bluuebunny/crossref_metadata_2025 huggingface dataset:
Transcriptional Plasticity Drives Leukemia Immune Escape
Authors: Eagle Kenneth , Harada Taku , Kalfon Jérémie , Perez Monika W. , Heshmati Yaser , Ewers Jazmin , Koren Jošt Vrabič , Dempster Joshua M. , Kugener Guillaume , Paralkar Vikram R. , Lin Charles Y. , Dharia Neekesh V. , Stegmaier Kimberly , Orkin Stuart H. , Pimkin Maxim
Published: June 2022

Relapse of acute myeloid leukemia (AML) after allogeneic bone marrow transplantation has been linked to immune evasion due to reduced expression of major histocompatibility complex class II (MHCII) genes through unknown mechanisms. In this work, we developed CORENODE, a computational algorithm for genome-wide transcription network decomposition that identified a transcription factor (TF) tetrad consisting of IRF8, MYB, MEF2C, and MEIS1, regulating MHCII expression in AML cells. We show that reduced MHCII expression at relapse is transcriptionally driven by combinatorial changes in the expression of these TFs, where MYB and IRF8 play major opposing roles, acting independently of the IFNγ/CIITA pathway. Beyond the MHCII genes, MYB and IRF8 antagonistically regulate a broad genetic program responsible for cytokine signaling and T-cell stimulation that displays reduced expression at relapse. A small number of cells with altered TF abundance and silenced MHCII expression are present at the time of initial leukemia diagnosis, likely contributing to eventual relapse.

Significance:

Our findings point to an adaptive transcriptional mechanism of AML evolution after allogeneic transplantation whereby combinatorial fluctuations of TF expression under immune pressure result in the selection of cells with a silenced T-cell stimulation program.

This article is highlighted in the In This Issue feature, p. 369
Bullous Pemphigoid Associated with Acquired Hemophilia A: A Case Report and Review of the Literature
Authors: Fakprapai Wuttidej , Wattanakrai Penpun
Published: June 2022

Acquired hemophilia A (AHA) is a rare autoimmune disorder with high morbidity and mortality. It results from the development of circulating autoantibodies against factor VIII. AHA can be seen in association with autoimmune vesiculobullous diseases, autoimmune diseases, malignancy, pregnancy, and medications. We report a 68-year-old Thai woman diagnosed and treated for bullous pemphigoid (BP) for 11 months who recently presented with a 3-day history of extensive hemorrhagic bullae and large intra-oral buccal hematoma. Laboratory investigations confirmed a prolonged activated partial thromboplastin time, a low factor VIII level, a high factor VIII inhibitor level, and elevated anti-BPAG180 and anti-BPAG230 titers, confirming the diagnosis of BP associated with AHA. Immunosuppressive therapy with systemic corticosteroids and cyclophosphamide combined with bypassing agents for bleeding control resulted in significant clinical improvement and subsequent negative antibody levels. There was no recurrence after a 7-month follow-up period. Due to life-threatening bleeding in severe AHA cases, early diagnosis and effective treatment in this condition are essential.
Comparison of the Clinical Effectiveness of AN69-oXiris versus AN69-ST Filter in Septic Patients: A Single-Centre Study
Authors: Zang Shouhua , Chen Qing , Zhang Yukun , Xu Li , Chen Jun
Published: June 2022

Introduction: The clinical effectiveness of AN69-oXiris remains unclear. This study aimed to compare the effects of AN69-oXiris and AN69-ST filters on cytokine levels and clinical improvement in septic patients. Methods: This prospective observational study recruited septic patients who underwent blood purification in the First Affiliated Hospital of Soochow University between December 2019 and May 2020. Patients were assigned to an AN69-oXiris (oXiris) or AN69-ST (ST) group based on their preferred filter. Patients’ clinical data, cytokine levels, and prognostic indicators were analysed at baseline (T0), 24 h after treatment (T1), and at the end of the treatment (T2). Results: Forty-four patients participated in this study (22 patients in each group). Participants in both groups showed improvements in mean arterial pressure (MAP) values, oxygenation indices, and urinary output, and decreased vasoactive-inotropic scores (VISs), heart rates, lactic acid levels, and serum creatinine levels after blood purification. Reductions in cytokine levels were observed at T1 in both groups. Improvement the haemodynamic status was higher in the oXiris group than in the ST group at T2 (MAP: 79.0 [76.0, 85.0] vs. 77.0 [72.75, 79.25] mm Hg, p = 0.04; VISs: 9.10 [0.00, 16.69] vs. 19.05 [10.60, 26.33], p = 0.03, respectively). Patients in the oXiris group also had lower cytokine levels than those in the ST group at T1 (tumour necrosis factor-α: 24.55 [16.9, 30.15] vs. 30.15 [23.38, 34.13] pg/mL, p = 0.04; interleukin (IL)-6: 66.63 [46.21, 102.20] vs. 125.48 [79.73, 167.97] pg/mL, p = 0.01; IL-8: 53.59 [35.10, 66.01] vs. 63.60 [45.58, 83.37] pg/mL, p = 0.04; IL-10: 13.50 [10.35, 18.68] vs. 17.15 [13.80, 21.95] pg/mL, p = 0.04, respectively). There were no significant differences between the 2 groups regarding hospital mortality, intensive care unit length of stay (LOS), and hospital LOS. Conclusion: Blood purification using the AN69-oXiris or AN69-ST filter proved useful for septic patients, which was associated with reduced cytokine levels and improved clinical condition. Patients treated with AN69-oXiris had a more remarkable improvement in haemodynamic status and lower cytokine levels than those treated with AN69-ST filter, but there were no differences in clinical outcomes. Further investigations are needed to prove this finding.
The Prognostic Capacity of Systemic Inflammation Response Index, Neutrophil-to-Lymphocyte Ratio, Lymphocyte-to-Monocyte Ratio, and Platelet-to-Lymphocyte Ratio in Patients with Hypopharyngeal Squamous Cell Carcinoma
Authors: Wang Tian , Lin Hanqing , Hsueh Chiyao , Lau Hui-Ching , Zhou Jian , Gong Hongli , Tao Lei , Zhou Liang , Wu Chunping
Published: June 2022

