bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cost-effectiveness of 20-valent pneumococcal conjugate vaccine compared with 23-valent pneumococcal polysaccharide vaccine among adults in a Norwegian setting
Authors: Malene B Mikkelsen , Oyvind Husby , Tor Molden , David N Mwaura , Jens Olsen , Nanna V Kristensen , Jeffrey Vietri 
Published: August 2023

Abstract
Background
The morbidity and mortality of adult diseases caused by S. pneumoniae increase with age and presence of underlying chronic diseases. Currently, two vaccine technologies against S. pneumoniae are used: the 23-valent pneumococcal polysaccharide vaccine (PPV23) and the pneumococcal conjugate vaccines, one of which is the 20-valent pneumococcal conjugate vaccine (PCV20) that has recently been approved for adults.

Objective
This study was conducted to investigate the cost-effectiveness of implementing PCV20 in a reimbursement scheme for Norwegian adults aged 18–99 years at risk of pneumococcal diseases and those aged 65 years and older at low risk compared to PPV23.

Methods
An established Markov model was adapted to a Norwegian setting to estimate the economic and clinical consequences of vaccinating the Norwegian population in specific age and risk groups against pneumococcal diseases. Inputs for the model were found in Norwegian or Danish real-world evidence or retrieved from available studies. The costs and clinical outcomes were assessed using a health sector perspective and a lifetime time horizon.

Results
The results showed that PCV20 was associated with better health outcomes including fewer disease cases, fewer disease-attributable fatalities, a higher gain of life years and quality-adjusted life years compared to PPV23. In addition, PCV20 had a lower total cost compared to PPV23. Therefore, PCV20 was the dominant vaccination strategy. The base case result was investigated in multiple sensitivity analyses, which showed that the results were robust to changes in input parameters and methodological assumptions, as PCV20 remained the dominant vaccination strategy in almost all scenarios.

Conclusion
Results showed that vaccinating the Norwegian adults with PCV20 was cost-effective compared to PPV23. Changes in the hospital cost of pneumonia, the price of PCV 20, the effectiveness of PCV20 against pneumonia, and the pneumonia disease incidence had the highest impact on the ICER, i.e., were the main drivers of the results.
The indirect impact of COVID‐19 pandemic on limb preservation care– a retrospective analysis of trends in lower limb revascularisation
Authors: Anthony Lakmali , Gillies Madeline , Tran Morica , Goh David 
Published: August 2023

AbstractBackgroundDisruptions caused by COVID‐19 pandemic have profoundly influenced the management of many conditions, especially vascular pathologies including limb preservation care. The aim of this study is to evaluate the impact of the pandemic on patients with peripheral arterial disease (PAD) focusing on lower limb revascularisation procedure volume, their indication and urgency of surgery.MethodsThe Australian Vascular Audit (AVA) was used to capture data on revascularisation procedures before and after the onset of the pandemic in Victoria, Australia. Information on patient demographics, procedures performed, their indication and urgency of surgery were collected.ResultsThere was a significant 22.7% increase in revascularisations for PAD during the COVID‐19 pandemic, driven solely by a 31.9% increase in endovascular revascularisation procedures. Revascularisation procedures for all indications of PAD, namely claudication, rest pain and tissue loss, increased by 14.8%, 39.2% and 27.4% respectively, during the pandemic compared to pre‐pandemic times. Open procedures declined by 10.2% during the pandemic. There were significant 13.9% and 62.2% increases in elective and semi‐urgent revascularisations respectively during the pandemic while emergency revascularisations for PAD fell by 4.2%. There were no significant increases in toe, forefoot or below knee amputations during the pandemic compared to pre‐pandemic times.ConclusionsThis study found that the volume of revascularisation for PAD increased significantly during the pandemic indicating that patients with PAD had significant deterioration of their condition during the pandemic. This is likely multifactorial; due to disruptions to standard provision of podiatry, vascular surgery and endocrinology services to these patients, a decline in overall health and changes in health‐related behaviours due to restrictions and infection control methods imposed during the pandemic. The number of elective and semi‐urgent procedures also increased during the pandemic which reflects the significant deterioration of PAD patients during the pandemic. This study highlights a concerning trend of worsening PAD when routine care of these patients is disrupted. Such data should be instrumental in contingency planning and resource allocation for managing the ongoing pandemic.
SMAD2 inhibits pyroptosis of fibroblast-like synoviocytes and secretion of inflammatory factors via the TGF-β pathway in rheumatoid arthritis
Authors: Mao Xingxing , Wu Weijie , Nan Yunyi , Sun Weiwei , Wang Youhua 
Published: August 2023

