bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of hospitalisation costs and their determinants among Covid-19 patients in South Central Ethiopia
Authors: Kaso Abdene Weya , Mohammed Esmael , Agero Gebi , Churiso Gemechu , Kaso Taha , Ewune Helen Ali , Hailu Alemayehu 
Published: September 2023

Abstract
Background
The coronavirus disease 2019 (Covid-19) pandemic is a global public health problem. The Covid-19 pandemic has had a substantial impact on the economy of developing countries, including Ethiopia.This study aimed to determine the hospitalisation costs of Covid-19 and the factors associated with the high cost of hospitalisation in South Central Ethiopia.

Methods
A retrospective cost analysis of Covid-19 patients hospitalised between July 2020 and July 2021 at Bokoji Hospital Covid-19 Treatment Centre was conducted using both the micro-costing and top-down approaches from the health system perspective. This analysis used cost data obtained from administrative reports, the financial reports of the treatment centre, procurement invoices and the Covid-19 standard treatment guidelines. The Student’s t-test, Mann-Whitney U test or Kruskal-Wallis test was employed to test the difference between sociodemographic and clinical factors when appropriate.To identify the determinants of cost drivers in the study population, a generalised linear model with gamma distribution and log link with a stepwise algorithm were used.

Results
A total of 692 Covid-19 patients were included in the costing analysis. In this study, the mean cost of Covid-19–infected patients with no symptoms was US$1,073.86, with mild symptoms US$1,100.74, with moderate symptoms US$1,394.74 and in severe–critically ill condition US$1,708.05.The overall mean cost was US$1,382.50(95% CI: 1,360.60–1,404.40) per treated episode.The highest mean cost was observed for personnel, accounting for 64.0% of the overall cost. Older age, pre-existing diseases, advanced disease severity at admission, admission to the intensive care unit, prolonged stay on treatment and intranasal oxygen support were strongly associated with higher costs.

Conclusions
This study found that the clinical management of Covid-19 patients incurred significant expenses to the health system. Factors such as older age, disease severity, presence of comorbidities, use of inhalation oxygen therapy and prolonged hospital stay were associated with higher hospitalisation costs.Therefore, the government should give priority to the elderly and those with comorbidities in the provision of vaccination to reduce the financial burden on health facilities and health systems in terms of resource utilisation.
Food insecurity and levels of marginalization: food accessibility, consumption and concern in Mexico
Authors: Martínez-Martínez Oscar A. , Gil-Vasquez Karol , Romero-González María Beatriz 
Published: September 2023

Abstract
Background
Food insecurity continues to be a problem throughout the world. When estimating food insecurity, few studies analyze the contexts where the phenomenon takes place. By bearing in mind levels of marginalization in four states of Mexico, this paper answers two questions: (I) What problems are experienced with access to food, and how these difficulties affect the amount of food consumed in households? and (II) How do households experience the concern of running out of food?

Methods
Our qualitative study draws data from urban and semi-urban areas of four Mexican states: Mexico City, Tamaulipas, the State of Mexico, and Oaxaca. Each state presents different levels of well-being. The study’s participants are selected using the snowball method. Eligibility criteria are based on demographic characteristics such as education, age, and gender. A thematic analytical approach is conducted to analyze collected data from a total of 212 semi-structured interviews.

Results
The study’s findings indicate that concern of food scarcity is a generalized feeling among participants across different levels of marginalization. Individuals with stable jobs living in contexts of low levels of marginalization experience worriedness when their budgets tightened before the end of the payday, a bi-weekly payment format, named the quincena in México. This psychological state of mind changes through the payday cycle, a period when the direct relationship between food accessibility and consumption weakens. In response, individuals develop strategies to cope with the uncertainty of experiencing food insecurity, such as rationing food portions and/or hoarding food supplies. Even when food accessibility exists, interviewees identify insufficient income as the primary issue in contexts of low and very low levels of marginalization.

