bluuebunny/crossref_metadata_2025_split huggingface dataset:
Protecting healthcare workers and patients during the COVID-19 pandemic: a comparison of baseline and follow-up infection prevention and control needs in Nigerian military healthcare facilities delivering HIV services
Authors: Lee Elizabeth H. , Rashid Ayesha , Lawal Ismail , Adekanye Usman , Adamu Yakubu , Godfrey Catherine , Agaba Patricia A. , Okeji Nathan , Desai Priyanka 
Published: November 2023

Abstract
Background
Protecting the HIV health workforce is critical for continuity of services for people living with HIV, particularly during a pandemic. Early in the COVID-19 pandemic, the Nigerian Ministry of Defence, in partnership with the US Military HIV Research Program, took steps to improve infection prevention and control (IPC) practices among staff working in select PEPFAR-supported Nigerian military health facilities.

Methods
We identified a set of IPC activities a priori for implementation at four Nigerian military hospitals in HIV and related departments in early 2021, including continuous medical masking, physical distancing, placement of additional hand washing stations and hand sanitizers throughout facilities, and training. We fine-tuned planned intervention activities through a baseline needs assessment conducted in December 2020 that covered eight IPC components: ‘IPC program structure, funding and leadership engagement’; ‘IPC policies, guidelines and standard operating procedures (SOPs)’; ‘infrastructure’; ‘triage and screening’; ‘training, knowledge and practice’; ‘personal protective equipment (PPE) materials, availability and adequacy’; ‘biosafety and waste management’; and ‘monitoring and remediation’ prior to implementation. Baseline results were compared with those of a follow up assessment administered in August 2021, following intervention implementation.

Results
IPC readiness remained high at both baseline and follow-up assessments for ‘IPC guidelines, policies, and SOPs’ (96.7%). The components ‘infrastructure’ and ‘monitoring and remediation’, which needed improvement at baseline, saw modest improvements at follow-up, by 2% and 7.5%, respectively. At follow-up, declines from high scoring at baseline were seen in ‘IPC program structure, funding and leadership engagement’, ‘training, knowledge and practice’, and ‘biosafety and waste management’. ‘PPE materials availability and adequacy’ improved to 88.9% at follow-up. Although unidirectional client flow was newly implemented, the score for ‘triage and screening’ did not change from baseline to follow-up (73%).

Conclusion
Variability in IPC component readiness and across facilities highlights the importance of building resilience and employing a quality improvement approach to IPC that includes regular monitoring, re-assessment and re-training at set intervals. Results can be used to encourage solutions-oriented dialogue between staff and leadership, determine needs and implement action plans to protect staff and people with HIV.
Metabolic engineering in Streptomyces albidoflavus for the biosynthesis of the methylated flavonoids sakuranetin, acacetin, and genkwanin
Authors: Pérez-Valero Álvaro , Ye Suhui , Magadán-Corpas Patricia , Villar Claudio J. , Lombó Felipe 
Published: November 2023

AbstractFlavonoids are important plant secondary metabolites showing antioxidant, antitumor, anti-inflammatory, and antiviral activities, among others. Methylated flavonoids are particularly interesting compared to non-methylated ones due to their greater stability and intestinal absorption, which improves their oral bioavailability. In this work we have stablished a metabolic engineered strain of Streptomyces albidoflavus with enhanced capabilities for flavonoid production, achieving a 1.6-fold increase in the biosynthesis of naringenin with respect to the parental strain. This improved strain, S. albidoflavus UO-FLAV-004, has been used for the heterologous biosynthesis of the methylated flavonoids sakuranetin, acacetin and genkwanin. The achieved titers of sakuranetin and acacetin were 8.2 mg/L and 5.8 mg/L, respectively. The genkwanin titers were 0.8 mg/L, with a bottleneck identified in this producing strain. After applying a co-culture strategy, genkwanin production titers reached 3.5 mg/L, which represents a 4.4-fold increase. To our knowledge, this study presents the first biosynthesis of methylated flavonoids in not only any Streptomyces species, but also in any Gram-positive bacteria.
A bedside to bench study of anti-PD-1, anti-CD40, and anti-CSF1R indicates that more is not necessarily better
Authors: Djureinovic Dijana , Weiss Sarah A. , Krykbaeva Irina , Qu Rihao , Vathiotis Ioannis , Moutafi Myrto , Zhang Lin , Perdigoto Ana L. , Wei Wei , Anderson Gail , Damsky William , Hurwitz Michael , Johnson Barbara , Schoenfeld David , Mahajan Amit , Hsu Frank , Miller-Jensen Kathryn , Kluger Yuval , Sznol Mario , Kaech Susan M. , Bosenberg Marcus , Jilaveanu Lucia B. , Kluger Harriet M. 
Published: November 2023

