bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implementation of distributed arithmetic-based symmetrical 2-D block finite impulse response filter architectures
Authors: Chowdari Ch Pratyusha , Seventline J.B. 
Published: September 2023

Background: This paper presents an efficient two-dimensional (2-D) finite impulse response (FIR) filter using block processing for two different symmetries. Architectures for a general filter (without symmetry) and two symmetrical filters (diagonal and quadrantal symmetry) are implemented. The proposed architectures need fewer multipliers because of the symmetry of the filter coefficients. Methods: A distributed arithmetic (DA)- based multiplication method is used in the proposed architecture. A dual-port memory-based lookup table (DP-MLUT) is used in the multiplication instead of lookup-table (LUT) to reduce the area and power of the FIR filter. The filter's throughput is increased by using block processing. Memory reuse and memory sharing methods are introduced, which reduces the need for many registers and hence the circuit complexity. The architectures are written in Verilog Hardware Description Language and synthesized using Genus Synthesis tool-19.1 in 45nm technology with a generic library of Cadence vendor constraints. The synthesis tool generates the area, delay, and power reports. Power consumption of architectures is calculated with an image size of 64 X 64 and at 20 MHz frequency. Results: Compared to existing architectures, the synthesis results show improvements in power, area, area delay product (ADP), and power delay product (PDP). The proposed MLUT-based 2-D block Quadrantal Symmetry Filter (QSF) for length 8 with block size 4 consumes 58.94% less power, occupies 59.5% less area, 48.44% less ADP and 47.78% less PDP compared to best existing methods. Conclusions: A novel DA-based 2-D block FIR filter architecture with various symmetries is realized. Symmetry is incorporated into the filter coefficients to minimize the number of multipliers. The LUT size is optimized by odd multiples or even multiples storage techniques. Also, the overall area of the architecture is decreased by DP-LUT-based multipliers. The proposed filter architecture is area-power-efficient. It is best suited for applications that have fixed coefficients.
Examining the link between social exclusion and social-risk taking: a correlational and experimental investigation
Authors: Pfundmair Michaela , Lermer Eva 
Published: September 2023

Background: Previous research has consistently shown that social exclusion increases the proclivity for risk-taking. However, theoretical approaches like the Social Risk Hypothesis suggest that this relationship flips when confronted with social risks. Accordingly, the current study hypothesized that social exclusion decreases the propensity for social risks, in contrast to that for risks of other domains. Methods: To investigate this hypothesis, we conducted a correlational pre-study and an experimental main study. In the latter, we tested our assumption manipulating exclusion vs. inclusion using the Cyberball and Future-Life paradigms. Results: Results of the pre-study revealed that exclusion was linked to some forms of risk-taking, however, not to risk-taking in social domains. The main study showed that an experimental induced instance of social exclusion dampened the propensity for social risks. It further disclosed this effect’s boundary condition: When individuals were socially excluded to a more severe extent, they did not demonstrate such a risk-averse reaction. Moreover, we identified low dominance as a mediator for the dampening effect of exclusion on social risk-taking. Conclusions: These findings indicate that social risk aversion in the aftermath of social exclusion might be an adaptive strategy in the short-term because the prevention of social risks and humble behaviors reduce signals of threat and elicit signals of support. However, this strategy might also produce a vicious circle of exclusion and, thus, higher costs in the long-term.
A cross-sectional analysis identifies a low prevalence of Plasmodium ovale species infections in symptomatic and asymptomatic individuals in Kilifi county, Kenya.
Authors: Akinyi Mercy Yvonne , Chifwete Margaret , Ndwiga Leonard , Kimenyi Kelvin Muteru , Osoti Victor , Ochola-Oyier Lynette Isabella 
Published: September 2023