Conclusions
Conclusive remarks drawn from our analysis underline the importance of the context of marginalization in influencing households’ experiences with food insecurity. At the quincena’s end, food insecurity increases, even in contexts of very low marginalization. Our study calls for rethinking the scales employed to measure food insecurity, specifically the questions related to fear of food scarcity. Coping strategies are implemented by surveyed individuals to resolve issues and repercussions that emerge from experiencing food insecurity differ by context of marginalization.
Application and risk prediction of thrombolytic therapy in cardio-cerebrovascular diseases: a review
Authors: Zhang Kexin , Jiang Yao , Zeng Hesong , Zhu Hongling 
Published: September 2023

AbstractCardiocerebrovascular diseases (CVDs) are the leading cause of death worldwide, consuming huge healthcare budget. For CVD patients, the prompt assessment and appropriate administration is the crux to save life and improve prognosis. Thrombolytic therapy, as a non-invasive approach to achieve recanalization, is the basic component of CVD treatment. Still, there are risks that limits its application. The objective of this review is to give an introduction on the utilization of thrombolytic therapy in cardiocerebrovascular blockage diseases, including coronary heart disease and ischemic stroke, and to review the development in risk assessment of thrombolytic therapy, comparing the performance of traditional scales and novel artificial intelligence-based risk assessment models.
Role of the cGAS-STING pathway in radiotherapy for non-small cell lung cancer
Authors: Yang Chunsheng , Liang Yan , Liu Ning , Sun Meili 
Published: September 2023

AbstractOne of the most important therapeutic interventions for non-small cell lung cancer is radiotherapy. Ionizing radiation (IR) is classified by traditional radiobiology principles as a direct cytocidal therapeutic agent against cancer, although there is growing recognition of other antitumor immunological responses induced by this modality. The most effective therapeutic combinations to harness radiation-generated antitumor immunity and enhance treatment results for malignancies resistant to existing radiotherapy regimens could be determined by a more sophisticated understanding of the immunological pathways created by radiation. Innate immune signaling is triggered by the activation of cGAS-STING, and this promotes adaptive immune responses to help fight cancer. This identifies a molecular mechanism radiation can use to trigger antitumor immune responses by bridging the DNA-damaging ability of IR with the activation of CD8 + cytotoxic T cell-mediated killing of tumors. We also discuss radiotherapy-related parameters that affect cGAS-STING signaling, negative consequences of cGAS-STING activation, and intriguing treatment options being tested in conjunction with IR to support immune activation by activating STING-signaling. Improved therapeutic outcomes will result from a better understanding of how IR promotes cGAS-STING signaling in immune-based treatment regimens that maximize radiotherapy’s anticancer effectiveness.
A child with polyarthritis and chronic lung disease: a case report of ataxia-telangiectasia
Authors: De Nardi Laura , Natale Marco Francesco , Messia Virginia , Tomà Paolo , De Benedetti Fabrizio , Insalaco Antonella 
Published: September 2023

Abstract
Background
Ataxia-telangiectasia (A-T) is a rare autosomal recessive DNA repair disorder, characterized by progressive cerebellar degeneration, telangiectasia, immunodeficiency, recurrent sinopulmonary infections, radiation sensitivity, premature aging and predisposition to cancer. Although the association with autoimmune and chronic inflammatory conditions such as vitiligo, thrombocytopenia and arthritis has occasionally been reported, an onset with articular involvement at presentation is rare.

Case presentation
We herein report the case of a 7-year-old Caucasian girl who was admitted to the Rheumatology Department with a history of febrile chough and polyarthritis which led initially to the suspicion of an autoinflammatory disease. She had overt polyarthritis with knees deformities and presented with severe pneumonia. A chest Computed Tomography (CT) scan showed bilateral bronchiectasis, parenchymal consolidation and interstitial lung disease; rheumatoid factor and type I interferon signature resulted negative, therefore excluding COatomer Protein subunit Alpha (COPA) syndrome. A diagnosis of sarcoidosis had been suspected based on histological evidence of granulomatous liver inflammation, but ruled out after detecting normal angiotensin converting enzyme and chitotriosidase blood levels. Based on her past medical history characterized by at least six episodes of pneumonia in the previous 4 years, immunological phenotyping was performed. This showed complete IgA and IgE deficiency with defective antigen-specific antibodies to Pneumococcal, Tetanus toxin and Hemophilus Influenzae B vaccines. Additionally, low numbers of B cells and recent thymic emigrants (RTE) were found (CD4Ra 1.4%), along with a low CD4+/CD8 + T cells ratio (< 1). Finally, based on gait disturbances (wobbly wide-based walking), serum alfa-fetoprotein was dosed, which resulted increased at 276 ng/ml (normal value < 7 ng/ml). A diagnosis of Ataxia-Telangiectasia was made, strengthened by the presence of bulbar telangiectasia, and then confirmed by Whole Exome Sequencing (WES).

