bluuebunny/crossref_metadata_2025_split huggingface dataset:
Examining the Influence of Health Sector Co-ordination on the Efficiency of County Health Systems in Kenya
Authors: Nyawira Lizah , Njuguna Rebecca G , Tsofa Benjamin , Musiega Anita , Munywoki Joshua , Hanson Kara , Mulwa Andrew , Molyneux Sassy , Maina Isabel , Normand Charles , Jemutai Julie , Barasa Edwine 
Published: October 2022

Abstract
Background: Health systems are complex, consisting of multiple interacting structures and actors whose effective co-ordination is paramount to enhancing health system goals. Poor health sector co-ordination is a potential source of inefficiency in the health sector. We examined how the co-ordination of the health sector affects health system efficiency in Kenya.
Methods: We conducted a qualitative cross-sectional study, collecting data at the national level and in two purposely selected counties in Kenya. We collected data using in-depth interviews (n = 36) with national and county level respondents, and document reviews. We analyzed the data using a thematic approach.
Results: The study found that while formal co-ordination structures exist in the Kenyan health system, duplication, fragmentation, and misalignment of health system functions and actor actions compromise the co-ordination of the health sector. These challenges were observed in both vertical (co-ordination within the ministry of health, and within the county departments of health, and between the national ministry of health and the county department of health) and horizontal co-ordination mechanisms (co-ordination between the ministry of health or the county department of health and non-state partners, and co-ordination among county governments). These co-ordination challenges are likely to impact on the efficiency of the Kenyan health system by increasing the transaction costs of health system functions. Inadequate co-ordination also impairs the implementation of health programmes and hence compromises health system performance.
Conclusion: The efficiency of the Kenyan health system could be enhanced by strengthening the co-ordination of the Kenyan health sector. This can be achieved by aligning and harmonizing the intergovernmental and health sector specific co-ordination mechanisms, strengthening the implementation of the Kenya health sector co-ordination framework at the county level, and enhancing donor co-ordination through common funding arrangements and the integration of vertical disease programmes with the rest of the health system. The ministry of health and county departments of health should also review internal organizational structures to enhance functional and role clarity of organizational units and staff respectively. Finally, counties should consider initiating health sector co-ordination mechanisms between counties to reduce the fragmentation of health system functions across neighboring counties.
Clinical effects of early debridement, internal fixation, and Masquelet technique for childhood chronic haematogenous osteomyelitis of long bones
Authors: Shi Jian , Qu Liang , Zhang Hu , Yang Xiaoyong , Song Muguo , Chen Xingyu , Zhou Tianhua , Zhang Xijiao , Xu Yongqing 
Published: October 2022

Abstract
Background
Childhood chronic haematogenous osteomyelitis (CCHOM) is a severe condition in paediatric patients. The optimal timing of debridement and the subsequent method of bone reconstruction in CCHOM patients remain controversial. The purpose of this study was to assess the treatment efficacy of Masquelet technique with early debridement and internal fixation in CCHOM of long bones.
Methods
Between January 2016 and January 2021, a total of 21 patients (18 males, 3 females) with CCHOM of long bone were included. The mean age was 10.4 years (range, 2–18 years). All cases were treated by a two-stage surgical protocol of Masquelet technique. In the first stage, aggressive debridement, sequestrectomy, and inducing membrane by bone cement spacer were performed after definite diagnosis. In the second stage, cement spacer was removed, and autologous and allogeneic bone were grafted. Internal fixation was used for the first and/or second stage depending on stability requirements. The patients’ clinical and imaging results were retrospectively analysed.
Results
The mean follow-up was 31.7 months (range, 21–61 months). None of the patients experienced recurrence of infection. Radiographic bone union time was 4.3 months (range, 2.5–11 months). Five cases underwent re-operation due to complications such as bone resorption or refracture. By the last follow-up visit, bones had healed and all of the patients had resumed daily living and sports activities.
Conclusions
The Masquelet technique with early debridement and internal fixation is a viable surgical method for the management of large long bone defects of CCHOM patients.
PRKAA1 predicts prognosis and is associated with immune characteristics in gastric cancer
Authors: chen yongyi , Chen Siyu , Zhu Jing , Yang Shaoxue , Yu Qiong , Xu Songxiao 
Published: October 2022

