bluuebunny/crossref_metadata_2025 huggingface dataset:
De igreja de taipa a catedral: aspectos históricos e arquitetônicos da igreja matriz da cidade de São Paulo
Authors: Ramirez Karen Niccoli , Lindenberg Neto Henrique
Published: September 2023

São Paulo de Piratininga, assim como o Brasil, surgiu sob o símbolo da cruz. Nas primeiras décadas de 1500, havia poucos lugares que oferecessem tanta fartura, como a região habitada pelos índios tupiniquins, que a intitularam de Campos de Piratininga, que significa “peixes secos”. O ponto referencial das antigas povoações católicas era a igreja matriz, da qual se constituía a nova cidade. Inaugurada aos 25 de janeiro de 1954, por ocasião do IV Centenário da fundação da cidade de São Paulo, a Catedral da Sé, construída essencialmente em estilo gótico, é um símbolo histórico, religioso e social. Sua Arquitetura abriga as crenças de um povo, e sua praça é palco de manifestações populares. A verticalidade e a iluminação fornecida por seus vitrais coloridos, anseios típicos das estruturas góticas, buscam a atmosfera de elevação aos céus. Este estilo é somente quebrado pela presença de um elemento estrutural incomum em edificações com esta Arquitetura: uma cúpula renascentista. Em 1934, a Praça da Sé tornou-se o marco zero da cidade. Na década de 70, recebeu a estação do Metrô. Na Sé, monumentos, como a estátua do Padre Anchieta, estão presentes. É também ponto de encontro de desempregados. E, bem em frente a este logradouro público, está a Catedral da Sé, construída junto à Praça João Mendes. Este artigo visa apresentar alguns aspectos históricos e arquitetônicos que levaram à obra da atual igreja matriz da cidade: a Catedral de São Paulo. São apresentadas as edificações anteriores e ressaltadas as motivações de sua construção, sobretudo arquitetônicas, de modo a auxiliar no enriquecimento da história da cidade de São Paulo.
O lugar sustentável: por uma inter-relação entre a arquitetura, o lugar e suas preexistências ambientais
Authors: Dias Fabiano Vieira
Published: September 2023

Esta pesquisa, baseada no conceito das preexistências ambientais, do arquiteto Ernesto Nathan Rogers (1909-1969), considera como hipótese a construção de lugares sustentáveis por meio da edificação de projetos arquitetônicos que tenham em sua inserção no lugar, preceitos corretos que relacionam a arquitetura com o meio ambiente. Para tanto, é necessário ampliar o conceito apresentado por Rogers, que trata o meio ambiente como um resultado de acumulações culturais e históricas, trazendo-o para as discussões contemporâneas sobre sustentabilidade, enquanto lugar que agrega valores climáticos e naturais, com fins sustentáveis, para a arquitetura e seu meio urbano. Assim, tanto cultura como sustentabilidade são temas fundamentais na construção de um lugar sustentável.
Knowledge Graph based Mutual Attention for Machine Reading Comprehension over Anti-Terrorism Corpus
Authors: Gao Feng , Hou Jin , Gu Jinguang , Zhang Lihua
Published: September 2023

Machine reading comprehension has been a research focus in natural language processing and intelligence engineering. However, there is a lack of models and datasets for the MRC tasks in the anti-terrorism domain. Moreover, current research lacks the ability to embed accurate background knowledge and provide precise answers. To address these two problems, this paper first builds a text corpus and testbed that focuses on the anti-terrorism domain in a semi-automatic manner. Then, it proposes a knowledge-based machine reading comprehension model that fuses domain-related triples from a large-scale encyclopedic knowledge base to enhance the semantics of the text. To eliminate knowledge noise that could lead to semantic deviation, this paper uses a mixed mutual attention mechanism among questions, passages, and knowledge triples to select the most relevant triples before embedding their semantics into the sentences. Experiment results indicate that the proposed approach can achieve a 70.70% EM value and an 87.91% F1 score, with a 4.23% and 3.35% improvement over existing methods, respectively.
Viola austroyunanensis (Violaceae), a new species from Yunnan province of China
Authors: LIAO SHU-YUAN , LIAO JUN-JIE , HE DE-MING , WU JIAN-YONG , CHEN YOU-SHENG
Published: September 2023

Viola austroyunnanensis is described and illustrated as a new species from southeastern Yunnan province of China. According to morphological studies, it belongs to Viola sect. Diffusae, and is related to V. fargesii, from which it differs by its stolons, petioles, stipules, abaxial leaf surface and sepals being all glabrous (vs. white puberulous), later petals glabrous (vs. beard), flower color usually blue-purple (vs. white); corolla throat nearly white (vs. yellow). But molecular phylogenetic results based on ITS dataset show that V. austroyunnanensis belongs to Viola sect. Adnatae. The systematic relationship of V. austroyunnanensis needs further research.
Descriptions of two new species of American Cerambycidae, and redescription of Leptostylus subfurcatus (Cerambycidae, Coleoptera)
Authors: HEFFERN DANIEL , SANTOS-SILVA ANTONIO
Published: September 2023

Two new species are described: Aneflus (Aneflus) monzoni sp. nov. (Cerambycinae, Elaphidiini), from Guatemala; and Aegomorphus personatus sp. nov. (Lamiinae, Acanthoderini), from Mexico. Leptostylus subfurcatus Bates, 1880 is redescribed based on a female from Panama, and a variation of the outer apex of the metafemora is reported for the first time.
A new Neoleptophlebia Kluge, 1997 species from eastern China (Ephemeroptera: Leptophlebiidae)
Authors: WANG KAI-CHEN , YANG QING-YI , ZHOU CHANG-FA
Published: September 2023

