bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mandatory health insurance and health care utilization in Togo
Authors: Djahini-Afawoubo Dossè Mawussi , Aguey Segnon T. 
Published: December 2022

Abstract
Background
Despite the implementation of a mandatory health insurance (MHI) scheme in Togo since 2011, its coverage rate remains low, resulting in a high out-of-pocket payment rate. More than 10 years after its implementation, there are few empirical studies investigating the extent to which Togo’s mandatory health insurance has improved beneficiaries’ access to health care. Examining how MHI and healthcare use in Togo are related is the goal of this study.

Methods
We use data from the Harmonized Survey on Living Conditions of Households (EHCVM), conducted in the member states of the West African Economic and Monetary Union (WAEMU) in 2018–2019 and covering 6,171 households in Togo. We employ multinomial logistic regression, given that the dependent variable is polytomous.

Results
The results reveal a high rate of non-utilization of healthcare professionals in the case of illness, even among individuals with MHI coverage. Furthermore, the findings show that the MHI increases the likelihood of seeing a specialist physician and other formal health care professionals when sick. The results also reveal that a household’s wealth is positively correlated with the likelihood of seeing formal health care professionals. Urban residents are statistically and significantly more likely than rural residents to see both a specialist physician and a general practitioner. The Grand Lomé region has a statistically and significantly higher likelihood of seeing a specialist physician than the Maritime region.

Conclusion
The results support the government’s plan to implement universal health insurance. The government should take action to raise the standard of treatment provided to insured patients in health care centers. Additionally, the government should consider waiving medical fees for low-income policyholders. When waiving medical costs for low-income policyholders, the Togolese government should focus on the regions with the worst economic conditions. These interventions should be essential to ensure that no one is left behind. The difference between urban and rural communities should be reduced through supply-side policies that focus on rural areas.
The relationships of OSBPL3 expression with KI-67 expression and KRAS mutations in CRC: implications for diagnosis and prognosis
Authors: Zhang Min , Meng Lei , Zhang Zhaoxuan , Wu Jing , Chen Xi , Wang Yuejing , He Jie 
Published: December 2022

Abstract
Background
OSBPL3 is overexpressed in a variety of malignancies and is closely associated with tumor growth and metastasis. However, its expression and function in colorectal cancer (CRC) are unclear. We aimed to investigate its prognostic and therapeutic value in this disease by detecting its expression in CRC and its correlation with the clinicopathological characteristics and prognosis of patients.

Methods
A total of 92 CRC samples were included in this study. According to the 2020 WHO diagnostic criteria, the criteria of the American Joint Committee on Cancer (AJCC) 8th edition staging system were used. OSBPL3 and Ki-67 expression in these samples was detected by immunohistochemistry. OSBPL3 mRNA expression was detected by qRT-PCR. KRAS/NRAS mutations were detected by an amplification refractory mutation system (ARMS). Data analysis was performed using the statistical analysis software Prism 8.

Results
OSBPL3 was found to be significantly overexpressed in CRC tumor tissues and was associated with worse progression-free survival and overall survival in patients. Additionally, OSBPL3 expression was negatively correlated with the degree of tumor differentiation. KRAS mutations were detected in approximately 32.6% of patients and were significantly associated with high OSBPL3 expression. In addition, OSBPL3 and Ki-67 expression was significantly correlated.

Conclusions
OSBPL3 is highly expressed in CRC samples and predicts a worse prognosis. OSBPL3 may become a new potential therapeutic target for CRC.
Respiratory strategy at birth initiates distinct lung injury phenotypes in the preterm lamb lung
Authors: Pereira-Fantini Prue M. , Ferguson Kristin , McCall Karen , Oakley Regina , Perkins Elizabeth , Byars Sean , Williamson Nicholas , Nie Shuai , Tingay David G. 
Published: December 2022

Abstract
Background
A lack of clear trial evidence often hampers clinical decision-making during support of the preterm lung at birth. Protein biomarkers have been used to define acute lung injury phenotypes and improve patient selection for specific interventions in adult respiratory distress syndrome. The objective of the study was to use proteomics to provide a deeper biological understanding of acute lung injury phenotypes resulting from different aeration strategies at birth in the preterm lung.

