bluuebunny/crossref_metadata_2025 huggingface dataset:
Telemedicine in Italy: Healthcare authorization profiles in the modern medico-legal reading
Authors: Bolcato Vittorio , Basile Giuseppe , Bianco Prevot Luca , Fassina Giovanni , Rapuano Silvia , Brizioli Enrico , Tronconi Livio P.
Published: January 2025

Background

The ruling n. 38485, 20 June 2019, of the Italian Supreme Court, III criminal section, addressed by the perspective of the law the very sensitive and new issue of telemedicine.

Objective

This commentary deals with the issue of authorization of telemedicine activities by the health authority, starting from the Italian Court of Criminal Cassation, III section, decision n. 38485/2019. The case law explored the authorization of a health point, which carries out telemedicine services.

Methods

Starting from the perspective discussed by Italian health regulations, the paper examines how the health act could be defined, with the possibilities offered by telecommunications, and how it now relates legally to the physical place where it takes place.

Results

Even if telemedicine opens the way to virtual spaces of health practice, the Ministry of Health Italian Guidelines pose functional and logistical issues to guarantee users’ safety and health care system accountability. Then, functional requirements for health legitimate practice, and their continuous monitoring, together with the responsibilities of the service centers, health professionals and health facilities, are discussed.

Conclusion

The questioning of States’ health law, in a broad health system such as that of the Europe, characterized by autonomous health regulations, is extremely important for cross-border health policy with telemedicine, as overall regulatory compliance in health care is the ground criterion for risk prevention and patient safety, to be properly verified.
The moral web of accessibility to medical assistance in dying: Reflections from the Canadian context
Authors: Pesut Barbara , Thorne Sally
Published: January 2025

In this paper, we reflect on factors that seem to have influenced the accessibility of medical assistance in dying (MAID) in the Canadian context. Since legalization in 2016, the uptake of MAID has increased rapidly to equal or exceed rates in other countries. In that MAID implementation involves numerous ethical/moral complexities, we consider four factors that appear to have influenced this growth. First, we reflect on the vague language contained within the legislation that has been interpreted by a community of practice in which making MAID accessible is an important priority. Second, we consider policies of effective referral and self-referral that have been strategies for enhancing accessibility in relation to a wider context that contains conscientious objection. Third, we examine the apparent impact of centralized clinical teams and coordination services that have enhanced accessibility for persons residing in rural and remote areas. Fourth, we reflect on ways in which public awareness of MAID has been enhanced through policies that enable healthcare providers to introduce the topic of MAID as an option within advance care planning. We conclude with a consideration of how these intersecting factors may be shaping the moral complexity inherent in the idea of making MAID accessible.
Shattering Our Idols: Understanding Dr. B. R. Ambedkar’s Vision for Cinema in India
Authors: Biswas Mohimarnab
Published: January 2025

While an anti-caste, Ambedkarite reading of Indian cinema(s) is gaining traction in contemporary Indian film and media scholarship, Dr B. R. Ambedkar’s own views on film remain underexplored. Through an archival investigation, this article performs a close reading of a rare interview of Ambedkar that appeared in the June 1942 edition of filmindia, one of the most widely read film magazines of its time. Some crucial aspects that emerge from the interview include Ambedkar’s idea of film as a pedagogical tool, his grudges against the extant use of film in India to spread Hindu dogmatism, and his cinematic utopias. In this article, I map Ambedkar’s location within filmindia, trace the circumstances leading to the appearance of this interview, engage with its themes and read into the ways in which Ambedkar’s views on film echo his larger socio-political thought. I argue that this interview acts as a portal, allowing us to imagine ways in which we could insert film into Ambedkar’s intellectual thought and political praxis, that could potentially have useful implications for future anti-caste, Ambedkarite readings of films in India.
Nontyphoidal Salmonellosis Is Associated with an Increased Risk of Stroke: Insights from Multinational Real-World Data
Authors: Chen Sunny Ssu-Yu , Lin Tina Ting-An , Chiang Yi-Lin , Chen Chien-Yun , Lin Wei-Jen , Chang Renin
Published: January 2025

Background

Stroke is a significant cause of morbidity and mortality worldwide, contributing substantially to the global burden of disease. In low- and middle-income countries, stroke tends to occur at younger ages, with infection being one of the notable contributing factors. Previous studies have explored the impact of nontyphoidal Salmonella (NTS) on vascular and blood-related diseases, with animal experiments confirming related mechanisms. This study aims to investigate the association between NTS and cerebrovascular diseases (CVD), with a focus on identifying specific patient populations more susceptible to stroke due to infection.

Methods

This retrospective cohort study utilized the TriNetX database, including 4,708 patients infected with NTS compared to a healthy population, with disease risk tracked over six months, one year, and lifelong periods. The primary outcome was cerebrovascular diseases (ICD-10-CM: I60-I69), while secondary outcomes examined hemorrhagic stroke (ICD-10-CM: I60-I62) and ischemic stroke (ICD-10-CM: I63). Subgroup analyses were conducted based on gender and age at index, with sensitivity analysis performed by comparing hospitalized patients, utilizing different databases, and evaluating the specificity of the NTS-CVD association by examining patients with a higher risk of acute myocardial infarction (AMI).

