bluuebunny/crossref_metadata_2025_split huggingface dataset:
Understanding Health System Resilience in responding to a pandemic: experience and lessons from an evolving context of federalization in Nepal
Authors: Regmi Shophika , Bertone Maria Paola , Shrestha Prabita , Sapkota Suprich , Arjyal Abriti , Martineau Tim , Raven Joanna , Witter Sophie , Baral Sushil 
Published: May 2023

Abstract
Introduction
The COVID-19 pandemic has tested the resilience capacities of health systems worldwide and has highlighted the need to understand the concept, pathways, and elements to resilience in different country contexts. In this study, we assessed the health system response to COVID-19 and examined the processes of policy formulation, communication and implementation at the three tiers of government in Nepal, including the dynamic interactions between tiers. Nepal was experiencing the early stages of federalization reform when COVID-19 pandemic hit the country and clarity in roles and capacity to implement functions were the prevailing challenges especially among the subnational governments.
Methods
We adopted a cross-sectional exploratory design, using mixed methods. We carried out a document review of all policy documents introduced in response to COVID-19 from January-December 2020, and collected qualitative data through 22 key informant interviews at three tiers of government, during January-March 2021. Two municipalities were purposively selected for data collection in Lumbini province. Our analysis is based on a resilience framework that has been developed by our research project, ReBUILD for Resilience, which helps to understand pathways to health system resilience through absorption, adaptation and transformation.
Results
In the newly established federal structure, the existing emergency response structure and plans were utilized, which were yet to be tested in the decentralized structure. Federal government effectively led the policy formulation process, with minimal engagement of sub-national governments. The local governments did not demonstrate resilience capacities, due to the novelty of the federal system and their consequent lack of experience, confusion on roles, insufficient management capacity and governance structures at local level and limited availability of human, technical and financial resources.
Conclusions
The study findings emphasize the importance of strong and flexible governance structures and strengthened capacity of subnational governments to effectively manage pandemics. The study elaborates on the key areas and pathways that contribute to resilience capacities of health systems from the experience of Nepal. We draw out lessons for other fragile and shock-prone settings.
Does the congenital blind have space-time mapping on the sagittal axis?
Authors: Hao Fengxiao , Shi Lingzheng , Sun Qiang , Che Lu , Jiang Yuewen , Huang Zhenyi , Cheng Xiaorong , Fan Zhao , Ding Xianfeng 
Published: May 2023

Abstract
Previous evolutionary perspectives proposed strongly that the space-time mapping on the sagittal axis originates from visual-locomotor coupling when walking/running forward. Thus, the congenital blind could not have the sagittal mental timeline. However, this conclusion was reached with single empirical evidence (Rinaldi et al., 2018) and requires corroboration from converging evidence using diverse methodologies. The present study systematically explored whether the congenital blind has space-time mapping on the sagittal axis using different paradigms in three experiments. In Experiment 1, the congenital blind showed preferred space-time mapping in the sagittal dimension as normal sighted using a typical implicit RT task. In Experiment 2, this space-time mapping could even occur automatically when using a temporal judgment irrelevant naming task. In Experiment 3, the congenital blind was more likely to put the past time behind the body and to put the future time in front of the body in an explicit space-time mapping task. Moreover, most blinds use spatial metaphors to make this space-time mapping on the sagittal axis. These results support that the congenital blind could have a sagittal mental timeline, and the visual-locomotor coupling experience was not critical for this space-time mapping. Taken together, the present study helps to clarify the long-standing debate on the origin of the sagittal mental timeline.
The challenge of assessing Posttraumatic Stress Disorder (PTSD): An umbrella review on the PTSD prevalence following different types of traumatic events
Authors: Schincariol Alexa , Orrù GRaziella , Otgaar Henry , Sartori Giuseppe , Scarpazza Cristina 
Published: May 2023

