bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative evaluation of antifungal susceptibility testing methods of invasive Candida species and detection of FKS genes mutations in caspofungin intermediate and resistant isolates
Authors: ElFeky Dalia Saad , El-Wakil Doaa Mahdy , Mwafy Mai M. , Atia Mohamed M.A. , Gohar Noha Mahmoud
Published: January 2025

Background

Fungal invasive infections caused by Candida species pose a substantial public health risk with limited therapeutic options. Antifungal susceptibility testing (AFST) is necessary to optimize the therapy. The study aimed to compare different AFST methods of Candida spp. and detect FKS gene mutations among caspofungin-intermediate and resistant isolates.

Methods

A total of 60 non-replicative invasive Candida isolates recovered from various clinical samples were included. In-vitro AFST was carried out using the ATB FUNGUS 3, Vitek-2 AST-YS08, and E-test. Hotspot (HS) regions of FKS genes were sequenced for caspofungin-intermediate and resistant isolates.

Results

Candida albicans (58.3%) was the most predominant spp., followed by C. glabrata (28.3%). Based on the clinical breakpoints (CBPs), fluconazole resistance was found in C. albicans (45.7%), C. tropicalis (25%), and the C. parapsilosis isolate, while 35.3% of C. glabrata were susceptible dose-dependent (SDD). None of C. albicans, C. tropicalis, or C. parapsilosis isolates were resistant to voriconazole. Using the epidemiological cut-off values (ECVs) for amphotericin B, 6.7% of isolates were non-wild type (non-WT), including C. guilliermondii (50%), C. tropicalis (25%), and C. glabrata (11.8%), while all C. albicans, C. parapsilosis, and C. kefyr isolates were classified as wild-type (WT). ATB FUNGUS 3 and Vitek-2 had the highest categorical agreement (CA) (83.1%) for amphotericin B, while a lower concordance was detected with voriconazole (23.2%) and fluconazole (52.2%). For caspofungin, Vitek-2 and E-test had a CA of 89.8%. Eleven isolates (10 C. glabrata and one C. parapsilosis) exhibited resistance or intermediate susceptibility to caspofungin (MICs: 0.25‒>32 µg/ml). Molecular characterization of the FKS gene demonstrated that FKS1 mutations V47I, V52K, V56T, D57S, L62F, I71Y, I71Q in the HS1 region, and G7S, P11H mutations in the HS2 region were associated with increased caspofungin MIC values (16 µg/ml). Mutations at the HS1 of the FKS2 gene; K33V, W35K, and W35V; were associated with the highest caspofungin MICs of > 32 µg/ml.

Conclusions

ATB FUNGUS 3 demonstrated acceptable performance for AFST, however, azole activity against Candida spp. should be interpreted carefully. Novel mutations within HS regions of FKS genes elucidated different levels of caspofungin resistance in C. glabrata and C. parapsilosis isolates.
Socioeconomic inequalities in health behaviors in children and adolescents: evidence from an Australian cohort
Authors: Gautam Nirmal , Rahman Mohammad Mafizur , Khanam Rasheda
Published: January 2025

Background

Understanding the association between socioeconomic inequalities and health behaviors is imperative for elucidating and effectively addressing health inequities among children and adolescents. Despite the wealth of literature on social gradients in health behaviors, longitudinal analyses of socioeconomic inequalities in the health behaviors of children and adolescents are relatively limited, particularly in the Australian literature. Therefore, this study aimed to investigate the association between socioeconomic inequalities and health behaviors among Australian children and adolescents.

Methods

This study utilized the secondary data from the Longitudinal Study of Australian Children (Waves 2–8), which included participants aged 2 to 15 years. Relative index inequality (RII) methods were used to investigate the associations between socioeconomic inequalities and the health behaviors of children and adolescents.

