dictates disease severity and is contributed to by multiple cell types. Activated in response to danger associated molecular patterns (DAMPs) including ATP, the NOD-like receptor protein-3 (NLRP3) inflammasome is integral to this inflammation. In vivo, we have previously observed that increased expression of Connexin 43 (Cx43) is linked to inflammation in chronic kidney disease (CKD) whilst in vitro studies in human proximal tubule cells highlight a role for aberrant Cx43 hemichannel mediated ATP release in tubule injury. A role for Cx43 hemichannels in priming and activation of the NLRP3 inflammasome in tubule epithelial cells remains to be determined.

Methods
Using the Nephroseq database, analysis of unpublished transcriptomic data, examined gene expression and correlation in human CKD. The unilateral ureteral obstruction (UUO) mouse model was combined with genetic (tubule-specific Cx43 knockout) and specific pharmacological blockade of Cx43 (Peptide5), to explore a role for Cx43-hemichannels in tubule damage. Human primary tubule epithelial cells were used as an in vitro model of CKD.

Results
Increased Cx43 and NLRP3 expression correlates with declining glomerular filtration rate and increased proteinuria in biopsies isolated from patients with CKD. Connexin 43-tubule deletion prior to UUO protected against tubular injury, increased expression of proinflammatory molecules, and significantly reduced NLRP3 expression and downstream signalling mediators. Accompanied by a reduction in F4/80 macrophages and fibroblast specific protein (FSP1+) fibroblasts, Cx43 specific hemichannel blocker Peptide5 conferred similar protection in UUO mice. In vitro, Peptide5 determined that increased Cx43-hemichannel activity primes and activates the NLRP3 inflammasome via ATP-P2X7 receptor signalling culminating in increased secretion of chemokines and cytokines, each of which are elevated in individuals with CKD. Inhibition of NLRP3 and caspase 1 similarly decreased markers of tubular injury, whilst preventing the perpetual increase in Cx43-hemichannel activity.

Conclusion
Aberrant Cx43-hemichannel activity in kidney tubule cells contributes to tubule inflammation via activation of the NLRP3 inflammasome and downstream paracrine mediated cell signalling. Use of hemichannel blockers in targeting Cx43-hemichannels is an attractive future therapeutic target to slow or prevent disease progression in CKD.
Therapeutic targeting of the TPX2/TTK network in colorectal cancer
Authors: Shaath Hibah , Vishnubalaji Radhakrishnan , Elango Ramesh , Velayutham Dinesh , Jithesh Puthen Veettil , Alajez Nehad M. 
Published: September 2023

Abstract
Background
While the increased screening, changes in lifestyle, and recent advances in treatment regimen have decreased colorectal cancer (CRC) mortality, metastatic disease and recurrence remains a major clinical challenge. In the era of precision medicine, the identification of actionable novel therapeutic targets could ultimately offer an alternative treatment strategy for CRC.

Methods
RNA-Seq was conducted using the illumina platform, while bioinformatics analyses were conducted using CLC genomics workbench and iDEP.951. Colony forming unit, flow cytometry, and fluorescent microscopy were used to assess cell proliferation, cell cycle distribution, and cell death, respectively. The growth potential of CRC cells under 3-dimensional (3D) conditions was assessed using Matrigel. STRING database (v11.5) and Ingenuity Pathway Analysis (IPA) tool were used for network and pathway analyses. CRISPR-Cas9 perturbational effects database was used to identify potential therapeutic targets for CRC, through integration with gene-drug interaction database. Structural modeling and molecular docking were used to assess the interaction between candidate drugs and their targets.

Results
In the current study, we investigated the therapeutic potential of targeting TPX2, TTK, DDX39A, and LRP8, commonly upregulated genes in CRC identified through differential expression analysis in CRC and adjacent non-cancerous tissue. Targeted depletion of TPX2 and TTK impaired CRC proliferation, cell cycle progression, and organoid formation under 3D culture conditions, while suppression of DDX39A and LRP8 had modest effects on CRC colony formation. Differential expression analysis and bioinformatics on TPX2 and TTK-deficient cells identified cell cycle regulation as the hallmark associated with loss of TPX2 and TTK. Elevated expression of TPX2 and TTK correlated with an oncogenic state in tumor tissue from patients with colon adenocarcinoma, thus corroborating an oncogenic role for the TPX2/TTK network in the pathogenesis of CRC. Gene set enrichment and pathway analysis of TPX2high/TTKhigh CRC identified numerous additional gene targets as integral components of the TPX2/TTK network. Integration of TPX2/TTK enriched network with CRISPR-Cas9 functional screen data identified numerous novel dependencies for CRC. Additionally, gene-drug interaction analysis identified several druggable gene targets enriched in the TPX2/TTK network, including AURKA, TOP2A, CDK1, BIRC5, and many others.

