bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient Satisfaction With a Public Health Insurance “the Sehat Sahulath Program Ssp” in Peshawar, Pakistan: a Comparative Cross-sectional Study
Authors: Ullah Ihsan , Ayub Ayaz , Khan Kashif , Shah Shabnam 
Published: November 2022

Abstract

Background:
In the lower-middle-income countries, Pakistan is the fifth most populous and one of the lowest financiers in the health system country in the world. According to Pakistan’s National Health Vision 2016–2025 report, UHC is the highest priority while some other national programs and policies have also allied to it. Pakistan has OOP is 65% in 2016. Therefore, Pakistan has witnessed the sustainable developmental goal (SDGs) and reached a UHC service index score of 80, while the country score was 40 in 2015 and 50 in 2020.
Materials and Methods:
This was a comparative cross-sectional study carried out in Peshawar, northwest Pakistan. The outcome was patient satisfaction with “sehat sahulath program “a national insurance scheme in Pakistan. Data on patient satisfaction with the sehat sahulat program was collected from public and private tertiary care hospitals in Peshawar. A total of 410 patients enrolled via an adapted semi-structured questionnaire. Data were analyzed using descriptive statistics for sociodemographic characteristics. Chi-square and Independent sample T-test was run for comparison of patient satisfaction in both public and private tertiary care hospitals.
Results:
The results, showed that patients’ awareness of sehat sahulath program, fulfillment of patient expectations, and patients’ perceived value of sehat sahulath coverage had directly affected patient satisfaction (p< 0.001). Privat hospitals had a greater level of satisfaction as compared to patients admitted in public tertiary hospital (p< 0.001).\
Conclusions:
Our study concludes that the public health insurance programs “The sehat sahulath program” can be introduced in all poor urban and rural regions of Pakistan, to avoid low-income families from facing hardship and financial devastation due to the burden of out-of-pocket expenditure OOP payments.
Environmental toxin biliatresone can induce biliary atresia: evidence from human liver organoids
Authors: Yue Haibing , Menon Sudheer Sivasankaran , Babu Rosana Ottakandathil , Wu Zhongluan , So Man-Ting , Chung Patrick Ho-Yu , Wong Kenneth Kak-Yuen , Tam Paul Kwong-Hang , Lui Vincent Chi-Hang 
Published: November 2022

Abstract
Biliary atresia (BA) is a poorly understood and devastating obstructive bile duct disease of newborns. Biliatresone, a plant toxin, caused BA-like syndrome in some animals but its relevance in humans is unknown. To validate the hypothesis that biliatresone exposure is a plausible BA disease mechanism in humans, we treated normal human liver organoids with biliatresone, and address its adverse effects on organoids’ development, functions and cellular organization. The control organoids (without biliatresone) were well-expanded and much bigger than biliatresone-treated organoids. Expression of cholangiocyte marker CK19 was reduced, while hepatocyte marker HFN4A was significantly elevated in biliatresone-treated organoids. ZO-1 (tight junction marker) immunoreactivity was localized at the apical intercellular junctions in control organoids, while it was markedly reduced in biliatresone-treated organoids. Cytoskeleton F-actin was localized at the apical surface of the control organoids, but it was ectopically expressed at the apical and basal sides in biliatresone-treated organoids. Cholangiocytes of control organoids possess primary cilia and elicited cilia mechano-sensory function. Number of ciliated cholangiocytes was reduced and cilia mechano-sensory function was hampered in biliatresone-treated organoids. In conclusion, biliatresone induces morphological and developmental changes of human liver organoids resemblance of our previously reported BA organoids, suggesting environmental toxins could contribute to BA pathogenesis.
Delirium Risk of Antiepileptic Drugs: A Study Based on the Adverse Drug Event Reporting Database in Japan
Authors: Kubo Toshiki , Sogawa Rintaro , Tsuruhashi Satoko , Murakawa-Hirachi Toru , Matsuoka Ayaka , Mizoguchi Yoshito , Monji Akira , Shimanoe Chisato 
Published: November 2022

