bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pooled coverage of community based health insurance scheme enrolment in Ethiopia, systematic review and meta-analysis, 2016–2020
Authors: Tahir Ahmed , Abdilahi Abdulahi Omer , Farah Abdifatah Elmi 
Published: July 2022

Abstract
Background
Community Based Health Insurance (CBHI) is a type of health insurance program that provides financial protection against the cost of illness and improving access to health care services for communities engaged in the informal sector. In Ethiopia, the coverage of CBHI enrolment varies across regions and decision of household enrolment is affected by different factors. There are pocket studies on CBHI scheme with different coverage in Ethiopia and there is no pooled study on CBHI enrolment coverage in Ethiopia for better understanding the scheme and decision making. The aim of this systematic review and meta-analysis was to identify the pooled coverage of CBHI enrolment in Ethiopia to understand its policy implications.

Methods
The systematic review and meta-analysis was done by adhering the PRISMA guideline with exhaustive search in PubMed/Medline, HINARI, SCOPUS and Google scholar complemented by manual search. Two authors independently selected studies, extracted data, and assessed quality of studies. The I2 test statistic was used to test heterogeneity among studies. The overall coverage of CBHI scheme was estimated by using random-effects model.

Result
Among 269 identified, 17 studies were included in this meta-analysis and the overall coverage of CBHI scheme was 45% (95% CI 35%, 55%) in Ethiopia. The sub-group analysis shows higher enrolment rate 55.97 (95%CI: 41.68, 69.77) in earlier (2016–2017) studies than recent 37.33 (95%CI: 24.82, 50.77) studies (2018–2020).

Conclusion
The pooled coverage of CBHI enrolment is low in Ethiopia compared the national target of 80% set for 2020. It is also concentrated in only major regions of the country. The finding of the study helps national decision making for CBHI scheme service improvement. Due attention to be given to improving geographic expansion of CBHI and to the declining coverages with in the CBHI implementing regions by addressing the main bottlenecks restraining coverages.

Trial registration
The protocol of this systematic review and meta-analysis was published in PROSPERO with registration number: CRD42021252762.
The focus clinical research in intrahepatic cholangiocarcinoma
Authors: Song Yinghui , Cai Mengting , Li Yuhang , Liu Sulai 
Published: July 2022

AbstractIntrahepatic cholangiocarcinoma (ICC), highly invasive and highly heterogeneous, has a poor prognosis. It has been confirmed that many risk factors are associated with ICC including intrahepatic lithiasis, primary sclerosing cholangitis (PSC), congenital abnormalities of the bile ducts, parasite infection, toxic exposures chronic liver disease (viral infection and cirrhosis) and metabolic abnormalities. In recent years, significant progress has been made in the clinical diagnosis and treatment of ICC. Advances in functional and molecular imaging techniques offer the possibility for more accurate preoperative assessment and detection of recurrence. Moreover, the combination of molecular typing and traditional clinical pathological typing provides accurate guarantee for clinical decision-making. Surgical resection is still the only radical treatment for ICC, while R0 resection, lymph node dissection, postoperative adjuvant therapy and recurrence resectomy have been confirmed to be beneficial for patients. New therapies including local therapy, molecular targeted therapy and immunotherapy are developing rapidly, which brings hopeful future for advanced ICC. The combination of traditional therapy and new therapy is the future development direction.
Effects of furosemide and tadalafil in both conventional and nanoforms against adenine-induced chronic renal failure in rats
Authors: Hamdy Moustafa Mahmoud , Abdel-Rahman Mahran S. , Badary Dalia M. , Sabra Mahmoud S. 
Published: July 2022

