bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing the sustainability of the Systems Analysis and Improvement Approach to increase HIV testing in family planning clinics in Mombasa, Kenya: results of a cluster randomized trial
Authors: Long Jessica E. , Eastment McKenna C. , Wanje George , Richardson Barbra A. , Mwaringa Emily , Mohamed Mwanakarama Athman , Sherr Kenneth , Barnabas Ruanne V. , Mandaliya Kishorchandra , Jaoko Walter , McClelland R. Scott 
Published: October 2022

Abstract
Background
In Kenya, HIV incidence is highest among reproductive-age women. A key HIV mitigation strategy is the integration of HIV testing and counseling (HTC) into family planning services, but successful integration remains problematic. We conducted a cluster-randomized trial using the Systems Analysis and Improvement Approach (SAIA) to identify and address bottlenecks in HTC integration in family planning clinics in Mombasa County, Kenya. This trial (1) assessed the efficacy of this approach and (2) examined if SAIA could be sustainably incorporated into the Department of Health Services (DOHS) programmatic activities. In Stage 1, SAIA was effective at increasing HTC uptake. Here, we present Stage 2, which assessed if SAIA delivery would be sustained when implemented by the Mombasa County DOHS and if high HTC performance would continue to be observed.

Methods
Twenty-four family planning clinics in Mombasa County were randomized to either the SAIA implementation strategy or standard care. In Stage 1, the study staff conducted all study activities. In Stage 2, we transitioned SAIA implementation to DOHS staff and compared HTC in the intervention versus control clinics 1-year post-transition. Study staff provided training and minimal support to DOHS implementers and collected quarterly HTC outcome data. Interviews were conducted with family planning clinic staff to assess barriers and facilitators to sustaining HTC delivery.

Results
Only 39% (56/144) of planned SAIA visits were completed, largely due to the COVID-19 pandemic and a prolonged healthcare worker strike. In the final study quarter, 81.6% (160/196) of new clients at intervention facilities received HIV counseling, compared to 22.4% (55/245) in control facilities (prevalence rate ratio [PRR]=3.64, 95% confidence interval [CI]=2.68–4.94). HIV testing was conducted with 60.5% (118/195) of new family planning clients in intervention clinics, compared to 18.8% (45/240) in control clinics (PRR=3.23, 95% CI=2.29–4.55). Interviews with family planning clinic staff suggested institutionalization contributed to sustained HTC delivery, facilitated by low implementation strategy complexity and continued oversight.

Conclusions
Intervention clinics demonstrated sustained improvement in HTC after SAIA was transitioned to DOHS leadership despite wide-scale healthcare disruptions and incomplete delivery of the implementation strategy. These findings suggest that system interventions may be sustained when integrated into DOHS programmatic activities.

Trial registration
ClinicalTrials.gov (NCT02994355) registered on 16 December 2016.
Successful concomitant minimally invasive surgery for aortic valve stenosis and right lung cancer via right mini-thoracotomy : A case report
Authors: Sakakibara Satoshi , Nishi Hiroyuki , Fukui Shinya , Kitahara Mutsunori , Handa Kazuma , Kakizawa Yumi , Goto Takasumi , Funakoshi Yasunobu 
Published: October 2022

Abstract
Background
The case of aortic valve stenosis complicated with lung cancer have compelled cardiovascular surgeons to make challenging. We report the first successful short-term outcomes of one-stage minimally invasive aortic valve replacement and video-assisted thoracoscopic surgery lobectomy through right mini-thoracotomy in a patient with synchronous bicuspid severe aortic valve stenosis which was unsuitable for transcatheter aortic valve implantation and right lung cancer.

Case presentation
A 76-year-old man with severe aortic valve stenosis was diagnosed with lung cancer of the right upper lobe with stage IA2. Considering the potential risk of tumor metastasis, a one-stage surgical therapy for right lung cancer and type 0 bicuspid aortic valve stenosis was required; however, transcatheter aortic valve implantation was unsuitable due to a bicuspid aortic valve with severe calcification. Therefore, concomitant minimally invasive aortic valve replacement and lobectomy via right mini-thoracotomy were performed. The postoperative course was uneventful.

