bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimal timing of thoracic endovascular aortic repair for subacute and chronic type B aortic dissection: insights from the Tokushukai medical database
Authors: Ueki Chikara , Uchida Naomichi , Ohashi Takeki , Higashiue Shinichi
Published: February 2025

OBJECTIVES

This study aimed to evaluate the impact of intervention timing on thoracic aortic remodelling following thoracic endovascular aortic repair (TEVAR) for subacute and chronic type B aortic dissection (TBAD).

METHODS

The study included 110 patients undergoing TEVAR for TBAD at least 2 weeks after onset, sourced from the Tokushukai Medical Database. The primary outcome was complete thoracic aortic remodelling (CTR) at 1 year, defined as thoracic false lumen thrombosis and a false lumen diameter < 10 mm up to the level of Th10.

RESULTS

The 1-year CTR rate was 67.3%. CTR was strongly associated with intervention timing: 88.4% (≤3 months: n = 69), 57.1% (3–12 months: n = 14), and 18.5% (≥12 months: n = 27). Receiver operating characteristic (ROC) curve analysis confirmed a 3-month cutoff for achieving CTR (area under the curve 0.857). Multivariable analysis identified interval from onset to TEVAR >3 months (odds ratio [OR] 9.75, 95% confidence interval [CI] 2.86–33.28) and initial thoracic false lumen diameter (OR 1.13, 95% CI 1.02–1.27) as independent predictors of CTR failure. Similar trends were observed in the DeBakey IIIb subgroup, with a 3-month cutoff for achieving CTR and interval from onset to TEVAR >3 months (OR 16.38, 95% CI 3.54–75.83), initial thoracic false lumen diameter (OR 1.25, 95% CI 1.00–1.54) and initial abdominal aortic diameters (OR 1.14, 95% CI 1.01–1.29) predicting CTR failure.

CONCLUSIONS

Early TEVAR within 3 months of onset is crucial for achieving complete aortic remodelling in TBAD. Therefore, early preventive TEVAR in eligible patients is recommended to optimize outcomes
Application of transcriptomics concentration-response modeling for prioritization of contaminants detected in tributaries of the North American Great Lakes
Authors: Cavallin Jenna E , Bush Kendra , Corsi Steve , DeCicco Laura , Flynn Kevin , Kasparek Alex , Hazemi Monique , Maloney Erin , Schumann Peter , Villeneuve Daniel L
Published: February 2025

As part of the Great Lakes Restoration Initiative, chemical monitoring and surveillance efforts have detected ∼330 chemicals in surface water of Great Lakes tributaries. There were 140 chemicals for which no empirical toxicity data were available. The aim of the present study was to generate transcriptomic points of departure (tPODs) for 10 of these compounds and demonstrate how they could be applied in a screening-level prioritization. Organisms representing three trophic levels of the aquatic food-web (P. promelas, D. magna, and R. subcapitata) were exposed for 24 h to a ½-log dilution series of nominal exposure concentrations typically ranging from 66.7 to 0.021 µM of each chemical. In addition to observations of apical effects (e.g., survival and morphology), whole body transcriptomic responses (tPODs) to each chemical were evaluated with targeted analysis using TempO-seq for P. promelas and D. magna and non-targeted RNA-seq for R. subcapitata. The tPODs ranged from 0.18 to 10.8 µM for P. promelas and 0.32 to 29 µM for D. magna, with the most potent of the chemicals tested being fipronil carboxamide for both species. For R. subcapitata, the tPODs ranged from 0.04 to 1.77 µM, with gabapentin as the most potent chemical tested. Empirically derived tPODs from these data-poor chemicals were compared to concentrations detected in the Great Lakes basin. Environmental concentrations were less than the tPODs, except for R. subcapitata and 3,4-dichlorophenyl isocyanate. Similarly, tPODs from previously tested data-rich chemicals were compared with environmental concentrations, in which case tPODs from several chemicals overlapped environmental concentrations. This work demonstrates the potential utility of emerging ecological high-throughput transcriptomics assays to support screening and prioritization of data-poor environmental contaminants.
Translational modeling of BTZ-043 in predicting phase IIA efficacy and evaluating drug-drug interactions with BPaL in murine models
Authors: Ngara Bernard , Flori Lorenzo , van Wijk Rob Christiaan , Ernest Jacqueline P , Tyagi Sandeep , Soni Heena , Hölscher Christoph , Walter Kerstin , Dreisbach Julia , Hoelscher Michael , Nuermberger Eric L , Savic Rada
Published: February 2025

Introduction

BTZ-043 is a promising novel drug candidate for anti-tuberculosis treatment. This study aimed to apply a previously developed mouse-to-human translational modeling platform for anti-tuberculosis drugs to predict phase IIA outcomes for BTZ-043 in humans and evaluate the impact of observed drug-drug interactions on the contribution of BTZ-043 to combotherapy in a mouse model.

Methods

The study utilized data from mouse experiments for BTZ-043 monotherapy and combotherapy with bedaquiline, pretomanid, and linezolid, and clinical information for BTZ-043 monotherapy. The translational models were applied to predict the colony-forming units as a measure of efficacy in humans treated with BTZ-043 monotherapy and evaluate the effect of BTZ-043 on the pharmacokinetics-pharmacodynamics of combotherapy bedaquiline, pretomanid, and linezolid.

