bluuebunny/crossref_metadata_2025 huggingface dataset:
Organic UV-filters and freshwater organisms: data gaps impede a robust retrospective environmental risk assessment
Authors: Kroll Alexandra , Kienle Cornelia , Junghans Marion
Published: January 2025

Background

For use in cosmetic products, 32 substances have been authorised in the EU as UV-filters as of August 2022 (Annex VI of the EU Cosmetics Regulation (EC) No 1223/2009). Although these substances can enter the aquatic environment directly through bathing, authorisation for use in cosmetic products does not require a specific environmental risk assessment, whereas risks to human health are specifically assessed. Furthermore, no environmental quality standards have been proposed at EU level. For the current review, data on freshwater ecotoxicity, physicochemical properties, environmental fate and measured exposure were retrieved from ECHA registration information and public databases and assessed for reliability and relevance. Environmental quality standards (EQS) were proposed based on the EU technical guidance for EQS for the Water Framework Directive (WFD).

Results

From a WFD perspective, there were significant or complete gaps for acute and chronic effects data, sediment organisms and rarely tested organisms at the time of data retrieval, as well as gaps for measured environmental concentrations in the assessed databases. The reliability of the reported data could not always be verified due to missing information. As expected from the heterogeneity of molecular structures, ecotoxicity data and environmental fate parameters vary considerably between the different substances. Our assessments indicate that the use of some of the substances in direct contact with surface water may pose a repeated risk to aquatic organisms.

Conclusions

We recommend a revision of the process for the inclusion of UV-filters in the EU Cosmetics Product Regulation, taking into account the potential environmental risks. A full assessment of all UV-filters using standard test organisms as well as rarely tested species for acute and chronic effects and bioaccumulation would require, among other things, a large number of fish tests. Therefore, new assessment methods (NAMs) are recommended, including the use of fish cell lines for acute toxicity testing and alternatives for the assessment of chronic toxicity.
The newborn behavioural observations (NBO) system embedded in routine postpartum care in at-risk families in Iceland: a randomised controlled trial
Authors: Valla Lisbeth , Slinning Kari , Wentzel-Larsen Tore , Røsand Gun-Mette , Arnardóttir Stefanía Birna
Published: January 2025

Background

The Newborn Behaviour Observation system (NBO) is a flexible relationship-based intervention designed to sensitise parents to their newborn’s capacities, to increase parental confidence and foster the bond between parent and infant. The aim of this study was to investigate the effects of an NBO intervention on maternal confidence during the first month postpartum, and on the quality of mother-infant interaction at infant age 4 months in a sample of mothers who exhibit elevated signs of distress or depression during pregnancy and/or describe prior experiences of mental health issues.

Method

Pregnant women with current emotional distress and/or a history of anxiety and depression were recruited from a healthcare centre in Reykjavik, between August 2016 and April 2018. The study used a two-group, randomised trial design with six measuring points, in which 54 women were randomly assigned to either the intervention or control group. The intervention group (n = 26) received the NBO in combination with standard care during routine home visits. The control group (n = 28) received the same numbers of home visits with standard care without NBO. Maternal confidence was measured using a parent questionnaire (covering learning outcomes relating to the infant’s communicative signals and maternal confidence) administered after each home visit in weeks 2, 3 and 4 postpartum. At 4 months infant age, a free-play situation involving mother-infant interaction was video-recorded in the participants’ homes and coded using the Emotional Availability Scale (EAS). Mixed effects models were used to estimate group differences in learning outcomes and maternal confidence across three time points. Two sample t-tests were used to compare the two groups’ EAS scores.

Results

The mothers in the intervention-group reported significantly higher maternal confidence and increased knowledge about their infant compared to the control group. Adjusted analyses suggest some evidence of a higher EAS non-hostility score in the intervention group (p = .031), but not for the other EAS scale scores (p ≥ .118).

Conclusion

Early home visits combining NBO with standard care enhance maternal confidence and the mother’s understanding of her infant. The small sample size makes it difficult to conclude whether repeated NBO sessions during the first month increase dimensions of maternal sensitivity in mother-infant interaction at 4 months postpartum.

Trial registration

ClinicalTrials.gov ID NCT04739332, Registered 02/01/2021.
Validation of biomarkers and clinical scores for the detection of uterine leiomyosarcoma: a case-control study with an update of pLMS
Authors: Vollmer Marcus , Köhler Günter , Radosa Julia Caroline , Zygmunt Marek , Zimmermann Julia , Köller Martina , Seitz Christine , Bralo Helena , Radosa Marc Philipp , Kaya Askin Cangül , Krichbaum Johann , Solomayer Erich-Franz , Kaderali Lars , Alwafai Zaher
Published: January 2025

Background

The diagnosis of rare uterine leiomyosarcoma (uLMS) remains a challenge given the high incidence rates of benign uterine tumors such as leiomyoma (LM). In the last decade, several clinical scores and blood serum markers have been proposed. The aim of this study is to validate and update the pLMS clinical scoring system, evaluating the accuracy of the scoring system by Zhang et al. and examining the discriminatory ability of blood markers such as serum lactate dehydrogenase (LDH), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR).

Methods

In a case-control study, 90 new uLMS from the DKSM consultation registry and 659 prospectively recruited LM cases from the Saarland University Hospital were used for validation. Welch’s t-test and Hedges’ g were used to evaluate blood markers and optimal thresholds and diagnostic odds ratios were calculated. Scoring systems were compared using receiver operating characteristics and proposed diagnostic cut-offs were reviewed. Missing values were imputed by random forest imputation to create the updated scoring system ‘pLMS2’ using penalized logistic regression based on the pooled data sets of 384 uLMS and 1485 LM.

