bluuebunny/crossref_metadata_2025 huggingface dataset:
छन्त्याल, चेपाङ र नेपाली भाषाको वचन, पुरुष र आदरगत तुलना
Authors: दाहाल Dahal दुर्गा प्रसाद Durga Prasad
Published: November 2023

छन्त्याल, चेपाङ र नेपाली भाषाको वचन, पुरुष र आदरगत तुलना’ शीर्षकको यस लेखमा छन्त्याल र चेपाङ र नेपाली भाषालाई वचन, पुरुष र आदरका आधारमा विश्लेषण गरिएको छ । सबै भाषामा वचन, पुरुष र आदरको व्यवस्था समान किसिमको देखिँदैन । कतिपय भाषामा वचनको प्रभाव कर्ता र क्रिया दुवैमा पर्ने गरेको पाइन्छ भने कतिपय भाषामा वचनको प्रभाव कर्तामा मात्र परी क्रियामा परेको पाइँदैन । छन्त्याल र चेपाङ भाषाको वचनको प्रभाव कर्तामा मात्र परेको देखिन्छ , यिनीहरूमा नेपाली भाषामा जस्तो वचनको प्रभाव क्रियामा परेको देखिँदैन । यसले गर्दा छन्त्याल र चेपाङ भाषीले नेपाली भाषाको प्रयोग गर्दा वचनका आधारमा क्रियाको सङ्गतिको प्रयोगमा कठिनाइ अनुभव गर्दछन् अर्थात् उनीहरूले नेपाली भाषाको अभिव्यक्तिमा वचनका आधारमा क्रियाको सङ्गतिमा त्रुटि गर्न सक्ने देखिन्छ । यसैगरी पुरुषको प्रभाव कतिपय भाषामा कर्ता र क्रिया दुवैमा परेको पाइन्छ भने कतिपय भाषामा कर्तामा मात्र परेको हुन्छ । छन्त्याल र चेपाङ भाषामा पुरुषको प्रभाव कर्तामा मात्र सीमित रहेको देखिन्छ, नेपाली भाषामा जस्तो पुरुषको प्रभाव क्रियामा परेको देखिँदैन । यसकारण छन्त्याल र चेपाङ मातृभाषीहरूले नेपाली भाषाको प्रयोगमा पुरुषगत क्रियाको सङ्गतिको प्रयोगमा जटिलता अनुभव गर्दछन्अर्थात्उनीहरूले नेपाली भाषाको अभिव्यक्तिमा पुरुषको आधारमा क्रियाको सङ्गतिमा त्रुटि गर्न सक्ने देखिन्छ । कतिपय भाषामा आदरार्थीका विभिन्न रूपहरू पाइन्छन् भने कतिपय भाषामा आदारार्थीका विभिन्न रूपहरू पाइँदैनन्। छन्त्याल र चेपाङ भाषाको अभिव्यक्तिमा नेपाली भाषामा जस्तो आदरको तहमा विभेद पाइँदैन त्यसैले यिनीहरूले नेपाली भाषाको प्रयोगमा आदरगत प्रयोगमा कठिनाइ अनुभव गर्दछन्अर्थात्उनीहरूले नेपाली भाषाको अभिव्यक्तिमा आदरगत प्रयोगमा त्रुटि गर्ने सम्भावना देखियो ।
Homogenization of Attractors to Ginzburg-Landau Equations in Media with Locally Periodic Obstacles: Critical Case
Authors: Bekmaganbetov K.A. , Chechkin G.A. , Chepyzhov V.V. , Tolemis A.A.
Published: November 2023

In this paper the Ginzburg-Landau equation is considered in locally periodic porous medium, with rapidly oscillating terms in the equation and boundary conditions. It is proved that the trajectory attractors of this equation converge in a weak sense to the trajectory attractors of the limit Ginzburg-Landau equation with an additional potential term. For this aim we use an approach from the papers and monographs of V.V. Chepyzhov and M.I. Vishik concerning trajectory attractors of evolution equations. Also we apply homogenization methods appeared at the end of the XX-th century. First, we apply the asymptotic methods for formal construction of asymptotics, then, we verify the leading terms of asymptotic series by means of the methods of functional analysis and integral estimates. Defining the appropriate axillary functional spaces with weak topology, we derive the limit (homogenized) equation and prove the existence of trajectory attractors for this equation. Then we formulate the main theorem and prove it with the help of axillary lemmas.
Ranks and approximations for families of cubic theories
Authors: Markhabatov N.D.
Published: November 2023

In this paper, we study the rank characteristics for families of cubic theories, as well as new properties of cubic theories as pseudofiniteness and smooth approximability. It is proved that in the family of cubic theories, any theory is a theory of finite structure or is approximated by theories of finite structures. The property of pseudofiniteness or smoothly approximability allows one to investigate finite objects instead of complex infinite ones, or vice versa, to produce more complex ones from simple structures.
Solution of a two-dimensional parabolic model problem in a degenerate angular domain
Authors: Ramazanov M.I. , Gulmanov N.K. , Kopbalina S.S.
Published: November 2023

In this paper, the boundary value problem of heat conduction in a domain was considered, boundary of which changes with time, as well as there is no the problem solution domain at the initial time, that is, it degenerates into a point. To solve the problem, the method of heat potentials was used, which makes it possible to reduce it to a singular Volterra type integral equations of the second kind. The peculiarity of the obtained integral equation is that it fundamentally differs from the classical Volterra integral equations, since the Picard method is not applicable to it and the corresponding homogeneous integral equation has a nonzero solution.
MOTIVATION FACTORS FOR EDUCATIONAL AND RESEARCH ENGAGEMENT AMONG STUDENTS DURING WARTIME
Authors: Mamontova T.V. , Miahkokhlib A.A. , Mishchenko I.V. , Donchenko V.I. , Mamontova V.D.
Published: November 2023