Results

The mouse-pharmacokinetic and mouse-pharmacodynamic data for BTZ-043 monotherapy were best described by two-compartmental and direct Emax models, respectively. The model-based prediction of efficacy in humans was comparable to the observed phase IIA efficacy. Single-compartmental models, developed separately, best described the mouse-pharmacokinetic data for bedaquiline, pretomanid, and linezolid in combotherapy. Co-administration with BTZ-043 was associated with at least a 2-fold reduction in bedaquiline, pretomanid, and linezolid exposures in mice, and model-based simulations suggested that the observed decreases in exposure to these drugs would have resulted in even lower efficacy than what was observed when BPaL is co-administered with BTZ-043.

Conclusion

The translational modeling platform adequately predicted the efficacy of BTZ-043 monotherapy. In the absence of drug-drug interactions, co-administration of BTZ-043 with bedaquiline, pretomanid, and linezolid in combotherapy is predicted to improve treatment efficacy.
Resolving ecological drivers of temporal variations of β-diversity across intertidal microbiomes
Authors: Liu Xia , Gong Xiaofan , Ma Kai , Song Wen , Zhou Jiayin , Wang Mengqi , Li Yueyue , Ji Mengzhi , Li Yan , Han He , Wang Yuzhuo , Tu Qichao
Published: February 2025

Resolving the ecological drivers mediating the diversity patterns of microbial communities across space and through time is a central issue in microbial ecology. Both regional species pools and local community assembly contribute to the spatial turnover of biodiversity. In this study, we extended the concept of regional species pool to temporal, and investigated the seasonal dynamics of intertidal microbiomes across four microbial domains (bacteria, archaea, fungi, and protists). The results showed that the seasonal variations of microbial β-diversity were primarily governed by community assembly processes rather than temporal species pools. Different microbial domains were structured by different ecological processes, with homogeneous selection as the major process for all microbial domains. Additionally, bacteria and fungi were critically shaped by drift, and protists by drift and homogeneous dispersal. Among various factors, temperature was important in shaping the temporal patterns of microbial β-diversity. The fluctuation in temperature was strongly associated with fungi and protists, resulting in high drift of community composition. This study demonstrated that community assembly processes governed the dynamic seasonal β-variations of intertidal microbiomes, expanding our understanding from spatial ecology.
Tech Priorities are Evolving for 2025
Authors: Runciman Brian
Published: February 2025

Each year we ask both leaders and professionals what they consider to be the top technology issues to be addressed. Here Brian Runciman MBCS analyses the latest results to extract key information about continuing trends, current concerns, the role of chartership and the skills and resource gaps to be addressed.
Digital Skills for Better Lives
Authors: Cooper Martin
Published: February 2025

Professor Rachid Hourizi MBE, Director of the Institute of Coding (IoC), tells Martin Cooper MBCS how digital skills can launch new careers and improve lives.
Wifi Security
Authors: Clark Timothy
Published: February 2025

In this issue's column, Tim Clark explains how you can increase your safety and security online — and reduce vulnerabilities you may not even know about.
Teach Yourself Quantum Computing
Authors: Fletcher Julian
Published: February 2025

Julian Fletcher, Lead Business Architect at the UK Health Security Agency, provides some recommended starting points and tips for understanding quantum computing.
The Lumen Prize 2024
Authors: Smith Georgia
Published: February 2025

The Lumen Prize celebrates art created with technology, and the BCS Award highlights works that explore the intersection of computing, art and society. Keiken, an artist collective co-founded by Tanya Cruz, Hana Omori and Isabel Ramos in 2015, won the 2024 BCS Award at the Lumen Prize for their immersive installation, Spirit Systems of Soft Knowing.
How Safe is Coffee Shop Wifi?
Authors: Card Daniel
Published: February 2025

Cyber security researcher Daniel Card separates the facts from the fi ction about the safety of public WiFi. Along the way, he gives safety tips to users and corporate IT policy writers.
Inside a Learning Health System
Authors: Cooper Martin
Published: February 2025

Professor Charles ‘Chuck’ Friedman refl ects on his career at the heart of America’s digital health systems and how technology, data and trust can help fuel discoveries and enhance care. Martin Cooper MBCS reports.
The Post Office Horizon IT Scandal
Authors: Cooper Martin
Published: February 2025

Registration of IT professionals and the role IT ethics should play in protecting the public were centre stage during a recent event where a Post Office Horizon IT Scandal victim shared their harrowing story.
How many truck drivers would have sleep disorders? : Investigation on lifestyle and stress on insomnia among Japanese male truck drivers
Authors: Aoki Ryoya , Miyachi Takashi , Sugano Yuta , Kanke Choichiro , Yamazaki Teiichiro , Mishima Kazuo , Nomura Kyoko
Published: February 2025

Objectives: This study aimed to investigate how many drivers would have sleep disorders and what factors would be most associated with chronic insomnia symptoms.

Methods: A cross-sectional study of 505 truck drivers in Akita prefecture was conducted using a self-administered questionnaire and health checkup data. We defined insomnia based on the International Classification of Sleep Disorders, 3rd edition (ICSD-3), sleep apnea syndrome (SAS) with a simple four-variable screening tool, and restless legs syndrome (RLS) with RLS/Willis-Ekbom disease diagnostic criteria. Investigated factors included sleep duration, driving characteristics, caffeine types (foods and beverage) and amounts, caffeine intake timing, state-trait anxiety inventory (STAI), individual stress, and other covariates.