Results

pLMS achieved an AUC of 0.97 on the validation data, but sensitivity and specificity varied at the proposed thresholds due to a shift in the score distributions. 43 uLMS and 578 LM were included in the comparison of pLMS with Zhang’s scoring system, with pLMS being superior (AUC 0.960 vs 0.845). LDH, NLR, and PLR achieved a diagnostic odds ratios of 18.03, 8.64 and 4.81, respectively. pLMS2 is based on subscores for menopausal status interacting with age, tumor diameter, intermenstrual bleeding, hypermenorrhea, dysmenorrhea, postmenstrual bleeding, rapid tumor growth, and suspicious sonography.

Conclusions

Validation of the pLMS shows stable discriminatory ability as expressed by AUC, although caution should be taken with cut-off values, as sensitivity and specificity may vary. Data collection of the updated clinical score pLMS2 remains simple and convenient, with no additional cost. The proposed thresholds of 1.5 and 5.5 can be used as a guide to avoid unnecessary or inappropriate surgery and to make the use of further diagnostic measures cost-effective. LDH, NLR and PLR provide further evidence to differentiate uLMS from LM in conjunction with clinical data.
Beliefs and attitudes of Syrian refugee mothers in Lebanon regarding children vaccination: a cross-sectional study
Authors: Shaarani Issam , Khadem Sleiman , Obeid Marwa , Saadieh Behnaz , Serhal Aya , Zakkour Karim , Mohammad Sara , Berjaoui Hussein , Izmirli Nour
Published: January 2025

Background

Vaccines have contributed to the disappearance of various diseases, and almost eradicated others across the world. Studies have shown that in Lebanon a profoundly small percentage of Syrian refugee children were fully immunized by routine vaccination services. Exploring the knowledge, attitudes, and practices of parents towards vaccination is of crucial importance, given the role of parents in children’s immunization. This study aims to investigate the knowledge, attitudes, and practices of the Syrian refugee mothers in Lebanon towards the immunization of their children.

Methods

This is a cross-sectional study conducted using questionnaires targeting Syrian refugee mothers whose children were born on Lebanese grounds, are below the age of five, and are following the Lebanese vaccination schedule.

Results

Majority of refugee mothers considered vaccination to be safe (89.9%) and stated that vaccination should be initiated at birth (87.2%). Almost all of the interviewed mothers plan to vaccinate their children according to the National Lebanese Vaccination Schedule. Concerning the children’s immunization status, 51.4% of Syrian refugee children were fully immunized and 48.6% had aberrant vaccination.

Conclusion

Although refugee mothers had some knowledge gaps regarding vaccines, the main issue lies within the accessibility. A collaborative coordinated approach involving governmental and non-governmental agencies seems to be an effective approach to improve rates of immunization.
Policy research on role of traditional medicine in emergency health system construction based on the PMC index model: evidence from China
Authors: Zhang Yujing , Tian Xia , Chen Zhao , Hu Ziteng , Li Huizhen , Zong Xingyu , Li An , Zhang Fuqiang , Chen Yaxin , Zhang Haili , Yan Lijiao , Liang Ning , Shi Nannan , Wang Yanping
Published: January 2025

Background

The integration of traditional Chinese medicine (TCM) into emergency health systems in China serves as a model for global policy development and refining the inclusion of traditional medicine in health emergencies.

Methods

This study investigated 13 public health emergency policies related to TCM released by the Chinese central government from 2003–2023. A PMC(Policy Modeling Consistency) index model was developed combining ROSTCM text mining analysis software. The contents of these policy documents were quantitatively assessed using 10 first- and 40 s-level indicators.

Results

The content analysis results showed that current policies focus on emergency treatment, and that the State Administration of Traditional Chinese Medicine is the issuing authority of the main policies, most of which are issued in the form of a notice. The scoring results for the 13 policies showed that two, five, three, and three policies were rated as excellent, good, qualified, and unqualified, respectively. This indicates that the policy quality related to TCM use in emergency response was normally distributed and generally qualified, although room for further improvement exists; policies should follow the principles of science, reasonableness, and operability, and should be updated in a timely manner with continuous development of the governance period while focusing on the policy content, safeguards, and role measures.

Conclusion

Effective integration of traditional medicine into health emergency policies backed by state institutions is vital. This includes enforcing relevant laws and regulations, establishing multidisciplinary medical teams, and developing integrated medicine strategies that support clinical research and maximize the unique benefits of traditional medicine.
‘That’s kind of under my work blanket’—redeployment experiences of children’s hospital staff during the covid-19 pandemic: a qualitative interview study
Authors: Kelly Paula , Aldiss Susie , Wray Jo , Vindrola-Padros Cecilia , Gibson Faith
Published: January 2025

Background

During COVID-19 pandemic, a rapid readjustment to continued delivery of healthcare was required. Redeployment is an intentional process to mobilise human resources by reassigning a healthcare worker to a new role or new work location, to achieve sustainable delivery of patient care. We report redeployment experiences of staff from a specialist children’s hospital during first and second waves of the United Kingdom COVID-19 pandemic.

Methods

This study focuses on a specialist children’s hospital where redeployment occurred externally to adult intensive care units and other COVID-19 specific initiatives, and internally as some service activity reduced and others expanded. This was a study of staff experiences using a qualitative rapid appraisal design. Hospital staff participated in an in-depth one-to-one telephone interview. We used a semi-structured interview guide, and recorded and transcribed all interviews. Rapid Research Evaluation and Appraisal Lab sheets were used to share data; team-based analysis was facilitated using a framework approach.

