bluuebunny/crossref_metadata_2025 huggingface dataset:
Fundamentals of telehealth: A learning compendium for residents
Authors: Wang Lulu , Chandra Shruti , Nash Christopher J. , Fabiano Anthony (Tony) , Hou Peter C. , Whitehead David C. , Kolkin Alexander , Tomovic Milos , Hayden Emily M.
Published: February 2025

Background

Telehealth is an integral part of modern care delivery. Accordingly, accrediting bodies have recognized the importance of telehealth in trainee education. In 2021, the Association of American Medical Colleges (AAMC) published a report identifying telehealth learner core competencies in six domains: patient safety and appropriate use, access and equity, communication, data collection and assessment, ethical practices and legal requirements, and technology for telehealth. We present here a Fundamentals of Telehealth Resource Compendium for residents that fulfills these competencies.

Methods

The compendium was curated by a group of telehealth subject matter experts from the Society for Academic Emergency Medicine (SAEM) Telehealth Interest Group, through a structured iterative process. Authors performed a literature review for open‐source telehealth educational resources. Each resource was rated for quality by two reviewers using the rMETRIQ score (Revised Medical Education Translational Resources: Impact and Quality). Resources with the highest composite rMETRIQ reviewer score were included in the final collection.

Results

Scores for resources ranged from 2 to 21 (with a maximum possible rMETRIQ score of 21). Of 201 resources reviewed and rated, 57 were included in the final collection. A Fundamentals of Telehealth section was added as an introduction (five resources)—these resources did not undergo the rMETRIQ scoring process.

Conclusions

This telehealth compendium is a resource from which residency programs can further tailor site‐specific training. Alternatively, an individual can use this compendium as a self‐study tool to gain a basic understanding of telehealth and its intersection with emergency medicine. Note that while this compendium is designed for the resident‐level learner, it is easily adaptable to a learner of any level, as many underlying concepts remain the same.
Reducing physical assaults on residents through implementation of project BETA: Best practices in the evaluation and treatment of agitation
Authors: Roppolo Lynn , Choe Joshua L. , Beyer Luke , Blumberg Garrett , Morris David W. , Metzger Jeffery , Leaf Jedidiah , Salazar Gilberto , Bishop‐Penn Deborah , Kirk A. J. , Ramdin Christine , Khan Fuad
Published: February 2025

Background and objectives

We created a multitude of initiatives that were in line with the principles of the BETA (Best Practices in the Evaluation and Treatment of Agitation) guidelines to determine if these initiatives would reduce the physical assault rate by patients on emergency medicine (EM) residents.

Methods

We conducted three cross‐sectional surveys of our EM residents (PGY‐1 to ‐3) to determine the incidence of physical assaults by agitated patients at a large county hospital emergency department. These were primarily anonymous REDCap surveys and were administered at the following intervals: (1) pre–BETA initiative implementation, (2) approximately 12 months after implementation, and (3) 5 years postimplementation. Unfortunately, the in‐person deescalation, self‐defense, and simulation training were canceled 2 years prior to the last survey due to COVID‐19. The second survey only looked at the incidence of physical assaults during the prior 6 months whereas the other two surveys evaluated the incidence of physical assaults since starting residency.

Results

The survey response rates for the three REDCap surveys were 76% (50/66), 80% (53/66), and 71% (49/69), respectively. The percentage of EM residents who were physically assaulted per survey period were as follows: preimplementation cumulative assaults 28% (14/50), 12 months after implementation for 1 full academic year 11.3% (6/53), and postimplementation cumulative assaults during residency 5 years later 30.6% (15/49). The two independent‐samples proportions tests comparing the number of physical assaults before and approximately 12 months after all of these initiatives were implemented was significant (p = 0.032).

Conclusions

An education and training curriculum designed to improve EM residents’ ability to manage agitated patients may reduce the incidence of physical assaults on them by patients in their care. However, the decrease in physical assaults after these initiatives followed by the increase in physical assaults experienced after the COVID‐19 pandemic are most likely multifactorial.
Randomized crossover trial comparing two open surgical cricothyrotomy techniques
Authors: Suria Ezra , Mallows James L. , Salter Mark D.
Published: February 2025

Objective

Emergency cricothyrotomy is a life‐saving procedure that is performed in “can't intubate can't oxygenate” scenario. A recent study comparing an open surgical technique using a bougie and endotracheal tube (ETT) with a Seldinger technique using the Cook Melker catheter showed that the open technique was quicker but suggested that the open technique could be quicker if using the Melker catheter instead of a bougie and ETT. The objective of this study was to compare the surgical technique using bougie and ETT with an open technique using the Melker catheter.

Methods

A randomized crossover trial was conducted involving emergency physicians (EPs) and trainees. Participants performed both techniques in succession on an airway model, with the technique performed first being randomized for each participant. The primary outcome was time to first insufflation of the artificial lung. Participants also indicated their comfort with each technique on a 5‐point Likert scale and which technique they preferred.

Results

Seventeen EPs and 19 trainees participated. The Melker catheter technique was performed quicker with a mean time of 29.2 s versus 44.3 s for the bougie/ETT technique (difference 15.1 s, 95% confidence interval 10.8–19.4 s). The Melker catheter was most preferred by participants (61% vs. 39%). There was no significant difference in the comfort ratings between each technique. Time to model lung insufflation was not affected by training level or time since last performed a cricothyrotomy, either real or simulated.