Results: The prevalence of suspected SAS was 23.2% (n = 154), and that of RLS was 0.8% (n = 5). After excluding those, chronic insomnia symptoms were present in 36/505 drivers (7.1%). After adjusting for covariates, a logistic model demonstrated that drinking habits (Odds ratio, OR 6.21, 95% Confidence Interval, CI:1.07–35.8), caffeine intake before sleep (OR 2.65, 95% CI:1.09–6.45), sleep duration on days off (OR 1.44, 95% CI: 1.01–2.05), and STAI score (OR 12.8, 95% CI: 2.53–64.2) were significantly associated with chronic insomnia symptoms. STAI was significantly positively correlated with individual stress, such as family worries (r = 0.22), relationships with non-partners (r = 0.28), and health (r = 0.23).

Conclusions: Our study revealed that one fourth of male truck drivers had sleep disorders that require further medical evaluation. For male truck drivers, a lifestyle modification and stress relief may be a key to address insomnia.
Incarcerated peri-inguinal hernia containing the appendix: a case report
Authors: Baumkirchner Julian M , Aydin Mustafa , Simoes de Almeida Sema , Zünd Michael
Published: February 2025

Primary ventral hernia (PVH) is a main differential diagnosis of abdominal wall masses and typically occurs at areas of structural weakness, such as the linea alba. This report draws attention to atypical PVHs of the peri-inguinal region, an underdiagnosed subgroup of defects located adjacent to the inguinal canal and below the semilunar line. The absence of a standardized definition or classification complicates the diagnosis of this infrequent pathology. We present a case of a patient with a tender abdominal wall mass, initially interpreted as superinfected hematoma. Despite drainage, the patient’s physical condition continued to deteriorate. Repeat imaging eventually revealed acute appendicitis inside a peri-inguinal hernia. Laparoscopic appendectomy was performed, and the abscess cavity was incised, debrided and left open, which led to successful secondary closure of the wound. This case highlights the need for greater awareness of atypical hernias and their potential complications to enable timely detection and adequate treatment.
Investigating the effects of fresh gas on the Active Galactic Nuclei luminosity of early- and late-type galaxies
Authors: Winiarska Martyna W , Raimundo Sandra I , Davis Timothy A , Riffel Rogério , Shankar Francesco , Wiseman Phil
Published: February 2025

The main fuelling processes for Active Galactic Nuclei (AGN) are currently unknown. Previous work showed that galaxies with a large kinematic misalignment between their stellar and gas reservoirs have a higher AGN fraction than galaxies without misalignment. Such misalignment is a strong indication of a past galaxy interaction or an external accretion event. In this work we use integral field spectroscopy data from the SAMI and MaNGA surveys to investigate the AGN luminosity as a function of kinematic misalignment angle. Our sample of AGN exhibit bolometric luminosities in the range 1040 to 1043 erg s−1, indicative of low to moderate luminosity AGN. We find no correlation between AGN luminosity as a function of misalignment for AGN host galaxies from both surveys. We find some differences between the AGN luminosity of early- and late-type AGN host galaxies (ETGs, LTGs). AGN in LTG hosts have a wider luminosity range, with most LTG hosts showing aligned stellar to gas kinematics. AGN in ETG hosts have a luminosity range that does not depend on misalignment angle, suggesting AGN in ETG hosts are consistent with being fuelled by external accretion events, irrespective of their stellar to gas kinematic misalignment. While all the AGN in ETGs in our sample are consistent with being activated and fuelled by external gas, the range of observed AGN luminosities is likely caused by secondary factors such as the amount of fresh gas brought into the galaxy by the external interaction.
Development and Pilot Testing of a Mobile App–Based Chatbot for the Self-management of Physical Activity for Older Adults
Authors: Park Sooyeon , Lee Su Jung
Published: February 2025

Chatbots can change health behaviors by generating conversations about health. A well-designed health-related chatbot can encourage people to be physically active by creating a therapeutic relationship. This study aimed to develop and evaluate the feasibility and usability of a chatbot-based physical activity self-management application to promote physical activity among community-dwelling older adults. The physical activity self-management application was designed based on the five stages of the ADDIE model (analysis, design, development, implementation, and evaluation). The mobile application (app) includes a chatbot and physical activity videos as key components to provide support and guidance for physical activity enhancement and self-management. Quantitative pilot testing demonstrated that participants were highly satisfied with the app’s usability, convenience, and overall satisfaction across all measures. Qualitative data analysis revealed that participants found it easy to watch and follow the videos as needed throughout the day and reported that the guidance and support from the chatbot helped motivate them to be more physically active. The findings suggest that it may be beneficial to expand the use of the chatbot-based physical activity self-management application to promote physical activity among older adults with chronic diseases and offer promising evidence for the feasibility of increasing mHealth accessibility for lifestyle modification interventions.
Mastering the Art of Independent Surgery: 10 Tips for Solo Surgeons in Reconstructive Microsurgery
Authors: Chang Chad , Berner Juan Enrique , Astolfi Martina , Di Meglio Filippo , Sorkin Alex , Chen Hung-Chi , Marcasciano Marco
Published: February 2025