Results

Recruitment and interviews took place from March-November 2021. Twenty-four staff participated: 17 nurses, five doctors and two other healthcare professionals. Interviewees articulated their experiences of redeployment both within the specialist children’s hospital and externally to other health settings (predominantly adult intensive care). Redeployment impacted staff in multiple ways professionally and personally and was reported to be both challenging and rewarding. The reality of working in different settings was felt by everyone, with unfamiliar environments, patient safety, and delivery of a more task-based model of care creating some negative experiences. We identified five main themes: (i) Drivers and Agency; (ii) Journey to Redeployment; (iii) Working Reality; (iv) Personal Impact and Support; (v) Professional Disruption.

Conclusions

Although experience of those redeployed varied, prior background of working in intensive care settings and with adult patients, with opportunities to share practice with colleagues, mitigated challanges for our participants. Positive experiences were associated with perceptions of support received, being welcomed in the new setting, and feeling valued. This study also highlights the act of ‘volunteering’, the nature of ‘voluntariness’ and the difference that may exert on the overall redeployment experience. Future guidance would be encouraged to consider the voluntary nature of redployment.
A rare case of intrathoracic Gauzoma
Authors: Adachi Taishi , Kayawake Hidenao , Hamakawa Hiroshi , Takahashi Yutaka
Published: January 2025

Background

Gauzoma is a foreign body reactive granuloma which is an extremely rare complication of thoracic surgery. We describe a case of a Gauzoma in which the gauzes were removed by mini-thoracotomy as a less invasive procedure, discovered incidentally after 35 years of follow-up.

Case presentation

A 51-year-old man was referred to our department for hyperhidrosis treatment, and imaging studies and biopsy confirmed the diagnosis of Gauzoma. As the Gauzoma gradually grew for a few years, surgical intervention was judged necessary, and the removal of the gauzes was performed in this case. A two-stage operation in two days was required to complete the surgery. The completion of gauze removal was confirmed in the second surgery using a postoperative computed tomography (CT) scan. The patient is currently doing well 17 months after surgery, and the size of granuloma unchanged.

Conclusion

We performed the removal of the gauzes as the treatment for Gauzoma. Although removing the gauze may have prevented its growth so far, careful follow-up is still needed.
Electrochemical study of anti-platelets tirofiban HCl in dosage form using nanomaterials modified sensors: developed and green assessed by eco-scale and complex-GAPI approach
Authors: Rizk Mohamed. , El-Alamin Maha Mahmoud Abou , Elkhalek Ola Abd , Hendawy Hassan A. M.
Published: January 2025

Tirofiban hydrochloride is used to inhibit platelet aggregation, which has a significant impact on the treatment of congestive heart failure the most common cause of death according to WHO. Therefore, its quantification in pharmaceutical dosage form is critical. In this work, an electrochemical method for the determination of tirofiban HCl in pharmaceutical dosage form was developed and validated. Carbon paste electrode modified with multi-walled carbon nanotubes (MWCNT) was utilized to examine the electrochemical response of tirofiban hydrochloride. Scanning electron microscopy and Energy-dispersive X-ray analysis was used to investigate the morphology of this electrode. A linear response was obtained within the range of (27.00–745.00 ng/mL) (5.4 × 10–5 M–1.5 × 10−3 M) with a correlation coefficient of 0.9995, and a detection limit of 15.50 ng/mL (3.1 × 10–5 M). The greenness profile of the method was assessed utilizing the eco-scale and the green analytical procedure Index.
Performance evaluation of biowashing pilot reactor for remediation of crude oil-contaminated soil of Kuwait
Authors: Lee Deok Jae , Lee Sung Jong , Kang Guyoung , Park Minkoo , Joo Young Hoon , Yeom Jae Ho , Chung Namhyun
Published: January 2025

Bioremediation of crude oil-contaminated soil in Kuwait was evaluated using the biowashing pilot reactor system, whose components included 3 biowashing reactors; an oil separator, a hydrocyclone, and a dissolved air flotation. The biowashing pilot reactor system was fed with hemoglobin, a cheap and rich nutrient source containing carbon and nitrogen for bacterial growth. The initial total petroleum hydrocarbons (TPH) concentration was about 84,000 mg/kg soil. The initial TPH concentration decreased to 38,000 mg/kg soil on day 1. The degradation extents of TPH were 55%, 91%, and 96% on days 1, 3, and 5. The first-order rate constant for TPH degradation rate was 0.682±0.0004/day. The initial unresolved complex mixture (UCM) concentration was 78,000 mg/kg soil. The degradation extents of UCM were 53%, 91%, and 98% on days 1, 3, and 5. Then, the degradation extents of individual components of total polycyclic aromatic hydrocarbons (PAH), alkylated PAH, and n-alkanes were measured for 5 days. 16 S rRNA gene copy number was measured during 5 days for bacterial population estimation. Although there was a day delay in the accretion of the number of copies, the number increased from day 2 to day 5. The present study suggests that the biowashing pilot reactor system with a capacity of 200 L is efficient for TPH degradation.
Domain adaptation-based multistage ensemble learning paradigm for credit risk evaluation
Authors: Zhang Xiaoming , Yu Lean , Yin Hang
Published: January 2025