Conclusion
Concomitant aortic valve replacement and right lobectomy via right mini-thoracotomy may reduce surgical invasiveness, leading to early recovery. This surgical strategy is a useful option, particularly for patients with aortic valve stenosis complicated with right lung cancer.
Understanding the tonifying and the detoxifying properties of Chinese medicines from their impacts on gut microbiota and host metabolism: a case study with four medicinal herbs in experimental colitis rat model
Authors: Li Ting , Gao Xuejiao , Yan Zhixiang , Wai Tai-Seng , Yang Wei , Chen Junru , Yan Ru 
Published: October 2022

Abstract
Background
Chinese medicines (CMs) have emerged as an alternative therapy for ulcerative colitis through reinforcing the vital qi and/or eliminating the pathogenic factors according to the traditional Chinese medicinal theory. Presystemic interactions of CMs with gut microbiota and the associated metabolic network shift are believed to be essential to achieve their holistic health benefits in traditional oral application.

Methods
This study first employed 16S rDNA-based microbial profiling and mass spectrometry-based urinary metabolomics to simultaneously evaluate four single CMs frequently prescribed as main constituent herbs for alleviating UC, the tonic ginseng and Astragali Radix (AR) and the detoxifying Scutellaria Radix (SR) and Rhubarb, on a dextran sodium sulfate (DSS)-induced colitis rat model, with aims to understanding the tonifying or detoxifying properties of CMs through clinical phenotypes, the common features and herb-specific signatures in gut microbial alterations and the associated host metabolic shifts. Colitis was induced in rats receiving 5% DSS for consecutive 7 days. Control group received water alone. Herbal groups received 5% DSS and respective herbal preparation by gavage once daily. Body weight, stool consistency, and rectal bleeding were recorded daily. Feces and urine were freshly collected at multiple time points. On day 7, blood and colon tissues were collected to determine anti-/pro-inflammatory cytokines levels, colonic myeloperoxidase activity, and histopathologic alterations.

Results
Gut microbiome was more prone to herb intervention than metabolome and displayed increasing associations with metabolic dynamics. Although both the tonic and the detoxifying herbs alleviated colitis and caused some similar changes in DSS-induced microbiome and metabolome disturbance, the tonic herbs were more effective and shared more common microbial and metabolic signatures. The detoxifying herbs elicited herb-specific changes. Rhubarb uniquely affected phenylalanine metabolism and established high correlations between Akkermansia muciniphila and Parasutterella and hydroxyphenylacetylglycine and phenylbutyrylglycine, while SR caused significant elevation of steroidal glucuronides dehydropregnenolone glucuronide and estriol glucuronide, both displaying exclusive correlations with genus Acetatifactor.

Conclusion
Both tonic and detoxifying herbs tested ameliorated experimental colitis and elicited alternative microbial and host metabolic reprogramming. The findings highlight the importance of presystemic interactions with gut microbiota to host metabolic shifts and promote modern translation of tonic and detoxifying properties of CMs.
Eco-friendly resolution of spectrally overlapping signals of a combined triple-action over-the-counter pharmaceutical formulation for symptomatic management of COVID-19 pandemic: application to content uniformity testing
Authors: Marzouk Hoda M. , Ibrahim Engy A. , Hegazy Maha A. , Saad Samah S. 
Published: October 2022

AbstractCurrently, all researchers are concentrating their efforts on countering the COVID-19 pandemic. The majority of patients are managed at home, according to recent statistics. An OTC triple action combination comprising paracetamol (PAR), aspirin (ASP), and diphenhydramine (DIPH) is commonly given for pain relief, fever control, and as a night-time sleep aid. This combination is currently recommended for COVID-19 patients as part of symptomatic treatment and management. In this work, three smart, simple, accurate, eco-friendly, and cost-effective spectrophotometric methods are developed for simultaneous determination of PAR, ASP, and DIPH in their combined over-the-counter caplet dosage form without any prior separation steps. The first method is the first derivative spectrophotometry (D1) which determined PAR at 259.7 nm. The second one is the dual-wavelength in ratio spectra (DWRS) for determination of ASP at 214.1 and 220.1 nm after using 10.0 μg/mL of PAR as a divisor, where PAR was a constant, and the wavelengths difference equal to zero for DIPH. The third method is the double divisor-ratio difference spectrophotometric one (DD-RD) which was based on using the sum of 15.0 µg/mL of each of PAR and ASP as a double divisor, and the difference in amplitudes was measured at two wavelengths ∆P(214.5–226.0) for determination of DIPH. The developed methods have been validated as per ICH guidelines. Furthermore, the three suggested methods were employed successfully to assay marketed pharmaceutical formulation and to investigate the content uniformity of the dosage units in accordance with the United States Pharmacopeia's guidelines. Finally, the greenness profile of the proposed methods was assessed and compared with the reported method using the analytical eco-scale system, national environmental method index (NEMI), green analytical procedure index (GAPI), and analytical greenness (AGREE) metric. The results from the proposed methods statistically agreed with those obtained by the reported one, with no significant differences in accuracy and precision.
Graphical Abstract
Augmented Hill-Climb increases reinforcement learning efficiency for language-based de novo molecule generation
Authors: Thomas Morgan , O’Boyle Noel M. , Bender Andreas , de Graaf Chris 
Published: October 2022