Results

The lifelong hazard ratios (HRs) for cardiovascular disease (CVD), hemorrhagic stroke, and ischemic stroke following nontyphoidal Salmonella (NTS) infection were 1.606 (95% CI, 1.410-1.830), 1.866 (95% CI, 1.304-2.669), and 1.717 (95% CI, 1.385-2.130), respectively. A significant increase in the risk of hemorrhagic stroke was observed in the short-term and mid-term, with HRs of 3.345 (95% CI, 1.091-10.259) and 2.816 (95% CI, 1.184-6.699), respectively. Subgroup analyses indicated statistically significant associations with the primary outcomes across all age groups. Males demonstrated a higher risk of hemorrhagic stroke, with an HR of 1.891 (95% CI, 1.142-3.310), whereas females exhibited a stronger association with ischemic stroke, with an HR of 1.592 (95% CI, 1.189-2.132). These associations remained significant among hospitalized patients, while no significant relationship was observed between NTS infection and acute myocardial infarction (AMI). The findings of this study were reproducible in a US-based database.

Conclusion

There is a significant association between NTS and CVD, with a particularly important impact on the occurrence of stroke in younger populations, especially regarding the elevated risk of hemorrhagic stroke.
Total wrist arthrodesis in patients with advanced osteoarthritis: current implants and outcomes
Authors: Chick Grégoire
Published: January 2025

Total wrist arthrodesis can be used to treat symptomatic end-stage wrist osteoarthritis after failed conservative treatment. It can also be considered the last-resort option when partial fusion, proximal row carpectomy, denervation or prosthetic arthroplasty is unsuccessful. Currently anatomic pre-contoured low-profile plates with angle stable screws are available with or without inclusion of the carpometacarpal joints. Generally, patients are satisfied after total wrist arthrodesis, although they are not always pain-free, even when wrist flexion and extension remain limited or absent. Complications and reoperations occur frequently, most often due to incomplete bone fusion or hardware-related problems. It is still not known which type of implant is best for degenerative osteoarthritis and if the carpometacarpal joint should be included in the arthrodesis. Future prospective randomized trials may shed more insights on these questions.
Surgical options and outcomes for treatment of osteoarthritis of the scaphotrapeziotrapezoidal joint
Authors: Bellemère Philippe , Ardouin Ludovic
Published: January 2025

Osteoarthritis of the scaphotrapeziotrapezoidal joint is frequent but often pain-free or well tolerated with non-surgical treatment. Surgical options are numerous and none seems to have clear evidence of superiority. In addition to well-established procedures, such as scaphotrapeziotrapezoidal joint arthrodesis, distal scaphoid resection and trapeziectomy, more recent surgical techniques have been reported. These include scaphotrapeziotrapezoidal arthroplasty and arthroscopic treatment. This article provides an overview of the procedures and their outcomes that can be proposed for isolated scaphotrapeziotrapezoidal joint osteoarthritis and when combined with symptomatic osteoarthritis of the thumb carpometacarpal joint or of the radiocarpal and midcarpal joints.
Different patterns of neurogenic quadrilateral space syndrome: a case series of undefined posterior shoulder pain
Authors: Porcellini Giuseppe , Brigo Alberto , Novi Michele , De Santis Elisa , Di Giacomo Silvia , Giorgini Andrea , Micheloni Gian Mario , Bonfatti Rocco , Donà Alessandro , Tarallo Luigi
Published: January 2025

Background

Quadrilateral space syndrome is a painful disorder of the shoulder caused by static or dynamic entrapment of the axillary nerve and the posterior humeral circumflex artery. It was first described in 1983; however, it is an uncommon syndrome that initially presents with nonspecific shoulder pain or selective deltoid atrophy, and diagnosis is often delayed owing to its rarity. Young athletes of overhead sports are more commonly affected by this syndrome. Symptoms of quadrilateral space syndrome include silent deltoid atrophy, persistent posterior shoulder pain, paresthesias, and tenderness over the quadrilateral space. Vascular symptoms may involve thrombosis and embolisms of the upper limb. Instrumental tests and imaging are not always conclusive, leading to frequent misdiagnosis of the syndrome.

Patients and methods

The aim of this study is to present a case series of four patients diagnosed with neurogenic quadrilateral space syndrome, describe different clinical presentations, and suggest tips for diagnosing this syndrome. All patients underwent a detailed medical history collection, were interviewed about the sports and hobbies they engaged in, and received a comprehensive clinical examination of the neck and shoulder. Patients also underwent diagnostic exams such as magnetic resonance imaging (MRI) and electromyography. An ultrasound-guided injection of local anesthetic was performed into the quadrilateral space.

Results

All patients affected by neurogenic quadrilateral space syndrome underwent conservative treatment, which included a rehabilitation program. Only one out of four patients experienced complete resolution of symptoms and did not require surgical decompression.

Conclusions

To properly treat this rare syndrome, we propose classifying it as either “dynamic” or “static,” on the basis of the clinical history, MRI findings, and physical examination. The study includes a rehabilitation program that was effective for one patient, demonstrating that surgical decompression may be avoidable if the cases are promptly diagnosed and classified.

