bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health systems in the European Union and policy responses to Covid-19: A comparative analysis between Germany, Sweden, and Greece
Authors: Tsalampouni Aikaterini 
Published: October 2022

Background: Existing health systems are a product of, and are influenced by, specific political, historical, cultural, and socio-economic traditions. Consequently, they may differ considerably across countries. The pandemic has become a turning point for our healthcare systems and at the same time has also highlighted the need to strengthen the EU’s role in coordinating health care. This paper analyzes the characteristics of the health care systems in three EU countries—Germany, Sweden, and Greece—that represent three different health care system types in Europe as well as their health policy response, to the COVID-19 pandemic. Design and methods: More analytically, the paper attempts to identify indications of interaction between heath care system types and national responses in the health crisis, using data collected from the COVID-19 Health Systems Response Monitor, the European Observatory on Health Systems and Politics as well as the OECD health system characteristics database and national health legislation. Results: The investigation revealed some common responses in all three systems. During the pandemic, in all three health care systems a new model is revealed where the private and the public sector coexist and is characterized by the dynamic state-market relationship. As a result a multilevel approach in health policy, combining national, sub-national, and supranational action is again in the foreground. Conclusions: The paper concludes by articulating some remarks regarding health policy during the pandemic, as well as the European health systems transformation and the importance of maintaining a strong welfare state in Europe.
Reliability of MRI Detection of Kaplan Fiber Injury in Pediatric and Adolescent Patients with ACL Tears
Authors: Shi Brendan Y. , Levine Benjamin , Ghazikhanian Varand , Bugarin Amador , Schroeder Grant , Wu Shannon , Kremen Thomas , Jones Kristofer 
Published: October 2022

Background: While studies have described Kaplan fiber (KF) injury in up to 60% of adults with anterior cruciate ligament (ACL) tears, the incidence of KF injury in the pediatric and adolescent population remains unknown. Purpose: To (1) determine the reliability of using magnetic resonance imaging (MRI) to identify KF injury in the pediatric and adolescent population and (2) define the incidence of KF injury in these patients with acute ACL injuries. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: The authors retrospectively identified patients ≤18 years of age who underwent ACL reconstruction for acute tears between 2013 and 2020. All preoperative MRI scans were reviewed independently and in a blinded fashion by 2 musculoskeletal radiologists, who noted the presence of the KF complex and any evidence of injury; interrater reliability was assessed. Patient characteristics, time from injury to MRI, laterality, and concomitant ligamentous or meniscal injuries were recorded, and associations between patient or injury characteristics and KF integrity on MRI were assessed. Results: In total, 51 patients (mean age, 14.9 years) met the inclusion criteria. Of these, 27 patients were female and 31 sustained an injury to the right knee. With respect to KF integrity, radiologist 1 visualized KF injury in 29% of patients, while radiologist 2 visualized KF injury in 35% of patients. In 12% of cases for radiologist 1 and 6% of cases for radiologist 2, KFs were unable to be visualized at all. The overall percentage agreement between the 2 radiologists was 76.5% with a kappa statistic of 0.57 (moderate agreement). There were no significant associations found between the presence of KF injury and patient age, sex, laterality, body mass index, concomitant ligamentous injury, or meniscal injury. However, visualization of KF injury on MRI was associated with a shorter time from index injury to MRI (15 days vs 23 days; P = .044). Conclusion: Approximately one-third of pediatric and adolescent patients who underwent ACL reconstruction were found to have KF injuries. Standard preoperative MRI scans can reliably be used to visualize KF injury in the majority of pediatric and adolescent patients with ACL tears, especially when the MRI is performed in the acute setting.
Cardiac thrombi detected by CT in patients with acute ischemic stroke: A substudy of Mind the Heart
Authors: Rinkel Leon A , Beemsterboer Chiel FP , Groeneveld Nina-Suzanne , Lobé Nick HJ , Boekholdt S Matthijs , Bouma Berto J , Muller Fenna F , Beenen Ludo FM , Marquering Henk A , Majoie Charles BLM , Roos Yvo BWEM , van Randen Adrienne , Planken R Nils , Coutinho Jonathan M 
Published: October 2022