The increasing necessity for solo surgery in plastic and reconstructive microsurgery is driven by contemporary challenges such as a growing and aging population, a shortage of qualified assistants, and the ongoing recovery efforts from COVID-19. Historically limited to remote or exceptional circumstances, solo surgery is now more frequently performed due to these evolving factors. Technological advancements, including robotics, play a crucial role in facilitating this transition and supporting the trend toward self-sufficiency in surgical practice. This article presents practical strategies for executing solo surgery based on our team’s experience and a review of current literature. Key considerations discussed include patient positioning and optimizing surgical workflows. By presenting these recommendations and techniques, derived from both practical experience and literature, we highlight that plastic surgeons and microsurgeons can maintain consistently high standards of surgical care, even when operating independently.
Effect of a Topical Antibiotic and Povidone-Iodine Versus Povidone Iodine Alone on Conjunctival Flora: A Systematic Review and Meta-Analysis
Authors: Rees Amelia Charlotte , Saleki Mohammed
Published: February 2025

Topic:

This systematic review and meta-analysis aimed to determine whether adding preoperative topical antibiotics to povidone-iodine (PVI) offers any additional benefit over PVI alone in reducing conjunctival bacterial flora, thereby potentially lowering the risk of postoperative endophthalmitis. The participants included 1423 eyes undergoing elective intraocular surgeries (e.g., cataract, keratoplasty, trabeculectomy) or receiving intravitreal injections. The interventions studied were PVI combined with third-generation quinolones (levofloxacin, moxifloxacin, or gatifloxacin) compared with PVI alone. The outcome measure was post-intervention rate of positive conjunctival bacterial cultures prior to ophthalmic procedure.

Clinical Relevance:

Postoperative endophthalmitis is a rare but serious complication of intraocular surgery, potentially leading to significant vision loss. While PVI is widely recognised as an essential prophylactic measure, the role of preoperative topical antibiotics remains debated. Defining the necessity of antibiotic use in routine cataract surgery is important, especially given the concerns about antibiotic resistance and the rising cost of healthcare. The current standard of care varies globally, with PVI commonly used alone in many regions, such as the UK.

Methods:

Studies were included based on the comparison of preoperative PVI with or without antibiotics in patients undergoing intraocular surgery. Searches were conducted in PubMed, Cochrane, and Embase databases, covering literature up to October 2024. Risk of bias was assessed using the Cochrane risk of bias tool.

Results:

Seven studies were included, comprising 1423 eyes. A meta-analysis revealed no significant difference in the reduction of conjunctival bacterial flora between PVI + antibiotics and PVI alone (OR: 0.77, 95% CI 0.42–1.42, p=0.41). Subgroup analysis showed that levofloxacin combined with PVI significantly reduced positive culture rates (OR: 0.48, 95% CI 0.29–0.81, p=0.006), while moxifloxacin and gatifloxacin did not show similar benefits. Moderate heterogeneity was observed across studies (I2=58%, p=0.04).

Conclusion:

This review found no conclusive benefit of using preoperative topical antibiotics alongside PVI in routine ophthalmic procedures. However, in patients at high-risk of endophthalmitis, levofloxacin may offer additional protection.
Successful lung transplantation in RPILD associated with anti-MDA5ab+: A case report
Authors: Zhang Chaoyang , Guo Jianxing , Ye Guowei , Zhang Dong
Published: February 2025

Rationale:

Lung transplantation in rapidly progressive interstitial lung disease associated with antimelanoma differentiation–associated gene 5 antibody positive may be a rescue therapy in case of medical treatment failure and impossible weaning from the ventilatory support.

Patient concerns:

A 59-year-old man with cough, expectoration, and fever for more than half a month, which aggravated with dyspnea for 4 days.

Diagnoses:

Rapidly progressive interstitial lung disease was confirmed through chest high-resolution computed tomography and antimelanoma differentiation–associated gene 5 antibody positive.

Interventions:

The patient was given extracorporeal membrane oxygenation and double lung transplantation.

Outcomes:

The patient is currently undergoing rehabilitation in a general ward and follow-up.

Lessons:

Lung transplantation should be considered when impossible weaning from the ventilatory support.
Long-term effect of sodium–glucose cotransporter 2 inhibitors in kidney functions: A systematic review and meta-analysis
Authors: Zheng Yanqun , Sun Jia
Published: February 2025

Background:

Sodium–glucose cotransporter 2 (SGLT2) inhibitors (such as dapagliflozin, empagliflozin, and canagliflozin) are essential for the treatment of type 2 diabetes because they improve the urine excretion of glucose. Although there are advantages, including weight loss and enhanced heart health, caution is necessary because of possible negative effects, such as higher urine output and euglycemic diabetic ketoacidosis. They may slow chronic kidney disease progression, therefore, renal function must be monitored. This study aims to determine the efficacy of SGLT2 inhibitors in the prevention of renal deterioration in terms of reduction of estimated glomerular filtration rate (eGFR) in patients with compromised renal functions.

Methods:

This study aimed to document the long-term effects of SGLT2 inhibitors on kidney function. PubMed and Google Scholar were the key sources of scholarly publications, and Boolean operators were used to perform exact searches. Nine articles were considered relevant out of a total of 244, following extensive screening of titles, abstracts, and full texts according to PRISMA recommendations.

