bluuebunny/crossref_metadata_2025 huggingface dataset:
Cultural Variation in Attitudes Toward Social Chatbots
Authors: Folk Dunigan P. , Wu Chenxi , Heine Steven J.
Published: February 2025

Across two studies (Total N = 1,659), we found evidence for cultural differences in attitudes toward socially bonding with conversational AI. In Study 1 ( N = 675), university students with an East Asian cultural background expected to enjoy a hypothetical conversation with a chatbot (vs. human) more than students with European background. Moreover, they were less uncomfortable and more approving of a hypothetical situation where someone else socially connected with a chatbot (vs. human) than the students with a European background. In Study 2 (preregistered; N = 984), we found similar evidence for cultural differences comparing samples of Chinese and Japanese adults currently living in East Asia to adults currently living in the United States. Critically, these cultural differences were explained by East Asian participants increased propensity to anthropomorphize technology. Overall, our findings suggest there is cultural variability in attitudes toward chatbots and that these differences are mediated by differences in anthropomorphism.
Frosted branch angiitis post COVID vaccine: A presumptive association with Behçet's disease
Authors: Alegre-Ituarte Victor , Bodaghi Bahram , Touhami Sara
Published: February 2025

Purpose

To report a case highlighting the uncommon presentation of Frosted Branch Angiitis (FBA) in Behçet's Disease (BD), notably in a patient who received a COVID vaccine one month prior to the onset of symptoms. We explore the possible role of vaccination in unmasking BD.

Methods

A comprehensive evaluation of a 45-year-old patient with FBA post-COVID vaccination was undertaken.

Results

The patient exhibited characteristic features of FBA, with classic perivascular sheathing, optic disc edema, and retinal ischemia, which manifested one month after receiving the Pfizer/BioNTech COVID vaccine. Despite a history of recurrent oral aphthosis, systemic workup for autoimmune conditions was unremarkable. Diagnosis of presumptive Behçet's Disease was made based on clinical criteria. Treatment with intravenous methylprednisolone and infliximabn (5 mg/kg) led to complete resolution of ocular symptoms and retinal signs.

Conclusion

FBA is an uncommon presentation of BD. This case also serves as a stark reminder of the potential consequences of vaccination on immune-mediated diseases. However, the correlation between FBA onset, COVID vaccination, and Behçet's Disease diagnosis necessitates cautious interpretation. Successful use of methylprednisolone and infliximab in achieving resolution of visual symptoms highlights potential therapeutic considerations in similar cases.
Smelly sounds: Intestine material, gendered labour, and infrastructures of craft in south India
Authors: Kannan Thamarai Selvan
Published: February 2025

This article deals with bovine-intestine material that female artisans use in crafting musical instruments in contemporary South India. It explores the material and how different people come closer to or keep distance from the bodily substance and the final artifact. Comparing urban and rural drum-making practices and use, the article moves beyond caste-centered narratives and analysis, and demonstrates how making and using of the drum and attitude toward the material entangled with multiple social and religious groups in the Tamil-speaking region of India. I use fieldwork and oral history interviews to enrich the very little documented drum-making practice. Drawing my analytical framework from the history of science and technology, science and technology studies, and sound studies the paper moves between the slaughterhouse, the makers’ workshop, and the users of the drum, the article reveals the material and spatial complexities involved in working with and understanding bodily substances.
EXPRESS: How do expert musicians deal with local complexity in a sight-reading task?
Authors: Perra Joris , Poulin-Charronnat Benedicte , Baccino Thierry , Bard Patrick , Pfister Philippe , Lalitte Philippe , Zerbib Mélissa , Drai-Zerbib Véronique
Published: February 2025

Expertise is associated with a knowledge-driven information processing approach. Experts benefit from long-term knowledge structures—chunks and retrieval structures/templates—leading them to formulate expectations about local stimulus characteristics and to extract information projected onto distant areas from the fixation location. In an attempt to shed light on the way knowledge-driven processing impacts eye movements during music reading, this study aimed to determine how expert musicians deal with local complexity in a sight-reading task. Thirty musicians from two expertise levels had to sight read 4-bar score excerpts. Local analyses were conducted to investigate how the gaze behaves prior to and during the sight reading of different score characteristics, such as alteration, location of the notes on the staff, note count, and heterogeneity of notes. The more experts (i) were less affected by the foveal load induced by local complexity, showing a lower increase in fixation durations between noncomplex features and local complexity compared to the less experts; (ii) presented a saccadic flexibility towards the local complexity projected onto the parafoveal area, being the only group to exhibit shorter progressive incoming saccade sizes on accidentals and larger progressive incoming saccade sizes on new notes compared to noncomplex features; and (iii) presented a visuomotor flexibility depending on the played complexity, being the only group to exhibit a shorter eye-hand span when playing accidentals or distant notes compared to noncomplex features. Overall, this study highlights the usefulness of local analyses as a relevant tool to investigate foveal and parafoveal processing skills during music reading.
Endovascular Therapy for Large Ischemic Stroke in Directly Admitted vs Transferred Patients - A Secondary Analysis
Authors: Li Man , Zheng Lina , Nie Ximing , Wang Mengxing , Liu Xin , Duan Wanying , zhang zhe , Wen Miao , yang zhonghua , Huo Xiaochuan , Leng Xinyi , Pan Yuesong , Nguyen Thanh N , Miao Zhongrong , Liu Liping
Published: February 2025

BACKGROUND: Endovascular therapy (EVT) has been proved to benefit patients with acute large vessel occlusion (LVO) with large infarcts, but it is unknown whether the benefit isaffected by the interhospital-transfer status. We investigated the efficacy of EVT according to the interhospital-transfer status in such patients.