Level of evidence IV according to “The Oxford 2011 Levels of Evidence”
Epigenetic modification regulates the ligamentum flavum hypertrophy through miR-335-3p/SERPINE2/β-catenin signaling pathway
Authors: Zhao Yongzhao , Jiang Shuai , Chen Longting , Xiang Qian , Lin Jialiang , Li Weishi
Published: January 2025

Background

Epigenetic modifications have been proved to play important roles in the spinal degenerative diseases. As a type of noncoding RNA, the microRNA (miRNA) is a vital class of regulatory factor in the epigenetic modifications, while the role of miRNAs in the regulation of epigenetic modifications in ligamentum flavum hypertrophy (LFH) has not been fully investigated.

Methods

The miRNA sequencing analysis was used to explore the change of miRNA expression during the fibrosis of ligamentum flavum (LF) cells caused by the TGF-β1 (10 ng/ml). The downregulated miRNA miR-335-3p was selected to investigate its effects on the fibrosis of LF cells and explored the accurate relevant mechanisms.

Results

A total of 21 miRNAs were differently expressed during the fibrosis of LF cells. The downregulated miR-335-3p was selected for further investigation. MiR-335-3p was distinctly downregulated in the LFH tissues compared to non-LFH tissues. Overexpression of miR-335-3p could inhibit the fibrosis of LF cells. Further research showed miR-335-3p prevented the fibrosis of LF cells via binding to the 3′-UTR of SERPINE2 to reduce the expression of SERPINE2. The increased SERPINE2 expression might promote the fibrosis of LF cells via the activation of β-catenin signaling pathway to promote the transcription of fibrosis-related genes (ACTA2 and COL3A1).

Conclusions

Our results revealed that miR-335-3p prevented the fibrosis of LF cells via the epigenetic regulation of SERPINE2/β-catenin signaling pathway. The epigenetic regulator miR-335-3p might be a promising potential target for the treatment of LFH.

Graphical Abstract
Acute administration of NLX-101, a Serotonin 1A receptor agonist, improves auditory temporal processing during development in a mouse model of Fragile X Syndrome
Authors: Tao Xin , Croom Katilynne , Newman-Tancredi Adrian , Varney Mark , Razak Khaleel A.
Published: January 2025

Background

Fragile X syndrome (FXS) is a leading known genetic cause of intellectual disability and autism spectrum disorders (ASD)-associated behaviors. A consistent and debilitating phenotype of FXS is auditory hypersensitivity that may lead to delayed language and high anxiety. Consistent with findings in FXS human studies, the mouse model of FXS, the Fmr1 knock out (KO) mouse, shows auditory hypersensitivity and temporal processing deficits. In electroencephalograph (EEG) recordings from humans and mice, these deficits manifest as increased N1 amplitudes in event-related potentials (ERP), increased gamma band single trial power (STP) and reduced phase locking to rapid temporal modulations of sound. In our previous study, we found that administration of the selective serotonin-1 A (5-HT1A)receptor biased agonist, NLX-101, protected Fmr1 KO mice from auditory hypersensitivity-associated seizures. Here we tested the hypothesis that NLX-101 will normalize EEG phenotypes in developing Fmr1 KO mice.

Methods

To test this hypothesis, we examined the effect of NLX-101 on EEG phenotypes in male and female wildtype (WT) and Fmr1 KO mice. Using epidural electrodes, we recorded auditory event related potentials (ERP) and auditory temporal processing with a gap-in-noise auditory steady state response (ASSR) paradigm at two ages, postnatal (P) 21 and 30 days, from both auditory and frontal cortices of awake, freely moving mice, following NLX-101 (at 1.8 mg/kg i.p.) or saline administration.

Results

Saline-injected Fmr1 KO mice showed increased N1 amplitudes, increased STP and reduced phase locking to auditory gap-in-noise stimuli versus wild-type mice, reproducing previously published EEG phenotypes. An acute injection of NLX-101 did not alter ERP amplitudes at either P21 or P30, but significantly reduces STP at P30. Inter-trial phase clustering was significantly increased in both age groups with NLX-101, indicating improved temporal processing. The differential effects of serotonin modulation on ERP, background power and temporal processing suggest different developmental mechanisms leading to these phenotypes.

Conclusions

These results suggest that NLX-101 could constitute a promising treatment option for targeting post-synaptic 5-HT1A receptors to improve auditory temporal processing, which in turn may improve speech and language function in FXS.
A data fusion approach for providing valid annual passenger transport statistics during the COVID-19 pandemic
Authors: Galich Anton , Eisenmann Christine , Köhler Katja
Published: January 2025

The global outbreak of the COVID19 pandemic dramatically changed people’s life’s and their travel behavior in 2020. Consequently, capturing these changes accurately and providing valid annual transport statistics constitutes a tremendous challenge all over the world. Against this background and the lack of a single comprehensive source of data revealing the ground truth, we present a data fusion approach to provide valid annual transportation statistics for Germany during the COVID19 pandemic. Therefore, we adapted our existing model approach at generating annual, national statistics for Germany on passenger transport. Unlike in the existing model, we do not model the whole year as one, but divide the year into pandemic stages in order to model passenger transport demand as adequately as possible within each stage. Three travel surveys capturing the altered travel behavior in the different stages of the pandemic were used in order to adapt our passenger kilometers travelled (PKT) model, which bases on a cross-sectional national household travel survey which in many countries serves as the data basis for providing annual transportation statistics.