AbstractA plethora of AI-based techniques now exists to conduct de novo molecule generation that can devise molecules conditioned towards a particular endpoint in the context of drug design. One popular approach is using reinforcement learning to update a recurrent neural network or language-based de novo molecule generator. However, reinforcement learning can be inefficient, sometimes requiring up to 105 molecules to be sampled to optimize more complex objectives, which poses a limitation when using computationally expensive scoring functions like docking or computer-aided synthesis planning models. In this work, we propose a reinforcement learning strategy called Augmented Hill-Climb based on a simple, hypothesis-driven hybrid between REINVENT and Hill-Climb that improves sample-efficiency by addressing the limitations of both currently used strategies. We compare its ability to optimize several docking tasks with REINVENT and benchmark this strategy against other commonly used reinforcement learning strategies including REINFORCE, REINVENT (version 1 and 2), Hill-Climb and best agent reminder. We find that optimization ability is improved ~ 1.5-fold and sample-efficiency is improved ~ 45-fold compared to REINVENT while still delivering appealing chemistry as output. Diversity filters were used, and their parameters were tuned to overcome observed failure modes that take advantage of certain diversity filter configurations. We find that Augmented Hill-Climb outperforms the other reinforcement learning strategies used on six tasks, especially in the early stages of training or for more difficult objectives. Lastly, we show improved performance not only on recurrent neural networks but also on a reinforcement learning stabilized transformer architecture. Overall, we show that Augmented Hill-Climb improves sample-efficiency for language-based de novo molecule generation conditioning via reinforcement learning, compared to the current state-of-the-art. This makes more computationally expensive scoring functions, such as docking, more accessible on a relevant timescale.
The Mayer-Eymar collection of Cenozoic mollusks
Authors: Etter Walter 
Published: October 2022

AbstractKarl Mayer (later Karl Mayer-Eymar, 1826–1906) was a stratigrapher and palaeontologist who assembled during his long career a collection of Cenozoic (then “Tertiary”) mollusks that numbers more than 500′000 specimens. He mostly collected them himself at various localities in Europe and Egypt. In more than 175 publications he described more than 1100 new bivalve and gastropod species, the types of which are of paramount importance for mollusk taxonomists. Based on his collection, he furthermore, erected 13 new Cenozoic stages, five of them still in use today. Here the structure and content of this collection is described, along with an explanation of the labels which are at first not so easy to understand. The Mayer-Eymar collection is in the propriety of the “Eidgenössische Technische Hochschule” (ETH) in Zürich. From 1966 until 2020 it was on a permanent loan to the Natural History Museum Basel, where it was also curated. In October 2020 the collection was returned to the ETH.
Right ventricular strain measurements in critically ill patients: an observational SICS sub-study
Authors: Vos Madelon E. , Cox Eline G. M. , Schagen Maaike R. , Hiemstra Bart , Wong Adrian , Koeze Jacqueline , van der Horst Iwan C. C. , Wiersema Renske ,   SICS Study Group
Published: October 2022

Abstract
Background
Right ventricular (RV) dysfunction is common in critically ill patients and is associated with poor outcomes. RV function is usually evaluated by Tricuspid Annular Plane Systolic Excursion (TAPSE) which can be obtained using critical care echocardiography (CCE). Myocardial deformation imaging, measuring strain, is suitable for advanced RV function assessment and has widely been studied in cardiology. However, it is relatively new for the Intensive Care Unit (ICU) and little is known about RV strain in critically ill patients. Therefore, the objectives of this study were to evaluate the feasibility of RV strain in critically ill patients using tissue-Doppler imaging (TDI) and explore the association between RV strain and conventional CCE measurements representing RV function.