AbstractBackgroundChronic renal failure (CRF) is a progressive loss of renal function that lead to reduced sodium filtration and inappropriate suppression of tubular reabsorption that ultimately leads to volume expansion. The aim of this study was to study the efficacy of furosemide and tadalafil nanoforms compared to conventional forms against adenine-induced CRF rat-model.MethodsAddition of 0.75% adenine to the diet of rats for 4 weeks gained general acceptance as a model to study kidney damage as this intervention mimicked most of the structural and functional changes seen in human chronic kidney disease Urine analysis, histopathological changes and immunohistochemical expression of caspase-3 and interleukin-1 beta (IL-1β) in renal tissues were performed.ResultsOur results showed that the combination of tadalafil and furosemide using conventional and nanoparticle formulations had better renoprotective effect than individual drugs. This was demonstrated by improvement of urinary, serum and renal tissue markers as indicative of organ damage. This was also reflected on the reduction of tubular expression of kidney injury molecule-1 (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL).Immunohistochemical studies showed that the deteriorated renal cellular changes indicated by increased expression of caspase-3 and IL-1β were greatly improved by the combined treatment particularly with the nanoforms.ConclusionsThe nanoforms of both furosemide and tadalafil had greater renopreventive effects compared with conventional forms against adenine-induced CRF in rats.
Association between sensitivity to thyroid hormone indices and the risk of osteoarthritis: an NHANES study
Authors: Chen Shuai , Sun Xiaohe , Zhou Guowei , Jin Jie , Li Zhiwei 
Published: July 2022

Abstract
Objectives
Thyroid hormones play an instrumental role in chondrogenic differentiation and matrix maturation. However, studies investigating the relationship between thyroid function and the risk of osteoarthritis (OA) remain scarce. This study was designed to investigate the correlation between thyroid status and OA from a novel perspective of sensitivity to thyroid hormones.

Methods
The study included 8478 people from the National Health and Nutrition Examination Survey (NHANES) 2007–2010. The sensitivity to thyroid hormone indices included Thyrotroph Thyroxine Resistance Index (TT4RI), Thyroid-stimulating hormone (TSHI), Thyroid Feedback Quantile-based Index (TFQI), and Free Triiodothyronine /Free thyroxine (FT3/FT4), which were calculated based on serum free triiodothyronine (FT3), free thyroxine (FT4), and thyroid stimulating hormone (TSH). Considering the complex survey design and sample weights, we employed multivariate linear regression models and stratified analysis to evaluate the correlation between sensitivity to thyroid hormone indices and OA.

Results
Study results indicated that participants with OA had elevated TT4RI, TSHI, and TFQI levels, and lower FT3/FT4 levels compared to those with non-arthritis. After adjusting for other covariates, FT3/FT4 was negatively associated with the risk of OA (OR = 1.162, 95%CI 1.048–1.478, P = 0.021); (OR = 1.261, 95%CI 1.078–1.623, P = 0.042). In subgroup analyses stratified by gender and BMI, participants with OA had higher TFQI levels compared to those without OA in both genders. (OR = 1.491, 95%CI 1.070–2.077, P = 0.018); (OR = 2.548, 95%CI 1.929–3.365, P < 0.001). The higher TFQI levels were consistently associated with the increased prevalence of OA in the BMI (< 18.5 kg/m2) group after adjusting for different covariates, but not in other BMI groups. In, addition, TFQI performed better than FT3/FT4, TSHI, and TT4RI on ROC analyses for OA prediction.

Conclusions
The levels of FT3/FT4, TSHI, TT4RI, and TFQI are strongly associated with the prevalence of OA, which illustrates the complex correlation between the thyroid system and chondrogenic differentiation. TFQI may be used as a helpful indicator to predict OA and provide novel ideas for the evaluation and treatment of OA.
Predictors of COVID-19-related health anxiety among health care workers: a cross-sectional study
Authors: Saeedi Maryam , Yazdi Sahar , Bahador Rasoul Corani 
Published: July 2022