Abstract
Objective
Rheumatoid arthritis (RA) is a chronic, progressive autoimmune disease. Over-activation of fibroblast-like synoviocytes is responsible for the hyperplasia of synovium and destruction of cartilage and bone and pyroptosis of FLS plays a key role in those pathological processes during RA. This study investigated the detailed mechanisms that SMAD2 regulates the pyroptosis of FLS and secretion of inflammatory factors in rheumatoid arthritis.

Methods
We collected synovial tissues of RA patients and FLS-RA and cultured FLS for detection of expression of SMAD2. ASC, NLRP3, cleaved-caspase-1, and GSDMD-N were detected by Western blot after overexpression of SMAD2. Besides, flow cytometry, electron microscope, ELISA, HE staining, and Safranin O staining were performed to further demonstrate that SMAD2 can affect the pyroptosis of FLS-RA.

Results
The expression of SMAD2 was down-regulated in synovial tissues of RA patients and FLS-RA. Overexpression of SMAD2 can inhibit the expression of ASC, NLRP3, cleaved-caspase-1, and GSDMD-N. Flow cytometry and electron microscope further demonstrated that SMAD2 attenuated pyroptosis of FLS-RA. In addition, overexpression of SMAD2 also inhibited inflammatory factors such as IL-1β, IL-18, IL-6, and IL-8 secretion and release of LDH. Besides, overexpression of SMAD2 can reverse the decrease of p-SMAD2 and TGF-TGF-β induced by nigericin. In vivo experiments on CIA rats further demonstrated that overexpression of SMAD2 by local intra-articular injection of LV-SMAD2 can effectively alleviate joint redness, swelling, and destruction of cartilage and bones.

Conclusion
SMAD2 inhibited FLS-RA pyroptosis by down-regulating of NLRP3 inflammasomes (NLRP3, ASC, and caspase-1 complex) and eased the secretion of inflammatory factors via the TGF-β signaling pathway, thereby improving the symptom of RA. We hope that this study may provide a new research idea for RA and a potential target for the treatment of RA.
Nocardia brain abscess in a patient with diabetes: a case report
Authors: Boctor Noelle , Aronowitz Paul 
Published: August 2023

Abstract
Background
Nocardia are aerobic Gram-positive bacilli that can invade multiple organ systems, including the brain and lungs. It is most frequently found in patients who are immunocompromised. Invasive nocardial disease is a potentially life-threatening infection that can pose a diagnostic challenge.

Case presentation
Our case details a 76-year-old Indian woman with poorly-controlled diabetes mellitus admitted for confusion and falls. Imaging revealed intracranial abscesses and necrotic masses in the mediastinum and lungs. The suspected diagnosis was tuberculosis; however, she underwent extensive workup without a final diagnosis. Ultimately, a craniotomy with partial brain abscess resection was performed. Dura matter samples revealed Nocardia farcinica.

Conclusions
This case illustrates the importance of considering Nocardia in patients with brain abscesses, particularly in those with immunocompromised states and demonstrates the diagnostic challenges that may arise in definitively making this diagnosis. Invasive procedures may be needed for diagnostic confirmation.
Xeno-free generation of human induced pluripotent stem cells from donor-matched fibroblasts isolated from dermal and oral tissues
Authors: Ali Hassan R. W. , Suliman Salwa , Osman Tarig Al-Hadi , Carrasco Manuel , Bruland Ove , Costea Daniela-Elena , Ræder Helge , Mustafa Kamal 
Published: August 2023

Abstract
Background
Induced pluripotent stem cells (iPS) can be generated from various somatic cells and can subsequently be differentiated to multiple cell types of the body. This makes them highly promising for cellular therapy in regenerative medicine. However, to facilitate their clinical use and to ensure safety, iPS culturing protocols must be compliant with good manufacturing practice guidelines and devoid of xenogenic products. Therefore, we aimed to compare the efficiency of using humanized culture conditions, specifically human platelet lysate to fetal bovine serum, for iPS generation from different sources, and to evaluate their stemness.

