bluuebunny/crossref_metadata_2025_split huggingface dataset:
Piercing the veil on the functioning and effectiveness of district health system governance structures: Perspectives from a South African province
Authors: Tshabalala Khanyisile , Rispel Laetitia C. 
Published: July 2023

Abstract
Background

Leadership and governance are critical for achieving universal health coverage (UHC). In South Africa, aspirations for UHC are expressed through the National Health Insurance policy, which underscores the importance of primary health care, delivered through the district health system (DHS). In light of this, the aim of this study was to determine the existence of legislated District Health Councils (DHCs) in Gauteng Province, and the perceptions of members on the functioning and effectiveness of these structures.

Methods

The study was done in all five districts in Gauteng. The population of interest was members of existing governance structures. Members completed an electronic-self- administered questionnaire (SAQ), which collected perceptions on the functioning and effectiveness of the governance structures, using a seven-point Likert scale. STATA® 13 was used to analyze the survey data. In-depth interviews with the chairpersons of the DHCs and the District Health Council Technical Committees complemented the survey. Interviews were analyzed using thematic content analysis.

Results

Only three districts had constituted DHCs. The survey response rate was 73%. The mean score for perceived functioning of the structures was 4.5 (SD=0.7) and 4.8. (SD=0.7) for perceived effectiveness. The interviews found that a collaborative district health development approach facilitated governance. In contrast, fraught inter-governmental relations fueled by the complexity of governing across two spheres of government, exacerbated by political differences, and contestations over limited resources constrained DHS governance. Both the survey and interviews identified gaps in accountability to communities.

Conclusion

In light of South Africa’s move toward NHI, strengthening the governance of the DHS is imperative. The governance gaps identified need to be addressed to ensure the successful implementation of UHC reforms.
Adipocyte p53 coordinates the response to cyclic fasting by regulating adipose tissue immune cell landscape
Authors: Reinisch Isabel , Michenthaler Helene , Moyschewitz Elisabeth , Krstic Jelena , Galhuber Markus , Wang Tongtong , Vujic Nemanja , Amor Melina , Chiozzi Riccardo Zenezini , Wabitsch Martin , Kolb Dagmar , Georgiadi Anastasia , Glawitsch Lisa , Heitzer Ellen , Schulz Tim J. , Schupp Michael , Sun Wenfei , Dong Hua , Ghosh Adhideb , Hoffmann Anne , Kratky Dagmar , J.R. Albert , Sulaj Alba , Blüher Matthias , Herzig Stephan , Wolfrum Christian , Prokesch Andreas 
Published: July 2023

Abstract
In obesity, sustained adipose tissue (AT) inflammation constitutes a cellular memory that limits the effectiveness of weight loss interventions. Yet, the impact of fasting regimens on the regulation of AT immune infiltration is still elusive. Here, we show that cyclic intermittent fasting (IF) exacerbates the lipid-associated macrophage (LAM) inflammatory phenotype of visceral AT in obese mice. Importantly, this increase in LAM abundance is strongly p53 dependent and, at least in part, mediated by p53-driven adipocyte apoptosis. Adipocyte-specific deletion of p53 prevents LAM accumulation in AT during IF and increases the catabolic state of adipocytes, ameliorates metabolic flexibility, and insulin sensitivity. Finally, in cohorts of obese/diabetic patients, we describe a p53 polymorphism that links to long-term efficacy of a fasting-mimicking diet and that the expression of p53 and TREM2 in AT negatively correlates with maintaining weight loss after bariatric surgery. Overall, our results demonstrate that p53 signaling in adipocytes dictates LAM accumulation in AT under IF and that adipocyte p53 modulates fasting effectiveness in mice and humans.
Benralizumab treatment resulted in remission of conventional therapy-resistant eosinophilic esophagitis: a case report
Authors: Ishii Azusa , Shibata Tomofumi , Tsunoda Yohei , Kayukawa Takafumi , Kobayashi Masahiro , Orinaka Masami , Miyamatsu Shoko , Ryuge Yoshio , Asano Shuichi , Tanaka Ichidai Tanaka. Ichidai 
Published: July 2023

