bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of government subsidy programs on equity in health financing
Authors: Mohammadzadeh Yousef , Sheikhmali Aysan , Yahyavi Dizaj Jafar , Mosadeghrad Ali Mohammad , Yusefzadeh Hasan , Refah Kahriz Arash 
Published: August 2023

Abstract
Background
Iran government implemented the targeted subsidy plan in December 2010 to reduce energy consumption and inequality. In addition, the Health Transformation Plan was implemented by the Ministry of Health to reduce out-of-pocket payments. This study aimed to examine the impact of these two government subsidy programs on equity in health financing.

Method
In this study, data on 528,046 households were collected using household surveys during 14 years (2007–2020). The Fairness in Financial Contribution index and Catastrophic Health Expenditures index were calculated. Also, a Logistic regression model was performed by the applied software of Stata V.14 to examine the effects of the two mentioned policies and other socioeconomic characteristics of households on their exposure to Catastrophic Health Expenditures.

Results
The FFC index was 0.829 and 0.795 respectively in 2007 and 2020. The trend analysis did not show significant changes in the FFC index between 2007 and 2020. TSP and HTP implementations do not reduce households’ exposure to CHE significantly. Crowded households with more elder people, belonging to low-income deciles, without houses, and living in rural areas and deprived provinces, are more likely to be at risk of CHE. Health insurance coverage did not protect households from CHE. Highly educated and employed households were exposed to less CHE.

Conclusion
The government subsidy programs have not been effective in improving FFC and reducing CHE indices. None of them has been able to realize the goal of the 6th National Development Plan of reducing CHE to 1%. The government should devise support packages for target households (households with more elderly people, lower incomes, without private houses, crowded, rural, and inhabited in deprived provinces), so they can protect households against CHE. Modifying and improving the quality of insurance coverage is strongly recommended due to its inefficiency.
PECAM-1 drives β-catenin-mediated EndMT via internalization in colon cancer with diabetes mellitus
Authors: Wu Qing , Du Xingxing , Cheng Jianing , Qi Xiuying , Liu Huan , Lv Xiaohong , Gong Xieyang , Shao Changxin , Wang Muhong , Yue Luxiao , Yang Xin , Li Shiyu , Zhang Yafang , Li Xuemei , Yang Huike 
Published: August 2023

Abstract
Background
Diabetes mellitus (DM) is considered to be a risk factor in carcinogenesis and progression, although the biological mechanisms are not well understood. Here we demonstrate that platelet-endothelial cell adhesion molecule 1 (PECAM-1) internalization drives β-catenin-mediated endothelial-mesenchymal transition (EndMT) to link DM to cancer.

Methods
The tumor microenvironment (TME) was investigated for differences between colon cancer with and without DM by mRNA-microarray analysis. The effect of DM on colon cancer was determined in clinical patients and animal models. Furthermore, EndMT, PECAM-1 and Akt/GSK-3β/β-catenin signaling were analyzed under high glucose (HG) and human colon cancer cell (HCCC) supernatant (SN) or coculture conditions by western and immunofluorescence tests.

Results
DM promoted the progression and EndMT occurrence of colon cancer (CC). Regarding the mechanism, DM induced PECAM-1 defection from the cytomembrane, internalization and subsequent accumulation around the cell nucleus in endothelial cells, which promoted β-catenin entry into the nucleus, leading to EndMT occurrence in CC with DM. Additionally, Akt/GSK-3β signaling was enhanced to inhibit the degradation of β-catenin, which regulates the process of EndMT.

Conclusions
PECAM-1 defects and/or internalization are key events for β-catenin-mediated EndMT, which is significantly boosted by enhanced Akt/GSK-3β signaling in the DM-associated TME. This contributes to the mechanism by which DM promotes the carcinogenesis and progression of CC.

Graphical Abstract
A case series on recurrent and persisting IgA vasculitis (Henoch Schonlein purpura) in children
Authors: Marro Julien , Williams Chloe , Pain Clare E. , Oni Louise 
Published: August 2023

Abstract
Background
IgA vasculitis (IgAV) is a small vessel vasculitis that is more common in childhood. Very limited evidence exists on patients who experience an atypical disease course. The aim of this study was to describe a cohort of children diagnosed with recurrent or persisting IgAV to identify any themes associated with their disease course and areas of unmet needs.