The genus Neoleptophlebia Kluge, 1997 includes five Asian species. Three of them were reported from northeastern Asia and two were found from Chinese Taiwan Island, leaving a huge geographic gap on the Chinese mainland. Here we find a new one, which is named N. uncinata Zhou sp. nov., from Nanjing municipality, eastern China. Via field collecting and indoor rearing, all life stages were obtained, and its nymphs are found living in small creeks (with a width less than 1 m) and shallow waters (with a depth less than 30 cm). Diagnostically, the imago of this new species has larger lateral penial appendages than its congeners, and its nymph has subequal broadened segments II and III of maxillary and labial palpi. Biogeographically, this species bridges two northern and southern groups of the genus.
On a new genus and four new species of the subfamily Cyprettinae (Crustacea, Ostracoda) from Brazilian floodplains
Authors: FERREIRA VITOR GÓIS , HIGUTI JANET , MARTENS KOEN
Published: September 2023

We describe the new genus Triangocypretta gen. nov. and four new species from Brazilian floodplains. Triangocypretta angustus gen. et spec. nov. and Triangocypretta labiata gen. et spec. nov. were described from the Amazon floodplain only, while Triangocypretta nates gen. et spec. nov. was described from Amazon, Araguaia, and Paraná River floodplains. Triangocypretta hirsuta gen. et spec. nov. was recorded from all four floodplains: Amazon, Araguaia, Pantanal and Paraná. The new genus is characterized by the triangular shape of the carapace in lateral view, the absence of teeth on the posteroventral inner list in the right valve and the presence of anterior marginal septa in both valves, as well as by the relatively short and thin α and β-setae on the mandibular palp. All populations found were asexual. Owing to the clear differences in valve anatomy and limb chaetotaxy as compared to species of Cypretta s.s., the four species were allocated to a new genus in the subfamily Cyprettinae.
Green Operations and Corporate Financial Performance: Does the ESG Sensitivity Matter?
Authors: Singh Kuldeep
Published: September 2023

This study investigates whether the relationship between green operations (GR-OPS) and corporate financial performance (CFP) is conditional on firms’ adherence to environmental, social and governance (ESG) practices. GR-OPS is quantified as an inverse of the energy intensity (ene-int) of the firm’s operations. CFP is proxied by return on equity and return on assets. The study uses panel data for non-financial firms listed on India’s Bombay Stock Exchange (BSE) 100 index. The ESG-sensitive firms are bifurcated from a broader list of BSE 100 index based on their belongingness to the BSE ESG 100 index for econometric analysis. The findings confirm that the impact of GR-OPS on CFP is subject to the firms’ adherence to ESG practices. A positive relationship between GR-OPS and CFP is established for ESG-sensitive firms, while the linkage is non-existent for non-ESG firms. Such findings are attributable to ESG sensitivity (reduced risks) and not the reduced operational costs due to reduced ene-int. The study claims that the benefits of ESG are evident via GR-OPS. Firms should attempt to meet ESG practices to unlock the financial benefits of GR-OPS. When coupled, these practices can reduce the overall risk of the firms as well as generate better economic profits. Adherence to ESG practices and GR-OPS will build environmentally and socially sensitive firms. This is a greater need of modern society, which is increasingly fighting social unrest, global health concerns and climate change.
Modelling Global Bond Markets under Covid-19 Shadow
Authors: Siddiqui Saif , Gaur Arushi
Published: September 2023

The spread of the novel coronavirus has had an impact on the world economy including the stock and bond markets. This paper investigates the linkages between bond and stock markets of Asia, USA, and Europe in pre-Covid and Covid period. Daily data of Asia (Pan-Asia corporate bond), US (Treasury Bonds) and Europe (Eurozone-Investment-grade corporate bond) have been taken for two different periods. First period is from 1 November 2018 (pre-Covid) to 31 October 2019 and second period is from 1 November 2019 to 10 August 2020 (Covid period). Descriptive statistics, correlation, ARDL method, Granger-Causality analysis and VAR Model were applied to examine the long-run and short-run associations among these indices /variables. It is concluded that the correlation relationship of selected indices have changed from pre-Covid time to Covid time. One of the interesting findings is that long term association among the selected variables does not change between two periods. Few variables that were previously not influencing other variables have started affecting them during Covid period. This study aims for portfolio managers and investors who are keen on taking decisions for investment purposes in pandemic period.
Impact of Exchange Rate and Inflation on the Export Performance of the Indian Economy: An Empirical Analysis
Authors: Jacob Tom , Raphael Rincy , V.S Ajina
Published: September 2023

Since liberalisation, exports have been playing an increasingly crucial role in India’s economic performance. This research paper is an attempt to analyse the determinants of exports in India, with special reference to inflation and exchange rate in the wake of this unprecedented importance of export in Indian economy. The main data for the study is collected from the RBI Database 2020 over a period of 25 years (1995 to 2020). The study was conducted employing econometric techniques like Augmented Dickey Fuller (ADF) Test, Johansen’s Co-integration Maximum Likelihood Test and Vector Error Correction Model (VECM). In order to study the stationary properties of the variables, the long run relationship among the macroeconomic variables and export, and the dynamic interrelationship among the variables of the model, respectively. The results derived from this study suggest that all variables are statistically significant for influencing the export performance, that is, exchange rate and inflation are found to have positive impact on export performance in India. These findings suggest some policy implications in managing inflation and the exchange rate system to promote export in India, and thereby achieve the overall growth rate of the economy.
Apple ID: Building a Model of Consumer Brand Identification
Authors: Demar Carolina , Lins Samuel , Aquino Sibele D.
Published: September 2023