Abstract
Purpose
PRKAA1 is the α-subunit of 5-AMP-activated protein kinase. This study aimed to investigate the role of PRKAA1 expression in multiple clinical parameters, the overall survival rate, blood indexes, and immune infiltration in gastric cancer (GC) patients.
Methods
We investigated PRKAA1 expression data of in GC patients using an ELISA, proteinatlas, ualcan, and GEPIA. PRKAA1 expression was associated with immune cell infiltration, and immune cell types were analyzed with the TIMER, DICE, and proteinatlas databases. We compared the level of PRKAA1 expression based on the clinical features of GC patients (n = 345). GC patients were divided into two groups based on PRKAA1 expression, and the lymphocyte subsets, overall survival rate, and clinical parameters were compared with peripheral blood mononuclear cell and biochemical indexes.
Results
PRKAA1 was highly expressed in the serum of GC patient compared with that of healthy individuals. GC patients with distant metastases, a later TNM stage, and stage IV in UICC exhibited higher PRKAA1 expression. PRKAA1 expression was significantly correlated with circulating T cells. The proteinatlas and DICE database results confirmed that PRKAA1 was closely associated with T cells in a single cell cluster. Furthermore, GC patients with low PRKAA1 expression had better OS rates.
Conclusion
PRKAA1 may serve as a potential prognostic biomarker for GC and have an association with immune infiltrates.
An exceptional infrared transient from a star engulfing a planet
Authors: De Kishalay , MacLeod Morgan , Karambelkar Viraj , Jencson Jacob , Chakrabarty Deepto , Conroy Charlie , Dekany Richard , Eilers Anna-Christina , Graham Matthew , Hillenbrand Lynne , Kara Erin , Kasliwal Mansi , Kulkarni Shri , Lau Ryan , Loeb Abraham , Masci Frank , Medford Michael , Meisner Aaron , Patel Nimesh , Quiroga-Nunez Luis , Riddle Reed , Rusholme Benjamin , Simcoe Robert , Sjouwerman Lorant , Teague Richard , Vanderburg Andrew 
Published: October 2022

Abstract
It is well known that planets with short orbital periods (< 10 days) are common around stars like the Sun. Stars expand as they evolve, and thus we expect their close planetary companions to be engulfed. However, this phase has never been directly observed. Here, we present the discovery of ZTF SLRN-2020, a short-lived optical outburst in the Galactic disk accompanied by bright and long-lived infrared emission. The resulting light curve and spectra share striking similarities with those of red novae -- a class of eruptions now confirmed to arise from mergers of binary stars. Its exceptionally low optical luminosity (10^{35} erg/s) and radiated energy (6.5 X 10^{41} erg) point to the engulfment of a planet (of 1 - 10 Jupiter masses) by its Sun-like host star. We estimate the Galactic rate of such Sub-luminous Red Novae (SLRNe) to be $\sim 0.1 - few per year. Future Galactic plane surveys are well-poised to routinely identify them, revealing the demographics of planetary engulfment and the ultimate fate of planets in the inner Solar System.
Reflection of plane waves from the stress-free boundary surface of a microstretch elastic solid half-space containing voids
Authors: Garg Manisha , Singh Dilbag , Tomar S. K. 
Published: October 2022

Abstract
Reflection phenomena of coupled longitudinal/transverse waves from the stress-free boundary surface of a microstretch elastic solid half-space containing voids have been investigated. Stress-free boundary surface provided a restriction on the cross-coupling parameter between curvature tensor and voids. Using appropriate boundary conditions and Snell’s law, the formulae corresponding to various reflection coefficients and their corresponding energy ratios have been obtained. Numerical computations have been carried out for a specific model and the variation of all the reflection coefficients and corresponding energy ratios is depicted graphically against the angle of incidence. Some special cases have been reduced from the present model and discussed.
The impact of the secondary infections in ICU patients affected by COVID-19 during three different phases of the SARS-CoV-2 pandemic
Authors: Murgia Federica , Fiamma Maura , Serra Silvia , Marras Giulia , Argiolas Raul , Mattana Chiara , Mattu Maria Grazia , Garau Maria Cristina , Doneddu Sonia , Olla Sabrina , Cocco Eleonora , Lorefice Lorena , Muntoni Sandro , Paffi Peppino , Porru Stefano , Abis Marta , Bellizzi Saverio , Pani Antonello , Angioi Andrea , Mussap Michele , Massidda Orietta , Carta Franco , Atzori Luigi 
Published: October 2022