Methods
A single centre retrospective study of children diagnosed with recurrent or persisting IgAV at Alder Hey Children’s Hospital (Liverpool, UK). Clinical data, including features at presentation and during follow up, potential triggers, abnormal laboratory and histology results, treatment and outcome at last clinical review were retrospectively collected. Key themes were identified.

Results
A total of 13 children met the inclusion criteria (recurrent disease, n = 4; persisting disease, n = 9). Median age at first presentation was 10.2 years [2.6–15.5], female:male ratio 1.2:1. Children in the atypical cohort were significantly older than a larger cohort of children who followed a non-complicated disease course (median age 5.5 years (range [0.6–16.7], p = 0.003)). All children re-presented with a purpuric rash (either recurring or persisting), accompanied by joint involvement in 92% of patients (12/13). Disease-modifying anti-rheumatic drugs (DMARDs) were used in 8/13 (62%) children. The median time from first presentation to diagnosis of atypical disease was 18.4 months [5.3-150.8] and the time from first presentation to treatment was 24.1 months [1.8–95.4]. Use of corticosteroids was significantly higher in children with renal involvement (p = 0.026). During follow up, 8/13 (62%) children were admitted at least once, whilst 10/13 (77%) had re-presented at least once to the emergency department. Five (38%) children were referred to psychology services and 7 (54%) children reported feelings of frustration.

Conclusions
This series describes some characteristics of a small cohort of children with atypical IgAV. It also identifies unmet needs in children with atypical IgAV, which includes delays in diagnosis and lengthy waits for treatment, lack of high-quality evidence regarding treatment choices and a high unrecognised disease burden. Further research is needed to study this subgroup of children as evidence is lacking.
Exacerbating effects of single-dose acute ethanol exposure on neuroinflammation and amelioration by GPR110 (ADGRF1) activation
Authors: Banerjee Sharmistha , Park Taeyeop , Kim Yoo Sun , Kim Hee-Yong 
Published: August 2023

Abstract
Background
Neuroinflammation is a widely studied phenomenon underlying various neurodegenerative diseases. Earlier study demonstrated that pharmacological activation of GPR110 in both central and peripheral immune cells cooperatively ameliorates neuroinflammation caused by systemic lipopolysaccharide (LPS) administration. Ethanol consumption has been associated with exacerbation of neurodegenerative and systemic inflammatory conditions. The goal of this study is to determine the effects of single-dose acute ethanol exposure and GPR110 activation on the neuro-inflammation mechanisms.

Methods
For in vivo studies, GPR110 wild type (WT) and knockout (KO) mice at 10–12 weeks of age were given an oral gavage of ethanol (3 g/kg) or maltose (5.4 g/kg) at 1–4 h prior to the injection of LPS (1 mg/kg, i.p.) followed by the GPR110 ligand, synaptamide (5 mg/kg). After 2–24 h, brains were collected for the analysis of gene expression by RT-PCR or protein expression by western blotting and enzyme-linked immunosorbent assay (ELISA). Microglial activation was assessed by western blotting and immunohistochemistry. For in vitro studies, microglia and peritoneal macrophages were isolated from adult WT mice and treated with 25 mM ethanol for 4 h and then with LPS (100 ng/ml) followed by 10 nM synaptamide for 2 h for gene expression and 12 h for protein analysis.

Results
Single-dose exposure to ethanol by gavage before LPS injection upregulated pro-inflammatory cytokine expression in the brain and plasma. The LPS-induced Iba-1 expression in the brain was significantly higher after ethanol pretreatment in both WT and GPR110KO mice. GPR110 ligand decreased the mRNA and/or protein expression of these cytokines and Iba-1 in the WT but not in GPR110KO mice. In the isolated microglia and peritoneal macrophages, ethanol also exacerbated the LPS-induced expression of pro-inflammatory cytokines which was mitigated at least partially by synaptamide. The expression of an inflammasome marker NLRP3 upregulated by LPS was further elevated with prior exposure to ethanol, especially in the brains of GPR110KO mice. Both ethanol and LPS reduced adenylate cyclase 8 mRNA expression which was reversed by the activation of GPR110. PDE4B expression at both mRNA and protein level in the brain increased after ethanol and LPS treatment while synaptamide suppressed its expression in a GPR110-dependent manner.