Introduction: Systemic inflammation response index (SIRI), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) have been proposed as peripheral blood biomarkers. We compared these blood biomarkers to identify the best predictor in patients with hypopharyngeal squamous cell carcinoma (HPSCC). Methods: We conducted a retrospective study on 304 patients with HPSCC. SIRI was divided into three groups using X-tile version 3.6.1. The optimal cut-off points for NLR, LMR, and PLR were selected through RStudio. We compared the prognostic capacity of SIRI with that of NLR, LMR, and PLR using receiver operating characteristic curves. Results: Smoking, cancer in the postcricoid region, lymph node metastasis (N+), extracapsular invasion, SIRI in the highest tertile (>2.80), and LMR in the lowest tertile (<5.0) may cause poor 5-year overall survival (OS) in patients with HPSCC. Local and distant recurrences may occur earlier in those with lymph node metastasis and a tumor invading beyond the mucosa layer. Conclusions: SIRI was a better predictor of OS than LMR, PLR, and NLR in HPSCC patients. SIRI in the highest tertile (>2.80) and LMR in the lowest tertile (<5.0) may cause poor 5-year OS.
Molecular Genetic Analysis of Newborns with Congenital Microcephaly
Authors: Ye Chang , Mei Hongfang , Chen Huiyao , Dong Xinran , Lu Yulan , Wu Bingbing , Wang Huijun , Hu Liyuan , Cheng Guoqiang , Zhou Wenhao , Yang Lin
Published: June 2022

Introduction: Data on the genetic landscape of congenital microcephaly (CM) in China are scarce, and the incidence of CM caused by the most commonly mutated gene ASPM in China remains unknown. Methods: Sixty-one neonates with CM who were hospitalized in the Children’s Hospital of Fudan University between August 1, 2016, and August 31, 2020, were enrolled, and the clinical data and clinical exome-sequencing data were analyzed. An additional 18,103 parental data entries from the Chinese Children’s Genetic Testing Clinical Collaboration System database were collected to estimate the incidence of ASPM-related congenital microcephaly (ASPM-CM) in East China by analyzing the carrier frequency of ASPM mutations. Results: Among the 61 neonates with CM, 35 (57.4%) patients were identified with genetic findings, including 24 patients with single nucleotide variants (SNVs) and 11 patients with copy number variations (CNVs). ASPM was the most common gene with detrimental SNVs detected in 3 patients. Patients with genetic findings showed a significantly higher incidence of developmental delay (91.3%, 21/23) than those without genetic findings (60%, 9/15) (p = 0.04). All the 3 decreased patients had genetic findings. The estimated ASPM-CM incidence in East China was 1/1,295,044. Conclusion: Comprehensive genetic testing, detecting both SNVs and CNVs, is recommended for newborns with CM. Patients with genetic findings should be aware of the potential for developmental delay. ASPM gene defect was the most common genetic cause of CM in this study. The estimation of the incidence of ASPM-CM in East China might provide a reference for analyzing overall incidence.
Effect of the Gastrojejunostomy Position on the Postoperative Amount of Oral Intake in Pancreaticoduodenectomy
Authors: Iida Hiroya , Maehira Hiromitsu , Maekawa Takeru , Mori Haruki , Nitta Nobuhito , Takebayashi Katsushi , Kojima Masatsugu , Kurihara Mika , Bamba Shigeki , Sasaki Masaya , Tani Masaji
Published: June 2022

Introduction: We investigated the effect of the gastrojejunostomy position on the postoperative oral intake in patients who have undergone pancreaticoduodenectomy (PD). Methods: We investigated 119 patients who underwent PD between June 2013 and December 2019 and examined the effect of the horizontal and vertical distance rates of the gastrojejunostomy position on the postoperative oral intake. The patients were categorized as having poor or good oral intake based on whether their intake was up to half the required calorie intake. Results: There were significant differences in the number of cases with grade B or C postoperative pancreatic fistula (good, 20.3% vs. poor, 60.0%; p < 0.001), horizontal distance rate (good, 0.57 vs. poor, 0.48; p = 0.02), and postoperative hospitalization period (good, 15 vs. poor, 35 days; p < 0.001). However, there was no significant difference in the vertical distance rate (good, 0.67 vs. poor, 0.71; p = 0.22). The horizontal distance rate was the independent risk factor for postoperative poor oral intake at 2–3 weeks (risk ratio, 3.69; 95% CI: 1.48–9.20). Discussion: The oral intake was greater in patients whose gastrojejunostomy position in PD was farther from the median, suggesting the necessity of intraoperative placement of the gastrojejunostomy position as far from the median as possible.
Orçamento por desempenho: uma análise sobre a relação entre o desempenho da Secretaria de Atenção da Saúde e os recursos orçamentários alocados em suas ações.
Authors: Grzybowski Márcia , Lunkes Rogério João , Lyrio Maurício Vasconcellos Leão
Published: June 2022