This study aims to understand the meanings that Apple consumers attribute to the brand. It also aims to test a brand identification model. To this end, a mixed-method approach has been adopted. Qualitative data were analysed using the Iramuteq computer program while for quantitative data structural equation modelling was used. The results show that when Apple consumers think about the brand, they think about the quality and the distinctive properties of and the different parts that make up the product. The results also indicate that customer satisfaction and social benefits precede brand identification, which leads to greater advocacy of, loyalty to and a greater tendency for an impulse buying of Apple products. These results provide useful insights into consumer-brand relationships from a social identity theory perspective and important implications for brand management strategies.
Identification of Followership Styles and Examining Association with Demographics in Indian Public Sector Telecommunication Corporation
Authors: Katyayan Daya Nand , Thakur Sanjay
Published: September 2023

Leadership research has too often neglected the follower, choosing instead to pursue what Meindl referred to as ‘The Romance of Leadership’. Execution and goal achievement is primarily dependent upon the follower in the leader–follower relationship. In the context of prevailing COVID-19 situation and prevalent work from home culture, it is argued that there is permanent shift in the dynamics between followership and leadership in favour of followership. This study contributes by empirically testing Kelley’s The Followership Questionnaire (TFQ) with its two sub-scales of Independent Critical Thinking (ICT) and Active Engagement (AE) in Indian context, identifying followership style prevalent in the studied organisation and examining the relationship of followership styles with demographic variables. The Followership Questionnaire was administered to 331 respondents from North, East, South and West zones of India.
Spatial transcriptomics reveals distinct tissue niches linked with steroid responsiveness in acute gastrointestinal GVHD
Authors: Patel Bidish K. , Raabe Michael J. , Lang Evan R. , Song Yuhui , Lu Chenyue , Deshpande Vikram , Nieman Linda T. , Aryee Martin J. , Chen Yi-Bin , Ting David T. , DeFilipp Zachariah
Published: September 2023

Severe acute graft-versus-host disease (aGVHD) is associated with significant mortality and morbidity, especially in steroid-resistant (SR) cases. Spatial transcriptomic technology can elucidate tissue-based interactions in vivo and possibly identify predictors of treatment response. Tissue sections from 32 treatment-naïve patients with biopsy-confirmed lower gastrointestinal (GI) aGVHD were obtained. The GeoMx digital spatial profiler was used to capture transcriptome profiles of >18 000 genes from different foci of immune infiltrates, colonic epithelium, and vascular endothelium. Each tissue compartment sampled showed 2 distinct clusters that were analyzed for differential expression and spatially resolved correlation of gene signatures. Classic cell-mediated immunity signatures, normal differentiated epithelial cells, and inflamed vasculature dominated foci sampled from steroid-sensitive cases. In contrast, a neutrophil predominant noncanonical inflammation with regenerative epithelial cells and some indication of angiogenic endothelial response was overrepresented in areas from SR cases. Evaluation of potential prognostic biomarkers identified ubiquitin specific peptidase 17–like (USP17L) family of genes as being differentially expressed in immune cells from patients with worsened survival. In summary, we demonstrate distinct tissue niches with unique gene expression signatures within lower GI tissue from patients with aGVHD and provide evidence of a potential prognostic biomarker.
High-dose (40 mg)versuslow-dose (20 mg) prednisolone for treating sarcoidosis: a randomised trial (SARCORT trial)
Authors: Dhooria Sahajal , Sehgal Inderpaul Singh , Agarwal Ritesh , Muthu Valliappan , Prasad Kuruswamy Thurai , Dogra Pooja , Debi Uma , Garg Mandeep , Bal Amanjit , Gupta Nalini , Aggarwal Ashutosh Nath
Published: September 2023

Background

Current guidelines recommend 20–40 mg·day−1of oral prednisolone for treating pulmonary sarcoidosis. Whether the higher dose (40 mg·day−1) can improve outcomes remains unknown.

Methods

We conducted an investigator-initiated, single-centre, open-label, parallel-group, randomised controlled trial (ClinicalTrials.govidentifierNCT03265405). Consecutive subjects with pulmonary sarcoidosis were randomised (1:1) to receive either high-dose (40 mg·day−1initial dose) or low-dose (20 mg·day−1initial dose) oral prednisolone, tapered over 6 months. The primary outcome was the frequency of relapse or treatment failure at 18 months from randomisation. Key secondary outcomes included the time to relapse or treatment failure, overall response, change in forced vital capacity (FVC, in litres) at 6 and 18 months, treatment-related adverse effects and health-related quality of life (HRQoL) scores using the Sarcoidosis Health Questionnaire and Fatigue Assessment Scale.

Findings

We included 86 subjects (43 in each group). 42 and 43 subjects completed treatment in the high-dose and low-dose groups, respectively, while 37 (86.0%) and 41 (95.3%), respectively, completed the 18-month follow-up. 20 (46.5%) subjects had relapse or treatment failure in the high-dose group and 19 (44.2%) in the low-dose group (p=0.75). The mean time to relapse/treatment failure was similar between the groups (high-dose 307 daysversuslow-dose 269 days, p=0.27). The overall response, the changes in FVC at 6 and 18 months and the incidence of adverse effects were also similar. Changes in HRQoL scores did not differ between the study groups.