Conclusions
Our data has implicated an essential role for TPX2 and TTK in CRC pathogenesis and identified numerous potential therapeutic targets and their drug interactions, suggesting their potential clinical use as a novel therapeutic strategy for patients with CRC.
Genetic evidence strengthens the bidirectional connection between gut microbiota and periodontitis: insights from a two-sample Mendelian randomization study
Authors: Ye Xinjian , Liu Bin , Bai Yijing , Cao Yue , Lin Sirui , Lyu Linshuoshuo , Meng Haohao , Dai Yuwei , Ye Ding , Pan Weiyi , Wang Zhiyong , Mao Yingying , Chen Qianming 
Published: September 2023

Abstract
Background
Recent research has established the correlation between gut microbiota and periodontitis via oral-gut axis. Intestinal dysbiosis may play a pivotal bridging role in extra-oral inflammatory comorbidities caused by periodontitis. However, it is unclear whether the link is merely correlative or orchestrated by causative mechanistic interactions. This two-sample Mendelian randomization (MR) study was performed to evaluate the potential bidirectional causal relationships between gut microbiota and periodontitis.

Materials and Methods
A two-sample MR analysis was performed using summary statistics from genome-wide association studies (GWAS) for gut microbiota (n = 18,340) and periodontitis (cases = 12,251; controls = 22,845). The inverse-variance weighted (IVW) method was used for the primary analysis, and we employed sensitivity analyses to assess the robustness of the main results. The PhenoScanner database was then searched for pleiotropy SNPs associated with potential confounders. In order to identify the possibly influential SNPs, we further conducted the leave-one-out analysis. Finally, a reverse MR analysis was performed to evaluate the possibility of links between periodontitis and genetically predicted gut microbiota alternation.

Results
2,699 single nucleotide polymorphisms (SNPs) associated with 196 microbiota genera were selected as instrumental variables (IVs). IVW method suggested that order Enterobacteriales (OR: 1.35, 95% CI 1.10–1.66), family Bacteroidales S24.7group (OR: 1.22, 95% CI 1.05–1.41), genus Lachnospiraceae UCG008 (OR: 1.16, 95% CI 1.03–1.31), genus Prevotella 7 (OR: 1.11, 95% CI 1.01–1.23), and order Pasteurellales (OR: 1.12, 95% CI 1.00–1.26) may be associated with a higher risk of periodontitis, while genus Ruminiclostridium 6 may be linked to a lower risk (OR: 0.82, 95% CI 0.70–0.95). The sensitivity and heterogeneity analyses yielded no indication of horizontal pleiotropy or heterogeneity. Only the association between order Enterobacteriales and the likelihood of periodontitis remained consistent across all alternative MR approaches. In the reverse MR analysis, four microbiota genera were genetically predicted to be down-regulated in periodontitis, whereas two were predicted to be up-regulated.

Conclusions
The present MR analysis demonstrated the potential bidirectional causal relationships between gut microbiota and periodontitis. Our research provided fresh insights for the prevention and management of periodontitis. Future research is required to support the finding of our current study.
Traditional ecological knowledge and non-food uses of stingless bee honey in Kenya’s last pocket of tropical rainforest
Authors: Héger Madeleine , Noiset Pierre , Nkoba Kiatoko , Vereecken Nicolas J. 
Published: September 2023

Abstract
Background
Stingless bee honey (SBH) is a natural remedy and therapeutic agent traditionally used by local communities across the (sub-)tropics. Forest SBH represents a prime non-timber forest product (NTFP) with a potential to revitalize indigenous foodways and to generate income in rural areas, yet it is also used in a variety of non-food contexts that are poorly documented in sub-Saharan Africa and that collectively represent a significant part of the local traditional ecological knowledge (TEK) passed on across generations. Documenting TEK of local communities in African tropical forests facing global change is a pressing issue to recognize the value of their insights, to evaluate their sustainability, to determine how they contribute to enhancing conservation efforts, and how TEK generally contributes to the well-being of both the natural environment and the communities that rely on it. This is particularly important to achieve in Kenya’s only tropical rainforest at Kakamega where SBH production and non-food uses have evolved and diversified to a remarkable extent.

Methods
We used ethnographic techniques and methods, including semi-structured questionnaires and recorded interviews. We used snowball sampling, a non-probability sampling method where new interviewees were recruited by other respondents, to collectively form a sample consisting of 36 interviewees (including only one woman).

Results
Our results indicate that local communities in Kakamega were able to discriminate between six different and scientifically recognized stingless bee species, and they provided detailed accounts on the species-specific non-food uses of these SBH. Collectively, we recorded an array of 26 different non-food uses that are all passed on orally across generations in the Kakamega community.

Conclusion
Our results uncover the vast and hitherto unexpected diversity of TEK associated with SBH and pave the way for a systematic survey of SBH and their non-food uses across a network of communities in different environments and with different cultural backgrounds in the Afrotropics. This, along with parallel and more in-depth investigations into honey chemistry, will help develop a comprehensive understanding of SBH, offering insights into holistic ecosystem management, resilience and adaptation while in the mid- to long-term promoting cross-cultural exchanges and pathways for the revitalization of cultural practices and traditions.