bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgical treatment of infective endocarditis with massive vegetations in a patient with a ventricular septal defect and atopic dermatitis: a case report
Authors: Kitagata Yuta , Tsuneyoshi Hiroshi , Ito Kenta , Yamanaka Ken , Hirano Masahiro , Hirose Keiichi , Ikai Akio 
Published: July 2023

Abstract
Background
It is well known that congenital heart disease, especially a ventricular septal defect, is associated with a high risk of infective endocarditis. There are few reports of infective endocarditis with vegetations extending from the right ventricle into the pulmonary artery, resulting in pulmonary artery embolism. It is also well known that atopic dermatitis can be associated with systemic infections such as infective carditis. Here, we report a patient with a ventricular septal defect and infective endocarditis caused by atopic dermatitis who presented with massively infected vegetations occluding the pulmonary artery and extending from the right ventricle into the pulmonary artery and was treated surgically.

Case presentation
A 26-year-old woman with a ventricular septal defect and a history of atopic dermatitis was diagnosed with infective endocarditis with mobile vegetations in the right ventricle, pulmonary artery occlusion caused by massive vegetations, and pulmonary abscesses. Because the obstructing vegetations did not regress with antibiotics, they were removed surgically and the ventricular septal defect was closed. A new causative organism was identified in the vegetation, enabling optimization of the antibiotic regimen. Appropriate antibiotics were administered for 2 months after surgery, resulting in complete resolution of the lung abscesses.

Conclusion
Aggressive surgical intervention can be effective in patients with massive vegetations obstructing their pulmonary arteries.
Effect of update rule transition triggered by Q-learning algorithm in evolutionary prisoner's dilemma game involving extortion
Authors: Wang Jianxia , Hao Mengqi , Ma Jinlong , Pang Huawei , Cai Liangliang 
Published: July 2023

Abstract
Most studies have shown that the heterogeneity of update rules has an important impact on evolutionary game dynamics. In the meanwhile, Q-learning algorithm has gained attention and extensive study in evolutionary games. Therefore, a mixed stochastic evolutionary game dynamic model involving extortion strategy is constructed by combining imitation and aspiration-driven updating rules. During the evolution of the model, individuals will use the Q-learning algorithm which is a typical self-reinforcement learning algorithm to determine which update rule to adopt. Herein, through numerical simulation analyses, it is found that the mixed stochastic evolutionary game dynamic model affected by the Q-learning algorithm ensures the survival of cooperators in the grid network. Moreover, the cooperators cannot form a cooperation cluster in the grid network but will form a chessboard-like distribution with extortioners to protect cooperators from the invasion of defectors. In addition, a series of results show that, before the evolution turns into steady state, our model increases the number of nodes utilizing the average aspiration-driven update rule, thereby promoting the emergence of chessboard-like distribution. Overall, our study may provide some interesting insights into the development of cooperative behavior in the real world.
DI/cle, a Measure Consisting of Insulin Sensitivity, Secretion, and Clearance, Captures Diabetic States
Authors: Sugimoto Hikaru , Hironaka Ken-ichi , Yamada Tomoko , Sakaguchi Kazuhiko , Ogawa Wataru , Kuroda Shinya 
Published: July 2023

Abstract

Context
Insulin clearance is implicated in regulation of glucose homeostasis independently of insulin sensitivity and insulin secretion.

Objective
To understand the relation between blood glucose and insulin sensitivity, secretion, and clearance.

Methods
We performed a hyperglycemic clamp, a hyperinsulinemic-euglycemic clamp, and an oral glucose tolerance test (OGTT) in 47, 16, and 49 subjects with normal glucose tolerance (NGT), impaired glucose tolerance (IGT), and type 2 diabetes mellitus (T2DM), respectively. Mathematical analyses were retrospectively performed on this dataset.