Interpretation

High-dose prednisolone was not superior to a lower dose in improving outcomes or the HRQoL in sarcoidosis and was associated with similar adverse effects.
Prognostic value of contrast staining on dual-energy CT after endovascular therapy in acute ischemic stroke: a meta-analysis
Authors: Yang Fan , Zeng Yi , Zhu Fei , Hu Xiaoyan
Published: September 2023

Background

Contrast staining (CS) on dual-energy CT (DECT) is common after endovascular therapy (EVT) in acute ischemic stroke (AIS). We performed a meta-analysis to investigate the prognostic significance of CS detected by DECT after EVT in AIS.

Method

MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Web of Science and Scopus databases were searched from inception to July 2023 for publications on the prognostic significance of CS on DECT after EVT in patients with AIS. Prognostic outcomes were hemorrhage transformation (HT) and poor functional outcome (modified Rankin Scale [mRS] Score of 3–6 at the 90-day follow-up). Data are presented as odds ratios (OR) and 95% confidence intervals (CI).

Results

Eleven studies including 1123 cases of AIS were included. Pooled results indicated a higher risk of HT in patients with CS than in those without CS (OR = 2.22; 95% CI 1.41–3.51, P = 0.001; I2 = 45.4%). No association between CS and symptomatic HT was observed (OR = 2.10; 95% CI 0.64–6.95, P = 0.223; I2 = 67.3%). Moreover, there was also higher odds of poor functional outcome in patients with CS than in those without CS (OR = 2.76; 95% CI 1.53–4.97, P = 0.001; I2 = 44.9%).

Conclusions

The presence of contrast staining on DECT after EVT is associated with a higher risk of hemorrhage transformation and poor functional outcome. However, further high-quality studies with standardized processes are required to confirm these results.
An exploratory study of cell stiffness as a mechanical label-free biomarker across multiple musculoskeletal sarcoma cells
Authors: Daniel Cyril , Traub Frank , Sachsenmaier Saskia , Riester Rosa , Mederake Moritz , Konrads Christian , Danalache Marina
Published: September 2023

Background

Cancer cells are characterized by changes in cell cytoskeletal architecture and stiffness. Despite advances in understanding the molecular mechanisms of musculoskeletal cancers, the corresponding cellular mechanical properties remain largely unexplored. The aim of this study was to investigate the changes in cellular stiffness and the associated cytoskeleton configuration alterations in various musculoskeletal cancer cells.

Methods

Cell lines from five main sarcoma types of the musculoskeletal system (chondrosarcoma, osteosarcoma, Ewing sarcoma, fibrosarcoma and rhabdomyosarcoma) as well as their healthy cell counterparts (chondrocytes, osteoblasts, mesenchymal stem cells, fibroblasts, skeletal muscle cells) were subjected to cell stiffness measurements via atomic force microscopy (AFM). Biochemical and structural changes of the cytoskeleton (F-actin, β-tubulin and actin-related protein 2/3) were assessed by means of fluorescence labelling, ELISA and qPCR.

Results

While AFM stiffness measurements showed that the majority of cancer cells (osteosarcoma, Ewing sarcoma, fibrosarcoma and rhabdomyosarcoma) were significantly less stiff than their corresponding non-malignant counterparts (p < 0.001), the chondrosarcoma cells were significant stiffer than the chondrocytes (p < 0.001). Microscopically, the distribution of F-actin differed between malignant entities and healthy counterparts: the organisation in well aligned stress fibers was disrupted in cancer cell lines and the proteins was mainly concentrated at the periphery of the cell, whereas β-tubulin had a predominantly perinuclear localization. While the F-actin content was lower in cancer cells, particularly Ewing sarcoma (p = 0.018) and Fibrosarcoma (p = 0.023), this effect was even more pronounced in the case of β-tubulin for all cancer-healthy cell duos. Interestingly, chondrosarcoma cells were characterized by a significant upregulation of β-tubulin gene expression (p = 0.005) and protein amount (p = 0.032).

Conclusion

Modifications in cellular stiffness, along with structural and compositional cytoskeleton rearrangement, constitute typical features of sarcomas cells, when compared to their healthy counterpart. Notably, whereas a decrease in stiffness is typically a feature of malignant entities, chondrosarcoma cells were stiffer than chondrocytes, with chondrosarcoma cells exhibiting a significantly upregulated β-tubulin expression. Each Sarcoma entity may have his own cellular-stiffness and cytoskeleton organisation/composition fingerprint, which in turn may be exploited for diagnostic or therapeutic purposes.
Predicting the outcomes of hepatocellular carcinoma downstaging with the use of clinical and radiomics features
Authors: Wang Si-Yuan , Sun Kai , Jin Shuo , Wang Kai-Yu , Jiang Nan , Shan Si-Qiao , Lu Qian , Lv Guo-Yue , Dong Jia-Hong
Published: September 2023

Background

Downstaging of hepatocellular carcinoma (HCC) makes it possible for patients beyond the criteria to have the chance of liver transplantation (LT) and improved outcomes. Thus, a procedure to predict the prognosis of the treatment is an urgent requisite. The present study aimed to construct a comprehensive framework with clinical information and radiomics features to accurately predict the prognosis of downstaging treatment.