METHODS: This was a secondary analysis of the ANGEL-ASPECT trial. Patients with acute anterior-circulation LVO and large infarcts, defined by ASPECTS 3-5 or infarct core volume 70-100mL, were enrolled from forty-six centers across China and randomized (1:1) to receive EVT with medical management (MM) versus MM alone. We dichotomized patients into two subgroups based on whether admitted directly to the EVT-capable center or transferred from a primary center. The primary outcome was the 90-day modified Rankin Scale (mRS).

RESULTS: From October 2020 to May 2022, 456 patients were recruited and one withdrew consent. 455 patients were included in this analysis, with 210 (46.2%) in the direct subgroup and 245 (53.8%) in the transfer subgroup. The transfer subgroup had longer median onset-to-arrival time than the direct patients (379 vs 279mins, p <0.001), while there was no significant difference in the arrival-to-recanalization time (197 vs 205 mins, p=0.087) between the two subgroups. A significant ordinal shift of 90-day mRS towards a better functional outcome in EVT than MM (generalized odds ratio [gOR], 1.67; 95% CI, 1.03-2.70, p=0.036 versus gOR, 1.60; 95% CI, 1.02-2.50, p=0.039) was found in the direct and transfer group, respectively. There was no significant interaction of the two subgroups over the treatment effect of EVT versus MM on the primary outcome (p for interaction=0.706).

CONCLUSIONS: In acute anterior-circulation LVO patients with large infarcts, the benefit of EVT compared to MM did not vary by the interhospital-transfer status.
Biogenic pyrite and metastable iron sulfides: Emerging formation pathways and geological and societal relevance
Authors: Mansor Muammar , Duverger Arnaud , Pasquier Virgil , Gorlas Aurore , Guyot François , Berg Jasmine S. , Marin-Carbonne Johanna , Cosmidis Julie , Picard Aude
Published: February 2025

Iron sulfide (Fe-S) minerals such as mackinawite (FeS), greigite (Fe3S4) and pyrite (FeS2) are widespread on Earth, where their formation and dissolution are strongly linked to the biogeochemical cycles of iron, sulfur, carbon, oxygen, nutrients and trace metals. Recent studies have shed light on how microorganisms mediate their formation, with breakthroughs linked to biogenic pyrite. In this review, we highlight the formation pathways of Fe-S minerals, starting with the increasingly recognized roles of Fe(III) and intermediate sulfur species (e.g. S0 and polysulfides) during the initial steps. The mechanisms by which microorganisms affect Fe-S mineral formation are compiled and discussed for low (25–35°C) and high (≥ 80°C) temperatures, with specific examples from experimental studies. The morphology and precipitation rates obtained from experiments are compared to natural environments, and their similarities and differences are critically discussed. We then review the current state of the art for Fe-S minerals in the context of the origin of life and as environmental proxies and biosignatures in the geological record using their texture and chemical and isotopic compositions. We end by highlighting the importance of Fe-S minerals for current societal issues, such as the sequestration of organic carbon, the formation of acid drainages, metal recovery and nitrate removal, and their potential use as technological bio-materials in the future.
Defining pathogenic IL-17 and CSF-1 gene expression signatures in chronic graft-versus-host disease
Authors: Boiko Julie R , Ensbey Kathleen S. , Waltner Olivia G , Jenkins Isaac C , Bhise Shruti S , MacDonald Kelli PA , Blazar Bruce R , Hall Anne Marcie , Gooley Ted A , Minnie Simone A , Lee Stephanie J. , Furlan Scott N , Hill Geoffrey R
Published: February 2025

Chronic graft-versus-host disease (cGVHD) remains the leading cause of non-relapse morbidity and mortality after allogeneic hematopoietic cell transplantation (HCT). Effective therapeutics agents targeting dysregulated cytokines including IL-17 and CSF-1 have been defined in preclinical models of cGVHD, and efficacy in subsequent clinical trials has led to their recent FDA approval. Despite this, these agents are effective in only a subset of patients, expensive, difficult to access outside the US, and used in a trial-and-error fashion. The ability to readily discern druggable, dysregulated immunity in these patients is desperately needed to facilitate the selection of appropriate treatment and to potentially identify high-risk individuals for preemptive therapy. We used single cell sequencing-based approaches in our informative preclinical cGVHD models to "reverse engineer" temporal IL-17 and CSF-1 signatures in mouse blood that could be used to interrogate patients. We defined distinct, non-intuitive IL-17 and CSF-1 signatures in mouse blood monocytes that could be identified in relevant monocytes within 70% of patients at diagnosis of cGVHD and in half of patients at day +100 post-HCT who subsequently developed cGVHD. These signatures can now be evaluated prospectively in clinical studies to help delineate potential responder and non-responders to relevant therapeutics targeting these pathways.
Predictors of storage lower urinary tract symptoms after bipolar transurethral resection of the prostate
Authors: Emam Ahmed , ElSaeed Karim
Published: February 2025

Background

Storage lower urinary tract symptoms (LUTS) are often experienced after transurethral resection of the prostate (TURP). The purpose of this study was to determine potential risk factors that could contribute to this condition.

