bluuebunny/crossref_metadata_2025_split huggingface dataset:
Costs and cost-effectiveness of the Kerala Pilot Screening Programme for Diabetic Retinopathy in the public health system
Authors: Wittenberg Raphael , Anderson Robert , Redding Stuart , Gopal Bipin , Sadanandan Rajeev , Sahasranamam Vasudeva , George Simon , Premnazir Lakshmi , Netuveli Gopalakrishnan , Srin Jyotsna , Conroy Dolores , Sivaprasad Sobha 
Published: September 2023

Abstract

Background/Objectives
The Government of Kerala initiated a pilot screening programme for diabetic retinopathy in 16 Family Health Centres in Thiruvananthapuram district in 2019 in collaboration with the ORNATE India project. The evaluation of this pilot included a study of its costs and cost-effectiveness to inform decisions about extending the programme throughout Kerala.
Subjects/Methods
The participants comprise all 5,307 people who were screened for diabetic retinopathy under the pilot programme for whom data could be collected.
Results
The costs of the pilot programme are estimated at INR 11.3 million ((including INR 1.9 million costs to individuals) and the benefits at 514 QALYs, slightly over one QALY per person treated. The cost per QALY was INR22,000, which is well below India’s Gross National Income per person.
Conclusions
Kerala’s 2019 pilot screening programme for diabetic retinopathy was highly cost-effective.
Prognostic value and clinicopathological correlation of tumor location in gastrointestinal stromal tumor (GIST) after surgery: A propensity matched retrospective cohort study with development of a survival nomogram
Authors: Chen Jinxia , Xu Jingli , Xiao Hui , Ma Yubo , Zi Mengli , Pang Chuhong , Liang Chen , Cheng Xiangdong , Yuan Li , Yang Litao 
Published: September 2023

Abstract
Background: There is controversy over whether tumor location affects the prognosis of GIST. The objective of this study is to compare the clinicopathological features and overall survival (OS) rates of gastrointestinal stromal tumors (GISTs) in the stomach and small bowel, as well as to identify independent prognostic factors and predict OS for GIST.
Methods: A total of 504 patients who underwent surgical treatment for GIST between 2005 and 2020 were included in this retrospective cohort study. The OS of patients with small bowel GIST was compared to those with gastric GIST using Cox regression analyses and propensity score matching (PSM) techniques. Furthermore, a nomogram was developed based on significant risk factors identified through multivariate Cox analysis. The performance of the nomogram was evaluated using the area under the receiver operating characteristic (ROC) curves and calibration curves.
Results: Among the entire cohort, 308 patients (61.1%) had a primary tumor located in the stomach, 129 patients (25.6%) in the duodenum, 21 patients (4.2%) in the colorectum, and 46 patients (9.1%) in other sites. Small bowel GISTs exhibited larger tumor size, higher mitotic count, higher risk stratification, and higher rates of recurrence or metastasis compared to gastric GISTs. After adjusting for potential confounders using PSM, multivariate analyses revealed that the OS of patients with small bowel GIST [hazard ratio (HR) 3.735, 95% confidence interval (CI) 1.279-10.908] was significantly shorter than that of patients with gastric GIST. Subsequently, a nomogram incorporating four prognostic risk factors, namely gender, tumor location, mitotic count, and drug therapy, was constructed to predict the 3-, 5-, and 10-year OS. The nomogram demonstrated good discriminative ability, as indicated by the area under the curve (AUC) values of 0.734, 0.849, and 0.823, respectively.
Conclusions: GIST patients with tumors located in the small bowel exhibit more aggressive pathological features. Importantly, patients with small bowel GIST experience inferior survival outcomes compared to those with gastric GIST, even after adjusting for relevant risk factors through multivariate analysis and PSM. Furthermore, we successfully developed a robust nomogram which demonstrated excellent predictive accuracy for estimating long-term OS probability among GIST patients who underwent surgical intervention.
Transparent ultrasonic transducers based on relaxor ferroelectric crystals for advanced photoacoustic imaging
Authors: Li Fei , Qiu Chaorui , Zhang Zhiqiang , Xu Zhiqiang , Qiao Liao , Zhang Shujun , Su Min , Wu Weichang , Song Kexin , Xu Zhuo , Chen Long-Qing , Zheng Hairong , Liu Chengbo , Qiu Weibao 
Published: September 2023