Abstract
Background
Antiepileptic drugs may cause delirium, and the risk may vary with each drug. However, related studies have provided inconsistent results.
Aim
To investigate whether antiepileptic drugs cause delirium by analysing adverse drug event reports compiled in the post-marketing stages of drugs and recorded in a database established by Japanese regulatory authorities.
Method
A total of 573,316 reports registered between 2004 and 2020 were used to create a dataset. The search terms for delirium as the item of interest were selected from the Standardized Medical Dictionary for Regulatory Activities Queries. Reporting odds ratios and 95% confidence intervals of adverse events associated with use of antiepileptic drugs were calculated after adjusting for potential confounders.
Results
There were 27,194 reports of antiepileptic drug-related adverse events. Of these, 189 reports were associated with antiepileptic drugs and delirium (crude reporting odds ratio, 1.66; 95% confidence interval, 1.43–1.92). The use of lacosamide (adjusted reporting odds ratio, 2.51; 95% confidence interval, 1.28–4.94), lamotrigine (adjusted reporting odds ratio, 1.71; 95% confidence interval, 1.16–2.52), levetiracetam (adjusted reporting odds ratio, 1.82; 95% confidence interval, 1.28–2.59), and valproic acid (adjusted reporting odds ratio, 1.53; 95% confidence interval, 1.19–1.97) was related to a significantly higher reporting odds ratio for delirium, even after adjustment for possible confounding factors. However, no signals for delirium were detected with any of these drugs under benzodiazepine receptor agonist usage.
Conclusion
The study findings suggest that antiepileptic drugs may cause delirium.
Multi-center study on predicting breast cancer lymph node status from core needle biopsy specimens using multi-modal and multi-instance deep learning
Authors: Liu Yueping , Ding Yan , Yang Fan , Han Mengxue , Li Chunhui , Wang Yanan , Xu Xin , Zhao Min , Zhao Meng , Yue Meng , Deng Huiyan , Yang Huichai , Yao Jianhua 
Published: November 2022

Abstract
Objective
To develop a deep learning model based on clinicopathological data and digital pathological image of core needle biopsy specimens for predicting breast cancer lymph node metastasis.
Methods
We collected 3701 patients from the Fourth Hospital of Hebei Medical University and 190 patients from four medical centers in Hebei Province. Integrating clinicalpathological data and image features build multi-modal and multi-instance (MMMI) deep learning model to obtain the final prediction.
Results
1. For predicting with or without lymph node metastasis, the AUC was 0.770, 0.709, 0.809 based on the clinicopathological features, WSI and MMMI, respectively. 2. For predicting four classification of lymph node status (no metastasis, isolated tumor cells (ITCs), micrometastasis, and macrometastasis), the prediction based on clinicopathological features, WSI and MMMI were compared. The AUC for no metastasis was 0.770, 0.709, 0.809, respectively; ITCs were 0.619, 0.531, 0.634, respectively; micrometastasis were 0.636, 0.617, 0.691, respectively; and macrometastasis were 0.748, 0.691, 0.758, respectively. MMMI developed a more accurate prediction effect. 3. For prediction of different molecular types of breast cancer, MMMI demonstrated a better prediction effect for any type of lymph node status, especially in the molecular type of triple negative breast cancer (TNBC). 4. In the external validation set, MMMI also showed better predictive effect in the four classification, with AUC of 0.725, 0.757, 0.525, and 0.708, respectively.
Conclusions
We developed a breast cancer lymph node metastasis prediction model by using MMMI. Through all cases tests, the results showed that the overall prediction ability was high and relatively stable.
Genome-wide analysis on characterization of LEA gene family in responses to dehydration stress in recalcitrant Panax notoginseng seeds
Authors: Jia Jin-Shan , Ge Na , Wang Qing-Yan , Zhao Li-Ting , Chen Cui , Chen Jun-Wen 
Published: November 2022