Abstract
Posttraumatic stress disorder (PTSD) is one of the most serious and incapacitating mental diseases that can result from trauma exposure. However, despite its relevance, there is still considerable confusion and debate surrounding its diagnosis. The aim of this umbrella review is to clarify the overall prevalence of PTSD. Furthermore, the study examined whether the diagnostic methodology applied (self-reported vs structured interviews) and the nature of the traumatic event (interpersonal vs not interpersonal) impact on PTSD prevalence. A systematic search of major databases and additional sources was conducted. Fifty-nine reviews met the criteria of this umbrella review. Overall PTSD prevalence was 23.95% (95% CI 20.74 - 27.15), with no publication bias or significant small-study effects, but a high level of heterogeneity between meta-analyses. Findings suggest that using structured clinical interviews results in a lower PTSD prevalence than using of self-report instruments, while no difference was found in the disorder prevalence when confronting interpersonal and non-interpersonal events. This analysis gives a solid foundation for future research and PTSD assessment.
Biodiversity-production feedback effects lead to intensification traps in agricultural landscapes
Authors: Burian Alfred , Kremen Claire , Wu James , Beckmann Michael , Bulling Mark , Garibaldi Lucas , Krisztin Tamas , Mehrabi Zia , Ramankutty Navin , Seppelt Ralf 
Published: May 2023

Abstract
Intensive agriculture with high reliance on pesticides and fertilizers constitutes a major strategy for ‘feeding the world’. However, such conventional intensification is linked to diminishing returns and can result in ‘intensification traps’ – production declines triggered by the negative feedback of biodiversity loss at high input levels. We developed a novel framework that integrates biodiversity in crop-yield assessments to evaluate risk and magnitude of intensification traps. Simulations grounded in literature reviews demonstrated that intensification traps emerge in most agricultural landscapes (73%), but rarely in major calorie production systems. Small reductions in maximal production by just 5–10% could be frequently transmitted into substantial biodiversity gains, resulting in small-loss large-gain trade-offs prevailing in landscapes with and without intensification traps. However, systematic sensitivity analyses revealed a strong context-dependence complicating the identification of optimal management practices at the field level. Hence, management safety margins need to be considered to prevent the double loss of biodiversity and food security linked to intensification traps.
Petrosal Artery in Middle Fossa Approach: Rare Entity
Authors: Turkis Omer Furkan , Karadag Ali , Özdemir Ahmet Faruk , Tanriover Necmettin 
Published: May 2023

Abstract
Purpose In middle fossa approach, middle meningeal artery is sacrified during the surgery but, sacrification of this artery sometimes disrupts the supply of the ganglion geniculate, causing facial nerve palsy. The aim of this study is to show the petrosal artery that originates from the middle meningeal artery and feeds the ganglion geniculate, which can be seen very rarely in surgical and cadaver dissections.Method In Cerrahpaşa Faculty of Medicine, Micro-Endoneurosurgery and Neuroanatomy Laboratory, the middle fossa approach was applied with the help of a microscope on 2 silicone-injected cadavers with classical methods. Each stage of the dissections was 3D photographed.Result After temporal craniotomy, the foremen spinosum and the middle meningeal artery (OMA) were reached by retraction of the temporal lobe. Mandibular and maxillary branches of trigeminal nerve were exposed after going on dissecting anterior to foramen spinosum. Sometimes these structures may be covered with bone tissue and light drilling may be required for dissection. After greater petrosal nerve and ganglion geniculate are exposed, arcuate eminence is pierced approximately 60 degrees medially, and internal acoustic canal is opened superiorly and 7–8. nerve bundle is reached.Conclusion OMA gives rise to the petrosal artery, a branch that supplies the ganglion geniculate. If the OMA is to be sacrificed during surgery, this should be done above the petrosal artery level so that the arterial supply of the ganglion geniculate is not impaired. Preservation of the petrosal artery is important in neurosurgery practice.
Concomitant cancer surgery and risk-reducing surgery for noninvasive breast cancer diagnosed during surveillance for undiagnosed hereditary breast and ovarian cancer (HBOC) syndrome: A case report
Authors: Tanaka Aya , Matsumoto Megumi , Takao Mami , Miura Shoko , Hasegawa Yuri , Otsubo Ryota , Hayashi Hiroko , Isomoto Ichiro , Miura Kiyonori , Nagayasu Takeshi 
Published: May 2023