Results:

This study included randomized, double-blind, placebo-controlled trials evaluating the long-term effects of SGLT2 inhibitors on renal function across patient demographics and locations. Clinical investigations showed different effects on eGFR across control and study groups, suggesting renal protection. A meta-analysis showed that SGLT2 inhibitors enhanced kidney function more than the controls.

Conclusion:

This meta-analysis concluded that SGLT2 inhibitors have the potential to prevent eGFR reduction and improve renal function in patients with compromised renal function and underlying conditions such as chronic kidney disease or type 1 and 2 diabetes. However, this meta-analysis showed beneficial results in the prevention of renal deterioration within several follow-up periods, with an average of 11 to 12 months.
Advancements in nanoparticles-based therapeutic approaches for osteosarcoma: Insights from catechins-modified selenium-doped hydroxyapatite: A review
Authors: Degang Tao , Wei Xu , Jianying Shen , Aining Lai , Chenyu Jiang , Haitang Li , Rong Zhou
Published: February 2025

Osteosarcoma is common in all age groups, and a multifaceted strategy that includes radiation therapy, surgical intervention and chemotherapy remains the conventional treatment for osteosarcoma. Existing therapies typically result in recurring malignancies and postsurgical bone abnormalities, necessitating novel strategies for targeted drug administration and bone defects. The most significant components that are crucial for maintain strong bones include trace elements, calcium, selenium, and vitamins K and D. A deficiency in selenium advances the risk of cancer in many organs, including the bones. The progression of an effective technique such as a “local delivery system” is required to efficiently deliver the antioxidant to the targeted tissues for treatment as the circulatory system is unable to convey an adequate concentration of catechin to the regions of bone abnormalities. In this regard the combination of selenium and catechin with mesoporous hydroxyapatite nanoparticles displays promise as a nanoscale delivery method, offering an ideal approach to use it for the treatment and prevention of bone-related diseases. Therefore, this review mainly focusing in exploring the therapeutic potential of catechins-modified selenium-doped hydroxyapatite nanomaterials, chitosan–PEG–folate–Fe (III) complexes as nanocarriers for epigallocatechin-3-gallate, and catechin-conjugated mesoporous hydroxyapatite nanoparticle, highlighting their novel functions as nano-antioxidants with improved osteogenic characteristics in osteosarcoma treatment.
Infrared monitoring-based optimization of interventional lumbar sympathectomy outcomes evaluation in peripheral vascular disease patients: Experimental trial thermovision-guided lumbar sympathectomy
Authors: Kočan Ladislav , Rajťúková Viktória , Rašiová Mária , Kočanová Hana , Hudák Radovan , Vašková Janka , Šatnik Vasil , Martuliak Igor , Hudák Marek
Published: February 2025

Chronic limb-threatening ischemia (CLTI) is associated with significant mortality and limb loss. The interventional lumbar sympathectomy (LS) is one of the supportive treatment options for CLTI patients, reducing pain intensity and peripheral arterial resistance. The use of LS has gradually declined despite its positive effects. The contradictory results of studies dealing with evidence of tissue perfusion improvement after LS are one of the possible explanations. We describe a new approach for the evaluation of LS efficacy in 2 CLTI patients and below-the-knee arteries pathology in our observational cohort experimental trial. We utilized the angiosome concept of foot. Angiography identified angiosomes with occluded source artery. The relationship between angiosomes and corresponding surface areas of angiosomes-dermatomes was identified. The infrared thermography was used for the measurement of thermal changes in dermatomes before and after LS. Based on the thermal changes in dermatomes and the relationship between angiosomes and their dermatomes, we estimated perfusion in angiosomes after the LS procedure. We found that the clinically relevant increase in temperature (>1°C) was presented only in dermatomes corresponding to angiosomes with occluded source artery. We hypothesize that LS opens up anastomoses between angiosomes, resulting in redistribution of blood flow between angiosomes that is associated with an increase in temperature in angiosomes with occluded source artery.
Development of a pressure ulcer stage determination system for community healthcare providers using a vision transformer deep learning model
Authors: Cho Young-Bok , Yoo Hana
Published: February 2025

This study reports the first steps toward establishing a computer vision system to help caregivers of bedridden patients detect pressure ulcers (PUs) early. While many previous studies have focused on using convolutional neural networks (CNNs) to elevate stages, hardware constraints have presented challenges related to model training and overreliance on medical opinions. This study aimed to develop a tool to classify PU stages using a Vision Transformer model to process actual PU photos. To do so, we used a retrospective observational design involving the analysis of 395 images of different PU stages that were accurately labeled by nursing specialists and doctors from 3 hospitals. In the pressure ulcer cluster vision transformer (PUC-ViT) model classifies the PU stage with a mean ROC curve value of 0.936, indicating a model accuracy of 97.76% and F1 score of 95.46%. We found that a PUC-ViT model showed higher accuracy than conventional models incorporating CNNs, and both effectively reduced computational complexity and achieved low floating point operations per second. Furthermore, we used internet of things technologies to propose a model that allows anyone to analyze input images even at low computing power. Based on the high accuracy of our proposed model, we confirm that it enables community caregivers to detect PUs early, facilitating medical referral.
Causal link between dietary antioxidant vitamins intake, oxidative stress injury biomarkers and colorectal cancer: A Mendelian randomization study
Authors: Zhao Minghui , Ye Mujie , Zhao Yucui
Published: February 2025