Conclusions

The Melker catheter was quicker to perform and the most preferred by participants.
The standardized letter of evaluation (SLOE) in emergency medicine: The internal validity of the SLOE 2.0
Authors: Mannix Alexandra , Hegarty Cullen B. , Bord Sharon , Beardsley Thomas , Monteiro Sandra , Alvarez Alai , Davis Teresa , Gore Katarzyna , Parsons Melissa , Pandey Aman , Krzyzaniak Sara M. , Gottlieb Michael
Published: February 2025

Background

The standardized letter of evaluation (SLOE) is a crucial component of emergency medicine (EM) residency applications. Initially developed in 1995 and revised to electronic SLOE (eSLOE) 2.0, this tool aims to provide a standardized evaluation of medical students.

Objective

This study aimed to conduct internal validation by analyzing the distribution and correlation of scores in eSLOE 2.0 and identify any ranking skew.

Methods

A multi‐institutional cross‐sectional study conducted using eSLOE 2.0 data from applicants to five geographically diverse U.S. EM residency programs during the 2022–2023 application cycle. Data from 2891 eSLOE 2.0 s across 1633 applicants were analyzed using descriptive statistics, chi‐square, and Spearman's rho.

Results

Scores for all questions were moderately left‐skewed. The mean scores for all part B questions were above 4.0. Strong correlations were found between part A and B scores with anticipated guidance (AG) and rank list (RL) positions. The AG had a higher correlation with RL positions than grades. The mean RL score indicated that the average student fell between the middle and top thirds.

Conclusions

The study demonstrates left skew in eSLOE 2.0 scoring, including a higher prevalence of scores in the fully and mostly entrustable ranges for part A and the consistently high scores in part B.
Pesticide Behaviors Under Output Price Risk: Evidence From China's Lychee Market
Authors: Pan Zheng , Zheng Xuyun , Huang Chukun
Published: February 2025

The influence of output price risk on pesticide behavior is a critical area of research. This study explores the effect of output price risk on pesticide consumption by combining a nationally representative sample of lychee farmers with high‐frequency prices along the supply chain in China. Our findings robustly demonstrate that agricultural households significantly increase their pesticide expenditure when output price risk rises. Furthermore, we identify that the operating mechanism is driven by increased nonfarm work participation among peer households. The heterogeneity analysis indicates that the effects of output price risk are especially pronounced in the consumption of herbicides and conditioners and among small‐scale households. In the analysis of typical plots, we further find that agricultural households tend to increase spraying intensity instead of spraying frequency. The insights derived from this study can assist policymakers in formulating agricultural policies to enhance farmers' pesticide management practices amid the instability of output prices.
Impairment of Innate Immunity and Depletion of Vaccine‐Induced Memory B and T Cells in the Absence of the Spleen
Authors: Bordoni Veronica , Cinicola Bianca Laura , Piano Mortari Eva , Castilletti Concetta , Guarracino Federica , Albano Christian , Accordini Silvia , Baban Anwar , Di Sabatino Antonio , Rossi Carlo Maria , Lenti Marco Vincenzo , Zicari Anna Maria , Cirelli Riccardo , Spada Marco , Forni Gian Luca , Quinti Isabella , Algeri Mattia , Casale Maddalena , Perrotta Silverio , Locatelli Franco , Agrati Chiara , Carsetti Rita
Published: February 2025

Splenectomy or congenital asplenia is associated with severe reduction of memory B cells and increased risk of fulminant sepsis by encapsulated bacteria. Current guidelines recommend vaccinations against these pathogens before or after splenectomy, but the longevity of immunity acquired after splenectomy has not been determined. The impact of splenectomy on innate immune cells is unknown. We analyzed frequency, differentiation stage, and function of innate and adaptive immunity in the peripheral blood of adult (n = 41) and pediatric (n = 14) patients splenectomized or born asplenic and in spleens of solid organ donors. The absence of the spleen impacts the B‐cell compartment, causing a significant increase of circulating immature transitional and depletion of memory B cells. Using SARS‐CoV‐2 vaccination as a model, we show that 1 year after the last immunization, despite normal levels of neutralizing antibodies, memory B and T cells were significantly reduced. Analysis of post‐pandemic spleens shows that spike‐specific memory B and T cells homed to the spleen. We also show a previously unrecognized role of the spleen in the homeostasis of innate NK and Vδ2 T cells. These populations showed altered phenotype and impaired function in the adults, but not in children, suggesting that other tissues may support innate cell development during early life. The reduced function of innate lymphocytes must be considered as an additional immune impairment and risk factor. These findings emphasize the spleen's irreplaceable role in maintaining immune memory across all ages and suggest that its absence contributes to dysfunctions of innate and adaptive immunity in adults.
Novel Low‐Cytotoxic and Highly Efficient Type I Photoinitiators for Visible LED‐/Sunlight‐Induced Photopolymerization and High‐Precision 3D Printing
Authors: Lalevee Jacques , Gao Tong , Liu Zheng , Yin Jiansong , Feng Ji , Dietlin Céline , Morlet-Savary Fabrice , Schmitt Michael , Petithory Tatiana , Pieuchot Laurent , Zhang Jing , Dumur Frédéric , Xiao Pu
Published: February 2025