Abstract
Background: In Japan, genetic testing, surveillance, and risk-reducing surgery for hereditary breast and ovarian cancer (HBOC) syndrome have been covered by the Japanese national insurance system since April 2020. On the other hand, the current situation is that medical care, including surveillance of undiagnosed (cancer-free) patients, is self-funded even for individuals with HBOC. We report a case in which breast cancer was diagnosed at an early stage during surveillance for cancer-free HBOC at the patient's own expense, and risk-reducing surgery was performed at the same time as treatment for breast cancer.
Case presentation: The patient was a 63-year-old woman. Her sister had a history of breast cancer in her 30s and was found to be a BRCA2 pathogenic variant carrier by genetic testing. The patient therefore presented to the genetic department of our hospital and underwent genetic testing (out-of-pocket). A pathogenic variant was found at the same site. During annual breast and ovarian surveillance at the patient’s own expense, the physician with sufficient expertise in contrast-enhanced breast magnetic resonance imaging (MRI) noticed a change in the contrast enhancement pattern on breast MRI and performed needle biopsy, revealing ductal carcinoma in situ. At her request, she underwent concurrent contralateral risk-reducing mastectomy and risk-reducing salpingo-oophorectomy in addition to breast cancer treatment.
Conclusions: We have seen a case in which cancer treatment and risk-reducing surgery were performed at the same time for a pathogenic variant carrier who was very anxious about developing cancer. Surveillance of cancer-free BRCA1/2 mutation carriers and expansion of insurance coverage for surgery are important future issues.
Risk Factors of Hospitalization and Mortality among Hajj Pilgrims in Indonesia
Authors: Ardiana Meity , Paramitha Annisya Dinda , Shabrina Farah Aisha , Harsoyo Primasitha Maharany 
Published: May 2023

Abstract
Objectives
The incidence of hospitalization in Hajj pilgrims can be influenced by age, physical activity, and comorbidities, such as hypertension and diabetes melitus. Smoking, low levels of physical activity, cardiovascular, respiratory and endocrine metabolic diseases are the risk factors of mortality for Indonesian pilgrims. This study aims to identify the relationship between risk factors owned by pilgrims with hospitalization and mortality that occurs during the Hajj period.
Methods
This was a cross-sectional, non-intervention study with data retrieved from the pre-embarkation Hajj screening records. The diagnosis of hospitalization and cause of death during the Hajj period were obtained from the medical report and hospital/flight doctor death certificate.
Results
A total of 2933 eligible subjects were analyzed in this study, with 11 subjects having a history of hospitalization. The 11 subjects were over 50 years old with male (n=6, 54.5%) and women (n=5, 45.4%) having almost the same number. Bivariate analysis for comorbidities and laboratory outcomes resulted in diabetes melitus as the only comorbidity that increases the risk for hospitalization in Hajj pilgrims (p=0.035). There was no association between existing comorbidities with mortality during the Hajj period. Multivariate analysis using logistic regression showed that higher white blood cell levels were associated with higher risk of both hospitalization (p<0.001) and mortality (p<0.001) with mean value of 8030 ± 5290 mg/dl.
Conclusions
The risk factors associated with the hospitalization rate of pilgrims in Indonesia are a history of diabetes mellitus and higher white blood cell levels. Pilgrims with higher white blood cell levels with a mean value of 8030 ± 5290 mg/dl also have an increased risk of mortality during Hajj period.
Semantic Segmentation Algorithm for Autonomous Driving using UNET Architectures: A Comparative Study
Authors: Subhedar Javed , Bachute Mrinal , Koundal Deepika , Kotecha Ketan 
Published: May 2023