Abstract

Photoacoustic imaging (PAI) is promising as a non-invasive functional imaging modality for various applications, from clinical diagnosis to fundamental research. However, achieving capillary-level resolution, wide field-of-view (FOV) and high imaging frame rate simultaneously in a PAI system remains very challenging. To address this, transparent ultrasonic transducer (TUT) was considered to be an alternative to conventional opaque one in PAI systems. While this concept shows promise, existing TUTs have limitations in bandwidth and sensitivity, hindering their practical application. To overcome these limitations, we propose to use our newly developed transparent relaxor ferroelectric crystals as piezoelectric elements for the TUT design. Owing to their ultrahigh dielectric and piezoelectric properties, the newly designed TUT exhibits a four-fold enhancement of photoacoustic detection sensitivity when compared to conventional LiNbO3-based counterpart. In addition, we implemented a transparent-double-matching-layer design via an innovative transducer fabrication process, resulting in a 31-MHz TUT with an impressive bandwidth of 76%, surpassing existing TUTs (<37%) and comparable to opaque ultrasonic transducers with the same operation frequency. Leveraging the relatively large FOV and significantly improved performances of our newly developed TUT, we achieved a high-speed PAI of the mouse microvasculature at a frame rate of 1 Hz over a 1.5 mm × 1.5 mm area via optical scanning. This advancement surpasses the conventional mechanical-scanning-based PAI techniques by at least 30 times. As a result, we successfully monitored the dynamic change of the mouse cerebral cortex microvasculature during an epileptic seizure. The innovative TUT design holds great potential to drive progress in the field of high-performance and compact photoacoustic devices, particularly for applications in fundamental brain science research.
The Prevalence, Morphological Types and Factors Associated with Anemia Among Under- Five Children Hospitalized at Muhimbili National Hospital in Dar Es Salaam, Tanzania
Authors: Muhunzi David , Bairon Silvano , Ndobho Flora 
Published: September 2023

Abstract

Background
Anemia is a global public health concern that causes significant mortality and morbidity especially in children. The risk factors for anemia vary in different settings, including having intestinal parasites, malaria parasitemia, HIV infection, nutritional deficiencies, chronic diseases, and the habit of taking meals with tea. Understanding the burden, morphological types and factors associated with anemia is important in guiding the development and implementation of intervention programs.
Objective
The aim of this study was to assess the prevalence, morphological types and factors associated with anemia among under-five children hospitalized at Muhimbili National Hospital in Dar es Salaam, Tanzania.
Materials and Methods
This was a cross-sectional facility-based study conducted among under-five children hospitalized at Muhimbili National Hospital. A convenient sampling technique was used to obtain study participants. Data on sociodemographic characteristics of the children and their caregivers were obtained using a pretested structured questionnaire, and nutritional status of each child was assessed. Complete Blood Count (CBC) results on the day of admission was recorded. Data were entered in SPSS software version 27 for analysis. Continuous variables were expressed as median and interquartile range, while categorical variables were expressed as frequency and percentages. To determine the factors associated with anemia, significant variables from univariate analysis were entered into a multivariate logistic regression analysis, and adjusted odds ratio was calculated to determine the strength of association. A p-value of < 0.05 was considered significant.
Results
The prevalence of anemia was found to be 85.9% with the proportion of mild, moderate and severe anemia being 22.9%, 45.7% and 31.4% respectively. Microcytic hypochromic anemia was the predominant morphological type of anemia among the study participants. Receiving a last dose of anthelminthic medication more than three months prior to admission and the habit of taking meals with tea were found to be significantly associated with anemia.
Conclusion
Prevalence of anemia among under-five children hospitalized at Muhimbili National Hospital is high. Intervention programs to address anemia in Tanzania should take on board the identified modifiable factors in order to reduce the prevalence of anemia among under-five children.
Allosteric Site Mediates Inhibition of Tonic NMDA Receptor Activity by Low Dose Ketamine
Authors: Popescu Gabriela , Abbott Jamie , Wen Han , Liu Beiying , Gupta Sheila , Iacobucci Gary , Zheng Wenjun 
Published: September 2023