The development of photoinitiators (PIs) combining high initiation ability, low‐toxicity, and availability for high‐precision 3D printing is a key challenge in photopolymerization that has never been reported before. In this study, carbazole chalcone glyoxylate oxime ester derivatives (denoted as Cs, C1‐C5) containing both glyoxylate and oxime ester moieties with good light absorption properties in the visible range have been designed as type I PIs. Subsequent experimental results clearly show that the photoinitiation ability of C5 outperforms that of the benchmark commercial PIs (methyl benzoylformate (MBF) and diphenyl (2,4,6‐trimethylbenzoyl) phosphine oxide (TPO)) under the same conditions. In addition, C5 is successfully applied to 3D printing for the manufacture of large‐scale and high‐resolution object. The photochemical mechanism of C5 is systematically and comprehensively analyzed using a combination of steady state photolysis, decarboxylation reaction, fluorescence experiments, and electron spin resonance‐spin trapping (ESR‐ST) technology. Furthermore, the low‐toxicity of C5 is evidenced by cytotoxicity assays. The comprehensive molecular modeling and experimental approach adopted in this research has led to the development of novel PIs that are highly efficient and low‐toxic, and can be used for high‐precision 3D printing, which offers broad application prospects in the fields of environmental sustainability, visible light curing, and biomedical science.
Selective and Efficient Upcycling of Polyesters from Waste Plastic Blends Enabled by a Rationally Designed Manganese Pincer Catalyst
Authors: Hu Yue , Gu Yanwei , Dong Yongjing , Wang Yiqing , Xu Juanfang , Han Yingying , Zhang Chijian , Xie Yinjun
Published: February 2025

Herein, we report a new class of earth‐abundant pincer manganese catalysts that not only enable the efficient conversion of single‐component post‐consumer polyesters with a turnover number (TON) of up to 5300, but more importantly, allow the selective upcycling of polyesters from waste plastic blends (e.g., nylon, PA; polyethylene, PE; polyurethane, PU; polyvinyl chloride, PVC; cotton) or contaminants such as pigment, aluminum, or glass into highly valuable oxygenated products under mild conditions. Detailed mechanistic studies combined with DFT calculations revealed that the exceptional efficiency of this protocol is due to the use of rationally designed quinaldine‐based PNNH‐type Mn complexes with an extended π‐system and an N‐H moiety on the side arm to simultaneously enhance the stability and reactivity of the catalyst. In addition, the incorporation of dual metal‐ligand cooperation (MLC) relay catalysis more effectively facilitates the key steps of this transformation, including H2 activation and hydrogen bond‐assisted hydride transfer.
Nickel(II) Complexes of Benzoylpyridine Diaminoguanidinedihydrazone via In Situ One‐Pot Method: Structural, Spectral, and Catalytic Studies
Authors: Hashim K. K. Mohammed , Nishana Lahinakillathu , Kurup M. R. Prathapachandra , Sakthivel Ayyamperumal , Manoj E.
Published: February 2025

Seven Ni(II) complexes (1–7) designed from a new nitrogen‐rich ligand 1,3‐bis(phenyl(pyridin‐2‐yl)methylideneamino)guanidine hydrochloride (H3L‧ HCl) are reported. The complexes were synthesized using in situ one‐pot method and characterized by elemental analyses, FT‐IR, Far‐IR, electronic solution‐phase spectra, solid‐state electronic diffuse reflectance spectra (UV‐DRS), conductivity measurements, and room temperature magnetic moment calculations. The structures of H3L‧ HCl and complex 7 were confirmed via SCXRD analysis. Additionally, complex 4 on crystallization yielded a new mononuclear complex, [Ni(H2L)]Cl‧ 2H2O (4a), which was confirmed by SCXRD analysis. The molecular packing of the compounds is affected by the counter anions and stabilized by various noncovalent interactions within the crystal lattice, which were analyzed quantitatively by Hirshfeld surface analysis. The band gaps of the compounds indicate semiconductor characteristics, which were evaluated experimentally and subsequently analyzed by DFT calculations. The catalytic investigation reveals that the Ni(II) complex 7 facilitates a cinnamyl alcohol conversion of 90% with a selectivity of 92% for cinnamaldehyde under the optimal reaction conditions of 80°C for 24 h, employing TBHP in decane as the oxidizing agent. Similarly, all other complexes are also found to exhibit comparable conversions in the range of 81%–91% under optimal conditions. Furthermore, in silico molecular docking studies demonstrated the binding affinity of the ligand and complex 4 with SARS‐CoV‐2 main protease active site (Mpro), which makes them suitable candidates for further biological exploration.
Thermoreversible Nitrile Rubber Based on the Dual Role of Zinc Chloride
Authors: Dai Zi Wei , Wang Xiao Ping
Published: February 2025

A strategy for the preparation of thermoreversible nitrile rubber is demonstrated by introducing zinc chloride into sulfur‐cured nitrile rubber to form metal coordination bonds, thereby constructing a dynamic double‐crosslinking network as a potential solution for the severe environmental burden. In this study, the crosslinking structure and the mechanism of reprocessing are investigated by X‐ray diffraction, Fourier transform infrared spectroscopy, and Raman spectroscopy, revealing that the crosslinking network is formed by monosulfide bonds, disulfide bonds, polysulfide bonds, and Zn2+‐cyanide coordination bonds generated from zinc chloride that interact with the cyano groups on the nitrile rubber. Zinc chloride plays a dual role during the reprocessing process. On one hand, it participates in the cleavage/recombination of Zn2+‐cyanide coordination bonds. On the other hand, it catalyzes the disulfide exchange reaction in the sulfur crosslinking system, enabling the recycled nitrile rubber to possess recyclability. Due to the double‐crosslinking structure accompanied by the dual role of zinc chloride, nitrile rubber exhibits superior mechanical properties and impressive recyclability. The tensile strength and elongation at break of the double‐crosslinking nitrile rubber reach 5.59 MPa and 387%, respectively, stronger than those of sulfur‐cured nitrile rubber, maintaining 116.5% and 115.0% after the recycling process.
2,3‐bis((4‐(pyridin‐2‐yl)‐1H‐1,2,3‐triazol‐1‐yl)methyl)quinoxaline based Cyclometalated binuclear Ir (III) Complex for Photodynamic therapy in Triple Negative Breast Cancer Cell
Authors: U Sreelekha , Paira Priyankar
Published: February 2025