Machine learning methods are widely used to evaluate the risk of small- and medium-sized enterprises (SMEs) in supply chain finance (SCF). However, there may be problems with data scarcity, feature redundancy, and poor predictive performance. Additionally, data collected over a long time span may cause differences in the data distribution, and classic supervised learning methods may exhibit poor predictive abilities under such conditions. To address these issues, a domain-adaptation-based multistage ensemble learning paradigm (DAMEL) is proposed in this study to evaluate the credit risk of SMEs in SCF. In this methodology, a bagging resampling algorithm is first used to generate a dataset to address data scarcity. Subsequently, a random subspace is applied to integrate various features and reduce feature redundancy. Additionally, a domain adaptation approach is utilized to reduce the data distribution discrepancy in the cross-domain. Finally, dynamic model selection is developed to improve the generalization ability of the model in the fourth stage. A real-world credit dataset from the Chinese securities market was used to validate the effectiveness and feasibility of the multistage ensemble learning paradigm. The experimental results demonstrated that the proposed domain-adaptation-based multistage ensemble learning paradigm is superior to principal component analysis, joint distribution adaptation, random forest, and other ensemble and transfer learning methods. Moreover, dynamic model selection can improve the model generalization performance and prediction precision of minority samples. This can be considered a promising solution for evaluating the credit risk of SMEs in SCF for financial institutions.
Real-world effectiveness of intravenous belimumab in adults with systemic lupus erythematosus: results of the observational OBSErve study in the Russian Federation
Authors: Lila Alexander Mikhailovich , Aseeva Elena Aleksandrovna , Zagrebneva Alyona Igorevna , Vinogradova Irina Borisovna , Samigullina Ruzana Ramilovna , Khamashta Munther , Elfishawy Tamer , Teichman Lindsey , dos Santos Debora , Queiroz Juliana , Kniazeva Larisa Alexandrovna , Noibi Saeed
Published: January 2025

Background

The real-world effectiveness of intravenous (IV) belimumab in treating systemic lupus erythematosus (SLE) has been demonstrated in various countries through the OBSErve (evaluation Of use of Belimumab in clinical practice SEttings) program. Here we describe the clinical effectiveness of IV belimumab for treating SLE in real-world clinical practice in the Russian Federation.

Methods

In the retrospective, observational OBSErve Russia study (GSK Study 215349), eligible physicians enrolled adults with SLE receiving IV belimumab as part of their standard care. De-identified data were collected from patient medical records from September 2021 to March 2022. The primary outcome was the physician-assessed overall clinical response at 6 months post-index versus index (belimumab initiation) among patients receiving belimumab for ≥6 months. Other endpoints included change in Safety of Estrogens in Lupus Erythematosus National Assessment – SLE Disease Activity Index (SELENA-SLEDAI) score and glucocorticoid use.

Results

Overall, 59 patients initiated IV belimumab, mainly due to the previous regimen not being effective and to decrease glucocorticoid use (76.3% each); 15.3% of patients started belimumab within the first year of SLE diagnosis. Only 13.6% of patients discontinued belimumab within the first 6 months, mainly due to loss to follow-up and loss of insurance/reimbursement. At 6 months post-index, among patients who completed ≥6 months of belimumab therapy (full analysis set, n = 53), 90.6% and 60.4% had an overall clinical improvement of ≥20% and ≥50%, respectively. Mean (standard deviation, SD) change in SELENA-SLEDAI score from index to 6 months post-index was −5.9 (4.3). Mean (SD) glucocorticoid dose decreased from 12.2 (7.3) mg/day at index to 8.6 (5.1) mg/day at 6 months post-index (n = 50).

Conclusions

Patients with SLE receiving IV belimumab for 6 months in real-world settings in the Russian Federation experienced overall clinical improvements and reductions in glucocorticoid use, which is an important long-term strategy of SLE treatment.
Being there: effectiveness of a 360-degree virtual tour for increasing understanding of forest treatments for fire hazard reduction in California, USA
Authors: Taylor Alan H. , Wallgrün Jan Oliver , Knapp Eric E. , Klippel Alexander , Sánchez José J.
Published: January 2025

Background

The increasing extent and severity of wildfires in the western USA poses a significant challenge to managers and to society. Forest thinning and prescribed fire treatments reduce fire hazard and improve resilience to climatic stressors. However, expanding the pace and scale of forest management is hampered, in part, by limited understanding and exposure of interested parties and the public to fuel reduction treatments. Virtual tour applications provide an opportunity to extend tours of treatment demonstration areas to anyone with a computer and internet connection. Yet there is little research on the effectiveness of virtual tours for enhancing understanding of forest treatments and if managers would deploy virtual tours to increase public awareness. Here we describe the development and evaluation of a virtual tour (https://chorophronesis.geog.psu.edu/virtualexperiences/StanislausWebsite/indexSummer2022.html) using surveys for three occupational groups: forest managers, university students, and non-student non-managers.

Results

The virtual tour improved self-reported understanding of how fires historically shaped forests, how fuels changed in the absence of fire, how thinning affects wildfire hazard, how prescribed fire affects wildfire hazard, and how thinning can be modified to enhance biodiversity. The virtual tour was also effective at conveying differences between treatment and non-treatment and among thinning and prescribed fire treatments, for all three occupational groups. There was strong agreement by all groups that if a field tour of forest treatments was not an option, the virtual tour would be a good substitute. The manager and non-manager occupation groups expressed significantly greater agreement with questions on the utility of virtual technology for aiding land management planning discussions and stimulating dialog among their own networks compared to students.