Abstract
Background
Stimulating inflammatory tumor associated macrophages can overcome resistance to PD-(L)1 blockade. We previously conducted a phase I trial of cabiralizumab (anti-CSF1R), sotigalimab (CD40-agonist) and nivolumab. Our current purpose was to study the activity and cellular effects of this three-drug regimen in anti-PD-1-resistant melanoma.

Methods
We employed a Simon’s two-stage design and analyzed circulating immune cells from patients treated with this regimen for treatment-related changes. We assessed various dose levels of anti-CSF1R in murine melanoma models and studied the cellular and molecular effects.

Results
Thirteen patients were enrolled in the first stage. We observed one (7.7%) confirmed and one (7.7%) unconfirmed partial response, 5 patients had stable disease (38.5%) and 6 disease progression (42.6%). We elected not to proceed to the second stage. CyTOF analysis revealed a reduction in non-classical monocytes. Patients with prolonged stable disease or partial response who remained on study for longer had increased markers of antigen presentation after treatment compared to patients whose disease progressed rapidly. In a murine model, higher anti-CSF1R doses resulted in increased tumor growth and worse survival. Using single-cell RNA-sequencing, we identified a suppressive monocyte/macrophage population in murine tumors exposed to higher doses.

Conclusions
Higher anti-CSF1R doses are inferior to lower doses in a preclinical model, inducing a suppressive macrophage population, and potentially explaining the disappointing results observed in patients. While it is impossible to directly infer human doses from murine studies, careful intra-species evaluation can provide important insight. Cabiralizumab dose optimization is necessary for this patient population with limited treatment options.

Trial registration
ClinicalTrials.gov Identifier: NCT03502330.
Risky working conditions and chronic kidney disease
Authors: Lan Rui , Qin Yao , Chen Xiangjun , Hu Jinbo , Luo Wenjin , Shen Yan , Li Xue , Mao Lina , Ye Hanwen , Wang Zhihong 
Published: November 2023

Abstract
Background
Individuals in the workplace are exposed to various environments, tasks, and schedules. Previous studies have indicated a link between occupational exposures and an increased risk of chronic kidney disease (CKD). However, the social conditions of the work environment may also be a crucial contributing factor to CKD. Furthermore, individuals may encounter multiple occupational-related risk factors simultaneously, underscoring the importance of investigating the joint risk of different working conditions on CKD.

Methods
A prospective analysis of 65,069 UK Biobank participants aged 40 to 69 years without CKD at baseline (2006–2010) was performed. A self-administered questionnaire assessed working conditions and a working conditions risk score were developed. Participants who answered “sometimes” or “often” exposure to occupational heat or occupational secondhand cigarette smoke; involved in shift work or heavy workloads (“usually” or “always”), were grouped as high-risk working conditions. Each working condition was scored as 1 if grouped as high-risk, and 0 if not. The working conditions risk score was equal to the sum of these four working conditions. Cox proportional hazard regression models were used to estimate the associations between working conditions and CKD incidence.

Results
The mean follow-up time was 6.7 years. After adjusting for demographic, lifestyle, and working time factors, the hazard ratios for the development of CKD for heavy workloads, shift work, occupational secondhand cigarette smoke exposure, and occupational heat exposure were 1.24 (95%CI = 1.03, 1.51), 1.33 (95%CI = 1.10, 1.62), 1.13 (95%CI = 1.01, 1.26), 1.11 (95%CI = 0.99, 1.24), respectively. The risk of CKD was found to be significantly associated with an increasing working conditions risk score. Individuals with a working conditions risk score of 4 had an 88.0% (95% CI = 1.05, 3.35) higher risk of developing CKD when compared to those with a working conditions risk score of 0.

