bluuebunny/crossref_metadata_2025_split huggingface dataset:
Inequality and private health insurance in Zimbabwe: history, politics and performance
Authors: Mhazo Alison T. , Maponga Charles C. , Mossialos Elias 
Published: March 2023

Abstract
Introduction
Zimbabwe has one of the highest rates of private health insurance (PHI) expenditures as a share of total health expenditures in the world. The perfomamce of PHI, known as Medical Aid Societies in Zimbabwe, requires close monitoring since market failures and weaknesses in public policy and regulation can affect overall health system performance. Despite the considerable influence of politics (stakeholder interests) and history (past events) in shaping PHI design and implementation, these factors are frequently sidelined when analyzing PHI in Zimbabwe. This study considers the roles of history and politics in shaping PHI and determining its impact on health system performance in Zimbabwe.

Methods
We reviewed 50 sources of information using Arksey & O'Malley's (2005) methodological framework. To frame our analysis, we used a conceptual framework that integrates economic theory with political and historical aspects developed by Thomson et al. (2020) to analyze PHI in diverse contexts.

Results
We present a timeline of the history and politics of PHI in Zimbabwe from the 1930s to present. Zimbabwe's current PHI coverage is segmented along socio-economic lines due to a long history of elitist and exclusionary politics in coverage patterns. While PHI was considered to perform relatively well up to the mid-1990s, the economic crisis of the 2000s eroded trust among insurers, providers, and patients. That culminated in agency problems which severely lessened PHI coverage quality with concurrent deterioration in efficiency and equity-related performance dimensions.

Conclusion
The present design and performance of PHI in Zimbabwe is primarily a function of history and politics rather than informed choice. Currently, PHI in Zimbabwe does not meet the evaluative criteria of a well-performing health insurance system. Therefore, reform efforts to expand PHI coverage or improve PHI performance must explicitly consider the relevant historical, political and economic aspects for successful reformation.
Plant-derived extracellular vesicles (PDEVs) in nanomedicine for human disease and therapeutic modalities
Authors: Xu Zhijie , Xu Yuzhen , Zhang Kui , Liu Yuanhong , Liang Qiuju , Thakur Abhimanyu , Liu Wei , Yan Yuanliang 
Published: March 2023

Abstract
Background
The past few years have witnessed a significant increase in research related to plant-derived extracellular vesicles (PDEVs) in biological and medical applications. Using biochemical technologies, multiple independent groups have demonstrated the important roles of PDEVs as potential mediators involved in cell-cell communication and the exchange of bio-information between species. Recently, several contents have been well identified in PDEVs, including nucleic acids, proteins, lipids, and other active substances. These cargoes carried by PDEVs could be transferred into recipient cells and remarkably influence their biological behaviors associated with human diseases, such as cancers and inflammatory diseases.

Main body of the abstract
This review summarizes the latest updates regarding PDEVs and focuses on its important role in nanomedicine applications, as well as the potential of PDEVs as drug delivery strategies to develop diagnostic and therapeutic agents for the clinical management of diseases, especially like cancers.

Conclusion
Considering its unique advantages, especially high stability, intrinsic bioactivity and easy absorption, further elaboration on molecular mechanisms and biological factors driving the function of PDEVs will provide new horizons for the treatment of human disease.
The changing epidemiology of trauma in child-bearing age women
Authors: Abu-Zidan Fikri M. , Eid Hani O. , Alao David O. , Elbiss Hassan 
Published: March 2023