AbstractBackgroundOne of the psychological issues that may affect health care workers (HCWs) during the outbreak of COVID-19 is health anxiety. Health anxiety disorder goes beyond normal health concerns and can seriously affect occupational and interpersonal performance. The present study was designed to determine the level of COVID-19-related health anxiety and its predictors in Iranian HCWs.MethodsThis is a cross-sectional study. Data were collected online through a demographic information questionnaire and the short version of the Health Anxiety Questionnaire. The online questionnaires were created via Google Form and the URL link was sent to HCWs via email or social networking applications. In total, questionnaires were sent to more than 1,500 HCWs throughout Iran. Data were analyzed with SPSS software version 23.ResultsFive hundred and fifty-two HCWs completed and sent the questionnaires. The mean scores of health anxiety of HCWs were higher than the cutoff point of health anxiety (17.28 ± 8.84) and 58.1% of HCWs had health anxiety. There was a significant inverse relationship between health anxiety score and age (r = − 0.13;P = 0.002), work experience (r = − 0.16;P < 0.001) and income level (r = − 0.097;P = 0.03). The rate of health anxiety was significantly higher in females (P = 0.03). Based on regression results, age and hospital category were significant risk factors for health anxiety.ConclusionBased on the results of this study, employees working in health centers in Iran had high health anxiety. Due to the high level of health anxiety in HCWs, it is important to consider strategies to reduce their health anxiety in the current situation.
A novel nitidine chloride nanoparticle overcomes the stemness of CD133+EPCAM+ Huh7 hepatocellular carcinoma cells for liver cancer therapy
Authors: Li Danni , Zhang Qiying , Zhou Yuzhu , Zhu Hua , Li Tong , Du Fangkai 
Published: July 2022

Abstract
Background
Stemness of CD133+EPCAM+ hepatocellular carcinoma cells ensures cancer resistance to apoptosis,which is a challenge to current liver cancer treatments. In this study, we evaluated the tumorcidal activity of a novel nanoparticle of nitidine chloride (TPGS-FA/NC, TPGS-FA: folic acid modified D-α-tocopheryl polyethylene glycol 1000 succinate, NC: nitidine chloride), against human hepatocellular carcinoma (HCC) cell line Huh7 growth in vitro and in vivo.

Methods
Huh7 cells were treated with TPGS-FA/NC. Cell proliferation was assessed using MTT and colony assays. The expression of cell markers and signaling proteins was detected using western blot analyses. A sphere culture technique was used to enrich cancer stem cells (CSC) in Huh7 cells. TPGS-FA/NC (7.5, 15, 30, 60, 120 μg/mL) dose-dependently inhibited the proliferation of HCC cells, which associated with a reduction in AQP3 and STAT3 expression. Importantly,TPGS-FA/NC (10, 20, and 40 μg/mL) significantly reduced the EpCAM+/CD133+cell numbers, suppressed the sphere formation. The in vivo antitumor efficacy of TPGS-FA/NC was proved in Huh7 cell xenograft model in BALB/c nude mice, which were administered TPGS-FA/NC(4 mg· kg − 1· d − 1, ig) for 2 weeks.

Results
TPGS-FA/NC dose-dependently suppressed the AQP3/STAT3/CD133 axis in Huh7 cells. In Huh7 xenograft bearing nude mice, TPGS-FA/NC administration markedly inhibited Huh7 xenograft tumor growth .

Conclusions
TPGS-FA/NC inhibit HCC tumor growth through multiple mechanisms, and it may be a promising candidate drug for the clinical therapy of hepatocellular carcinoma.
Porosity estimation of a geothermal carbonate reservoir in the German Molasse Basin based on seismic amplitude inversion
Authors: Wadas Sonja Halina , von Hartmann Hartwig 
Published: July 2022