Abstract
Background
Interleukin-5 (IL-5) has recently been shown to play a crucial role in eosinophil-mediated diseases, implying that an IL-5 receptor alpha chain (IL-5Rα) antibody (benralizumab) can be effective against eosinophilic esophagitis (EoE). Here, we present a case in which benralizumab significantly improved the symptoms and signs of an elderly Asian woman with EoE who had become resistant to existing treatments.
Case presentation:
A 73-year-old woman with an 8-year history of asthma and a 7-year history of dysphagia presented to our hospital with worsening dysphagia and other digestive symptoms. Blood biochemical findings revealed an increase in the eosinophil fraction of white blood cells (42.2%), and a conventional chest computed tomography scan revealed esophageal wall thickening. An upper gastrointestinal endoscopy revealed mucosal edema as well as multiple esophageal rings, and esophageal biopsy specimens showed an eosinophilic infiltrate of more than 15 cells/ high power field (HPF). Based on these findings, she was diagnosed as EoE complicated by severe asthma. We firstly administrated 20 mg/day of prednisolone, rabeprazole sodium and budesonide oral therapy; however, they were ineffective and her dysphagia worsened over time. Then, benralizumab treatment in combination with these drugs was started. Her dysphagia completely disappeared 2 weeks after starting benralizumab, and an upper endoscopy showed that the clinical findings had completely disappeared. Benralizumab was then given to her for 41 months, and her symptoms remained in remission. In addition, she had no EoE recurrence for more than 6 months after discontinuing benralizumab.
Conclusions
Benralizumab in combination with other multiple drugs significantly improved the symptoms and examination findings of an elderly patients with EoE. Furthermore, she experienced no recurrence even after discontinuing benralizumab withdrawal, suggesting that benralizumab is an appropriate therapeutic option for EoE.
Traditional Complementary and Alternative Medicine(TCAM) Use Among PLHIV on Antiretroviral Medication.
Authors: Denu Mawulorm KI , Buadu Maame Araba E. , Adrah Frederick , Normeshie Cornelius A. , Berko Kofi Poku 
Published: July 2023

Abstract
Background: Traditional complementary and alternative medicine (TCAM) are products and practices that differ from conventional allopathic medicine. There continues to be an increase in the use of these methods of treatment in developed and developing countries worldwide. This often owes to the perceived ability of these treatment methods to cure chronic medical conditions like HIV. However, TCAM use may be associated with reduced compliance with antiretroviral medications, which leads to poor viral load suppression and increased risk for opportunistic infections. The concomitant use of antiretroviral drugs and TCAM practice may be influenced by some sociodemographic and health-related factors.
Objective: To determine the prevalence of TCAM use and examine the sociodemographic and health-related factors associated with its use among PLHIV on antiretroviral medications at the Infectious Disease unit of Korle-Bu Teaching Hospital in Ghana.
Methods: A cross-sectional study was conducted among attendants at an adult HIV clinic. 420 study participants were selected by systematic sampling. Data related to TCAM use, sociodemographic and health-related factors were collected using a standardized questionnaire and patient chart review. Multivariate logistic regression model was used to determine the association between TCAM use, sociodemographic and health-related factors.
Results: Majority of participants were female (76.2%) and had been diagnosed with HIV for ≥ 5 years (77.4%). The prevalence of TCAM use among PLHIV was 25.2%. No sociodemographic or health-related factor was significantly associated with TCAM use.
Conclusion: TCAM use was high among PLHIV. No sociodemographic or health-related factor was found to be associated with TCAM use. Further studies employing a qualitative approach using key informant interviews and focused group discussions are needed to explore reasons for its use. Care providers and policy-makers should look beyond sociodemographic and health-related factors in addressing TCAM use among PLHIV.
Vitamin B12 and folate deficiencies, elevated homocysteine and their roles in the biochemical basis of neuropsychiatric diseases in children and adolescents: Case series, review and recommendations
Authors: Esnafoglu Erman 
Published: July 2023