Conclusions
Adverse working conditions, particularly when considered in combination, can significantly elevate the risk of chronic kidney disease (CKD). These results provide a reference for implementing measures to prevent CKD.
Early outcome of simplified total arch reconstruction under mild hypothermia (30–32 °C) with distal aortic perfusion
Authors: Zheng Hua-Jie , Liu Xin , He Ping , Li Jun , Zhang Xian-Pu , Cheng Yong-Bo , Lin De-Qing , Yan Chao-Jun , Yu San-Jiu , Cheng Wei 
Published: November 2023

Abstract
Objective
We designed a simplified total arch reconstruction (s-TAR) technique which could be performed under mild hypothermia (30–32 °C) with distal aortic perfusion. This study aimed to compare its efficacy of organ protection with the conventional total arch reconstruction (c-TAR).

Methods
We reviewed the clinical data of 195 patients who had ascending aortic aneurysm with extended aortic arch dilation and underwent simultaneous ascending aorta replacement and TAR procedure between January 2018 and December 2022 in our center. 105 received c-TAR under moderate hypothermia (25–28 °C) with circulatory arrest (c-TAR group); rest 90 received s-TAR under mild hypothermia (30–32 °C) with distal aortic perfusion (s-TAR group).

Results
The s-TAR group demonstrated shorter CPB time, cross-clamp time and lower body circulatory arrest time compared with the c-TAR group. The 30-day mortality was 2.9% for the c-TAR group and 1.1% for the s-TAR group (P = 0.043). The mean duration of mechanical ventilation was shorter in the s-TAR group. Paraplegia was observed in 4 of 105 patients (3.8%) in the c-TAR group, while no such events were observed in the s-TAR group. The incidence of temporary neurologic dysfunction was significantly higher in the c-TAR group. The incidence of permanent neurologic dysfunction also showed a tendency to be higher in the c-TAR group, without statistical significance. Furthermore, the incidence of reoperation for bleeding were significantly lower in the s-TAR group. The rate of postoperative hepatic dysfunction and all grades of AKI was remarkably lower in the s-TAR group. The 3-year survival rate was 95.6% in the s-TAR group and 91.4% in the c-TAR group.

Conclusions
s-TAR under mild hypothermia (30–32℃) with distal aortic perfusion is associated with lower mortality and morbidity, offering better neurological and visceral organ protection compared with c-TAR.
Investigating the quality of Iranian hospitals’ websites and their association to the Province’s share of medical tourism
Authors: Shaygani Fatemeh , Jahangiri Soodeh , Roozegar Mohammad Hassan Zahed , Kavosi Zahra , Marzaleh Milad Ahmadi 
Published: November 2023

Abstract
Background
Nowadays, virtual methods are among the most important and influential marketing instruments in various industries, such as medical tourism. This study aims to investigate the quality of Iranian hospitals’ web pages and their association with the province’s share of the medical tourism industry in Iran and the ownership type of hospitals.

Methods
In this analytical cross-sectional study, the quality of hospitals’ websites was investigated through a 36-item self-administered questionnaire which was validated, and its reliability was verified (Cronbach’s alpha = 74%.). The questionnaire was categorized into three sections: hospital services and facilities, hospital’s medical tourism-related services, and tourism information of the destination province. The census method was used for data collection. Data analysis was performed using the independent t-test and analysis of variance in SPSS software (version 25), and a P-value < 0.05 was considered statistically significant.

Results
A total of, 102 hospitals with an IPD (International Patients Department) were included in the study, and 21.6% did not have an English-language page and were excluded from the study. The mean total score was 47 ± 7.5, indicating low-quality content. Public hospitals had lower quality scores than semi-private and private hospitals. The total quality score, information about the hospital and its services, and the score of information about medical tourism-related services were associated with the province’s share of national medical tourism.