AbstractThe Molasse Basin is one of the most promising areas for deep geothermal exploitation in Germany and the target horizon is the aquifer in the Upper Jurassic carbonates. Carbonate deposits can be very heterogeneous even over a small area due to diagenetic processes and varying depositional environments. The preferential targets for geothermal exploitation in carbonate deposits are fault zones, reef facies and karstified areas, since they are expected to act as hydraulically permeable zones due to high porosity and high permeability. Therefore, identifying these structures and characterizing, e.g., their internal porosity distribution are of high importance. This can be accomplished using 3D reflection seismic data. Besides structural information, 3D seismic surveys provide important reservoir properties, such as acoustic impedance, from which a porosity model can be derived. In our study area in Munich we carried out a seismic amplitude inversion to get an acoustic impedance model of the Upper Jurassic carbonate reservoir using a 3D seismic data set, a corresponding structural geological model, and logging data from six wells at the ‘Schäftlarnstraße’ geothermal site. The impedance model and porosity logs were than used to calculate a porosity model. The model shows a wide porosity range from 0 to 20% for the entire reservoir zone and the lithology along the wells reveals that dolomitic limestone has the highest porosities and calcareous dolomite has the lowest porosities. The study area is cut by a large W–E striking fault, the Munich Fault, and the footwall north of it shows higher porosities and more intense karstification than the hanging wall to the south. Considering the entire study area, an increase in porosity from east to west is observed. Furthermore, we identified a complex porosity distribution in reef buildups and pinnacle reefs. The reef cores have mostly low porosities of, e.g., < 3% and the highest porosities of up to 7 to 14% are observed at the reef caps and on the reef slopes. The reef slopes show a characteristic interfingering of the reef facies with the surrounding bedded facies, which indicates a syn-sedimentary reef development with slightly varying build up growth rates. We also assessed the reservoir quality with regard to porosity distribution and determined areas with moderate to good quality for geothermal exploitation by defining porosity evaluation levels. The porosity evaluation maps show that the carbonate rocks of Berriasian to Malm$$\zeta$$ζ1 are preferential targets for exploitation, especially in the footwall of the Munich Fault and to the west of the hanging wall, because these areas are characterized by high porosities due to intense karstification of bedded and massive facies, although the latter is mainly restricted to reef caps and reef slopes.
Estimating the health burden of road traffic injuries in Malawi using an individual-based model
Authors: Manning Smith Robert , Cambiano Valentina , Colbourn Tim , Collins Joseph H. , Graham Matthew , Jewell Britta , Li Lin Ines , Mangal Tara D. , Manthalu Gerald , Mfutso-Bengo Joseph , Mnjowe Emmanuel , Mohan Sakshi , Ng’ambi Wingston , Phillips Andrew N. , Revill Paul , She Bingling , Sundet Mads , Tamuri Asif , Twea Pakwanja D. , Hallet Timothy B. 
Published: July 2022

AbstractBackgroundRoad traffic injuries are a significant cause of death and disability globally. However, in some countries the exact health burden caused by road traffic injuries is unknown. In Malawi, there is no central reporting mechanism for road traffic injuries and so the exact extent of the health burden caused by road traffic injuries is hard to determine. A limited number of models predict the incidence of mortality due to road traffic injury in Malawi. These estimates vary greatly, owing to differences in assumptions, and so the health burden caused on the population by road traffic injuries remains unclear.MethodsWe use an individual-based model and combine an epidemiological model of road traffic injuries with a health seeking behaviour and health system model. We provide a detailed representation of road traffic injuries in Malawi, from the onset of the injury through to the final health outcome. We also investigate the effects of an assumption made by other models that multiple injuries do not contribute to health burden caused by road accidents.ResultsOur model estimates an overall average incidence of mortality between 23.5 and 29.8 per 100,000 person years due to road traffic injuries and an average of 180,000 to 225,000 disability-adjusted life years (DALYs) per year between 2010 and 2020 in an estimated average population size of 1,364,000 over the 10-year period. Our estimated incidence of mortality falls within the range of other estimates currently available for Malawi, whereas our estimated number of DALYs is greater than the only other estimate available for Malawi, the GBD estimate predicting and average of 126,200 DALYs per year over the same time period. Our estimates, which account for multiple injuries, predict a 22–58% increase in overall health burden compared to the model ran as a single injury model.ConclusionsRoad traffic injuries are difficult to model with conventional modelling methods, owing to the numerous types of injuries that occur. Using an individual-based model framework, we can provide a detailed representation of road traffic injuries. Our results indicate a higher health burden caused by road traffic injuries than previously estimated.
mRNA vaccine development for cholangiocarcinoma: a precise pipeline
Authors: Tang Tian-Yu , Huang Xing , Zhang Gang , Lu Ming-Hao , Liang Ting-Bo 
Published: July 2022

AbstractCholangiocarcinoma (CHOL) is one of the most aggressive tumors worldwide and cannot be effectively treated by conventional and novel treatments, including immune checkpoint blockade therapy. The mRNA vaccine-based immunotherapeutic strategy has attracted much attention for various diseases, however, its application in CHOL is limited due to the thoughtlessness in the integration of vaccine design and patient selection. A recent study established an integrated path for identifying potent CHOL antigens for mRNA vaccine development and a precise stratification for identifying CHOL patients who can benefit from the mRNA vaccines. In spite of a promising prospect, further investigations should identify immunogenic antigens and onco-immunological characteristics of CHOL to guide the clinical application of CHOL mRNA vaccines in the future.
Effect of preoperative nutritional support in malnourished patients with pancreatobiliary cancer: a quasi-experimental study
Authors: Park Hyeong Min , Kang Young Hwa , Lee Dong Eun , Kang Mee Joo , Han Sung-Sik , Park Sang-Jae 
Published: July 2022

Abstract
Background
In malnourished patients, postoperative morbidity, hospitalization period, and medical expenses are reportedly to be high. We evaluated the clinical impact of a preoperative nutritional support program (PNSP) among malnourished cancer patients.