The Russian invasion of Ukraine on February 24, 2022 dealt a severe blow to the educational and scientific aspirations of the young generation in our country. The destruction of universities, lack of essential equipment and reagents, power shortages, and disrupted communication between students and their academic mentors due to the adoption of distance learning have significantly hindered their pursuit of education and science. This study aims to analyze the motivational factors that drive students to engage in academic and scientific work during the ongoing wartime. Materials and methods. For this cross-sectional study, we gathered data from 75 respondents who were studying in higher educational institutions of Ukraine as of February 24, 2022 in the period from September to October 2022. Results. Since the beginning of the war in Ukraine, 36% of respondents reported a reduction in available time for educational activities, 18.67% of respondents noted a decrease in the time allocated to scientific work. An analysis of the respondents' involvement in scientific research during their study at higher education institutions revealed that 67% of respondents considered student scientific research to be an integral part of the educational environment. Prior to the war, key motivational factors for young women included seeking social approval from family or friends and pursuing rewards. For young men, it was challenging to pinpoint a singular most significant factor, but social approval from family or friends, personal satisfaction, and interest in research projects were notably prominent. With the onset of the war, among young women, the primary motivating factors that remained pivotal were an interest in science and the recognition of the value of their research outcomes. Among young men, a loss of distinct boundaries between motivational priorities for engaging in scientific work was observed. Conclusion. The ongoing war has brought about a substantial shift in how students perceive scientific work, leading to a discernible decrease in motivation among this demographic. This research serves as a valuable foundation for developing strategies aimed at bolstering motivation and encouraging active participation in scientific research among young individuals. Furthermore, it offers insights that can be instrumental in enhancing the quality of education at Ukrainian universities during times of conflict.
Sustainable method for tender selection using linear Diophantine multi-fuzzy soft set
Authors: KANNAN Jeevitha , JAYAKUMAR Vimala
Published: November 2023

Tender selection is a fundamental issue for the success of construction projects since it contributes to the overall outline’s performance. In reallife problems, the decision-makers cannot express certain crisp data, so there is uncertainty and vagueness in the values. In this paper, a sustainable technique is proposed to find desirable tenderers coherently and fairly under the needed circumstances. This paper presents three methods of an algorithmic approach to evaluate the tendering process and rank the tenderers. The attributes are expressed as Linear Diophantine Multi-Fuzzy Soft numbers (LDMFSN) since the existence of reference parameters makes the DM freely choose their grade values. Some of the rudimentary properties of LDMFSN are presented. An illustrative example is demonstrated to validate our proposed method. The uniqueness of the result in all three algorithms shows the effectiveness of our proposed approach.
Analysis of abnormal returns and trading volume activity before and after the announcement of the implementation of new normal
Authors:   Accounting Department, Politeknik Negeri Bali, Indonesia, Juniantara Pande I Komang , Dwijayanti Ni Made Ayu ,   Accounting Department, Politeknik Negeri Bali, Indonesia, Suprapto Putu Adi ,   Accounting Department, Politeknik Negeri Bali, Indonesia
Published: November 2023

The announcement of the New Normal implementation on June 1, 2020 is anticipated to serve as a pivotal moment poised to revitalize the previously sluggish Indonesian Capital Market during the COVID-19 Pandemic. The purpose of this study was to see whether there were differences in abnormal returns and trading volume activity between before and after the announcement of the implementation of the New Normal in Indonesia. This type of research is comparative quantitative research with an event study approach in hotel, restaurant and tourism companies. The population in this research is all company shares listed on the Indonesian capital market until 2020, totaling 711 company shares. The sample selection used purposive sampling, resulting in a research sample of 37 company shares. The observation period was carried out for 15 days, namely 7 days before, 7 days after, and 1 day of the New Normal event in Indonesia. The analysis technique uses Descriptive Statistics Test, Normality Test and Hypothesis Test. The results of the study show that there is no significant difference in abnormal returns and trading volume activity between before and after the announcement of the implementation of the New Normal in Indonesia. This proves that there is still information asymmetry between market participants regarding the announcement of the implementation of the New Normal in Indonesia which causes the market not to react to this event.
CORRELATION BETWEEN BIRTH WEIGHT AND STUNTING IN CHILDREN UNDER FIVE A CASE-CONTROL STUDY
Authors: Amartha Tecky Afifah Santy
Published: November 2023

Stunting is a condition in which children experience delayed growth and development due to poor nutrition, recurrent infections, and inadequate psychosocial stimulation. The prevalence of children under 5 affected by stunting in 2020 is 22.3% or 148.1 million children worldwide. The analytical case-control study was conducted to explore the prevalence of child stunting and determine the association between birth weight and stunting occurrence among children under 5 years. It shows statistically significant with a p-value of 0.009 (p-value 0.05). A history of birth weight 2500 gr babies have a 3,660 times greater risk of experiencing stunting compared to children under 5 who were born with birth weight ≥2500 gr (CI=95%). There was a significant association between birth weight and stunting incidence among children under 5 years.
Exploring the relationship between gender and competencies development in higher education institutions: Perspectives from a university in Zimbabwe
Authors: Zvavahera Promise , Pasipanodya Sheppard , Bogalin Victor , Aquino Emmanuel
Published: November 2023