Conclusions

There was an overwhelmingly positive response to the virtual tour by all groups indicating significant potential to use virtual tours to improve understanding of fuel treatments. This could reduce social barriers impeding the scaling up of fuel reduction treatments that are needed to reduce fire hazard in California and elsewhere.
Advancing breast cancer diagnosis: token vision transformers for faster and accurate classification of histopathology images
Authors: Abimouloud Mouhamed Laid , Bensid Khaled , Elleuch Mohamed , Ammar Mohamed Ben , Kherallah Monji
Published: January 2025

The vision transformer (ViT) architecture, with its attention mechanism based on multi-head attention layers, has been widely adopted in various computer-aided diagnosis tasks due to its effectiveness in processing medical image information. ViTs are notably recognized for their complex architecture, which requires high-performance GPUs or CPUs for efficient model training and deployment in real-world medical diagnostic devices. This renders them more intricate than convolutional neural networks (CNNs). This difficulty is also challenging in the context of histopathology image analysis, where the images are both limited and complex. In response to these challenges, this study proposes a TokenMixer hybrid-architecture that combines the strengths of CNNs and ViTs. This hybrid architecture aims to enhance feature extraction and classification accuracy with shorter training time and fewer parameters by minimizing the number of input patches employed during training, while incorporating tokenization of input patches using convolutional layers and encoder transformer layers to process patches across all network layers for fast and accurate breast cancer tumor subtype classification. The TokenMixer mechanism is inspired by the ConvMixer and TokenLearner models. First, the ConvMixer model dynamically generates spatial attention maps using convolutional layers, enabling the extraction of patches from input images to minimize the number of input patches used in training. Second, the TokenLearner model extracts relevant regions from the selected input patches, tokenizes them to improve feature extraction, and trains all tokenized patches in an encoder transformer network. We evaluated the TokenMixer model on the BreakHis public dataset, comparing it with ViT-based and other state-of-the-art methods. Our approach achieved impressive results for both binary and multi-classification of breast cancer subtypes across various magnification levels (40×, 100×, 200×, 400×). The model demonstrated accuracies of 97.02% for binary classification and 93.29% for multi-classification, with decision times of 391.71 and 1173.56 s, respectively. These results highlight the potential of our hybrid deep ViT-CNN architecture for advancing tumor classification in histopathological images. The source code is accessible: https://github.com/abimouloud/TokenMixer.
The importance of Ki-67 proliferation index in small cell lung cancer
Authors: Sağmen Seda Beyhan , Doğan Coşkun , Cömert Sevda , Kıral Nesrin , Parmaksız Elif Torun , Fidan Ali , Barisik Nagehan Ozdemir , Gul Sule Karabulut
Published: January 2025

Background

As in numerous cancers, the connection between the Ki-67 proliferation index and response to treatment in cellular breakdown in the lungs is underlined. The purpose of this study was to investigate the connection between the Ki-67 proliferation index and radiotherapy’s therapeutic and survival effects in small cell lung cancer.

Methods

The limited-stage small cell lung cancer patients in our hospital were retrospectively reviewed. Patients receiving standard chemoradiotherapy were included in the study. Age, sex, cancer stage, comorbidities, response to treatment, and survival time were recorded. Bronchoscopic or transthoracic lung biopsy specimens which were taken at the time of diagnosis were stained with the Ki-67 immunohistochemical stain. Survival of patients and treatment response were compared statistically with the Ki-67 values.

Results

The Ki-67 proliferation index (62.29 ± 7.52) was lower in patients with partial response than in patients with complete response (77.08 ± 2.84) (p < 0.001). When the correlation between survival time and Ki-67 was examined, there was a positive correlation between the Ki-67 and survival time (p: 0.019; r: 0.426). The patients were divided into two groups: Ki-67 < 68.70 and Ki-67 ≥ 68.70. In patients with Ki-67 ≥ 68.70, the survival rate was better than that of patients with Ki-67 < 68.70 (p: 0.012). In Cox regression analysis, Ki-67 PI < 68.7 was found that increased mortality by 2742 times independently.

Conclusions

Patients with a high Ki-67 had a better survival effect than those with low Ki-67, and patients with complete responses had a higher Ki-67 value.
Population sequencing of cherry accessions unravels the evolution of Cerasus species and the selection of genetic characteristics in edible cherries
Authors: Lei Yahui , Jiu Songtao , Xu Yan , Chen Baozheng , Dong Xiao , Lv Zhengxin , Bernard Anthony , Liu Xunju , Wang Lei , Wang Li , Wang Jiyuan , Zhang Zhuo , Cai Yuliang , Zheng Wei , Zhang Xu , Li Fangdong , Li Hongwen , Liu Congli , Li Ming , Wang Jing , Zhu Jijun , Peng Lei , Barreneche Teresa , Yu Fei , Wang Shiping , Dong Yang , Elisabeth Dirlewanger , Duan Shengchang , Zhang Caixi
Published: January 2025

Cerasus is a subgenus of Prunus in the family Rosaceae that is popular owing to its ornamental, edible, and medicinal properties. Understanding the evolution of the Cerasus subgenus and identifying selective trait loci in edible cherries are crucial for the improvement of cherry cultivars to meet producer and consumer demands. In this study, we performed a de novo assembly of a chromosome-scale genome for the sweet cherry (Prunus avium L.) cultivar ‘Burlat’, covering 297.55 Mb and consisting of eight chromosomes with 33,756 protein-coding genes. The resequencing and population structural analysis of 384 Cerasus representative accessions revealed that they could be divided into four groups (Group 1, Group 2, Group 3, and Group 4). We inferred that Group 1 was the oldest population and Groups 2, 3, and 4 were clades derived from it. In addition, we found selective sweeps for fruit flavor and improved stress resistance in different varieties of edible cherries (P. avium, P. cerasus, and P. pseudocerasus). Transcriptome analysis revealed significant differential expression of genes associated with key pathways, such as sucrose starch and sucrose metabolism, fructose and mannose metabolism, and the pentose phosphate pathway, between the leaves and fruits of P. avium. This study enhances the understanding of the evolutionary processes of the Cerasus subgenus and provides resources for functional genomics research and the improvement of edible cherries.
Incomplete Toxicity Reporting and Use of Toxicity-Minimizing Language in Phase III Oncology Trials
Authors: Miller Avital M. , Passy Adina H. , Sherry Alexander D. , Kouzy Ramez , Abi Jaoude Joseph , Lin Timothy A. , Kupferman Gabrielle S. , Beck Esther J. , Msaouel Pavlos , Ludmir Ethan B.
Published: January 2025