Methods

This prospective study included 120 consecutive patients undergoing bipolar TURP. Patients undergoing other procedures besides TURP, such as cystolitholapaxy, diverticulectomy, and urethrotomy were excluded, as were patients with neurological diseases or active urinary tract infection (UTI). The standard preoperative evaluation was done routinely, including the International Prostate Symptom Score (IPSS) with its storage and voiding sub-scores, urine culture, and abdominopelvic ultrasonography with an assessment of postvoiding residual urine (PVRU). Possible preoperative, intraoperative, and postoperative variables that may lead to storage LUTS following bipolar TURP were recorded and analyzed.

Results

Of 120 patients included in our study, 52 (43.3%) patients experienced storage LUTS at 1 week after catheter removal following bipolar TURP. Of the tested variables, age (68.5 ± 6.0 vs 63.7 ± 5.4 years), higher preoperative irritative IPSS subscore (11.0 ± 2.3 vs 8.0 ± 2.7), smaller prostate size (55.3 ± 12.7 vs 61.0 ± 16.3 gm), gross vs fine hemostasis of prostatic fossa, shorter catheter duration (2.3 ± 0.8 vs 3.0 ± 0.9 days), and post-TURP UTI were found to be statistically significant in univariate analysis. Using backward multivariate logistic regression, after adjustment of significant factors in univariate analysis, it was shown that IPSS irritative subscore was an independent factor affecting storage LUTS post-TURP (OR = 1.525; CI  1.298–1.79, P < 0.001).

Conclusions

Variable prognostic factors were related to storage LUTS following TURP; however, preoperative IPSS irritative subscore was an independent factor associated with such a condition, which should be emphasized during preoperative patient counseling.
Can a novel set of handgrips on a walking frame increase stability and support users when transferring to/from a chair?
Authors: Thies Sibylle Brunhilde , Bevan Susan , Wassall Matthew , Mootien Cynthia Poolay , Kenney Laurence , Howard David
Published: February 2025

Introduction

One important aspect of walking aid use is transferring safely to the aid from sitting and transferring back to the chair after walking, since these activities have been associated with falls in older adults. Standard frames require their user to push off the chair or ask for help from a carer, which may over time lead to back pain. This study’s aim was to assess whether novel handgrips located above the rear feet of a walking frame would facilitate safe transfer as compared to utilizing only the seat cushion or armrests of the chair.

Methods

In a gait lab-based trial 10 healthy older adults repeatedly transferred from sitting to standing, pushing off the chair’s seat cushion, armrests, or using the new lower handles on the frame (alone or in combination with the seat cushion or armrest). The stability margin ‘SM’, defined as the distance between the centre of pressure and the nearest edge of the base of support for the user-device-chair system, was calculated as a mechanical measure of stability. Specifically, SM provides a measure of how close the system is to the point of tipping over. Additionally, 13 older frame users tried to use the new handgrips to transfer to/from the new frame and gave interviews which were thematically analysed.

Results

Stability for the 10 healthy older adults was statistically either equivalent or better when using one or both handles on the novel frame as compared to pushing off the chair’s seat cushion or armrests. Amongst the 13 older frame users the frame’s new handgrips were useful to those living in the community and one person living in care, and they perceived them to facilitate independence and control.

Discussion & conclusions

The novel handgrips offer continuous support when getting up/sitting down and are well-received by those able to use them. The significance of the research lies in the reported number of falls during transfer from sitting to standing and vice versus, with underlying causes reported including loss of support. The proposed design is timely considering the documented increases in frailty and walking aid use in our ageing population.
Pilot randomised controlled trial on the feasibility and intervention satisfaction with an educational group programme for adults with attention deficit hyperactivity disorder and their caregivers
Authors: Skliarova Tatiana , Gråwe Rolf W. , Vaag Jonas , Mandahl Arthur , Kolltveit Inger , Løvås Ina , Torgersen Terje , Lara-Cabrera Mariela L.
Published: February 2025

Background

This pilot randomised controlled trial (RCT) study presents a patient-centred educational group programme collaboratively developed with user representatives and caregivers from two organisations and health personnel from a community mental health centre (CMHC). The objectives were to investigate the feasibility of the psychoeducational programme and the satisfaction of outpatients and caregivers with programme participation. This RCT explored the potential benefits of this innovative psychoeducational programme for adults recently diagnosed with attention deficit hyperactivity disorder (ADHD).

Methods

This pilot study employed a two-arm RCT design and recruited 60 outpatients from a Norwegian CMHC. The CMHC clinicians offered the intervention group (IG) participants a two-session, patient-centred, peer-cofacilitated programme along with the standard treatment. The control group (CG) received the standard treatment and a 1-h individual informational session during the same period. The recruitment, attendance, and dropout rate indicators were assessed for feasibility. Acceptability was assessed via the Client Satisfaction Questionnaire four-item scale (CSQ-4) and a three-item scale evaluating patient satisfaction with the information provided about ADHD. In addition, four patient-reported outcome measures (PROMs) were applied: one scale to assess self-efficacy, two to assess ADHD symptoms, and one for quality of life. The statistical analysis applied intention-to-treat (ITT) and per-protocol (PP) analyses.

Results

In total, 56 outpatients were divided into the IG (n = 30) or CG (n = 26), and the recruitment rate was 93.3%, with a dropout rate of 16%. The attendance rate was 92%, and the retention rates for the IG and CG were 56.6% and 76.9%, respectively. Concerning intervention satisfaction, the ITT analysis conducted using a linear mixed model revealed statistical improvements in satisfaction, with the scale measuring satisfaction with the information and the CSQ-4 scale. In addition, caregivers expressed high satisfaction with the programme, as measured by the CSQ-4 scale. Regarding PROMs, the ITT and PP analyses yielded mixed findings.