This research explores challenges faced by female academics in higher education institutions (HEIs) as they strive to cultivate the competencies necessary for a sustainable future. To delve into these challenges, a qualitative case study was conducted at a Zimbabwean university. All 64 academics employed at the university participated in the study, employing focus group discussions, face-to-face interviews, and online questionnaires, adapting to COVID-19 restrictions. The findings uncovered a lack of gender integration in university programmes and initiatives, leading to unequal engagement and limited access to resources and opportunities. A substantial portion of female academics lacked essential competencies in research, interdisciplinary collaboration, and grant proposal writing. These imbalances stemmed from male academics holding influential roles and controlling significant resources. Consequently, the research concludes that the institution's prevailing culture, systems, and procedures impede the development of vital skills among female academics, restricting their ability to contribute fully to a better future.
Klinikoradyolojik Olarak Maligniteleri Taklit Eden Santral Sinir Sistemi Enfeksiyöz Hastalıkları
Authors: ÖZŞEN Mine , TOLUNAY Sahsine , DİNÇ Havva Merve , DOĞAN Şeref , KOCAELİ Hasan
Published: November 2023

Santral sinir sistemi (SSS) enfeksiyonları gelişen tanı ve tedavi yöntemlerine rağmen hala önemli bir morbidite ve mortalite nedenidir. Gözlenen şikayetlerin nonspesifik olması özellikle intrakranial tüberküloma ve beyin absesi başta olmak üzere çeşitli SSS enfeksiyon hastalığının klinikoradyolojik olarak malignitelerle karışabilmesine neden olmaktadır. Bu durum göz önünde bulundurularak çalışmamızda klinikoradyolojik olarak maligniteleri taklit eden SSS enfeksiyöz hastalıklarının klinikoradyolojik ve histomorfolojik özelliklerini olgularımız üzerinden paylaşarak bilimsel literatüre katkıda bulunmak amaçlanmıştır. Bu retrospektif çalışmada patoloji arşivi taranarak, 2010-2023 yılları arasında klinikoradyolojik bulgular doğrultusunda malignite ön tanısı ile opere edilen ancak histopatolojik değerlendirme sonucu santral sinir sisteminin enfeksiyon hastalıkları ile uyumlu tanı alan 19 olgu dahil edildi. Çalışmaya dahil edilen 19 olgunun 8’i kadın, 11’i erkekti. Olguların ortalama yaş değeri 51+15,68 iken yaş dağılımı 21 ile 72 arasında değişmekteydi. Klinikoradyolojik bulgular doğrultusunda 6 olguya glial tümör, 3 olguya tümöral lezyon, 3 olguya neoplaziye bağlı patolojik kırık, 2 olguya meningioma, 2 olguya metastaz, 2 olguya sinir kılıfı tümörü ve 1 olguya hipofiz adenomu ön tanısı ile eksizyon planlandı. Histomorfolojik değerlendirmede olguların %52,6’sında nekrotizan granülomatöz iltihap, %15,8’inde süpüratif inflamasyon ve %10,5’inde kist hidatik ile uyumlu bulgular saptandı. SSS enfeksiyonları farklı predispozan durumlarda farklı etkenlerin neden olduğu, doğru ve etkin tedavi edilmediği takdirde morbidite ve mortalite oranları yüksek hastalıklardır. Bu hastalıkların santral sinir sisteminin primer ve metastatik maligniteleri ile örtüşen şikayet, semptom ve radyolojik bulguya sahip olması doğru tanı koymayı zorlaştıran durumlardır. Olguyu değerlendirirken ihtimaller akılda bulundurulmalı ve olgu klinik öyküsü ile birlikte bir bütün halinde değerlendirilmelidir.
Hotspot areas of marine introduced species in the Southwestern Atlantic
Authors: Reyna PB , Alurralde G , Taverna A , Calcagno E , Scarabino F , Vélez-Rubio GM , Tatián M , Schwindt E
Published: November 2023

Some worldwide marine regions have been invaded by introduced species more than others, and those accruing a large number of introduced species are identified as hotspot areas. The southern Southwest Atlantic (SWA) is a vast region that has a variety of heterogeneous environments that are affected by different environmental and anthropogenic drivers and have been colonized by many introduced species. Nevertheless, a comprehensive analysis considering all these aspects together to identify hotspots of introduced species has not been developed, nor has a statistically based procedure to define and identify these hotspots been produced. Therefore, the main objectives of this study were to (1) quantify the spatial richness of introduced species (ISR) in the SWA, (2) identify introduced species hotspots, (3) explore the environmental and anthropogenic drivers that explain the ISR pattern and the assemblage composition of introduced species in these hotspots, and (4) assess the variation in the assemblage species composition among the introduced species in the identified hotspots. Six different hotspots were identified. The ISR in these hotspots was significantly explained by a set of environmental (maximum and minimum sea surface temperature, distance to shore, maximum salinity) and anthropogenic drivers (maritime traffic density, distance to the nearest port). Assemblage composition was related only to the environmental predictors. The variation in assemblage composition showed heterogeneity among introduced species hotspots. Our study shows that mapping introduced species hotspots and identifying them through spatial statistics facilitates the synthesis and integration of information objectively. This represents a cutting-edge approach to prioritize areas for management and adopt policies for the SWA.
REDUCING PUBLIC SKEPTISM THROUGH CORPORATE SOCIAL RESPONSIBILITY COMMUNICATION
Authors: Uljanatunnisa Uljanatunnisa , Febriany  , Hidayah Della Bagusnur
Published: November 2023

Penelitian ini bertujuan untuk menganalisis komunikasi Corporate social Responsibility sebagai upaya mengurangi skeptisme publik terhadap PT HM Sampoerna, hal ini didasari atas pro dan kontra Program CSR dan komunikasi CSR khususnya pada Industri kontroversi seperti perusahaan Rokok. Menggunakan empat dimensi pesan insitiatif CSR yaitu CSR Komitmen, CSR impact, CSR Motive dan CSR FIT dengan metode analisis isi kualitatif, data primer penelitian ini adalah postingan pada akun media sosial resmi @insidesampoerna pada periode pengambilan data dilakukan sejak 1 Januari 2023 hingga 30 Mei 2023. Berdasarkan hasil koding, peneliti menemukan bahwa sebagian besar komunikasi CSR Perusahaan menggunakan pesan inistiatif CSR Impact yang direpresentasikan dengan keterangan “dampak yang sudah dirasakan oleh stakeholder. Selanjutnya CSR motiv, CSR Komitmen dan CSR Fit juga terlihat pada postinga Instagram perusahaan
Milled rapeseeds and oats decrease milk saturated fatty acids and ruminal methane emissions in dairy cows without changes in product sensory quality
Authors: Halmemies-Beauchet-Filleau Anni , Jaakkola Seija , Kokkonen Tuomo , Turpeinen Anu M. , Givens D. Ian , Vanhatalo Aila
Published: November 2023

