bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sustainable thresholds, health outcomes, health expenditures and education nexus in selected African countries: quadratic and moderation modelling
Authors: Adegoke Yetunde Oluranti , George Gavin , Mbonigaba Josue 
Published: October 2022

Abstract
Background
This study aligns with Sustainable Development Goal 3 which borders on “good health and well-being for people by ensuring healthy lives and promoting well-being for all at all ages”. It contributes to the health literature by evaluating the roles of health expenditures and educational quality on three health outcomes (infant mortality, maternal mortality and life expectancy at birth).

Methods
The study uses the panel spatial correlation consistent (PSCC) approach on balanced panel data on 25 selected sub-Saharan African countries from 2000 to 2020 to interrogate the nexus.

Results
The following findings are documented. First, health expenditures reveal significant asymmetric quadratic effects on health outcomes. Second, the interactions between health expenditures and educational quality reduce infant and maternal mortalities while enhancing life expectancy. Third, the threshold points from the interaction effects indicate that enhancing educational quality beyond some critical thresholds of 1.51 and 1.49 can induce a drop in maternal and child mortalities while a point beyond 1.84 exerts an improvement in life expectancy.

Conclusions
Hence, policy makers should ensure that both health expenditures and educational quality exceed the established thresholds for sustainable health outcomes.
SPECT/CT imaging features of cystic degeneration of the talus and their relation to pathological findings
Authors: Song Qitao , Zeng Xiantie , Huang Haijing , Long Lei , Xu Jin , Cui Shuangshuang , Li Zhonghai , Ma Xinlong 
Published: October 2022

Abstract
Background
Osteochondral lesions of the talus (OLTs) are a common orthopedic condition. The image presentation is very similar to that of ischemic necrosis of the talus complicated by a talar neck fracture, but the two are very different lesions. When abnormalities in bone density (or signal) of the talar body (apex of the fornix) with concomitant bone defects and cystic changes are found on X-ray, computed tomography (CT), or magnetic resonance imaging, it is important to accurately determine the nature of the lesion and make a correct diagnosis for the treatment and prognosis of the patient. The purpose of this study was to explore the imaging features of three-phase single-photon emission computed tomography (SPECT)/CT images of cystic lesions of the talus.

Methods
A total of 189 patients with chronic pain in the ankle joint suspected to be caused by cystic degeneration of the talus were enrolled. All patients underwent 99mTc-methyl diphosphonate (99mTc-MDP) three-phase SPECT/CT bone imaging and delayed scans in our hospital. The location, range of involvement, classification, CT value, and radioactivity uptake of the sclerotic areas of cystic lesions on the talus, and the continuity of the articular surface, were recorded. All recorded parameters were analyzed in comparison with pathological results.

Results
Eighty-three percent (157/189) of the talar cysts were located on the medial fornix, largely involving the anterior middle part (43.27%), with larger cysts involving the posterior part (9.6%). Sixty-three percent (119/189) of the patients had type I lesions and 37% (70/189) had type II lesions. The articular surface of the medial dome of the talus was intact in all patients, but the subchondral bony articular surface was rough in 88% (166/189) of patients. The coincidence rate for the location, type, and range of involvement of cystic lesions with the pathological results was 87.83% (166/189). The mean CT value of the cystic lesions was 45 ± 15 HU (30–60 HU). The percentages of pathological chondrogenesis in high CT value ≥ 50 HU (19/70) and low CT value < 50 HU (51/70) groups were 89.47% (17/19) and 29.14% (15/51) (χ2 = 20.12, p < 0.001), respectively. The target/background ratio (T/B ratio) of the radioactivity-uptake area of the talus vault was 2.0 ± 0.5 (1.5–2.5). The percentages of pathological new trabecular bone in those with a T/B ratio ≥ 2.0 (157/189) and T/B ratio < 2.0 (32/189) were 82.80% (130/157) and 25.00% (8/32; χ2 = 45.08, p < 0.001), respectively.