Abstract
Background
Late embryogenesis abundant (LEA) proteins play an important role in dehydration process of seed maturation. The seeds of Panax notoginseng (Burkill) F. H. Chen are typically characterized with the recalcitrance and are highly sensitive to dehydration. However, it is not very well known about the role of LEA proteins in response to dehydration stress in P. notoginseng seeds. A genome-wide analysis would be performed in the LEA gene family of recalcitrant P. notoginseng seeds to learn more about the function of LEA proteins in response to dehydration stress.
Results
In this study, 61 LEA genes were identified from the P. notoginseng genome, and they were renamed as PnoLEA. The PnoLEA genes were classified into seven subfamilies based on the phylogenetic relationships, gene structure and conserved domains. The PnoLEA genes family showed relatively few introns and was highly conserved. Unexpectedly, the LEA_6 subfamily were not found, and the LEA_2 subfamily contained 46 (75.4%) members. Within 19 pairs of fragment duplication events, among them 17 pairs were LEA_2 subfamily. The Ka/Ks ratios are between 0.06 and 0.58 in all the homologous genes pairs, indicating that these homologous genes have experienced a purifying selection. In addition, the expression of the PnoLEA genes was obviously induced under dehydration stress, but the germination rate of P. notoginseng seeds decreased as the dehydration time prolonged.
Conclusions
We found that the lack of the LEA_6 subfamily, the expansion of the LEA_2 subfamily and low transcriptional levels of most PnoLEA genes might be implicated in the recalcitrant formation of P. notoginseng seeds. LEA proteins are essential in the response to dehydration stress in recalcitrant seeds, but the protective effect of LEA protein is not efficient. These results could improve our understanding of the function of LEA proteins in the response of dehydration stress and their contributions to the formation of seed recalcitrance.
Preferences for Redistribution: the role of Self-Interest, Social Values and Beliefs
Authors: Figueirêdo Lízia , Hisarciklilar Mehtap , Lima Thales Souza 
Published: November 2022

Abstract
We investigate the role of self-interest and of all social motivation systems - helping nonrelatives, redistribution of common resources, navigating hierarchies, being accepted in our groups - in establishing preferences for helping the needy and in supporting a decrease in income inequality. Guided by the “Moral Foundation Theory”, we have assumed that those preferences would be driven by different motivational systems. We have used data from the sixth wave of the Word Value Survey since it is the only wave with information on the Schwartz social values, which we use to discuss altruistic behaviours. We tested the role of a set of individual variables in shaping those preferences by applying Least Squares Dummy Variable approach to estimate country fixed effects models. Nonlinearities were especially sought with the use of categorical variables, fully exploiting the richness of the dataset. According to our results for 57 countries, motivations behind redistribution for the needy differ from motivations behind redistribution to decrease inequality. The income level and the social class of an individual are more important for shaping preferences for helping the needy, while the education level, an important proxy for mobility expectations, is more relevant for the assessment of income inequality. The very high or very low importance of God in someone's life and the belief that outcomes in life are driven by effort increase preferences for helping the needy. Higher levels of the importance of God and the belief that luck and networks shape outcomes decrease preferences for equality. Concerns about people who are close to us decrease preference for helping the needy, while concerns about distant people are positively correlated with preferences for equality.
Effect of material type and thickness of occlusal splints on maximum bite force and sleep quality in patients with sleep bruxism: A randomized controlled clinical trial
Authors: Benli Merve , Ozcan Mutlu 
Published: November 2022

Abstract
Objective: To evaluate the short-term effects of hard and soft splints of different thicknesses on maximum bite force (MBF) and sleep quality (SQ) in participants with sleep bruxism (SB).
Methods: One-hundred-fifteen patients were randomly allocated to five groups: Groups H2(Hard splint-2 mm), H3(Hard splint-3 mm), S2(Soft splint-2 mm), S3(Soft splint-3 mm), and C (control). Outcomes were MBF (assessed with a digital gnathodynamometer) and SQ (assessed with the Pittsburgh Sleep Quality Index). Measurements were performed at T0 (before the splints), T1 (1-month follow-up), and T2 (2-months follow-up). Data were analyzed using one-way ANOVA, Tukey’s HSD, and chi-square tests.
Results: At T1, the highest MBF values were in group H3 (658.01 ± 22.6 N), while the lowest was in group S2 (585.45 ± 8.68 N). For T2, the highest values belonged to the H3 group (676.85 ± 21.9 N), and the lowest values were observed at group S2 (565.65 ± 10.9 N) (p< 0.05).For SQ, groups S2 and S3 revealed the lowest PSQI values at T1 (9.1; 9.6) and T2 (9; 9.5) (p<0.001).
Conclusions: The use of both 2 and 3-mm thick soft splints resulted in a decrease in MBF. The improvement in SQ formed by the soft splint groups occurred in the 1st month and was maintained in the 2nd month.
Clinical Relevance: This study provides clinical tips in terms of material type and thickness of the occlusal splint, which should be applied according to the needs of SB patients (such as improving SQ and regulating MBF).
Urinary and Pelvic Solitary Fibrous Tumors: A Study on 22 Patients
Authors: Shen Hongwei , jiang Bo , Chen Wenyuan , Wang Xin , Zhang Gutian , Deng Yongming , Ji Changwei , Guo Hongqian , Zhang Shiwei 
Published: November 2022