O presente artigo objetiva analisar a alocação de recursos orçamentários nas ações funcionais programáticas da Secretaria de Atenção à Saúde (SAS), que faz parte do Ministério da Saúde do Poder Executivo Federal, com vistas de verificar se o desempenho da ação é considerado no momento de alocação de recursos. O estudo segue a linha de investigação conhecida como Performance-Based Budgeting (PBB) - Orçamento Baseado em Desempenho e utiliza estatística descritiva, organizando os dados quantitativos referentes aos resultados alcançados e recursos alocados nas ações funcionais programáticas coletadas dos relatórios de gestão da SAS, no período de 2010 a 2014. Os resultados evidenciaram que não houve relação entre a eficiência do programa e a alocação de recursos para o ano seguinte, o que vem de encontro às premissas do PBB, de que os recursos devem ser alocados conforme a eficiência dos programas.
Formação Continuada de Docentes no Ensino Superior: experiências e contradições em tempos de neoliberalismo
Authors: Martins Juliana Teixeira de Souza , Barbosa Bárbara Cristina Souza , Ueno Laura Satoe , Cavalcante Melina Borges Rosa , Greve Milena Sampaio , Teixeira Monica Gonçalves de Melo , Struwka Solange
Published: June 2022

Este artigo tem por objetivo discutir a formação continuada de docentes do ensino superior, considerando seus atuais desafios e dilemas e como estes têm sido convergidos e superados nos espaços coletivos construídos em algumas Instituições de Ensino Superior (IES). Compreende-se a educação como operadora de mudança, como espaço de formação cidadã, que considera os afetos e as subjetividades, nesse sentido, ela está impossibilitada de qualquer tentativa de neutralidade, seja nos espaços institucionais, nos objetivos das discussões, nas formações promovidas ou na forma de vínculos trabalhistas. Assim, a formação continuada de professores do ensino superior, entendida como continuidade da formação profissional, tem possibilidades de promover novas reflexões e meios de desenvolver e aprimorar o fazer profissional, de modo a repensar as necessidades institucionais e sociais. Notamos que as inovações didático-pedagógicas contribuem em determinados contextos, mas não se sustentam sem a reflexão sobre a função da educação na sociedade. A valorização da experiência prática que considere a importância de complementação didático-pedagógica e a convivência de profissionais experientes com iniciantes também são práticas que favorecem o processo da formação continuada dos docentes.
Eternos aprendizes de perpétuos fazeres: uma análise sobre a docência para o ensino superior e o pensamento constitucional brasileiro
Authors: Gonçalves Ingrid Rodrigues , Felippe da Silva Pedro Paulo Ferreira , Pereira Omar Calazans Nogueira , Benedito Maiara de Souza , Nisivoccia Juan Tomás Arregui
Published: June 2022

A formação docente vindica movimentos perpétuos entrelaçados à própria vida dos professores e das professoras. Eternos aprendizes de um mundo em constantes transformações, conjugando suas trajetórias de vida pessoais e formativas com as práticas docentes. Aprendizado ininterrupto e tanto mais avolumado, quanto maior a compreensão de que possuir a palavra em uma sala de aula, constitui-se num importante lugar político. A proposta deste trabalho é pensar acerca dos deslocamentos do processo de formação profissional do docente de educação superior, e, sobre a multiplicidade dos fazeres que tomam parte no cotidiano desses profissionais na contemporaneidade. Para tal, foi realizada uma análise de documentos históricos que influenciaram as políticas públicas educacionais brasileiras. Apresentaremos algumas articulações entre a formação para a docência no ensino superior; a multidimensionalidade dessa profissão na contemporaneidade; e, alguns movimentos do pensamento constitucional brasileiro acerca do trabalho e da formação para a docência nas cartas magnas, e, na Lei 9.394/96 (Lei de Diretrizes e Bases da Educação).
Políticas Públicas para Comunidades de Terreiro
Authors: França Maria Adelina
Published: June 2022

A desigualdade social é ainda uma grande dificuldade no planejamento de políticas públicas de maneira geral, por conta da escala territorial brasileira e de diferenças locais e regionais. Somando-se a isso, o acúmulo de carências é um elemento que cristaliza um círculo vicioso de reprodução da pobreza. As próprias desigualdades sociais acabam por gerar desigualdades de oportunidades e acesso às políticas dirigidas aos grupos mais vulneráveis, como as comunidades de terreiro, e mesmo o acesso destas aos direitos humanos básicos. Sendo assim, dispor de dados confiáveis e que traduzam de forma regular e constante as modificações nos territórios onde estão inseridas as comunidades de terreiro são uma primeira condição para se garantir a eficácia das políticas específicas dirigidas ao setor para diminuir as desigualdades. O artigo apresenta orientações para elaboração de pesquisas para o segmento, assim como para a construção de políticas públicas voltadas às comunidades de terreiro, produzidas a partir da análise de pesquisas, entrevistas, análise de documentos e observações da autora como consultora do PNUD – Programa das Nações Unidas para o Desenvolvimento.
Representações Sociais de Violência
Authors: França Maria Adelina
Published: June 2022

Este artigo apresenta resultado de pesquisa sobre representações sociais de violência e tipos de violência vivenciados por diferentes segmentos sociais no distrito de Itaquera, no município de São Paulo. Utilizando grupos focais e embasado na teoria das Representações Sociais de Serge Moscovici, o estudo identificou diferenças importantes entre os grupos. Também foi investigado o grau de eficácia política de cada segmento; ou seja, como cada grupo intervém e reage às violências. O conceito de Segurança Humana, de Amartya Sen, é apresentado como recurso para minimizar as desigualdades e a violência em todas as suas formas.
Identification of a Distinct Platelet Phenotype in the Elderly: ADP Hypersensitivity Coexists With Platelet PAR (Protease-Activated Receptor)-1 and PAR-4–Mediated Thrombin Resistance
Authors: Gnanenthiran Sonali R. , Pennings Gabrielle J. , Reddel Caroline J. , Campbell Heather , Kockx Maaike , Hamilton Justin R. , Chen Vivien M. , Kritharides Leonard
Published: June 2022

Background:

Thrombin (via PAR [protease-activated receptor]-1 and PAR-4) and ADP (via P2Y
12
receptors) are potent endogenous platelet activators implicated in the development of cardiovascular disease. We aimed to assess whether platelet pathways alter with aging.