Methods
This is a single-center sub-study of two prospective observational cohorts (Simple Intensive Care Studies (SICS)-I and SICS-II). All acutely admitted adults with an expected ICU stay over 24 h were included. CCE was performed within 24 h of ICU admission. In patients in which CCE was performed, TAPSE, peak systolic velocity at the tricuspid annulus (RV s’) and TDI images were obtained. RV free wall longitudinal strain (RVFWSL) and RV global four-chamber longitudinal strain (RV4CSL) were measured during offline analysis.

Results
A total of 171 patients were included. Feasibility of RVFWSL and RV4CSL was, respectively, 62% and 56% in our population; however, when measurements were performed, intra- and inter-rater reliability based on the intraclass correlation coefficient were good to excellent. RV dysfunction based on TAPSE or RV s’ was found in 56 patients (33%) and 24 patients (14%) had RV dysfunction based on RVFWSL or RV4CSL. In 14 patients (8%), RVFWSL, RV4CSL, or both were reduced, despite conventional RV function measurements being preserved. These patients had significantly higher severity of illness scores. Sensitivity analysis with fractional area change showed similar results.

Conclusions
TDI RV strain imaging in critically ill patients is challenging; however, good-to-excellent reproducibility was shown when measurements were adequately obtained. Future studies are needed to elucidate the diagnostic and prognostic value of RV strain in critically ill patients, especially to outweigh the difficulty and effort of imaging against the clinical value.
Bioinformatics analysis of diagnostic biomarkers for Alzheimer's disease in peripheral blood based on sex differences and support vector machine algorithm
Authors: Ji Wencan , An Ke , Wang Canjun , Wang Shaohua 
Published: October 2022

AbstractBackgroundThe prevalence of Alzheimer's disease (AD) varies based on gender. Due to the lack of early stage biomarkers, most of them are diagnosed at the terminal stage. This study aimed to explore sex-specific signaling pathways and identify diagnostic biomarkers of AD.MethodsMicroarray dataset for blood was obtained from the Gene Expression Omnibus (GEO) database of GSE63060 to conduct differentially expressed genes (DEGs) analysis by R software limma. Gene Ontology (GO) analysis, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis and Gene set enrichment analysis (GSEA) were conducted. Immune checkpoint gene expression was compared between females and males. Using CytoHubba, we identified hub genes in a protein–protein interaction network (PPI). Then, we evaluated their distinct effectiveness using unsupervised hierarchical clustering. Support vector machine (SVM) and ten-fold cross-validation were used to further verify these biomarkers. Lastly, we confirmed our findings by using another independent dataset.ResultsA total of 37 female-specific DEGs and 27 male-specific DEGs were identified from GSE63060 datasets. Analyses of enrichment showed that female-specific DEGs primarily focused on energy metabolism, while male-specific DEGs mostly involved in immune regulation. Three immune-checkpoint-relevant genes dysregulated in males. In females, however, these eight genes were not differentially expressed. SNRPG, RPS27A, COX7A2, ATP5PO, LSM3, COX7C, PFDN5, HINT1, PSMA6, RPS3A and RPL31 were regarded as hub genes for females, while SNRPG, RPL31, COX7C, RPS27A, RPL35A, RPS3A, RPS20 and PFDN5 were regarded as hub genes for males. Thirteen hub genes mentioned above was significantly lower in both AD and mild cognitive impairment (MCI). The diagnostic model of 15-marker panel (13 hub genes with sex and age) was developed. Both the training dataset and the independent validation dataset have area under the curve (AUC) with a high value (0.919, 95%CI 0.901–0.929 and 0.803, 95%CI 0.789–0.826). Based on GSEA for hub genes, they were associated with some aspects of AD pathogenesis.ConclusionDEGs in males and females contribute differently to AD pathogenesis. Algorithms combining blood-based biomarkers may improve AD diagnostic accuracy, but large validation studies are needed.
Effects of high albumin leakage on survival between online hemodiafiltration and super high-flux hemodialysis: the HISTORY study
Authors: Okada Kazuyoshi , Tashiro Manabu , Michiwaki Hiroyuki , Inoue Tomoko , Shima Hisato , Minakuchi Jun , Kawashima Shu 
Published: October 2022