Methods

Specifically, three-dimensional (3D) tumor segmentation from contrast-enhanced computed tomography (CT) is employed to extract spatial information of the lesions. Then, the radiomics features within the segmented region are calculated. Combining radiomics features and clinical data prompts the development of feature selection to enhance the robustness and generalizability of the model. Finally, we adopt the support vector machine (SVM) algorithm to establish a classification model for predicting HCC downstaging outcomes.

Results

Herein, a comparative study was conducted on three different models: a radiomics features-based model (R model), a clinical features-based model (C model), and a joint radiomics clinical features-based model (R-C model). The average accuracy of the three models was 0.712, 0.792, and 0.844, and the average area under the receiver-operating characteristic (AUROC) of the three models was 0.775, 0.804, and 0.877, respectively.

Conclusions

The novel and practical R-C model accurately predicted the downstaging outcomes, which could be utilized to guide the HCC downstaging toward LT treatment.
Psychometric validation of the Reported and Intended Behaviour Scale (RIBS) in Hungary with a particular focus on ‘Don’t know’ responses and further scoring recommendations
Authors: Őri D. , Vass E. , Vajsz K. , Vincze K. , Sztancsik V. , Szemán-Nagy A. , Simon L.
Published: September 2023

Aims

Reported and Intended Behaviour Scale (RIBS) was designed to measure mental health stigma-related behaviors in the general public. We aimed to examine its psychometric properties and validate the scale in a Hungarian non-clinical community sample. The secondary aim of this study was to assess the appropriateness of the current scoring recommendations of ‘Don’t know’ responses being coded as neutral, which had never been investigated before. In addition, we provide an overview of the results of already existing studies on the scale.

Methods

Hungarian participants completed the RIBS within this cross-sectional online survey study and were considered non-clinical individuals based on a cut-off point of the Global Severity Index T score of 63 on the Symptom Checklist-90-Revised. Confirmatory factor analysis, reliability measures, and comparative analyses were performed.

Results

Of the n = 5,701, n = 5,141 participants were included in the analysis. The mean age was 27.8 ± 11.1 years, and 89.2% (n = 4,587) of the sample were female. The unidimensional structure was supported by good model fit indices (RMSEA = 0.031, CFI = 0.999, TLI = 0.996, and WRMR = 0.006). Internal consistency of the RIBS and its test–retest reliability with a 5-month follow-up period were found to be good (Cronbach’s alpha = 0.88 and ICC = 0.838). We found statistically significant differences between the total scores when the ‘Don’t know’ responders were excluded from the sample or when they were coded as neutral as recommended by the scale authors (16 (IQR:13–18) vs. 15 (IQR:13–18) p < 0.0001). There were also statistically significant differences between ‘Neither agree nor disagree’ and ‘Don’t know’ participants in several aspects of lived experiences of mental health problems.

Conclusions

The RIBS demonstrated good psychometric properties and can be transferred to the Hungarian context. It will be a valuable tool in assessing stigmatizing behavior and testing the efficacy of antistigma programs. Our results suggest that ‘Neither agree nor disagree’ and ‘Don’t know’ responses bear different meanings, and coding should account for this.
Differential evolution of diabetic ketoacidosis in adults with pre-existent versus newly diagnosed type 1 and type 2 diabetes mellitus
Authors: Ata Fateen , Khan Adeel Ahmad , Khamees Ibrahim , Mohammed Baian Z. M. , Barjas Haidar Hussein , Muthanna Bassam , Bashir Mohammed , Kartha Anand
Published: September 2023

Background

Diabetic ketoacidosis (DKA) was once known to be specific to type-1 diabetes-mellitus (T1D); however, many cases are now seen in patients with type-2 diabetes-mellitus (T2D). Little is known about how this etiology shift affects DKA's outcomes.

Methods

We studied consecutive index DKA admissions from January 2015 to March 2021. Descriptive analyses were performed based on pre-existing T1D and T2D (PT1D and PT2D, respectively) and newly diagnosed T1D and T2D (NT1D and NT2D, respectively).

Results

Of the 922 patients, 480 (52%) had T1D, of which 69% had PT1D and 31% NT1D, whereas 442 (48%) had T2D, of which 60% had PT2D and 40% NT2D. The mean age was highest in PT2D (47.6 ± 13.1 years) and lowest in PT1D (27.3 ± 0.5 years) (P < 0.001). Patients in all groups were predominantly male except in the PT1D group (55% females) (P < 0.001). Most patients were Arabic (76% in PT1D, 51.4% in NT1D, 46.6% in PT2D) except for NT2D, which mainly comprised Asians (53%) (P < 0.001). Patients with NT2D had the longest hospital length of stay (LOS) (6.8 ± 11.3 days) (P < 0.001), longest DKA duration (26.6 ± 21.1 h) (P < 0.001), and more intensive-care unit (ICU) admissions (31.2%) (P < 0.001). Patients with PT1D had the shortest LOS (2.5 ± 3.5 days) (P < 0.001), DKA duration (18.9 ± 4.2 h) (P < 0.001), and lowest ICU admissions (16.6%) (P < 0.001).