PURPOSE

This study aimed to determine complete toxicity reporting (CTR), and the use of subjective toxicity-minimizing language (TML) among phase III oncology trials.

METHODS

Two-arm superiority-design phase III oncology trials published from 2002 to 2020 were reviewed for toxicity data. CTR was defined as reporting total adverse events (TAEs), total serious adverse events (SAEs), total deaths, and study therapy discontinuations because of toxicity. Guideline concordance was defined according to guidelines published in the
BMJ
(defined as reporting total SAEs, total deaths, and study therapy discontinuations because of toxicity). TML was defined as a set of terms that subjectively downplay the harm of therapies.

RESULTS

A total of 407 trials enrolling 322,645 patients were included. Most (51%, n = 207) reported SAEs, 88% (n = 358) reported total deaths, and 84% (n = 340) reported study therapy discontinuation because of toxicity. Although 55% of trials (n = 223) reported TAEs, only 32% (n = 131; 95% credible interval, 28 to 37) fit the criteria for CTR. CTR was more common in trials with industry sponsorship (37%) than with cooperative group sponsorship (4%). All 131 trials where CTR was observed were industry-sponsored, and only 3% (4/131) were cooperative group–sponsored trials. TML was used in 46% of trials (n = 186; 95% credible interval, 41 to 51), with no trial-related factors (including sponsorship source) associated with the odds of TML use.

CONCLUSION

Toxicity in phase III oncology clinical trials is often incompletely reported and is frequently minimized in its interpretation. Industry-sponsored trials more comprehensively report toxicity than do cooperative group–sponsored trials. CTR may improve patients' and oncologists' understanding of new treatments; thus, a more standardized approach to reporting toxicity data is needed.
Use of Olaparib in the Management of Metastatic Parathyroid Carcinoma With BRCA1 Mutation
Authors: Woodfield David , Le Trang , Prince Grace , Lee Hyun , Vachhani Hetal , Majety Priyanka
Published: January 2025

Parathyroid carcinoma (PC) is a rare cause of primary hyperparathyroidism with a highly variable clinical course. We report the case of a man with metastatic PC who presented with severe hypercalcemia, discovered incidentally after a fall. He underwent left upper parathyroidectomy with left thyroid lobectomy, and pathology confirmed PC. After a year of absence from follow-up, he developed recurrence with bilateral pulmonary metastases. Cinacalcet and denosumab were initiated due to persistent, severe hypercalcemia, followed by wedge resection and palliative radiotherapy of pulmonary metastases. Genetic analysis revealed no actionable pathogenic variants, but a BRCA1 mutation classified as a variant of unknown significance (VUS) was identified. He was started on olaparib, a poly adenosine diphosphate-ribose polymerase (PARP) inhibitor, 3 years after initial diagnosis. Following this, his PTH level declined by approximately 40% within 7 months. Subsequently, his PTH levels began increasing despite continuation of olaparib and, after 20 months, rose to his original PTH level prior to the initiation of therapy. This is a unique case of a patient with metastatic PC who had a BRCA1 VUS mutation, with initial partial reduction in PTH and calcium levels after PARP inhibitor treatment.
Conservative Management of Symptomatic Rathke Cleft Cyst With Recurrent Inflammatory Remission
Authors: Hasebe Masashi , Tsukaguchi Ryo , Shibue Kimitaka , Hamasaki Akihiro
Published: January 2025

Rathke cleft cyst (RCC) is a benign, nonneoplastic cystic lesion arising from embryonic remnants of the Rathke pouch and is increasingly detected with the widespread use of brain magnetic resonance imaging (MRI). Most RCCs remain asymptomatic; however, some present with symptoms such as headaches, visual disturbances, or pituitary dysfunction, often attributed to inflammatory processes within the cyst wall. We report the case of a 68-year-old woman with a year-long history of intermittent headaches, polydipsia, and polyuria. Initial MRI revealed a cystic lesion in the sellar region, and endocrinological assessment confirmed arginine vasopressin deficiency. A serial MRI follow-up revealed recurrent, short-term fluctuations in cyst size, suggesting intermittent inflammatory activity within the RCC. Despite the option for surgical intervention, conservative management alone resulted in the resolution of her headaches and substantial cyst shrinkage. This case underscores the potential for conservative management in symptomatic RCCs with inflammatory features, where hormone replacement and careful imaging follow-up may suffice. It also highlights the need for individualized care and long-term monitoring, especially in cases with dynamic inflammatory behavior.
Transnational Circulation of Ideas
Authors: Eroğlu Zeyneb Hale
Published: January 2025