The main results show a decline in the overall number of trips in 2020 in Germany of around a quarter and around a third less kilometers travelled compared to 2019. These changes in travel behavior differ considerably between different modes of transport, trip purpose and the different stages of the pandemic in 2020. The results produced were validated on the basis of other studies and further sources of data such as floating car data and automated count stations for bicycle traffic and ensure reliable passenger transport statistics in the years of the COVID19 pandemic.
The interactive use of augmented reality for educating the elderly on common age-related eye disease
Authors: Hung Yuet Yi , Chu Wang Yee , Jiang Juming , Yeung Wing Yiu , Yan Wing Huen , Kwok Tai On , Chan Yau Kei
Published: January 2025

Background

The prevalence of age-related eye disorders is increasing with the aging of the global population. Community-based visual health education for the elderly has become a crucial intervention. With the advancement of technology, the application of extended reality (XR), such as virtual reality (VR) and augmented reality (AR), in health education has become more popular. This study aims to assess the effectiveness of educating the elderly about common age-related eye disorders through a novel AR-based health education workshop.

Methods

An AR-based education workshop was designed for the elderly to understand the major visual symptoms of several eye diseases and experience the challenges faced by visually impaired people. The effectiveness of the workshop was assessed by conducting pre- and post-activity surveys to measure the knowledge acquisition of the participants from this workshop.

Results

The intervention was found to significantly improve knowledge of age-related eye diseases among the elderly, while the participants’ age and education level could influence the effectiveness of their knowledge gained from the workshop.

Conclusions

Our study revealed the potential of the use of AR technology in facilitating health education on eye diseases in the elderly. The specific backgrounds and characteristics of target participants and the combination of AR with other pedagogical approaches warrant further investigation to maximize the impact of AR-based workshops in health education in broader healthcare contexts.
The Bergen 4-Day Treatment for panic disorder patients in a rural clinical setting: a long-term follow-up study
Authors: Eide Thorstein Olsen , Olsen Thorbjørn , Hansen Hans , Hansen Bjarne , Solem Stian , Hagen Kristen
Published: January 2025

Background

The Bergen 4-Day Treatment (B4DT) is a concentrated cognitive behaviour therapy (CBT) approach that has shown promise in treating panic disorder (PD). However, the effectiveness of the B4DT, particularly regarding long-term outcomes in rural clinical settings, remains underexplored.

Methods

A total of 58 patients were included using a naturalistic open-label trial design. Patients were assessed at 12-month follow-up. Measures included the Panic Disorder Severity Scale (PDSS), the Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder-7 scale (GAD-7).

Results

The study revealed significant and lasting reductions in PD symptoms, with a high rate of remission maintained at 12-month follow-up (82.8%). Regarding the secondary outcomes, significant improvements in symptoms of depression and generalized anxiety were also shown.

Conclusions

The B4DT represents a promising treatment approach for PD, demonstrating stable long-term outcomes in rural settings. This finding supports the potential of concentrated CBT formats in achieving sustained symptom improvement in patients with PD, warranting further investigation and broader implementation.

Trial registration

The study was reviewed by the Regional Committee for Medical Research Ethics Northern Norway, REK North (REK Nord2021/273145).
Pursuing healthy homeownership: an evaluation of the neighborhood health trajectories of shared equity homeowners
Authors: Gusoff Geoffrey M. , Ramiller Alex , Acolin Arthur , Wang Ruoniu , Zimmerman Frederick J.
Published: January 2025

Background

Shared equity homeownership – a model in which low- and moderate-income households purchase homes at affordable prices on the condition that the houses remain affordable upon resale – has been shown to produce several health-enhancing housing outcomes. These include permanent affordability, housing stability, and modest wealth-building. However, studies suggest low- and moderate-income households may sacrifice neighborhood quality when becoming homeowners, which can undermine the health benefits of homeownership. To understand the health impacts of the shared equity homeownership model more fully, it is important to evaluate participants’ neighborhood health trajectories – how their neighborhood health environments change when they move into homeownership – and how these trajectories compare to those of similar households entering traditional homeownership and those continuing to rent.

Methods

We conducted difference-in-differences analyses comparing changes in neighborhood health characteristics (walkability, food access, socio-economic vulnerability, and life expectancy) for US households moving into shared equity homeownership between 1997 and 2017 compared to households moving into traditional homeownership and those continuing to rent. Shared equity homeowner data was obtained through the Grounded Solutions Network HomeKeeper National Data Hub and households from the Panel Study of Income Dynamics served as matched controls for the analysis. All data on neighborhood characteristics were obtained from publicly available, census tract-level datasets.

Results

Compared to households entering traditional homeownership, households entering shared equity homeownership experienced a relative increase in walkability (difference-in-differences 1.07, p = 0.004), increase in food access (0.13, p < 0.001), increase in socio-economic vulnerability (0.06, p = 0.02), and similar life expectancy. Compared to households moving between rental units, households entering shared equity homeownership experienced similar trajectories in terms of walkability and food access but experienced a relative increase in socio-economic vulnerability (0.06, p = 0.01) and decrease in average neighborhood life expectancy (-0.64, p = 0.01).