Results
The disposition index (DI), defined as the product of insulin sensitivity and secretion, showed a weak correlation with blood glucose levels, especially in IGT (r = 0.04; 95% CI, −0.63 to 0.44). However, an equation relating DI, insulin clearance, and blood glucose levels was well conserved regardless of the extent of glucose intolerance. As a measure of the effect of insulin, we developed an index, designated disposition index/clearance, (DI/cle) that is based on this equation and corresponds to DI divided by the square of insulin clearance. DI/cle was not impaired in IGT compared with NGT, possibly as a result of a decrease in insulin clearance in response to a reduction in DI, whereas it was impaired in T2DM relative to IGT. Moreover, DI/cle estimated from a hyperinsulinemic-euglycemic clamp, OGTT, or a fasting blood test were significantly correlated with that estimated from 2 clamp tests (r = 0.52; 95% CI, 0.37 to 0.64, r = 0.43; 95% CI, 0.24 to 0.58, r = 0.54; 95% CI, 0.38 to 0.68, respectively).

Conclusion
DI/cle can serve as a new indicator for the trajectory of changes in glucose tolerance.
A cross-sectional study on assessment of spiritual health and its associated factors among undergraduate students in a medical college in Mangalore, Karnataka
Authors: Raghuveer Pracheth , Bhatia Ravjot , Motappa Rohith , Sachith Malavika 
Published: July 2023

Background: Spirituality and spiritual health are an integral component of an individual’s health and wellbeing. Among medical undergraduates and professionals, spiritual health has positive effects on the individual by decreasing burnout, psychological distress, and rates of substance abuse. Spiritual health is also correlated with increased satisfaction and meaning in life. Spiritual health also influences future patient care, builds patient- provider communication channels, and improves patient outcomes. Methods: A cross-sectional study was conducted to assess the spiritual health levels of medical undergraduates in a medical college, in Karnataka, India, and to identify the factors associated with it. Using a pre-designed, validated semi-structed questionnaire, 600 medical undergraduates were approached and provided the forms. Spiritual health was assessed across the three domains of self-development, self-actualization, and self-realization using the Spiritual Health Assessment Scale (SHAS). Results: A total of 436 medical undergraduates participated. Majority (67.7%) of participants were girls. Most (62%) were found to have fair spiritual health with a large portion of the rest (36%) having good spiritual health and 2% had poor spiritual health. A significant association was found between spiritual health and the father’s (p=0.005) and mother’s (p=0.012) education levels. Spiritual health was also found to be associated with living in a nuclear family (p=0.04). Conclusions: Majority of the medical undergraduates had fair spiritual health. Parents' education levels and nuclear family were significantly associated with spiritual health.
Perceptions and experiences of intravenous iron treatment for anaemia in pregnancy in Malawi: a formative qualitative study
Authors: Manda-Taylor Lucinda , Kufankomwe Macdonald , Chatha Gertrude , Chipeta Effie , Mamani-Mategula Elisabeth , Mwangi Martin N. , Kelaher Magaret , Prang Khic-Houy , Ataíde Ricardo , Pasricha Sant-Rayn , Phiri Kamija Samuel 
Published: July 2023

Background: The study objective was to explore opinions, identify experiences, and describe perspectives on the acceptability of intravenous (IV) iron to treat anaemia in pregnancy and identify potential barriers and facilitators of introducing IV iron in the Malawian healthcare system. Methods: We conducted 15 in-depth interviews and two focus group discussions with pregnant women, and seven in-depth interviews with health workers at a community-based health centre in Blantyre and a tertiary hospital in Zomba. Results: Most women who used IV iron treatment during the second trimester of pregnancy reported feeling better and stronger after receiving the intervention. Women perceived that IV iron treatment worked faster and increased their haemoglobin count. However, cultural beliefs that IV iron treatment will cause miscarriage and the perception that study procedures involved Satanism and vampirism practices were barriers to acceptability. Health workers found IV iron treatment easy to administer because it is a single-dose treatment, simultaneously reducing the burden for pregnant women taking daily oral iron tablets. However, health workers expressed concerns about the costs and the need to train health workers before the large-scale implementation and integration of IV iron treatment into Malawi’s routine care. Conclusions: Despite the perceived concerns and challenges experienced in participating in the first IV iron infusion trial in Malawi, participants’ reflections suggest that IV iron infusion is acceptable for treating iron-deficiency anaemia in pregnancy. Participant advocate groups can offer a peer-to-peer education approach to sensitize and engage community members on the benefits of treatment and dispel concerns when the country contemplates integrating IV iron infusion for treating anaemia in pregnancy in Malawi.
Patterns and determinants of breastfeeding and complementary feeding practices over the first year of life in a rural Gambian population
Authors: Washabaugh Jennifer R. , Moore Sophie E. , Doel Andrew M. , Drammeh Saikou , Ong Ken K. , Dunger David B. , Prentice Andrew M. , Bernstein Robin M. 
Published: July 2023