Conclusions
Although rare, A-T should always be ruled out in case of pulmonary bronchiectasis and gait disturbances even in the absence of bulbar or skin telangiectasia. Autoimmune and granulomatous disorders must to be considered as differential diagnosis.
Progress from morbidity control to elimination as a public health problem of schistosomiasis and the status of soil-transmitted helminth infection in Togo: a second impact assessment after ten rounds of mass drug administration
Authors: Dorkenoo Ameyo M. , Phillips Anna E. , Klein Luke , Lack Fiali , Ataba Essoham , Yakpa Kossi , Tagba Atna-Edi , Assoti Bozi-Esso , Sossou Efoe , Tchalim Mawèké , Datagni Gbati , Seim Anders , Milord Marie Denise , Kassankogno Yao 
Published: September 2023

Abstract
Background
Due to the burden of schistosomiasis (SCH) and soil-transmitted helminths (STH), Togo Ministry of Health launched a program for Preventive Chemotherapy Neglected Tropical Diseases (PC-NTDs) in 2009, initiating integrated mass drug administration (MDA) the following year for the three PC-NTDs: SCH, STH and onchocerciasis. Significant reduction of infection across the country was noted in 2015 during the first impact assessment, following 5 years of high-coverage MDA implemented at the sub-district level for SCH and district level for STH. After another 5 years of effective MDA, a second survey was conducted in 2021 to re-evaluate the situation of SCH and STH.

Methods
A cross-section of school-aged children was taken across ten districts of Togo. A total of 302 schools in 92 sub-districts were sampled, with 24 school-aged children per school resulting in 7248 children surveyed. Urine samples were tested by haemastix® for Schistosoma haematobium, with urine filtration for the presence of eggs conducted on haematuria-positive samples. Stool samples were collected in a subset of 34 sub-districts in seven out of the ten surveyed districts, where STH and Schistosoma mansoni endemicity was high during the 2015 impact assessment. Duplicate (two) Kato-Katz analysis was performed for each stool sample. Sociodemographic and school-level water, sanitation and hygiene information was also collected.

Results
Overall, SCH prevalence was 5.90% (95% CI: 5.4–6.5), with 5.09% (95% CI: 4.64–5.67) for S. haematobium and 2.56% (95% CI: 1.98–3.29) for S. mansoni. STH prevalence was 19.7% (95% CI: 18.2–21.4), with 19.6% (95% CI: 18.1–21.3) hookworm, 0.08% (95% CI: 2.2–5.8) Trichuris trichiura and 0.04% (95% CI: 0.01–0.33) Ascaris lumbricoides. Compared to baseline, a significant reduction in both SCH (22.2% to 5.90%) and STH (29.2% t0 19.7%) prevalence was observed. Children aged 5–9 years were less infected than older peers aged 10–14 years: 4.76% vs. 7.53% (P < 0.01) for SCH and 17.2% vs. 23.0% (P < 0.01) for STH.

Conclusions
After 10 years of high coverage integrated MDA, Togo has achieved low prevalence SCH infection through the sub-district MDA implementation with considerable infection heterogeneity within sub-districts. As STH infection has not reached a level where the infections are not a public health problem, the sub-district treatment strategy could also be adopted in addition to improvement of treatment coverage among preschool age children and hygiene and sanitation practices.