Methods
Changes in protein abundance against an unventilated group (n = 7) were identified via mass spectrometry in a biobank of gravity dependent and non-dependent lung tissue from preterm lambs managed with either a Sustained Inflation (SI, n = 20), Dynamic PEEP (DynPEEP, n = 19) or static PEEP (StatPEEP, n = 11). Ventilation strategy-specific pathways and functions were identified (PANTHER and WebGestalt Tool) and phenotypes defined using integrated analysis of proteome, physiological and clinical datasets (MixOmics package).

Results
2372 proteins were identified. More altered proteins were identified in the non-dependent lung, and in SI group than StatPEEP and DynPEEP. Different inflammation, immune system, apoptosis and cytokine pathway enrichment were identified for each strategy and lung region. Specific integration maps of clinical and physiological outcomes to specific proteins could be generated for each strategy.

Conclusions
Proteomics mapped the molecular events initiating acute lung injury and identified detailed strategy-specific phenotypes. This study demonstrates the potential to characterise preterm lung injury by the direct aetiology and response to lung injury; the first step towards true precision medicine in neonatology.
Monophosphoryl lipid A ameliorates radiation-induced lung injury by promoting the polarization of macrophages to the M1 phenotype
Authors: Guo Xingdong , Du Lehui , Ma Na , Zhang Pei , Wang Yuan , Han Yanan , Huang Xiang , Zhang Qian , Tan Xin , Lei Xiao , Qu Baolin 
Published: December 2022

Abstract
Background
Radiation-induced lung injury (RILI) often occurs during clinical chest radiotherapy and acute irradiation from accidental nuclear leakage. This study explored the role of monophosphoryl lipid A (MPLA) in RILI.

Materials and Methods
The entire thoracic cavity of C57BL/6N mice was irradiated at 20 Gy with or without pre-intragastric administration of MPLA. HE staining, Masson trichrome staining, and TUNEL assay were used to assess lung tissue injury after treatment. The effect of irradiation on the proliferation of MLE-12 cells was analyzed using the Clonogenic assay. The effect of MPLA on the apoptosis of MLE-12 cells was analyzed using flow cytometry. Expression of γ-H2AX and epithelial-mesenchymal transition (EMT) markers in MLE-12 cells was detected by immunofluorescence and Western blot, respectively.

Results
MPLA attenuated early pneumonitis and late pulmonary fibrosis after thoracic irradiation and reversed radiation-induced EMT in C57 mice. MPLA further promoted proliferation and inhibited apoptosis of irradiated MLE-12 cells in vitro. Mechanistically, the radioprotective effect of MPLA was mediated by exosomes secreted by stimulated macrophages. Macrophage-derived exosomes modulated DNA damage in MLE-12 cells after irradiation. MPLA promoted the polarization of RAW 264.7 cells to the M1 phenotype. The exosomes secreted by M1 macrophages suppressed EMT in MLE-12 cells after irradiation.

Conclusion
MPLA is a novel treatment strategy for RILI. Exosomes derived from macrophages are key to the radioprotective role of MPLA in RILI.
Hemolytic anemia caused by kinked graft 6 months after aortic dissection repair
Authors: Tamura Kazuki , Tatsuishi Wataru , Konishi Yasunobu , Konno Naoki , Kato Yusuke , Abe Tomonobu 
Published: December 2022

Abstract
Background
Clinically insignificant hemolytic anemia is occasionally a complication of prosthetic valve replacement. However, hemolysis related to kinked grafts is a very rare complication after central repair for acute aortic dissection.

Case presentation
A 42-year-old man had undergone replacement of the ascending aorta and a root repair for type A aortic dissection 6 months previously. Laboratory data showed mild hemolysis 5 months later, and he began to complain of fatigue on exertion. The serum hemoglobin level reduced to 8.6 g/dL, and lactate dehydrogenase levels increased to 3071 IU/L with gross change in urine color, indicating hemoglobinuria. We diagnosed mechanical hemolytic anemia caused by a kinked graft and planned a repeat operation. The kinked graft was resected and graft-graft anastomosis was performed. Postoperatively, the clinical course was uneventful, and the hemolytic anemia completely resolved.