Oxidative stress and reactive oxygen species play a pivotal role in carcinogenesis. Recent studies have indicated a potential reduction in cancer incidence associated with antioxidant intake; however, these results remain controversial. We performed 2-sample Mendelian randomization (MR) analysis to explore the causal relationship between dietary antioxidant vitamins (retinol, carotene, vitamin C, and vitamin E), oxidative stress injury biomarkers (GST, CAT, SOD, and GPX), and the risk of colorectal cancer (CRC). The genetic instrumental variants (IVs) that had previously shown significant association with dietary antioxidant vitamins and oxidative stress injury biomarkers were screened from the UK Biobank and relevant published studies. The genome-wide association study (GWAS) data for total colorectal, colon, and rectal cancer were obtained from the FinnGen cohort. The primary MR analysis employed the inverse-variance-weighted (IVW) method. Furthermore, sensitivity analysis was performed to assess heterogeneity and horizontal pleiotropy. The results revealed no significant causal associations between dietary antioxidant vitamins, oxidative stress injury biomarkers, and the risk of CRC. The odds ratios (ORs) were as follows: 1.22 (95% confidence interval (CI): 0.65–2.28, P = .53) for retinol, 0.77 (95% CI: 0.50–1.18, P = .24) for carotene, 0.82 (95% CI: 0.42–1.63, P = .58) for vitamin C, and 1.20 (95% CI: 0.86–1.68, P = .28) for vitamin E. Regarding oxidative stress injury biomarkers, the ORs were 0.99 (95% CI: 0.93–1.06, P = .88) for GST, 0.99 (95% CI: 0.93–1.05, P = .65) for CAT, 1.02 (95% CI: 0.95–1.09, P = .57) for SOD, and 1.01 (95% CI: 0.95–1.07, P = .76) for GPX. Likewise, stratified analysis by tumor site revealed no beneficial effects in colon and rectal cancers. Our findings indicate that elevated levels of diet-related antioxidant vitamins, as well as biomarkers of oxidative stress injury, do not provide a protective effect against CRC risk.
Carcinoid tumor arising from a mature cystic teratoma of the ovary: A case report
Authors: Huang Weitao , Han Xiaowei , Zhou Jinhong , Zhang Guozheng
Published: February 2025

Rationale:

Carcinoid tumors arising from mature cystic teratomas of the ovary (MCTO) are exceptionally rare and often misdiagnosed as benign teratomas on imaging studies, which can lead to delayed or inappropriate treatment. The purpose of this study is to raise awareness of this rare condition by presenting a case of a carcinoid tumor originating from MCTO, highlighting its unique imaging features and clinical presentation, and discussing the importance of accurate preoperative diagnosis.

Patient concerns:

A 59-year-old woman was admitted to the hospital following an ultrasound physical examination that revealed an anterior uterine parenchymal mass. She exhibited no obvious abnormal clinical symptoms.

Diagnosis:

CT and MRI of the pelvis revealed a cystic-solid soft tissue mass with small calcified foci and a significant cystic fatty component. There was a marked enhancement of the solid component in the pelvis off to the right, leading to the consideration of a teratoma.

Interventions:

The final clinical preoperative diagnosis was an ovarian teratoma. Pelvic tumor resection was performed after the exclusion of contraindications to surgery. Postoperative pathology revealed a carcinoid tumor arising from MCTO.

Limitations:

This study is limited by the fact that it reports a single case, which makes it difficult to generalize the findings to a larger population. Additionally, the rarity of this condition means that there is limited literature available for comparison, which could provide a broader understanding of the potential challenges in diagnosing similar cases. The retrospective nature of the case also restricts the ability to conduct a more extensive analysis of potential risk factors.

Outcomes:

The patient did not receive adjuvant therapy post-surgery. During the 36-month follow-up period, the tumor showed no signs of recurrence or metastasis. The follow-up was concluded without further complications, indicating a favorable outcome.

Lessons:

Mature cystic teratoma is a common ovarian tumor, but its association with carcinoid tumors is very rare and prone to preoperative misdiagnosis. The imaging presentation of this case is characteristic and has significant diagnostic implications for this disease.
Autoimmune encephalitis with dizziness in children: A case report presented to the otolaryngology department
Authors: Li Guifang , Zhang Anqi , Lu Xinge , Liang Hua , Fang Jinglei , Wang Yabo , Zhang Yanzhuo
Published: February 2025

Rationale:

Motion sickness is frequently encountered condition, characterized primarily by symptoms such as nausea, vomiting, headache, dizziness, and drowsiness. Autoimmune encephalitis refers to a group of diseases that can present with a variety of clinical symptoms according to the expressed autoantigen. One of the rare types is myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD). Herein, we report the case of a child who presented to our otolaryngology department with a diagnosis of motion sickness but was eventually diagnosed with MOGAD. To our knowledge, this is the first such case reported in the literature.

Patient concerns:

An 11-year-old boy presented to a vertigo clinic with the primary complaints of dizziness, occasional nausea, and vomiting after traveling with his family for 3 days. He was diagnosed with motion sickness and was administered oral betastine mesylate tablets (6 mg, 3 times/d for 3 days). The dizziness resolved after 3 days of medication. However, 1 week later, the child developed symptoms of vision loss, poor mental performance, and sluggish responses.

Diagnosis:

The patient was diagnosed with MOGAD.