Conclusion
According to the obtained results and the possible role of website quality in increasing provinces’ medical tourism development, the IPD page on hospital websites should be revised and regularly updated to make them more informative for prospective medical tourists.
Extracellular vesicles derived from human ESC–MSCs target macrophage and promote anti-inflammation process, angiogenesis, and functional recovery in ACS-induced severe skeletal muscle injury
Authors: Jiang Xiangkang , Yang Jingyuan , Lin Yao , Liu Fei , Tao Jiawei , Zhang Wenbin , Xu Jiefeng , Zhang Mao 
Published: November 2023

Abstract
Background
Acute compartment syndrome (ACS) is one of the most common complications of musculoskeletal injury, leading to the necrosis and demise of skeletal muscle cells. Our previous study showed that embryonic stem cells-derived mesenchymal stem cells (ESC–MSCs) are novel therapeutics in ACS treatment. As extracellular vesicles (EVs) are rapidly gaining attention as cell-free therapeutics that have advantages over parental stem cells, the therapeutic potential and mechanisms of EVs from ESC–MSCs on ACS need to be explored.

Method
In the present study, we examined the protective effects in the experimental ACS rat model and investigated the role of macrophages in mediating these effects. Next, we used transcriptome sequencing to explore the mechanisms by which ESC–MSC-EVs regulate macrophage polarization. Furthermore, miRNA sequencing was performed on ESC–MSC-EVs to identify miRNA candidates associated with macrophage polarization.

Results
We found that intravenous administration of ESC–MSC-EVs, given at the time of fasciotomy, significantly promotes the anti-inflammation process, angiogenesis, and functional recovery of muscle in ACS. The beneficial effects were associated with ESC–MSC-EVs affecting macrophage polarization by delivering various miRNAs which regulate NF-κB, JAK/STAT, and PI3K/AKT pathways. Our data further illustrate that ESC–MSC-EVs mainly modulate macrophage polarization via the miR-21/PTEN, miR-320a/PTEN, miR-423/NLRP3, miR-100/mTOR, and miR-26a/TLR3 axes.

Conclusion
Together, our results demonstrated the beneficial effects of ESC–MSC-EVs in ACS, wherein the miRNAs present in ESC–MSC-EVs regulate the polarization of macrophages.
On the global existence and analyticity of the mild solution for the fractional Porous medium equation
Authors: Abidin Muhammad Zainul , Marwan Muhammad 
Published: November 2023

AbstractIn this research article we focus on the study of existence of global solution for a three-dimensional fractional Porous medium equation. The main objectives of studying the fractional porous medium equation in the corresponding critical function spaces are to show the existence of unique global mild solution under the condition of small initial data. Applying Fourier transform methods gives an equivalent integral equation of the model equation. The linear and nonlinear terms are then estimated in the corresponding Lei and Lin spaces. Further, the analyticity of solution to the fractional Porous medium equation is also obtained.
Ozonated water soaking improves the flower growth, antioxidant activity, and bioactive compound accumulation in Agastache rugosa
Authors: Lam Vu Phong , Loi Dao Nhan , Kim Sunwoo , Shin Juhyung , Park Jongseok 
Published: November 2023

AbstractOzonated water (OW) is now being recognized as an innovative and eco-friendly solution for managing plant growth while also promoting the production of bioactive compounds and essential plant metabolites. This study aimed to identify the most effective duration of OW treatment to promote plant growth and accumulation of antioxidant activity and bioactive compounds in Agastache rugosa in a plant factory. Whole plants were subjected to OW soaking treatments for varying durations (0, 1, 10, 20, 40, and 80 s) at a concentration of 1 µmol·mol−1, once per week, at 0, 1, 2, 3, and 4 weeks after transplantation. Five weeks after transplantation, plant samples were collected for the analysis of their plant growth parameters, photosynthetic pigments and parameters, total flavonoid, antioxidant activity, and bioactive compounds. Stem length was decreased in all OW treatments, while the number of flower branches, the flower fresh and dry weights were significantly increased under 20, 40, and 80 s OW treatments than in the control group. The net photosynthetic rate decreased significantly in 20, 40, and 80 s OW treatments compared with the control. Chlorophyll a concentration was the highest in the 20-s OW treatment, and chlorophyll b concentration was the highest in the 10-s OW treatment. Total flavonoid levels in plants increased significantly under 20-, 40-, and 80-s OW treatments, and their antioxidant activity (superoxide dismutase, catalase, and peroxidase) were significantly higher under 40- and 80-s OW treatments than in the control. Rosmarinic acid content increased significantly under the 10- and 40-s OW treatments, whereas the tilianin and acacetin contents increased significantly under the 20-, 40-, and 80-s OW treatments compared to those in the control. Our results suggest that soaking whole plants in OW for 20–80 s enhances the flower growth and bioactive compounds in A. rugosa for medicinal use.
Graphical Abstract
Artificial ecosystem optimized neural network controlled unified power quality conditioner for microgrid application
Authors: Ratnakaran Rajeev , Rajagopalan Gomathi Bhavani , Fathima Asma 
Published: November 2023