Conclusion
We herein report a case of hemolytic anemia caused by kinking of the graft 6 months after acute aortic dissection repair. The diagnosis was swiftly made, and the patient was successfully managed with redo surgery.
Chinese integrated guideline on the management of gastric precancerous conditions and lesions
Authors: Wang Ping , Li Peng , Chen Yingxuan , Li Li , Lu Yuanyuan , Zhou Weixun , Bian Liqun , Zhang Beihua , Yin Xiaolan , Li Junxiang , Chen Jie , Zhang Shutian , Shi Yongquan , Tang Xudong 
Published: December 2022

AbstractThe standardized diagnosis and management of gastric precancerous conditions and lesions are important to prevent gastric cancer. This guideline, created by 5 traditional Chinese medicine and Western medicine associations, based on the current morbidity and diagnosis and treatment of gastric precancerous conditions and lesions, provides specific key points and strategies for diagnosis and treatment in the following five aspects: definition and epidemiology, diagnosis and stage, surveillance, treatment and efficacy evaluation. It is hoped that these aspects, assessed by integrating Western medicine and traditional Chinese medicine and involving multidisciplinary participation, will play a guiding role in clinical diagnosis and treatment and achieve effective secondary prevention of gastric cancer.
Long-term safety and clinical outcomes of olipudase alfa enzyme replacement therapy in pediatric patients with acid sphingomyelinase deficiency: two-year results
Authors: Diaz George A. , Giugliani Roberto , Guffon Nathalie , Jones Simon A. , Mengel Eugen , Scarpa Maurizio , Witters Peter , Yarramaneni Abhimanyu , Li Jing , Armstrong Nicole M. , Kim Yong , Ortemann-Renon Catherine , Kumar Monica 
Published: December 2022

Abstract
Background
Olipudase alfa is a recombinant human acid sphingomyelinase (ASM) enzyme replacement therapy (ERT) for non-central-nervous-system manifestations of acid sphingomyelinase deficiency (ASMD). We report 2-year cumulative safety and efficacy data after olipudase alfa treatment in 20 children (four adolescents [12–17 year], nine children [6–11 year], and seven infants/early child [1–5 year]) with baseline splenomegaly and growth deficits who completed the 1-year ASCEND-Peds clinical trial (NCT02292654) and who continue to receive olipudase alfa in a long-term study (NCT02004704). Efficacy endpoints include spleen and liver volumes, diffusing capacity of the lung for carbon monoxide (DLCO), high-resolution computed tomography (HRCT) lung imaging, lipid profiles, liver function tests, and height Z-scores.

Results
All 20 former ASCEND-Peds patients completed at least 2 years of olipudase alfa treatment. No patient discontinued and no new safety issue arose during the second year of treatment; 99% of adverse events were mild or moderate. During year 2, one patient had two treatment-related serious events of hypersensitivity that resolved. Mean reductions from baseline in spleen and liver volumes were 61% and 49%, respectively (p < 0.0001) and mean percent-predicted-DLCO increased by 46.6% (p < 0.0001) in nine patients who performed the test at baseline. Lipid profiles and elevated liver transaminase levels that improved or normalized by 1 year remained stable. Mean height Z-scores improved in all age groups (mean change from baseline 1.17, P < 0.0001).

Conclusion
Olipudase alfa was generally well-tolerated during 2 years of treatment. Improvements in clinically relevant disease endpoints observed during the first year of treatment were maintained or augmented in the second year.
Trial registration NCT02004704 registered 26 Nov 2013, https://clinicaltrials.gov/ct2/show/record/NCT02004704.
ASCOT ADAPT study of COVID-19 therapeutics in hospitalised patients: an international multicentre adaptive platform trial
Authors: Denholm Justin T. , Venkatesh Balasubramanian , Davis Joshua , Bowen Asha C. , Hammond Naomi E. , Jha Vivekanand , McPhee Grace , McQuilten Zoe , O’Sullivan Matthew V. N. , Paterson David , Price David , Rees Megan , Roberts Jason , Jones Mark , Totterdell James , Snelling Thomas , Trask Nanette , Morpeth Susan , Tong Steven YC ,   on behalf of the ASCOT ADAPT investigators
Published: December 2022

Abstract
Background
SARS-CoV-2 infection is associated with a significant risk of hospitalisation, death, and prolonged impact on quality of life. Evaluation of new treatment options and optimising therapeutic management of people hospitalised with SARS-CoV-2 infection remains essential, but rapid changes in pandemic conditions and potential therapies have limited the utility of traditional approaches to randomised controlled trials.