Abstract
Purpose
Microbial secondary infections can contribute to an increase in the risk of mortality in COVID-19 patients, particularly in case of severe diseases. In this study, we collected and evaluated the clinical, laboratory and microbiological data of COVID-19 critical ill patients requiring intensive care (ICU) to evaluate the significance and the prognostic value of these parameters.
Methods
One hundred seventy-eight ICU patients with severe COVID-19, hospitalized at the S. Francesco Hospital of Nuoro (Italy) in the period from March 2020 to May 2021, were enrolled in this study. Clinical data and microbiological results were collected. Blood chemistry parameters, relative to three different time points, were analyzed through multivariate and univariate statistical approaches.
Results
Seventy-four percent of the ICU COVID-19 patients had a negative outcome, while 26% had a favorable prognosis. A correlation between the laboratory parameters and days of hospitalization of the patients was observed with significant differences between the two groups. Moreover, Staphylococcus aureus, Enterococcus faecalis, Candida spp, Pseudomonas aeruginosa and Klebsiella pneumonia were the most frequently isolated microorganisms from all clinical specimens.
Conclusions
Secondary infections play an important role in the clinical outcome. The analysis of the blood chemistry tests was found useful in monitoring the progression of COVID-19.
Sex-biased gene and microRNA expression in the developing mouse brain is associated with neurodevelopmental functions and neurological phenotypes
Authors: Szakats Susanna , McAtamney Alice , Cross Hugh , Wilson Megan J 
Published: October 2022

Abstract
Background: Sex differences pose a challenge and an opportunity in biomedical research. Understanding how sex chromosomes and hormones affect disease-causing mechanisms will shed light on the mechanisms underlying predominantly idiopathic sex-biased neurodevelopmental disorders such as ADHD, schizophrenia and autism. Gene expression is a crucial conduit for the influence of sex on developmental processes; therefore, this investigation focused on sex differences in gene expression and regulation of gene expression. Mounting interest in microRNAs (miRNAs), small, non-coding RNAs for their contribution to normal and pathological neurodevelopment prompted us to test how miRNA expression differs between the sexes in the developing brain.
Methods: High-throughput sequencing approaches were used to identify transcripts, including miRNAs, showing significantly different expression between male and female brains at day 15.5 of development (E15.5).
Results: Robust sex differences were identified for a portion of genes and miRNAs, confirming the influence of biological sex on RNA in this context. Many miRNAs showing the greatest differences between males and females have established roles in neurodevelopment, implying that sex-biased expression could drive sex differences in developmental processes. In addition to highlighting sex differences for individual miRNAs, gene ontology analysis suggests several broad categories in which sex-biased RNAs might be acting to establish sex differences in the embryonic mouse brain. Finally, mining publically available SNP data indicated that some sex-biased miRNAs reside near genomic regions associated with neurodevelopmental disorders.
Conclusions: Together, these findings reinforce the importance of cataloguing sex differences in molecular biology research and highlight genes, miRNAs and pathways of interest that may be important for sexual differentiation of the mouse and possibly the human brain.
Effect of corrections for water vapor sensitivity of coumarin targets and for density fluctuations (WPL) on O3 fluxes measured with the eddy covariance technique
Authors: Gerosa Giacomo A. , Bignotti Laura , Marzuoli Riccardo 
Published: October 2022

