bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of the value driven outcomes program among cataract surgery patients in Singapore: an interrupted time series analysis
Authors: Hoong Jian Ming , Gibbons Brent , Loh Benedict , Tan Clement , Chen Cynthia 
Published: May 2023

Abstract
Background
Healthcare cost is increasing rapidly in Singapore. Moving towards a value-based healthcare framework enables a sustainable health system. The National University Hospital (NUH) implemented the Value Driven Outcome (VDO) Program for cataract surgery due to its high volume and cost variability. We aimed to evaluate the association between VDO program implementation and costs and quality outcomes for cataract surgery in NUH.

Methods
We conducted an interrupted time-series analysis for cataract surgery episodes between January 2015 and December 2018. Using segmented linear regression models, we estimate the changes in levels and trends of cost and quality outcomes post-program implementation. We adjusted for autoregression and various confounders.

Results
Following VDO program implementation, the total cost of cataract surgery had a significantly decreased by $327.23 (95% CI: -$421.04 to -$233.43; p < 0.01) and the trend significantly decreased by $13.75 per month (95% CI: -$23.19 to -$4.30 per month; p < 0.01). There was a small improvement in the combined quality outcome score (0.028, 95% CI: 0.016 to 0.040; p < 0.01), but the trend remained unchanged.

Conclusion
The VDO program was associated with a reduction in cost without compromising on quality outcomes. The program provides a structured methodology to measure performances, and through these data, initiatives were implemented to improve value. There are benefits to providing a data reporting system to physicians to understand actual care costs and quality outcomes achieved by individual patients with defined clinical conditions.
Value of information analysis for pandemic response: intensive care unit preparedness at the onset of COVID-19
Authors: Eze Peter U. , Geard Nicholas , Baker Christopher M. , Campbell Patricia T. , Chades Iadine 
Published: May 2023

Abstract
Background
During the early stages of the COVID-19 pandemic, there was considerable uncertainty surrounding epidemiological and clinical aspects of SARS-CoV-2. Governments around the world, starting from varying levels of pandemic preparedness, needed to make decisions about how to respond to SARS-CoV-2 with only limited information about transmission rates, disease severity and the likely effectiveness of public health interventions. In the face of such uncertainties, formal approaches to quantifying the value of information can help decision makers to prioritise research efforts.

Methods
In this study we use Value of Information (VoI) analysis to quantify the likely benefit associated with reducing three key uncertainties present in the early stages of the COVID-19 pandemic: the basic reproduction number ($$R_0$$

R
0

), case severity (CS), and the relative infectiousness of children compared to adults (CI). The specific decision problem we consider is the optimal level of investment in intensive care unit (ICU) beds. Our analysis incorporates mathematical models of disease transmission and clinical pathways in order to estimate ICU demand and disease outcomes across a range of scenarios.

Results
We found that VoI analysis enabled us to estimate the relative benefit of resolving different uncertainties about epidemiological and clinical aspects of SARS-CoV-2. Given the initial beliefs of an expert, obtaining more information about case severity had the highest parameter value of information, followed by the basic reproduction number $$R_0$$

R
0

. Resolving uncertainty about the relative infectiousness of children did not affect the decision about the number of ICU beds to be purchased for any COVID-19 outbreak scenarios defined by these three parameters.

Conclusion
For the scenarios where the value of information was high enough to justify monitoring, if CS and $$R_0$$

R
0

are known, management actions will not change when we learn about child infectiousness. VoI is an important tool for understanding the importance of each disease factor during outbreak preparedness and can help to prioritise the allocation of resources for relevant information.
Diabetes is accompanied by secretion of pro-atherosclerotic exosomes from vascular smooth muscle cells
Authors: Yu Heng , Douglas Hunter F. , Wathieu Donald , Braun Ryan A. , Edomwande Christine , Lightell Daniel J. , Pham Thaidan , Klingenberg Natasha C. , Bishop Shelia Pugh , Khismatullin Damir B. , Woods T. Cooper 
Published: May 2023

Abstract
Background
Atherosclerosis is a common co-morbidity of type 2 diabetes mellitus. Monocyte recruitment by an activated endothelium and the pro-inflammatory activity of the resulting macrophages are critical components of atherosclerosis. Exosomal transfer of microRNAs has emerged as a paracrine signaling mechanism regulating atherosclerotic plaque development. MicroRNAs-221 and -222 (miR-221/222) are elevated in vascular smooth muscle cells (VSMCs) of diabetic patients. We hypothesized that the transfer of miR-221/222 via VSMC-derived exosomes from diabetic sources (DVEs) promotes increased vascular inflammation and atherosclerotic plaque development.