Abstract

Vitamin B12 and folate deficiencies can be frequently seen in children and adolescents and may manifest with neuropsychiatric symptoms. Vitamin B12 and folate deficiencies and the associated increase in homocysteine are related to one-carbon metabolism (OCM) and may play a role in the pathogenesis of childhood and adolescent psychiatric disorders. Here, twelve adolescent cases with vitamin B12 and folate deficiencies and homocysteine increase, diagnosed with major depressive disorder, generalized anxiety disorder and obsessive compulsive disorder are presented. The possible biochemical roles of OCM in the pathogenesis of psychiatric disorders at these ages were explained. In addition, the diagnosis and treatment methods for vitamin B12 and folate deficiencies are summarized for clinicians.
Utilization of Health Service and Associated Factors Among Women in Child-bearing Age in Selected Internaly Displaced Persons Camps, Hargeisa – Somaliland
Authors: Nuh Abdulkadir Mohamed , Asker Isahaq Mohamoud 
Published: July 2023

Abstract
Introduction: The utilization of health care services is an important public health problem in developing countries for the accomplishment of global health coverage. Access to and use services in health care are significant to the development of health outcomes in many African countries. In most sub-Saharan countries, the utilization of health care services is very low. Reproductive health problems are the leading cause of morbidity and mortality among women of childbearing age in developing countries. Although global strategies have been planned to improve access to high-quality health services, there are still obstacles to attain. Women of child-bearing age usually need more health services than other age groups, and they are more likely to experience complications during pregnancy and childbirth, which might result in increased morbidity and mortality.
Objective: To assess the utilization of health services and associated factors among women of childbearing age in internal displaced person (IDP) camps in Hargeisa, Somaliland.
Methods: A community-based cross-sectional study design was employed among women of childbearing age in the selected IDP camps in Hargeisa. Out of eight IDPs in Hargeisa, three were selected by the lottery method. A total of 402 women of childbearing age were selected using a simple random sampling method. Data were collected using an interviewer-administered structured questionnaire. The data were cleaned, coded and entered into SPSS version 23 for further analysis. Bivariate and multivariable logistic regression was used to analyse the data.
Results: The overall health service utilization among women of childbearing age in Hargeisa IDPs was found to be 61.5%.The age groups of 23 – 27 years old and 33 – 37 years old were 5 times and 3 times more likely to utilize health services, respectively [AOR 5.2 (Cl: 2.1 – 13.0)] and [AOR 2.7 (Cl: 1.2 – 5.9)]. Married women had higher odds of utilizing health services than single women. (AOR: 0.23 (0.07 – 0.73).
Conclusion: The overall health service utilization among women in childbearing in IDPs in Hargeisa was found to be unsatisfactory. Respondents’ age group, marital status,and educational level were found to be significantly associated with health service utilization among mothers in childbearing in IDPs in Hargeisa Somaliland.
Fear of COVID-19 among caregivers of older people in southern Portugal: A cross-sectional study
Authors: Mendes Felismina Rosa , Sim-Sim Margarida , Gemito Maria Laurência , Barros Maria da Luz , Serra Isaura da Conceição , Caldeira Ana Teresa 
Published: July 2023

Abstract
The COVID-19 pandemic infected many institutionalized older people in its first and second waves. Workers at homes for older people, were in the first line of contact. In Portugal, the level of pandemic fear among these workers is unknown, as are its predictive factors. This study aimed to identify predictors of fear of COVID-19 in workers caring for institutionalized older people in homes. It's a quantitative, cross-sectional study using multiple linear regression applied in a population of 652 formal caregivers located in 14 municipalities at southern Portugal. The questionnaire contained questions on sociodemographic variables, occurrence of infection, occurrence of symptoms similar, to COVID-19, exposure to infection in the environment, occurrence of chronic disease, smoking habits, and knowledge about COVID-19. The criterion variable was the fear of COVID-19, an interval variable. The values of the non-standardized regression coefficients showed that the fear of COVID-19 infection increased when the educational level was lower (b=-2.599), and this variable was the most important predictor. For each additional symptom similar, to COVID-19 infection, a worker had in the last two weeks, fear of the disease increased 2.12-fold. Workers vaccinated against influenza had a 1.16-fold greater fear of COVID-19 infection.
Association between falls and musculoskeletal pain among middle-aged and older adults: Findings from the China health and retirement longitudinal study
Authors: Mei Fengyao , Li Jiaojiao , Xing Dan , Lin Jianhao , Dong Shengjie 
Published: July 2023