Methods:

We characterized platelet activity in community-dwelling volunteers (n=174) in the following age groups: (1) 20 to 30 (young); (2) 40 to 55 (middle-aged); (3) ≥70 years (elderly). Platelet activity was assessed by aggregometry; flow cytometry (surface markers [P-selectin: alpha granule release, CD63: dense granule release, PAC-1: measure of conformationally active GPIIb/IIIa at the fibrinogen binding site]) measured under basal conditions and after agonist stimulation [ADP, thrombin, PAR-1 agonist or PAR-4 agonist]); receptor cleavage and quantification; fluorometry; calcium flux; ELISA.

Results:

The elderly had higher basal platelet activation than the young, evidenced by increased expression of P-selectin, CD63, and PAC-1, which correlated with increasing inflammation (IL [interleukin]-1β/IL-6). The elderly demonstrated higher P2Y
12
receptor density, with greater ADP-induced platelet aggregation (
P
<0.05). However, elderly subjects were resistant to thrombin, achieving less activation in response to thrombin (higher EC
50
) and to selective stimulation of both PAR-1 and PAR-4, with higher basal PAR-1/PAR-4 cleavage and less inducible PAR-1/PAR-4 cleavage (all
P
<0.05). Thrombin resistance was attributable to a combination of reduced thrombin orienting receptor GPIbα (glycoprotein Ibα), reduced secondary ADP contribution to thrombin-mediated activation, and blunted calcium flux. D-Dimer, a marker of in situ thrombin generation, correlated with platelet activation in the circulation, ex vivo thrombin resistance, and circulating inflammatory mediators (TNF [tumor necrosis factor]-α/IL-6).

Conclusions:

Aging is associated with a distinctive platelet phenotype of increased basal activation, ADP hyperreactivity, and thrombin resistance. In situ thrombin generation associated with systemic inflammation may be novel target to prevent cardiovascular disease in the elderly.
Epicardial Adipose Tissue Ceramides Are Related to Lipoprotein Lipase Activity in Coronary Artery Disease: Unfolding a Missing Link
Authors: Barchuk Magalí , Ancel Patricia , Miksztowicz Verónica , Doukbi Elisa , Svilar Ljubica , Yñón Daniel , Nogueira Juan Patricio , Rubio Miguel , Schreier Laura , Dutour Anne , Martin Jean Charles , Gaborit Bénédicte , Berg Gabriela
Published: June 2022

Background:

Epicardial adipose tissue (EAT) contributes to coronary artery disease (CAD). EAT presents a specific lipidomic signature, showing increased ceramides and other proinflammatory lipids content. Besides, LPL (lipoprotein lipase) activity in EAT would contribute to its expansion, supplying fatty acids to the tissue. Our aim was to evaluate the relations between LPL activity, regulators of LPL, and ceramides in EAT from CAD patients.

Methods:

We studied patients undergoing coronary bypass graft (CAD, n=25) and patients without CAD (no CAD, n=14). EAT and subcutaneous AT (SAT) were obtained, tissue LPL activity and its regulator’s expression (ANGPTL4, GPIHBP1 [glycosylphosphatidylinositol-anchored high-density lipoprotein-binding protein 1], and PPARγ [peroxisomal proliferator–activated receptor γ]) were assessed. Tissue lipidomes were evaluated by UHPLC-MS, in positive and negative ionization modes.

Results:

LPL activity was higher in EAT from CAD (
P
<0.001), and in EAT than SAT in both groups (
P
<0.001). ANGPTL4 levels were lower, GPIHBP1 and PPARγ levels were higher in EAT from CAD (
P
<0.001). In both groups, EAT exhibited more ceramide (
P
=0.01), directly associated with LPL activity, being the strongest association with Cer18:1/24:1 (
P
<0.001). EAT Cer18:1/16:0 to Cer18:1/24:0 and Cer18:1/24:1 to 18:1/24:0 ratios were higher in CAD (
P
=0.03;
P
<0.001, respectively), the latter directly associated with LPL activity (
r
=0.63,
P
<0.001) GPIHBP1 levels (
r
=0.68,
P
<0.001), and inversely to EAT ANGPTL4 expression (
r
=−0.49,
P
=0.03). Pairwise partial correlation network showed associations among bioactive lipids and LPL and its regulators (
P
<0.001 in all cases).