Methods
iPS were generated via a platelet lysate or fetal bovine serum-based culturing protocol from matched dermal, buccal and gingival human fibroblasts, isolated from healthy donors (n = 2) after informed consent, via episomal plasmid transfection. Pluripotency, genotype and phenotype of iPS, generated by both protocols, were then assessed by various methods.

Results
More attempts were generally required to successfully reprogram xeno-free fibroblasts to iPS, as compared to xenogenic cultured fibroblasts. Furthermore, oral fibroblasts generally required more attempts for successful iPS generation as opposed to dermal fibroblasts. Morphologically, all iPS generated from fibroblasts formed tight colonies surrounded by a reflective “whitish” outer rim, typical for iPS. They also expressed pluripotency markers at both gene (SOX2, OCT4, NANOG) and protein level (SOX2, OCT4). Upon stimulation, all iPS showed ability to differentiate into the three primary germ layers via expression of lineage-specific markers for mesoderm (MESP1, OSR1, HOPX), endoderm (GATA4) and ectoderm (PAX6, RAX). Genome analysis revealed several amplifications and deletions within the chromosomes of each iPS type.

Conclusions
The xeno-free protocol had a lower reprogramming efficiency compared to the standard xenogenic protocol. The oral fibroblasts generally proved to be more difficult to reprogram than dermal fibroblasts. Xeno-free dermal, buccal and gingival fibroblasts can successfully generate iPS with a comparable genotype/phenotype to their xenogenic counterparts.
Biocontrol of Lysobacter enzymogenes CQ18 against the tobacco powdery mildew fugus, Erysiphe cichoracearum
Authors: Yang Hongjun , Peng Liyuan , Li Zhimo , Huang Chunyang , Huang Jianguo 
Published: August 2023

AbstractBackgroundPowdery mildew is a common leaf disease of crops worldwide. A large quantity of chemical fungicides is used to control this disease in horticulture and agriculture, producing serious safety and environmental problems. To suppress this disease in safe and environment-friendly ways, the biocontrol of a self-isolated new strain ofLysobacter enzymogenes(CQ18) was studied against flue-cured tobacco powdery mildews.ResultsL. enzymogenesCQ18 produced chitinase, protease, β-1,3-glucanase, phosphatase, and siderophore, which may enable this biocontrol bacterium to degrade pathogen cell membranes and walls and deprive pathogens of iron. HPLC/MS analysis identified 14 antifungal metabolites present inL. enzymogenesCQ18 fermentation liquid (LEFL), which were grouped into organic acids, azoles, and pyrimidines. The variable targets in or on pathogen cells and combinative effects of these multiple metabolites may potently suppress the powdery mildew and be less likely to makeErysiphe cichoracearumdevelop resistance. LEFL was rich in L-pyroglutamate. Both LEFL and L-pyroglutamate inhibited the germination ofE. cichoracearumconidia in vitro and reduced the powdery mildew index in the greenhouse and field. L-Pyroglutamate at a concentration of 0.50% achieved the same control efficacy as the chemical fungicide triadimefon (91–94%).ConclusionsL. enzymogenesCQ18 and the metabolite L-pyroglutamate effectively controlled flue-cured tobacco powdery mildew.L. enzymogenesCQ18 grows rapidly and is resilient to adversity. L-Pyroglutamate has no toxicity to humans and is easy to synthesize at a low cost. Both show potential use in controlling plant powdery mildews.Graphical Abstract
Identification and analysis of key hypoxia- and immune-related genes in hypertrophic cardiomyopathy
Authors: Yu Haozhen , Gu Lanxin , Du Linfang , Dong Zhao , Li Zhuang , Yu Mujun , Yin Yue , Wang Yishi , Yu Lu , Ma Heng 
Published: August 2023

Abstract
Background
Hypertrophic cardiomyopathy (HCM), an autosomal dominant genetic disease, is the main cause of sudden death in adolescents and athletes globally. Hypoxia and immune factors have been revealed to be related to the pathology of HCM. There is growing evidence of a role for hypoxia and inflammation as triggers and enhancers in the pathology in HCM. However, the role of hypoxia- and immune-related genes in HCM have not been reported.

