bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing inequalities in publicly funded health insurance scheme coverage and out-of-pocket expenditure for hospitalization: findings from a household survey in Kerala
Authors: Sharma Santosh Kumar , Joseph Jaison , D Hari Sankar , Nambiar Devaki 
Published: September 2023

Abstract
Background
Increasing financial risk protection is a key feature of Universal Health Coverage and the path towards health for all. Publicly Funded Health Insurance Schemes (PFHIS) have been considered as one of the pathways to safeguard against financial shocks and potentially reduce Out-of-Pocket Expenditure (OOPE). The south Indian state of Kerala has roughly a decade-long experience in implementing PFHIS. To date, there have been very few assessments of the coverage of these schemes and their impact on expenditure. Aiming to fill this gap, we explored the extent of and inequalities in insurance coverage, as well as choice of providers, and median cost of hospitalization in Kerala among insured and uninsured individuals.

Methods
A cross-sectional household survey was conducted in four districts of Kerala as part of a larger health systems research study from July–October 2019. We employed multistage random sampling to collect data from 13,064 individuals covering 3234 households in the catchment area of eight primary health care facilities. We used descriptive statistics, bivariate and multivariate analysis. We evaluated socioeconomic disparities using an absolute measure of inequality—the Slope Index of Inequality (SII) and a relative measure—the Relative Concentration Index (RCI).

Results
A substantial proportion of our study respondents reported that they were covered by PFHIS (45.8%). Respondents belonging to lowest and middle wealth quintiles of household had significantly greater odds of being covered by insurance than respondents belonging to the richest wealth quintile. The negative magnitude of RCI [-16.8% (95%CI: -25.3, -8.4)] and SII [-21.5% (95%CI: -36.1, -7.0)] suggest a higher concentration of PFHIS coverage among the poor. Median OOPE for hospitalisation at private health facilities was INR 9000 (approx. USD 108.70) among those covered by PFHIS, whereas it was INR 10500 (approx. USD 126.82) at private health facilities among those not covered by insurance.

Conclusion
While PFHIS seems to be appropriately targeting poorer populations, among the insured, OOPE for hospitalization persists. Among the uninsured, population subgroups with advantage are spending the greatest amount, raising questions about whether those facing relative disadvantage are forgoing care altogether or seeking care using cheaper, public avenues. Further policy action to more effectively reduce financial burden among left behind eligible populations under PFHIS will be essential to UHC progress in the state.
Tumor microenvironment in a minipig model of spinal cord glioma
Authors: Tora Muhibullah S. , Neill Stewart G. , Lakhina Yuliya , Assed Hemza , Zhang Michelle , Nagarajan Purva P. , Federici Thais , Gutierrez Juanmarco , Hoang Kimberly B. , Du Yuhong , Lei Kecheng , Boulis Nicholas M. 
Published: September 2023

Abstract
Background
Spinal cord glioma (SCG) is considered an orphan disease that lacks effective treatment options with margins that are surgically inaccessible and an overall paucity of literature on the topic. The tumor microenvironment is a critical factor to consider in treatment and modeling design, especially with respect to the unresectable tumor edge. Recently, our group developed a high-grade spinal cord glioma (SCG) model in Göttingen minipigs.

Methods
Immunofluorescence and ELISA were performed to explore the microenvironmental features and inflammation cytokines in this minipig SCG model. Protein carbonyl assay and GSH/GSSG assay were analyzed in the core and edge lesions in the minipig SCG model. The primary core and edge cells proliferation rate were shown in vitro, and the xenograft model in vivo.

Results
We identified an elevated Ki-67 proliferative index, vascular and pericyte markers, CD31 and desmin in the tumor edge as compared to the tumor core. In addition, we found that the tumor edge demonstrated increased pro-inflammatory and gliomagenic cytokines including TNF-α, IL-1β, and IL-6. Furthermore, the mediation of oxidative stress is upregulated in the tumor edge. Hypoxic markers had statistically significant increased staining in the tumor core, but were notably still present in the tumor edge. The edge cells cultures derived from SCG biopsy also demonstrated an increased proliferative rate compared to core cell cultures in a xenotransplantation model.