Conclusions:

The association between LPL activity, total ceramide, and the atherogenic ceramide ratios highlights the importance of the enzyme and these bioactive lipids contributing to the different metabolic profile of EAT in CAD.
Revascularization for Renovascular Disease: A Scientific Statement From the American Heart Association
Authors: Bhalla Vivek , Textor Stephen C. , Beckman Joshua A. , Casanegra Ana I. , Cooper Christopher J. , Kim Esther S.H. , Luther James M. , Misra Sanjay , Oderich Gustavo S. ,   on behalf of the American Heart Association Council on the Kidney in Cardiovascular Disease; Council on Hypertension; Council on Peripheral Vascular Disease; and Council on Cardiovascular Radiology and Intervention
Published: June 2022

Renovascular disease is a major causal factor for secondary hypertension and renal ischemic disease. However, several prospective, randomized trials for atherosclerotic disease failed to demonstrate that renal revascularization is more effective than medical therapy for most patients. These results have greatly reduced the generalized diagnostic workup and use of renal revascularization. Most guidelines and review articles emphasize the limited average improvement and fail to identify those clinical populations that do benefit from revascularization. On the basis of the clinical experience of hypertension centers, specialists have continued selective revascularization, albeit without a summary statement by a major, multidisciplinary, national organization that identifies specific populations that may benefit. In this scientific statement for health care professionals and the public-at-large, we review the strengths and weaknesses of randomized trials in revascularization and highlight (1) when referral for consideration of diagnostic workup and therapy may be warranted, (2) the evidence/rationale for these selective scenarios, (3) interventional and surgical techniques for effective revascularization, and (4) areas of research with unmet need.
Trends, Predictors, and Outcomes of Cardiovascular Complications Associated With Polycystic Ovary Syndrome During Delivery Hospitalizations: A National Inpatient Sample Analysis (2002–2019)
Authors: Zahid Salman , Khan Muhammad Zia , Gowda Smitha , Faza Nadeen N. , Honigberg Michael C. , Vaught Arthur (Jason) , Guan Carolyn , Minhas Anum S. , Michos Erin D.
Published: June 2022

Background

Women with polycystic ovary syndrome (PCOS) have an increased risk of pregnancy‐associated complications. However, data on peripartum cardiovascular complications remain limited. Hence, we investigated trends, outcomes, and predictors of cardiovascular complications associated with PCOS diagnosis during delivery hospitalizations in the United States.

Methods and Results

We used data from the National Inpatient Sample (2002–2019).
International Classification of Diseases, Ninth Revision
(
ICD‐9
), or
International Classification of Diseases, Tenth Revision
(
ICD‐10
), codes were used to identify delivery hospitalizations and PCOS diagnosis. A total of 71 436 308 weighted hospitalizations for deliveries were identified, of which 0.3% were among women with PCOS (n=195 675). The prevalence of PCOS, and obesity among those with PCOS, increased during the study period. Women with PCOS were older (median, 31 versus 28 years;
P
<0.01) and had a higher prevalence of diabetes, obesity, and dyslipidemia. After adjustment for age, race and ethnicity, comorbidities, insurance, and income, PCOS remained an independent predictor of cardiovascular complications, including preeclampsia (adjusted odds ratio [OR], 1.56 [95% CI, 1.54–1.59];
P
<0.01), eclampsia (adjusted OR, 1.58 [95% CI, 1.54–1.59];
P
<0.01), peripartum cardiomyopathy (adjusted OR, 1.79 [95% CI, 1.49–2.13];
P
<0.01), and heart failure (adjusted OR, 1.76 [95% CI, 1.27–2.45];
P
<0.01), compared with no PCOS. Moreover, delivery hospitalizations among women with PCOS were associated with increased length (3 versus 2 days;
P
<0.01) and cost of hospitalization ($4901 versus $3616;
P
<0.01).

Conclusions

Women with PCOS had a higher risk of preeclampsia/eclampsia, peripartum cardiomyopathy, and heart failure during delivery hospitalizations. Moreover, delivery hospitalizations among women with PCOS diagnosis were associated with increased length and cost of hospitalization. This signifies the importance of prepregnancy consultation and optimization for cardiometabolic health to improve maternal and neonatal outcomes.
Unveiling the distinctive traits of a nation’s research performance: The case of Italy and Norway
Authors: Abramo Giovanni , Aksnes Dag W. , D’Angelo Ciriaco Andrea
Published: June 2022

In this study, we analyze the research performance of Italian and Norwegian professors using constituent components of the Fractional Scientific Strength (FSS) indicator. The main focus is on differences across fields in publication output and citation impact. The overall performance (FSS) of the two countries, which differ considerably in research size and profile, is remarkedly similar. However, an in-depth analysis shows that there are large underlying performance differences. An average Italian professor publishes more papers than a Norwegian, while the citation impact of the research output is higher for the Norwegians. In addition, at field level, the pattern varies along both dimensions, and we analyze in which fields each country has its relative strengths. Overall, this study contributes to further insights into how the research performance of different countries may be analyzed and compared to inform research policy.
Operative vaginal delivery: practice patterns and outcomes at a tertiary general hospital
Authors: Zhang Valencia Ru-Yan , Tan Eng Loy , Edison Priyantha Ebenezer , Kanagalingam Devendra
Published: June 2022

Introduction:

There has been a global decrease in operative vaginal deliveries, with a marked shift towards the vacuum extractor. However, little is known about the trends in operative vaginal delivery in Singapore.

Methods:

A retrospective study was conducted on all operative vaginal deliveries performed from 2012 to 2017 at Singapore General Hospital (SGH). Maternal outcomes in terms of postpartum haemorrhage and obstetric anal sphincter injuries were compared between forceps- and vacuum-assisted deliveries. Neonatal outcomes in terms of neonatal intensive care unit (NICU) admission and clinically significant neonatal events were compared. The instrument preference of obstetricians was analysed.