Abstract
Background: Solitary fibrous tumors (SFT), most commonly found in the pleura, have a low incidence in the urinary and pelvic organs. This study aimed to discuss the diagnosis, treatment, and prognosis of urinary and pelvic SFT(UPSFT) as well as differences between benign and malignant UPSFTs. We aimed to gain a better understanding of this disease in the urinary and pelvic systems.
Methods: Twenty-two patients with UPSFTs treated in our hospital between January 2004 and August 2021 were enrolled. General characteristics, clinical symptoms, imaging results, treatments, pathologies, and follow-up results were reviewed and analyzed.
Results: Of the 22 patients, six (27.3%) showed non-specific clinical symptoms, including dysfunction of defecation, lower extremity weakness, urodynia, dysuria, frequent urination accompanied by changes in stool habits, low back pain, and abdominal wall mass with abdominal pain. Sixteen (72.7%) patients were asymptomatic. The median SFT diameter was 5.65 cm (range: 1.7–15 cm). All tumors were found to be space-occupying lesions on Doppler ultrasound, computed tomography, or magnetic resonance imaging. All patients were surgically treated, including nine, six, five, and two cases of robotic, open, laparoscopic, and transurethral resection of bladder tumor surgery, respectively. Pathology results revealed that frequent nuclear divisions, morphological variations, necrosis, and high expressions of Ki-67 were higher in malignant SFT compared with benign SFT. All patients were initially followed up 3 months post-surgery and every 6 months thereafter. Disease-free survival (DFS) in malignant SFT ranged from 5–63 months, with a median DFS of 37.0 months. Additionally, DFS was significantly longer in benign cases than that in malignant cases.
Conclusions: UPSFTs do not typically present with specific clinical symptoms. Imaging exams were important in diagnosing UPSFT, with final diagnoses depending on histopathology results. In addition, surgical resection was the most common treatment with subsequent excellent prognoses, except in the case of malignancy.
Antibiotic resistance of biofilm-related catheter-associated urinary tract isolates of Pseudomonas aeruginosa
Authors: Khabipova Nailya , Valeeva Lia , Shaidullina Elvira , Kabanov Daniil , Vorobev Viacheslav , Gimadeev Zufar , Sharipova Margarita 
Published: November 2022

Abstract
Catheter-associated urinary tract infections (CAUTI) is one of the most common nosocomial diseases accounting for up to about 23% of healthcare-associated infections. High antibiotic resistance of biofilm-associated bacteria is a serious limiting factor in the treatment of patients. Therefore, the investigations of bacterial biofilms and their regulation can play a pivotal role in the development of new approaches to treating infections. P. aeruginosa is a key bacterium responsible for most urinary tract infections. In this study, urinary catheter-associated P. aeruginosa strains were isolated and their antibiotic resistance was studied. Polymicrobial biofilms were found on the urinary catheter surfaces derived from patients with different urinary tract diseases. Three strains of Pseudomonas aeruginosa were isolated from the catheter-associated biofilms. Their resistance to beta-lactam antibiotics (carbapenems and cephalosporins) of P. aeruginosa strains 96347 and 96349 was observed to be mediated by VIM-type metallo-β-lactamase gene expression.
Mosquito bed net use and associated factors among pregnant women in Rwanda: a nationwide survey
Authors: Kawuki Joseph , Donkor Elorm , Gatasi Ghislaine , Nuwabaine Lilian 
Published: November 2022