Abstract

Background
Falls are common particularly in elderly people and usually associated with poor prognosis or healing outcomes. Musculoskeletal pain is considered an independent risk factor for falls, by being associated with joint pathology and instability, neuromuscular effects of pain, and changes in cognitive and psychological function. Understanding the relationship between musculoskeletal pain and the risk of falls will help with falls prevention among older adults.
Methods
A nationally representative sample for the Chinese population was derived from the China Health and Retirement Longitudinal Study (CHARLS). Information on the patients’ demographic characteristics, socioeconomic status, other health-related behavior, as well as history on musculoskeletal pain and falls were obtained. Univariate and multivariate analysis were used to explore the effect factors of falls, including individual factors and musculoskeletal pain factors. P for trend test was performed to examine the trend of each continuous variable.
Results
Among 18813 respondents, 3697 have experienced a fall. The risk of falls was lower for respondents who were male, lived in urban areas, had higher education level, and were married (P < 0.05). The risk of falls increased with higher age (P < 0.05), as well as for respondents who were still drinking alcohol or who used to drink alcohol at the time of the survey (P < 0.05). The risk of falls also increased for respondents who had suffered from pain in the fingers, waist, legs and knees (P < 0.05), as well as for those who had a higher number of painful sites (P < 0.05).
Conclusion
Factors including gender, age, education level and health-related behavior may affect the risk of falls. Musculoskeletal pain is one of the factors that could be targeted to help prevent falls in older people.
Examining Airflow Velocity Distribution Measurement in Large Ducts: Introducing an Innovative Automatic Positioning-Based Concept for Multipoint Single Probe Hot-Wire Anemometry
Authors: ADANKPO Miguel Thomas Yaovi , Xiang Zhong , Qian Miao 
Published: July 2023

Abstract
This paper presents a case study on the application of an automated multipoint single probe hot-wire anemometry in the context of a stenter machine, which is used for textile processing. The study focuses on capturing the airflow velocity distribution within the stenter machine ducts to ensure consistent and uniform drying of fabrics. The research explores the effectiveness and practicality of the automated multipoint single probe hot-wire anemometry in capturing airflow velocity profiles within the ducts. The article discusses various traditional techniques used for airflow velocity measurement, such as Pitot Tube Traverse, Hot-Wire Anemometry, Ultrasonic Anemometry, Laser Doppler Anemometry, Particle Image Velocimetry, Thermal Imaging, Constant Temperature Anemometry, and Volumetric Velocimetry. However, recent advancements in automation and sensing technologies have paved the way for more sophisticated and efficient measurement methods. The case study introduces the concept of automated multipoint single probe hot-wire anemometry and its potential in steady-state conditions. The methodology includes a detailed presentation of the experimental setup, including device configuration and calibration methods. The obtained results are presented and discussed, followed by an evaluation of the measurement uncertainty associated with airflow and mass flow measurements. The experimental setup utilizes a combination of hardware components controlled by an Arduino microcontroller for precise positioning of the hot-wire anemometer probe. The study also discusses the characteristics of the hot-wire anemometer used in the experiment. The data acquisition system involves an Arduino Mega 2560 microcontroller board and customized code for precise positioning of the anemometer probe at multiple locations. The acquired data is recorded using PLX-DAQ, an Excel add-in, and further analyzed using OriginPro software. The article emphasizes the importance of sensor calibration and discusses the calibration by comparison method used in the experiment. The findings of the case study contribute to the broader understanding of airflow dynamics in industrial duct systems and highlight the potential benefits of using automated multipoint single probe hot-wire anemometry for enhancing process efficiency in textile processing.
Enhancing Eye Diseases Diagnosis through Transfer Learning: Study of Deep Convolutional Neural Networks for Accurate Classification of Glaucoma and Diabetic Retinopathy from Healthy Eye Using Fundus Images
Authors: Tajerian Amin , Keshtkar Mohsen , Almasi-Hashiani Amir , Tajerian Mohammad 
Published: July 2023