Background: Cardiac thrombi are a major risk factor for ischemic stroke, but are rarely diagnosed in the acute phase. We examined characteristics and functional outcome of patients with ischemic stroke and a concomitant cardiac thrombus detected on cardiac CT performed in the acute phase. Patients and Methods: We used data from “Mind the Heart,” a prospective cohort study in which consecutive adult patients with acute ischemic stroke underwent prospective ECG-gated cardiac CT during their acute stroke imaging protocol. We compared characteristics, functional outcome (modified Rankin scale) and stroke recurrence rate at 90 days of patients with a cardiac thrombus on CT (defined as filling defect <100 Hounsfield Units) to those without a cardiac thrombus. Results: Among 452 included patients, cardiac CT detected 41 thrombi in 38 (8%) patients. Thrombi were most often located in the left atrial appendage (31/38 [82%]). Patients with a cardiac thrombus more frequently had intracranial occlusions in multiple vascular territories (5% vs 0.5%, p = 0.04) and a higher baseline NIHSS score (17 [IQR 6–22] vs 5 [IQR 2–3], p < 0.001) compared to patients without a cardiac thrombus. In 13/38 (34%) patients with a cardiac thrombus, no atrial fibrillation was detected. A cardiac thrombus was associated with worse functional outcome (adjusted common odds ratio 3.18 95%CI 1.68–6.00). Recurrence rate was not significantly different (8% vs 4%, aOR 1.50 (0.39–5.82). Discussion and Conclusion: Cardiac CT detected a cardiac thrombus in one in every 12 patients with acute ischemic stroke, and these patients had more severe deficits, multivessel occlusions, and a worse functional outcome.
Does Emotional Intelligence Change After 1 Year of Courses for the Diagnostic Medical Sonography or Radiography Students?
Authors: Miller Elena 
Published: October 2022

Objective: The purpose of the study was to determine whether emotional intelligence (EI) changes after completion of 1 year of courses for diagnostic medical sonography (DMS) or radiography (RAD) students. Materials and Methods: The participants of this study were 26 imaging undergraduate students. The convenient sample included 10 DMS and 16 RAD students, enrolled in an Associate Degree in Applied Sciences program, within a community college. The study was conducted by administering the Trait Emotional Intelligence Questionnaire (TEIQue) that collected EI data and demographic data of the participants in both programs. These data were gathered at the beginning of each respective program, as well as 1 year later. Results: The analysis of the findings determined that there was no significant change in global EI and four factors such as wellbeing, self-control, emotionality, and sociability of EI among this cohort of DMS and RAD students after 1 year. However, one of the three trait EI subscales “Optimism” revealed a significant increase after 1 year for this cohort of RAD students. Interestingly, this cohort of DMS students did not show the same outcome. Conclusion: The results of this study provide limited empirical evidence that one of the three trait EI subscales “Optimism” increased after completion of 1 year of courses in this RAD student cohort. This is an important finding that should be carefully considered. This outcome shows that RAD students in this cohort felt significantly more optimistic after 1 year, which reflects their emotional state. However, DMS students in this cohort did not demonstrate the same results.
Three-Dimensional Numerical Study on the Metal Rotating Spray Transfer Process of High-Current GMAW
Authors: Xiao Lei , Fan Ding , Huang Jiankang 
Published: October 2022