Background: Although breastfeeding is common in The Gambia, high rates of undernutrition in children under five highlight the importance of understanding drivers of particular feeding patterns in this environment, especially early introduction of non-breast milk foods (NBMFs). The country’s marked seasonality, which is associated with annual food insecurity and heavy maternal workload, may influence breastfeeding patterns; however, longitudinal assessments of infant diet in relationship to such factors are limited. We aimed to characterize infant breastfeeding patterns and timing of introduction of local complementary foods in a rural Gambian population across the first twelve months of life. Potential environmental and sociodemographic predictors of exclusive breastfeeding (EBF) duration were explored in order to identify factors that may influence infant feeding decisions in this population. Methods: Data from dietary questionnaires (administered every ten days until 12 months of age) collected as a part of the Hormonal and Epigenetic Regulators of Growth study (2013-2018) were used to calculate EBF duration in a subsample of 194 mother-infant pairs. Socioeconomic questionnaires and Principal Component Analysis were used to calculate household sociodemographic position (SEP). Multiple linear regression analyses were used to investigate potential predictors of EBF duration, including seasonality, SEP, and maternal and infant factors. Results: Mean age at introduction of food or liquid other than maternal milk was five months (±1.5). At twelve months, 98.7% of infants continue to receive some maternal milk. Being born in May significantly predicted shorter EBF duration by -1.68 months (95% CIs: -2.52, -0.84mo; P<.0001). SEP, maternal parity, and infant sex were non-significant predictors of EBF duration. Conclusions: Maternal milk is a vital component of infant diet across the first twelve months of life in this population. Earlier introduction of NBMFs coincides with the annual period where maternal agricultural workload intensifies in this region, though additional investigation is warranted.
Is mpox an STI? The societal aspects and healthcare implications of a key question
Authors: Garcia Iglesias Jaime , Nagington Maurice , Pickersgill Martyn , Brady Michael , Dewsnap Claire , Highleyman Liz , Membrillo de Novales Francisco Javier , Nutland Will , Thrasher Steven , Umar Eric , Muchamore Ian , Webb Jamie 
Published: July 2023

This letter explores the societal aspects and healthcare implications that underlie thinking about mpox (formerly known was monkeypox), in the 2022 outbreak, as a sexually transmitted infection (STI). The authors examine what underlies this question, exploring what is an STI, what is sex, and what is the role of stigma in sexual health promotion. The authors argue that, in this specific outbreak, mpox is an STI among men who have sex with men (MSM). The authors highlight the need of critically thinking about how to communicate effectively, the role of homophobia and other inequalities, and the importance of the social sciences.
QUALITY CRITERION OF SOCIO-ECONOMIC SYSTEMS AND ITS IMPACT ON THE SUSTAINABILITY OF THE SYSTEM
Authors: Smetanina T. 
Published: July 2023