Methods
Firstly, we obtained four HCM-related datasets from the Gene Expression Omnibus (GEO) database for differential expression analysis. Immune cells significantly expressed in normal samples and HCM were then screened by a microenvironmental cell population counter (MCP-counter) algorithm. Next, hypoxia- and immune-related genes were screened by the LASSO + support vector machine recursive feature elimination (SVM-RFE) and weighted gene co-expression network analysis (WGCNA). Single-gene enrichment analysis and expression validation of key genes were then performed. Finally, we constructed a competing endogenous RNA (ceRNA) network of key genes.

Results
In this study, 35 differentially expressed hypoxia genes were found. By using LASSO + SVM-RFE analysis, 10 more targets with differentially expressed hypoxia genes were identified. The MCP-count algorithm yielded five differentially expressed immune cells, and after assessing them for WGCNA characteristics, 612 immune genes were discovered. When hypoxia and immune genes were combined for cross-tabulation analysis, three hypoxia- and immune-related genes (ATP2A2, DDAH1, and OMA1) were identified.

Conclusion
Based on hypoxia characteristic genes, three key genes were identified. These were also significantly related to immune activation, which proves a theoretical basis and reference value for studying the relationship between HCM and hypoxia and immunity.

Graphical Abstract
Skeletal structure of asymmetric mandibular prognathism and retrognathism
Authors: Xi Tong , Vinayahalingam Shankeeth , Bergé Stefaan , Maal Thomas , Kwon Tae-Geon 
Published: August 2023

Abstract
Background
This study aimed to compare the skeletal structures between mandibular prognathism and retrognathism among patients with facial asymmetry.

Results
Patients who had mandibular asymmetry with retrognathism (Group A) in The Netherlands were compared with those with deviated mandibular prognathism (Group B) in Korea. All the data were obtained from 3D-reformatted cone-beam computed tomography images from each institute. The right and left condylar heads were located more posteriorly, inferiorly, and medially in Group B than in Group A. The deviated side of Group A and the contralateral side of Group B showed similar condylar width and height, ramus-proper height, and ramus height. Interestingly, there were no inter-group differences in the ramus-proper heights. Asymmetric mandibular body length was the most significantly correlated with chin asymmetry in retrognathic asymmetry patients whereas asymmetric elongation of condylar process was the most important factor for chin asymmetry in deviated mandibular prognathism.

Conclusion
Considering the 3D positional difference of gonion and large individual variations of frontal ramal inclination, significant structural deformation in deviated mandibular prognathism need to be considered in asymmetric prognathism patients. Therefore, Individually planned surgical procedures that also correct the malpositioning of the mandibular ramus are recommended especially in patients with asymmetric prognathism.
Circularity-based decision-making framework for the integrated conservation of built heritage: the case of the Medina of Tunis
Authors: Tira Yasmine , Türkoğlu Handan 
Published: August 2023

AbstractSeveral factors overlap in making urban heritage conservation vulnerable in terms of long-term sustainability. The purpose of this study is to offer insights into the dynamic role that heritage governance plays in the current sustainability debate. This purpose is achieved by investigating the shift from a ‘governing for culture’ approach to a ‘governing through culture’ approach in heritage conservation. Subsequently, a case is built for a circularity-based conservation strategy applicable to the governance of historic cities. Different indicators of the circular governance approach are considered, and useful data are collected in comparative form. The cross-matching relationship between the factors is then evaluated by employing the analytic hierarchy process (AHP) on the collected data. As a test case, the conservation strategy of the Medina of Tunis is presented. For a more general conservation model, case-specific data are acquired. Finally, the same framework is applied to compare the case-dependent and case-independent data to define an integrated conservation framework. The obtained results show that the knowledge and data exchange factor, carries the highest significance. This result translates into heritage-led urban regeneration through knowledge sharing and the effective redistribution of cultural activities in historic city centres.
Postoperative constrictive pericarditis caused rupture of lymphatic collaterals: a rare etiology of chylothorax
Authors: Nakamura Yasuhito , Doi Kiyoshi , Fujii Ryo , Ogura Hiroki , Umeda Etsuji , Kato Takayoshi , Sakai Osamu , Shimabukuro Katsuya 
Published: August 2023

Abstract
Background
Chylothorax after cardiovascular surgery is primarily caused by direct injury to the thoracic duct or its branches, and occurs in early postoperative period. In the present case, we describe a rare case of chylothorax manifesting three months after surgery secondary to constrictive pericarditis.