Conclusions

Households entering shared equity homeownership avoid the sacrifices in neighborhood walkability and food access that are associated with moving into traditional homeownership, but they experience increased neighborhood socio-economic vulnerability. While understanding the net impact of these factors on individual and household health requires further study, these results can inform the siting and design of shared equity homeownership units to maximize the health benefits of the model.
Association between the prognosis and comorbidity of active cancer in chronic thromboembolic pulmonary hypertension
Authors: Fujii Hiroyuki , Taniguchi Yu , Tamura Yuichi , Sakamoto Miki , Yoneda Sachiyo , Yanaka Kenichi , Emoto Noriaki , Hirata Ken-ichi , Otake Hiromasa
Published: January 2025

Background

Prognosis of chronic thromboembolic pulmonary hypertension (CTEPH) has improved after the availability of balloon pulmonary angioplasty (BPA) and approved drugs. However, the clinical effects of cancer, which is one of the associated medical conditions of CTEPH, remain unclear. We aimed to investigate prognosis in patients with CTEPH and comorbid cancer.

Methods

Between January 2011 and December 2022, data of 264 consecutive patients with CTEPH who were treated with pulmonary endarterectomy, BPA, or medical therapy were retrospectively analyzed. The patients were allocated, based on the comorbidity of cancer as of December 2022, into the cancer (n = 47) and non-cancer (n = 217) groups. In the cancer group, active and non-active cancers were identified in 30 (64%) and 17 (36%) patients, respectively.

Results

The baseline characteristics, hemodynamics, and treatments were similar between the groups. More than half of the cancer were diagnosed within two years before or after CTEPH diagnosis. Twenty-seven patients died during the study period. Among them, 13 (48%) and 7 (26%) died of cancer and right heart failure, respectively. The 5-year survival rate was lower in the cancer group than in the non-cancer group (67.8% vs. 94.5%, p < 0.001). In the active cancer group, the 5-year survival rate was also lower than that in the non-active cancer and non-cancer groups (52.0% vs. 99.5%, p < 0.001 and 52.0% vs. 92.3%, p < 0.001, respectively). Multivariate Cox hazard analysis revealed that hemodialysis (p < 0.001) and cancer (p < 0.001) were independently associated with poor survival.

Conclusion

Patients with CTEPH rarely die of right heart failure, even if hemodynamically severe at diagnosis in the modern management era. However, patients with CTEPH frequently have comorbid cancer, which may be a strong prognostic factor.
Practices supporting cue-based breastfeeding of preterm infants in neonatal intensive care units across Europe
Authors: Tandberg Bente Silnes , Grundt Hege , Maastrup Ragnhild , Aloysius Annie , Nagy Livia , Flacking Renée
Published: January 2025

Background

Emerging knowledge about supportive neurodevelopmental neonatal care shows the need for an individual approach to establish breastfeeding. However, evidence on how cue-based breastfeeding is supported in neonatal intensive care units (NICUs) is scarce. Therefore, the aim was to describe supporting practices for cue-based breastfeeding.

Method

Through Delphi rounds, a questionnaire was developed comprising questions on the usage and occurrence of supportive practices for cue-based breastfeeding. A multinational online survey was distributed September to October in 2023 to NICUs in Europe using snowball sampling. Practices such as the practice of skin-to-skin contact (SSC), restrictions for breastfeeding, providing information to parents, observing and responding to infants’ cues were explored.

Results

The survey was completed by 105 neonatal units across 15 European countries. Less than half (46%) of the NICUs had no restrictions upon placing the infant in SSC with the parents. Approximately half (49%) of the NICUs stated that infants had SSC within the first hour after birth. Many units (68%) had some restriction for breastfeeding. One week after birth, 48% of the NICUs encouraged breastfeeding for infants at 33 postmenstrual age whenever the infant showed cues, regardless of scheduled tube feeding time. This percentage increased to 59% at 33–35 gestational age. Less than half of the units (47%) stated that they had the necessary tools/instruments to support the transition from tube feeding to breastfeeding. There were variations in how milk intake was assessed, such as weighing before and after breastfeeding or estimating milk intake by time spent sucking. Infants in 50% of the units had to be fed exclusively orally before discharge. Many units (65%) provided specific support to or enabled discharge before the infant was exclusively orally fed.

Conclusion

European NICUs employ supportive practices, SSC, early initiation of breastfeeding, and provide information to parents. Staff plays a significant role in fostering cue-based feeding in preterm infant-mother dyads. There still exist restrictions for SSC and breastfeeding. To understand the impact of different strategies and practices, there is need for evaluations by parents and testing of the implementation of cue-based feeding practices in neonatal care.
Imaging abnormalities of the acromioclavicular joint and subacromial space are common in asymptomatic shoulders: a systematic review
Authors: Ibounig Thomas , Rämö Lasse , Haas Romi , Jones Mark , Järvinen Teppo L. N. , Taimela Simo , Docking Sean , Sanders Sharon , Buchbinder Rachelle
Published: January 2025

Objectives

To determine the prevalence of acromioclavicular (AC) joint and subacromial space imaging abnormalities in asymptomatic adults, with a secondary objective of comparing findings between asymptomatic and symptomatic shoulders within the same study populations.