Conclusions
Our study demonstrates heterogeneity in microenvironmental features in our minipig model of high-grade SCG, with a phenotype at the edge showing increased oxidative stress, proliferation, inflammatory cytokines, neovascularization, and decreased but present staining for hypoxic markers. These findings support the utility of this model as a means for investigating therapeutic approaches targeting the more aggressive and surgically unresectable tumor border.
Intercellular adhesion molecule 2 as a novel prospective tumor suppressor induced by ERG promotes ubiquitination-mediated radixin degradation to inhibit gastric cancer tumorigenicity and metastasis
Authors: Tang Xiaocheng , Huang Jintuan , Jiang Yingming , Qiu Jun , Li Tuoyang , Li Weiyao , Chen Zijian , Huang Zhenze , Yu Xihu , Yang Tao , Ji Xiang , Tan Rongchang , lv Li , Yang Zuli , Chen Hao 
Published: September 2023

Abstract
Background
Gastric cancer (GC) is a fatal cancer with unclear pathogenesis. In this study, we explored the function and potential mechanisms of intercellular adhesion molecule 2 (ICAM2) in the development and advancement of GC.

Methods
Quantitative real-time polymerase chain reaction (qRT-PCR) and Western blotting were performed to quantify ICAM2 expression in harvested GC tissues and cultured cell lines. Immunohistochemical analyses were conducted on a GC tissue microarray to quantify ICAM2 expression and explore its implication on the prognosis of GC patients. In vitro experiments were carried out to reveal the biological functions of ICAM2 in GC cell lines. Further, in vivo experiments were conducted using xenograft models to assess the impact of ICAM2 on GC development and metastasis. Western blot, immunofluorescence, immunoprecipitation, luciferase assay, chromatin immunoprecipitation, and ubiquitination analysis were employed to investigate the underlying mechanisms.

Results
ICAM2 expression was downregulated in GC, positively correlating with advanced T stage, distant metastasis, advanced clinical stage, vessel invasion, and shorter patient survival time. ICAM2 overexpression suppressed the proliferation, migration, invasion, metastasis of GC cells as well as their ability to form tumors, whereas ICAM2 knockdown yielded opposite results. Erythroblast transformation-specific-related gene (ERG) as a transcription factor promoted the transcription of ICAM2 by binding to the crucial response element localized within its promoter region. Further analysis revealed that ICAM2 reduced radixin (RDX) protein stability and expression. In these cells, ICAM2 bound to the RDX protein to promote the ubiquitination and degradation of RDX via NEDD4 Like E3 Ubiquitin Protein Ligase (NEDD4L), and this post-translational modification resulted in the inhibition of GC.

Conclusions
In summary, this study demonstrates that ICAM2, which is induced by ERG, suppresses GC progression by enhancing the ubiquitination and degradation of RDX in a NEDD4L-dependent manner. Therefore, these results suggest that ICAM2 is a potential prognostic marker and a therapeutic target for GC.
A phospholipid:diacylglycerol acyltransferase is involved in the regulation of phospholipids homeostasis in oleaginous Aurantiochytrium sp.
Authors: Zhang Huidan , Wang Zhuojun , Sun Caili , Zhang Chuchu , Liu Huan , Cui Qiu , Song Xiaojin , Wang Sen 
Published: September 2023

Abstract
Background
Thraustochytrids have gained attention as a potential source for the production of docosahexaenoic acid (DHA), where DHA is predominantly stored in the form of triacylglycerol (TAG). The TAG biosynthesis pathways, including the acyl-CoA-dependent Kennedy pathway and the acyl-CoA-independent pathway, have been predicted in thraustochytrids, while the specific details regarding their roles are currently uncertain.

Results
Phospholipid:diacylglycerol acyltransferase (PDAT) plays a key role in the acyl-CoA-independent pathway by transferring acyl-group from phospholipids (PL) to diacylglycerol (DAG) to from TAG. In thraustochytrid Aurantiochytrium sp. SD116, an active AuPDAT was confirmed by heterologous expression in a TAG-deficient yeast strain H1246. Analysis of AuPDAT function in vivo revealed that deletion of AuPDAT led to slow growth and a significant decrease in cell number, but improved PL content in the single cell during the cell growth and lipid accumulation phases. Interestingly, deletion of AuPDAT did not affect total lipid and TAG content, but both were significantly increased within a single cell. Moreover, overexpression of AuPDAT also resulted in a decrease in cell number, while the total lipid and cell diameter of a single cell were markedly increased. Altogether, both up-regulation and down-regulation of AuPDAT expression affected the cell number, which further associated with the total lipid and TAG content in a single cell.