Conclusion
Single-dose ethanol exposure exacerbated LPS-induced inflammatory responses. The GPR110 ligand synaptamide ameliorated this effect of ethanol by counteracting on the cAMP system, the common target for synaptamide and ethanol, and by regulating NLRP3 inflammasome.
Deep learning based automatic segmentation of organs-at-risk for 0.35 T MRgRT of lung tumors
Authors: Ribeiro Marvin F. , Marschner Sebastian , Kawula Maria , Rabe Moritz , Corradini Stefanie , Belka Claus , Riboldi Marco , Landry Guillaume , Kurz Christopher 
Published: August 2023

Abstract
Background and purpose
Magnetic resonance imaging guided radiotherapy (MRgRT) offers treatment plan adaptation to the anatomy of the day. In the current MRgRT workflow, this requires the time consuming and repetitive task of manual delineation of organs-at-risk (OARs), which is also prone to inter- and intra-observer variability. Therefore, deep learning autosegmentation (DLAS) is becoming increasingly attractive. No investigation of its application to OARs in thoracic magnetic resonance images (MRIs) from MRgRT has been done so far. This study aimed to fill this gap.

Materials and methods
122 planning MRIs from patients treated at a 0.35 T MR-Linac were retrospectively collected. Using an 80/19/23 (training/validation/test) split, individual 3D U-Nets for segmentation of the left lung, right lung, heart, aorta, spinal canal and esophagus were trained. These were compared to the clinically used contours based on Dice similarity coefficient (DSC) and Hausdorff distance (HD). They were also graded on their clinical usability by a radiation oncologist.

Results
Median DSC was 0.96, 0.96, 0.94, 0.90, 0.88 and 0.78 for left lung, right lung, heart, aorta, spinal canal and esophagus, respectively. Median 95th percentile values of the HD were 3.9, 5.3, 5.8, 3.0, 2.6 and 3.5 mm, respectively. The physician preferred the network generated contours over the clinical contours, deeming 85 out of 129 to not require any correction, 25 immediately usable for treatment planning, 15 requiring minor and 4 requiring major corrections.

Conclusions
We trained 3D U-Nets on clinical MRI planning data which produced accurate delineations in the thoracic region. DLAS contours were preferred over the clinical contours.
Histopathological features of asymmetric lacrimal gland enlargement in patients with thyroid eye disease
Authors: Gounder Pav , Oliphant Huw , Juniat Valerie , Koenig Michael , Selva Dinesh , Rajak Saul N. 
Published: August 2023

Abstract
Purpose
Lacrimal gland enlargement can be a feature of thyroid eye disease (TED). Unilateral or asymmetric lacrimal gland enlargement is poorly described and may impede diagnosis. We present the histological and clinical findings of four patients with asymmetric lacrimal gland enlargement.

Methods
A retrospective case note review was performed for patients over two tertiary orbital clinics (Royal Adelaide Hospital, South Australia and the Sussex Eye Hospital, Brighton, United Kingdom) presenting with an asymmetrical lacrimal gland enlargement with a background of TED that underwent biopsy to exclude alternate diagnoses. Baseline data was collected for each patient and histopathological images and reports were reviewed.

Results
All four patients were hyperthyroid at time of lacrimal gland biopsy. Biopsy demonstrated nonspecific, lymphoid aggregates, typically of B cell type, with no diagnostic findings to support lymphocyte clonality or IgG4-related disease. One biopsy specimen demonstrated evidence of some fibrosis.