Results:

A total of 906 consecutive operative vaginal deliveries were included in the study, comprising 461 forceps- and 445 vacuum-assisted deliveries. The rate of operative vaginal delivery was maintained at approximately 10% from 2012 to 2017. Neonatal cephalohematomas were more common after vacuum-assisted deliveries. Other maternal and neonatal outcomes did not differ significantly between the two groups. Clinically significant neonatal events were mostly due to shoulder dystocia, whereas all cases of NICU admissions were not directly related to the mode of delivery. Obstetricians’ choice of instrument appeared to reflect personal preference and was not affected by the year of graduation.

Conclusion:

The rates of neonatal and maternal morbidity were low at SGH. Overall instrument use of forceps and vacuum was balanced, and proficiency in both was demonstrated by all operators. Operative vaginal delivery remains an essential skill in facilitating safe vaginal delivery, which should be maintained to keep Caesarean section rates in check.
Cymbopleura deqinensis sp. nov. (Cymbellaceae; Bacillariophyceae), a new species from Yunnan Province, China
Authors: MENG WEN-WEN , GUO JI-SHU , ZHANG YU , PATRICK KOCIOLEK JOHN , LI YAN-LING
Published: June 2022

Cymbopleura deqinensis sp. nov. was found in surface sediments of a small, oligotrophic high-mountain lake in Deqin County, Yunnan Province, Southwest China. We describe the morphology of this new species using light and scanning electron microscopy. Cymbopleura deqinensis sp. nov. has the morphological characteristics that are typical for the genus, including dorsally deflected external distal raphe ends and often ventrally deflected proximal raphe ends as well as lacking stigmata and apical pore fields. The new species is most similar to C. similiformis var. angusta and shares features with some other species in this genus, as well. Due to the apices being bent in opposite directions, giving the valves the appearance of being slightly sigmoid, this species may, also due to its small size and finer striation, be compared to species in the genus Encyonopsis. However, a unique set of characteristics sets C. deqinensis sp. nov. apart as a new species: 1) valve ends bend in opposite directions, 2) the shape of areolae are mostly round to elliptical, partly T-shaped, V-shaped or irregularly-shaped externally and round internally, 3) it has several larger areolae near the central area, 4) the shape of central area is rectangular to elliptical or occasionally not well expressed, with irregularly shortened striae. Brief notes on the associated diatom flora and its ecology are provided.
Lectotypification of Chloris montana (Poaceae: Chloridoideae) and taxonomic notes on a few species from India
Authors: LANDGE SHAHID NAWAZ , SHINDE RAJENDRA D.
Published: June 2022

The name Chloris montana is lectotypified here, based on the morphological study and illustration from Roxburgh’s Icon stored at CAL herbarium. Chloris telanganae has been relegated as a new heterotypic synonym of C. montana. The variability in morphological characters of some species viz. C. montana, C. bournei, C. wightiana and C. quinquesetica have been discussed in detail in the Table 1 and also under a separate section at the end in addition to the correct identification and distribution of C. bournei. Additionally, an updated key to the species occurring in India is provided for easy identification.
Rediscovery of Bauhinia conceptionis (Leguminosae: Cercidoideae), a rare and endemic species of Colombian legume from Chocó - Colombia, after eighty years
Authors: CASTELLANOS CESAR , VARGAS FRANK
Published: June 2022

During a series of botanical fieldtrips in the rural areas of the municipality of Quibdó in the Pacific region of Colombia, between 2017 and 2018, a very small population of Bauhinia conceptionis Britton & Killip (Leguminosae: Cercidoideae) was detected. Bauhinia conceptionis, a rare and endemic species of Colombian legume was described based on specimens collected by W. A. Archer in 1931. Since then, the species has not been recorded again. Bauhinia conceptionis is distinguished from other Colombian species of Bauhinia by the following combination of characters: leaves suborbicular and bilobed for less than 1/5 their length, leaf base cordate and apical lobe rounded, stigma oblique – capitate, bud up to 5.5 cm long, and distribution restricted to the Chocó area. The stigma, anther and fruits are described for the first time, since the original description. We report the rediscovery of this species in its natural habitat, surroundings of La Concepcion River, area municipality of Quibdó, in a disturbed area of tropical rainforest subject to strong anthropogenic pressures including illegal logging; additionally, new taxonomic information of this specie is provided.
A taxonomic review of the genus Axinoscymnus Kamiya, with descriptions of three new species (Coleoptera, Coccinellidae)
Authors: PENG FENG , XIE XIUFENG , PENG ZHENGQIANG , WANG XINGMIN , CHEN XIAOSHEN
Published: June 2022

Eleven species of the genus Axinoscymnus Kamiya are revised, and additional three new species are described: Axinoscymnus pingxiangicus Peng et Chen sp. n., Axinoscymnus gongxinensis Peng et Chen sp. n. and Axinoscymnus hamulatus Peng et Chen sp. n. The genus Axinoscymnus is recorded from Nepal for the first time. Several species are also newly reported from the following countries: Axinoscymnus puttarudriahi Kapur et Munshi for China, Laos and Nepal, Axinoscymnus macrosiphonatus Hoàng for China and Laos, Axinoscymnua navicularis Ren et Pang for Laos and Nepal, Axinoscymnus cardilobus Ren et Pang and Axinoscymnus nigripennis Kamiya for Laos. Nomenclatural history, diagnoses, detailed description, illustrations, and distribution for most species have been provided. A key to the species of this genus is also given.
Comparisons of two cryptic Ampedus species (Coleoptera: Elateridae) by using classical systematics, ecological niche modeling, and DNA barcoding
Authors: KABALAK MAHMUT , KARACAOĞLU ÇAĞAŞAN , BİLGİÇ HAYRİYE AKEL , KARAGUZEL DILARA , KARAASLAN ÇAĞATAY
Published: June 2022