Conclusions
Three-phase bone imaging could identify damage of the talus caused by cystic degeneration, while delayed SPECT/CT images showed advantages for displaying bone microstructure, blood supplement, and bone metabolism when examining the location, range of involvement, classification, and repair of cystic lesions of the talus.
Metabolic recycling of storage lipids promotes squalene biosynthesis in yeast
Authors: Son So-Hee , Kim Jae-Eung , Moon Soo Young , Jang In-Seung , Yu Byung Jo , Lee Ju Young 
Published: October 2022

Abstract
Background
Metabolic rewiring in microbes is an economical and sustainable strategy for synthesizing valuable natural terpenes. Terpenes are the largest class of nature-derived specialized metabolites, and many have valuable pharmaceutical or biological activity. Squalene, a medicinal terpene, is used as a vaccine adjuvant to improve the efficacy of vaccines, including pandemic coronavirus disease 2019 (COVID-19) vaccines, and plays diverse biological roles as an antioxidant and anticancer agent. However, metabolic rewiring interferes with inherent metabolic pathways, often in a way that impairs the cellular growth and fitness of the microbial host. In particular, as the key starting molecule for producing various compounds including squalene, acetyl-CoA is involved in numerous biological processes with tight regulation to maintain metabolic homeostasis, which limits redirection of metabolic fluxes toward desired products.

Results
In this study, focusing on the recycling of surplus metabolic energy stored in lipid droplets, we show that the metabolic recycling of the surplus energy to acetyl-CoA can increase squalene production in yeast, concomitant with minimizing the metabolic interferences in inherent pathways. Moreover, by integrating multiple copies of the rate-limiting enzyme and implementing N-degron-dependent protein degradation to downregulate the competing pathway, we systematically rewired the metabolic flux toward squalene, enabling remarkable squalene production (1024.88 mg/L in a shake flask). Ultimately, further optimization of the fed-batch fermentation process enabled remarkable squalene production of 6.53 g/L.

Conclusions
Our demonstration of squalene production via engineered yeast suggests that plant- or animal-based supplies of medicinal squalene can potentially be complemented or replaced by industrial fermentation. This approach will also provide a universal strategy for the more stable and sustainable production of high-value terpenes.
Correlation between insulin-based and C-peptide based homeostatic model assessment of insulin resistance in adults without diabetes in a sub-Saharan African setting: a cross-sectional study
Authors: Tekoh Blessing N. , Mbono-Samba Esther Astrid E. , Etoa-Etoga Martine Claude , Eko Manuela Audrey , Amazia Falmata , Agoons Batakeh Ba , Nansseu Jobert Richie , Bigna Jean Joel , Ama-Moor Vicky Jocelyne 
Published: October 2022

Abstract
Objective
To assess the correlation between the insulin-based and C-peptide based HOMA-IR in the general population without diabetes in sub-Saharan Africa as well as to identify factors associated with IR.

Results
This was a cross-sectional study in urban settings in Yaoundé, Cameroon. We included 84 people with a body mass index (BMI) ≥ 18.5 Kg/m² and without diabetes (females: 72.6%; mean age: 37 years). IR was assessed using the following formulae: HOMA-IRINS = fasting insulin (mU/ml) x fasting plasma glucose (FPG) (mmol/L)/ 22.5; HOMA-IRCP1 = fasting C-peptide (mU/ml) x FPG (mmol/L)/ 22.5; and HOMA-IRCP2 = 1.5 + (FPG (mg/dl) x fasting C-peptide (ng/ml))/ 2800. Correlation (rho) between HOMA-IRINS and C-peptide based HOMA-IR was investigated using the Spearman rank test. The median (25th -75th percentiles) HOMA-IRINS, HOMA-IRCP1, and HOMA-IRCP2 were: 1.94 (1.36–3.50), 0.18 (0.11–0.27) and 9.91 (6.81–14.52), respectively. There was no correlation between the insulin-based and C-peptide-based HOMA-IR indices: rho = 0.043, p = 0.697. IR (HOMA-IRINS ≥ 2.8) was associated with obesity: A BMI ≥ 30 Kg/m² (adjusted odds ratio (aOR): 16.9, 95% confidence intervals (CI): 3.1–92.5) and being a student (aOR: 8.9, 95%CI: 2.1–38.2) were associated with IR.
DAR-PCR: a new tool for efficient retrieval of unknown flanking genomic DNA
Authors: Sun Tianyi , Jia Mengya , Wang Lingqin , Li Zhaoqin , Lin Zhiyu , Wei Cheng , Pei Jinfeng , Li Haixing 
Published: October 2022