Interventions:

The patient was treated with human immunoglobulin (2 g/kg, divided into 3 doses), mannitol, and a high dose of methylprednisolone succinate (20 mg/kg for 3 consecutive days). The dose of methylprednisolone succinate was then gradually tapered over 18 days.

Outcomes:

After 15 days of treatment, the child’s vision in the left eye improved, with visual acuity returned to 0.25. His sense of taste and pain in the left limb returned to normal, his mental responses were good, and no antinuclear antibodies were detectable.

Lessons:

Although most childhood episodes of dizziness are benign, it is important for clinicians to remain vigilant for the possibility of central nervous system disease as the underlying cause. When the diagnosis is uncertain, doctors and parents must closely monitor affected children to avoid misdiagnosis and treatment delays.
Castleman disease complicated by rheumatoid arthritis and postoperative chylous leakage: A case report
Authors: Liu Wei , Tao Zhuoyan , Liang Rong , Hu Xinpeng
Published: February 2025

Rationale:

Castleman disease (CD) is a rare disorder characterized by nonspecific clinical presentations and imaging findings, making it prone to misdiagnosis and missed diagnosis. This report details the diagnosis and treatment process of a patient with CD complicated by rheumatoid arthritis (RA) who developed chylous leakage postoperatively, highlighting the potential risks of infection and nutritional depletion, aiming to enhance the understanding of CD.

Patient concerns:

A patient with CD complicated by RA developed chylous leakage postoperatively, which posed risks of infection and nutritional depletion.

Diagnoses:

The patient underwent a left axillary lymph node excisional biopsy on November 13, 2019, and was diagnosed with HV-CD based on pathology.

Interventions:

No further axillary lymph node dissection or adjuvant therapy was performed. Postoperatively, the patient developed significant chylous leakage from the biopsy incision, which resolved after 2 weeks of drainage, dietary modifications, and anti-infective treatment.

Outcomes:

Follow-up showed no disease progression, and the chylous leakage resolved with appropriate management.

Lessons:

A history of RA may be associated with the onset of CD. HV-CD generally has a favorable prognosis, and chylous leakage post-axillary lymph node biopsy, though rare, can be effectively managed with appropriate drainage, dietary control, and infection prevention.
Treatment outcomes of pathological fractures in patients with benign bone tumors
Authors: Hashimoto Kazuhiko , Nishimura Shunji , Ito Tomohiko , Kakinoki Ryosuke , Goto Koji
Published: February 2025

Pathological fractures of benign bone tumors can be difficult to treat, and the underlying pathogenesis remains unclear. Herein, we aimed to determine preventive measures for pathological fractures in patients with benign bone tumors based on fracture outcomes. Between April 2015 and July 2023, we enrolled 18 consecutive patients with oncological pathological fractures treated at our department. Age, sex, histopathological diagnosis, site of origin, whether incisional or pathological fracture, treatment, operative time, blood loss, recurrence, and characteristics of impending and pathological fractures were examined. The median patient age was 22 years, comprising 9 males and 9 females. The pathology included bone cysts (n = 6), enchondromas (n = 5), fibrous dysplasia (n = 4), giant cell tumors (n = 2), and aneurysm bone cysts (n = 1). Six cases involved the humerus, 5 the femur, 3 the phalanges, 2 the toes, 1 the ribs, and 1 the tibia. Five and 13 cases were impending and pathological fractures, respectively. Thirteen patients underwent surgery, whereas 5 were treated conservatively. Surgical methods included curettage and artificial bone graft (n = 6); curettage and artificial bone graft plus compression hip screw fixation (n = 3); and curettage and artificial bone graft plus plate fixation, intramedullary nail, artificial head replacement, and plate fixation (n = 1 case each). The mean operative time and blood loss were 76 ± 56 minutes and 10 ± 80.1 mL, respectively. Recurrence occurred in 1 case. All impending fractures had onset in the lower extremity bones. Pathological fractures due to benign bone tumors of the lower extremities should not be overlooked as symptoms of pain.
An Integrative Nursing Fellowship Approach to Increase Nurse Retention
Authors: Sullivan Shanna D. , Cormier Pamela J. , Lincoln Nicole , Heelan-Fancher Lisa , Hayes Carolyn
Published: February 2025

Nurses are leaving the profession because of stress, burnout, and retirement. An integrative nursing fellowship pilot program was designed to enhance well-being, professional engagement, and development among new and experienced nurses. A hospital-based return-on-investment model is provided, and implications are discussed for nurse leaders to enhance retention using an integrative framework.
Prognostic Value of 18F-FDG PET in Primary Central Nervous System Lymphoma
Authors: Song Ga-Young , Jang Ho Cheol , Kim Mihee , Ahn Seo-Yeon , Jung Sung-Hoon , Ahn Jae-Sook , Lee Je-Jung , Kim Hyeoung-Joon , Moon Jang Bae , Yoo Su Woong , Kwon Seong-Young , Min Jung-Joon , Bom Hee-Seung , Kang Sae-Ryung , Yang Deok-Hwan
Published: February 2025

Purpose of the Report

The usefulness of brain 18F-FDG PET/CT in primary central nervous system lymphoma (PCNSL) remains underexplored. This study investigated whether early metabolic responses in interim brain FDG PET/CT serve as a prognostic indicator of PCNSL treatment outcomes.