Methods
Exosomes were obtained from VSMCs, following exposure to non-targeting or miR-221/-222 siRNA (-KD), isolated from diabetic (DVEs) and non-diabetic (NVEs) sources and their miR-221/-222 content was measured using droplet digital PCR (ddPCR). Expression of adhesion molecules and the adhesion of monocytes was measured following exposure to DVEs and NVEs. Macrophage phenotype following exposure to DVEs was determined by measuring mRNA markers and secreted cytokines. Age-matched apolipoprotein-E-deficient mice null (ApoE−/−) mice were maintained on Western diet for 6 weeks and received injections of saline, NVEs, NVE-KDs, DVEs or DVE-KDs every other day. Atherosclerotic plaque formation was measured using Oil Red Oil staining.

Results
Exposure of human umbilical vein and coronary artery endothelial cells to DVEs, but not NVEs, NVE-KDs, or DVE-KDs promoted increased intercellular adhesion molecule-1 expression and monocyte adhesion. DVEs but not NVEs, NVE-KDs, or DVE-KDs also promoted pro-inflammatory polarization of human monocytes in a miR-221/222 dependent manner. Finally, intravenous administration of DVEs, but not NVEs, resulted in a significant increase in atherosclerotic plaque development.

Conclusion
These data identify a novel paracrine signaling pathway that promotes the cardiovascular complications of diabetes mellitus.
Population monitoring of trisomy 21: problems and approaches
Authors: Sperling Karl , Scherb Hagen , Neitzel Heidemarie 
Published: May 2023

AbstractTrisomy 21 (Down syndrome) is the most common autosomal aneuploidy among newborns. About 90% result from meiotic nondisjunction during oogenesis, which occurs around conception, when also the most profound epigenetic modifications take place. Thus, maternal meiosis is an error prone process with an extreme sensitivity to endogenous factors, as exemplified by maternal age. This contrasts with the missing acceptance of causal exogenous factors. The proof of an environmental agent is a great challenge, both with respect to ascertainment bias, determination of time and dosage of exposure, as well as registration of the relevant individual health data affecting the birth prevalence. Based on a few exemplary epidemiological studies the feasibility of trisomy 21 monitoring is illustrated. In the nearer future the methodical premises will be clearly improved, both due to the establishment of electronic health registers and to the introduction of non-invasive prenatal tests. Down syndrome is a sentinel phenotype, presumably also with regard to other congenital anomalies. Thus, monitoring of trisomy 21 offers new chances for risk avoidance and preventive measures, but also for basic research concerning identification of relevant genomic variants involved in chromosomal nondisjunction.
Objective and subjective cognition in survivors of COVID-19 one year after ICU discharge: the role of demographic, clinical, and emotional factors
Authors: Godoy-González Marta , Navarra-Ventura Guillem , Gomà Gemma , de Haro Candelaria , Espinal Cristina , Fortià Cristina , Ridao Natalia , Miguel Rebanal Nuria , Oliveras-Furriols Laia , Subirà Carles , Jodar Mercè , Santos-Pulpón Verónica , Sarlabous Leonardo , Fernández Rafael , Ochagavía Ana , Blanch Lluís , Roca Oriol , López-Aguilar Josefina , Fernández-Gonzalo Sol 
Published: May 2023

Abstract
Background
Intensive Care Unit (ICU) COVID-19 survivors may present long-term cognitive and emotional difficulties after hospital discharge. This study aims to characterize the neuropsychological dysfunction of COVID-19 survivors 12 months after ICU discharge, and to study whether the use of a measure of perceived cognitive deficit allows the detection of objective cognitive impairment. We also explore the relationship between demographic, clinical and emotional factors, and both objective and subjective cognitive deficits.