Case presentation
A 71-year-old man underwent mitral valve replacement, tricuspid valve annuloplasty, and the maze procedure. He developed acute perioperative myocardial infarction on postoperative day one due to plaque rupture in the left anterior descending artery and underwent percutaneous coronary intervention. Although the patient was discharged on postoperative day 36, he required readmission on postoperative day 83 because of right side chylothorax associated with constrictive pericarditis. Lymphangiography revealed thoracic duct interruption and development of lymphatic collateral vessels via the right hilum. Single-photon emission computed tomography revealed abnormal tracer accumulation in the right hilum, suggesting a lymphatic leakage site. A catheter study indicated biventricular dip and plateau patterns with a reduced cardiac index (1.6 L/min/m2) and elevated central venous pressure (18 mmHg). Conservative treatment for chylothorax, including a low-fat diet and continuous drainage with chest tube, was unsuccessful. Drainage of chyle at approximately 500 mL/day continued. On hospitalization day 50, complete pericardiectomy via median sternotomy was performed because the patient’s cardiac function deteriorated. The central venous pressure dramatically decreased, and the chylothorax gradually subsided. There was no recurrence of symptoms 1 year postoperatively.

Conclusions
Chylothorax associated with constrictive pericarditis subsequent to cardiac surgery is extremely rare. Although conservative management failed, the present case was successfully treated via pericardiectomy alone and did not require any additional precedures, such as thoracic duct ligation via a right thoracotomy.
Political trust in the handling of the COVID-19 pandemic: a survey in Denmark and Sweden
Authors: Kallemose Thomas , Kirk Jeanette Wassar , Karlsson Elin , Seing Ida , Stefánsdóttir Nina Thórný , Vrangbæk Karsten , Andersen Ove , Nilsen Per 
Published: August 2023

Abstract
Background
The initial responses to the COVID-19 pandemic in Denmark and Sweden differed markedly. Balancing disparate concerns was crucial to generate trust in the COVID-19 restrictions. The aim was to investigate the extent to which there was trust in the handling of the pandemic by the Danish and Swedish governments and public health authorities in each country. A further aim was also to investigate the characteristics of those in Denmark and Sweden who expressed the lowest degree of trust.

Methods
Cross-sectional surveys were conducted in 2021, using web panels that are nationally representative of the socio-demographic characteristics. The population consisted of 2619 individuals from Denmark and 2633 from Sweden, representative of the age, sex and region of residence of the populations aged ≥ 18 years. Trust in government and health authorities was captured in two separate trust questions on a 5-point Likert scale and dichotomized into low trusters and non-low trusters for analysis.

Results
Approximately, 61% of the Danish respondents expressed moderately large or very large trust in the government’s handling of the pandemic. The corresponding proportion for Sweden was 42%. The proportion of low trusters was 11% in Denmark and 34% in Sweden (p < 0.001). Moderately large or very large trust in the public health authority’s handling was expressed by 83% of the Danish respondents and 74% of the Swedish respondents. The proportion of low trusters was 5% in Denmark and 17% in Sweden (p < 0.001). In both countries, trust was lower among men than among women. Age and education were associated with trust but differed between countries (p <  = 0.011).

Conclusions
In this study, differences in trust between Denmark and Sweden and both overall and within socio-demographic factors were observed. However, given the limitations and bias in the study, it is difficult to determine the cause and true size of these differences. With that in mind, we still believe specific populations and subgroups within those populations have the potential to affect trust in handling of the COVID-19 pandemic, and that these should be kept in mind when developing and communicating responses to pandemics.
Viewpoint: Assessing the value of mental health treatments in Europe
Authors: Simon Judit , Boyer Patrice , Caldas-de-Almeida Jose M. , Knapp Martin , McCrone Paul , Gorwood Philip , Oertel Wolfgang , Arango Celso , Treasure Janet , Young Allan H. , Destrebecq Frederic , Quoidbach Vinciane 
Published: August 2023

Abstract
One in eight individuals worldwide lives with a mental health disorder. For many European countries, the prevalence is even higher, with one in four people reporting mental health problems [1]. Three-quarters of all mental health disorders develop before age 25, with many presenting initially in undiagnosed forms already in the mid-teens and eventually manifesting as severe disorders and lasting into old age [2]. There is also growing evidence that mental health disorder symptoms cross diagnoses and people frequently have more than one mental health disorder [3].