Herein, we have developed a novel 2,3‐bis((4‐(pyridin‐2‐yl)‐1H‐1,2,3‐triazol‐1‐yl)methyl)quinoxaline based binuclear cyclometalated Iridium (III) complex (CIr2L) for TNBC treatment. The complex has high protein binding affinity (KHSA= 0.362 × 106 M‐1) and high DNA binding affinity (Kb = 0.92 × 106 M‐1). The complex exhibited best efficiency as a Type II PDT agent due to its ability to induce 1O2 generation. The low dark cytotoxicity, high phototoxicity (IC50 = 2.3 ± 0.8 µM, PI = 31.3) and selectivity (selectivity factor > 50‐fold over normal HEK‐293 cells) of complex CIr2L in MDA‐MB‐231 TNBC cell line makes it well‐suited for PDT. The DCFDA comparison study conducted in MDA‐MB‐231 cells under light and dark conditions demonstrated significant ROS generation with light exposure. JC‐1 staining revealed a substantial disruption in mitochondrial membrane potential (MMP). The mechanism of cell death was evaluated using an annexin V‐FITC/PI flow cytometric assay, confirming a higher percentage of early apoptotic cells under light exposure. Mechanistically, this type of electropositive binuclear complex is being selectively transported to cancer cell membrane through serum albumin and depleted the GSH level by the generation of ROS in presence of light leading to DNA photocleavage followed by apoptosis.
Expert consensus on Rezūm™: Indications, surgical technique and postoperative care
Authors: Alcina Emilio López , Arjona Manuel Fernández , Guzmán Ester Fernández , Zuazu Jorge Rioja , Jochamowitz Iván Schwartzman
Published: February 2025

Background

Lower urinary tract symptoms associated to benign prostatic hyperplasia (LUTS/BPH) is a growing condition in males associated to a high clinical, economic and humanistic burden. Currently, there is a wide range of therapeutic options, both pharmacological and surgical. In recent years, several minimally invasive therapies have emerged, but they still have limitations. In this context, water vapour thermal therapy (WVTT), Rezüm™, is a new minimally invasive surgical technique with a low retreatment rate and the ability to preserve sexual function. The objective of this study is to establish recommendations for the correct execution of WVTT, as well as to define the ideal patient profile for the intervention.

Methods

A literature search was conducted in PubMed, without date limitations, using the terms ‘benign prostatic hyperplasia’, ‘benign prostatic enlargement’, ‘prostatic hyperplasia’, ‘bph’, ‘Rezūm’, ‘water vapour thermal therapy’, ‘quality of life’ and ‘HRQOL’. A systematic review of the evidence was conducted and subsequently discussed in a face‐to‐face meeting with a panel of five experts in the field of urology. The aspects addressed were classified into patient profile, pre‐intervention, intervention and post‐intervention.

Results

The search returned 172 results, ultimately leading to the analysis of 49 articles. Evidence and expert opinion showed that WVTT could be a good option for patients with moderate to severe symptomatology, no age restriction, Qmax <15 mL/s and prostate volume greater than 30 cm3, but not necessarily less than 80 cm3. Low retreatment rate and low impact on erectile capacity and ejaculatory function were also demonstrated.

Conclusions

WVTT is considered a safe treatment option, even as a first‐line approach for certain patient profiles. However, further research is needed in areas where evidence and clinical experience remain limited, including postoperative catheter management, anaesthesia, antibiotic prophylaxis and follow‐up care for patients after the procedure.
Wardrobe Renaissance—The Intersection of Circular Economy and Sustainable Fashion Consumption—From Bibliometric Analysis to a Conceptual Framework Model
Authors: Goel Radhika , Joshi Meha , Jayant Arvind
Published: February 2025

This study aims to conduct a comprehensive bibliometric analysis of research on circular economy and sustainable fashion consumption. By examining the existing literature, we seek to identify key predictors that influence consumer behaviour and adoption of sustainable fashion practices within a circular economy framework. Using a bibliometric approach, we will analyse a large dataset of scholarly publications to identify research trends, most productive countries and relevant sources. Through text mining techniques, we will extract keywords, co‐citation networks and citation analysis to uncover the most prominent predictors influencing sustainable fashion consumption. Drawing on prominent theories such as the Theory of Planned Behaviour, SHIFT model and Goal Framing Theory, we will draw up a conceptual model of potential predictors such as environmental awareness, trust, social influence, hedonic value and fashion consciousness. This study will contribute to a deeper understanding of the factors driving sustainable fashion consumption and provide valuable insights for policymakers, businesses and consumers. By identifying key predictors, we can develop more effective strategies to promote sustainable fashion practices and transition towards a circular economy.
Delivering Trio Germline Whole Genome Sequencing to Patients Newly Diagnosed With Childhood Cancer: Healthcare Professionals' Perspectives of the PREDICT Study
Authors: Hunter Jacqueline D. , Hetherington Kate , Wakefield Claire E. , Tucker Katherine M. , McGill Brittany C. , Grant Andrew , Fuentes‐Bolanos Noemi A. , Padhye Bhavna , Gleeson Margaret , Bhatia Kanika , Peate Michelle
Published: February 2025

Background

Germline genomic sequencing (GS) is increasingly offered to children with cancer. To optimize integration into routine care, assessment of implementation barriers and a better understanding of healthcare professionals' perspectives and experiences are needed.