Background: The focus on P. falciparum diagnosis has led to an underestimation of the global burden of malaria resulting from neglected Plasmodium species. However, there is still scarce data on the prevalence of P. ovale globally. To address this knowledge gap, data collected from cross-sectional studies in Kilifi county were used to: 1) determine the prevalence of P. ovale species infections; and 2) determine the sensitivity of different diagnostic assays in detecting P. ovale species infections. Methods: A total of 531 individuals were sampled across three study sites in Kilifi County, Kenya between 2009 and 2020. Blood smears were prepared from peripheral blood and screened for Plasmodium parasite stages using light microscopy. Molecular screening involved DNA extraction of dried blood spots and blood in ethylenediaminetetraacetic acid, polymerase chain reaction (PCR) using primers targeting the 18 small ribosomal subunit and sequencing. Results: Microscopy screening revealed that the most prevalent species was P. falciparum (32.0%) followed by P. malariae (9.0%) and then P. ovale (1.5%). PCR screening identified additional P. ovale species positives cases. Overall, 48 (8.2%) out of the 531 individuals harbored P. ovale species infection with the highest prevalence reported in the tertiary health facility, (14.6%, 95% CI 8-23.6%), followed by the primary health facility (8.6%, 95% CI 5.4-11.9%), and the community from a cross-sectional blood survey, (6.5%, 95% CI 3.0-11.8%). Microscopy screening for P. ovale had a low sensitivity of 7% (95% CI 1-19-30%) and a high specificity of 99% (95% CI 98-100%). Sequencing results confirmed the presence of P.ovale curtisi. Conclusions: This study provides baseline data for P. ovale species surveillance in Kilifi County, primarily using PCR to improve diagnosis. These results suggest that malaria elimination and eradication efforts should not only concentrate on P. falciparum but should embrace a holistic approach towards elimination of all Plasmodium species.
Packaging cost-effectiveness models in R: A tutorial.
Authors: Smith Robert , Mohammed Wael , Schneider Paul 
Published: September 2023

Background: The use of programming languages such as R in health economics and decision science is increasing, and brings numerous benefits including increasing model development efficiency, improving transparency, and reducing human error. However, there is limited guidance on how to best develop models using R. So far, no clear consensus has emerged. Methods: We present the advantages of creating health economic models as R packages - structured collections of functions, data sets, tests, and documentation. Assuming an intermediate understanding of R, we provide a tutorial to demonstrate how to construct a basic R package for health economic evaluation. All source code used in or referenced by this paper is available under an open-source licence. Case Study: We use the Sick Sicker Model as a case study applying the steps from the tutorial to standardise model development, documentation and aid review. This can improve the distribution of code, thereby streamlining model development, and improving methods in health economic evaluation. Conclusion: R packages offer a valuable framework for enhancing the quality and transparency of health economic evaluation models. Embracing better, more standardised software development practices, while fostering a collaborative culture, has the potential to significantly improve the quality of health economic models, and, ultimately, support better decision making in healthcare.
Absorption coefficients and scattering losses of TGG, TGP, KTF, FS, and CeF3 magneto-optical crystals in the visible via cavity ring-down spectroscopy
Authors: Xygkis Michalis , Linaraki Artemis N. , Toutoudaki Eirini N. , Katsoprinakis Georgios E. , Rakitzis T. Peter 
Published: September 2023

We demonstrate a method for determining small absorption coefficients and surface-scattering losses of crystals using cavity ring-down spectroscopy and perform measurements on magneto-optical crystals of terbium gallium garnet (TGG), terbium gallium phosphate (TGP), fused silica (FS), potassium terbium fluoride (KTF), and CeF3 at 532 and 634 nm. Surface scattering is distinguished from absorption losses by using crystals of different lengths. A figure of merit (FoM) for magneto-optical crystals is defined to evaluate their suitability as intracavity optics in optical cavity applications. It is found that TGP has the highest FoM for crystal lengths up to ∼10mm, whereas CeF3 and FS potentially outperform TGP for longer crystals. Single-pass applications are also briefly discussed.
Incidence and predictors of tuberculosis among children receiving antiretroviral therapy in the Wolaita Zone: A retrospective cohort study
Authors: Tekese Daneil , Dawit Desalegn , Hawulte Behailu , Mohammed Hussein , Asefa Fekede , Oljira Lemessa 
Published: September 2023

Background
Tuberculosis is the leading cause of morbidity and mortality among children living with the human immunodeficiency virus (HIV), mainly in sub-Saharan Africa, including Ethiopia. Tuberculosis remains a significant health concern for HIV-positive children in Ethiopia. There is a paucity of data on the incidence and predictors of tuberculosis among children living with HIV on antiretroviral therapy in the Wolaita zone. Hence, this study aimed to assess the incidence and predictors of tuberculosis among children living with HIV on antiretroviral therapy in the Wolaita zone between January 2010 to December 2020.