Graphical Abstract
Exploring the structure of the university-students obsessive–compulsive tendency scale in Iranian university students: a network analysis study
Authors: Davoudi Mohammadreza , Sadoughi Mitra , Pourshahbaz Abbas , Dolatshahi Behrooz , Astaneh Ali Nazeri 
Published: September 2023

Abstract
Introduction
A risk factor for developing obsessive–compulsive disorder (OCD) in non-clinical samples is obsessive–compulsive tendencies (OCT). An OCT scale has recently been developed for university students (UOC) and showed promising psychometric properties. However, no validated Persian language scale evaluates OCT in non-clinical samples. Accordingly, this study aimed to validate the Persian version of the UOC in Iranian university students.

Methods
Three hundred sixty-eight university students (54.6% females, mean ages: 22.4 ± 4.51) entered the study. The Persian version of UOC was evaluated concerning the structure of Exploratory Factor Analysis (EFA), Confirmatory factor analysis (CFA), and Exploratory graph analysis (EGA). Regarding the construct validity, the concurrent validity was assessed between the UOC and The Obsessive–Compulsive Inventory-Revised (OCI-R), Kessler Psychological Distress Scale (K10), and Yale-Brown Obsessive–Compulsive Scale (Y-BOCS). We calculated Cronbach’s alpha to evaluate the reliability of the UOC. All statistical calculations were done in R programming language (in R-Studio Desktop version 4.2.1).

Results
The Persian version of UOC showed a convenient internal consistency with Cronbach’s alpha coefficient for the total scale 0.88. UOC scores were significantly correlated with OCI-R, K-10, and YBOCS. The EFA and EGA showed four and three-factor solutions with 25 and 28 items, respectively. Also, CFA showed that these two solutions were reliable, and the three-factors solution showed higher fit indexes. Finally, the results showed that item-27 was the most central item in the UOC network structure.

Conclusion
The findings from the present study indicated that the Persian version of UOC has acceptable psychometric properties. So, this scale can be used for examining obsessive–compulsive tendencies in Iranian university students.
Genotype variation of ACE and ACE2 genes affects the severity of COVID-19 patients
Authors: Faustine Ingrid , Marteka Deli , Malik Amarila , Supriyanto Eko , Syafhan Nadia F. 
Published: September 2023

Abstract
Objective
Genetic polymorphisms in ACE and ACE2 genes are involved in the RAS regulation of blood pressure and their activity may confer susceptibility to hypertension. In addition, they may play a role in SARS-CoV-2 pathogenesis and the severity of COVID-19. This study aims to determine the effect of genetic variations in the ACE (rs4331) and ACE2 (rs2074192) genes with hypertension comorbidity on the severity of COVID-19 in the Indonesian population.

Result
186 patients were enrolled and assigned into the COVID-19 group (n = 95) and non-COVID-19 group (n = 91) in this cross-sectional study. GG genotype frequency was dominant in ACE gene, but there were no significant differences between the groups (p = 0.163). The two groups had a significant difference (p = 0.000) for the CC genotype frequency (0,37 vs. 0.01) in the ACE2 gene. The proportion of women with COVID-19 is higher (51%), but men with hypertension had more severe symptoms (44%). Men with hypertension comorbidity, GG (ACE), and TT (ACE2) genotypes tended to have moderate-to-severe symptoms (25%). Similarly, women with hypertension as well as GG and CT genotypes tended to have moderate-to-severe symptoms (21%). We conclude that hypertension and mutations in the ACE (rs4331) and ACE2 (rs2074192) genes affect the severity of COVID-19.
Spiritual leadership influence on employee creative service performance: a moderated mediation analysis
Authors: Chiu Yu-Wen , Amin Muhammad Waqas , Li Sheng Tun , Ali Muhammad 
Published: September 2023

AbstractThis paper expands the understanding of the relationship between spiritual leadership (SPL) and the creative service performance of employees. The research model, based on cognitive evaluation theory, examines the mediating role of employee autonomy and the moderating role of proactive personality in the relationship between SPL and employee creative service performance. Data was collected from 351 employees in China to test the moderated mediation model of this study. The empirical analysis reveals a positive association between SPL and employee autonomy, which in turn leads to increased employee creative service performance. Furthermore, the results show that SPL indirectly affects employee creative service performance via employee autonomy. Additionally, the findings suggest that a proactive personality can enhance the direct effect of SPL on employee autonomy and the indirect effect of SPL on employee creative service performance via employee autonomy. These results contribute significantly to the literature on SPL and creativity. The contributions and implications of this study are discussed in the subsequent section.
Extracellular vesicles derived from M1 macrophages enhance rat midpalatal suture expansion by promoting initial bone turnover and inflammation
Authors: Liu Yi , Zhong Yuan , Zheng Bowen , Liu Yi 
Published: September 2023