Abstract
Ozone vertical fluxes above land surfaces are commonly measured with the eddy covariance (EC) technique which requires non-conventional ozone fast analyzer mostly based on a chemiluminescence reaction of ozone with a reagent, either gaseous or solid. Currently, the most adopted reagent for this kind of O3 analyzers is a coumarin-47 solid dye absorbed on silica gel targets. However, ozone-induced chemiluminescence of coumarin-47 is enhanced by the presence of water vapor in the air sample. The aim of this paper is to evaluate the magnitude of the corrections to the ozone flux measurements due to coumarin-47 sensitivity to water vapor fluctuations, performed above a forest ecosystem from 2013 and 2020, and the combined effect with the WPL correction, another well-established correction for density fluctuations related to water vapor and sensible heat fluxes.
Results confirm that water vapor sensitivity correction for the chemiluminescence reaction between coumarine-47 and ozone is quite small and negligible in most of the environmental conditions. On the contrary, WPL correction is almost one order of magnitude greater than the former correction. The combination of the two corrections results, on average, in a 6.6% reduction of the absolute value of the uncorrected ozone fluxes. Since the combined effect of the two corrections can be remarkable depending on the seasonal period of measurements, both corrections to the measured ozone fluxes are recommended, as well as the indication of their application in the published works.
A study of the prevalence of COVID-19 among students of the Syrian Private University.
Authors: Tahlo Dlsher , Suliman Muhammed , Hussam  
Published: October 2022

Abstract
Introduction

Coronavirus disease 2019 (COVID-19) is an airway infection caused by a novel coronavirus (SARS-CoV-2, severe acute respiratory syndrome coronavirus) that was first detected in Wuhan, China in December. 2019.

Materials and Methods

An Observational Study, Cross-Sectional Study. This study targeted students of the Faculty of Human Medicine at the Syrian Private University. Where the sample was chosen randomly, and about (567) students were selected, where a paper questionnaire was distributed to the students to fill out the information.

Results and Discussion

By studying the relationship between the patient's symptoms and the patient's gender, we found statistically significant relationships between these two variables. As for the rest of the symptoms, the ratios between the sexes converged, and thus we did not find those statistical relationships. As for studying the relationship between the presence of symptoms and smoking in the patient, we found a statistically significant relationship between the increased incidence of symptoms and smoking in the patient. By studying the relationship between sex and taking the vaccine and the preventive measures followed, we did not find a relationship between any of them, as the ratios of males and females were equal in relation to taking the vaccine, and they converged in following the preventive measures. As for the study of the relationship between taking the vaccine and the number of times of infection with the Coronavirus, we found a statistically significant relationship between these two variables, with a p value of 0.0111.

Recommendations

The most important objectives of the studies were to conduct awareness campaigns among students about the extent of the harm of smoking and its negative impact on infection with the Corona virus. And conduct awareness campaigns about the importance of the vaccine to reduce the severity of infection and protect against it in the future.
Identification and Analysis of Molecular Pathways and Key Candidate Biomarkers in Glioblastoma Multiforme
Authors: Kumari Aditi Stuti 
Published: October 2022

Abstract
Glioblastoma Multiforme (GBM) is a Grade IV malignant primary tumor present in the central nervous system. Despite advancements in treatments, it has a poor prognosis as the median survival is 14-15 months. The goal of this study was to identify the candidate biomarkers as well as the functional pathways regulated in GBM. The dataset (GSE100675) accessed included 3 glioblastoma tissues, 3 paired tissues, and 3 normal tissues. The differentially expressed genes (DEGs) were identified using GEO2R, which found a total of 1,609 DEGs (916 downregulated and 693 upregulated). A gene ontology and KEGG pathway analysis was done with the DEGs. The KEGG pathway analysis was then utilized in constructing a protein-protein interaction (PPI) network, identifying the genes of interest. The interaction network was then put into Cytoscape and 10 hub genes were identified. To ensure reliability of the research, those hub genes were put in GEPIA, and the data was compared for consistency of the research, with the regulation of all 10 hub genes matching that of a larger dataset. Kaplan-Meier analysis was done on the hub genes, which demonstrated that an upregulation in signal transducer and activator of transcription 3 (STAT3) was associated with lower survival. Study shows that STAT3 gene may be a key factor in the progression of GBM, being crucial in cell proliferation. In conclusion, STAT3, along with the molecular pathways identified, may be used as a potential prognostic and diagnostic biomarker and can be used to further our understanding of GBM.
Quantifying microstructures of Earth materials using higher-order spatial correlations and deep generative adversarial networks
Authors: Amiri Hamed , Vasconcelos Ivan , Jiao Yang , Chen Pei-En , Plumper Oliver 
Published: October 2022