AbstractA three-dimensional numerical model based on the volume-of-fluid (VOF) method is typically preferred for studying high-current gas metal arc welding (GMAW) metal transfer mechanism and then controlling it. It is informed that the rotating spray transfer is extremely complicated, and some researchers have focused on simplified models without considering the energy conservation to make analysis manageable for the unstable metal transfer process. Using our created numerical model, the metal transfer of high-current GMAW with shielding gas of different conductivities has been studied by analyzing acting forces and fluid flows in the metal liquid column, especially for the contributions of the self-induced electromagnetic force, equivalent volume force of the capillary pressure of the surface tension (Named surface tension force in this work), static arc pressure. It is found that the unbalanced electromagnetic force greatly promotes the metal rotating motion in 500 A metal inert gas (MIG) welding with pure argon shielding gas and it pushes the metal liquid column to rotate. Considering the arc constricting effect in active shielding gas by simply changing the arc conductivity, it is found that the metal liquid column no longer rotates, it turns to swing since the unbalanced electromagnetic force is large enough to break the rotating motion. The calculated results of the metal liquid column deflected angle and rotating/swing frequency agree well with the experiment of high-speed camera observations.
Bioinformatics approaches for classification and investigation of the evolution of the Na/K-ATPase alpha-subunit
Authors: Shahnazari Marzieh , Zakipour Zahra , Razi Hooman , Moghadam Ali , Alemzadeh Abbas 
Published: October 2022

Abstract
Background
Na,K-ATPase is a key protein in maintaining membrane potential that has numerous additional cellular functions. Its catalytic subunit (α), found in a wide range of organisms from prokaryotes to complex eukaryote. Several studies have been done to identify the functions as well as determining the evolutionary relationships of the α-subunit. However, a survey of a larger collection of protein sequences according to sequences similarity and their attributes is very important in revealing deeper evolutionary relationships and identifying specific amino acid differences among evolutionary groups that may have a functional role.

Results
In this study, 753 protein sequences using phylogenetic tree classification resulted in four groups: prokaryotes (I), fungi and various kinds of Protista and some invertebrates (II), the main group of invertebrates (III), and vertebrates (IV) that was consisted with species tree. The percent of sequences that acquired a specific motif for the α/β subunit assembly increased from group I to group IV. The vertebrate sequences were divided into four groups according to isoforms with each group conforming to the evolutionary path of vertebrates from fish to tetrapods. Data mining was used to identify the most effective attributes in classification of sequences. Using 1252 attributes extracted from the sequences, the decision tree classified them in five groups: Protista, prokaryotes, fungi, invertebrates and vertebrates. Also, vertebrates were divided into four subgroups (isoforms). Generally, the count of different dipeptides and amino acid ratios were the most significant attributes for grouping. Using alignment of sequences identified the effective position of the respective dipeptides in the separation of the groups. So that 208GC is apparently involved in the separation of vertebrates from the four other organism groups, and 41DH, 431FK, and 451KC were involved in separation vertebrate isoform types.

Conclusion
The application of phylogenetic and decision tree analysis for Na,K-ATPase, provides a better understanding of the evolutionary changes according to the amino acid sequence and its related properties that could lead to the identification of effective attributes in the separation of sequences in different groups of phylogenetic tree. In this study, key evolution-related dipeptides are identified which can guide future experimental studies.
Functional transcriptome analyses of Drosophila suzukii midgut reveal mating-dependent reproductive plasticity in females
Authors: Xing Shisi , Deng Dan , wen Wen , Peng Wei 
Published: October 2022