Methods
ASCOT ADAPT is an international, investigator-initiated, adaptive platform, randomised controlled trial of therapeutics for non-critically ill patients hospitalised with COVID-19. The study design is open label and pragmatic. Potential participants are hospitalised adults with PCR confirmed, symptomatic, SARS-CoV-2 infection, within 14 days of symptom onset. Domains include antiviral, antibody and anticoagulant interventions, with a composite primary outcome of 28-day mortality or progression to intensive-care level respiratory or haemodynamic support. Initial interventions include intravenous nafamostat and variable dose anticoagulation. A range of secondary endpoints, and substudies for specific domains and interventions are outlined.

Discussion
This paper presents the trial protocol and management structure, including international governance, remote site monitoring and biobanking activities and provides commentary on ethical and pragmatic considerations in establishing the ASCOT ADAPT trial under pandemic conditions.

Trial registration
Australian and New Zealand Clinical Trials Registry (ACTRN12620000445976) and ClinicalTrials.gov (NCT04483960).
Does Trypanosoma cruzi (Chagas, 1909) (Kinetoplastida: Trypanosomatidae) modify the antennal phenotype of Triatoma dimidiata (Latreille, 1811) (Hemiptera: Triatominae)?
Authors: May-Concha Irving J. , Escalante-Talavera Maryrose J. , Dujardin Jean-Pierre , Waleckx Etienne 
Published: December 2022

Abstract
Background
Triatoma dimidiata is a vector of the protozoan parasite Trypanosoma cruzi, the etiologic agent of Chagas disease. Phenotypic plasticity allows an organism to adjust its phenotype in response to stimuli or environmental conditions. Understanding the effect of T. cruzi on the phenotypic plasticity of its vectors, known as triatomines, has attracted great interest because of the implications of the parasite–triatomine interactions in the eco-epidemiology and transmission of the etiologic agent of Chagas disease. We investigated if the infection of the vector with T. cruzi may be associated with a change in the antennal phenotype of sylvatic, domestic, and laboratory-reared populations of T. dimidiata.

Methods
The abundance of each type of sensillum (bristles, basiconic, thick- and thin-walled trichoid) on the antennae of T.cruzi-infected and non-infected T.dimidiata reared in the laboratory or collected in sylvatic and domestic ecotopes were measured under light microscopy and compared using Kruskal–Wallis non-parametric tests and permutational multivariate analysis of variance.

Results
We found significant differences between sensilla patterns of infected and non-infected insects within sylvatic and domestic populations. Conversely, we found no significant differences between sensilla patterns of infected and non-infected insects within the laboratory-reared population. Besides, for sylvatic and domestic populations, sexual dimorphism tended to be increased in infected insects.

Conclusion
The differences observed in infected insects could be linked to higher efficiency in the perception of odor molecules related to the search for distant mates and hosts and the flight dispersal in search of new habitats. In addition, these insects could have a positive effect on population dynamics and the transmission of T.cruzi.

Graphical Abstract
Molecular detection of Ehrlichia spp. in ticks parasitizing wild lagomorphs from Spain: characterization of a novel Ehrlichia species
Authors: Remesar Susana , Castro-Scholten Sabrina , Morrondo Patrocinio , Díaz Pablo , Jiménez-Martín Débora , Rouco Carlos , Camacho-Sillero Leonor , Cano-Terriza David , García-Bocanegra Ignacio 
Published: December 2022

Abstract
Background
Several species belonging to the genus Ehrlichia are considered pathogenic for animals and humans. Although wildlife are known to play an important role in the epidemiology of these bacteria, information on the role of wild lagomorphs in their sylvatic cycle is limited. Thus, the objective of the present study was to assess the occurrence of Ehrlichia spp. in ticks collected from wild lagomorphs in Spanish Mediterranean ecosystems.