Conclusion

Preliminary evidence indicates that a two-session, patient-centred, peer-cofacilitated psychoeducational programme is feasible and well-received, with high ratings for satisfaction from outpatients and caregivers.

Cliniclatrials.gov Identifier

NCT03547843, 27/01/2022.
Comparative analysis between Reverdin-Isham Osteotomy (RIO) and minimally invasive intramedullary nail device (MIIND) in association with AKIN osteotomy for Hallux valgus correction
Authors: Biz Carlo , Bragazzi Nicola Luigi , Di Rita Anna , Pozzuoli Assunta , Belluzzi Elisa , Rodà Maria Grazia , Ruggieri Pietro
Published: February 2025

Background

Hallux valgus (HV) is a widespread condition that leads to discomfort in daily life. There are different surgical techniques for HV. This retrospective and comparative study aimed to compare the clinical and radiographic outcomes of the Reverdin-Isham osteotomy (RIO) and the Minimally Invasive Intramedullary Nail Device (MIIND) surgical techniques.

Methods

One hundred ninety-six patients with mild-to-severe HV were enrolled and divided into two groups: 98 patients with mild-moderate HV and 98 with moderate-severe HV, treated with the RIO and MIIND techniques, respectively. Radiographic and clinical evaluations were assessed preoperatively at 3, 12 and 60 months after surgery. Radiologically, the Hallux Valgus Angle (HVA), Intermetatarsal Angle (IMA), Distal Metatarsal Articular Angle (DMAA) and Tibial Sesamoid Position (TSP) were evaluated. Clinically, the AOFAS hallux metatarsophalangeal-interphalangeal scale and the Numeric Rating Scale (NRS-11) for pain were assessed. A propensity score matching (PSM) model was implemented to compare the two techniques.

Results

In the RIO group, the mean HVA correction from preoperative value to 60 months of follow-up was 8.69° (p < 0.0001), the mean IMA correction was 2.42° (p < 0.0001), and the mean DMAA correction was 0.09°. In the MIIND group, the mean HVA correction was 24.92° (p < 0.0001), the mean IMA correction was 8.75° (p < 0.0001), and the mean DMAA correction was 6.28° (p < 0.0001). The mean AOFAS score improved over time, and NRS-11 decreased in both groups. After PSM model application, the variables that impacted the allocation to RIO or MIIND techniques were age, preoperative HVA values and HV severity.

Conclusion

Our study demonstrates the efficacy of RIO for mild-moderate HV and MIIND for moderate-severe HV. Radiographic and clinical outcomes improved in both groups, but older patients with higher HVA and severe HV should be treated with the MIIND technique to achieve satisfactory outcomes.

Level of evidence

III, retrospective cohort study.
The revised Canadian Bleeding (CAN-BLEED) score for risk stratification of bleeding trauma patients: a mixed retrospective—prospective cohort study
Authors: Tran Alexandre , Lamb Tyler , Fernando Shannon M. , Charette Manya , Nemnom Marie-Joe , Matar Maher , Lampron Jacinthe , Vaillancourt Christian
Published: February 2025

Background

Traumatic hemorrhage is a significant cause of morbidity and mortality. There is considerable interest in risk stratification tools to aid with early activation of intervention pathways for bleeding patients. In this study, we refine the Canadian Bleeding (CAN-BLEED) score for the prediction of major interventions in bleeding trauma patients.

Methods

We conducted a mixed retrospective-prospective cohort study. We included a retrospective cohort from the CAN-BLEED derivation study, from September 2014 to September 2017. We also conducted a prospective cohort from May 2019 to August 2021 and included both datasets for refinement of the CAN-BLEED score. The primary outcome was major intervention, defined by a composite of massive transfusion, embolization, or surgery for hemostasis. Predictors were pre-specified based on previous validation work. We used a stepdown procedure and regression coefficients to create a clinical risk stratification score. We used bootstrap internal validation to assess optimism-corrected performance.

Results

We included 1368 patients in the overall cohort. Incidence of penetrating injury was 23% and median injury severity score was 17. The overall incidence of the need for major intervention was 17%. The revised score included 8 variables: systolic blood pressure, heart rate, lactate, penetrating mechanism, pelvic instability, Focused Abdominal Sonography for Trauma positive for free fluid, computed tomography positive for free fluid, or contrast extravasation. The C-statistic for the simplified score is 0.89. A score cut-off of less than 2 points yielded a 97% (94–98%) sensitivity in ruling out the need for major intervention.

Conclusion

The revised CAN-BLEED score offers a clinically intuitive and internally validated tool with excellent performance in identifying patients requiring major intervention for traumatic bleeding. Further efforts are required to evaluate its performance with an external validation.
Enzymes involved in trehalose-chitin synthesis in Haemonchus contortus could be vaccine candidates for goats
Authors: Wen Zhaohai , Amu Jilata , Aimulajiang Kalibixiati , Feng Jiajun , Chen Cheng , Xu Yongde , Lu Mingmin , Xu Lixin , Song Xiaokai , Li Xiangrui , Yan Ruofeng
Published: February 2025

Background

Trehalose-6-phosphate synthase (HcTPS) and trehalose-6-phosphate phosphatase (HcGOB) are key enzymes for trehalose synthesis in Haemonchus contortus. In addition, previous studies have also demonstrated that HcTPS and HcGOB can regulate the function of host immune cells in vitro, and are important immunosuppressive molecules. Therefore, this study evaluated the potential of HcTPS and HcGOB as vaccine candidates through in vitro and in vivo experiments.