Methods

Healthcare professionals delivered trio germline GS to newly diagnosed pediatric and adolescent patients with cancer via the PREDICT completed questionnaires with qualitative and quantitative items. Each study site recorded reasons for eligible families' nonenrolment in PREDICT to identify barriers to recruitment. Quantitative data were analyzed via descriptive statistics, whereas qualitative data underwent inductive content analysis, with results integrated for interpretation.

Results

Thirty‐three healthcare professionals participated, including 23 oncology professionals and 10 genetic professionals. Healthcare professionals perceived PREDICT as beneficial to participating and future families, and that perceptions of personal benefit and altruism were drivers of family uptake. Concerns included workforce capacity and potential family distress given the trio design and high‐stress diagnosis setting. Barriers to recruitment related to clinical decision‐making, family factors, and logistics. Although most rated their genetics/genomics knowledge as “good,” regarding germline results, few were “very confident” interpreting (29%), explaining (32%), making treatment recommendations (9.7%), and providing psychosocial support to families (29%). They acknowledged a need for further training in these areas for trainees; yet, fewer were interested in training for themselves.

Conclusion

Successful implementation of routine germline GS will require targeted strategies to address logistical issues and alleviate potential negative psychosocial impacts for families. Recognizing the escalating demand on genetics experts, upskilling of the current workforce and involvement of a broader spectrum of healthcare professionals are warranted.
Optimizing Prognostic Assessment in High‐Risk Head and Neck Squamous Cell Carcinomas: The Impact of Tumor Budding and a Novel Histomorphological Scoring System
Authors: Knebel Moritz , Philipp Kühn Jan , Körner Sandrina , Braun Felix , Brust Lukas , Wemmert Silke , Smola Sigrun , Ertz Martin , Wagner Mathias , Schick Bernhard , Morris Luc G. T. , Linxweiler Maximilian , Klamminger Gilbert Georg
Published: February 2025

Background

Head and neck squamous cell carcinomas (HNSCC) pose significant clinical challenges, particularly in high‐risk cases with positive lymph node status. Current prognostic biomarkers are often costly and methodologically demanding. In this regard, histomorphological biomarkers such as tumor buds (TB) and poorly differentiated clusters (PDC) represent promising, cost‐effective prognostic indicators that are relatively straightforward to implement.

Methods

The prognostic significance of TB and PDC, in conjunction with stromal tumor‐infiltrating lymphocytes (sTILs) and the tumor‐stroma ratio (TSR), was evaluated in a cohort of 50 high‐risk, nodal‐positive HNSCC patients. Histomorphological features were assessed using standard hematoxylin and eosin (H&E) staining, while HPV association and PD‐L1 expression were determined by means of immunohistochemistry (IHC) and/or PCR. All variables collected were subsequently correlated with traditional histopathological and clinical parameters. Finally, a novel scoring system incorporating TB and PDC was developed, and its association with overall survival (OS) was analyzed.

Results

TB and PDC both demonstrated a significant impact on patients' OS (TB Log‐rank test, p = 0.0499, PDC Log‐rank test, p = 0.0235). A novel scoring system based on these features had strong association with patients' OS (Log‐rank test, p = 0.0200) in contrast to the conventional and routinely performed grading system, which evaluates the degree of differentiation within neoplastic cells (Log‐rank test, p = 0.3325). PD‐L1 expression was not associated with TB and PDC formation. HPV‐negative status was associated with a higher number of tumor buds.

Conclusion

This study reveals the potential prognostic value of TB and PDC in high‐risk HNSCC, which may offer a practical and cost‐effective alternative to traditional markers. Our proposed practicable and straightforward employable scoring system significantly correlates with OS, suggesting its potential benefit in clinical practice. These findings advocate for further validation to enhance prognostic accuracy and guide treatment strategies in HNSCC.
Improving Radiotherapy Plan Quality for Nasopharyngeal Carcinoma With Enhanced UNet Dose Prediction
Authors: Jian Junming , Yuan Xingxing , Xu Longfei , Gong Changfei , Gong Xiaochang , Zhang Yun
Published: February 2025

Background

Individualized dose prediction is critical for optimizing radiation treatment planning. This study introduces DESIRE, an enhanced UNet‐based dose prediction model with progrEssive feature fuSion and dIfficult Region lEarning, tailored for nasopharyngeal carcinoma (NPC) patients receiving volumetric modulated arc therapy. We aimed to assess the impact of integrating DESIRE into the treatment planning process to improve plan quality.

Methods

This retrospective study included 131 NPC patients diagnosed at Jiangxi Cancer Hospital between 2017 and 2020. Twenty patients were randomly allocated to a testing cohort, while the remaining 111 comprised a training cohort. Target delineation included three planning target volumes (PTVs): PTV70, PTV60, and PTV55, along with several organs at risk (OARs). The DESIRE model predicted dose distributions, and discrepancies between DESIRE's predictions and the ground truth (GT) were quantified using dosimetric metrics and gamma pass rates. Two junior physicians used DESIRE's predictions for treatment planning, and their plans were compared to the GT.