Abstract

Fundoscopy, or ophthalmoscopy, is a medical procedure used to examine the inner structures of the eye. Fundoscopic images are valuable resources for developing artificial intelligence systems to aid in the diagnosis and management of eye conditions. This paper focuses on enhancing the robustness and generalizability of machine learning-based retinal image classification systems. A diverse and large-scale dataset of approximately 100,000 retinal images was utilized, along with a complex machine learning model. The study employed multiple datasets, including Kim's Eye Hospital, Drishti-GS1, DR HAGIS, APTOS 2019 Blindness Detection, ACRIMA, and Diabetic Retinopathy Detection 2015, to evaluate the performance of the model. Preprocessing techniques, including contrast enhancement and image resizing, were applied to prepare the dataset. The DenseNet121 model, which addresses the vanishing gradient problem, was used for transfer learning. The model created in this study can classify fundus images to three classes of Diabetic retinopathy, Glaucoma, and healthy eye with an average accuracy of 84.78%, a precision of 84.75%, and a recall of 84.76%. Although by training a model on a mild DR omitted dataset, these metrics increased significantly to an accuracy of 97.97%, a precision of 97.97%, and a recall of 97.96%. Results demonstrated that excluding mild diabetic retinopathy cases from the dataset significantly improved the model's performance.
A Deep-Learning Approach for Identifying Prospective Chemical Hazards
Authors: Habiballah Sohaib , Heath Lenwood S. , Reisfeld Brad 
Published: July 2023

Abstract
With the aim of helping to set safe exposure limits for the general population, various techniques have been implemented to conduct risk assessments for chemicals and other environmental stressors; however, none of these tools facilitate the identification of completely new chemicals that are likely hazardous and elicit an adverse biological effect. Here, we detail a novel in silico, deep-learning framework that is designed to systematically generate structures for new chemical compounds that are predicted to be chemical hazards. To assess the utility of the framework, we applied the tool to four endpoints related to environmental toxicants and their impacts on human and animal health: (i) toxicity to honeybees, (ii) immunotoxicity, (iii) endocrine disruption via ER-α antagonism, and (iv) mutagenicity. In addition, we characterized the predicted potency of these compounds and examined their structural relationship to existing chemicals of concern. As part of the array of emerging new approach methodologies (NAMs), we anticipate that such a framework will be a significant asset to risk assessors and other environmental scientists when planning and forecasting. Though not in the scope of the present study, we expect that the methodology detailed here could also be useful in the de novo design of more environmentally-friendly industrial chemicals.
Total and Differential Ionization Cross Sections in collision between Nitrogen atom and Singly Charged Sodium Ion
Authors: Al-Ajaleen M , Tőkési K 
Published: July 2023

Abstract
We present a theoretical study of the ionization of nitrogen atom by a singly charged sodium ion using the classical trajectory Monte Carlo (CTMC) method. Although we suffer from a lack of cross section data of this collision system, the knowledge of the basic cross sections is essential in fusion science, because this reaction has potential applications in the diagnostic of magnetically confined fusion plasmas. In our investigations, the Na +-N(2p) collision system is reduced to a three-body problem. The interaction between the collision partners is described by the Garvey-type model potential. The results of our study provide insight into the dynamics of singly charged sodium-nitrogen interactions. The total cross sections are presented in the impact energy range between 10 keV and – 100 MeV and compared them with the available experimental data. The single and double differential cross sections are presented at 30, 40, 50 and 60 keV energies related to the energies of the plasma diagnostic used in the nuclear fusion.