bluuebunny/crossref_metadata_2025_split huggingface dataset:
The performance of using dried blood spot specimens for HIV-1 viral load testing: A systematic review and meta-analysis
Authors: Vojnov Lara , Carmona Sergio , Zeh Clement , Markby Jessica , Boeras Debrah , Prescott Marta R. , Mayne Anthony L. H. , Sawadogo Souleymane , Adje-Toure Christiane , Zhang Guoqing , Perez Gonzalez Mercedes , Stevens Wendy S. , Doherty Meg , Yang Chunfu , Alexander Heather , Peter Trevor F. , Nkengasong John ,   the DBS for VL Diagnostics Investigation Consortium
Published: August 2022

Background
Accurate routine HIV viral load testing is essential for assessing the efficacy of antiretroviral treatment (ART) regimens and the emergence of drug resistance. While the use of plasma specimens is the standard for viral load testing, its use is restricted by the limited ambient temperature stability of viral load biomarkers in whole blood and plasma during storage and transportation and the limited cold chain available between many health care facilities in resource-limited settings. Alternative specimen types and technologies, such as dried blood spots, may address these issues and increase access to viral load testing; however, their technical performance is unclear. To address this, we conducted a meta-analysis comparing viral load results from paired dried blood spot and plasma specimens analyzed with commonly used viral load testing technologies.

Methods and findings
Standard databases, conferences, and gray literature were searched in 2013 and 2018. Nearly all studies identified (60) were conducted between 2007 and 2018. Data from 40 of the 60 studies were included in the meta-analysis, which accounted for a total of 10,871 paired dried blood spot:plasma data points. We used random effects models to determine the bias, accuracy, precision, and misclassification for each viral load technology and to account for between-study variation. Dried blood spot specimens produced consistently higher mean viral loads across all technologies when compared to plasma specimens. However, when used to identify treatment failure, each technology compared best to plasma at a threshold of 1,000 copies/ml, the present World Health Organization recommended treatment failure threshold. Some heterogeneity existed between technologies; however, 5 technologies had a sensitivity greater than 95%. Furthermore, 5 technologies had a specificity greater than 85% yet 2 technologies had a specificity less than 60% using a treatment failure threshold of 1,000 copies/ml. The study’s main limitation was the direct applicability of findings as nearly all studies to date used dried blood spot samples prepared in laboratories using precision pipetting that resulted in consistent input volumes.

Conclusions
This analysis provides evidence to support the implementation and scale-up of dried blood spot specimens for viral load testing using the same 1,000 copies/ml treatment failure threshold as used with plasma specimens. This may support improved access to viral load testing in resource-limited settings lacking the required infrastructure and cold chain storage for testing with plasma specimens.
Composite carotid intima-media thickness as a risk predictor of coronary heart disease in a selected population in Sri Lanka
Authors: Abeysuriya Visula , Wijesinha Nirmala A. I. , Priyadharshan Prakash P. , Chandrasena Lal G. , Wickremasinghe Ananda Rajitha 
Published: August 2022

Background
Segment-specific variations of carotid intima-media thickness (CIMT) have not been assessed in South Asian populations. The purpose of this study was to determine if segment-specific CIMTs or a composite-CIMT score is a better risk predictor of coronary heart disease in South Asian populations.

Methods
A comparative prospective study was conducted from November 2019 to October 2020 in a hospital in Colombo, Sri Lanka. Based on pre-defined inclusion and exclusion criteria, cases (having a diagnosis of Coronary Heart Disease (CHD), n = 338) and controls (non-CHD group, n = 356) were recruited. Ultrasound examination of the common carotid (CCA), the carotid bulb (CB) and the internal carotid segments (ICA) of the carotid vessels was conducted by a radiologist, and CIMTs were measured. A composite-CIMT score defined as the average value of all six segments of the left and right sides was derived.

Results
694 participants were enrolled (male n = 399, 57.5%). The mean (±SD) age of the study sample was 60.2 (±9.86) years. There were variations in segment-specific values between the left and right vessels. The mean composite-CIMT value of the CHD group was significantly higher than that of the non-CHD group. A composite-CIMT score of 0.758 had a sensitivity of 98.4% and a specificity of 64.6% in distinguishing CHD from non-CHD groups (Area under the curve (AUC): 0.926).