Results

Most of DESIRE's predicted dosimetric metrics closely aligned with GT (mean difference < 1 Gy), with no significant differences (p > 0.05) in Dmean and D1 values across OARs. While significant differences were observed in PTV metrics, the mean differences in D98, D95, D50, and Dmean between DESIRE and GT did not exceed 1 Gy. Assisted by DESIRE, the junior physicians' plans were comparable to the GT in nearly all OARs, with no significant differences in dosimetric metrics. The conformity index (CI) and homogeneity index (HI) for PTV70 surpassed the GT (0.847 ± 0.036 vs. 0.827 ± 0.037 for CI, and 0.057 ± 0.009 vs. 0.052 ± 0.008 for HI). The average three‐dimensional gamma passing rates were 0.85 for PTV70 and 0.87 for the 35‐Gy isodose line.

Conclusions

The DESIRE model shows promise for patient‐specific dose prediction, enhancing junior physicians' treatment planning capabilities and improving plan quality.
Treatment Outcomes of Cognitive Behavioural Therapy for Earthquake‐Related Distress
Authors: Woods Cate F. , McIntosh Virginia V. W. , Frampton Christopher M. , Carter Frances A. , Colhoun Helen C. , Jordan Jennifer , Smith Rebekah A. , Bell Caroline
Published: February 2025

Background

Cognitive behavioural therapy (CBT) is an effective treatment for post‐traumatic stress disorder (PTSD), but few studies have examined its effectiveness among individuals exposed to natural disasters. Group CBT could be an efficient way to treat disaster‐related PTSD, but it is unclear how the outcome of group and individual formats compare.

Aims

The current study used a non‐controlled design to examine CBT outcomes among adults with severe, ongoing earthquake‐related distress and a non‐randomised design to compare the outcomes of group and individual CBT.

Materials & Methods

Participants were 175 adults with earthquake‐related PTSD or adjustment disorder consecutively referred for treatment at a specialist mental health service between one and four and a half years post‐earthquake. Participants completed a diagnostic interview and self‐report measures pertaining to PTSD severity; depression, anxiety, and stress; fear and avoidance; social adjustment; aggression; and resilience before and after treatment.

Results

Following treatment, 92.3% of participants (with available interview data) no longer met criteria for their primary earthquake‐related disorder (PTSD or adjustment disorder), and significant reductions in PTSD severity were observed. Following treatment, participants had significantly fewer mental disorders, less depression, anxiety, stress, fear, avoidance, and aggression, and greater social adjustment and resilience. Treatment format (group vs. individual) and timing of treatment presentation were not associated with any treatment outcomes of interest.

Conclusion

Findings suggest CBT is effective for individuals exposed to natural disasters when delivered in real‐world post‐disaster settings. Group CBT is an efficient way to treat large numbers of people using limited resources, strengthening the rationale for group treatment following natural disasters.
College Sports Law in a Nutshell provides comprehensive guide for today's environment
Authors: Rychlak Ronald J.
Published: February 2025

If you’re looking for a concise but comprehensive guide to today's complex and evolving legal landscape surrounding collegiate athletics, consider reading College Sports Law in a Nutshell (West Academic Publishing, 2024) by William Berry and Daniel Lust. The authors distill the vast body of law governing this area into a concise and informative text, making it a valuable resource for student‐athletes, administrators, and others working in or around collegiate athletics.
Attend to the big picture: Balance strategic visioning with daily tasks
Authors: Schwebel David C.
Published: February 2025

As administrators at colleges and universities, we face a seemingly endless stream of daily tasks. We approve budgets and timesheets. We attend and lead meetings. We read and respond to emails, texts, and phone calls. We supervise, encourage, congratulate, and mentor, and we make decisions on how to allocate funds, assign duties, and interpret policies.
Consider potential impact of Pavia case on eligibility
Authors: Romano Robert
Published: February 2025

In a not‐so‐surprising turn of events due to recent federal court decisions, Chief U.S. District Judge William L. Campbell, Jr., granted Vanderbilt University quarterback Diego Pavia's preliminary injunction that he filed against the NCAA in November. Pavia's request to the U.S. District Court, Middle District of Tennessee at Nashville challenged the legality of NCAA Bylaws 12.8, 12.02.6, and 14.3.3 (JUCO Eligibility Limitation Bylaws). He claimed these rules violate Section 1 of the Sherman Act by reducing the number of years that former junior college players can participate in Division I football, while at the same time shortening the period of time in which they can monetize their name, image, and likeness (see Pl. Complaint, Pavia v. Nat’l Collegiate Athletic Ass’n, No. 3:24‐cv‐01336 (M.D. TN Nov. 8, 2024)).
Limit liability by preparing coaches, staff to properly manage cardiac events involving student‐athletes
Authors: O’Brien Timothy
Published: February 2025

Potential liability is lurking around almost every corner in today's litigation‐filled world of college athletics, particularly with respect to injuries or medical conditions that arise during practices and competitions. As a result, the early identification of, immediate response to, and proper treatment of those injuries and conditions are a constant and never‐ending challenge for coaches and medical staff.
Successful leadership requires learning to become comfortable with ambiguity
Authors: McCarthy Claudine
Published: February 2025

Relationship‐building stands out as a common thread across all the leadership roles Tim Hall has held during his nearly 30‐year career in college athletics. “Nothing good ever gets done without a relationship,” said Hall, now Athletics Director and Vice President for Intercollegiate Athletics at Longwood University in Virginia. To build successful relationships and lead effectively, you must take time to understand others, learn how they think and why, and figure out what motivates them. To make this happen, Hall strives to learn as much about psychology as he can.
Inhibition of IL‐21/IL‐21R Signaling by Fucoxanthin: Structure‐Based and Experimental Analysis
Authors: Ruan Pinglang , Guo Hui , Yi Ping , Chen Yongjian , Jia Chen , Yang Miao , Deng Yaxiong , Li Qianwen , Gao Fei , Liu Yu , Yang Ming
Published: February 2025

