bluuebunny/crossref_metadata_2025_split huggingface dataset:
СУЧАСНИЙ ПОГЛЯД СТРАТЕГІЇ РОЗВИТКУ ВИЩОЇ МЕДИЧНОЇ ОСВІТИ КРІЗЬ ПРИЗМУ “HARD І SOFT SKILLS”
Authors: Маланчук Л. М. , Мартинюк В. М. , Маланчук С. Л. , Франчук У. Я. , Франчук М. О. 
Published: September 2023

Анотація. У статті розглядається сучасний запит до вищої медичної освіти у формуванні компетентного фахівця, який буде здатним надавати якісну медичну допомогу, проявляти лідерські якості, злагоджено працювати у команді, виявляти критичне мислення та креативність у самостійних рішеннях і при цьому залишатися співчутливим, милосердним. Впровадження уніфікованого підходу протягом магістратури, ординатури та подальшого безперервного навчання системи “Soft Skills + Hard Skills” дозволить на якісно новому рівні вирішувати питання комунікації в галузі охорони здоров’я.
З огляду на зростання поколінь від Х до Z із різними цінностями світогляду, що формувалися під впливом технічно-інформаційного прогресу, процес навчання вимагає цілковитого оновлення академічної поведінки. Формат неакадемічних навичок (“soft skills”), що включають поведінкові реакції відношення до інших та контрольоване управління емоціями в процесі навчання та професійної реалізації, набуває актуальності. «Мʼякі» навички сприяють успіху особистості і не є знаннями чи навичками, які безпосередньо засвоюються у процесі опанування навчальних програм.
Здобувачі вищої медичної освіти покоління Y мають академічну поведінку, яка суттєво відрізняється від попередніх поколінь. Їхні вимоги до надавачів освіти охоплюють широкий спектр модифікації поведінкових реакцій, спонукають до розвитку навичок міжособистісного спілкування із врахуванням внутрішньоособистісної складової, і таке навчання повинно мати безперервний характер.
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

ABSTRACT
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.
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

Abstract
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 &gt;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

BackgroundCurrent 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.MethodsWe 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.FindingsWe 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.InterpretationHigh-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

Abstract
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

Abstract
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

Abstract
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

Abstract
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

Abstract
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

Abstract
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

Abstract
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.