During the Republican period, Chinese Muslim intellectuals engaged with both local Chinese and transnational Muslim thinkers as they selected, adapted, and appropriated from these different streams of thought. One reformist movement that appealed to a considerable number of Chinese Muslim intellectuals was the Ahmadiyya of India, which was considered “heterodox” by the majority of “orthodox” Muslims. This article explores how and why these prominent Chinese Muslims were attracted to the Ahmadiyya movement. It argues that Ahmadiyya, despite its marginal nature, offered an alternative interpretation of Islam to Chinese Muslims, who were looking for theological grounds that would enable them to argue for the compatibility of Islam and modernity and guarantee the integration of Muslims into modern China without jeopardizing their distinct Muslim identity.
The Chain before the Commodity
Authors: Paredes Alyssa
Published: January 2025

How do you build supply chain logistics to facilitate a political idea and not merely the movement of goods? This essay offers a historical and ethnographic account of “people-to-people trade” (minshū kōeki) between Japanese and Filipino activists from the 1970s onward. In contrast to a vast majority of transnational chains designed foremost to facilitate the efficient circulation of commodities, people-to-people trade has seen its main thrust as supporting linkage politics against the backdrop of a hacienda- and plantation-dominated economy. Encountering each other on the Philippine sugarcane capital of Negros, a vibrant circuit of activists, laborers, farmers, and housewives came together to build the chain in response to the island's descent into economic and political turmoil. Their trade partnership in a wild banana variety called “Balangon” enabled social relationships, ecological arrangements, and labor conditions distinct from Negros’ sugarcane monocultures at the time. Recounting this history offers a prism into a period when transnational concerns over authoritarianism, military counterinsurgency, famine, and pollution export linked the Philippines and Japan, transforming leftist politics in both contexts. Ultimately, this essay aims to show that commodity chains, when placed in the hands of civil society actors, can become meaningful platforms for social change.
Ανατομικές μεταβολές του έσω χιτώνα (INTIMA) της κοιλιακής αορτής από την επίδραση των α-ΜΕΑ
Authors: Παππάς Νικόλαος
Published: January 2025

Τα τελευταία χρόνια, το σύνολο των καρδιαγγειακών νοσημάτων αποτελεί με τεράστια διαφορά την κύρια αιτία θανάτου στον παγκόσμιο πληθυσμό ξεπερνώντας μάλιστα κατά πολύ τη συχνότητα θανάτων από νεοπλασματικές νόσους, αναπνευστικά προβλήματα ακόμα και την πανδημία του ιού COVID-19. Ο ιατρικός κόσμος και οι επαγγελματίες υγείας έχουν λοιπόν να αντιμετωπίσουν μια τεράστια πρόκληση απέναντι στα καρδιαγγειακά νοσήματα τα οποία αυξάνουν όχι μόνο τον δείκτη θνησιμότητας, αλλά και τις μερικές ή ολικές αναπηρίες, επιβαρύνοντας με αυτό τον τρόπο τόσο την ποιότητα ζωής των ασθενών, αλλά και τα ίδια τα συστήματα υγείας των χωρών, τα οποία έχουν κληθεί να αντιμετωπίσουν τεράστιο αριθμό ασθενών οι οποίοι χρειάζονται συχνά υποστήριξη για το υπόλοιπο της ζωής τους. Πολλοί είναι οι λόγοι στους οποίους οφείλεται αυτή η αύξηση της συχνότητας των καρδιαγγειακών νοσημάτων. Οι παράγοντες οι οποίοι έχουν συμβάλει δραστικά στην αύξηση της εμφάνισης των καρδιαγγειακών νοσημάτων είναι η υπέρταση, ο σακχαρώδης διαβήτης, το κάπνισμα, η παχυσαρκία, η αθηρωμάτωση, διάφοροι φαρμακευτικοί παράγοντες, καθώς φυσικά και το στρες που συνδέεται με το σύγχρονο τρόπο ζωής. Ειδικότερα στις παθήσεις των αγγείων, η αθηρωμάτωση βρίσκεται σε εξέχουσα θέση. Μια σειρά μηχανισμών προκαλούν μεταβολές στο ενδοθήλιο των αγγείων, προκαλώντας πάχυνση αυτού, ρωγμές της συνεκτικότητάς του και θέτουν με αυτόν τον τρόπο τις βάσεις αρχής δημιουργίας της αθηρωματικής νόσου. Λόγω της συχνότητας χρήσης των αντιυπερτασικών φαρμάκων στον πληθυσμό, κυρίως στους γηραιότερους ασθενείς, καθώς και του σημαντικού ρόλου που κατέχουν οι μεταβολές του ενδοθηλίου των αγγείων στην εμφάνιση της αθηρωματικής νόσου, η παρούσα διδακτορική διατριβή μελετά την επίδραση στον έσω χιτώνα της αορτής μιας ευρέως χρησιμοποιούμενης ομάδας φαρμάκων, των αναστολέων του μετατρεπτικού ενζύμου της αγγειοτενσίνης σε υπερτασικούς ασθενείς που χρησιμοποιούσαν στη θεραπεία τους την εν λόγω κατηγορία. Η συχνότητα χρήσης των φαρμακευτικών αυτών παραγόντων στους υπερτασικούς ασθενείς, ο αριθμός των οποίων έχει αυξηθεί ραγδαία τα τελευταία χρόνια, καθιστά σημαντική την μελέτη της επίδρασης της κατηγορίας αυτής των φαρμάκων στον έσω μυϊκό χιτώνα των αγγείων καθώς αυτό επιδρά άμεσα στην δημιουργία της αθηρωματικής νόσου.
The short-, medium-, and long-term prevalence of physical health comorbidities in first-episode psychosis: a systematic review and meta-analysis protocol
Authors: Zierotin Anna , Murphy Jennifer , O'Donoghue Brian , O'Connor Karen , Norton Michael , Clarke Mary
Published: January 2025