Plant lipids in the diet are known to modify milk fatty acid (FA) composition and mitigate ruminal methane emissions. The objective of the present work was to examine the potential of milled rapeseeds and oats to decrease both milk saturated FAs and ruminal methane emissions in practical farm settings. In the pilot study, six Finnish Ayrshire cows were fed a control diet for 3 weeks, which was then followed by a lipid-rich test diet for 3 weeks. The experimental diets were based on grass silage supplemented with barley and rapeseed meals in the control diet and with oats and milled rapeseeds in the test diet. The lipid inclusion rate was 55 g/kg dry matter (DM). In the main study, the whole Finnish Ayrshire research herd in milk (n = 49–59) was used in a switch-back-designed study. The cows were fed a control diet for 3 weeks, then a test diet for 4 weeks, and, finally, a control diet for 3 weeks. The diets were the same as in the pilot study except for a lower lipid inclusion level of 50 g/kg DM. The test diet decreased DM intake by 15% and energy-corrected milk (ECM) yield by 13% in the pilot study. The adjustment of supplemental lipids from 55 g/kg to 50 g/kg DM was successful, as the DM intake decreased only by 4% relative to the control diet in the main study. Furthermore, the yields of milk, lactose, protein, and fat were also unaffected by dietary lipids in the main study. The milk fat composition was significantly altered in both studies. The milk fat saturated FAs were decreased by 16%–20% in the test diet, mainly due to the de novo FAs of 6- to 16-carbons (a reduction of 22%–48%). Milk fat cis-9 18:1 was increased by 63%–78% in the test diet relative to the control. Dairy products’ (milk, butter, and cheese) organoleptic quality was not compromised by the modified lipid profile. Ruminal methane and hydrogen intensities (n = 23; g or mg/kg ECM) were 20% and 39% lower, respectively, in the test diet than in the control diet. This reduction can be attributed to a lower amount of organic matter fermented in the rumen, as indicated by the lower DM intake and nutrient digestibility.
PRP coating on different modified surfaces promoting the osteointegration of polyetheretherketone implant
Authors: Shi Xiaotong , Wang Zongliang , Guo Min , Wang Yu , Bi Zhiguo , Li Dongsong , Zhang Peibiao , Liu Jianguo
Published: November 2023

Introduction: Polyetheretherketone (PEEK) material implants have been applied more and more clinically recently. In order to increase the osteogenic activity of PEEK material, the microstructure change of the material surface and the construction of functional microcoatings have become a hot research topic. This study investigated the ability of PEEK surfaces modified by different methods to carry Platelet-rich plasma (PRP) and the osteogenic ability of different PEEK microstructures after carrying PRP in vivo/in vitro.

Methods: In this study, PEEK surfaces were modified by sulfuric acid, gaseous sulfur trioxide and sandpaper. Next, PRP from SD rats was prepared and incubated on PEEK material with different surface microstructures. Lactate dehydrogenase test, scanning electron microscope and Elisa assay was used to evaluate adhesion efficiency of PRP. Then in vitro tests such as CCK-8, ALP staining, ARS staining and RT-qPCR et al were used to further evaluate osteogenesis ability of the PRP coating on PEEK surface. Finally, The tibia defects of SD rats were established, and the new bone was evaluated by Micro-CT, HE staining, and immunofluorescence staining.

Results: The sandpaper-polished PEEK with the strongest PRP carrying capacity showed the best osteogenesis. Our study found that the modified PEEK surface with PRP coating has excellent osteogenic ability and provided the basis for the interface selection of PRP for the further application of PEEK materials.

Discussion: Among the three PEEK modified surfaces, due to the most PRP carrying and the strongest osteogenic ability in vitro/vivo, the frosted surface was considered to be the most suitable surface for the preparation of PRP coating.
Surgical treatment of tertiary hyperparathyroidism: does one fit for all?
Authors: Casella Claudio , Guarneri Claudio , Campanile Manuela , Adhoute Xavier , Gelera Pier Paolo , Morandi Riccardo
Published: November 2023

Background

Tertiary hyperparathyroidism (3HPT) is defined as a condition of excessive autonomous excretion of intact parathyroid hormone (iPTH) with persistent hypercalcemia (>10.5 mg/dL) that lasts for more than 12 months after a successful kidney transplantation, in the context of a long course secondary hyperparathyroidism (2HPT). The chronic high levels of iPTH cause a worsening of graft function, accompanied by systemic symptoms of hypercalcemia. The only curative therapy is parathyroidectomy (PTX). It remains unclear whether total parathyroidectomy with autotransplantation (TPTX-AT) or subtotal parathyroidectomy (SPTX) lead to better outcomes.

Aims

The aim of this retrospective, single-institution cohort study is to evaluate the rate of persistent or recurrent disease and postoperative calcium/iPTH disturbances in patients treated with TPTX-AT or SPTX for 3HPT.

Methods

A single-center retrospective analysis of 3HPT patients submitted to TPTX-AT or SPTX between 2007–2020 with at least 24 months follow-up was conducted. The outcome parameters included persistence/recurrence of disease, incidence of transitory hypocalcemia, and temporary/permanent hypoparathyroidism.