AbstractVarious PCR-based genome-walking methods have been developed to acquire unknown flanking DNA sequences. However, the specificity and efficacy levels, and the operational processes, of the available methods are unsatisfactory. This work proposes a novel walking approach, termed differential annealing-mediated racket PCR (DAR-PCR). The key to DAR-PCR is the use of primer-mediated intra-strand annealing (ISA). An ISA primer consists of a 5’ root homologous to the known sequence and a heterologous 3’ bud. In the single low-stringency cycle, the ISA primer anneals to a site on an unknown region and extends towards the sequence-specific primer (SSP) 1 site, thereby forming a target single-stranded DNA bound by the SSP1 complement and the ISA primer. In the subsequent more stringent cycles, its complementary strand is accumulated, owing to the differential annealing between the moderate-stringency ISA primer and the high-stringency SSP1. The accumulation of this strand provides an opportunity for ISA mediated by the ISA primer root. A loop-back extension subsequent to ISA occurs, creating a racket-like DNA with the known region positioned at both ends of the unknown sequence. This DNA is exponentially amplified during the secondary PCR driven by an SSP pair inner to SSP1. DAR-PCR was validated as an efficient walking method by determining unknown flanking sequences in Lactobacillus brevis and Oryza sativa.
An enhanced encryption-based security framework in the CPS Cloud
Authors: Priyadarshini R. , Quadir Md Abdul , Rajendran N. , Neelanarayanan V. , Sabireen H. 
Published: October 2022

AbstractThe rapid advancement of computation techniques and cloud computing has led to substantial advancements in Cyber-Physical Systems (CPS), particularly in the field of health care. There are a variety of ways in which CPS is used in healthcare today, including delivering intelligent feedback systems, automatically updating patient data digitally, monitoring patients passively with biosensors, etc. In recent years, cyber-physical systems have become capable of making lifesaving decisions as they are becoming more connected to the cloud. However, healthcare has become one of the most critical issues for many. A CPS network uses the Internet of Medical Things (IoMT) to continuously monitor patients’ health metrics such as body temperature, heart rate, etc. Due to physical connectivity restrictions, networks are more susceptible to security threats. In spite of the fact that the data is stored in the cloud, it is necessary to provide security regardless of device security and network security. Several cyber-security vulnerabilities have been identified in cloud-based healthcare systems in particular. To give patients a reliable healthcare experience, security concerns with CPSs need to be addressed carefully. In this context, this paper proposes a Cross-Breed Blowfish and MD5 (CBM) approach to improve the security of health data in the CPS cloud. The proposed model uses the wireless sensor network, in which data acquired by the network is transmitted via the transmitting node. Using the fuzzified effective trust-based routing protocol (FET-RP), the most efficient path for data travel is selected. The best route is determined using Butter-Ant Optimization (BAO) algorithm. The proposed method conveys data throughput encryption and decryption in a decoded format. The encrypted data is then stored in the cloud database for security reasons. The route finding algorithm is the one which is sending the data from one end to other end. The data is encrypted based on the source and destination. We compare the performance metrics of our recommended technique to those of other existing techniques, such as RSA, Two fish, ICC, and FHEA, in order to ensure that it performs optimally. The values of Cross Breed Blowfish and MD5 and FET-RP with regard to the performance metrics in terms of encryption (60 ms), decryption (55 ms), latency (60 s), throughput (97 mbps), security level (98%), and execution time (57 ms) which outperforms the conventional methods by 10–15%. Also the proposed encryption shows the considerable improvement in the level of security making our model a real world solution.
Managing type 2 diabetes or prediabetes and binge eating disorder: a qualitative study of patients’ perceptions and lived experiences
Authors: Salvia Meg G. , Ritholz Marilyn D. , Craigen Katherine L.E. , Quatromoni Paula A. 
Published: October 2022

Abstract
Background
The overlap in prevalence between type 2 diabetes and binge eating disorder is substantial, with adverse physical and mental health consequences. Little is known about patients’ efforts at managing these two conditions simultaneously. The research objective was to explore patients’ experiences managing co-existing type 2 diabetes or prediabetes and binge eating disorder.