Abstract
Background
Midpalatal suture (MPS) expansion can be affected by many factors, and researchers have attempted to regulate the initial inflammatory stage of expansion to optimize clinical outcomes and their underlying mechanisms. This study aimed to investigate the potential effects and mechanisms of M1 macrophage small extracellular vesicles during rat MPS expansion.

Materials and methods
RAW264.7 cells were induced to M1 or M2 polarization and, small extracellular vesicles were isolated from the polarized macrophages. Male Sprague–Dawley rats (6–7 weeks) were administered 70 ± 5 g expansion force devices for 7 days. Rats with expanders without force served as controls. M1/M2 small extracellular vesicles were injected into the MPS region (50 µg/day) in the M1 and M2 small extracellular vesicle-assisted groups, while 0.9% saline was injected into the expansion-only group. Suture width, bone mass, and morphological changes in the region of interest (ROI) were examined.

Results
The M1 small extracellular vesicle-assisted group showed a significantly increased MPS suture width in vivo (P < 0.001), and less bone mass was observed in the ROI (P < 0.05). Histological examination showed that the M1 small extracellular vesicle-assisted group exhibited a wider palatal area and obvious fibrous tissue rearrangement. The expression of RANKL and the number of osteoclasts were increased (P < 0.01) in the bony edges, and the p65 protein expression was significantly higher (P < 0.001).

Conclusions
M1 macrophage-derived small extracellular vesicles have a positive effect in MPS expansion and increase p65 protein content and RANKL expression, thus promoting bone turnover. This study may contribute to the clinical application of small extracellular vesicles in the expansion of the palatal suture.
A nomogram based on biparametric magnetic resonance imaging for detection of clinically significant prostate cancer in biopsy-naïve patients
Authors: Hu Beibei , Zhang Huili , Zhang Yueyue , Jin Yongming 
Published: September 2023

Abstract
Purpose
This study aimed to develop and validate a model based on biparametric magnetic resonance imaging (bpMRI) for the detection of clinically significant prostate cancer (csPCa) in biopsy-naïve patients.

Method
This retrospective study included 324 patients who underwent bpMRI and MRI targeted fusion biopsy (MRGB) and/or systematic biopsy, of them 217 were randomly assigned to the training group and 107 were assigned to the validation group. We assessed the diagnostic performance of three bpMRI-based scorings in terms of sensitivity and specificity. Subsequently, 3 models (Model 1, Model 2, and Model 3) combining bpMRI scorings with clinical variables were constructed and compared with each other using the area under the receiver operating characteristic (ROC) curves (AUC). The statistical significance of differences among these models was evaluated using DeLong’s test.

Results
In the training group, 68 of 217 patients had pathologically proven csPCa. The sensitivity and specificity for Scoring 1 were 64.7% (95% CI 52.2%-75.9%) and 80.5% (95% CI 73.3%-86.6%); for Scoring 2 were 86.8% (95% CI 76.4%-93.8%) and 73.2% (95% CI 65.3%-80.1%); and for Scoring 3 were 61.8% (95% CI 49.2%-73.3%) and 80.5% (95% CI 73.3%-86.6%), respectively. Multivariable regression analysis revealed that scorings based on bpMRI, age, and prostate-specific antigen density (PSAD) were independent predictors of csPCa. The AUCs for the 3 models were 0.88 (95% CI 0.83–0.93), 0.90 (95% CI 0.85–0.94), and 0.88 (95% CI 0.83–0.93), respectively. Model 2 showed significantly higher performance than Model 1 (P = 0.03) and Model 3 (P < 0.01).

Conclusion
All three scorings had favorite diagnostic accuracy. While in conjunction with age and PSAD the prediction power was significantly improved, and the Model 2 that based on Scoring 2 yielded the highest performance.