Methods

We conducted a systematic review of studies examining shoulder imaging abnormalities detected by X-ray, ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI) in asymptomatic adults (PROSPERO registration CRD42018090041). This report focuses on AC joint and subacromial space abnormalities. Databases searched included Ovid MEDLINE, Embase, CINAHL and Web of Science from inception to June 2023. Our primary analysis used data from population-based studies, and risk of bias and certainty of evidence were evaluated with tools for prognostic studies.

Results

Thirty-one studies (4 X-ray, 11 US, 15 MRI, 1 both X-ray and MRI) provided useable prevalence data. One study was population-based (20 shoulders), 16 included miscellaneous study populations (2436 shoulders) and 14 focused on athletes (708 shoulders). The certainty of evidence was very low mainly due to high risk of bias, imprecision, and indirectness across studies. Clinical diversity precluded pooling. Population-based prevalence of acromioclavicular osteoarthritis (AC OA) ranged from 85% on MRI to 95% on X-ray. In other study populations, AC OA prevalence in asymptomatic shoulders varied from 6 to 47% on X-ray, 1 to 65% on US, and 0 to 82% on MRI. Among eight studies that included both asymptomatic and symptomatic shoulders, AC OA prevalence ranged from 13 to 95% in asymptomatic shoulders and from 20 to 100% in symptomatic shoulders.

Conclusion

The prevalence of AC joint and subacromial space abnormalities in asymptomatic shoulders is highly variable, and often comparable to that in symptomatic shoulders. Due to the low certainty of evidence and significant variation among study populations, further research is needed to clarify these prevalence estimates and to guide evidence-based management of shoulder abnormalities.
Perturbation-theory machine learning for mood disorders: virtual design of dual inhibitors of NET and SERT proteins
Authors: Kleandrova Valeria V. , Cordeiro M. Natália D. S. , Speck-Planche Alejandro
Published: January 2025

Mood disorders affect the daily lives of millions of people worldwide. The search for more efficient therapies for mood disorders remains an active field of research. In silico approaches can accelerate the search for inhibitors against protein targets related to mood disorders. Here, we developed the first model perturbation-theory machine learning model based on a multiplayer perceptron network (PTML-MLP) for the simultaneous prediction and design of virtual dual-target inhibitors against two proteins associated with mood disorders, namely norepinephrine and serotonin transporters (NET and SERT, respectively). The PTML-MLP model had an accuracy of around 80%. From a chemical point of view, the PTML-MLP model could accurately identify both single- and dual-target inhibitors present in the dataset used to build it. Through the application of the fragment-based topological design (FBTD) approach, the molecular descriptors (multi-label graph-based indices) present in the PTML-MLP model were physicochemically and structurally interpreted. Such interpretations enabled (a) the extraction of different molecular fragments with a positive influence on the enhancement of the dual-target activity and (b) the design of four new drug-like molecules by assembling (fusing and/or connecting) several suitable molecular fragments. The designed molecules were predicted by the PTML-MLP model to exhibit dual-target activity against the NET and SERT proteins. These predictions, together with the estimated druglikeness suggest that the designed molecules could be new promising chemotypes to be considered for future synthesis and biological experimentation in the context of treatments for mood disorders.
Comparative evaluation of non-contrast MRI versus gadoxetic acid-enhanced abbreviated protocols in detecting colorectal liver metastases
Authors: Dai Haoran , Yan Cheng , Jia Xi , Xiao Yuyao , Liang Xinyue , Yang Chun , Liu Kai , Zeng Mengsu
Published: January 2025

Purpose

This study compares the diagnostic efficacy of non-contrast abbreviated MRI protocols with Gadoxetic acid-enhanced abbreviated MRI for detecting colorectal liver metastasis (CRLM), focusing on lesion characterization and surveillance.

Methods

Ninety-four patients, including 55 with pathologically verified CRLM, were enrolled, totaling 422 lesions (287 metastatic, 135 benign). Two independent readers assessed three MRI protocols per patient: Protocol 1 included non-contrast sequences (T2-weighted turbo spin-echo, T1-weighted Dixon, diffusion-weighted imaging (DWI), and ADC mapping). Protocol 2 included gadoxetic acid enhancement with hepatobiliary phase imaging, T2 TSE, DWI, and ADC maps. Protocol 3 utilized the standard Gadoxetic Acid-enhanced MRI sequence, which included pre-contrast T1-weighted imaging, T1-weighted Dixon sequences, post-contrast T1-weighted imaging (including arterial, portal venous, transitional and hepatobiliary phases), and additional T2-weighted and DWI sequences. Diagnoses were scored on a 5-point scale (benign = 1; malignant = 5), with scores ≥ 3 indicating CRLM. ROC curves analyzed diagnostic accuracy, comparing area under the curve (AUC) values across protocols.

Results

No significant difference in AUCs was observed between Protocol 1 (0.899–0.909) and Protocol 2 (0.906–0.931) versus Protocol 3 (0.935–0.939) (p = 0.091–0.195). For lesions ≤ 10 mm, Protocol 1 was slightly inferior to Protocol 3 (p = 0.002–0.032), while Protocol 2 remained comparably effective (p = 0.096–0.179). These findings held when using a threshold of ≥ 4 to define CRLM.