Abstract
In autonomous driving systems, the semantic segmentation task involves scene partition into numerous expressive portions by classifying and labeling every image pixel for semantics. The algorithm used for semantic-segmentation has a vital role in autonomous driving architecture. The main contribution of this paper is the design of UNET architecture for the semantic-segmentation algorithm of autonomous driving. We address semantic image segmentation by the images captured using the open-source Car Learning to Act (CARLA) simulator platform for this research work. Semantic segmentation processes images from the camera obtained from the simulated vehicle for classification into multiple classes, including roads, cars, bikes, lanes, bicycles, trees, sky, etc. This study is intended to capture the merits of the U-NET semantic segmentation Algorithms for autonomous driving using the Keras framework. The proposed algorithm was evaluated on a dataset generated using CARLA simulation software and the CAMViD dataset for different metrics.
Synthesis of Rizatriptan Analogues via the Fischer Indole Synthesis in the Presence of Sustainable Natural Deep Eutectic Solvents and Catalyst
Authors: Raya Indah , Altimari Usama S. , Alami Baraa G. , Srika Seelam , Gatea M. Abdulfadhil , Romero-Parra Rosario Mireya , Barboza-Arenas Luis Andres , Mustafa Yasser Fakri 
Published: May 2023

Abstract
In this research, a facile and efficient protocol for the synthesis of rizatriptan analogues using natural deep eutectic solvents as an inexpensive, easily available, and environmentally friendly catalyst is developed. The reaction of various phenyl hydrazines (a–j) and 3,3-dimethoxy-N,N-dimethylpropan-1-amine (2) using natural deep eutectic solvents affords fused indole heterocyclic compounds under optimised conditions at 70°C to produce the desired products with excellent to good yields (77–89%) at short reaction times (1 h). This new facile methodology Compared with previous reactions, has the advantages of a reusable catalyst, short reaction times and simplicity of the product isolation.
Analysis of inter-layer crack propagation and strength prediction of steel bridge deck asphalt pavement based on XFEM-CZM coupling
Authors: ZHU Chen , Wang Hongchang 
Published: May 2023

Abstract

The extended finite method (XFEM) is used to simulate the internal defects of the binder layer, and the cohesion model (CZM) is used to simulate the binder layer/steel plate interface and the binder layer/asphalt pavement interface, which are coupled to analyze the inter-layer type I crack expansion and interfacial debonding and delamination phenomena of the binder layer. The feasibility and accuracy of the XFEM-CZM coupling method were verified by comparing it with Virtual Crack Closure Method (VCCT), CZM, XFEM-VCCT, and experiments. A double cantilever beam experimental model was established to simulate the process of inter-ply type I cracks expanding from the inside of the bonded layer to the interface between the bonded layer and the upper and lower layers and causing debonding, to analyze the damage failure mechanism of inter-ply type I cracks in asphalt pavement of steel bridge decks, and to discuss the effects of initial crack length, interface stiffness, interface strength and bond layer thickness on the overall inter-ply bond strength performance. The results show that the inter-layer strength decreases with the increase of initial crack length, and the expansion angle increases with the increase of crack length; the interface strength, interface stiffness, and bond layer thickness have obvious influence on the inter-layer strength and less influence on the expansion path of inter-layer cracks.
Evaluation of flavaspidic acid BB from Dryopteris fragrans (L.) Schott against resistant Staphylococcus haemelyticus in planktonic and biofilm forms
Authors: Liu Jiaxin , Liu Ruijie , Deng Rongrong , Zheng Shiqian , Shen Zhibin 
Published: May 2023