Conclusions
Our study demonstrates that AuPDAT-mediated pathway play a minor role in TAG synthesis, and that the function of AuPDAT may be involved in regulating PL homeostasis by converting PL to TAG in a controlled manner. These findings expand our understanding of lipid biosynthesis in Aurantiochytrium sp. and open new avenues for developing “customized cell factory” for lipid production.
luxS contributes to intramacrophage survival of Streptococcus agalactiae by positively affecting the expression of fruRKI operon
Authors: Cao Qing , Dong Yuhao , Guo Changming , Ji Shuting , Nie Meng , Liu Guangjin , Wan Xihe , Lu Chengping , Liu Yongjie 
Published: September 2023

AbstractThe LuxS quorum sensing system is a widespread system employed by many bacteria for cell-to-cell communication. The luxS gene has been demonstrated to play a crucial role in intramacrophage survival of piscine Streptococcus agalactiae, but the underlying mechanism remains largely unknown. In this study, transcriptome analysis, followed by the luxS gene deletion and subsequent functional studies, confirmed that impaired bacterial survival inside macrophages due to the inactivation of luxS was associated with reduced transcription of the fruRKI operon, encoding the fructose-specific phosphotransferase system. Further, luxS was determined not to enhance the transcription of fruRKI operon by binding its promoter, but to upregulate the expression of this operon via affecting the binding ability of catabolite control protein A (CcpA) to the catabolite responsive element (cre) in the promoter of fruRKI. Collectively, our study identifies a novel and previously unappreciated role for luxS in bacterial intracellular survival, which may give a more thorough understanding of the immune evasion mechanism in S. agalactiae.
Lithofacies identification from well-logging curves via integrating prior knowledge into deep learning
Authors: Jiang Chunbi , Zhang Dongxiao 
Published: September 2023

Lithofacies is a key parameter in reservoir characterization. With advances in machine learning, many researchers have attempted to predict lithofacies from well-log curves by using a machine-learning algorithm. However, existing models are built purely on data, which do not provide interpretability. In addition, lithofacies distribution is highly imbalanced. We incorporate domain knowledge into a gated recurrent unit network to force the model to learn from the data and knowledge. The domain knowledge that we use is expressed as first-order logic rules and is incorporated into the machine-learning pipeline through additional loss terms. Specifically, these rules are: (1) if the density is smaller than or equal to [Formula: see text], then the lithofacies is coal; (2) if the density is larger than or equal to [Formula: see text] or the neutron porosity is smaller than or equal to [Formula: see text], then the lithofacies is anhydrite; and (3) if the gamma-ray value is larger than or equal to [Formula: see text], then the lithofacies is shale. Here, [Formula: see text], [Formula: see text], [Formula: see text], and [Formula: see text] are the parameters that are learned by the model. By applying this domain knowledge, we aim to elucidate why the model predicts lithofacies as coal, anhydrite, or shale and reduce the effect of imbalanced data on the model’s performance. We evaluate the method on a data set from the North Sea, and the machine-learning pipeline with domain knowledge embedded is slightly superior compared with the baseline model that does not consider domain knowledge. One drawback of the method is that the domain knowledge that we provide only works for coal, anhydrite, and shale, which is incomplete. In future work, we will attempt to develop more rules that work for other types of lithofacies.
Occupational Factors Associated With Time to Breastfeeding Discontinuation After Return to Work Among Female Anesthesiologists in China: A Nationwide Survey
Authors: Xu Xiaohan , Wang Ruiqi , Zhang Yuelun , Li Juan , Li Hange , Yu Xuerong , Zhang Jiao , Li Xu , Huang Yuguang 
Published: September 2023

BACKGROUND:
Breast milk is of great benefit to both infants and mothers. Due to occupational barriers, female physicians are at high risk of unintentionally discontinuing breastfeeding. However, evidence among anesthesiologists was limited. The purpose of this study was to investigate occupational factors associated with time to breastfeeding discontinuation among female anesthesiologists following maternity leave in China.

METHODS:
We conducted a nationwide survey of female anesthesiologists who had given birth since January 1, 2015. A 60-item anonymous questionnaire was developed to collect information regarding breastfeeding practices and related factors. The questionnaire was revised based on the recommendations of 15 experts and feedback from the pilot survey. The survey was distributed by the Chinese Society of Anesthesiology.