Conclusion

The non-enhanced abbreviated MRI protocol is as effective as the gadoxetic acid-enhanced protocol in identifying CRLM. The proposed Ab-MRI approach may be a viable alternative for CRLM surveillance.

Critical relevance statement

The non-enhanced abbreviated MRI (Ab-MRI) protocol is as effective as the gadoxetic acid-enhanced protocol in identifying colorectal liver metastasis (CRLM). The proposed Ab-MRI approach may be a viable alternative for CRLM surveillance.

Key Points

Two abbreviated protocols are proposed for colorectal liver metastasis (CRLM) surveillance.

The non-enhanced protocol showed equivalent efficacy and was more cost-effective.

The non-enhanced protocol may be a viable alternative for CRLM surveillance.

Graphical Abstract
The therapeutic role of naringenin nanoparticles on hepatocellular carcinoma
Authors: Elwan Aya G. , Mohamed Tarek M. , Beltagy Doha M. , El Gamal Doaa M.
Published: January 2025

Background

Naringenin, a flavonoid compound found in citrus fruits, possesses valuable anticancer properties. However, its potential application in cancer treatment is limited by poor bioavailability and pharmacokinetics at tumor sites. To address this, Naringenin nanoparticles (NARNPs) were prepared using the emulsion diffusion technique and their anticancer effects were investigated in HepG2 cells.

Methods

The particle size of NARNPs was determined by transmission electron microscopy and scanning electron microscopy analysis. NARNP is characterized by Fourier transform infrared spectroscopy and X-ray diffraction. Study the cytotoxic effects of various doses of naringenin, NARNPs and DOX on HepG2 and WI38 cell lines after 24 h and 48 h using the MTT assay. Flow cytometric analysis was used to study the apoptotic cells. The study also examined the expression of apoptotic proteins (p53) and autophagy-related genes ATG5, LC3 after treatment with naringenin, NARNPs, doxorubicin, and their combinations in HepG2 cells.

Results

The particle size of NARNPs was determined by transmission electron microscopy and scanning electron microscopy analysis, showing mean diameters of 54.96 ± 18.6 nm and 31.79 ± 6.8 nm, respectively. Fourier transform infrared spectroscopy confirmed successful conjugation between naringenin and NARNPs. NARNPs were in an amorphous state that was determined by X-ray diffraction. The IC50 values were determined as 22.32 µg/ml for naringenin, 1.6 µg/ml for NARNPs and 0.46 µg/ml for doxorubicin. Flow cytometric analysis showed that NARNPs induced late apoptosis in 56.1% of HepG2 cells and had no cytotoxic effect on WI38 cells with 97% viable cells after 48 h of incubation. NARNPs induced cell cycle arrest in the Go/G1 and G2/M phases in HepG2 cells. The results showed increased expression of ATG5, LC3, and p53 in HepG2 cells treated with IC50 concentrations after 48 h of incubation. NARNPs enhanced the cytotoxic effect of doxorubicin in HepG2 cells but decreased the cytotoxic effect of doxorubicin in WI38 cells.

Conclusions

The study demonstrated that NARNPs effectively inhibit cell proliferation and induce apoptosis in human hepatocellular carcinoma cells. Importantly, NARNPs showed no cytotoxic effects on normal cells, indicating their potential as a promising therapy for hepatocarcinogenesis. Combining NARNPs with chemotherapy drugs could present a novel approach for treating human cancers.
Lentivirus-based production of human chimeric antigen receptor macrophages from peripheral blood
Authors: Choi Ji U , Kim Yeongrin , Lee Da Yeon , Park Jin Song , Jeun Moonjung , Lee Heung Kyoung , Park Chi Hoon
Published: January 2025

Although chimeric antigen receptor (CAR) T cell therapy has shown remarkable efficacy against leukemic cells, it still has critical limitations. CAR macrophage has been regarded as a potential alternative to CAR T cells. However, due to the difficulties in gene transduction into macrophages, the production of primary human CAR macrophages from peripheral blood mononuclear cells (PBMC) using lentivirus is highly challenging. Here, we report on how to generate CAR macrophages from human PBMC with lentiviral particles. Using our lentiviral protocol, we produced functional CAR macrophages to lyse and phagocytose target cancer cells efficiently.
Explaining higher VET dropout rates among adolescents with a migration background in Germany: the role of career compromises
Authors: Busse Robin , Glauser David , Scharenberg Katja
Published: January 2025

Research has consistently revealed that adolescents with a migration background are more likely to drop out from vocational education and training (VET) at the upper-secondary level than their native peers. While recent research has provided rich empirical evidence of mechanisms leading to dropouts from VET, little is known about such mechanisms for adolescents with a migration background. In our contribution, we assume that the difficulties that adolescents with a migration background face when entering the VET system are associated with a restricted range of occupational opportunities and, thereby, higher levels of career compromises in terms of the desired and attained VET occupation. Following previous findings on key dimensions of career compromise, we examine the relevance of compromises in the field of work and social status in explaining the higher propensity of adolescents with a migration background to drop out from their first VET position. Using logistic regressions and KHB decomposition analyses, our results underline that gaps in VET dropout rates between adolescents with and without a migration background can partially be ascribed to migration-specific compromises in the field of work between the aspired and attained VET occupation, while compromises in social status seem to be unimportant.
Same-session dual chromophore riboflavin/UV-A and rose bengal/green light PACK-CXL in Acanthamoeba keratitis: a case report
Authors: Hafezi Farhad , Messerli Jürg , Torres-Netto Emilio A. , Lu Nan-Ji , Aydemir M. Enes , Hafezi Nikki L. , Hillen Mark
Published: January 2025