Methods

To evaluate the inhibitory effects of polyclonal antibodies on egg hatching and larval development, anti-rHcTPS and anti-rHcGOB antibodies were incubated separately with eggs and first-stage larvae (L1s) under controlled in vitro conditions. For immunization studies, recombinant proteins (rHcTPS and rHcGOB) were formulated with Quil-A adjuvant, and administered to goats through subcutaneous injection. Vaccine efficacy against Haemonchus contortus infection was determined through comprehensive analysis of multiple parasitological parameters, including: (1) egg abnormality rate, (2) hatching success rate, (3) reduction egg output rates, and (4) reduction in adult worm burden.

Results

The results of in vitro experiments showed that polyclonal antibodies against HcTPS and HcGOB had no effect on the hatching rate of eggs, but significantly affected the development from L1s to infectious third stage larvae (L3s). After immunization with recombinant HcTPS protein (rHcTPS) and recombinant HcGOB protein (rHcGOB), high levels of antigen-specific immunoglobulin G (IgG) were produced in goats, and remained till the end of the experiment. Compared with the Quil-A adjuvant control group, the number of deformed eggs in the rHcTPS protein- immunized group and the rHcGOB protein- immunized group were significantly increased. In the rHcTPS protein-immunized group and the rHcGOB protein-immunized group, the deformity rate of eggs was 9.59% and 17.30%, respectively, and the hatching rate of eggs was reduced by 11.27% and 13.71%, respectively. Moreover, compared with the Quil-A adjuvant control group, the number of eggs and adults in the HcTPS protein- immunized group decreased by 64.47% and 60.93%, respectively, and the number of eggs and adults in the rHcGOB protein- immunized group decreased by 63.97% and 69.54%, respectively. Furthermore, compared with the control group (Quil-A adjuvant), the trehalose content in the rHcTPS protein- immunized group and the rHcGOB protein- immunized group was also significantly reduced.

Conclusions

These findings indicate that rHcTPS and rHcGOB exhibit superior immune protective effects, rendering them promising candidates for vaccine development.

Graphical Abstract
From defensive reasoning to innovation: how digital tools foster positive emotions in organizations
Authors: Tian Guyang , Yang Yang , Zhang Xue , Zhao Manlu , Tian Yezhuang
Published: February 2025

Researchers of organizational learning and innovation have frequently claimed that defensive reasoning is an inducer of negative emotions present in most organizations, inhibiting continuing innovation and development and individuals’ effective learning. Although a significant amount of research has been conducted on the factors that reduce defensive reasoning in an organization, the breakthrough process and its outcomes have not yet been studied. This study uses narrative network analysis on longitudinal data from a Chinese tourist resort to explore how organizational factors—such as institutional environments, social media platforms, and virtual-reality role transformations—help employees overcome defensive reasoning and foster innovation. It demonstrates how digital management tools and corporate social platforms transform negative emotions into positive, creativity-enhancing actions. By analyzing individual defenses from both general and job position perspectives, the study introduces a comprehensive theoretical framework that highlights the role of emotional guidance and digital tools in reducing defensiveness, promoting collaboration, and improving organizational effectiveness and innovation.
Over a decade of successful treatment with tocilizumab in a maintenance hemodialysis patient for Castleman disease: a case report and literature review
Authors: Shima Aya , Shima Takahiro , Matsuo Chie , Suehiro Takaichi , Kamimura Tomohiko , Niiro Hiroaki , Hirakawa Makoto
Published: February 2025

Background

Castleman disease (CD) is a rare, non-neoplastic lymphoproliferative disorder with characteristic histopathological features in lymph nodes. The clinical presentation of CD is highly variable, which can complicate both diagnosis and treatment. Tocilizumab, an interleukin-6 receptor antibody, is approved for the treatment of CD, but there is limited data regarding its use, efficacy, and safety in patients undergoing maintenance hemodialysis.

Case presentation

We present the case of a 53-year-old woman with CD who has been successfully and safely treated with tocilizumab for over 10 years, while on maintenance hemodialysis. Initially, at the age of 48 years, the patient presented with anemia and renal impairment, leading to a diagnosis of CD after an inguinal lymph node biopsy. Treatment with prednisolone was initiated, but poor compliance led to discontinuation of follow-up. At the age of 53 years, she returned with severe renal dysfunction (serum creatinine 7.16 mg/dL) and profound anemia (hemoglobin 4.0 g/dL), necessitating initiation of hemodialysis and erythropoiesis-stimulating agents. Despite these interventions, her anemia persisted. Additional findings of residual lymphadenopathy, polyclonal hypergammaglobulinemia, and elevated C-reactive protein (CRP) levels indicated that her anemia was likely attributable to CD. As a result, tocilizumab therapy was initiated, leading to rapid improvement in both anemia and CRP levels. Although her renal function did not recover, and she remained dialysis-dependent, the patient has continued to receive tocilizumab for over a decade without major adverse events, and has achieved stable disease control.