The presence of cryptic species is one of the important problems in systematics. To deal with this systematic issue, certain approaches have been utilized. DNA sequencing is one of the common techniques for estimating biodiversity, such as DNA barcoding, which might reveal cryptic species. In this study, we explore how to identify two cryptic saproxylic species using a combination of general and aedeagus morphologies, distributional patterns (in provinces and altitude), specimen abundance, ecological niche modeling (ENM), and mtDNA sequencing data (for the endemic species Ampedus platiai and A. samedovi). The close relationship and validity of these species based on classical systematics was confirmed by the available literature and by Neighbor-Joining (NJ) analysis in Mega Software. Additionally, the DNA barcoding data acquired in this study also confirmed the species status of these species  within the genus Ampedus. This also provides insights into classical systematics. ENM’s for possible current and future distributional scenarios of endemic A. platiai and A. samedovi are created by Maxent Software. Possible suitable habitats in 2050 and 2070 for the species are calculated according to IPCC5 Climate scenarios. Precipitation seasonality (coefficient of variation) has the highest percentage contribution to the resulting prediction pattern for A. platiai (52.3), the mean temperature of the wettest quarter has the highest percentage contribution to the resulting prediction pattern for A. samedovi (42.7) respectively among used bioclimatic variables in ENM. Depending on the temperature increase in 2050 and 2070, the distributions of A. platiai and A. samedovi could decrease gradually.
Developing 4D-Var for Strongly Coupled Data Assimilation Using a Coupled Atmosphere–Ocean Quasigeostrophic Model
Authors: Goodliff Michael , Penny Stephen G.
Published: June 2022

Four-dimensional variational (4D-Var) data assimilation (DA) is developed for a coupled atmosphere–ocean quasigeostrophic application. Complications arise in coupled data assimilation (CDA) systems due to the presence of multiple spatiotemporal scales. Various formulations of the background error covariance matrix (), using different localization strategies, are explored to evaluate their impact on 4D-Var performance in a CDA setting. 4D-Var requires access to tangent linear and adjoint models (TLM/AM) to propagate information about the misfit between the forecast and observations within an optimization window. In practice, particularly for coupled models, the TLM and adjoint are often difficult to produce, and for some models are nonexistent in analytic form. Accordingly, a statistical data-driven alternative is also employed and evaluated to determine its feasibility for a 4D-Var CDA system. Using experiments conducted with a coupled atmosphere–ocean quasigeostrophic model, it is found that ensemble generation of flow-dependent error covariance statistics can increase the accuracy of 4D-Var CDA. When observing all variables, the hybrid climatological/flow-dependent constructions outperform either independently. The use of a hybrid matrix combined with a rapid updating ensemble transform Kalman filter (RU-ETKF) using either strongly or weakly CDA resulted in lower overall RMSE. The ocean component achieved its lowest RMSE when using a fully flow-dependent matrix generated using 4D-ETKF and using weakly CDA. These results show the importance of time scales and analysis update frequencies. The use of a statistically derived TLM/AM generated from the ETKF ensemble perturbations produces results similar to cases using the analytical coupled TLM/AM in 4D-Var.
Should We Perform Incidental Appendectomy in Trauma Patients Undergoing Laparotomy?
Authors: Morris Erin , Marschke Brianna , Bashrum Bryan , Dhanasekara Chathurika S. , Siddiqui Arham , Tucker Amber , Dissanaike Sharmila
Published: June 2022

Incidental appendectomy (IA) is sometimes performed in patients undergoing abdominal operations to prevent subsequent development of appendicitis. Patients who undergo laparotomy for major abdominal trauma are at high risk of developing dense adhesions, increasing the risk of future operations. Therefore, there is a potential benefit to IA for patients undergoing trauma laparotomy. We performed a retrospective review of patients who underwent IA during laparotomy for abdominal trauma at a Level 1 trauma center between January 2010, and June 2020. Twenty-three patients underwent IA; they tended to be young (33.7 ± 18.9 years) and male (87%) with 12 penetrating and 11 blunt injuries. Regarding indications, 13 had no documented intra-operative abnormalities of the appendix, 6 patients had a fecalith, and 3 had trauma to the appendix. One patient’s appendix was adhered to the peritoneum and one patient had unusual anatomic location. Only one patient developed an appendiceal stump leak after IA.
Driver Visual Attention Before and After Take-Over Requests During Automated Driving on Public Roads
Authors: Pipkorn Linda , Dozza Marco , Tivesten Emma
Published: June 2022

Objective

This study aims to understand drivers’ visual attention before and after take-over requests during automated driving (AD), when the vehicle is fully responsible for the driving task on public roads.

Background

Existing research on transitions of control from AD to manual driving has mainly focused on take-over times. Despite its relevance for vehicle safety, drivers’ visual attention has received little consideration.

Method

Thirty participants took part in a Wizard of Oz study on public roads. Drivers’ visual attention was analyzed before and after four take-over requests. Visual attention during manual driving was also recorded to serve as a baseline for comparison.

Results

During AD, the participants showed reduced visual attention to the forward road and increased duration of single off-road glances compared to manual driving. In response to take-over requests, the participants looked away from the forward road toward the instrument cluster. Levels of visual attention towards the forward road did not return to the levels observed during manual driving until after 15 s had passed.

Conclusion

During AD, drivers may look toward non-driving related task items (e.g., mobile phone) instead of forward. Further, when a transition of control is required, drivers may take over control before they are aware of the driving environment or potential threat(s). Thus, it cannot be assumed that drivers are ready to respond to events shortly after the take-over request.