Abstract
Key to most subsurface processes is to determine how structural and topological features at small length scales, i.e., the microstructure, control the effective and macroscopic properties of earth materials. Recent progress in imaging technology has enabled us to visualise and characterise microstructures at different length scales and dimensions. However, one limitation of these technologies is the trade-off between resolution and sample size (or representativeness). A promising approach to this problem is image reconstruction which aims to generate statistically equivalent microstructure but at a larger scale and/or additional dimension. In this work, a generative adversarial network (GAN), trained with Wasserstein-loss and gradient penalty, is used to reconstruct two-dimensional images of two hydrothermally rock samples with varying degrees of complexity. Moreover, we employ multi-point spatial correlation functions - known as statistical microstructural descriptors (SMDs) to evaluate the reconstruction performance of our GAN and show that it can reconstruct higher-order, spatially-correlated patterns of complex earth materials, capturing underlying structural and morphological properties. Comparing our results with a stochastic reconstruction method based on a two-point correlation function, we show the importance of coupling training/assessment of GANs with higher-order SMDs, especially in the case of complex microstructures.
In-Situ Quality Assessment and Control in Additive Manufacturing Processes Using Laser Surface Profilometer and Deep Learning Techniques
Authors: akhavan javid , Lyu Jiaqi , Manoochehri Souran 
Published: October 2022

Abstract
Additive Manufacturing (AM) has become one of the most popular manufacturing techniques in various fields. Their layer-by-layer printing process allows an easier fabrication of complex geometries. However, the quality and accuracy of fabricated artifacts in these techniques have low repeatability. In the era of Industry 4.0 by using the emerging sensory and data processing capabilities such as Laser Surface Profilometer (LSP) and Deep Learning (DL), it is possible to improve the repeatability and quality of AM processes. This work presents an in-situ quality assessment and improvement using LSP for data acquisition and DL for data processing and decision making. The utilized LSP module generates a point cloud dataset containing information about the top surface geometry and quality. Once the point cloud data is preprocessed, an improved deep Hybrid Convolutional Auto-Encoder decoder (HCAE) model is used to perform the artifact's quality measurement and statistical representation. The HCAE model's statistical representation is comprised of 9*9 segments, each including four channels with the segment's probability to contain one of four labels, 1) Under-printed region, 2) Normally printed region, 3) Over-printed region, 4) Empty region. This data structure plays a significant role in determining the commands needed to optimize the fabrication process. The implemented HCAE model's accuracy and repeatability were measured by a multi-label multi-output metric developed in this study. The assessments made by HCAE are then used to perform an in-situ process adjustment by manipulating the future layer's fabrication through the G-code modification. By adjusting the machine's print speed and feedrate, the control algorithm exploits the next layer deposition, segment by segment. The algorithm is then tested with two manually defected settings, one part with severe under extrusion and one with over extrusion parameters. Both test artifacts' quality advanced significantly and converged to an acceptable state by four iterations.
Designing embedded retaining walls relying on the Generalized Coefficient of Earth Pressure and the elastic beam theory
Authors: Pantelidis Lysandros 
Published: October 2022

Abstract
Intermediate values of earth pressure occur if the wall movements are insufficient to mobilize the active or passive limiting values. These values are of particular importance for designing embedded retaining walls, due to their flexible nature. The methods included in a standard are supposed to reflect the best (current) practice, however, the empirical methods included in EN1997-1:2004 and prEN1997-3:2022 are far from being considered reliable. Very recently, the author proposed a continuum mechanics approach for deriving earth pressure coefficients for any soil state between the at-rest state and the active or passive state, applicable to cohesive-frictional soils and both horizontal and vertical pseudo-static conditions. The same method also provides analytical expression for the calculation of the required wall movement (at any depth) for the mobilization of the active or passive failure state. In the present paper the author suggests a new, fully analytical method for designing embedded retaining walls, combining the aforementioned method with the well-known elastic beam theory. An application example is given indicating remarkable agreement with the finite element method, while when the proposed method is followed, more stable results are returned.