Methods
Critically ill COVID-19 survivors from two medical ICUs underwent cognitive and emotional assessment one year after discharge. The perception of cognitive deficit and emotional state was screened through self-rated questionnaires (Perceived Deficits Questionnaire, Hospital Anxiety and Depression Scale and Davidson Trauma Scale), and a comprehensive neuropsychological evaluation was carried out. Demographic and clinical data from ICU admission were collected retrospectively.

Results
Out of eighty participants included in the final analysis, 31.3% were women, 61.3% received mechanical ventilation and the median age of patients was 60.73 years. Objective cognitive impairment was observed in 30% of COVID-19 survivors. The worst performance was detected in executive functions, processing speed and recognition memory. Almost one in three patients manifested cognitive complaints, and 22.5%, 26.3% and 27.5% reported anxiety, depression and post-traumatic stress disorder (PTSD) symptoms, respectively. No significant differences were found in the perception of cognitive deficit between patients with and without objective cognitive impairment. Gender and PTSD symptomatology were significantly associated with perceived cognitive deficit, and cognitive reserve with objective cognitive impairment.

Conclusions
One-third of COVID-19 survivors suffered objective cognitive impairment with a frontal-subcortical dysfunction 12 months after ICU discharge. Emotional disturbances and perceived cognitive deficits were common. Female gender and PTSD symptoms emerged as predictive factors for perceiving worse cognitive performance. Cognitive reserve emerged as a protective factor for objective cognitive functioning.
Trial registration: ClinicalTrials.gov Identifier: NCT04422444; June 9, 2021.
Univariate versus multivariate spectrophotometric data analysis of triamterene and xipamide; a quantitative and qualitative greenly profiled comparative study
Authors: Abd El-Hadi Heidi R. , Eissa Maya S. , Zaazaa Hala E. , Eltanany Basma M. 
Published: May 2023

AbstractTriamterene (TRI) and xipamide (XIP) mixture is used as a binary medication of antihypertension which is considered as a major cause of premature death worldwide. The purpose of this research is the quantitative and qualitative analysis of this binary mixture by green univariate and multivariate spectrophotometric methods. Univariate methods were zero order absorption spectra method (D0) and Fourier self-deconvolution (FSD), as TRI was directly determined by D0 at 367.0 nm in the range (2.00–10.00 µg/mL), where XIP show no interference. While XIP was determined by FSD at 261.0 nm in the range (2.00–8.00 µg/mL), where TRI show zero crossing. Multivariate methods were Partial Least Squares, Principal Component Regression, Artificial Neural Networks, and Multivariate Curve Resolution-Alternating Least Squares. A training set of 25 mixtures with different quantities of the tested components was used to construct and evaluate them, 3 latent variables were displayed using an experimental design. A set of 18 synthetic mixtures with concentrations ranging from (3.00–7.00 µg/mL) for TRI and (2.00–6.00 µg/mL) for XIP, were used to construct the calibration models. A collection of seven synthetic mixtures with various quantities was applied to build the validation models. All the proposed approaches quantitative analyses were evaluated using recoveries as a percentage, root mean square error of prediction, and standard error of prediction. Strong multivariate statistical tools were presented by these models, and they were used to analyze the combined dosage form available on the Egyptian market. The proposed techniques were evaluated in accordance with ICH recommendations, where they are capable of overcoming challenges including spectral overlaps and collinearity. When the suggested approaches and the published one were statistically compared, there was no discernible difference between them. The green analytical method index and eco-scale tools were applied for assessment of the established models greenness. The suggested techniques can be used in product testing laboratories for standard pharmaceutical analysis of the substances being studied.
Efficient integrated production of bioethanol and antiviral glycerolysis lignin from sugarcane trash
Authors: Khattab Sadat Mohamed Rezk , Okano Hiroyuki , Kimura Chihiro , Fujita Takashi , Watanabe Takashi 
Published: May 2023

Abstract
Background
Sugarcane trash (SCT) represents up to 18% of the aboveground biomass of sugarcane, surpassing 28 million tons globally per year. The majority of SCT is burning in the fields. Hence, efficient use of SCT is necessary to reduce carbon dioxide emissions and global warming and establish agro-industrial biorefineries. Apart from its low costs, conversion of whole biomass with high production efficiency and titer yield is mandatory for effective biorefinery systems. Therefore, in this study, we developed a simple, integrated method involving a single step of glycerolysis pretreatment to produce antiviral glycerolysis lignin (AGL). Subsequently, we co-fermented glycerol with hydrolyzed glucose and xylose to yield high titers of bioethanol.