Conclusion
Asymmetrical lacrimal gland enlargement can occur as part of the TED spectrum but may require biopsy to exclude alternate pathology. Histology demonstrates a non-specific lymphocytic infiltrate.
Gamified family-based health exercise intervention to improve adherence to 24-h movement behaviors recommendations in children: “3, 2, 1 Move on Study”
Authors: Alonso-Martínez Alicia M. , Legarra-Gorgoñon Gaizka , García-Alonso Yesenia , Ramírez-Vélez Robinson , Alonso-Martínez Loreto , Erice-Echegaray Blanca , Izquierdo Mikel 
Published: August 2023

Abstract
Background
Evidence suggests that movement patterns, including physical activity, sedentary behavior, and sleep duration, throughout a 24-h period, have a significant impact on biological processes and health outcomes for both young and adult populations. However, 80% of adolescents worldwide are not sufficiently active, and many children do not meet international physical activity recommendations for their age. Thus, the aim of this study is to evaluate the impact of a 12-week gamified family-based health and exercise intervention on physical fitness, basic motor competencies, mental and behavioral health, and adherence to 24-h movement guidelines in children aged 4 to 5 years old. The study will evaluate changes in sedentary levels, physical fitness, basic motor competencies, mental and behavioral disorders, adherence to the exercise program, and compliance with physical activity recommendations. In addition, the aim of this protocol is to describe the scientific rationale in detail and to provide information about the study procedures.

Methods/design
A total of 80 children, aged 4 to 5 years old, will be randomly assigned in a 1:1 ratio to one of two groups: the exercise group and the routine care group. The exercise group will undergo a 12-week exercise intervention, followed by a 12-week follow-up period. On the other hand, the routine care group will undergo a 12-week period of routine care, followed by a 12-week follow-up control period. The exercise program will be implemented in a family setting and facilitated through a gamified web platform with online supervision, with the hypothesis that it will have a positive impact on physical fitness, anthropometric measures, basic motor competencies, and adherence to 24-h movement guidelines.

Discussion
The results of this study will provide valuable insights into the impact of a gamified, family-oriented health and exercise program on various aspects of health, including physical fitness, basic motor competencies, mental and behavioral well-being, and adherence to 24-h movement guidelines. The findings will contribute to closing the gap in current knowledge on the effectiveness of these types of interventions for children and their parents. These findings will also contribute to the development of future guidelines for promoting physical activity in children who do not meet the World Health Organization’s recommended levels. An online “3, 2, 1 Move on Study” is believed to increase accessibility, promoting health equity, and reducing economic barriers for all children and their families across diverse social groups.

Trial registration
Trial registration: NCT05741879. Registered February 14, 2023, Version 1.
Slittable sheath supported right ventricular pacing lead implantation in persistent left superior vena cava with absent right superior vena cava: a case report
Authors: Plášek Jiří , Vrtal Jiří , Šipula David , Grézl Tomáš , Václavík Jan 
Published: August 2023

Abstract
Background
Persistent left superior vena cava (PLSVC) is the most common variant of systemic venous drainage. In the absence of the right superior vena cava (RSVC), implantation of a right ventricular pacing lead may be challenging. Therefore specific implantation techniques and experiences in PLSVC are worth reporting.

Case presentation
We present a case report of a 90-year-old Caucasian female patient with PLSVC during single chamber pacemaker implantation due to the third-degree atrioventricular block. With common implantation techniques, we did not even reach the right ventricle. Therefore slittable CPS Direct ™ Universal sheath was employed to overcome the acute angle from PLSVC to tricuspid valve and ensure more fixation stability for longer 100-cm right ventricular lead placement.

Conclusion
This case demonstrates safe implantation of 100-cm long right ventricular bipolar active fixation pacing lead using common slittable CPS Direct ™ Universal sheath after failed attempts with „C“ and „J“ stylet shaped electrode. This sheath provides different angle towards tricuspid valve and more fixation stability in patient with PLSVC and absent connection to right atrium.
New insights into the important roles of phase seperation in the targeted therapy of lung cancer
Authors: Zou Ying , Zheng Hongmei , Ning Yue , Yang Yang , Wen Qiuyuan , Fan Songqing 
Published: August 2023