AbstractBackgroundIn the last two decades, there have been major improvements in the trauma system in the United Arab Emirates (UAE). We aimed to study the changes in the incidence, type, severity, and outcome of trauma of hospitalized child-bearing age women in Al-Ain City, UAE, during that time.MethodsData from two separate trauma registries of Al-Ain Hospital, which were prospectively collected from March 2003 to March 2006 and January 2014 to December 2017, were analyzed retrospectively. All women aged 15–49 years were studied. The two periods were compared.ResultsTrauma incidence of hospitalized child-bearing age women was reduced by 47% during the second period. There were no significant differences in the mechanism of injury between the two periods. Road traffic collision was the main cause of injury (44% and 42%, respectively) followed by fall down (26.1% and 30.8%, respectively). The location of injury was significantly different (p = 0.018), with a strong trend of more home injuries in the second period (52.8% compared with 44%, p = 0.06). There was a strong statistical trend of mild traumatic brain injury (GCS 13–15) in the second period (p = 0.067, Fisher’s Exact test). Those who had normal GCS of 15 were significantly higher in the second period compared with those in the first period (95.3% compared with 86.4%, p < 0.001, Fisher’s Exact test) despite having more anatomical injury severity of the head (AIS 2 (1–5) compared with 1 (1–5), p = 0.025). The NISS was significantly higher in the second period (median (range) NISS 5 (1–45) compared with 4 (1–75), p = 0.02). Despite that, mortality was the same (1.6% compared with 1.7%, p = 0.99) while the length of hospital stay was significantly less (mean (SD) 5.6 (6.3) days compared with 10.6 (13.6) days, p < 0.0001).ConclusionsThe incidence of trauma in hospitalized child-bearing-age women was reduced by 47% over the last 15 years. Road traffic collisions and falls are the leading cause of injury in our setting. Home injuries increased over time. The mortality remained stable despite the increased severity of injured patients. More injury prevention efforts should target home injuries.
MRI-based vertebral bone quality score for the assessment of osteoporosis in patients undergoing surgery for lumbar degenerative diseases
Authors: Chen Zan , Lei Fei , Ye Fei , Yuan Hao , Li Songke , Feng Daxiong 
Published: March 2023

Abstract
Purpose
To explore the value of vertebral bone quality (VBQ) scores in diagnosing osteoporosis in patients with lumbar degeneration.

Methods
A retrospective analysis was conducted of 235 patients treated with lumbar fusion surgery at the age of ≥ 50; they were divided into a degenerative group and a control group according to the severity of degenerative changes on three-dimensional computed tomography. The L1-4 vertebral body and L3 cerebrospinal fluid signal intensities in the T1-weighted lumbar magnetic resonance imaging (MRI) image were recorded, and the VBQ score was calculated. Demographics, clinical data, and dual-energy X-ray absorptiometry (DXA) indicators were recorded, and the VBQ value was compared with bone density and T-score using the Pearson correlation coefficient. The VBQ threshold was obtained according to the control group and compared with the efficacy of osteoporosis diagnosis based on DXA.

Results
A total of 235 patients were included in the study, and the age of the degenerative group was older than that of the control group (61.8 vs. 59.4, P = 0.026). The VBQ score of the control group suggested a higher correlation with the bone mineral density (BMD) value and T-score (r = − 0.611 and − 0.62, respectively). The BMD value and T-score in the degenerative group were higher than those in the control group (P < 0.05). Receiver-operating characteristic curve analysis showed that the VBQ score had a good predictive ability for osteoporosis (AUC = 0.818), with a sensitivity of 93% and a specificity of 65.4%. Among the undiagnosed osteoporosis patients with T-score, the VBQ score after adjusting the threshold was higher in the degenerative group (46.9% vs. 30.8%).

Conclusions
Emerging VBQ scores can reduce the interference caused by degenerative changes compared to traditional DXA measures. Screening for osteoporosis in patients undergoing lumbar spine surgery provides new ideas.
A translatome-transcriptome multi-omics gene regulatory network reveals the complicated functional landscape of maize
Authors: Zhu Wanchao , Miao Xinxin , Qian Jia , Chen Sijia , Jin Qixiao , Li Mingzhu , Han Linqian , Zhong Wanshun , Xie Dan , Shang Xiaoyang , Li Lin 
Published: March 2023

AbstractBackgroundMaize (Zea maysL.) is one of the most important crops worldwide. Although sophisticated maize gene regulatory networks (GRNs) have been constructed for functional genomics and phenotypic dissection, a multi-omics GRN connecting the translatome and transcriptome is lacking, hampering our understanding and exploration of the maize regulatome.ResultsWe collect spatio-temporal translatome and transcriptome data and systematically explore the landscape of gene transcription and translation across 33 tissues or developmental stages of maize. Using this comprehensive transcriptome and translatome atlas, we construct a multi-omics GRN integrating mRNAs and translated mRNAs, demonstrating that translatome-related GRNs outperform GRNs solely using transcriptomic data and inter-omics GRNs outperform intra-omics GRNs in most cases. With the aid of the multi-omics GRN, we reconcile some known regulatory networks. We identify a novel transcription factor,ZmGRF6, which is associated with growth. Furthermore, we characterize a function related to drought response for the classic transcription factorZmMYB31.ConclusionsOur findings provide insights into spatio-temporal changes across maize development at both the transcriptome and translatome levels. Multi-omics GRNs represent a useful resource for dissection of the regulatory mechanisms underlying phenotypic variation.
The shaky foundations of simulating single-cell RNA sequencing data
Authors: Crowell Helena L. , Morillo Leonardo Sarah X. , Soneson Charlotte , Robinson Mark D. 
Published: March 2023