Results
SCT was subjected to pretreatment with microwave acidic glycerolysis with 50% aqueous (aq.) glycerol (MAG50); this pretreatment was optimized across different temperature ranges, acid concentrations, and reaction times. The optimized MAG50 (opMAG50) of SCT at 1:15 (w/v) in 1% H2SO4, 360 µM AlK(SO4)2 at 140 °C for 30 min (opMAG50) recovered the highest amount of total sugars and the lowest amount of furfural byproducts. Following opMAG50, the soluble fraction, i.e., glycerol xylose-rich solution (GXRS), was separated by filtration. A residual pulp was then washed with acetone, recovering 7.9% of the dry weight (27% of lignin) as an AGL. AGL strongly inhibited the replication of encephalomyocarditis virus (EMCV) in L929 cells without cytotoxicity. The pulp was then saccharified in yeast peptone medium by cellulase to produce a glucose concentration similar to the theoretical yield. The total xylose and arabinose recoveries were 69% and 93%, respectively. GXRS and saccharified sugars were combined and co-fermented through mixed cultures of two metabolically engineered Saccharomyces cerevisiae strains: glycerol-fermenting yeast (SK-FGG4) and xylose-fermenting yeast (SK-N2). By co-fermenting glycerol and xylose with glucose, the ethanol titer yield increased to 78.7 g/L (10% v/v ethanol), with a 96% conversion efficiency.

Conclusion
The integration of AGL production with the co-fermentation of glycerol, hydrolyzed glucose, and xylose to produce a high titer of bioethanol paves an avenue for the use of surplus glycerol from the biodiesel industry for the efficient utilization of SCT and other lignocellulosic biomasses.
Benign breast disease with malignant imaging features: a case report
Authors: Zhong Yuanyuan , Cheng Yiqin , Chen Ling , Yin Yulian 
Published: May 2023

Abstract
Background
Diabetic mastopathy is a rare breast condition that occurs in women with poorly controlled diabetes and is characterized by hardening of the breast tissue. The purpose of this case report is to provide an overview of the clinical characteristics and therapeutic principles of this rare disease to support front-line physicians in their crucial activity of case identification.

Case presentation
A 64-year-old Asian female patient with a history of type II diabetes mellitus was referred to our clinic for an evaluation of a newly discovered breast mass. The patient had been diagnosed with diabetes more than 20 years prior and was being managed with oral hypoglycemic agents. Her past medical history was otherwise unremarkable. Physical examination of the breast revealed a palpable, mobile, and firm mass measuring 6 × 4 cm in the upper quadrant of the right breast. Ultrasound images showed an uneven hypoechoic nodule, BI-RADS 4B. Mammography showed the compact and flaky nature of the two breasts and the heterogeneity of the substantive density increases. The patient’s clinical manifestations and imaging findings suggest the possibility of breast cancer. The patient opted for surgical excision of the mass. Through surgery, the mass was completely excised with negative margins. Pathological examination of the mass revealed a proliferation of fibroblastic cells, with an increased nuclear/cytoplasmic ratio, consistent with a diagnosis of diabetic mastopathy.

Conclusions
This case report serves to highlight the importance of recognizing diabetic mastopathy as a possible differential diagnosis of a breast mass in patients with diabetes mellitus. In our patient, early diagnosis and treatment with lumpectomy resulted in a favorable outcome, emphasizing the importance of prompt medical and surgical management. In addition, more research is needed to mine the diagnostic marker of diabetic mastopathy and provide data related to its prognosis.
Endophytic actinobacteria from wild medicinal plants are a natural source of insecticide to control the African cotton leafworm (Spodoptera littoralis)
Authors: Diab Mohamed K. , Mead Hala M. , Khedr Mohamad A. , Nafie Mohamed S. , Abu-Elsaoud Abdelghafar M. , Hanora Amro , El-Shatoury Sahar A. 
Published: May 2023