Results

A cohort of 52 patients was analyzed and divided in two groups: 38 (73%) were submitted for TPTX-AT, and 14 patients (27%) were submitted for SPTX. The TPTX-AT population showed lower plasmatic calcium concentrations compared with the SPTX group during the entire follow-up period (p<0.001). There were eight cases (21%) of transitory hypocalcemia in the TPTX-AT group and none in the SPTX group, with p=0.065. Two cases (5%) of temporary hypoparathyroidism occurred in the TPTX-AT group and none in the SPTX group, with p= 0.530. There were no cases of permanent hypoparathyroidism and no cases of persistent disease. No statistical difference was assessed for the recurrence of 3HPT between the TPTX-AT group and the SPTX group (N=1, 3% vs N=1, 7%) (p=0.470).

Conclusion

No significative difference was registered between the TPTX-AT and SPTX groups in terms of persistence/recurrence of disease, incidence of transitory hypocalcemia, and temporary/permanent hypoparathyroidism. Mean calcium levels iPTH values were statistically lower among the TPTX-AT group compared with the SPTX group while remaining always in the range of normality.
Effects of mulberry twig alkaloids(Sangzhi alkaloids) and metformin on blood glucose fluctuations in combination with premixed insulin-treated patients with type 2 diabetes
Authors: Meng Ziyu , Xu Chengye , Liu Haoling , Gao Xinyuan , Li Xinyu , Lin Wenjian , Ma Xuefei , Yang Changwei , Hao Ming , Zhao Kangqi , Hu Yuxin , Wang Yi , Kuang Hongyu
Published: November 2023

Introduction

We aimed to evaluated the effect of premixed insulin (Ins), premixed insulin combined with metformin (Ins+Met) or mulberry twig alkaloids(Ins+SZ-A) on blood glucose fluctuations in patients with type 2 diabetes (T2DM) using continuous glucose monitors (CGM).

Methods

Thirty patients with T2DM and poor blood glucose control using drugs were evaluated for eligibility during the screening period. Subsequently, their original hypoglycemic drugs were discontinued during the lead-in period, and after receiving Ins intensive treatment for 2 weeks, they were randomly assigned to receive either Ins, Ins+Met, or Ins+SZ-A treatment for the following 12 weeks. The main efficacy endpoint comprised changes in their CGM indicators changes (mean blood glucose level [MBG], standard deviation of blood glucose [SDBG], mean amplitude of glycemic excursions [MAGE], postprandial glucose excursions [PPGE], the largest amplitude of glycemic excursions [LAGE], mean of daily difference [MODD], time in range between 3.9–10.0 mmol/L [TIR] and area under the curve for each meal [AUCpp]) during the screening, lead-in, and after 12-week treatment period. Changes in glycosylated hemoglobin (HbA1c), fasting blood glucose (FBG), 1-h postprandial blood glucose (1h-PBG), 2-h postprandial blood glucose (2h-PBG), fasting blood lipids and postprandial blood lipids were also measured at baseline and after 12 weeks of treatment

Results

The CGM indicators of the three groups during the lead-in period all showed significant improvements compared to the screening period (P<0.05). Compared with those in the lead-in period, all of the CGM indicators improved in the the Ins+Met and Ins+SZ-A groups after 12 weeks of treatment (P<0.05), except for MODD. After 12-week treatment, compared with the Ins group, Ins+Met and Ins+SZ-A groups showed improved MBG, SDBG, TIR, breakfast AUCpp,lunch AUCpp, HbA1c, FBG, 1h-PBG, fasting blood lipid and postprandial blood lipid indicators (P<0.05). Further, the LAGE, PPGE, MAGE, dinner AUCpp and 2h-PBG levels of the Ins+SZ-A group were significantly lower than those of the Ins+Met and Ins groups (P<0.05).

Conclusion

Our findings highlight the efficacy of combination therapy (Ins+SZ-A or Ins+Met) in improving blood glucose fluctuations, as well as blood glucose and lipid levels. Ins+SZ-A reduces postprandial blood glucose fluctuations more than Ins+Met and Ins groups.

Trial registration number

ISRCTN20835488.
Management and surgical treatment of parathyroid carcinoma: a 6-year experience of a single centre of endocrine surgery unit
Authors: Laforgia Rita , Tomasicchio Giovanni , Cavalera Federica , Sblendorio Maria , Spadone Annamaria , Anelli Ferdinando Massimiliano , Lobascio Pierluigi , Marzaioli Rinaldo , Panebianco Annunziata , Pezzolla Angela
Published: November 2023

Background

Parathyroid carcinoma (PC) affects 0.1-0.3% of the general population and represents the rarest malignant neoplasms among endocrinological diseases, comprising less than 1%. The best therapeutic treatment and management methods are still debated in the literature. The aim of this study is to evaluate the management and surgical treatment of parathyroid carcinoma after 6 years of enrolment with the Endocrine Surgery Unit of the University Hospital of Bari.

Materials and methods

A retrospective observational study was carried out using a prospectively maintained database of patients affected by primary hyperparathyroidism between January 2017 and September 2022. Consecutive patients over 18 years old with a final histopathological finding of PC were included in the study. Patients with secondary or tertiary hyperparathyroidism, parathyroid hyperplasia, and parathyroid adenoma were excluded. All patients underwent follow-up every 6 months for the first 2 years, and annually thereafter.

Results

In this study, 9 out of 40 patients affected by hyperparathyroidism were included; 6 (66.6%) were female and 3 (33.3%) were male patients, with a median age of 59 years (IQR 46-62). None had a family history of PC. No mortality was recorded while the incidence of recurrence was 22.2%, with a disease-free survival of 8 and 10 months. Parathyroidectomy was performed in five patients, while four patients underwent parathyroidectomy with concurrent thyroidectomy for thyroid goitre. No intraoperative complications were recorded. Open parathyroidectomy was performed with a mini-cervicotomy in seven patients, while two patients underwent robotic surgery. All patients were discharged on the second postoperative day.