AbstractBackgroundWith the emergence of hundreds of single-cell RNA-sequencing (scRNA-seq) datasets, the number of computational tools to analyze aspects of the generated data has grown rapidly. As a result, there is a recurring need to demonstrate whether newly developed methods are truly performant—on their own as well as in comparison to existing tools. Benchmark studies aim to consolidate the space of available methods for a given task and often use simulated data that provide a ground truth for evaluations, thus demanding a high quality standard results credible and transferable to real data.ResultsHere, we evaluated methods for synthetic scRNA-seq data generation in their ability to mimic experimental data. Besides comparing gene- and cell-level quality control summaries in both one- and two-dimensional settings, we further quantified these at the batch- and cluster-level. Secondly, we investigate the effect of simulators on clustering and batch correction method comparisons, and, thirdly, which and to what extent quality control summaries can capture reference-simulation similarity.ConclusionsOur results suggest that most simulators are unable to accommodate complex designs without introducing artificial effects, they yield over-optimistic performance of integration and potentially unreliable ranking of clustering methods, and it is generally unknown which summaries are important to ensure effective simulation-based method comparisons.
Metabolic engineering to improve production of 3-hydroxypropionic acid from corn-stover hydrolysate in Aspergillus species
Authors: Dai Ziyu , Pomraning Kyle R. , Deng Shuang , Kim Joonhoon , Campbell Kristen B. , Robles Ana L. , Hofstad Beth A. , Munoz Nathalie , Gao Yuqian , Lemmon Teresa , Swita Marie S. , Zucker Jeremy D. , Kim Young-Mo , Burnum-Johnson Kristin E. , Magnuson Jon K. 
Published: March 2023

Abstract
Background
Fuels and chemicals derived from non-fossil sources are needed to lessen human impacts on the environment while providing a healthy and growing economy. 3-hydroxypropionic acid (3-HP) is an important chemical building block that can be used for many products. Biosynthesis of 3-HP is possible; however, low production is typically observed in those natural systems. Biosynthetic pathways have been designed to produce 3-HP from a variety of feedstocks in different microorganisms.

Results
In this study, the 3-HP β-alanine pathway consisting of aspartate decarboxylase, β-alanine-pyruvate aminotransferase, and 3-hydroxypropionate dehydrogenase from selected microorganisms were codon optimized for Aspergillus species and placed under the control of constitutive promoters. The pathway was introduced into Aspergillus pseudoterreus and subsequently into Aspergillus niger, and 3-HP production was assessed in both hosts. A. niger produced higher initial 3-HP yields and fewer co-product contaminants and was selected as a suitable host for further engineering. Proteomic and metabolomic analysis of both Aspergillus species during 3-HP production identified genetic targets for improvement of flux toward 3-HP including pyruvate carboxylase, aspartate aminotransferase, malonate semialdehyde dehydrogenase, succinate semialdehyde dehydrogenase, oxaloacetate hydrolase, and a 3-HP transporter. Overexpression of pyruvate carboxylase improved yield in shake-flasks from 0.09 to 0.12 C-mol 3-HP C-mol−1 glucose in the base strain expressing 12 copies of the β-alanine pathway. Deletion or overexpression of individual target genes in the pyruvate carboxylase overexpression strain improved yield to 0.22 C-mol 3-HP C-mol−1 glucose after deletion of the major malonate semialdehyde dehydrogenase. Further incorporation of additional β-alanine pathway genes and optimization of culture conditions (sugars, temperature, nitrogen, phosphate, trace elements) for 3-HP production from deacetylated and mechanically refined corn stover hydrolysate improved yield to 0.48 C-mol 3-HP C-mol−1 sugars and resulted in a final titer of 36.0 g/L 3-HP.