Abstract

Ketamine, a general anesthetic, has rapid and sustained antidepressant effects when administered at lower doses. At anesthetic doses, ketamine causes a drastic reduction in excitatory transmission by lodging in the centrally located hydrophilic pore of the NMDA receptor, where it blocks ionic flow. In contrast, the molecular and cellular targets responsible for the antidepressant effects of ketamine remain controversial. Here, we report functional and structural evidence that, at nanomolar concentrations, ketamine interacts with membrane-accessible hydrophobic sites where it stabilizes desensitized receptors to cause an incomplete, voltage- and pH-dependent reduction in NMDA receptor activity. This allosteric mechanism spares brief receptor activations and reduces preferentially currents from tonically active receptors. The hydrophobic site is a promising target for safe and effective therapies against acute and chronic neurodegeneration.
Global Trends and Research Progress of Occupational Exposure to Formaldehyde and Cancer: A Bibliometric Analysis (1991-2022)
Authors: Pourbabaki Reza , Abbaslou Hossein , Sadeghi-Yarandi Mohsen , Soleimani Esmaeel , Hwang Jooyeon 
Published: September 2023

Abstract
This study aimed to evaluate the global scientific output of cancer of formaldehyde (CFA) in occupational exposure and explore the hot spots and research trends. Articles related to the CFA between 1991–2022 were retrieved from the Web of Science Core Collection database. We retrieved the articles for a bibliometric analysis including countries/institutions, international cooperation, journals, citations, and keywords. Among 758 retrieved articles, 350 eligible studies were identified for further analysis. The National Cancer Institute conducted more research than others about CFA. The journal of “American Journal of Industrial Medicine” published the most studies on “CFA”. The past few years have witnessed research focused on the mechanism of formaldehyde in causing cancer at the cellular level. Numerous studies have registered significant increases in oxidative and DNA damage in the bone marrow of mice exposed to formaldehyde. There have been reports of increased DNA-protein crosslinks and structural chromosomal alterations in lymphocytes in pathology and anatomy laboratory workers exposed to formaldehyde. Further original research on representative samples of workers exposed to measurable levels of formaldehyde is essential. In order to investigate the toxicity caused by formaldehyde, studies should be designed to minimize bias caused by co-exposure to other carcinogens. The current trends may suggest research gaps in our understanding of formaldehyde mechanisms and shifting occupational exposure levels for formaldehyde. As a result, future studies should most likely concentrate on molecular biology and human exposure assessment to formaldehyde and its substitutes.
Machine-Learning Workflow for Edge Computed Arrhythmia Detection in Exploration-Class Missions
Authors: Mani Cyril , Paul Tanya , Archambault Patrick , Marois Alexandre 
Published: September 2023

Abstract

Deep-space missions require preventative care methods based on predictive models for identifying in-space pathologies. Deploying such models requires flexible edge computing, which Open Neural Network Exchange (ONNX) formats enable by optimizing inference directly on wearable edge devices. This work demonstrates an innovative approach to point-of-care machine learning model pipelines by combining this capacity with an advanced self-optimizing training scheme to classify periods of Normal Sinus Rhythm (NSR), Atrial Fibrillation (AFIB) and Atrial Flutter (AFL). 742 hours of electrocardiogram (ECG) recordings were pre-processed into 30-second normalized samples where variable mode decomposition purged muscle artifacts and instrumentation noise. Seventeen heart rate variability and morphological ECG features were extracted by convoluting peak detection with Gaussian distributions and delineating QRS complexes using discrete wavelet transforms. The decision tree classifier’s features, parameters and hyperparameters were self-optimized through stratified triple nested cross-validation ranked on F1-scoring against cardiologist labelling. The selected model achieved a macro F1-score of 0.899 with 0.993 for NSR, 0.938 for AFIB and 0.767 for AFL. The most important features included median P-wave amplitudes, PNN20, and mean heart rates. The ONNX-translated pipeline took 9.2 s/sample. The novel combination of our self-optimizing scheme and deployment use case of ONNX demonstrated overall accurate operational tachycardia detection.
Valorization of Malaysian fish sausage (Keropok Lekor) by-products into bioactive fish protein hydrolysate by Bacillus licheniformis fermentation: Influence of by-products characteristics on nutritional, antioxidant and antibacterial capacities
Authors: Rashid Nur Yuhasliza Abd , Indran Santhiya Ravi , Manan Musaalbakri Abd , Pa'ee Khairul Faizal , Saari Nazamid , Wong Fadzlie Wong Faizal 
Published: September 2023