Methods
A retrospective cohort study was conducted among 389 children receiving antiretroviral therapy in Wolaita zone health facilities between January 2010 to December 2020. The checklist was adapted from the standardized antiretroviral treatment (ART) follow-up form currently used by the institutions’ ART clinics. The Kaplan-Meier survival function and Log-rank were used to estimate the survival for each categorical variable to compare the survival between different exposure groups. Both bivariable and multivariable parametric survival Gompertz models were fitted to identify predictors of tuberculosis among HIV-positive children. The association was summarized using an adjusted hazard ratio (AHR), and statistical significance was declared at 95% CI and p-value < 0.05. The goodness of the model fit was assessed using a Cox-Snell residual plot.

Results
The incidence rate of tuberculosis among children living with HIV was 3.5 (95% CI 2.7–4.5) per 100 child years. World Health Organization clinical stage III or IV (AHR = 2.31, 95% CI [1.26, 4.22]), hemoglobin level <10 g/dL (AHR = 2.87, 95% CI [1.51, 5.45]), fair or poor ART adherence (AHR = 4.4, 95% CI[2.18, 9.05]), underweight (AHR = 2.55, 95% CI [1.45, 4.51]), age >10 years (AHR = 3.62; 95% CI [1.29, 10.0]), and cotrimoxazole preventive therapy (AHR = 0.23; 95% CI [0.08, 0.60]) were among the independent predictors of TB occurrence.

Conclusion
The incidence of tuberculosis among children on ART was high. HIV-positive children presenting with advanced disease staging (III and IV), anemia, “fair” and “poor” ART adherence, underweight, age above ten years, and not receiving cotrimoxazole preventive therapy were at higher risk of TB. Therefore, counseling on ART adherence, early diagnosis, and prompt treatment of anemia and malnutrition are recommended to avert tuberculosis.
Unpacking the challenges of fragmentation in community-based maternal newborn and child health and health system in rural Ethiopia: A qualitative study
Authors: Gebremeskel Akalewold T. , Udenigwe Ogochukwu , Etowa Josephine , Yaya Sanni 
Published: September 2023

Introduction
In Ethiopia, country-wide community-based primary health programs have been in effect for about two decades. Despite the program’s significant contribution to advancing Maternal Newborn and Child Health (MNCH), Ethiopia’s maternal and child mortality is still one of the highest in the world. The aim of this manuscript is to critically examine the multifaceted fragmentation challenges of Ethiopia’s Community Health Workers (CHWs) program to deliver optimum MNCH and build a resilient community health system.

Methods
We conducted a qualitative case study in West Shewa Zone, rural Ethiopia. A purposive sampling technique was used to recruit participants. Data sources were two focus group discussions with sixteen CHWs, twelve key informant interviews with multilevel public health policy actors, and a policy document review related to the CHW program to triangulate the findings. Thematic analysis of the qualitative data was conducted. The World Health Organization’s health systems framework and socio-ecological model guided the data collection, analysis, and interpretation.

Results
The CHWs program has been an extended arm of Ethiopia’s primary health system and has contributed to improved health outcomes. However, the program has been facing unique systemic challenges that stem from the fragmentation of health finance; medical and equipment supply; working and living infrastructures; CHWs empowerment and motivation, monitoring, supervision, and information; coordination and governance; and community and stakeholder engagement. The ongoing COVID-19 and volatile political and security issues are exacerbating these fragmentation challenges.

Conclusion
This study emphasized the gap between the macro (national) level policy and the challenge during implementation at the micro (district)level. Fragmentation is a blind spot for the community-based health system in rural Ethiopia. We argue that the fragmentation challenges of the community health program are exacerbating the fragility of the health system and fragmentation of MNCH health outcomes. This is a threat to sustain the MNCH outcome gains, the realization of national health goals, and the resilience of the primary health system in rural Ethiopia. We recommend that beyond the current business-as-usual approach, it is important to emphasize an evidence-based and systemic fragmentation monitoring and responsive approach and to better understand the complexity of the community-based health system fragmentation challenges to sustain and achieve better health outcomes. The challenges can be addressed through the adoption of transformative and innovative approaches including capitalizing on multi-stakeholder engagement and health in all policies in the framework of co-production.
Secondhand smoke exposure and associated factors among city residents living in multiunit housing in Bangladesh
Authors: Kibria Md. Golam , Hossain Ahmed , Islam Taslima , Islam Kazi Rakibul , Mahmud H. M. Miraz , Nabi Mohammad Hayatun , Hawlader Mohammad Delwer Hossain 
Published: September 2023