Application

It is important to consider the effect of the design of take-over requests on drivers’ visual attention alongside take-over times.
Trust in Shared-Space Collaborative Robots: Shedding Light on the Human Brain
Authors: Hopko Sarah K. , Mehta Ranjana K.
Published: June 2022

Background

Industry 4.0 is currently underway allowing for improved manufacturing processes that leverage the collective advantages of human and robot agents. Consideration of trust can improve the quality and safety in such shared-space human-robot collaboration environments.

Objective

The use of physiological response to monitor and understand trust is currently limited due to a lack of knowledge on physiological indicators of trust. This study examines neural responses to trust within a shared-workcell human-robot collaboration task as well as discusses the use of granular and multimodal perspectives to study trust.

Methods

Sixteen sex-balanced participants completed a surface finishing task in collaboration with a UR10 collaborative robot. All participants underwent robot reliability conditions and robot assistance level conditions. Brain activation and connectivity using functional near infrared spectroscopy, subjective responses, and performance were measured throughout the study.

Results

Significantly, increased neural activation was observed in response to faulty robot behavior within the medial and right dorsolateral prefrontal cortex (PFC). A similar trend was observed for the anterior PFC, primary motor cortex, and primary visual cortex. Faulty robot behavior also resulted in reduced functional connectivity strengths throughout the brain.

Discussion

These findings implicate regions in the prefrontal cortex along with specific connectivity patterns as signifiers of distrusting conditions. The neural response may be indicative of how trust is influenced, measured, and manifested for human-robot collaboration that requires active teaming.

Application

Neuroergonomic response metrics can reveal new perspectives on trust in automation that subjective responses alone are not able to provide.
Revealed Comparative Advantage in Services Exports: How Is India Different from China?
Authors: Banerjee Purna , Rajmal
Published: June 2022

In recent years, India has become one of the select few emerging economies to feature in the list of the world’s top services exporters. However, given similarities in demography, resource endowments and comparable shares in world services exports, India faces potential competition from China in this sector. Using a theoretically founded, regression-based measure of revealed comparative advantage, we contrast India’s revealed comparative advantage vis-à-vis China in disaggregated services sectors between 2005 and 2018. India, we find, has a comparative advantage in sectors, such as ‘telecommunications, computer, and information services’ and ‘other business services’. However, China’s advantage lies in ‘manufacturing services’ and ‘transport’. Notably, the sectors of India’s comparative advantage are also the sunrise sectors within services, displaying high growth rates and an increasing share in world services trade. A related measure—the trade elasticity index—reveals that, due to sectoral differences in comparative advantage, China does not pose a major threat to India in most of the latter’s major export destinations. Our finding implies that even if China were to enter free trade agreements with India’s major services export partners, the trade diversion losses for India would be small.

JEL Codes: F11, F14
Effect of the spark plasma sintering temperature on the microstructure and mechanical properties of a ceramic/metallic glass reinforced hybrid composite
Authors: Rezaei MR , Albooyeh A , Chachei R , Malahi P
Published: June 2022

In this investigation, hybrid aluminum matrix composites reinforced with Fe-based metallic glass (FMG) and SiC particles were synthesized using spark plasma sintering (SPS) at different sintering temperatures. The effects of sintering temperature on densification, phases, microstructure, and mechanical properties of the composites were evaluated. The findings indicate that the density of the sintered samples improved with increasing the sintering temperature. The X-ray diffraction results showed no remarkable difference in the phases of the samples sintered at different temperatures; only some small structural changes occurred in the metallic glass reinforcements. The sintering temperature had a significant effect on mechanical properties. For example, the hybrid aluminum matrix composite reinforced with 3 vol% FMG and 7 vol% SiC sintered at 550°C exhibited the ultimate compressive strength of 494 MPa, which is about 47% higher than the same composite sintered at 450°C.
Investigation of physical, mechanical, and thermal properties of glass fiber reinforced polymer composites strengthened with KH550 and KH570 silane-coated silicon dioxide nanoparticles
Authors: Uzay Çağrı
Published: June 2022

Silicon dioxide (SiO2) nanoparticles can be used as reinforcing material for composites due to their favorable characteristics. However, they are commonly subjected to surface treatments with silane coupling agents to achieve fine dispersibility and better mechanical interlocking at interface. In this study, the silane-coated SiO2 nanoparticles (as received) were used as secondary reinforcement without applying additional silane treatment process. KH550 and KH570 silane-coated SiO2 nanoparticles were dispersed, respectively, into polymer matrix, and then the modified matrix was reinforced with glass fibers. Silanized SiO2 filled glass fiber reinforced polymer (GFRP) nanocomposites were investigated for physical, mechanical, morphological, and thermal properties. Depending on the nanoparticles' ratio and silane coating, the increments were obtained till 10% for tensile strength, between 18.40% and 75.26% for flexural strength, and till 81% for impact strength. SEM confirmed that the enhancements could be attributed to the improved interfacial adhesion between the modified matrix and fiber reinforcements. The void contents within the polymer nanocomposites decreased by 38%–54% compared to a pure one. DSC and TGA examinations revealed that silanized SiO2 nanoparticles provided a better curing behavior (10% increase in Tg for 3 wt.% KH550-SiO2) and improved thermal stability for the GFRP composites (increase in Tend values by 50–70°C). Generally, KH550 silane-coated SiO2 has provided enhanced interface strengthening, leading to better characteristics for GFRP composites since the amino functional groups contained in KH550 have more favorable integration with epoxy matrix.