AbstractBackgroundInsect females undergo a huge transition in energy homeostasis after mating to compensate for nutrient investment during reproduction. To manage with this shift in metabolism, mated females experience extensive morphological, behavioral and physiological changes, including increased food intake and altered digestive processes. However, the mechanisms by which the digestive system responds to mating in females remain barely characterized. Here we performed transcriptomic analysis of the main digestive organ, the midgut, to investigate how gene expression varies with female mating status inDrosophila suzukii, a destructive and invasive soft fruit pest.ResultsWe sequenced 15,275 unique genes with an average length of 1,467 bp. In total, 652 differentially expressed genes (DEGs) were detected between virgin and matedD. suzukiifemale midgut libraries. The DEGs were functionally annotated utilizing the GO and KEGG pathway annotation methods. Our results showed that the major GO terms associated with the DEGs from the virgin versus mated female midgut were largely appointed to the metabolic process, response to stimulus and immune system process. We obtained a mass of protein and lipid metabolism genes which were up-regulated and carbohydrate metabolism and immune-related genes which were down-regulated at different time points after mating in female midgut by qRT-PCR. These changes in metabolism and immunity may help supply the female with the nutrients and energy required to sustain egg production.ConclusionOur study characterizes the transcriptional mechanisms driven by mating in theD. suzukiifemale midgut. Identification and characterization of the DEGs between virgin and mated females midgut will not only be crucial to better understand molecular research related to intestine plasticity during reproduction, but may also provide abundant target genes for the development of effective and ecofriendly pest control strategies against this economically important species.
Prevalence and factors associated with food insecurity in eight high-altitude cities in Peru during the second wave of the COVID-19 pandemic: a retrospective, cross-sectional study
Authors: Zila-Velasque J. Pierre , Grados-Espinoza Pamela , Quispe-Chura Katherine , Valdiviezo-Morales Christopher G. , Diaz-Vélez Cristian , Valladares-Garrido Mario J. 
Published: October 2022

Abstract
Background
Food insecurity has increased during the COVID-19 pandemic, affecting an estimated 260 million people. However, little evidence is available on how pandemic-related characteristics influence food security in a high-altitude population. The objective of this study was to assess factors associated with food insecurity in high-altitude Peruvian cities during the second epidemic wave of COVID-19.

Methods
A retrospective, cross-sectional study was conducted in eight Peruvian cities over 1,500 m above sea level. An online survey measuring food security, presence of anxiety & depressive symptoms, sleep quality, post-traumatic stress disorder (PTSD), resilience, and sociodemographic characteristics was disseminated through social networks between December 2020 and February 2021. Generalized linear models were used to identify an association between the study variables.

Results
Of 700 participants, the median age was 23 years, and more than half were female (56.7%). The prevalence of food insecurity was 37.1%. Anxiety symptoms, depressive symptoms, and PTSD were present in 72.7%, 64.1%, and 15% of respondents, respectively. The prevalence of food insecurity was higher in people with fair (PR: 1.60, 95% CI: 1.23–2.07) and very bad perception of their health (PR: 4.06, 95% CI: 2.63–6.26), individuals seeking mental health support (PR: 1.42, 95% CI: 1.25–1.62), and in those who lost their job due to the pandemic (PR: 1.82, 95% CI: 1.62–2.04). Having moderate (PR: 1.52, 95% CI: 1.26–1.83) and moderate to severe depressive symptoms (PR: 1.58, 95% CI: 1.11–2.27) also increased the prevalence of food insecurity.

Conclusion
During the pandemic, the prevalence of food insecurity has increased in the Peruvian high-altitude population, revealing the need for preventive strategies. Identification of pandemic-related characteristics that influence food insecurity can guide interventions in at-risk individuals and reduce the long-term impact of this problem on overall health and quality of life.
Application of deep learning artificial intelligence technique to the classification of clinical orthodontic photos
Authors: Ryu Jiho , Lee Yoo-Sun , Mo Seong-Pil , Lim Keunoh , Jung Seok-Ki , Kim Tae-Woo 
Published: October 2022

Abstract
Background
Taking facial and intraoral clinical photos is one of the essential parts of orthodontic diagnosis and treatment planning. Among the diagnostic procedures, classification of the shuffled clinical photos with their orientations will be the initial step while it was not easy for a machine to classify photos with a variety of facial and dental situations. This article presents a convolutional neural networks (CNNs) deep learning technique to classify orthodontic clinical photos according to their orientations.

Methods
To build an automated classification system, CNNs models of facial and intraoral categories were constructed, and the clinical photos that are routinely taken for orthodontic diagnosis were used to train the models with data augmentation. Prediction procedures were evaluated with separate photos whose purpose was only for prediction.

Results
Overall, a 98.0% valid prediction rate resulted for both facial and intraoral photo classification. The highest prediction rate was 100% for facial lateral profile, intraoral upper, and lower photos.