Dysregulated activation of the interleukin‐21 (IL‐21)/IL‐21 receptor (IL‐21R) signaling pathway is strongly associated with inflammatory and autoimmune disorders, which positions the pathway as a promising therapeutic target. Given the current lack of approved inhibitors or monoclonal antibodies targeting IL‐21/IL‐21R, we employed a structure‐based virtual screening strategy coupled with experimental validation to identify potential IL‐21 antagonists from a library of marine natural products provided by TargetMol. Our investigation identified fucoxanthin, a marine‐derived carotenoid, as a potent binder to IL‐21R, exhibiting a docking score of −8.19 kcal/mol. Molecular dynamics simulations further confirmed the stability of the IL‐21R–fucoxanthin complex, with a calculated binding free energy (ΔG) of −33.25 kcal/mol as determined by MM/PBSA analysis. Importantly, fucoxanthin demonstrated significant immunomodulatory effects by reducing the frequency of key immune cell populations, including CD19+ B cells, memory B cells, and activated follicular helper CD4+ T (Tfh) cells in cultures of peripheral blood mononuclear cells in vitro. These findings suggest that fucoxanthin acts as a potential IL‐21 antagonist, offering a novel therapeutic avenue for autoimmune diseases driven by aberrant B‐ and T‐cell differentiation via the IL‐21/IL‐21R axis.
Metabolite‐Profiling and DNA‐Fingerprinting of Some Selected Species of Family Zygophyllaceae with Assessment of Their Bioactive Potential
Authors: Draz Amal A. , Farid Mai M. , Hosni Hasnaa A. , Shamso Eman M. , Kawashty Salwa A. , Hussein Sameh R.
Published: February 2025

Zygophyllaceae R.Br. is a family with a high level of variability in plasticity that results in many conflicts about its taxa ranking and authenticating processes. Five selected Egyptian species belonging to genera, Fagonia, Tribulus, and Zygophyllum were applied for a comparative chemical and molecular study to assess their range of variations. The plants were evaluated for their DPPH radical scavenging activity. LC‐ESI‐MS/MS profiling of the aqueous methanol extracts of the investigated plants and GNPS molecular networking tentatively identified 174 compounds belonging to various chemical classes. Flavonoids are predominant, and myricetin derivatives were reported for the first time from Fagonia glutinosa. Diethyl ether extracts analysis with GC/FID detected 10 unsaturated and 13 saturated fatty acids. T. terrestris possessed the largest concentration of unsaturated fatty acids (up to 76.39%) whereas Z. simplex had the highest concentration of the saturated ones (76.82%). DNA fingerprinting was performed using ISSR markers and variations with 75.32% polymorphism were detected. Chemical and molecular data suggest the distinction of Tribulus sp. from the other studied taxa and grouping Fagonia close to Zygophyllum. Moreover, the DPPH assay showed weak to moderate radical scavenging activity at 500 µg/ml with cell viability ranging from 63.5% to 90.1%.
Hosta plantaginea flower ameliorates chronic pharyngitis by suppressing inflammation via the JAK‐STAT/PI3K/MAPK signaling axis in rats
Authors: Li Xiaomei , Wang Jiashui , Liang Jian , He Junwei , Cao Lan , Yang Li
Published: February 2025

Hosta plantaginea flower is an important Chinese herb in treating chronic pharyngitis (CP); however, its pharmacodynamics against CP and the underlying mechanisms remain unclear. This study demonstrated that the ethyl acetate (HPB) and n‐butanol (HPC) fractions of the H. plantaginea flower were identified as the active fractions against CP, significantly increasing the body weight, improving damaged pharyngeal tissues, and reducing TNF‐α, PGE2, IL‐1β, and IL‐6 levels in rats induced by 5% ammonia solution. Metabolomics studies identified 55 differential metabolites, with 26 being reversely regulated by HPB and HPC. These 26 metabolites are closely associated with phosphoinositide 3‐kinase‐protein kinase B (PI3K‐Akt), just another kinase‐signal transducers and activators of transcription (JAK‐STAT), mitogen‐activated protein kinases (MAPKs), and nuclear factor kappa‐B (NF‐κB) pathways. Mechanically, HPB and HPC prominently suppressed the expression of phosphorylated PI3K, Akt1, JAK1, STAT3, JNK, p38, Erk, p65, and inhibitor of NF‐κB (IκBα) proteins. Finally, HPLC analysis identified flavonoids as the primary phytochemicals of HPB and HPC. In conclusion, HPB and HPC are the main active fractions of H. plantaginea flower against CP, acting through regulating energy metabolism and inhibiting PI3K‐Akt, JAK‐STAT, MAPKs, and NF‐κB signaling pathways, and the flavonoids are the primary constituents.
Study on the Chemical Constituents of Different Parts of Xanthoceras Sorbifolia Bunge Based on Plant Metabolomics
Authors: Kuang Zhulingzhi , Zhou Hongxu , Wang Liangyi , Feng Xiangyu , Wang Yumeng , Meng Dali
Published: February 2025