Methods
For this quasi-experimental study, we enrolled 90 patients who underwent major pancreatobiliary cancer surgery. Malnutrition was defined as at least one of the following: (1) Patient-Generated Subjective Global Assessment (PG-SGA) grade B or C; (2) > 10% weight loss within 6 months; (3) body mass index <18.5 kg/m2; and (4) serum albumin level < 3.0 g/dL. Forty-five malnourished patients allocated to the PNSP group received in-hospital PNSP for a median of 6 (4–35) days. In the PNSP group, the nutrition support team calculated the patients’ daily nutritional requirements based on their nutritional status and previous day’s intake. The supplementation targets were as follows: total calorie intake, 30–35 kcal/kg/day; protein intake, 1.2–1.5 g/kg/day; and lipid intake, 1–1.5 g/kg/day. Patients who did not meet the diagnostic criteria for malnutrition were allocated to the well-nourished group and underwent surgery without receiving the PNSP (n = 45). We compared the perioperative nutritional indices (as measured using PG-SGA), postoperative outcome, and quality of life (QOL) according to the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire version 3.0.

Results
In the PNSP group, the proportion of patients with serum prealbumin <16 mg/dL decreased significantly after PNSP (29.5% vs. 8.9%, p = 0.013). Moreover, patients with PG-SGA grade A had a statistically significant increase (2.2% vs. 50%, p < 0.001). The overall and major complication rates were higher in the PNSP group than in the well-nourished group without significance (51.1%, 33.3%; 42.2%, 26.7%, respectively). However, the overall and major complication rates were similar between the subgroup with PG-SGA improvement after PNSP and the well-nourished group (40.9% vs. 42.2%, p = 0.958; 27.3% vs. 26.7%, p = 0.525, respectively). QOL indicators in the PNSP group were comparable with those in the well-nourished group after PNSP.

Conclusion
PNSP may improve perioperative nutritional status and clinical outcomes among malnourished patients with pancreatobiliary cancer.
Choosing the right model for unified flexibility modeling
Authors: Brandt Jonathan , Frost Emilie , Ferenz Stephan , Tiemann Paul Hendrik , Bensmann Astrid , Hanke-Rauschenbach Richard , Nieße Astrid 
Published: July 2022

AbstractUsing aggregated flexibility from distributed small-scale power devices is an extensively discussed approach to meet the challenges in modern and increasingly stochastic energy systems. It is crucial to be able to model and map the flexibility of the respective power devices in a unified form to increase the value of the cumulative flexibility from different small-scale power devices by aggregation. In order to identify the most suitable approach for unified flexibility modeling we present a framework to evaluate and compare the advantages and disadvantages of already existing modeling approaches in different levels of detail. As an introduction to flexibility modeling and as a basis for the evaluation process we initially provide a comprehensive overview of the broad range of flexibility models described in scientific literature. Subsequently, five selected modeling approaches allowing the generation of a unified flexibility representation for different power devices are presented in detail. By using an evaluation metric we assess the suitability of the selected approaches for unified flexibility modeling and their applicability. To allow a more detailed performance analysis, the best evaluated models are implemented and simulations with different small-scale devices are performed. The results shown in this paper highlight the heterogeneity of modeling concepts deriving from the various interpretations of flexibility in scientific literature. Due to the varying complexity of the modeling approaches, different flexibility potentials are identified, necessitating a combination of approaches to capture the entire spectrum of the flexibility of different small-scale power devices. Furthermore, it is demonstrated that a complex model does not necessarily lead to the discovery of higher flexibility potentials, and recommendations are given on how to choose an appropriate model.