Conclusion

PC represents a great challenge in terms of preoperative diagnosis, management and treatment. A surgical approach represents the first best option for PC in referral endocrine surgery units. The early identification of risky patients should be the dominant goal to plan an appropriate therapy and to perform adequate en bloc surgery.
Association between triglyceride glucose-body mass index and heart failure in subjects with diabetes mellitus or prediabetes mellitus: a cross-sectional study
Authors: Yang Shuping , Shi Xiangxiang , Liu Wanlu , Wang Zhaokai , Li Ruoshui , Xu Xianzhi , Wang Chaofan , Li Lei , Wang Ruili , Xu Tongda
Published: November 2023

Background

The triglyceride glucose-body mass index (TyG-BMI) is a surrogate indicator of insulin resistance. However, the association of TyG-BMI with heart failure (HF) in individuals with diabetes mellitus or prediabetes mellitus is unknown.

Methods

This study included 7,472 participants aged 20–80 years old with prediabetes or diabetes from the National Health and Nutrition Examination Survey (2007–2018). The TyG-BMI was calculated as Ln [triglyceride (mg/dL) × fasting blood glucose (mg/dL)/2] × BMI, and individuals were categorized into tertiles based on TyG-BMI levels. The relationship of TyG-BMI with HF was analyzed using multiple logistic regression models. Subgroup analyses were stratified by gender, age, hypertension, and diabetes mellitus status.

Results

This cross-sectional study had 7,472 participants (weighted n = 111,808,357), including 329 HF participants. Participants with a high TyG-BMI were prone to HF. The highest tertile group with a fully adjusted model was more likely to have HF compared to the lowest tertile group (odds ratio [OR], 2.645; 95% CI, 1.529–4.576). Restricted cubic spline analysis showed a significant dose-response relationship between TyG-BMI and HF (P < 0.001). In subgroup analyses, similar results were seen in terms of age (≥50 years old), gender, hypertension, and diabetes mellitus status.

Conclusion

A high TyG-BMI is significantly associated with HF risk in participants with diabetes mellitus or prediabetes mellitus.
Analysis of D-Q small-signal impedance of back-to-back frequency converter
Authors: Cai Zhongqi , Han Jizhi , Chen Jianfu , Gan Deshu , Zhang Haitao , Wang Xiuli
Published: November 2023

The back-to-back frequency converter plays a vital role in the formation of the fractional frequency transmission system Despite their numerous advantages, however, impacted by the unique impedance characteristics of power electronics, the wide-band oscillations occur more frequency as well as more common recently, which have posed great challenges to the system operation and raised great concern over the researchers worldwide. To address this issue and properly investigate the impedance characteristics of the back-to-back frequency converter, this manuscript establishes the small-signal impedance of the back-to-back frequency converter with inner current control loop and outer voltage/power control loop in the synchronous reference (dq) frame. Then, by using the impedance model and determinant-based General Nyquist Criterion (GNC), the stability assessment and instability cause identification are studied. Finally, the analysis presented in this paper is verified based on frequency and time-domain simulations in the MATLAB/Simulink environment.
Analyzing the response distribution of DO concentration and its environmental factors under the influence of typhoon rain events with remote sensing
Authors: Shen Weiping , Jin Yuhao , Li Gengying , Cong Peitong
Published: November 2023

Typhoon rain events are important factors that trigger changes in dissolved oxygen concentrations in watersheds. The direction of the typhoon driving force is clear, but the mode of action and mechanism are complex. Moreover, quantifying the relationship between these actions and dissolved oxygen is challenging. This study collected measured data from water quality monitoring and remote sensing during the 2022 typhoon rain events. By analyzing the changes in typhoon driving factors and dissolved oxygen (DO) concentrations in water under various typhoon storms, extended MOORA plus the full multiplicative form (MULTIMOORA), Multiscale Geographic Weighted Regression (MGWR), and spatial autocorrelation analysis were used to evaluate the response of DO concentration. Furthermore, the effects of the atmospheric environment under the influence of human activities on the response distribution of the urban water environment were analyzed. The results of the study showed that under the effect of a typhoon with higher rainfall intensity, the response of DO concentration in the water body of the river in the center of the city was better. However, the response of DO concentration in the water body at the mouth of the sea had a tendency to become worse. Under the influence of typhoon rain events with smaller intensity, the scouring effect of rainwater dominated, and the DO concentration response in the water body had a tendency to become worse. The analysis of spatial heterogeneity under the influence of human activities showed that the ranking values of DO concentration response in rivers in the city area of Zhongshan, under the influence of typhoon rain events, were positively correlated with the distribution of ozone (O3) concentration and sulfur dioxide (SO2) concentration in the eastern, central, and western parts of Zhongshan. Conversely, it was negatively correlated with the distribution of O3 concentration and SO2 concentration in the northern and southern parts of Zhongshan. Based on the research results, we constructed a technique to evaluate the response of dissolved oxygen concentration during the typhoon transit period, which can provide an indicator reference for urban managers in water environment management.
Immunotherapy in patients with brain metastasis: advances and challenges for the treatment and the application of circulating biomarkers
Authors: Brozos-Vázquez E. M. , Rodríguez-López C. , Cortegoso-Mosquera A. , López-Landrove S. , Muinelo-Romay L. , García-González J. , López-López R. , León-Mateos L.
Published: November 2023