Patients and Methods

This prospective study included 53 patients with PCNSL who underwent a high-dose methotrexate–based treatment. Brain FDG PET was performed at diagnosis (baseline PET) and after induction chemotherapy (interim PET), assessing interim PET parameters such as the highest maximum standardized uptake value (hSUVmax), sum of SUVmax (sumSUVmax), highest tumor-to-normal ratio (hTNRmax), sum of TNRmax (sumTNRmax), highest metabolic tumor volume (MTV) (hMTV), and sum of MTV (sumMTV) across all PET-positive lesions.

Results

High interim hTNRmax (hazards ratio: 9.76, 95% confidence interval: 1.90–50.11, P = 0.01) was an independently significant predictor of poor progression-free survival in multivariate analysis. Patients with low interim hTNRmax (≤1.0) had a significantly longer median progression-free survival than those with high interim hTNRmax (>1.0) (25.0 vs 3.6 months, P < 0.001). Incorporating interim MRI-based clinical response assessments and hTNRmax allowed the classification of partial response subgroups with markedly different prognoses (P < 0.001). High interim hTNRmax (hazards ratio: 2.76, 95% confidence interval: 1.39–5.48, P = 0.004) was an independently significant predictor of poor overall survival in multivariate analysis.

Conclusions

The hTNRmax measurement from interim brain FDG PET scans emerges as an important prognostic marker in PCNSL. These findings underscore the potential of interim FDG PET evaluations to refine response assessments and inform tailored therapeutic strategies.
Data-centric Artificial Intelligence and Cancer Research: Construction of a Real-World Head and Neck Treatment Data Repository
Authors: Butterworth Victoria , Young Tom , Drake Haleema , Palmer Isabel , Avgoulea Tania , Ivy Eleanor , Andriolo Joshua , Creppy Carole , Routledge Corla , Adjogatse Delali , Kong Anthony , Petkar Imran , Reis Ferreira Miguel , Eaton David , Lei Mary , Misson Sarah , Vilic Dijana , Guerrero Urbano Teresa
Published: February 2025

Background and Purpose

The performance and generalisability of machine learning (ML) models relies on high-quality data. Retrospective and prospective collection of high-quality data for research use whilst respecting data protection and patient privacy remains a challenge in the clinical environment. Currently, months of laborious extraction and clinical annotation are often necessary before data analysis can begin. We present a novel institutional federated data lake, utilising open-source software, to facilitate efficient production of ML models from Head and Neck Cancer (HNC) imaging and Radiotherapy (RT) data. This structured pipeline dramatically reduces the time associated with the production of ML models and real-world evidence generation. This paper describes our governance-compliant processes and provides a framework for establishing similar databases.

Materials and Methods

XNAT, is a powerful open-source imaging platform. Within our department, it forms a part of the local secure enclave for the purposes of federated learning in artificial intelligence projects and provides import, archiving, processing, search and secure distribution facilities for imaging and RT data.

Results

We have created a clinically annotated, carefully curated, data lake of 2,895 consenting HNC patients containing 22,170 relevant diagnostic, staging, treatment and monitoring imaging sets. Key recommendations for replication include infrastructure planning, robust patient and data selection criteria and prioritising patient consent and privacy.

Conclusions

This secure and extensible imaging and HNC RT cancer database set-up promises to be an exceedingly useful tool for research, revolutionising the time and cost associated with the production of ML models, making the process safer, faster and more efficient.

Highlights

Real-world data is critical for building predictive clinical models.

Curation of clinical data for machine learning can necessitate months of laborious extraction and annotation.

Patients have the right to have their data handled with the highest standards of respect, security and governance.

We describe a database infrastructure constructed under a transparent and safe system of control and stewardship.

This secure and extensible structured database dramatically reduces data extraction time for AI-driven cancer research.
Machine learning driven acceleration of biopharmaceutical formulation development using Excipient Prediction Software (ExPreSo)
Authors: Vidal-Henriquez Estefania , Holder Thomas , Lee Nicholas Franciss , Pompe Cornelius , Teese Mark George
Published: February 2025

Formulation development of protein biopharmaceuticals has become increasingly challenging due to new modalities and higher desired drug substance concentrations. The constraint in drug substance supply and the need for a holistic set of analytical methods means that only a small selection of excipients can be thoroughly tested in the wet lab. Until now there have been few in-silico tools developed to refine the candidate excipients selected for wet lab testing. To fill this gap we developed the Excipient Prediction Software (ExPreSo), a machine learning algorithm that suggests inactive ingredients based on the properties of the protein drug substance and target product profile. A dataset of over 350 peptide/protein drug formulations with proven long-term stability was created. The dataset was augmented with predictive features including protein structural properties, protein language model embeddings, and drug product characteristics. Supervised machine learning was conducted to create a model that suggests excipients for each drug substance in the dataset. ExPreSo could successfully predict the presence of the nine most prevalent excipients, with validation scores well above a random prediction, and minimal overfitting. A fast variant of ExPreSo using only sequence-based input features showed similar prediction power to slower models that relied on molecular modeling. Interestingly, an ExPreSo variant with only protein-based input features also showed good performance, proving that the algorithm was resilient to the influence of platform formulations in the dataset. To our knowledge, this is the first time that machine learning has been used to suggest biopharmaceutical excipients. Overall, ExPreSo shows great potential to reduce the time, costs, and risks associated with excipient screening during formulation development.