AbstractInsecticide resistance in agricultural pests has prompted the need to discover novel compounds with new modes of action. We investigated the potency of secondary metabolites from seventy endophytic actinobacteria against laboratory and field strains of Spodoptera littoralis (fourth instar), comparable to the bioinsecticide spinetoram (Radiant SC 12%). Endophytes from Artemisia herba-alba and A. judaica were highly effective. Chemical profiling of the most potent metabolite of the strain Streptomyces sp. ES2 was investigated using LC-QTOF-MS-MS technique, and the activity was validated through molecular docking studies. Metabolic extracts from actinobacteria belonging to Streptomyces, Nocardioides, and Pseudonocardia showed immediate and latent death to the Spodoptera littoralis fourth instar larvae. The metabolite from strain ES2 has shown the most promising and significant histopathological and inhibitory effects on the fourth instar larvae. ES2 metabolite caused lesions in the body wall cuticle, indicating a different mode of action than that of Radiant. Chemical profiling of ES2 showed the presence of cyromazine (molt inhibitor), 4-nitrophenol, and diazinon as key constituents. In conclusion, these findings suggest that secondary metabolites from endophytic actinobacteria inhabiting wild medicinal plants can be a sustainable source for promising natural biocontrol agents. This is the first illustration of the insecticidal activity of Artemisia spp. microbiome, and natural cyromazine synthesis by actinobacteria.
Some properties of branching processes with random control functions and affected by viral infectivity in random environments
Authors: Ren Min , Zhang Guanghui 
Published: May 2023

AbstractIn this paper, a model of branching processes with random control functions and affected by viral infectivity in independent and identically distributed random environments is established, and the Markov property of the model and a sufficient condition for the model to be certainly extinct under some conditions are discussed. Then, the limit properties of the model are studied. Under the normalization factor $\{S_{n}:n\in N\}$
{

S
n

:
n
∈
N
}
, the normalization processes $\{\hat{W}_{n}:n\in N\}$
{

W
ˆ

n

:
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}
are studied, and the sufficient conditions of $\{\hat{W}_{n}:n\in N\}$
{

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n

:
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∈
N
}
a.s., $L^{1}$

L
1

and $L^{2}$

L
2

convergence are given; A sufficient condition and a necessary condition for convergence to a nondegenerate at zero random variable are obtained. Under the normalization factor $\{I_{n}:n\in N\}$
{

I
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:
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}
, the normalization processes $\{\bar{W}_{n}:n\in N\}$
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are studied, and the sufficient conditions of $\{\bar{W}_{n}:n\in N\}$
{

W
¯

n

:
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∈
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}
a.s., and $L^{1}$

L
1

convergence are obtained.
Exploring energy citizenship in the urban heating system with the ‘Walking with Energy’ methodology
Authors: Palm Jenny , Ambrose Aimee 
Published: May 2023

Abstract
Background
Energy citizenship has emerged as a concept which attempts to capture the new role envisaged for urban citizens as engaged and active in the energy transition. However, exactly how to successfully engage energy citizens requires more research and this article aims to contribute to this knowledge gap. The article presents a new methodology, ‘Walking with Energy’, which seeks to (re)connect citizens with where their energy is coming from. By experimenting with the application of this method in the UK and Sweden, we consider how viewing and talking about heating provision, while in the energy landscape, can encourage participants to reflect upon their local, mundane energy experiences and foster a greater sense of energy citizenship and greater motivation to engage with debates around heating transition.

Results
The article presents four different events: (1) a physical walk to an energy recovery facility, (2) a walk to view a building’s heat exchanger, (3) a round-table discussion using pictures to communicate in a language café, and (4) a virtual tour around an Energy Recovery Facility. The way we conducted the events influenced who engaged, for example: the walk through a heat facility and the walk to visit a heat exchanger in the basement of a University building tended to attract white middle-class people, while the virtual tour attracted a more mixed audience in terms of age and background, but most had a strong environmental interest. The language café targeted immigrants. The different events resulted in many similar reflections, but there was also variation. For example, the walk through the heat facility generated the most focused and least diverse reflections, while the event focussed on the heat exchanger opened up a wide range of issues for discussion.

Conclusions
We find that the method encouraged the sharing of personal experiences, storytelling, and deepened the engagement of participants with debates about energy. The method can help promote energy democracy and boost a deliberative dialogue about present and future energy systems among citizens. We also learnt that promotion of energy citizenship requires not only active citizens but also active facilitation to create opportunities for citizens to engage and reflect.