RESULTS:
The completion rate was 57.9%. In total, 1364 responders were analyzed from all 31 provinces of Mainland China. In total, 1311 (96.1%) responders reported a reduction in breast milk supply on returning to work. Among the 1161 responders who discontinued breastfeeding, 836 (72.0%) did not achieve desired goals due to occupational factors. The median [interquartile range] of maternity leave length and breastfeeding duration were 5 [4–6] months and 10 [7–12] months, respectively. The following occupational factors were associated with longer time to breastfeeding discontinuation after adjusting for confounding effects of personal factors: length of maternity leave (hazard ratio [HR] per month 0.44; 95% confidence interval [CI], 0.36–0.54; P < .001), pumping breast milk during work time (HR, 0.04; 95% CI, 0.02–0.08; P < .001), support from colleagues (HR, 0.92; 95% CI, 0.86–0.99; P = .032), and additional nonclinical activities (HR, 0.87; 95% CI, 0.77–0.98; P = .022). Trainees under supervision (HR, 1.20; 95% CI, 1.06–1.43; P = .005) and the need to remain in the operating room during cases (HR, 2.59; 95% CI, 1.09–6.12; P = .031) were associated with shorter time to breastfeeding discontinuation. Approximately 899 (65.9%) responders pumped breast milk during work time. Among them, reduction in pumping frequency (HR, 1.17; 95% CI, 1.00–1.36; P = .049) and difficulty in finding opportunities for pumping (HR, 2.34; 95% CI, 1.36–4.03; P = .002) were associated with shorter time to breastfeeding discontinuation.

CONCLUSIONS:
We identified modifiable occupational factors associated with time to breastfeeding discontinuation. These findings underscored the necessity of facilitating breastfeeding in the workplace, including encouraging longer maternity leave and breastfeeding breaks, considering the feasibility of pumping in daily case assignments, establishing supportive culture, providing lactation rooms, and offering nonclinical activities.
Materiality and Language at El Escorial
Authors: Ibarreta Carmen Urbita 
Published: September 2023

Abstract
David Bestué’s recent take on Philip II’s reification of centrality (El Escorial: Imperio y estómago, 2021) is an open contestation of the royal site’s conception—and later reception—as an immutable, transcendental edifice meant to “stop the entropy of physical processes.” Distancing himself from castizo evocations of El Escorial as “piedra lírica” (Ortega y Gasset) and “líneas puras” (Unamuno), Bestué guides us through the building’s secluded sewers, the granite quarries that nourished its construction, and its many scenes of fire and dereliction to dismantle the monastery’s value as purely symbolic permanence. As Bestué explains, his book functions “no como un acto más de significación, otra capa, sino como un corte.” This mechanistic notion of the written word as a device with which to shape abstraction back into physicality, however, is not a novel addition to the literature on El Escorial. This article revisits José de Sigüenza’s Fundación del monasterio de El Escorial (1605)—the most exhaustive and authoritative chronicle of its construction—as a reaction to the official representational apparatus of the building. Whereas the language of Philip II’s instructions allied with Juan de Herrera’s designs to project an immutability beyond space and time, Sigüenza, this article shows, enacts a ventriloquist mimicking of artisanal practice that vindicates process and local experience in conflict with the notion of a petrified center of empire. It also examines, as reverberations of these disparities, late nineteenth- to early twentieth-century appraisals of Sigüenza’s text that have projected the unblemished geometrical lines of the Escorial onto the friar’s writing. Its overall aim is to shed light on the lingering tensions around language, architecture, and place that characterize the most instrumentalized—and yet paradoxically dematerialized—of Iberian materialities.
“Acaricié las cosas”
Authors: Varón González Carlos 
Published: September 2023