Background Individuals with first-episode psychosis (FEP) face an increased risk of physical comorbidities, notably cardiovascular diseases, metabolic disorders, respiratory disorders, and certain types of cancer. Previous reviews report pooled physical health prevalence from chronic psychosis and FEP groups. By contrast, this review will focus on antipsychotic-naïve FEP cohorts and incorporate data from observational longitudinal studies and antipsychotic intervention studies to understand the progression of physical health comorbidities from the onset to later stages of psychosis. This review aims to examine the short-, medium-, and long-term period prevalence of these comorbidities in FEP and variations related to demographic factors. Methods Using the PRISMA and MOOSE guidelines, Medline, Embase, PsycINFO, and CINAHL+, as well as Clinical Trials gov.uk, OpenGrey, WHO International Clinical Trials Registry Platform, Current Controlled Trials, United States National Institute of Health Trials Registry, and the Irish Health Repository, will be searched from inception. Longitudinal studies and antipsychotic intervention studies monitoring health outcomes in antipsychotic naïve FEP individuals will be eligible for inclusion. Two reviewers will independently screen titles, abstracts, and full-text articles. Risk of bias will be assessed using the Joanna Briggs Institute Critical Appraisal Checklist. A meta-analysis of the short-, medium-, and long-term prevalence of cardiovascular, metabolic, cancer, and respiratory outcomes and a narrative synthesis will be conducted. Where feasible, a meta-regression on the impact of demographic variables will be conducted. Potential limitations include the risk of diagnostic heterogeneity across studies and possible underreporting of certain comorbidities. Conclusions This systematic review will clarify the progression of physical health comorbidities in FEP, informing early intervention strategies and policies. Subsequent findings will be submitted to a leading journal, supplemented by a recovery education module and a lay summary for wider dissemination. Registration The study was registered in PROSPERO, the International Prospective Register of Systematic Reviews (CRD42023431072; 17/06/2023).
Examining the impact of implementing routine rotavirus vaccination on the number of paediatric admissions due to diarrhoea and dehydration in Kenyan hospitals: A study using interrupted time series analysis.
Authors: Chelangat Daisy , Malla Lucas , Langat Reuben C. , Akech Samuel ,   Clinical Information Network Author Group
Published: January 2025

Background Dehydration secondary to diarrhoea is a major cause of hospitalization and mortality in children aged less than five years. Most diarrhoea cases in childhood are caused by rotavirus, and routine introduction of rotavirus vaccine is expected to reduce the incidence and severity of dehydration secondary to diarrhoea in vaccinated infants. Previously, studies have examined changes in admissions with stools positive for rotavirus but this study reports on all admissions with dehydration secondary to diarrhoea regardless of stool rotavirus results. We aimed to assess the changes in all-cause severe diarrhoea and dehydration (DAD) admissions following the vaccine’s introduction. Methods We examined changes in admissions of all clinical cases of DAD before and after introduction of routine vaccination with rotavirus vaccine in July 2014 in Kenya. We use data from 13 public hospitals currently involved in a clinical network, the Clinical Information Network (CIN). Routinely collected data for children aged 2-36 months were examined. We used a segmented mixed effects model to assess changes in the burden of diarrhoea and dehydration after introduction of rotavirus vaccine. For sensitivity analysis, we examined trends for non-febrile admissions (surgical or burns). Results There were 17,708 patients classified as having both diarrhoea and dehydration. Average monthly admissions due to DAD for each hospital before vaccine introduction (July 2014) was 35 (standard deviation: ±22) and 17 (standard deviation: ±12) after vaccine introduction. Segmented mixed effects regression model showed there was a 33% (95% CI, 30% to 38%) decrease in DAD admissions immediately after the vaccine was introduced to the Kenya immunization program in July 2014. There was no change in admissions due to non-febrile admissions pre-and post-vaccine introduction. Conclusion The rotavirus vaccine, after introduction into the Kenya routine immunization program resulted in reduction of all-cause admissions of diarrhoea and dehydration in children to public hospitals.
Doenças Falciformes: Metanálise dos Correlatos de Déficits nas Funções Executivas
Authors: Nunes de Santana Alanny , Gaia Ribeiro Dias Janaína , Labres Lautert Sintria
Published: January 2025

Indivíduos diagnosticados com doenças falciformes estão suscetíveis a comprometimentos cognitivos. Objetivou-se com este estudo analisar os correlatos biológicos/orgânicos e psicológicos/psicossociais de déficits nas funções executivas em indivíduos com doenças falciformes. Realizou-se uma revisão sistemática com metanálise a partir da busca por artigos nas bases SCOPUS, ScienceDirect e MedLine, no mês de outubro de 2021 e, posteriormente, em julho de 2024. A análise envolveu 19 estudos que abrangeram 864 participantes (idade média = 13,9; 53% do sexo feminino). Para a avaliação da qualidade dos artigos incluídos foram utilizados cinco critérios da ferramenta de avaliação de qualidade do National Institutes of Health. Os resultados indicaram consistentes evidências de que as características biológicas e psicológicas/psicossociais estão associadas às funções executivas com efeitos significativos de tamanho moderado nesta população, com ênfase na cerebrovasculopatia e na velocidade do fluxo sanguíneo cerebral, bem como em habilidades sociais, na qualidade de vida e no estresse socioambiental, respectivamente. Para estudos futuros com portadores de doenças falciformes propõem-se investigações precoces das habilidades cognitivas, junto a elaboração de ações interventivas no intuito de minimizar prejuízos no desenvolvimento global.