Conclusions
The results of this study establish A. niger as a host for 3-HP production from a lignocellulosic feedstock in acidic conditions and demonstrates that 3-HP titer and yield can be improved by a broad metabolic engineering strategy involving identification and modification of genes participated in the synthesis of 3-HP and its precursors, degradation of intermediates, and transport of 3-HP across the plasma membrane.
Modulation of long noncoding RNA (lncRNA) and messenger RNA (mRNA) expression in the liver of Beagle dogs by Toxocara canis infection
Authors: Zou Yang , Zheng Wen-Bin , Elsheikha Hany M. , He Jun-Jun , Lu Yi-Xin , Wang Shuai , Guo Aijiang , Zhu Xing-Quan 
Published: March 2023

Abstract
Background
Long non-coding RNAs (lncRNAs) and messenger RNAs (mRNAs) play crucial roles in regulating various physiological and pathological processes. However, the role of lncRNAs and mRNAs in mediating the liver response during Toxocara canis infection remains incompletely understood.

Methods
In the present study, the expression profile of lncRNAs and mRNAs was investigated in the liver of Beagle dogs infected by T. canis using high-throughput RNA sequencing.

Results
Compared with the control groups, 876 differentially expressed (DE) lncRNAs and 288 DEmRNAs were identified at 12 h post-infection (hpi), 906 DElncRNAs and 261 DEmRNAs were identified at 24 hpi, and 876 DElncRNAs and 302 DEmRNAs were identified at 36 days post-infection (dpi). A total of 16 DEmRNAs (e.g. dpp4, crp and gnas) were commonly identified at the three infection stages. Enrichment and co-localization analyses identified several pathways involved in immune and inflammatory responses during T. canis infection. Some novel DElncRNAs, such as LNC_015756, LNC_011050 and LNC_011052, were also associated with immune and inflammatory responses. Also, LNC_005105 and LNC_005401 were associated with the secretion of anti-inflammatory cytokines, which may play a role in the healing of liver pathology at the late stage of infection.

Conclusions
Our data provided new insight into the regulatory roles of lncRNAs and mRNAs in the pathogenesis of T. canis and improved our understanding of the contribution of lncRNAs and mRNAs to the immune and inflammatory response of the liver during T. canis infection.

Graphical Abstract
Enhancing the value of death registration with verbal autopsy data: a pilot study in the Senegalese urban population in 2019
Authors: Niang Khadim , Fall Atoumane , Ndiaye Samba , Sarr Maguette , Ba Khady , Masquelier Bruno 
Published: March 2023

Abstract
Background
There is no source of data on causes of death in Senegal that covers both community and hospital deaths. Yet the death registration system in the Dakar region is relatively complete (>80%) and could be expanded to provide information on the diseases and injuries that led to death.

Methods
In this pilot study, we recorded all deaths that occurred over 2 months and were reported in the 72 civil registration offices in the Dakar region. We selected the deaths of residents of the region and administered a verbal autopsy to a relative of the deceased to identify the underlying causes of death. Causes of death were assigned using the InterVA5 model.

Results
The age structure of deaths registered at the civil registry differed from that of the census, with a proportion of infant deaths about twice as high as in the census. The main causes of death were prematurity and obstetric asphyxia in newborns. Meningitis and encephalitis, severe malnutrition, and acute respiratory infections were the leading causes from 1 month to 15 years of age. Cardiovascular diseases accounted for 27% of deaths in adults aged 15-64 and 45% of deaths among adults above age 65, while neoplasms accounted for 20% and 12% of deaths in these two age groups, respectively.

Conclusions
This study demonstrates that the epidemiological transition is at an advanced stage in urban areas of Dakar, and underlines the importance of conducting regular studies based on verbal autopsies of deaths reported in civil registration offices.
A multi-institutional exploration of emergency medicine physicians’ attitudes and behaviours on antibiotic use during the COVID-19 pandemic: a mixed-methods study
Authors: Huang Zhilian , Tay Evonne , Kuan Win Sen , Tiah Ling , Weng Yanyi , Tan Hann Yee , Seow Eillyne , Peng Li Lee , Chow Angela 
Published: March 2023

Abstract
Background
The COVID-19 pandemic has changed the epidemiology of upper respiratory tract infections (URTI) and the disease profile of patients attending the emergency department (ED). Hence, we sought to explore the changes in ED physicians’ attitudes and behaviours in four EDs in Singapore.