Background
Secondhand smoke (SHS) poses a high health risk to those living in multiunit housing (MUH) since it can easily spread from unit to unit and throughout the building’s communal areas. MUH residents in Bangladesh are particularly vulnerable to SHS due to the absence of smoking restrictions within a housing complex. Therefore, this study aimed to assess the prevalence of SHS exposure and its associated factors among MUH residents living in seven divisional cities of Bangladesh- Dhaka, Chattogram, Rajshahi, Khulna, Sylhet, Barishal, and Rangpur.

Methods
From April 2019 to November 2019, a cross-sectional survey was conducted with 616 MUH residents aged 18 or older who had been residing in MUH for at least two years in the seven divisional cities of Bangladesh. A multivariable logistic regression model was performed to determine the associated factors of SHS exposure.

Results
In MUH complexes, more than half (54.9%) of the 616 respondents were exposed to SHS. The key factors positively associated with SHS exposure were females (aOR: 1.8, 95% CI:1.236–2.681), residents with a low monthly family income (aOR: 1.9, 95% CI: 1.162–3.220), those whose family members smoked (aOR: 2.4, 95% CI: 1.537–3.746), and Dhaka city residents (aOR: 1.9, 95% CI: 1.013–3.440).

Conclusions
This study revealed a high prevalence of SHS exposure among Bangladeshi MUH residents. Therefore, a smoking ban is needed in and around MUH complexes to protect non-smoking residents from SHS exposure.
Effect of sacubitril/valsartan on brain natriuretic peptide level and prognosis of acute cerebral infarction
Authors: Shen Xiaozhu , Gong Chen , Liu Mengqian , Jiang Yi , Xu Yiwen , Ge Zhonglin , Tao Zhonghai , Dong Nan , Liao Juan , Yu Liqiang , Fang Qi 
Published: September 2023

Background and purpose
Previous studies demonstrated that elevated brain natriuretic peptide (BNP) level is associated with adverse clinical outcomes of acute cerebral infarction (ACI). Researchers hypothesized that BNP might be a potential neuroprotective factor against cerebral ischemia because of the antagonistic effect of the natriuretic peptide system on the renin-angiotensin system and regulation of cardiovascular homeostasis. However, whether decreasing the BNP level can improve the prognosis of ACI has not been studied yet. The main effect of sacubitril/valsartan is to enhance the natriuretic peptide system. We investigated whether the intervention of plasma BNP levels with sacubitril/valsartan could improve the prognosis of patients with ACI.

Methods
In a randomized, controlled, parallel-group trial of patients with ACI within 48 hours of symptom onset and need for antihypertensive therapy, patients have randomized within 24 hours to sacubitril/valsartan 200mg once daily (the intervention group) or to conventional medical medication (the control group). The primary outcome was a change in plasma BNP levels before and after sacubitril/valsartan administration. The secondary outcomes included plasma levels of brain-derived neurotrophic factor (BDNF), Corin and neprilysin (NEP) before and after medication, the modified Rankin scale, and the National Institutes of Health Stroke Scale (at onset, at discharge, 30 days, and 90 days after discharge).

Results
We evaluated 80 eligible patients admitted to the Stroke Center of Lianyungang Second People’s Hospital between 1st May, 2021 and 31st June, 2022. Except for 28 patients excluded before randomization and 14 patients who did not meet the criteria or dropped out or lost to follow-up during the trial, the remaining 38 patients (intervention group: 17, control group: 21) had well-balanced baseline features. In this trial, we found that plasma BNP levels (P = 0.003) decreased and NEP levels (P = 0.006) increased in enrolled patients after treatment with sacubitril/valsartan. There were no differences in plasma BDNF and Corin levels between the two groups. Furthermore, no difference in functional prognosis was observed between the two groups (all P values>0.05).