Abstract
Background
In malaria-endemic countries such as Rwanda, the appropriate use of mosquito bed nets is an effective intervention for malaria prevention. Despite being one of the demographics most impacted by malaria, the usage of mosquito bed nets by pregnant women in Rwanda has received relatively little attention. The study aimed to assess the prevalence and associated factors for mosquito bed net use among pregnant women in Rwanda.
Methods
We used weighted data from the 2020 Rwanda Demographic and Health Survey of 870 pregnant women, and multistage stratified sampling was used to select participants. Multivariable logistic regression was conducted to determine the factors associated with mosquito bed net use, using SPSS (version 25).
Results
Of the 870 pregnant women, 57.9% (95%CI: 54.6–61.1) used mosquito bed nets. However, 16.7% did not use bed nets among those owning a bed net. On one hand, older age (AOR = 1.59, 95%CI: 1.04–2.44), primary education (AOR = 1.18, 95%CI: 1.07–2.23), being married (AOR = 2.17, 95%CI: 1.43–3.20), being from Kigali region (AOR = 1.97, 95%CI: 1.19–3.91), husband’s education (AOR = 1.22, 95%CI: 1.13–3.41), having recently visited a health facility (AOR = 2.07, 95%CI: 1.35–3.18), and being in the third pregnancy trimester (AOR = 2.14, 95%CI: 1.44–3.18) were positively associated with mosquito bed net use. On the other hand, low wealth index (AOR = 0.13, 95%CI: 0.07–0.24), and being from Eastern region (AOR = 0.42, 95% CI: 0.26–0.66) had a negative association.
Conclusions
Mosquito bed net use was just above average and associated with various socio-demographics. There is a need for equal efforts in malaria prevention programs to address the regional imbalance in bed net use. Early antenatal care attendance, male engagement and continuous education on malaria prevention and mosquito net use, as well as consideration of household dynamics, are also crucial in improving not only mosquito net coverage, but also utilisation.
A practice method for the retrieval of tulip-head polyaxial pedicle screw by reusing the rod in revision and implants removal surgery: introduction of technique and evaluation of clinical outcomes
Authors: Zhang Yao , Song Jipeng , Lu Yuzheng , Yi Meng , Xu Xiaohang , Ding Lixiang 
Published: November 2022

Abstract
Background
The removal of spinal implants was needed in revision surgery or in some cases whose fracture had healed or fusion had occured. The slip of polyaxial screw or mismatch of instruments would make this simple procedure intractable. Here we introduced a simple and practical method to address this clinical dilemma.
Methods
This is a retrospective study. The patients underwent new technique for retrieving the implants from July 2019 to July 2022 were labeled as group A, while the patients January 2017 to January 2020 were labeled as group B. Patients in each group were subdivided into revision surgery group and simple implants removal group according to the surgery fashion. In the new technique, the retrieved rod was cut off to a proper length which was matched with the size of tulip head, and was replaced into the tulip head. After tightened with nut, a monoaxial screw-rod “construct” was formed. Finally, a counter torque was applied to remove the “construct”. The operation duration, intraoperative blood loss, post-operative bacteria culture, hospital stay and costs were documented and analyzed.
Results
A total of 116 polyaxial screws with difficult removal of 78 patients (43 screws in group A, 73 screws in group B) were successfully retrieved by using this method. Significant differences were found in the mean operation duration, intraoperative blood loss when comparing the r group in group A and B, as well as the s group in group A and B (P < 0.05). There were no significant differences in hospital stay and costs between group A and B. Three patients were found positive bacteria culture of drainage tube/tape in group A (3/30), while 7 patients in group B (7/48). The most prevalent bacteria was Propionibacterium acnes.
Conclusion
This technique is practical and safe in for the poly-axial screw with difficult retrieval. Reduced operation duration and intraoperative bloods loss may potentially alleviate the hospitalization burden of patients. Positive cultivation results are common after implants removal surgery, but they rarely represent an organized infection. A positive culture with P. acnes or S. epidermidis should be interpreted with caution.
Relative enrichment of oral bacteria in feces indicates loss of intestinal commensals with implications for host health
Authors: Liao Chen , Rolling Thierry , Djukovic Ana , Liu Hongbin , Dai Lei , Zhai Bing , Peled Jonathan , Brink Marcel van den , Hohl Tobias , Xavier Joao 
Published: November 2022

Abstract

High relative abundance of oral bacteria in the gut is considered abnormal and has been linked to intestinal disorders. However, this reported association has two alternate explanations: ectopic oral bacteria may increase in absolute numbers in the intestine and drive disease (the driver hypothesis) or, instead, intestinal commensals may decrease in absolute numbers and the relative rise in oral bacteria is simply an indicator of this loss (the marker hypothesis). Here we use experiments in mice and clinical data from patients to provide evidence in favor of the marker hypothesis. We demonstrate that depletion of intestinal bacteria by antibiotics increases the relative abundance of oral bacteria in the host feces without increasing their absolute abundance, and the relative enrichment can indicate host health parameters such as stool consistency, pathogen overgrowth, and immunity. Our results reframe the conventional interpretation of microbiome sequencing data with implications for intestinal disorders and microbiome therapies.