Conclusions/interpretation

We presented the largest regional data on differences in DKA based on the type and duration of diabetes- mellitus (DM), showing that T2D is becoming an increasing cause of DKA, with worse clinical outcomes (especially newly diagnosed T2D) compared to T1D.
Maternal multimorbidity and preterm birth in Scotland: an observational record-linkage study
Authors: Azcoaga-Lorenzo Amaya , Fagbamigbe Adeniyi Francis , Agrawal Utkarsh , Black Mairead , Usman Muhammad , Lee Siang Ing , Eastwood Kelly-Ann , Moss Ngawai , Plachcinski Rachel , Nelson-Piercy Catherine , Brophy Sinead , O’Reilly Dermot , Nirantharakumar Krishnarajah , McCowan Colin ,   on behalf of the MuM-PreDiCT Group
Published: September 2023

Background

Multimorbidity is common in women across the life course. Preterm birth is the single biggest cause of neonatal mortality and morbidity. We aim to estimate the prevalence of multimorbidity in pregnant women and to examine the association between maternal multimorbidity and PTB.

Methods

This is a retrospective cohort study using electronic health records from the Scottish Morbidity Records. All pregnancies among women aged 15 to 49 with a conception date between 1 January 2014 and 31 December 2018 were included. Multimorbidity was defined as the presence of two or more pre-existing long-term physical or mental health conditions, and complex multimorbidity as the presence of four or more. It was calculated at the time of conception using a predefined list of 79 conditions published by the MuM-PreDiCT consortium. PTB was defined as babies born alive between 24 and less than 37 completed weeks of gestation. We used Generalised Estimating Equations adjusted for maternal age, socioeconomic status, number of previous pregnancies, BMI, and smoking history to estimate the effect of maternal pre-existing multimorbidity. Absolut rates are reported in the results and tables, whilst Odds Ratios (ORs) are adjusted (aOR).

Results

Thirty thousand five hundred fifty-seven singleton births from 27,711 pregnant women were included in the analysis. The prevalence of pre-existing multimorbidity and complex multimorbidity was 16.8% (95% CI: 16.4–17.2) and 3.6% (95% CI: 3.3–3.8), respectively. The prevalence of multimorbidity in the youngest age group was 10.2%(95% CI: 8.8–11.6), while in those 40 to 44, it was 21.4% (95% CI: 18.4–24.4), and in the 45 to 49 age group, it was 20% (95% CI: 8.9–31.1). In women without multimorbidity, the prevalence of PTB was 6.7%; it was 11.6% in women with multimorbidity and 15.6% in women with complex multimorbidity. After adjusting for maternal age, socioeconomic status, number of previous pregnancies, Body Mass Index (BMI), and smoking, multimorbidity was associated with higher odds of PTB (aOR = 1.64, 95% CI: 1.48–1.82).

Conclusions

Multimorbidity at the time of conception was present in one in six women and was associated with an increased risk of preterm birth. Multimorbidity presents a significant health burden to women and their offspring. Routine and comprehensive evaluation of women with multimorbidity before and during pregnancy is urgently needed.
Long noncoding RNA SNHG16 regulates TLR4-mediated autophagy and NETosis formation in alveolar hemorrhage associated with systemic lupus erythematosus
Authors: Hsieh Yu-Tung , Chen Yi-Cheng , Chou Yu-Chi , Kuo Pin‑Yu , Yen Yi-Ting , Tsai Hung-Wen , Wang Chrong-Reen
Published: September 2023

Background

Dysregulated long noncoding RNA (lncRNA) expression with increased apoptosis has been demonstrated in systemic lupus erythematosus (SLE) patients with alveolar hemorrhage (AH). SNHG16, a lncRNA, can enhance pulmonary inflammation by sponging microRNAs, and upregulate toll-like receptor 4 (TLR4) expression via stabilizing its mRNAs. TRAF6, a TLR4 downstream signal transducer, can induce autophagy and NETosis formation. In this study, we investigated whether SNHG16 could regulate TLR4-mediated autophagy and NETosis formation in SLE-associated AH.

Methods

Expression of SNHG16, TLR4 and TRAF6 and cell death processes were examined in lung tissues and peripheral blood (PB) leukocytes from AH patients associated with SLE and other autoimmune diseases, and in the lungs and spleen from a pristane-induced C57BL/6 mouse AH model. SNHG16-overexpressed or -silenced alveolar and myelocytic cells were stimulated with lipopolysaccharide (LPS), a TLR4 agonist, for analyzing autophagy and NETosis, respectively. Pristane-injected mice received the intra-pulmonary delivery of lentivirus (LV)-SNHG16 for overexpression and prophylactic/therapeutic infusion of short hairpin RNA (shRNA) targeting SNHG16 to evaluate the effects on AH. Renal SNHG16 expression was also examined in lupus nephritis (LN) patients and a pristane-induced BALB/c mouse LN model.

Results

Up-regulated SNHG16, TLR4 and TRAF6 expression with increased autophagy and NETosis was demonstrated in the SLE-AH lungs. In such patients, up-regulated SNHG16, TLR4 and TRAF6 expression was found in PB mononuclear cells with increased autophagy and in PB neutrophils with increased NETosis. There were up-regulated TLR4 expression and increased LPS-induced autophagy and NETosis in SNHG16-overexpressed cells, while down-regulated TLR4 expression and decreased LPS-induced autophagy and NETosis in SNHG16-silenced cells. Pristane-injected lung tissues had up-regulated SNHG16, TLR4/TRAF6 levels and increased in situ autophagy and NETosis formation. Intra-pulmonary LV-SNHG16 delivery enhanced AH through up-regulating TLR4/TRAF6 expression with increased cell death processes, while intra-pulmonary prophylactic and early therapeutic sh-SNHG16 delivery suppressed AH by down-regulating TLR4/TRAF6 expression with reduced such processes. In addition, there was decreased renal SNHG16 expression in LN patients and mice.