AbstractUnified power quality conditioner is chiefly employed to offer power quality improvement, especially in grid connected mode of operation in microgrid applications. This article proposes an artificial ecosystem optimized neural network for control of photovoltaic system and battery powered UPQC for microgrid applications. The intelligent routine implemented by the proposed controller helps tune parameters such as the error between load voltage references and measured load voltage signals so that the optimal performance of the system can be reached as its exploratory and exploitation capabilities are leveraged in controller design. A prototype of a three-phase system with a dually powered conditioner is tested and validated in MATLAB-Simulink environment in a variety of dynamic scenarios that are commonly present in a contemporary distribution network, such as grid voltage changes, grid inaccessibility, variation in photovoltaic power output, and nonlinear load. It is shown that the proposed controller, being aware of the instantaneous values of grid voltages, was able to adequately compensate in magnitude and phase under all dynamic scenarios to maintain the load voltage constant at the nominal value and sinusoidal. When the system switches automatically from grid-connected mode to islanded mode due to a grid fault, it was observed that the controller prioritizes delivering uninterrupted power to critical loads and enables fast discharge from the battery. The total harmonic distortion percentages of grid currents and load voltages are found to be within the limits as per IEEE-519 standards.
Fibroblast Growth Factor 23 Neutralizing Antibody Ameliorates Abnormal Renal Phosphate Handling in Sickle Cell Disease Mice
Authors: Xiao Liping , Clarke Kai , Hurley Marja M 
Published: November 2023

Abstract
We assessed the involvement of fibroblast growth factor 23 (FGF23) in phosphaturia in sickle cell disease (SCD) mice. Control and SCD mice were treated with FGF23 neutralizing antibody (FGF23Ab) for 24 hours. Serum ferritin was significantly increased in SCD mice and was significantly reduced in female but not male SCD mice by FGF23Ab. FGF23Ab significantly reduced increased erythropoietin in SCD kidneys. Serum intact FGF23 was significantly increased in SCD female mice and was markedly increased in SCD male mice; however, FGF23Ab significantly reduced serum intact FGF23 in both genotypes and sexes. Serum carboxy-terminal-fragment FGF23 (cFGF23) was significantly reduced in SCD IgG male mice and was markedly but not significantly reduced in SCD IgG female mice. FGF23Ab significantly increased cFGF23 in both sexes and genotypes. Serum 1,25-dihydroxyvitamin D3 was significantly increased in SCD IgG and was further significantly increased by FGF23Ab in both sexes and genotypes. Significantly increased blood urea nitrogen in SCD was not reduced by FGF23Ab. The urine phosphate (Pi)/creatinine ratio was significantly increased in SCD in both sexes and was significantly reduced by FGF23Ab. Increased SCD kidney damage marker kidney injury molecule 1 was rescued, but sclerotic glomeruli, increased macrophages, and lymphocytes were not rescued by short-term FGF23Ab. FGF23Ab significantly reduced increased phospho-fibroblast growth factor receptor 1, αKlotho, phosphorylated extracellular signal-regulated kinase, phosphorylated serum/glucocorticoid-regulated kinase 1, phosphorylated sodium-hydrogen exchanger regulatory factor-1, phosphorylated janus kinase 3, and phosphorylated transducer and activator of transcription-3 in SCD kidneys. The type II sodium Pi cotransporter (NPT2a) and sodium-dependent Pi transporter PiT-2 proteins were significantly reduced in SCD kidneys and were increased by FGF23Ab. We conclude that increased FGF23/FGF receptor 1/αKlotho signaling promotes Pi wasting in SCD by downregulating NPT2a and PIT2 via modulation of multiple signaling pathways that could be rescued by FGF23Ab.