Methods
We employed a sequential mixed-methods approach (quantitative survey followed by in-depth interviews). Principal component analysis was performed to derive latent factors, followed by multivariable logistic regression to explore the independent factors associated with high antibiotic prescribing. Interviews were analysed using the deductive-inductive-deductive framework. We derive five meta-inferences by integrating the quantitative and qualitative findings with an explanatory bidirectional framework.

Results
We obtained 560 (65.9%) valid responses from the survey and interviewed 50 physicians from various work experiences. ED physicians were twice as likely to report high antibiotic prescribing rates pre-COVID-19 pandemic than during the pandemic (AOR = 2.12, 95% CI 1.32 to 3.41, p = 0.002). Five meta-inferences were made by integrating the data: (1) Less pressure to prescribe antibiotics due to reduced patient demand and more patient education opportunities; (2) A higher proportion of ED physicians self-reported lower antibiotic prescribing rates during the COVID-19 pandemic but their perception of the overall outlook on antibiotic prescribing rates varied; (3) Physicians who were high antibiotic prescribers during the COVID-19 pandemic made less effort for prudent antibiotic prescribing as they were less concerned about antimicrobial resistance; (4) the COVID-19 pandemic did not change the factors that lowered the threshold for antibiotic prescribing; (5) the COVID-19 pandemic did not change the perception that the public's knowledge of antibiotics is poor.

Conclusions
Self-reported antibiotic prescribing rates decreased in the ED during the COVID-19 pandemic due to less pressure to prescribe antibiotics. The lessons and experiences learnt from the COVID-19 pandemic can be incorporated into public and medical education in the war against antimicrobial resistance going forward. Antibiotic use should also be monitored post-pandemic to assess if the changes are sustained.
Comprehensive evaluations of individual discrimination, kinship analysis, genetic relationship exploration and biogeographic origin prediction in Chinese Dongxiang group by a 60-plex DIP panel
Authors: Chen Man , Cui Wei , Bai Xiaole , Fang Yating , Yao Hongbin , Zhang Xingru , Lei Fanzhang , Zhu Bofeng 
Published: March 2023

Abstract
Background
Dongxiang group, as an important minority, resides in Gansu province which is located at the northwest China, forensic detection system with more loci needed to be studied to improve the application efficiency of forensic case investigation in this group.

Methods
A 60-plex system including 57 autosomal deletion/insertion polymorphisms (A-DIPs), 2 Y chromosome DIPs (Y-DIPs) and the sex determination locus (Amelogenin) was explored to evaluate the forensic application efficiencies of individual discrimination, kinship analysis and biogeographic origin prediction in Gansu Dongxiang group based on the 60-plex genotype results of 233 unrelated Dongxiang individuals. The 60-plex genotype results of 4582 unrelated individuals from 33 reference populations in five different continents were also collected to analyze the genetic background of Dongxiang group and its genetic relationships with other continental populations.

Results
The system showed high individual discrimination power, as the cumulative power of discrimination (CPD), cumulative power of exclusion (CPE) for trio and cumulative match probability (CMP) values were 0.99999999999999999999997297, 0.999980 and 2.7029E− 24, respectively. The system could distinguish 98.12%, 93.78%, 82.18%, 62.35% and 39.32% of full sibling pairs from unrelated individual pairs, when the likelihood ratio (LR) limits were set as 1, 10, 100, 1000 and 10,000 based on the simulated family samples, respectively. Additionally, Dongxiang group had the close genetic distances with populations in East Asia, especially showed the intimate genetic relationships with Chinese Han populations, which were concluded from the genetic affinities and genetic background analyses of Dongxiang group and 33 reference populations. In terms of the effectiveness of biogeographic origin inference, different artificial intelligent algorithms possessed different efficacies. Among them, the random forest (RF) and extreme gradient boosting (XGBoost) algorithm models could accurately predict the biogeographic origins of 99.7% and 90.59% of three and five continental individuals, respectively.

Conclusion
This 60-plex system had good performance for individual discrimination, kinship analysis and biogeographic origin prediction in Dongxiang group, which could be used as a powerful tool for case investigation.