The central nervous system (CNS) is one of the most frequent metastatic sites of various cancers, including lung cancer, breast cancer and melanoma. The development of brain metastases requires a specific therapeutic approach and is associated with high mortality and morbidity in cancer patients. Advances in precision medicine and the introduction in recent years of new drugs, such as immunotherapy, have made it possible to improve the prognosis of these patients by improving survival and quality of life. New diagnostic techniques such as liquid biopsy allow real-time monitoring of tumor evolution, providing molecular information on prognostic and predictive biomarkers of response to treatment in blood or other fluids. In this review, we perform an exhaustive update of the clinical trials that demonstrate the utility of immunotherapy in patients with brain metastases and the potential of circulating biomarkers to improving the results of efficacy and toxicity in this subgroup of patients.
Diversity of the microbiota communities found in the various regions of the intestinal tract in healthy individuals and inflammatory bowel diseases
Authors: Lawal Samuel Adefisoye , Voisin Athalia , Olof Hana , Bording-Jorgensen Michael , Armstrong Heather
Published: November 2023

The severe and chronic inflammatory bowel diseases (IBD), Crohn disease and ulcerative colitis, are characterized by persistent inflammation and gut damage. There is an increasing recognition that the gut microbiota plays a pivotal role in IBD development and progression. However, studies of the complete microbiota composition (bacteria, fungi, viruses) from precise locations within the gut remain limited. In particular, studies have focused primarily on the bacteriome, with available methods limiting evaluation of the mycobiome (fungi) and virome (virus). Furthermore, while the different segments of the small and large intestine display different functions (e.g., digestion, absorption, fermentation) and varying microenvironment features (e.g., pH, metabolites), little is known about the biogeography of the microbiota in different segments of the intestinal tract or how this differs in IBD. Here, we highlight evidence of the differing microbiota communities of the intestinal sub-organs in healthy and IBD, along with method summaries to improve future studies.
Conversion therapy with immunotherapy plus chemotherapy achieves a pathological complete response in stage IIIC NSCLC
Authors: Fu Yu , Duan Weichen , Xu Ran , Chen Jiajia
Published: November 2023

As stage IIIC non-small cell lung cancer (NSCLC) is not recommended for surgical resection, the survival and prognosis for stage IIIC NSCLC remain poor. More powerful and individualized therapies are urgently needed to improve the prognosis of stage IIIC NSCLC. Recently, immunotherapeutics have been increasingly considered in the neoadjuvant therapy of NSCLC. This study presents a patient with stage IIIC NSCLC achieving a pathological complete response (pCR) following conversion therapy with immunotherapy plus chemotherapy. This case also presents a histologic transformation from squamous cell carcinoma to adenocarcinoma after prolonged progression-free survival (PFS) following surgery. Collectively, this case suggests that conversion immunotherapy with chemotherapy and subsequent surgery can be considered and benefits a subset of unresectable stage IIIC NSCLC.
High maternal-fetal HLA eplet compatibility is associated with severe manifestation of preeclampsia
Authors: Stefańska Katarzyna , Kurkowiak Małgorzata , Piekarska Karolina , Chruściel Elżbieta , Zamkowska Dorota , Jassem-Bobowicz Joanna , Adamski Przemysław , Świątkowska-Stodulska Renata , Abacjew-Chmyłko Anna , Leszczyńska Katarzyna , Zieliński Maciej , Preis Krzysztof , Zielińska Hanna , Tymoniuk Bogusław , Trzonkowski Piotr , Marek-Trzonkowska Natalia Maria
Published: November 2023

Introduction

Preeclampsia is responsible for more than 70 000 and 500 000 maternal and fetal deaths, respectively each year. Incomplete remodelling of the spiral arteries in placenta is the most accepted theory of preeclampsia pathogenesis. However, the process is complexed with immunological background, as pregnancy resembles allograft transplantation. Fetus expresses human leukocyte antigens (HLA) inherited from both parents, thus is semiallogeneic to the maternal immune system. Therefore, induction of fetal tolerance is crucial for physiological outcome of pregnancy. Noteworthy, the immunogenicity of discordant HLA antigens is determined by functional epitopes called eplets, which are continuous and discontinuous short sequences of amino acids. This way various HLA molecules may express the same eplet and some HLA incompatibilities can be more immunogenic due to different eplet combination. Therefore, we hypothesized that maternal- fetal HLA incompatibility may be involved in the pathogenesis of gestational hypertension and its progression to preeclampsia. We also aimed to test if particular maternal-fetal eplet mismatches are more prone for induction of anti- fetal HLA antibodies in gestational hypertension and preeclampsia.

Methods

High resolution next-generation sequencing of HLA-A, -B, -C, -DQB1 and -DRB1 antigens was performed in mothers and children from physiological pregnancies (12 pairs) and from pregnancies complicated with gestational hypertension (22 pairs) and preeclampsia (27 pairs). In the next step HLA eplet identification and analysis of HLA eplet incompatibilities was performed with in silico approach HLAMatchmaker algorithm. Simultaneously maternal sera were screened for anti-fetal HLA class I, class II and anti-MICA antibodies with Luminex, and data were analyzed with HLA-Fusion software.

Results

We observed that high HLA-C, -B, and DQB1 maternal-fetal eplet compatibility was associated with severe preeclampsia (PE) manifestation. Both quantity and quality of HLA epletmismatches affected the severity of PE. Mismatches in HLA-B eplets: 65QIA+76ESN, 70IAO, 180E, HLA-C eplets: 193PL3, 267QE, and HLA-DRB1 eplet: 16Y were associated with a mild outcome of preeclampsia if the complication occurred.