Conclusions
Carotid artery segment-specific CIMT variations were present in this population. The composite CIMT score is better than segment-specific CIMTs in predicting CHD and may be used to predict CHD in this population.
Depressive symptoms and socioeconomic status among the labor force: Evidence from China’s representative sample
Authors: Zhang Guoying , Cai Chang , Zou Wenxin , Jing Lu , Wu Shaolong 
Published: August 2022

Objectives
The purpose of this paper is to describe the prevalence of depressive symptoms in the Chinese labor force; to explore the relationship between depressive symptoms and socioeconomic status among the Chinese labor force, including both the structural determinants and the intermediary determinants of health inequities; and to identify vulnerable populations who would benefit from intervention measures.

Methods
Data were from the China Labor-Force Dynamics Survey (CLDS) 2016. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to assess depressive symptoms. The World Health Organization’s theoretical framework of the social determinants of health was adopted to analyze the relationship between social determinants and depressive symptoms.

Results
Of the participants in the research from the Chinese labor force, 17.34% were identified as having depressive symptoms. Depression was significantly related to socioeconomic factors such as hukou status (p < 0.05 in the age < 45 model), education (p < 0.01 in all five models), employment (p < 0.05 in the male model), income (p < 0.05 in all five models), and self-assessed social class position (p < 0.01 in all five models). Intermediary factors were also related to depressive symptoms, such as gender (p < 0.001 in the overall model), age (p < 0.05 in the overall model), marriage (p < 0.05 in the female model), occupational exposure (p < 0.01 in the overall model), exercise (p < 0.05 in all five models), and health insurance (p < 0.05 in the overall model). The results showed that low socioeconomic status was associated with an increased risk of depression and there were some gradient changes in the distribution of depressive symptoms in socioeconomic status.

Conclusions
The findings showed that depression symptoms are significantly related to structural determinants and intermediary determinants in China’s labor force. There are some gradient changes in the distribution of depressive symptoms among people of different socioeconomic status. Low socioeconomic status is associated with increased risk of depression. Women, older people, and single and divorced people are the relative vulnerable groups in China’s labor force.
Relationship between liver dysfunction, lipoprotein concentration and mortality during sepsis
Authors: Tanaka Sébastien , De Tymowski Christian , Stern Jules , Bouzid Donia , Zappella Nathalie , Snauwaert Aurélie , Robert Tiphaine , Lortat-jacob Brice , Tran-dinh Alexy , Augustin Pascal , Boutten Anne , Tashk Parvine , Peoc’h Katell , Meilhac Olivier , Montravers Philippe 
Published: August 2022

Background
High-density lipoproteins (HDLs) are synthesized by the liver and display endothelioprotective properties, including anti-inflammatory, antiapoptotic, antithrombotic and antioxidant effects. In both septic and chronic liver failure patients, a low HDL cholesterol (HDL-C) concentration is associated with overmortality. Whereas sepsis-associated liver dysfunction is poorly defined, the aim of this study was to characterize the relationship between liver dysfunction, lipoprotein concentrations and mortality in septic patients in the intensive care unit (ICU).

Methods
A prospective observational study was conducted in a university hospital ICU. All consecutive patients admitted for septic shock or sepsis were included. Total cholesterol, HDL-C, low-density lipoprotein-cholesterol (LDL-C), and triglyceride levels were assessed at admission. Sepsis-associated liver dysfunction was defined as a serum bilirubin≥ 2N or aspartate aminotransferase/alanine aminotransferase concentrations ≥ 2N. Short-term and one-year prognostic outcomes were prospectively assessed.

Results
A total of 219 septic patients were included, and 15% of them presented with sepsis-associated liver dysfunction at admission. Low concentrations of lipoproteins were associated with mortality at Day 28 in the overall population. Sepsis-associated liver dysfunction at admission was associated with overmortality. In this subgroup, patients had a lower HDL-C concentration than patients without hepatic dysfunction (HDL-C = 0.31 [0.25, 0.55] mmol/L vs. 0.48 [0.29, 0.73] mmol/L, p = 0.0079) but there was no relationship with the outcome. Interestingly, no correlation was observed between lipoprotein concentrations and liver dysfunction markers.