Conclusions

Our results demonstrate that lncRNA SNHG16 regulates TLR4-mediated autophagy and NETosis formation in the human and mouse AH lungs, and provide a therapeutic potential of intra-pulmonary delivery of shRNA targeting SNHG16 in this SLE-related lethal manifestation.
SARS-CoV-2 infection induces a long-lived pro-inflammatory transcriptional profile
Authors: Zhang Jia-Yuan , Whalley Justin P. , Knight Julian C. , Wicker Linda S. , Todd John A. , Ferreira Ricardo C.
Published: September 2023

Background

The immune response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in COVID-19 patients has been extensively investigated. However, much less is known about the long-term effects of infection in patients and how it could affect the immune system and its capacity to respond to future perturbations.

Methods

Using a targeted single-cell multiomics approach, we have recently identified a prolonged anti-inflammatory gene expression signature in T and NK cells in type 1 diabetes patients treated with low-dose IL-2. Here, we investigated the dynamics of this signature in three independent cohorts of COVID-19 patients: (i) the Oxford COVID-19 Multi-omics Blood Atlas (COMBAT) dataset, a cross-sectional cohort including 77 COVID-19 patients and ten healthy donors; (ii) the INCOV dataset, consisting of 525 samples taken from 209 COVID-19 patients during and after infection; and (iii) a longitudinal dataset consisting of 269 whole-blood samples taken from 139 COVID-19 patients followed for a period of up to 7 months after the onset of symptoms using a bulk transcriptomic approach.

Results

We discovered that SARS-CoV-2 infection leads to a prolonged alteration of the gene expression profile of circulating T, B and NK cells and monocytes. Some of the genes affected were the same as those present in the IL-2-induced anti-inflammatory gene expression signature but were regulated in the opposite direction, implying a pro-inflammatory status. The altered transcriptional profile was detected in COVID-19 patients for at least 2 months after the onset of the disease symptoms but was not observed in response to influenza infection or sepsis. Gene network analysis suggested a central role for the transcriptional factor NF-κB in the regulation of the observed transcriptional alterations.

Conclusions

SARS-CoV-2 infection causes a prolonged increase in the pro-inflammatory transcriptional status that could predispose post-acute patients to the development of long-term health consequences, including autoimmune disease, reactivation of other viruses and disruption of the host immune system-microbiome ecosystem.
Dietary supplementation of laminarin improves the reproductive performance of sows and the growth of suckling piglets
Authors: Zhang Pengguang , Jiang Guoyuan , Ma Chenghong , Wang Yubo , Yan Enfa , He Linjuan , Guo Jianxin , Zhang Xin , Yin Jingdong
Published: September 2023

Background

Maternal nutrition is essential in keeping a highly efficient production system in the pig industry. Laminarin has been shown to improve antioxidant capacity, reduce the inflammatory response, and favor the homeostasis of intestinal microbiota. However, the effect of dietary supplementation of laminarin on the reproductive performance of sows and the growth of suckling offspring remains unknown.

Methods

A total of 40 Landrace × Yorkshire multiparous sows on d 85 of gestation, similar in age, body weight (BW), parity and reproductive performance, were randomly divided into four dietary treatments with 10 sows per treatment, receiving a control diet (basal pregnancy or lactating diets) and a basal diet supplemented with 0.025%, 0.05% and 0.10% laminarin, respectively. The experiment lasted from d 85 of gestation to d 21 of lactation.

Results

Laminarin supplementation linearly increased number born alive per litter (P = 0.03), average daily feed intake (ADFI, P < 0.01), and total milk yield of sows during the lactation of 1–21 d (P = 0.02). Furthermore, maternal laminarin supplementation increased the average daily gain (ADG) of piglets while tending to reduce the culling and death rate before weaning. In addition, alterations to the composition of colostrum and milk, as well as to serum inflammatory cytokines and immunoglobulins of sows were observed. The fecal microbiota profile of sows supported the improvement of reproductive performance in sows and the growth performance in suckling offspring.

Conclusions

Dietary supplementation of laminarin during late pregnancy and lactation could significantly improve reproductive performance of sows and growth performance of piglets.

Graphical Abstract
Between settlement, double return and re-emigration: motivations for future mobility of Polish and Lithuanian return migrants
Authors: Czeranowska Olga , Parutis Violetta , Trąbka Agnieszka
Published: September 2023

Although research on return migration is growing, little is known about returnees’ plans and attitudes regarding further migration. This article contributes to the filling of this knowledge gap by studying the likelihood of engaging in further mobility among Polish and Lithuanian returnees. Using a mixed method approach we explore under which circumstances return migrants intent to stay in their country of origin permanently and what factors would make them consider leaving again. Our quantitative sample (CAWI survey) consists of 740 responses from Poles and Lithuanians who returned to their home countries from the UK. We conducted a binary logistic regression analysis concerning plans to move abroad again. In the qualitative part of the analysis, based on in-depth interviews with 60 Polish or Lithuanian returnees, we have contextualised quantitative results by presenting four case studies representing different likelihoods of re-migrating. Our research shows that both return and post-return plans are always negotiated in the context of a variety of personal, family and professional considerations. Having a job, having children and strong attachment to the current place of living turned out to be the strongest negative predictors of the likelihood of further migration.
A deep-learning system to help make the surgical planning of coil embolization for unruptured intracranial aneurysms
Authors: Nie Xin , Yang Yi , Liu Qingyuan , Wu Jun , Chen Jingang , Ma Xuesheng , Liu Weiqi , Wang Shuo , Chen Lei , He Hongwei
Published: September 2023

Background

Coil embolization is a common method for treating unruptured intracranial aneurysms (UIAs). To effectively perform coil embolization for UIAs, clinicians must undergo extensive training with the assistance of senior physicians over an extended period. This study aimed to establish a deep-learning system for measuring the morphological features of UIAs and help the surgical planning of coil embolization for UIAs.