Abstract
After her father’s death, the poetic subject in Luz Pichel’s Galician-language Casa pechada (Closed Home, 2006) returns from the city to clear the things in her house in a small Galician village. However, these things do not conform to any sense of social, emotional, or material permanence. The decay of closed-down houses and abandoned farm tools speaks to and reproduces the imprint of rural extractivism, symbolic violence, and ecological precarization on the Galician countryside. The act of naming can determine what things are and the emotions they awaken: utensils or trash, repurposed tools or ruins, personal souvenirs or museum pieces. However, the rural, at times impoverished, at times gentrified, may lack names for its materials. Pichel’s self-translation Cativa en su lughar (Cativa in Her Place, 2013) gets this point across by using familiar Castrapo rather than Spanish: a pidgin romance variation that belongs to no normative language that it is closely related to (Spanish, Galician, or Portuguese) but traverses them all. Phonetic aspects, like accent and phonemes (the “gheada”), resist incorporation to any standardized, state-sponsored language, and in turn, the names that may care for / curate rural things rely on paronomastic associations, identifications, and oppositions across languages. The article claims that in Cativa, signs and names may define the monetary value, the purpose, and the substance of things, but language’s material embodiment also supports and mobilizes their emotional and political meanings.
When Diane Tells Me a Story
Authors: Daley Lashon 
Published: September 2023

Abstract
This essay examines the complex relationship that developed between ethnographer Lashon Daley and her research subject, Diane Ferlatte, over the course of Daley’s master’s thesis project and the years beyond. Through storytelling and narrative prose, Daley investigates the roles that grief, death, Black motherhood, and the Black southern oral tradition play within their ever-growing bond. As their relationship progresses from researcher and respondent to mother and daughter, their bond displays the connective tissue that binds one person to another through history, memory, and the common experience of loss. By exploring the performativity of Black women who are bonded by love and not blood, this essay demonstrates how Black womanhood becomes a conduit for grieving and healing.
scTOP: physics-inspired order parameters for cellular identification and visualization
Authors: Yampolskaya Maria , Herriges Michael J. , Ikonomou Laertis , Kotton Darrell N. , Mehta Pankaj 
Published: September 2023

ABSTRACT
Advances in single-cell RNA sequencing provide an unprecedented window into cellular identity. The abundance of data requires new theoretical and computational frameworks to analyze the dynamics of differentiation and integrate knowledge from cell atlases. We present ‘single-cell Type Order Parameters’ (scTOP): a statistical, physics-inspired approach for quantifying cell identity given a reference basis of cell types. scTOP can accurately classify cells, visualize developmental trajectories and assess the fidelity of engineered cells. Importantly, scTOP does this without feature selection, statistical fitting or dimensional reduction (e.g. uniform manifold approximation and projection, principle components analysis, etc.). We illustrate the power of scTOP using human and mouse datasets. By reanalyzing mouse lung data, we characterize a transient hybrid alveolar type 1/alveolar type 2 cell population. Visualizations of lineage tracing hematopoiesis data using scTOP confirm that a single clone can give rise to multiple mature cell types. We assess the transcriptional similarity between endogenous and donor-derived cells in the context of murine pulmonary cell transplantation. Our results suggest that physics-inspired order parameters can be an important tool for understanding differentiation and characterizing engineered cells. scTOP is available as an easy-to-use Python package.
Transcription inhibition suppresses nuclear blebbing and rupture independently of nuclear rigidity
Authors: Berg Isabel K. , Currey Marilena L. , Gupta Sarthak , Berrada Yasmin , Nguyen Bao V. , Pho Mai , Patteson Alison E. , Schwarz J. M. , Banigan Edward J. , Stephens Andrew D. 
Published: September 2023

ABSTRACT
Chromatin plays an essential role in the nuclear mechanical response and determining nuclear shape, which maintain nuclear compartmentalization and function. However, major genomic functions, such as transcription activity, might also impact cell nuclear shape via blebbing and rupture through their effects on chromatin structure and dynamics. To test this idea, we inhibited transcription with several RNA polymerase II inhibitors in wild-type cells and perturbed cells that presented increased nuclear blebbing. Transcription inhibition suppressed nuclear blebbing for several cell types, nuclear perturbations and transcription inhibitors. Furthermore, transcription inhibition suppressed nuclear bleb formation, bleb stabilization and bleb-based nuclear ruptures. Interestingly, transcription inhibition did not alter the histone H3 lysine 9 (H3K9) modification state, nuclear rigidity, and actin compression and contraction, which typically control nuclear blebbing. Polymer simulations suggested that RNA polymerase II motor activity within chromatin could drive chromatin motions that deform the nuclear periphery. Our data provide evidence that transcription inhibition suppresses nuclear blebbing and rupture, in a manner separate and distinct from chromatin rigidity.