Conclusion
Sepsis-associated liver dysfunction at ICU admission is strongly associated with overmortality and is associated with a lower HDL-C concentration. However, in this subgroup of patients, HDL-C concentration had no relationship with mortality. Further exploratory studies are needed to better understand the interaction between lipoproteins and liver dysfunction during sepsis.
The epidemiology of diphtheria in Haiti, December 2014–June 2021: A spatial modeling analysis
Authors: Ikejezie Juniorcaius , Langley Tessa , Lewis Sarah , Bisanzio Donal , Phalkey Revati 
Published: August 2022

Background
Haiti has been experiencing a resurgence of diphtheria since December 2014. Little is known about the factors contributing to the spread and persistence of the disease in the country. Geographic information systems (GIS) and spatial analysis were used to characterize the epidemiology of diphtheria in Haiti between December 2014 and June 2021.

Methods
Data for the study were collected from official and open-source databases. Choropleth maps were developed to understand spatial trends of diphtheria incidence in Haiti at the commune level, the third administrative division of the country. Spatial autocorrelation was assessed using the global Moran’s I. Local indicators of spatial association (LISA) were employed to detect areas with spatial dependence. Ordinary least squares (OLS) and geographically weighted regression (GWR) models were built to identify factors associated with diphtheria incidence. The performance and fit of the models were compared using the adjusted r-squared (R2) and the corrected Akaike information criterion (AICc).

Results
From December 2014 to June 2021, the average annual incidence of confirmed diphtheria was 0.39 cases per 100,000 (range of annual incidence = 0.04–0.74 per 100,000). During the study period, diphtheria incidence presented weak but significant spatial autocorrelation (I = 0.18, p<0.001). Although diphtheria cases occurred throughout Haiti, nine communes were classified as disease hotspots. In the regression analyses, diphtheria incidence was positively associated with health facility density (number of facilities per 100,000 population) and degree of urbanization (proportion of urban population). Incidence was negatively associated with female literacy. The GWR model considerably improved model performance and fit compared to the OLS model, as indicated by the higher adjusted R2 value (0.28 v 0.15) and lower AICc score (261.97 v 267.13).

Conclusion
This study demonstrates that GIS and spatial analysis can support the investigation of epidemiological patterns. Furthermore, it shows that diphtheria incidence exhibited spatial variability in Haiti. The disease hotspots and potential risk factors identified in this analysis could provide a basis for future public health interventions aimed at preventing and controlling diphtheria transmission.
A bidirectional Mendelian randomization study supports the causal effects of a high basal metabolic rate on colorectal cancer risk
Authors: Wu E. , Ni Juntao , Tao Lin , Xie Tian 
Published: August 2022

PurposeWe conducted a bidirectional two-sample Mendelian randomization (MR) study to determine whether genetically predicted basal metabolic rate (BMR) was a causal risk factor for colorectal cancer (CRC) or whether a genetically predicted CRC risk can influence the BMR level (i.e., reverse causation).MethodsWe employed 1,040 genetic variants as proxies for BMR to obtain effect estimates on CRC risk. Another 58 CRC-associated variants were used to estimate effects on BMR levels. Stratified analysis by tumor site was used to examine the causal associations between BMR and colon/rectal cancer risk.ResultsThe inverse variance weighted (IVW) method indicated a significant causal effect of genetically determined BMR on CRC risk (ORSD= 1.27, 95% CI = 1.07–1.51). No significant reverse causal association was identified between genetically increased CRC risk and BMR levels [IVW (β= 0, 95% CI = -0.01 to 0)]. The results of MR-Egger and the weighted median method were consistent with the IVW method. Stratified analysis by CRC sites identified significant causal associations between BMR and colon cancer [IVW (ORSD= 1.45, 95% CI = 1.16-1-80)], and null evidence of a causal association between BMR and rectal cancer risk was found (p> 0.05).ConclusionOur findings add to the current literature by validating a positive relationship between high BMR levels and CRC risk instead of reverse causality. The genetically predicted BMR level was causally associated with colon cancer risk but not rectal cancer risk.
“I feel like I’m in a revolving door, and COVID has made it spin a lot faster”: The impact of the COVID-19 pandemic on youth experiencing homelessness in Toronto, Canada
Authors: Noble Amanda , Owens Benjamin , Thulien Naomi , Suleiman Amanda 
Published: August 2022