Conclusions

This case highlights the successful long-term management of CD with tocilizumab in a patient on maintenance hemodialysis. It underscores the potential for tocilizumab to provide sustained disease control and symptom relief in CD, even in the setting of renal failure and hemodialysis. Further research is needed to evaluate the safety and efficacy of tocilizumab in this patient population.
Spatial transcriptomics in autoimmune rheumatic disease: potential clinical applications and perspectives
Authors: Miyamoto Atsuko Tsujii , Shimagami Hiroshi , Kumanogoh Atsushi , Nishide Masayuki
Published: February 2025

Spatial transcriptomics is a cutting-edge technology that analyzes gene expression at the cellular level within tissues while integrating spatial location information. This concept, which combines high-plex RNA sequencing with spatial data, emerged in the early 2010s. Spatial transcriptomics has rapidly expanded with the development of technologies such as in situ hybridization, in situ sequencing, in situ spatial barcoding, and microdissection-based methods. Each technique offers advanced mapping resolution and precise spatial assessments at the single-cell level. Over the past decade, the use of spatial transcriptomics on clinical samples has enabled researchers to identify gene expressions in specific diseased foci, significantly enhancing our understanding of cellular interactions and disease processes. In the field of rheumatology, the complex and elusive pathophysiology of diseases such as rheumatoid arthritis, systemic lupus erythematosus, and Sjögren’s syndrome remains a challenge for personalized treatment. Spatial transcriptomics provides insights into how different cell populations interact within disease foci, such as the synovial tissue, kidneys, and salivary glands. This review summarizes the development of spatial transcriptomics and current insights into the pathophysiology of autoimmune rheumatic diseases, focusing on immune cell distribution and cellular interactions within tissues. We also explore the potential of spatial transcriptomics from a clinical perspective and discuss the possibilities for translating this technology to the bedside.
Investigating the higher education institutions’ guidelines and policies regarding the use of generative AI in teaching, learning, research, and administration
Authors: An Yunjo , Yu Ji Hyun , James Shadarra
Published: February 2025

This study examined the guidelines issued by the top 50 U.S. universities regarding the use of Generative AI (GenAI) in academic and administrative activities. Employing a mixed methods approach, the research combined topic modeling, sentiment analysis, and qualitative thematic analysis to provide a comprehensive understanding of institutional responses to GenAI. Topic modeling identified four core topics: Integration of GenAI in Learning and Assessment, GenAI in Visual and Multimodal Media, Security and Ethical Considerations in GenAI, and GenAI in Academic Integrity. These themes were further explored through sentiment analysis, which revealed highly positive attitudes towards GenAI across all institution types, with significant differences between faculty and student-targeted guidelines. Qualitative thematic analysis corroborated these findings and provided deeper insights, revealing that 94% of universities had faculty guidelines emphasizing the importance of establishing and communicating course-specific GenAI policies. This analysis also highlighted recurring themes such as academic integrity and privacy concerns, which aligned with the security and ethical considerations identified in the topic modeling. The study highlights the rapid evolution of GenAI guidelines in higher education and the need for flexible, stakeholder-specific policies that address both the opportunities and challenges presented by this technology.
The evaluation of clinical outcomes assessments and digital health technologies in clinical trials for obesity
Authors: Goetz Iris A. , Sutter Carolyn , Abraham Traci , Kanu Chisom , Boye Kristina S. , Symonds Tara
Published: February 2025

Background

Clinical trials for obesity have traditionally focused on weight loss and resolution of comorbidities as primary outcomes. However, secondary outcomes, such as the impact of weight reduction on patient experience, like health-related quality of life (HRQoL), have increasingly been recognized as important. Therefore, a review was conducted to determine the Clinical Outcome Assessments (COAs) and Digital Health Technologies (DHTs) used in clinical trials for obesity to assess the patient experience.

Methods

Two clinical trial databases (United States & European Union) were reviewed to identify Phase 2–4 clinical trials for obesity (2018–2023). A targeted literature review was also conducted using the OVID database to identify clinical trial for obesity publications which included COAs/DHTs (2010–2023).

Result

Trials from the databases (n = 53) and publications (n = 42) were included in data extraction (N = 73). This resulted in identification of 108 COAs, the majority being patient-reported outcome (PRO) measures (n = 83), but also 24 performance outcomes (PerfO) measures, and 1 composite PRO-clinician-reported outcomes (ClinRO) measure, as well as 2 DHTs. The most frequently identified PRO measures were the Short Form 36 and the Impact of Weight on Quality of Life Lite Clinical Trials. Twenty-four PerfO measures were also identified, with the 6-minute walk test being most common. These measures were most often used to construct secondary endpoints, with physical function (PF) being the most frequently specified domain. PRO measures assessing eating-related thoughts/behaviours, physical activity, and disordered eating were also frequently included, although individual measures varied widely across trials.