Conclusions

High HLA-C, HLA-DQB1 and HLA-B eplet compatibility between mother and child is associated with severe manifestation of preeclampsia. Both quantity and quality of maternal-fetal HLA eplet mismatches affects severity of preeclampsia.
SARS-CoV-2 specific immune responses in overweight and obese COVID-19 patients
Authors: Onyango Therese Bredholt , Zhou Fan , Bredholt Geir , Brokstad Karl A. , Lartey Sarah , Mohn Kristin G.-I. , Özgümüs Türküler , Kittang Bård Reiakvam , Linchausen Dagrun Waag , Shafiani Shahin , Elyanow Rebecca , Blomberg Bjørn , Langeland Nina , Cox Rebecca Jane ,   Bergen COVID-19 Research Group
Published: November 2023

Obesity is a known risk factor for severe respiratory tract infections. In this prospective study, we assessed the impact of being obese or overweight on longitudinal SARS-CoV-2 humoral and cellular responses up to 18 months after infection. 274 patients provided blood samples at regular time intervals up to 18 months including obese (BMI ≥30, n=32), overweight (BMI 25-29.9, n=103) and normal body weight (BMI 18.5-24.9, n=134) SARS-CoV-2 patients. We determined SARS-CoV-2 spike-specific IgG, IgA, IgM levels by ELISA and neutralising antibody titres by neutralisation assay. RBD- and spike-specific memory B cells were investigated by ELISpot, spike- and non-spike-specific IFN-γ, IL-2 and IFN-γ/IL-2 secreting T cells by FluoroSpot and T cell receptor (TCR) sequencing was performed. Higher BMI correlated with increased COVID-19 severity. Humoral and cellular responses were stronger in overweight and obese patients than normal weight patients and associated with higher spike-specific IgG binding titres relative to neutralising antibody titres. Linear regression models demonstrated that BMI, age and COVID-19 severity correlated independently with higher SARS-CoV-2 immune responses. We found an increased proportion of unique SARS-CoV-2 specific T cell clonotypes after infection in overweight and obese patients. COVID-19 vaccination boosted humoral and cellular responses irrespective of BMI, although stronger immune boosting was observed in normal weight patients. Overall, our results highlight more severe disease and an over-reactivity of the immune system in overweight and obese patients after SARS-CoV-2 infection, underscoring the importance of recognizing overweight/obese individuals as a risk group for prioritisation for COVID-19 vaccination.
Characterisation of macrophage infiltration and polarisation based on integrated transcriptomic and histological analyses in Primary Sjögren’s syndrome
Authors: Zong Yuan , Yang Yi , Zhao Jiawen , Li Lei , Luo Danyang , Hu Jiawei , Gao Yiming , Wei Li , Li Ning , Jiang Liting
Published: November 2023

Background

Primary Sjögren’s syndrome (pSS) is a progressive inflammatory autoimmune disease. Immune cell infiltration into glandular lobules and ducts and glandular destruction are the pathophysiological hallmarks of pSS. Macrophages are one of the most important cells involved in the induction and regulation of an inflammatory microenvironment. Although studies have reported that an abnormal tissue microenvironment alters the metabolic reprogramming and polarisation status of macrophages, the mechanisms driving macrophage infiltration and polarisation in pSS remain unclear.

Methods

Immune cell subsets were characterised using the single-cell RNA sequencing (scRNA-seq) data of peripheral blood mononuclear cells (PBMCs) from patients with pSS (n = 5) and healthy individuals (n = 5) in a public dataset. To evaluate macrophage infiltration and polarisation in target tissues, labial salivary gland biopsy tissues were subjected to histological staining and bulk RNA-seq (pSS samples, n = 24; non-pSS samples, n = 12). RNA-seq data were analysed for the construction of macrophage co-expression modules, enrichment of biological processes and deconvolution-based screening of immune cell types.

Results

Detailed mapping of PBMCs using scRNA-seq revealed five major immune cell subsets in pSS, namely, T cells, B cells, natural killer (NK) cells, dendritic cells (DCs) and monocyte-macrophages. The monocyte-macrophage subset was large and had strong inflammatory gene signatures. This subset was found to play an important role in the generation of reactive oxygen species and communicate with other innate and adaptive immune cells. Histological staining revealed that the number of tissue-resident macrophages was high in damaged glandular tissues, with the cells persistently surrounding the tissues. Analysis of RNA-seq data using multiple algorithms demonstrated that the high abundance of pro-inflammatory M1 macrophages was accompanied by the high abundance of other infiltrating immune cells, senescence-associated secretory phenotype and evident metabolic reprogramming.

Conclusion

Macrophages are among the most abundant innate immune cells in PBMCs and glandular tissues in patients with pSS. A bidirectional relationship exists between macrophage polarisation and the inflammatory microenvironment, which may serve as a therapeutic target for pSS.
Embolia cutis Medicamentosa (Nicolau syndrome): case series
Authors: Fekete Gyula Laszlo , Iantovics Laszlo Barna , Fekete Júlia Edit , Fekete Laszlo
Published: November 2023

Introduction

Embolia cutis medicamentosa or Nicolau syndrome is a rare drug reaction associated with the administration of various injectable medications. The pathogenesis of the disease is unknown, though intra and periarterial injection of the drug is a possible cause. The aim of this study was to describe and analyze the clinical characteristics of Nicolau syndrome in patients examined in daily dermatological practice.

Methods

We performed a retrospective chart review, between January 2011 and December 2020, in patients diagnosed with Nicolau syndrome, from the cases of a private dermatology medical office in Târgu Mureș, Romania.

Results

During the 10-year period, 7 patients were diagnosed with Nicolau syndrome. Of these, 4 (57%) patients were males and 3 (43%) were females, The male to female ratio was 1.33. The median age was 64 (interquartile range, IQR, 62–71), with the youngest patient being diagnosed at age 61 and the oldest at age 74. Regarding the drugs classes that caused Nicolau syndrome, these were intravenous antibiotics in 57%, and non-steroidal anti-inflammatory drugs in 43% of cases.

Conclusion

All patients healed in a period of 6 to 8 weeks. No complications occurred. In conclusion, Nicolau syndrome is a rare side effect of injectable drug administration.