Methods
This is a qualitative descriptive study using semi-structured interviews. Participants included 21 women with type 2 diabetes or prediabetes (90% non-Hispanic White; mean age 49 ± 14.8 years, mean BMI 43.8 ± 8.4; 48% with type 2 diabetes and mean HbA1c was 8.4%). Interviews were analyzed using thematic analysis and NVivo software.

Results
Qualitative analysis revealed that participants reported binge episodes frequently started in childhood or adolescence and went undiagnosed for decades; notably, they recalled that diabetes diagnosis preceded the binge eating disorder diagnosis. They also described trying to lose weight throughout their lives and how feelings of deprivation, shame, and failure exacerbated binge eating. Participants further reported how binge eating made diabetes self-care and outcomes worse. Finally, participants observed that when binge eating disorder treatment and diabetes management were synergistically integrated, they experienced improvements in both binge eating and glycemic outcomes. This integration included reframing negative thoughts surrounding binge eating disorder and diabetes self-management and increasing their understanding of how the two disorders were inter-related.

Conclusion
Findings highlight the importance of increasing healthcare providers’ awareness of and screening for binge eating disorder in the treatment of diabetes and inform specific integrated interventions that address both diagnoses.

Plain ENGLISH summary
From this study where we interviewed 21 women with binge eating disorder (BED) and type 2 diabetes/prediabetes, we learned how binge eating impacted diabetes management and how diabetes impacted BED. Most participants reported receiving the diabetes diagnosis before being diagnosed with BED despite the earlier onset of binge eating, pointing to the need for BED screening. Participants described trying to lose weight throughout their lives and reported feelings of failure and shame, which made binge eating worse. Binge eating made diabetes management harder, but when diabetes and BED treatment were aligned, participants experienced improvements in binge symptoms and diabetes outcomes.
The Maximal Intensity Period: Rationalising its Use in Team Sports Practice
Authors: Weaving Dan , Young Damien , Riboli Andrea , Jones Ben , Coratella Giuseppe 
Published: October 2022

AbstractQuantifying the highest intensity of competition (the maximal intensity period [MIP]) for varying durations in team sports has been used to identify training targets to inform the preparation of players. However, its usefulness has recently been questioned since it may still underestimate the training intensity required to produce specific physiological adaptations. Within this conceptual review, we aimed to: (i) describe the methods used to determine the MIP; (ii) compare the data obtained using MIP or whole-match analysis, considering the influence of different contextual factors; (iii) rationalise the use of the MIP in team sports practice and (iv) provide limitations and future directions in the area. Different methods are used to determine the MIP, with MIP values far greater than those derived from averaging across the whole match, although they could be affected by contextual factors that should be considered in practice. Additionally, while the MIP might be utilised during sport-specific drills, it is inappropriate to inform the intensity of interval-based, repeated sprint and linear speed training modes. Lastly, MIP does not consider any variable of internal load, a major limitation when informing training practice. In conclusion, practitioners should be aware of the potential use or misuse of the MIP.
Vertical distribution of microplastics in the sediment profiles of the Lake Taihu, eastern China
Authors: Huang Yinan , Fan Jiajia , Liu Huan , Lu Xiancai 
Published: October 2022

AbstractMicroplastics are ubiquitous in the freshwater environment, while its abundance in the sediment profiles has received little attention. The vertical microplastic distribution in the sediment of the North (NTH) and Southwest (SWTH) of Lake Taihu was identified and characterized in this study. Microplastics could be detected at all depths (0–50 cm) at the two sites, with the total abundance of 8100 and 5300 particles kg−1 dry weight sediment at NTH and SWTH, respectively. This indicates that the microplastic storage in the sediment of the Lake Taihu may be underestimated, if only the surface sediment is considered. Microplastics composed of various polymer types were identified in the sediment of the two sites, including polyamide (PA), acrylic acid, polyethylene terephthalate and cellulose acetate, while high density polyethylene and polypropylene were only detected at NTH. The main type of polymers detected at NTH (42%) and SWTH (43%) were PA. The major shape of microplastics was fibers, with a ratio of 76% and 78%, respectively at the site NTH and SWTH. The colors of microplastics were mainly white (accounted for 42 and 43% at NTH and SWTH, respectively), which may be caused by the long-term decomposition of dyestuff in the syngenesis of sediment and/or probably the degradation during sample treatments. The textile industry and fishery activities may provide the source. In summary, our findings in the Lake Taihu provide better understanding of the microplastic pollution and tackle microplastics challenges.
Modeling TSH Receptor Dimerization at the Transmembrane Domain
Authors: Mezei Mihaly , Latif Rauf , Davies Terry F 
Published: October 2022