Conclusion

Review of COAs and DHTs in registered clinical trials and publications for obesity found that PRO measures were the most common type of COA used to develop endpoints with current use of DHTs limited. Specifically, the physical function domain of multidimensional patient-reported outcome measures assessing health-related quality of life were often used to construct secondary endpoints. Further work is warranted to assess how the COAs and DHT data collected in clinical trials are viewed by regulators and payers.
Optimizing Wastewater Treatment Using Endophytic Fungi Isolated from Acacia saligna L. Bark
Authors: Serag Mamdouh S. , Mohesien Marwa T. , Hasballah Amany F.
Published: February 2025

Endophytic fungi’s application in biological wastewater treatment is a cost, clean, and eco-friendly. This study aimed to assess the efficiency of three Aspergillus species in the mycoremediation of industrial (I) and agricultural (A) wastewater. These species were Aspergillus flavipes, Aspergillus niger, and Aspergillus flavus isolated from the bark of a medicinal plant (A0cacia saligna). Aspergillus species were subculture on potato dextrose broth at 28 °C for 7 days on a rotatory shaker at 180 rpm until fungal pellets were formed. Before and after treatment with fungi, all wastewater samples were examined for pH, TDS, salinity, EC, COD, BOD, TP, TN, and turbidity. According to the results, Aspergillus flavipes has a good removal efficiency of total phosphorus, removing 78% of it from sample (I) after 25 days, and turbidity removing 91% after 20 days in (A) sample. Aspergillus niger has a high chemical oxygen demand removal efficiency of 99% and 99.8% in (I and A) samples after the 15th and 10th day, respectively, in addition to total nitrogen removal efficiency of 99% in (A) sample after the 25th day; and turbidity removal efficiency of 99.7% in the same sample. Also, Aspergillus flavus recorded high removal of biological oxygen demand by 76% and 66% in (I and A) samples after the 10th day of each, respectively; total nitrogen by 69% after the 10th day in (I) sample; total phosphorus by 23% after 10th day in (A) sample; electrical conductivity by 10.7% after 10th day in (I) sample; and total dissolved salts by 1.3% after 5th day in (I) sample. The results explained that Aspergillus niger and Aspergillus flavus were the most efficient in the removal of chemical oxygen demand and biological oxygen demand which represented indicators of pollution in wastewater. The obtained results will be useful for optimal management of agricultural and industrial wastewater.
Quercetin inhibits steroid-induced hypergluconeogenesis in Saccharomyces cerevisiae
Authors: Doss Victor Arokia , Subramaniam Gowtham , Manoharan Keerthana
Published: February 2025

Background

Steroid-induced hypergluconeogenesis is a significant contributor to hyperglycemia, often complicating the therapeutic use of steroids. This study investigates the potential of quercetin, a naturally occurring flavonoid, to mitigate steroid-induced hypergluconeogenesis in Saccharomyces cerevisiae. The levels of glucose, total proteins, free amino acids, pyruvate, lactate and antioxidants were assessed in the quercetin-treated yeast cells induced with betamethasone at different time intervals. The glucose uptake potential of yeast cells treated with quercetin was also studied and also the effect of steroids and quercetin on cell viability was analyzed.

Results

Our results show that quercetin effectively reduces gluconeogenesis by normalizing the levels of metabolites involved in the process and alleviates the hyperglycemic effects associated with steroid exposure. Quercetin-treated yeast cells also demonstrated a better uptake of glucose. Additionally, quercetin was found to improve the overall cell viability highlighting its role in modulating glucose metabolism.

Conclusion

These outcomes suggest that quercetin can serve as a promising adjunct therapy for managing steroid-induced metabolic disturbances, providing a natural and effective approach to counteracting steroid-induced hyperglycemia.
Overall Survival and Economic Impact of Triple-Negative Breast Cancer in Brazilian Public Health Care: A Real-World Study
Authors: Mattar André , Antonini Marcelo , Amorim Andressa Gonçalves , Teixeira Marina Diógenes , de Resende Cristiano Augusto Andrade , Cavalcante Francisco Pimentel , Zerwes Felipe , Arakelian Renata , Millen Eduardo de Camargo , Brenelli Fabricio Palermo , Frasson Antonio Luiz , Leite Renata Montarroyos , Gebrim Luiz Henrique
Published: February 2025

PURPOSE

Triple-negative breast cancer (TNBC) presents notable treatment difficulties, especially in the public health care systems of low- and middle-income countries where access to advanced therapies is restricted. This study investigates TNBC's clinical, epidemiologic, and economic effects on survival within Brazil's public health care system.

METHODS

We conducted a retrospective cohort study of patients with TNBC treated between 2010 and 2019. Overall survival (OS) rates by stage were analyzed across various patient groups, including those receiving neoadjuvant or adjuvant treatment, patients with or without complete pathologic response, Black and non-Black patients, and those treated with or without carboplatin-based therapy. Cox proportional hazards models were applied to estimate hazard ratios (HRs) with 95% CIs, and annual treatment costs were calculated per stage.

RESULTS

Among 1,266 patients with TNBC, 710 met eligibility criteria. Kaplan-Meier analysis indicated stage II patients had a 47% lower mortality risk than stage III (HR, 0.53 [95% CI, 0.33 to 0.85];
P
= .009). Patients in the adjuvant treatment group had a reduced risk (HR, 0.48 [95% CI, 0.34 to 0.69]) compared with the neoadjuvant group. Achieving complete pathologic response (pCR) greatly improved OS (HR, 0.21 [95% CI, 0.11 to 0.43];
P
< .001). Black patients had better survival rates than non-Black (HR, 0.58 [95% CI, 0.40 to 0.86];
P
= .006). Carboplatin use did not significantly affect OS (HR, 0.96 [95% CI, 0.65 to 1.43];
P
= .857). The average monthly cost for systemic TNBC treatment increased with disease progression, from $101.87 in US dollars (USD) for stage I to $314.77 USD for stage IV second-line therapy.