Purpose
Research has shown that youth experiencing homelessness (YEH) face barriers to social inclusion and are at risk for poor mental health. With the COVID-19 pandemic threatening the health, wellbeing, and economic circumstances of people around the world, this study aims to assess the impacts of the pandemic on YEH in Toronto, Ontario, as well as to identify recommendations for future waves of COVID-19.

Methods
Semi-structured interviews were conducted with YEH (ages 16–24, n = 45) and staff who work in one of four downtown emergency shelters for youth (n = 31) in Toronto, Ontario.

Results
YEH experienced both structural changes and psychosocial impacts resulting from the pandemic. Structural changes included a reduction in services, barriers to employment and housing, and changes to routines. Psychosocial outcomes included isolation, worsened mental health, and increased substance use. Impacts were magnified and distinct for subpopulations of youth, including for youth that identified as Black, 2SLGBTQ+, or those new to Canada.

Conclusions
The COVID-19 pandemic increased distress among YEH while also limiting access to services. There is therefore a need to balance health and safety with continued access to in-person services, and to shift the response to youth homelessness to focus on prevention, housing, and equitable supports for subpopulations of youth.
Voluntary Green Commitment and Optimal Privatization Policy in a Mixed Eco-Industry
Authors: Park Chul-Hi , Lee Sang-Ho , Nakamura Tamotsu 
Published: August 2022

Abstract
This study investigates the impact of target emissions from polluting firms on the production of green technology and the optimal policy decisions of privatization on the eco-industry under their voluntary commitments. For this, we formulate a vertical structure consisting of a downstream polluting industry and an upstream mixed eco-industry where private and public eco-firms produce emission abatement goods. The results show a U-shaped non-monotone relationship between environmental damage and the optimal degree of privatization, that is, welfare-maximizing public ownership is full nationalization or full or partial privatization, depending on the environmental damage. It supports that the government should have large ownership of partially privatized eco-firms for environmental protection, especially when environmental damage is serious.
A structured approach to EHR surveillance of diagnostic error in acute care: an exploratory analysis of two institutionally-defined case cohorts
Authors: Malik Maria A. , Motta-Calderon Daniel , Piniella Nicholas , Garber Alison , Konieczny Kaitlyn , Lam Alyssa , Plombon Savanna , Carr Kevin , Yoon Catherine , Griffin Jacqueline , Lipsitz Stuart , Schnipper Jeffrey L. , Bates David W. , Dalal Anuj K. 
Published: August 2022

Abstract

Objectives
To test a structured electronic health record (EHR) case review process to identify diagnostic errors (DE) and diagnostic process failures (DPFs) in acute care.

Methods
We adapted validated tools (Safer Dx, Diagnostic Error Evaluation Research [DEER] Taxonomy) to assess the diagnostic process during the hospital encounter and categorized 13 postulated e-triggers. We created two test cohorts of all preventable cases (n=28) and an equal number of randomly sampled non-preventable cases (n=28) from 365 adult general medicine patients who expired and underwent our institution’s mortality case review process. After excluding patients with a length of stay of more than one month, each case was reviewed by two blinded clinicians trained in our process and by an expert panel. Inter-rater reliability was assessed. We compared the frequency of DE contributing to death in both cohorts, as well as mean DPFs and e-triggers for DE positive and negative cases within each cohort.

Results
Twenty-seven (96.4%) preventable and 24 (85.7%) non-preventable cases underwent our review process. Inter-rater reliability was moderate between individual reviewers (Cohen’s kappa 0.41) and substantial with the expert panel (Cohen’s kappa 0.74). The frequency of DE contributing to death was significantly higher for the preventable compared to the non-preventable cohort (56% vs. 17%, OR 6.25 [1.68, 23.27], p<0.01). Mean DPFs and e-triggers were significantly and non-significantly higher for DE positive compared to DE negative cases in each cohort, respectively.