Abstract
Biophysical studies have established that the thyrotropin (TSH) receptor (TSHR) undergoes posttranslational modifications including dimerization. Following our earlier simulation of a TSHR–transmembrane domain (TMD) monomer (called TSHR-TMD-TRIO) we have now proceeded with a molecular dynamics simulation (MD) of TSHR-TMD dimerization using this improved membrane-embedded model. The starting structure was the TMD protein with all extracellular and intracellular loops and internal waters, which was placed in the relative orientation of the model originally generated with Brownian dynamics. Furthermore, this model was embedded in a DPPC lipid bilayer further solvated with water and added salt. Data from the MD simulation studies showed that the dimeric subunits stayed in the same relative orientation and distance during the 1000 ns of study. Comparison of representative conformations of the individual monomers when dimerized with the conformations from the monomer simulation showed subtle differences as represented by the backbone root mean square deviations. Differences in the conformations of the ligand-binding sites, suggesting variable affinities for these “hot spots,” were also revealed by comparing the docking scores of 46 small-molecule ligands that included known TSHR agonists and antagonists as well as their derivatives. These data add further insight into the tendency of the TSHR-TMD to form dimeric and oligomeric structures and show that the differing conformations influence small-molecule binding sites within the TMD.
Investigating the Association Between a Risk-Directed Prophylaxis Protocol and Postoperative Nausea and Vomiting: Validation in a Low-Income Setting
Authors: Tuyishime Jean de Dieu H. , Niyitegeka Joseph , Olufolabi Adeyemi J. , Powers Samuel , Naik Bhiken I. , Tsang Siny , Durieux Marcel E. , Twagirumugabe Theogene 
Published: October 2022

BACKGROUND:
The efficacy of postoperative nausea and vomiting (PONV) prevention protocols in low-income countries is not well known. Different surgical procedures, available medications, and co-occurring diseases imply that existing protocols may need validation in these settings. We assessed the association of a risk-directed PONV prevention protocol on the incidence of PONV and short-term surgical outcomes in a teaching hospital in Rwanda.

METHODS:
We compared the incidence of PONV during the first 48 hours postoperatively before (April 1, 2019–June 30, 2019; preintervention) and immediately after (July 1, 2019–September 30, 2019; postintervention) implementing an Apfel score-based PONV prevention strategy in 116 adult patients undergoing elective open abdominal surgery at Kigali University Teaching Hospital in Rwanda. Secondary outcomes included time to first oral intake, hospital length of stay, and rate of wound dehiscence. Interrupted time series analyses were performed to assess the associated temporal slopes of the outcome before and immediately after implementation of the risk-directed PONV prevention protocol.

RESULTS:
Compared to just before the intervention, there was no change in the odds of PONV at the beginning of the postintervention period (odds ratio [OR], 0.23; 95% confidence interval [CI], 0.05–1.01). There was a decreasing trend in the odds of nausea (OR, 0.60; 95% CI, 0.36–0.97) per month. However, there was no difference in the incidence of nausea immediately after implementation of the protocol (OR, 0.96; 95% CI, 0.25–3.72) or in the slope between preintervention and postintervention periods (OR, 1.48; 95% CI, 0.60–3.65). In contrast, there was no change in the odds of vomiting during the preintervention period (OR, 1.01; 95% CI, 0.61–1.67) per month. The odds of vomiting decreased at the beginning of the postintervention period compared to just before (OR, 0.10; 95% CI, 0.02–0.47; P = .004). Finally, there was a significant decrease in the average time to first oral intake (estimated 14 hours less; 95% CI, −25 to −3) when the protocol was first implemented, after adjusting for confounders; however, there was no difference in the slope of the average time to first oral intake between the 2 periods (P = .44).

CONCLUSIONS:
A risk-directed PONV prophylaxis protocol was associated with reduced vomiting and time to first oral intake after implementation. There was no substantial difference in the slopes of vomiting incidence and time to first oral intake before and after implementation.