Abstract
Background
All-cause mortality is lower with a high substitution volume in predilution (pre) and postdilution (post) online hemodiafiltration (OHDF) than with hemodialysis (HD), and mortality does not significantly differ between pre- and post-OHDF groups. Despite the improved survival with a high substitution volume, there may be limitations. On the other hand, either normoalbuminemia or high albumin leakage in HD can reduce mortality, and super high-flux (SHF) membrane dialyzers can reduce mortality compared with low-flux and high-flux membrane dialyzers. Here, we investigated the associations of serum albumin concentration (s-Alb), albumin leakage, and substitution volume with all-cause mortality in OHDF and SHF-HD.

Methods
In a 3-year retrospective observational study of patients receiving dialysis from April 1 to July 1, 2017, we developed a propensity score-matched model using 783 stable patients (SHF-HD, 355; OHDF, 428). We used the log-rank test to compare Kaplan–Meier survival curves and Cox regression analysis to calculate hazard ratio (HR). Cox regression analysis was also used to compare the effect of estimated albumin leakage (EAL) and substitution volume on 3-year all-cause mortality.

Results
All-cause mortality was significantly lower with high EAL than with low EAL (SHF-HD: P = 0.012, log-rank test; HR, 0.44; 95% confidence interval [CI] 0.23–0.85; OHDF: P = 0.027, log-rank test; HR, 0.41; 95% CI 0.18–0.93). The mortality of high EAL was not significantly different between high and low s-Alb in SHF-HD (3.5 ± 0.1 and 3.2 ± 0.2 g/dL) and OHDF (3.6 ± 0.2 and 3.2 ± 0.1 g/dL), despite significant differences in s-Alb. Mortality did not significantly differ between SHF-HD and OHDF with higher EAL ranges or a lower difference in EAL. Mortality in pre-OHDF was significantly correlated with EAL (P = 0.007, beta − 0.32) rather than substitution volume, and mortality in post-OHDF was not analyzed because of fewer deaths.

Conclusions
The results suggest that survival is improved more with high EAL than with low EAL in both OHDF and SHF-HD patients, that high EAL with mild-to-moderate hypoalbuminemia does not necessarily worsen survival in OHDF and SHF-HD patients, and that survival is equivalent between OHDF and SHF-HD patients with a similar level of EAL.
Civilization and Its Discontents
Authors: Gilks David 
Published: October 2022

AbstractThis article reinterprets Antoine Quatremère de Quincy's Letters on the Plan to Abduct the Monuments of Italy (1796). In response to official justifications that seizing cultural patrimony was France's civilizing mission, Quatremère argued that civilization required all nations to leave Rome intact and respect eighteenth-century conventions. The article shows how he attempted to make his work acceptable to republican readers by using a language uncharacteristic of his other writings and by mimicking the concept of a singular and secular civilization that was central to the post-Thermidorian Republic's identity. The Letters was part of the broader strategy of the royalist Clichy club to make republicans question the Republic. However, informed contemporaries saw through his conceit: they discerned an attack on the Directory in his description of how the papacy nourished and protected the civilization that the Directory protected in theory but endangered in practice.Cet article propose une nouvelle lecture des Lettres sur le déplacement des monuments de l'art de l'Italie (1796). Au discours officiel qui justifiait la saisie du patrimoine culturel de l'Italie vaincue au nom de la mission civilisatrice de la France, Quatremère oppose l'idée que c'est justement au nom de la civilisation que Rome doit être protégée et qu'il faut respecter les droits des nations tels qu'on les a définis au XVIIIe siècle. Quatremère s'est efforcé de présenter son texte de manière à le rendre acceptable aux lecteurs républicains : pour ce faire, il a eu recours à un langage très différent de celui de ses autres écrits, et il a fait semblant d'adhérer à l'idée de la civilisation unique et laïque au cœur de l'idéologie de la République post-Thermidorienne. Malgré ces efforts, les lecteurs avertis ont décelé son stratagème qui consiste à attaquer le Directoire tout en faisant de la papauté la vraie protectrice d'une civilisation que la République affirme défendre mais attaque en réalité. Les Lettres apparaissent ainsi comme un des éléments de la stratégie des Clichyens pour amener les républicains à remettre en question la République elle-même.