Methods
A total of 1122 pooled ticks (254 pools) collected from 506 wild rabbits (Oryctolagus cuniculus) and 29 Iberian hares (Lepus granatensis) were analysed using a nested PCR assay targeting the partial groEL gene. Ehrlichia spp.-positive samples were further subjected to a second PCR assay targeting 16S rRNA.

Results
Three (1.2%) tick pools comprising Rhipicephalus pusillus collected from nine wild rabbits were positive for Ehrlichia spp. All the Ehrlichia DNA sequences were identical, and use of sequence and phylogenetic analyses allowed us to identify a novel Ehrlichia species.

Conclusions
We provide evidence that a novel Ehrlichia species, named herein as ‘Candidatus Ehrlichia andalusi’, which may be of concern for animal and public health, is circulating in R. pusillus in Spanish Mediterranean ecosystems. Further studies are warranted to assess the epidemiology, pathogenicity and zoonotic potential of this Ehrlichia species.

Graphical Abstract
Multiple lumbar punctures aiming to relieve headache results in iatrogenic spinal hematoma: a case report
Authors: Lyons Hannah S. , Ramalingam Satheesh , Mitchell James L. , Yiangou Andreas , Thaller Mark , Sinclair Alexandra J. , Mollan Susan P. 
Published: December 2022

Abstract
Background
Multiple lumbar punctures have historically been a strategy to relieve headaches associated with idiopathic intracranial hypertension despite limited clinical evidence of long-term efficacy. Lumbar puncture is typically a straightforward procedure with minimal complications reported, however, serious complications can occur. Lumbar-puncture-related spinal hematomas are rare but can lead to irreversible paralysis.

Case presentation
We report a case of a 28-year-old Caucasian woman who was treated with multiple lumbar punctures to manage headache, thought to be attributed to idiopathic intracranial hypertension. The patient developed a lumbosacral epidural hematoma following a lumbar puncture, which led to incomplete cauda equina syndrome. Multiple lumbar punctures had been the long-term management for the patient’s chronic headaches associated with her diagnosis of idiopathic intracranial hypertension. She had no risks of an underlying coagulopathy. Following a lumbar puncture, she re-presented with lower back pain and bilateral paresthesia. Over the subsequent 48 hours, this progressed to urinary incontinence and saddle paresthesia. Imaging revealed an epidural hematoma, which was conservatively managed. She continued to report saddle paresthesia and urinary incontinence 7 months following the lumbar puncture. Between 1974 to 2022, our literature search found 41 case reports detailing lumbar-puncture-related spinal hematomas. It is an established but rare complication of lumbar puncture and there are limited studies looking at the incidence of its occurrence. Whilst coagulopathy has been found to be a risk factor, it is unclear if the gauge of the needle is relevant. Case evidence suggests there may be no significant difference in outcomes between surgical and conservative management of spinal hematomas. This case highlights that lumbar punctures can be invasive, with potentially serious complications. A lumbar puncture should therefore only be performed when clinically justified.

Conclusions
This case highlights a rare complication of lumbar puncture and emphasizes the importance of a risk–benefit discussion for each procedure. Spinal hematoma following lumbar puncture is a rare complication but with potentially devastating consequences. Within the setting of idiopathic intracranial hypertension, the evidence base for the long-term benefit of headache relief by repeat lumbar puncture is low.
Speech improvement in noisy reverberant environments using virtual microphones along with proposed array geometry
Authors: Sadeghi Mohammad Ebrahim , Sheikhzadeh Hamid , Emadi Mohammad Javad 
Published: December 2022

AbstractThis paper proposes a novel approach for improving the speech of a single speaker in noisy reverberant environments. The proposed approach is based on using a beamformer with a large number of virtual microphones with the suggested arrangement on an open sphere. Our method takes into account virtual microphone signal synthesizing using the non-parametric sound field reproduction in the spherical harmonics domain and the popular weighted prediction error method. We obtain entirely accurate beam steering towards a known source location with more directivity. The suggested approach is proven to perform effectively not just in boosting the directivity factor but also in terms of improving speech quality as measured by subjective metrics like the PESQ. In comparison to current research in the area of speech enhancement by beamformer, our experiments reveal more noise and reverberation suppression as well as improved quality in the enhanced speech samples due to the usage of virtual beam rotation in the fixed beamformer. Text for this section.