Quality is a property of goods and services that determines the sustainability of systems. Synergy and the bifurcation point are stages in the evolutionary development of society. Satisfaction with quality is a variant of system stability. There is a dependence of the system quality criterion on its size. The quality of the socio-economic system is manifested through the result of its activities — the goods and services it produces. The current stage of development requires socio-economic systems to have an organic structure. Informatization of society leads to the emergence of new mechanisms for promoting goods and services in the modern world. One of these tools is streaming. Due to it, the formation of an opinion on the quality criteria by most of the society is formed online. Stakeholders allow you to assess the stability of the system. The collective unconscious makes it possible to bring the socio-economic system to a new level through bifurcation points. Sustainability and quality are concepts that underlie the modern development of the collective unconscious. Experts are the key stakeholder in assessing the quality criterion.
The Price of Safety: The Evolution of Municipal Bond Insurance Value
Authors: Cornaggia Kimberly , Hund John , Nguyen Giang 
Published: July 2023

Economic theory predicts that bond insurance lowers issuers’ financing costs by resolving asymmetric information and mitigating credit risk. With comprehensive data over the last 36 years, we find increasingly diminished empirical support for these models. The value of insurance in resolving asymmetric information beyond that resolved by credit ratings and other observable bond characteristics is economically minimal. The average gross value of insurance ranges from 4 to 14 bps when bond insurers offer Aaa-rated coverage. However, this gross value becomes insignificant after 2008 when Aaa-rated insurance no longer exists. Evidence suggests that the lack of insurance benefit in the postcrisis period is attributable to the deteriorated creditworthiness of insurance companies. Examining noninterest saving explanations for the continued use of insurance in the no-Aaa insurance market, we find evidence that issuers purchase insurance out of habit (with insurance value most diminished for habitual purchasers with low governance quality) and for the convenience it affords in default, but no evidence that insurance improves secondary market liquidity. This paper was accepted by Gustavo Manso, finance. Supplemental Material: The data files and online appendix are available at https://doi.org/10.1287/mnsc.2023.4813 .
Equilibrium Traffic Dynamics with Mixed Autonomous and Human-Driven Vehicles and Novel Traffic Management Policies: The Effects of Value-of-Time Compensation and Random Road Capacity
Authors: Wang Hua , Wang Jing , Chen Shukai , Meng Qiang 
Published: July 2023

Emerging autonomous vehicles (AVs) are expected to bring about a revolution in both the automotive industry and transportation systems. Introducing AVs into the existing mobility system with human-driven vehicles (HVs) yields mixed traffic with the following new features: in-vehicle compensation on value of time for AV users, distinct road capacities for pure AV and HV flows, and stochastic road capacity for the inseparable AV-HV traffic pattern. In this paper, we aim to investigate equilibrium traffic dynamics for the morning commuting problem where AVs and HVs coexist in a transportation corridor by considering these new features, and also explore several novel mixed AV-HV traffic management strategies. The AV-HV traffic pattern could be either separable (i.e., pure AV flow and pure HV flow depart from home in different periods) or inseparable, depending on the user profile condition. In addition to deriving departure time equilibriums for scenarios with separable traffic flows, significant effort is put into the scenario with an inseparable AV-HV traffic pattern, where stochastic road capacity is taken into account. Based on these equilibrium traffic analyses, we propose and explore some new traffic management strategies, including AV certificate of entitlement management scheme for scenarios with separable traffic flows and departure-period management (DPM) scheme and lane management policies for the scenario with an inseparable AV-HV traffic pattern. Eligibilities for applying these strategies are analytically derived and extensively discussed, and numerical experiments are conducted to demonstrate our theoretical findings and reveal the underlying impacts of road capacity randomness. Some lessons learned from the numerical experiments are (i) overlooking the impact of road capacity uncertainty will lead to an overestimation of system performance and even yield biased policymaking, (ii) the full dedicated-lane policy is the preferred option for the medium-level AV situation and partial dedicated-lane policies are more attractive choices for the early AV era or a market with a high AV share, and (iii) the DPM scheme could be a better substitute for partially dedicated-lane policies. Funding: This study was supported by the Ministry of Education of Singapore [Project T2EP40222-0002 under the MOE Tier 2 Grant] and the National Natural Science Foundation Council of China [Grant 72001133] and the Excellent Young Scientists Fund Program (Overseas). Supplemental Material: The online appendix is available at https://doi.org/10.1287/trsc.2021.0469 .
Effective Bio-mediated Nanoparticles for Bioremediation of Toxic Metal Ions from Wastewater – A Review
Authors: V. Yamini  , V. Devi Rajeswari  
Published: July 2023