X. sorbifolia is valued in food, landscape, and medicine, with its husk containing triterpenoid Triterpenoids known for anti‐Alzheimer's effects. This study, using UHPLC‐HRMS and plant metabolomics, compared the chemical profiles of different parts of X. sorbifolia to assess their potential for replacing the husk in medicinal use. The findings show that only the bark and wood contain small amounts of triterpene Triterpenoids, which cannot substitute the husk’s medicinal value. These results support the quality control and clinical application of the husk.
Advancing Spin‐Controlled Electrocatalysis using Chiral Gold Nanoparticles Functionalized Bimetallic Spinel Oxide
Authors: Banerjee Ghosh Koyel , Balo Anujit , Utkarsh Utkarsh , Yasmine Mive , Gosh Utpal
Published: February 2025

Oxygen reduction reaction (ORR) and oxygen evolution reaction (OER) are the foundations of renewable energy technology. However, both processes have significant activation barriers, severely limiting the overall performance of energy conversion devices that utilize ORR/OER. Though traditional catalyst design prioritizes crystal and electronic structure, understanding the detailed mechanism requires consideration of spin selection rules as the ground electronic state of diatomic oxygen is a triplet. Here, we demonstrate the enhancement of the electrocatalytic performance of Mn and Co‐based bimetallic spinel oxides by functionalizing with chiral gold nanoparticles. Chiral gold nanoparticles impart spin‐selective charge transfer during oxygen reduction, resulting in higher current density  in comparison with the achiral composite catalyst. Moreover, the chiral composite containing carbon black also performs better than the achiral one. Furthermore, the onset potential gets reduced by 120 mV at 2.6 mA cm‐2 current density toward the OER activity of the chiral gold nanoparticle‐functionalized catalyst, attributed to the spin‐polarization mechanisms via. chiral‐induced spin selectivity effect. This work emphasizes the use of chirality in the transition metal based oxide to induce the spin‐polarization in the oxide‐based catalysts in advancing ORR and OER efficiencies that is very essential for the application in renewable energy technology.
Electrochemical Removal Of Doxycycline Hydrochloride With Cerium‐aluminum Catalytic Anode
Authors: Qu Guangfei , Liu Guojun , Zhao Chenyang , Li Zhishuncheng , Cai Yingying
Published: February 2025

Doxycycline hydrochloride (DOX) is a widely used broad‐spectrum antibiotic that is challenging to degrade, leading to a series of environmental issues. In this study, a bimetallic oxide catalyst was synthesized through hydrothermal calcination followed by annealing. The catalytic carbon cloth anode was fabricated by bonding materials directly onto carbon cloth. Various characterization methods were employed to analyze the surface morphology, composition, and electrochemical properties of the electrodes. The materials exhibited rich surface morphology and exceptional electrochemical surface area. The catalyst primarily consisted of CeO2 and CeAlO3, demonstrating a 93.85% removal efficiency of DOX within 2 hours under optimized conditions. Even after seven consecutive degradation cycles, the DOX degradation rate remained at 82%, confirming the remarkable stability of the electrodes. The product distribution generated during the degradation of DOX was identified using LC‐MS analysis, and a potential electrochemical degradation mechanism was proposed. Our results indicate that the bimetallic hybrid coordination significantly enhances the catalytic activity and electrochemical stability of the materials. This work offers a novel approach for preparing modified carbon cloth anodes with high catalytic activity and durability, laying a crucial foundation for the efficient degradation of the antibiotic DOX.
Clinicopathological Study on Morphological Subtypes of Hepatocellular Carcinoma: A Single Tertiary Referral Center Experience
Authors: Saler C. H. A. , Shuai S. , Beckervordersandforth J. C. , Rennspiess D. , Roemen G. , Gevers T. , Stoehr‐Kleinegris M. C. F. , Bouwense S. A. W. , Dewulf M. J. L. , Coolsen M. M. E. , Bemelmans M. H. A. , Damink S. W. Olde , Winnepenninckx V. , Hausen A. zur , Kramer M. , Samarska I. V.
Published: February 2025

Aim

We aimed to analyze hepatocellular carcinoma (HCC) morphological subtypes characterized according to the WHO classification and the International Collaboration on Cancer Reporting (ICCR) recommendations, and their prognostic features in a Dutch population.

Methods and Results

This retrospective study in a tertiary referral center included the histopathological revision of 62 HCC resection specimens, obtained from 22 female and 40 male patients (median age: 67 years), in a period between 2011 and 2021 at the Maastricht University Medical Center +. Clinical data, morphological subtypes, growth pattern (GP), tumor grade, tumor extension, margins, and vascular and perineural invasion were collected. Eighteen cases were assigned a specific morphologic subtype and steatohepatic HCC was the most common in our cohort. Twenty‐one tumors classified as conventional type HCC (HCC‐NOS), commonly exhibiting two concurrent GPs. Twenty‐three cases revealed a heterogeneous morphologic differentiation, compromising the combination of HCC‐NOS with another morphologic subtype, most frequently a steatohepatitic component. Comparison of HCC‐NOS and HCC with heterogeneous morphology did not show significant differences in the main clinicopathological characteristics and survival.

Conclusion

Although the most common morphologic subtype was steatohepatitic HCC, the majority of cases demonstrated multiple morphologic patterns. In case of HCC‐NOS, heterogeneous GPs were often observed. Therefore, a histomorphological diagnosis based on a single tumor biopsy specimen may lead to incorrect classification of HCC. Sufficient tumor sampling of HCC resection specimens is required for the complete evaluation of all histomorphological features followed by correct subclassification in order to meet the clinical needs regarding prognostic relevance and patient follow‐up.