Abstract
Background Staphylococcus haemolyticus (S. haemolyticus) is the main etiological factor in skin and soft tissue infections (SSTI). S. haemolyticus infections are an important concern worldwide, especially with the associated biofilms and drug resistance. Herein, we investigated the inhibitory effect of Flavaspidic acid BB obtained from plant extractions on clinical S. haemolyticus strains and their biofilms. Moreover, we predicted its ability to bind to the protein-binding site by molecular simulation. Since the combination of Hsp70 and RNase P synthase after molecular simulation with flavaspidic acid BB is relatively stable, enzyme-linked immunosorbent assay (ELISA) was used to investigate Hsp70 and RNase P synthase to verify the potential antimicrobial targets of flavaspidic acid BB.Results The minimal inhibition concentration value of 16 clinical strains of S. haemolyticus was 5 ~ 480 µg/mL, and flavaspidic acid BB had a slightly higher inhibitory effect on the biofilm than MUP. The inhibitory effect of flavaspidic acid BB on biofilm formation was better with an increase in the concentration of BB. Molecular simulation verified its ability to bind to the protein-binding site. The combination of ELISA kits showed that the bacteriostatic activity of flavaspidic acid BB may be achieved by inhibiting the utilization and re-synthesis of proteins and synthesis of tRNA, thus inhibiting bacterial growth and biofilm formation to a certain extent.Conclusions This study could potentially provide a new prospect for the development of flavaspidic acid BB as an antibacterial agent for resistant strains.
Comparison of early surgical outcomes of robotic and laparoscopic colorectal cancer resection in a single centre: A cohort study
Authors: Sultana Momotaz , Butnari Valentin , Mansuri Ahmer , Rao Christopher , Kaul Sandeep , Boulton Richard , Huang Joseph , Rajendran Nirooshun 
Published: May 2023

AbstractIntroduction: Robotic platforms provide a stable tool with high-definition views and improved ergonomics compared to laparoscopic approaches. Purpose The aim of this retrospective study was to compare the intra- and short-term postoperative results of oncological resections performed robotically (RCR) and laparoscopically (LCR) at a single centre. Methods Between February 2020 and October 2022, retrospective data on RCR were compared to LCR undertaken during the same period. Parameters compared include total operative time (TOT), length of stay (LOS), re-admission rates, 30-day morbidity. Results 100 RCR and 112 LCR satisfied inclusion criteria. There was no difference between the two group’s demographic and tumour characteristics. Overall, median operative time was shorter in LCR group [200 vs 247.5 min,p < 0.005], but this advantage was not observed with pelvic and muti-quadrant resections. There was no difference in the rate of conversion [5(5%) vs 5(4.5%),p > 0.9]. With respects to perioperative outcomes, there was no difference in the overall morbidity, or mortality between RCR and LCR, in particular requirement for blood transfusion [3(3%) vs 5(4.5%),p 0.72], prolonged ileus [9(9%) vs 15(13.2%),p 0.38], surgical site infections [5(4%) vs 5(4.4%),p > 0.9] anastomotic leak [7(7%) vs 5(4.4%),p 0.55], and re-operation rate [9(9%) vs 7(6.3%),p 0.6]. RCR had shorter LOS by one night, but this did not reach statistical significance. No difference was observed in completeness of resection but there was a statically significant increase in lymph node harvest in the robotic series. Conclusion Robotic approach to oncological colorectal resections is safe, with comparable intra- and peri-operative morbidity and mortality to laparoscopic surgery.
The pace of life expectancy gains in China 2000-2019, in compare with developed countries
Authors: Zhang Leyi , Sun Lijuan 
Published: May 2023

Abstract
Background
The slowing pace of LE gains at elder ages of China compared to that of developed countries is found. We aim to describe and analyze the gap of LE at birth and elderly between China and developed countries by comparing LE gains.
Methods
The LE of China is estimated by log-quadratic model, and data of developed country is obtained from HMD. The LE age-specific decomposition and LE gains by level of LE is used to explain the gap between China and developed countries.
Results
During the study period, the LEB gap between China and developed countries exhibited a decreasing trend. However, the LE60 gap among men increased by 0.6 year, while it decreased by 1.2 years among women. The reduction in the LEB gap 2000–2009 in China was primarily attributed to significant improvements in child and adult mortality, from 2010 to 2019, the increase in LEB in China is gradually dominated by the mortality improvement of the elder ages. Moreover, the comparison of LEB gains by level of LEB shows the LEB gains of Chinese men decreased from being substantially higher than that of developed countries to becoming comparable with it, while the LEB of Chinese female also decreased significantly but remained relatively higher; the LE60 gains of Chinese male approached, while that of female of China remained higher than that of developed countries.
Conclusion
The study indicates that the pace of male LEB and at elder ages gains in China is close to that of developed countries, and that of female are still faster in recent years. In the future, the gaps of LEB and at elder ages between China and developed countries will both show a decreasing trend.