Water tainted with colours, heavy metal ions and biological toxins, contributes to eutrophication, which in turn contributes to a variety of fatal diseases in humans and other animals, owing to the fact that water purification equipment and methods are not cheap. Due to this, there is a pressing need for economically viable wastewater treatment components. Eco-friendly nanomaterials, highly efficient and selective, renewable, earth-abundant and stable, have emerged as a major priority, overcoming a number of challenges and restrictions. Currently, the combination of nanomaterials and biomolecules from plants, including polyphenols, amines and other components, as well as intracellular and extracellular enzymes found in microbes, has become more significant in bioremediation. Biogenic nanoparticles are favoured because they are easy to expand for large-scale biosynthesis, maintain stability for an extended period, consume less time, are eco-friendly, and do not produce any detrimental by-products. The processes of nano-bioremediation and wastewater treatment are discussed in detail in this review. It primarily focuses on synthesizing, characterizing and applying bio-mediated nanoparticles, which actively remove heavy metal ions from wastewater, without adversely affecting individuals or other living things, especially in aquatic environments.
Idegennyelv-tanítással foglalkozó szervezetek a felsőoktatásban
Authors: Einhorn Ágnes 
Published: July 2023

This study explores the situation of foreign language teaching in higher education based on managerial interviews. Organizational units offering foreign language courses in different higher education institutions operate in different organizational frameworks with different degree of independence and acceptance. The goals and content of language teaching is substantially defined by the language skills of the students entering the higher education institution. Most of the institutions primarily focus on supporting students in acquiring the language exams necessary for obtaining a diploma. All institutions offer language teaching for specific purposes, however their interpretation of it widely differs. Several organizational units teach subclasses which develop professional communication in foreign languages. The opportunities of students to access foreign language learning are good and the institutions aim to achieve multilingualism.
In addition to language teaching, organisations carry out several activities: many of them operate language schools, provide language certification, professional translator trainings, and all organisations conduct translation and proofreading within the university. These activities increase both the prestige and the economic independence of the organisations, but at the same time they usually absorb many resources. In terms of scientific work there are large differences. Almost half of the organisations don’t have or have very few lecturers/researchers and the organisations have different approaches to this. The organisations which identify themselves more as language schools tend to be more accepting with this, but for the improvement of the up-to-date professional communication, the research-based developments are necessary.
Organisations dealing with foreign language teaching try to serve the needs of universities, as a result, development and professional cooperation within the universities are important.
Demographic Transition and Population Development in Belarus: Theory and Reality
Authors: Jin Xin 
Published: July 2023

Abstract
The population transition theory provides a macro-level overview where one can see the connection between social and economic development and the progression of population transition. This study conducts a systematic analysis of Belarus’ social development and immigration trends over the last 30 years to investigate the regularities and generalities in its population development. Research has shown that during this period of demographic transition Belarus has characteristics that are different from the demographic transition theory. Belarus’ demographic development is characterized by negative population growth, an imbalance in the sex ratio and an aging demographic structure, all of which are inherent to the period of demographic transition. The demographic transition of Belarus is characterized by the following trends: greater difficulty in changing fertility attitudes, a lack of a stable external environment for population development, the absence of large-scale population outflow, stability with respect to the composition of the main ethnic groups, and the susceptibility of the population to chronic diseases. The solution requires a scientifically-integrated programme for the sustainable development of the population in a stable and orderly socio-economic environment. Future research should focus on the problems of migration within the region and the impact of ethnic, religious and cultural spheres on demographic development.