Methods

Preoperative computational tomography angiography (CTA) data and surgical data from UIA patients receiving coil embolization in our medical institution were retrospectively reviewed. A convolutional neural network (CNN) model was trained on the preoperative CTA data, and the morphological features of UIAs were measured automatically using this CNN model. The intraclass correlation coefficient (ICC) was utilized to examine the similarity between the morphologies measured by the CNN model and those determined by experienced clinicians. A deep neural network model to determine the diameter of first coil was further established based on the CNN model within the derivation set (75% of all patients) using neural factorization machines (NFM) model and was validated using a validation set (25% of all patients). The general match ratio (the difference was within ± 1 mm) between the predicted diameter of first coil by model and that used in practical scenario was calculated.

Results

One-hundred fifty-three UIA patients were enrolled in this study. The CNN model could diagnose UIAs with an accuracy of 0.97. The performance of this CNN model in measuring the morphological features of UIAs (i.e., size, height, neck diameter, dome diameter, and volume) was comparable to the accuracy of senior clinicians (all ICC > 0.85). The diameter of first coil predicted by the model established based on CNN model and the diameter of first coil used actually exhibited a high general match ratio (0.90) within the derivation set. Moreover, the model performed well in recommending the diameter of first coil within the validation set (general match ratio as 0.91).

Conclusion

This study presents a deep-learning system which can help to improve surgical planning of coil embolization for UIAs.
Use of Objective Structured Clinical Examination (OSCE) in a hybrid digital / in-person training for hormonal IUD in Nigeria: findings and applications of the approach
Authors: Nwokoma Ezechukwu , Anyasi Helen , Archie Samantha , Onyezobi Chinedu , OlaOlorun Funmilola , Anyanti Jennifer , Nwala Anthony , Afolabi Kayode , Little Kristen , Demise Eden , Danna Kendal , Rademacher Kate , Plotkin Marya
Published: September 2023

Background: The hormonal intrauterine device, a long-acting reversible contraceptive method, is being introduced to pilot sites in the private and public sector in Nigeria by the Nigerian Federal Ministry of Health since 2019. To inform training of health care providers, a study was conducted on a hybrid digital and in-person training which utilized Objective Structured Clinical Examination (OSCE) to assess competency of provider trainees. This study represents one of few documented experiences using OSCE to assess the effectiveness of a digital training.

Methods: From September – October 2021, in Enugu, Kano and Oyo states of Nigeria, 62 health care providers from public and private sector health facilities were trained in hormonal IUD service provision using a hybrid digital / in-person training approach. Providers, who were skilled in provision of copper IUD, underwent a didactic component using digital modules, followed by an in-person practicum, and finally supervised service provision in the provider trainee’s workplace. Skills were assessed using OSCE during the one-day practicum. 

Results: Use of the OSCE to assess skills provided valuable information to study team. The performance of provider trainees was high (average 94% correct completion of steps in the OSCE). 

Conclusions: OSCE was used as a research methodology as part of this pilot study; to date, OSCE has not been integrated into the training approach to be scaled up by FMOH. Uniformly high performance of provider trainees was seen on the OSCE, unsurprising since provider trainees were experienced in providing copper IUD. If and when training is rolled out to providers inexperienced with copper IUD, OSCE may have a more important role to assess skills before service provision. The role of OSCE in design of hybrid digital / in-person training approaches should be further explored in rollout of hormonal IUD and other contraceptive technologies.
Big Data in Healthcare - A Comprehensive Bibliometric Analysis of Current Research Trends
Authors: Reshi Aijaz , Shah Arif , Shafi Shabana , Qadri Majid Hussain
Published: September 2023

The primary purpose of this study is to perform a comprehensive bibliometric analysis of research landscape of big data in healthcare. Big data as a significant technology used in healthcare during the past decade has led to the exponential growth in scientific literature. This study is focused on analysis of many crucial bibliometric indicators such as, overall research output, author productivity, institutional productivity, country wise productivity, collaboration analysis, research trends along with a thematic focus of research output in big data and healthcare. The analysis has been performed on 2294 research articles published in 1018 publication sources from SCOPUS and Web of Science databases. The initial results of the study performed from year 2012 reveals that in the first year 6 research articles were published in the given domain. Then every year the growth of published articles in the field was exponential, however years 2019 to 2021 were the most productive and incremental in terms of number of publications. The analysis results of the study present the performance analysis of research production in terms of annual scientific production, most globally cited articles, author’s production over the time, most productive countries, and most relevant affiliations. In addition, the science mapping analysis including the indicators such as, keyword Co-occurrence, Thematic Mapping, Most Relevant Authors, annual source distribution, and collaboration Network analysis has been presented. The study delivers expedient contribution to the field of study by noticeably offering comprehensive analysis results regarding research hotspots and trends, thematic emphasis, and future direction of research in the field. These outcomes will aid researchers in big data and healthcare in planning and designing the research and the challenges and opportunities needed to be explored.