Conclusion
An artificial intelligence system that utilizes deep learning with proper training models can successfully classify orthodontic facial and intraoral photos automatically. This technique can be used for the first step of a fully automated orthodontic diagnostic system in the future.
Early prediction of patient discharge disposition in acute neurological care using machine learning
Authors: Mickle Charles F. , Deb Debzani 
Published: October 2022

Abstract
Background
Acute neurological complications are some of the leading causes of death and disability in the U.S. The medical professionals that treat patients in this setting are tasked with deciding where (e.g., home or facility), how, and when to discharge these patients. It is important to be able to predict potential patient discharge outcomes as early as possible during the patient’s hospital stay and to know what factors influence the development of discharge planning. This study carried out two parallel experiments: A multi-class outcome (patient discharge targets of ‘home’, ‘nursing facility’, ‘rehab’, ‘death’) and binary class outcome (‘home’ vs. ‘non-home’). The goal of this study is to develop early predictive models for each experiment exploring which patient characteristics and clinical variables significantly influence discharge planning of patients based on the data that are available only within 24 h of their hospital admission.

Method
Our methodology centers around building and training five different machine learning models followed by testing and tuning those models to find the best-suited predictor for each experiment with a dataset of 5,245 adult patients with neurological conditions taken from the eICU-CRD database.

Results
The results of this study show XGBoost to be the most effective model for predicting between four common discharge outcomes of ‘home’, ‘nursing facility’, ‘rehab’, and ‘death’, with 71% average c-statistic. The XGBoost model was also the best-performer in the binary outcome experiment with a c-statistic of 76%. This article also explores the accuracy, reliability, and interpretability of the best performing models in each experiment by identifying and analyzing the features that are most impactful to the predictions.

Conclusions
The acceptable accuracy and interpretability of the predictive models based on early admission data suggests that the models can be used in a suggestive context to help guide healthcare providers in efforts of planning effective and equitable discharge recommendations.
An asparagine metabolism-based classification reveals the metabolic and immune heterogeneity of hepatocellular carcinoma
Authors: Bai Jianguo , Tang Ruifeng , Zhou Keyu , Chang Jialei , Wang Hongyue , Zhang Qixin , Shi Jiahui , Sun Chao 
Published: October 2022

Abstract
Introduction and objectives
hepatocellular carcinoma (HCC) is the major form of liver cancer with a poor prognosis. Amino acid metabolism has been found to alter in cancers and contributes to malignant progression. However, the asparagine metabolism status and relevant mechanism in HCC were barely understood.

Methods
By conducting consensus clustering and the least absolute shrinkage and selection operator regression of HCC samples from three cohorts, we classified the HCC patients into two subtypes based on asparagine metabolism level. The Gene Ontology, Kyoto Encyclopedia of Genes and Genomes analyses and Gene Set Enrichment Analysis of the differentially expressed genes between two subgroups were conducted. Immune cell infiltration was evaluated using CIBERSORT algorithm. The prognostic values of genes were analyzed by univariate and multivariate cox regression, ROC curve and Kaplan–Meier survival estimate analyses. Cell types of sing-cell RNA sequencing (scRNA-seq) data were clustered utilizing UMAP method.

Results
HCC patients with higher asparagine metabolism level have worse prognoses. Moreover, we found the distinct energy metabolism patterns, DNA damage response (DDR) pathway activating levels, drug sensitivities to DDR inhibitors, immune cell compositions in the tumor microenvironment and responses to immune therapy between two subgroups. Further, we identified a potential target gene, glutamic-oxaloacetic transaminase 2 (GOT2). GOT2 downregulation was associated with worse HCC prognosis and increased infiltration of T regulatory cells (Tregs). ScRNA-seq revealed the GOT2 downregulation in cancer stem cells compared with HCC cells.

Conclusions
Taken together, HCC subtype which is more reliant on asparagine and glutamine metabolism has a worse prognosis, and a core gene of asparagine metabolism GOT2 is a potential prognostic marker and therapeutic target of HCC. Our study promotes the precision therapy of HCC and may improve patient outcomes.