Conclusions
Sacubitril/valsartan reduced endogenous plasma BNP levels in patients with ACI and did not affect their short-term prognosis.
Angiotensin-Converting Enzyme (ACE) gene polymorphism and arterial blood pressure among the Tawang Monpa of Eastern Himalayan Mountains: Is there a signature of natural selection?
Authors: Ghosh Sudipta 
Published: September 2023

Objectives
The present paper aims to characterize the Angiotensin-converting enzyme (ACE) genotype, with particular emphasis on its association with arterial oxygen saturation, arterial blood pressure, hemoglobin [Hb] concentration, and ventilatory measures among the Tawang Monpa, a high-altitude native population of the Eastern Himalaya, India.

Methods
A cross-sectional sample of 168Monpa participants from Tawang town, Arunachal Pradesh, India, was selected who live at an altitude of ∼3,200 meters (m) above sea level. For each participant, height, weight, and skinfold thickness were measured, based on which body mass index (BMI, kg/m2) and percentage of body fat (%BF) were calculated. Physiological measures, such as the transcutaneous arterial oxygen saturation (SaO2), hemoglobin [Hb] concentration, forced vital capacity (FVC), forced expiratory volume in 1-second (FEV1), and systemic arterial blood pressure were measured. First, the peripheral venous blood samples (four ml) were drawn, and then white blood cells were separated for the ACE genotyping of each participant.

Results
Unlike high-altitude natives from Peru and Ladakh, who exhibit high frequencies of II homozygotes, the Tawang Monpa shows a significantly high frequency of ID heterozygotes (p<0.0001). In addition, no significant association was identified between ACE gene polymorphism and arterial blood pressure, oxygen saturation at rest, vital capacity, or [Hb] concentration.

Discussion
The results suggest that the association of the ACE gene with resting SaO2 is inconsistent across native populations living under hypobaric hypoxia. Further, ACE I/D gene polymorphism may not be under natural selection in specific native populations, including Tawang Monpa, for their adaptation to high-altitude hypoxia.
The level of the gender gap in academic publishing varies by country and region of affiliation: A cross-sectional study of articles published in general medical journals
Authors: Sebo Paul , Schwarz Joëlle 
Published: September 2023

Background
Women are generally under-represented as authors of publications, and especially as last authors, but this under-representation may not be uniformly distributed across countries. We aimed to document by country and region the proportion of female authors (PFA) in high-impact general medical journals.

Methods
We used PyMed, a Python library that provides access to PubMed, to retrieve all PubMed articles published between January 2012 and December 2021 in the fifty general internal medicine journals with the highest 2020 impact factor according to Journal Citation Reports. We extracted first/last authors’ main country of affiliation for all these articles using regular expressions and manual search, and grouped the countries into eight regions (North/Latin America, Western/Eastern Europe, Asia, Pacific, Middle East, and Africa). We used NamSor to determine first/last authors’ gender and computed the PFA for each country/region.

Results
We retrieved 163,537 publications for first authors and 135,392 for last authors. Gender could be determined for 160,891 and 133,373 publications, respectively. The PFA was 41% for first authors and 33% for last authors, but it varied widely by country (first authors: >50% for eight countries, maximum = 63% in Romania, minimum = 19% in Japan; last authors: >50% for two countries, maximum = 53% in Romania, minimum = 9% in Japan). The PFA also varied by region. It was highest for Eastern Europe (first authors = 53%, last authors = 40%), and lowest for Asia (36% and 29%) and the Middle East (35% and 27%).

Conclusion
We found that the PFA varied widely by country and region, and was lowest in Asia, particularly Japan, and the Middle East. The under-representation of women as authors of publications, especially in these two regions, needs to be addressed and correcting persistent gender discrimination in research should be a top priority.
Slow and Steady: A Slowly Progressing Neuroendocrine Tumor
Authors: Zheng Christie , Al Shabeeb Reem , Shah Dipam , Sardana Nitin 
Published: September 2023

ABSTRACT
Neuroendocrine tumors (NETs) are rare malignant tumors that arise from neuroendocrine cells throughout the body, most commonly in the gastrointestinal and respiratory tracts. We report a case of well-differentiated grade 2 NET with a computed tomography scan showing multiple liver lesions consistent with the liver lesions seen 11 years before diagnosis. This case highlights the possibility of an indolent or prolonged clinical course of metastatic NET with an unknown primary vs primary hepatic NET.