Background

Acanthamoeba keratitis (AK) is the most challenging corneal infection to treat, with conventional therapies often proving ineffective. While photoactivated chromophore for keratitis-corneal cross-linking (PACK-CXL) with riboflavin/UV-A has shown success in treating bacterial and fungal keratitis, and PACK-CXL with rose bengal/green light has demonstrated promise in fungal keratitis, neither approach has been shown to effectively eradicate AK. This case study explores a novel combined same-session treatment approach using both riboflavin/UV-A and rose bengal/green light in a single procedure.

Case presentation

A 44-year-old patient with active AK in the left cornea, unresponsive to 10 months of conventional treatment according to American Academy of Ophthalmology (AAO) guidelines, was treated using same-session sequential PACK-CXL with riboflavin/UV-A (365 nm) irradiation (10 J/cm2) and rose bengal/green light (522 nm) irradiation (5.4 J/cm2) in a single setting. The procedure was repeated twice due to persistent signs of inflammation and infection. After three combined same-session PACK-CXL treatments, the patient’s cornea converted to a quiescent scar, and symptoms of ocular pain, photophobia, epiphora, and blepharospasm resolved. Confocal microscopy revealed no detectable Acanthamoeba cysts. The patient currently awaits penetrating keratoplasty.

Conclusions

The same-session combination of riboflavin/UV-A and rose bengal/green light PACK-CXL effectively treated a patient with confirmed AK that was resistant to conventional medical therapy, suggesting that using two chromophores in a single procedure may represent a future treatment alternative for AK.
Accuracy of robot-assisted implant surgery versus freehand placement: a retrospective clinical study
Authors: Younis Hamza , Xu Boya , Acharya Kiran , He Longlong , Du Liangzhi , Elayah Sadam Ahmed , Chang Xiaofeng , Lv Chengpeng
Published: January 2025

Purpose

This study evaluated the accuracy of implant placement using a robotic system (Remebot) compared to freehand surgery and explored factors influencing accuracy.

Methods

This retrospective study included 95 implants placed in 65 patients, divided into robot-assisted (50 implants) and freehand (45 implants) groups. Platform, apical, and angular deviations were measured by superimposing preoperative plans and the postoperative CBCT images. Mean deviations between groups were compared, and regression analysis assessed the impact of implant dimensions and positioning on accuracy.

Results

The robot-assisted group exhibited significantly lower mean deviations in platform (0.44 ± 0.17 mm), apical (0.46 ± 0.17 mm), and angular deviations (0.85 ± 0.47°) compared to the freehand group (1.38 ± 0.77 mm, 1.77 ± 0.82 mm, and 6.63 ± 3.90°, respectively; p < 0.001). Regression analysis indicated no significant impact of implant location, jaw type, or implant dimensions on the robotic system’s accuracy, unlike the freehand placement where these factors influenced deviations.

Conclusions

Robot-assisted implant surgery significantly enhances accuracy and clinical safety compared to freehand techniques. Despite limitations, robotic surgery presents a promising advancement in implant dentistry by reducing human error.
Profile of maladaptive and normative eating behaviors in correlation with rumination: a cross-sectional study among Lebanese adults
Authors: Awad Emmanuelle , Malaeb Diana , Fawaz Mirna , Youssef Lara , Brytek-Matera Anna , Hallit Souheil , Obeid Sahar
Published: January 2025

Background

Dieting is a common practice around the world. People who wish to lose weight, improve their eating habits, or reach a desired level of health often diet. Rumination, a pattern of repetitive negative thoughts and emotions, is typically found when individuals diet. The current study aimed to identify physical and psychological differences between maladaptive and normative eating behaviors in a sample from Lebanon.

Methods

A cross-sectional design was adopted for the current study. It occurred between June and July 2022. Four hundred participants aged 18 and above participated. The research team used a snowball sampling method to recruit volunteers from all governorates of Lebanon.

Results

Beta values were used to compare independent variables in order to infer those that have the strongest effect on the dependent ones. Higher Body Mass Index, and belonging to cluster 3 (restriction of food intake and rumination) and cluster 1 (maladaptive eating behavior and rumination) compared to cluster 2 (normative eating behavior and thought) were significantly related to more dieting. Higher physical activity index and belonging to cluster 3 (restriction of food intake and rumination) and cluster 1 (maladaptive eating behavior and rumination) compared to cluster 2 (normative eating behavior and thought) were significantly related to higher levels of orthorexia nervosa tendencies.

Conclusions

The current research demonstrated a relationship between Body Mass Index, physical activity, rumination, and maladaptive eating patterns including restriction of food intake, dieting, and orthorexia nervosa. These results can help with identifying physical and psychological factors associated with maladaptive eating patterns, as well as guide interventions within the Lebanese population.