Conclusions
We observed substantial agreement among final consensus and expert panel reviews using our structured EHR case review process. DEs contributing to death associated with DPFs were identified in institutionally designated preventable and non-preventable cases. While e-triggers may be useful for discriminating DE positive from DE negative cases, larger studies are required for validation. Our approach has potential to augment institutional mortality case review processes with respect to DE surveillance.
Making Sense of Landscape: A New Study of Sound Propagation between Tarquinian Funerary and Habitation Settings
Authors: Ortoleva Jacqueline 
Published: August 2022

AbstractThe study of pre-Roman landscape settings has progressed across a long trajectory in its consideration of urban and rural adaptations in Etruria. Such studies, while providing valuable details regarding social organization, have not considered the unique aural nature of the landscape, particularly with respect to funerary settings. Nowhere is this more evident than with painted chambered tombs. Our understanding of Etruscan painted tombs is still largely guided by analytic studies of tomb paintings, epigraphic sources, and typologies. Thus, the bilateral relationship between each tomb’s landscape setting and habitation contexts has been explored from a solely visual perspective, rather than from a multisensory perspective, and consequently, ritual performed in and around the tomb space remains unclear. A further understanding of perceptual constructs involving aural information offers a new way forward in confronting these realities. This article utilizes acoustic modeling tools to illustrate the potential range of audibility between the Necropoli dei Monterozzi in Tarquinia and various locations in the landscape. Acoustic and spatial data collected in 2019 inside a series of painted tombs in the Calvario area of the Necropoli dei Monterozzi in Tarquinia provides further information regarding the painted tomb’s landscape setting and its environs. The preliminary study suggests that aural information can greatly enhance our understanding of funerary practices in Tarquinia, particularly with respect to how habitation areas in Tarquinia may have engaged with funerary landscapes.
Application of embedded Linux in the design of Internet of Things gateway
Authors: Wang Tao , Wang Li , Yan Pengfei , Popli Renu , Rani Poonam , Kumar Rajeev 
Published: August 2022

AbstractTo study the development trend of embedded platforms in home appliances Internet of Things (IoT), an application of embedded Linux in the design of IoT gateway is designed. ARM microprocessor S3C2410, EM310 radio frequency (RF) module, and Ethernet DM9000A module are used to realize the home network information-processing platform. The platform utilizes existing network facilities, RF modules, and network interface modules to realize the interconnection of the home perception network through wireless or wired links. For experimental analysis, Ping the central server (gateway) from the IoT node B is set to twice: The first time ttl = 255 time = 1.9 ms, the second time: ttl = 255 time = 2.4 ms. After application verification, the system has the characteristics of low cost, small size, low power consumption, and vital ease of use. It can not only integrate the home Internet and the IoT gateway but also directly run application-layer communication protocols such as HTTP/MQTT between IoT nodes and Internet terminals. The design supports multi-hop communication and significantly increases the deployment range of IoT nodes without signal relay equipment, hence reducing the cost of IoT networking and the complexity of the network architecture.
The Question of Transcendence and Constraint in a Panartifactual Account of Being, Knowing and Making
Authors: Baç Murat , Temizler Büke 
Published: August 2022

Abstract
Barry Allen defends a highly unorthodox and compact account of humans and their evolutionary adventure, which comprises inter alia epistemological, alethic, technological, and artistic aspects. His anthropocentric view distinguishes itself from traditional forms of realism and anti-realism by virtue of its dynamic and non-reductionist character. Allen adopts a certain perspective of techno-artistic and onto-epistemic construction, which we dub “panartifactualism,” claiming principally that nothing at all escapes the artifactualizing power of human beings. We maintain that, under closer scrutiny, various dimensions of Allen’s account conflict and that his philosophical approach to “being” and “making” ultimately gives rise to a rather problematic ontological picture. Having pointed out its shortcomings and untenable results, we spell out the conceptual contours of a contemporary and far more attractive version of realism which suffers neither from the issues faced by views like panartifactualism nor from the obvious difficulties of noumenalist realism justifiably opposed by Allen.