AbstractLung cancer is a complex and heterogeneous disease characterized by abnormal growth and proliferation of lung cells. It is the leading cause of cancer-related deaths worldwide, accounting for approximately 18% of all cancer deaths. In recent years, targeted therapy has emerged as a promising approach to treat lung cancer, which involves the use of drugs that selectively target specific molecules or signaling pathways that are critical for the growth and survival of cancer cells. Liquid–liquid phase separation (LLPS) is a fundamental biological process that occurs when proteins and other biomolecules separate into distinct liquid phases in cells. LLPS is essential for various cellular functions, including the formation of membraneless organelles, the regulation of gene expression, and the response to stress and other stimuli. Recent studies have shown that LLPS plays a crucial role in targeted therapy of lung cancer, including the sequestration of oncogenic proteins and the development of LLPS-based drug delivery systems. Understanding the mechanisms of LLPS in these processes could provide insights into new therapeutic strategies to overcome drug resistance in lung cancer cells.
Experimental study on the effects of hydrochemistry and periodic changes in temperature and humidity on sandstone weathering in the Longshan Grottoes
Authors: Sun Bo , Li Xingyue , Cui Kai , Hong Jie , Chen Rui , Jia Chen , Peng Ningbo 
Published: August 2023

Abstract
Changes in precipitation, temperature and humidity can lead to the weathering of rock masses in grottoes; these changes are common in sandstone grottoes. To simulate this cyclic process, different salt solutions were designed according to the main precipitated components. Sandstone specimens taken from Longshan Grottoes were soaked in these solutions for 48 h and then placed in a simulated environment with temperature and humidity changes for 5 cycles (50 h) to study the effects of hydrochemical, temperature and humidity changes on the sandstone. Physical indexes, such as mass, wave velocity, surface hardness and tensile strength, of the rock samples were measured every three cycles, and the damage characteristics and mechanisms of the sandstone were discussed based on SEM and XRD test results. The results showed that the macroindicators and microstructures of the samples gradually decreased with increasing number of cycles. The physical indexes of the rock samples in different solutions changed at different rates, the changes in surface hardness and tensile strength were consistent, and the responses were less sensitive to deterioration than to longitudinal wave velocity. In different solutions, the microstructures and mineral compositions of the samples showed different trends with increasing number of cycles. This damage was caused by a combination of various actions, such as feldspar dissolution, chemical erosion, water scouring, clay mineral expansion and disintegration, and salt crystallization, which increased the number of pores, enlarged the holes and expanded the cracks inside the rock samples.
Prompt penetration effects on Equatorial Electrojet from the Indian sector
Authors: Archana R. K. , Arora Kusumita , Nagarajan Nandini 
Published: August 2023

AbstractThe morphology of prompt penetration effects (PP) in the Equatorial Electrojet (EEJ) at Vencode (VEN, Geomagnetic latitude 0.29ºN) was studied using 5-min samples of EEJ and interplanetary Ey component data from 2011 to 2015. In contrast to previous studies that mainly focused on storm-time PP events, our study investigated the characteristics of PP effects on EEJ during both quiet and disturbed periods. Our findings reaffirm earlier reports of high PP efficiency during local noon for both quiet and disturbed days. Moreover, PP amplitudes were greater when IMF-Bz was oriented northward compared to southward, indicating the presence of overshielding effects even during quiet conditions. Additionally, we examined seasonal variations in PP amplitudes and observed weaker PP during the solstice compared to the equinox. Furthermore, our study analysed the equatorial counter electrojet (CEJ) caused by PP events associated with northward-turning IMF-Bz. We report 15% of CEJs at VEN associated with PP effects; a few PP events were observed while the equatorial electric field at VEN was already westward (i.e. PP within CEJ), indicating the combined effects of magnetospheric and ionospheric perturbations. Identifying CEJs caused by PP during quiet days helps to differentiate between magnetospheric and ionospheric mechanisms/processes. Additionally, we investigated the spatial variability in PP amplitudes at closely spaced sites, utilizing one year of concurrent data from Minicoy (MNC, Geomagnetic latitude 0.19ºN), VEN, and Campbell Bay (CBY, Geomagnetic latitude 0.29ºN) situated at geographic longitudes 72º, 77º and 93º, respectively. Our results showed significant differences in PP amplitudes between VEN-CBY and MNC-CBY, separated by 15º and 20º longitude, respectively. Observations from the three equatorial sites demonstrated a longitudinal trend, with PP amplitudes increasing westward towards MNC, inverse to the amplitudes of EEJ.
Graphical Abstract