Abstract

The Malaysian fish sausage industry, Keropok Lekor (KL), generates large amounts of by-products (FBs), that are underutilised and inappropriately disposed of, resulting in negative environmental implications. This study aimed to transform the FBs into bioactive fish protein hydrolysate (FPH) via the Bacillus licheniformis fermentative approach. Besides the various FBs and strain type used, this study was significant for its detailed analysis exploring the effect of the FB's nutritional and amino acid contents on antioxidant and antibacterial activities, as well as the nutritional qualities of the FPHs. The B. licheniformis fermentation improved the FBs nutritional quality by increasing protein digestibility and essential amino acid content. The highest degree of hydrolysis (DH) was linked to soluble protein concentration, and there was a significant correlation (R2 = 0.9) between the DH and protein yields in the samples. The FPHs demonstrated stronger DPPH (32.5–58.4%) and ABTS (74.8–90.1%) antiradical activities, and ferrous chelating activity (25.3–59.9%) than that of the FBs (p < 0.05). The highest peptide concentration was found in fraction 3–10 kDa, which also showed the strongest inhibition of DPPH and ABTS, and ferrous chelating activity. The amino acid composition of the FPH significantly influenced the level of antioxidant activity. However, all FPHs showed no significant (p > 0.05) difference in growth inhibition against all tested pathogens compared to their FBs. Hence, KL FBs valorisation into high-value product like bioactive FPH by microbial fermentation serves as a green strategy to improve waste management and to advocate a circular and sustainable bioeconomy.
Eco-evolutionary strategies for relieving carbon limitation under salt stress differ across microbial clades
Authors: Chen Ruirui , Dong Yang , Graham Emily , Yu Bingqian , Bao Yuanyuan , Li Xin , You Xiangwei , Feng Youzhi 
Published: September 2023

Abstract

The eco-evolutionary tradeoff between microbial mitigation of carbon limitation and maintenance of functional traits in saline soils, a habitat rapidly expanding in extent under climate change, represents a significant knowledge gap in predicting future soil health and ecological function. Through shotgun metagenomic sequencing of coastal soils along a salinity gradient, we show contrasting eco-evolutionary directions of soil bacteria and archaea that manifest in changes to genome size and functional potential of the soil microbiome with increasing saline stress. Bacteria exhibited reduced genome sizes associated with a depletion of core metabolic genes in response to salinity, while archaea displayed larger genomes and an enrichment of salt-resistance, core metabolic genes, and especially an enhanced capacity for carbon acquisition in saline soils. This suggests that bacteria conserve energy through genome streamlining when facing salt stress, while archaea invest in carbon acquisition pathways to broaden their resource usage. These findings suggest divergent patterns in eco-evolutionary adaptations to soil saline stress amongst microbial clades and serve as a foundation for understanding the response of soil microbiomes to escalating climate change.
Carboxypeptidase A4 regulates stemness and epithelial-mesenchymal transition in triple-negative breast cancer
Authors: Li Ying-dong , Qin Ou , Ai Yong-biao , Li Wenfang 
Published: September 2023

Abstract

To investigate the significance of carboxypeptidase A4 (CPA4) in triple negative breast cancer (TNBC). The expressions of CPA4, stem and epithelial-mesenchymal transition (EMT) related proteins in TNBC were detected by immunohistochemistry. The relationship between CPA4 and clinicopathological parameters in 168 cases of TNBC was analyzed. The effect of si-CPA4 on MDA-MB-231 was observed. The related proteins were detected by Western Blot. The results indicated the CPA4 positive rate in TNBC was 57.14% (96/168), which was significantly higher than that in non-TNBC tissues (37.5%, 15/40) (χ2 = 5.009,P = 0.025). The positive rate of CPA4 in TNBC tissues was significantly higher than that in breast hyperplasia tissues (20%, 4/20) (χ2 = 9.850,P = 0.002). High CPA4 in patients was positively correlated with NANOG (χ2 = 4.205,P = 0.040) and E-cadherin (χ2 = 11.764,P = 0.040). Vimentin (χ2 = 4.797,P = 0.029), EGFR (χ2 = 4.057,P = 0.044). Si-CPA4 inhibited MDA-MB-231 colony formation, sphere forming, migration and invasion, inhibited the expression of ALDH-1, NANOG and Vimentin, but promoted the expression of E-cadherin. We concluded CPA4 might play an important role in TNBC stemness progression and EMT conversion. CPA4 might be an important therapeutic target for TNBC therapy.
Three-Dimensional Observations of the Electric Field Distribution of Variable Frequency Microwaves: Scaling-up Organic Syntheses
Authors: Horikoshi Satoshi , Mura Haruka , Serpone Nick 
Published: September 2023