CONCLUSION

This study provides insight into TNBC in Brazil's public health system, showing that OS decreases with disease progression but is higher among Black patients. pCR and adjuvant therapy improve survival, although costs increase significantly at advanced stages, highlighting the economic burden of late-stage TNBC management.
Engage: A Survivorship Program to Improve Childhood Cancer Survivors' Self-Efficacy and Quality of Life
Authors: Signorelli Christina , McLoone Jordana , Wakefield Claire , Donoghoe Mark , Alchin Joseph Elliot , Johnston Karen , Baldwin Rachael , Thornton-Benko Elysia , Webber Kate , Foreman Tali , Neville Kristen , Cohn Richard
Published: February 2025

PURPOSE

We evaluated a survivorship program Engage, aimed at improving childhood cancer survivors' health-related self-efficacy and their health-related quality of life (HRQoL).

MATERIALS AND METHODS

Engage provides (1) a telehealth nurse-led health assessment, (2) a remote multidisciplinary case review, (3) personalized recommendations and care plan for survivors and their primary care physician (PCP), and (4) a telehealth nurse-led consultation to promote survivors' understanding of the recommendations. We recruited survivors >5 years postdiagnosis of any age who had not received cancer-related care in the past 24 months. We assessed survivors' outcomes pre-intervention and at 1-, 6-, 12-, and 24-month follow-ups.

RESULTS

Seventy-eight survivors participated: 62% male, median age = 30 years, and 14% lived regionally/rurally. Participating survivors' self-efficacy scores improved from baseline to 1 month and were maintained at 6-, 12-, and 24-month follow-ups (
P
< .001). Survivors' HRQoL remained similar from baseline to postintervention, as did the proportion of survivors reporting a regular PCP or engaging in health/risky behaviors (eg, exercise). Survivors' distress, anxiety, and anger significantly decreased pre- to 6 months postintervention. Survivors' satisfaction with care increased by 28% (
P
< .001) and was maintained across follow-up (
P
= .002). Information needs reduced from baseline to 1 month postintervention (
P
= .023) although they were similar at further follow-up.

CONCLUSION

Survivors' self-efficacy, satisfaction with care, and some psychosocial outcomes improved after participating in Engage. Further effort is needed to improve survivors' primary care engagement and health behaviors.
The Indian Question in Afrocentric Politics
Authors: Shankar Shobana
Published: February 2025

For African-Indian relationships, the idealism of Afro-Asian solidarity did not often match realities on the ground, which were volatile and rapidly changing from the 1940s. This essay explores how Idi Amin's expulsion of Asians was embedded in a racial calculus that had a history beyond Uganda in 1972, in the context of ongoing struggles for African independence, Pan-Africanism, the Cold War, and religious nationalism in the Middle East. The Indian question in Africa was a political and sociocultural one—emblematic of division and partition based on ethno-religious and cultural difference and hierarchy—and not simply an economic one for Africans. The Ugandan expulsion was complex and not a single event but one made in multiple registers, as wider continental African perspectives reveal.
Optimizing Mecca
Authors: Shah Omer
Published: February 2025

In the holy city of Mecca, crowds and numbers matter. A hadith or saying of the Prophet reports that when pilgrims number fewer than seven hundred thousand, angels will perform the rituals in their stead. One of the names of Mecca is umm al-zuhm or “Mother of Crowds.” Thinking about crowds in Mecca requires an alternate, Islamic genealogy of “the crowd.” But in contemporary Saudi Arabia, the crowd is becoming a resource in new ways. As part of the Vision 2030 national transformation plan, the Saudi government wants to intensify Mecca's crowds, increasing the annual number of pilgrims from eight million to thirty million. Under this plan, the holy city is to become a laboratory for new sciences and technologies of crowd management, logistics, and optimization. This article demonstrates how Mecca comes to be constitutive of these new crowd sciences. The author shows how a range of knowledges (both religious and more secular) compete and collaborate through the building of a massive hajj infrastructure (the Jamarāt Bridge) and its system of logistical optimization (tafwīj). While the author is generally interested in how Mecca comes to be useful for these new crowd sciences and technologies, he is particularly interested in how Islamic law is deployed as “optimization” and as a crowd management “solution.” These strategies of crowd efficiency and optimization not only transform the performance of ritual itself but also diminish the cosmopolitanism that undergirds the hajj and its knowledge worlds.
Activation of prep expression by Tet2 promotes the proliferation of bipotential progenitor cells during liver regeneration
Authors: Jia Kun , Cheng Bo , Huang Lirong , Xu Jiaxin , Liu Fasheng , Liao Xinjun , Liao Kai , Lu Huiqiang
Published: February 2025

Biliary epithelial cell (BEC)-derived liver regeneration in zebrafish exhibits similarities to liver regeneration in chronic liver injury. However, the underlying mechanisms remain poorly understood. Here, we identified a serine peptidase called prolyl endopeptidase (prep) as an indispensable factor during the BEC-derived liver regeneration process. Prep was significantly upregulated and enriched in bipotential progenitor cells (BP-PCs). Through gain- and loss-of-function assays, prep was found to potently accelerate liver regeneration and drastically increase the proliferation of BP-PCs. Mechanistically, prep expression was directly regulated by ten-eleven translocation 2 (Tet2)-mediated DNA demethylation. More strikingly, Tet2 regulated prep expression by directly interacting and reducing the methylation of CpG sites in the prep promoter. Subsequently, prep activated the PI3K-AKT-mTOR signaling pathway to regulate liver regeneration. Therefore, our study revealed the role and mechanism of Tet2-mediated DNA demethylation-associated upregulation of prep in the proliferation of BP-PCs during liver regeneration. These results identify promising targets for stimulating regeneration following chronic liver injury.