Abstract
This article reports, for the first time, the experimental in-situ three-dimensional measurements of the E-field’s uniform distribution of Variable Frequency Microwaves (VFM) within a multimode cavity under high power conditions, and subsequent comparison to fixed frequency microwaves (FFM). Such distribution could earlier be assessed only through a theoretical analysis. The article also examines the consequences of changes in VFM irradiation conditions and elucidates the threshold at which VFM irradiation is beneficial. With an ultimate focus of the use of VFM microwave radiation toward industrial applications, the effective synthesis of 4-methylbyphenyl (4-MBP) carried out in the presence of Pd (catalyst) supported on activated carbon particulates (Pd/AC) was revisited with two principal objectives:(a) the effective suppression of discharge phenomena (formation of hot spots); and (b) the scale-up of the synthesis using a 5-fold increase in sample quantity and a 7.5-fold larger reactor size (diameter) than used in earlier studies.
From Places to People: Human-centric Characterization of Life Activity Flood Exposure for Intra- and Inter-city Analysis
Authors: Rajput Akhil , Liu Chenyue , Liu Zhewei , Mostafavi Ali 
Published: September 2023

Abstract
A human-centric perspective on flood exposure assessment of flood-hazard vulnerability transcends the conventional focus on spatial exposure by quantifying the effect of daily human activities in flood-prone areas. Using a novel index to quantify the time individuals spend in flood-prone areas, this method characterizes latent flood exposure. Calculations rely on millions of fine-resolution location-based data points collected anonymously from smartphones of opted-in users. A comparative analysis of multiple U.S. metropolitan cities based on latent flood exposure with similar extents of spatial flood risk reveals significant spatial disparities in LAFE. A bimodal distribution in life activity flood exposure index values in 18 coastal metropolitan areas reveals flood exposure disparities. The inter-city analysis results also uncovers the role of urban forms and structures in shaping LAFE, revealing how spatial clustering of flood hazards and distance-decay characteristic of human visitation can exacerbate flood exposure. Our findings provide a novel and more human-centric approach to characterizing and quantifying flood exposure by shifting focus from places to people. The life activity flood exposure captures the extent to which a population’s daily life activities would be disrupted due to flooding and could capture the socio-economic aspects of flood exposure (such as loss of access to critical facilities and work) more objectively than the existing approaches. The findings provide interdisciplinary researchers and practitioners across urban sciences, flood risk management, emergency response with novel human-centric measure and insights to better examine flood exposure and risk.
Economic, Social and Family Factors of the Intergenerational Transmission of Educational in the 21 st Century. An analysis for Spanish Case
Authors: Garcia-Centeno Maria-Carmen , Escobar Laura De Pablos 
Published: September 2023

Abstract

Achieving greater economic and social equity among individuals has long been an important objective for various economic actors. Education has played a key role in achieving this goal, reducing inequalities and achieving equality of opportunity. Therefore, the aim of this paper is to make important contributions, on the one hand, to the characteristics of the intergenerational transmission of education at both national and regional levels in Spain and, on the other hand, to the identification of the most influential social, economic and family factors in the different categories of educational mobility in the first decades of the 21st century. To do so, we have used data from different modules of the Living Conditions Survey of the National Institute of Statistics for the years 2005, 2011 and 2019. Our results are important because, on the one hand, they show that this transmission is very different between the richest and the poorest autonomous communities and, on the other hand, that despite the significant increases in educational levels between generations within families, a high degree of determinism remains.
JEL classification codes: I21; J48; J62