Results

Compared with their counterparts, children and adolescents with high socioeconomic status (SES) are 84% more likely to consume fruits and vegetables (RII = 1.84, 95% CI = 1.63–2.09) and 19% less likely to consume sugary beverages (RII = 0.81, 95% CI = 0.77–0.86), but more likely to consume sweet and savory foods (RII = 1.09, 95% CI = 1.01–1.19). Children and adolescents with high SES were less likely to spend their free time on screens (RII = 0.86, 95% CI = 0.81–0.91) and more inclined toward outdoor activities (RII = 1.75, 95% CI = 1.53–1.98).

Conclusion

This study provides useful insight into socioeconomic inequalities and health behavior outcomes in children and adolescents. These findings stress the need for tailored interventions designed to improve the health behaviors of families from lower socioeconomic backgrounds. Additionally, addressing unhealthy dietary behaviors, such as the higher consumption of sweet and savory foods among children from higher SES backgrounds, is equally critical. Such comprehensive interventions have the potential to reduce socioeconomic disparities in health behaviors and improve the well-being of the broader population.
Knowledge, attitudes and practices of Australian dairy goat farmers towards the control of gastrointestinal parasites
Authors: Ali Endris A. , Abbas Ghazanfar , Beveridge Ian , Baxendell Sandra , Squire Berwyn , Stevenson Mark A. , Ghafar Abdul , Jabbar Abdul
Published: January 2025

Background

Gastrointestinal parasites such as nematodes and coccidia are responsible for significant economic losses in the goat industry globally. An indiscriminate use of antiparasitic drugs, primarily registered for use in sheep and cattle, in goats has resulted in drug-resistant gastrointestinal parasites. Very little is known about the gastrointestinal parasite control practices used by Australian dairy goat farmers that are pivotal for achieving sustainable control of economically important parasites. The study reported here provides insights into gastrointestinal parasite control practices of Australian dairy goat farmers based on responses to an online survey.

Methods

The questionnaire comprised 58 questions on farm demography, husbandry and grazing management, knowledge of gastrointestinal parasites and their importance in dairy goats, diagnosis of infections, antiparasitic drugs and alternate control options. After a pilot survey (n = 15 respondents), a link to the questionnaire was available to all (n = 456) registered members of the Dairy Goat Society of Australia Ltd from 17 April to 16 June 2023. Multiple correspondence analyses (MCA) were performed to explore the association between selected parasite control practices.

Results

A total of 66 (14%) respondents completed the questionnaire. Of these, 74% (49/66) observed parasite-related illnesses in their goats; two-thirds of them assessed worms burden using faecal egg counts (FECs), with 26% (39/149) deworming their goats based on the results of the FECs. Most respondents (97%; 183/188) perceived that gastrointestinal parasites caused production losses and ranked Haemonchus contortus as the most important parasite. Anitparasitic drugs were used by 94% (62/66) of respondents, with the most frequently used anthelmintics being a commercial combination of four anthelmintics (levamisole, closantel, albendazole and abamectin), benzimidazoles and macrocyclic lactones. Most respondents (77%; 51/66) were unaware of anthelmintic resistance on their property. MCA results delineated two clusters of gastrointestinal parasites management.

Conclusions

This study provides insights into the demography of Australian dairy goat farms, the husbandry and grazing practices used by dairy goat farmers, their knowledge regarding gastrointestinal parasites and their practices for internal parasite control, thereby paving the way for tackling drug resistance in gastrointestinal parasites in dairy goats.

Graphical Abstract
Development of a GIS-based register of biogas plant sites in Lower Saxony, Germany: a foundation for identifying P2G potential
Authors: Plinke Mareike , Berndmeyer Jonas , Hack Jochen
Published: January 2025

Background

Although Germany’s biogas capacity accounts for almost 7% of its installed worldwide capacity, the expansion of biogas plants has stagnated owing to the expiry of Germany’s Renewable Energy Sources Act Erneuerbare–Energien–Gesetz (EEG) subsidies for existing biogas plants. Indeed, without alternative concepts such as power-to-gas (P2G) ensuring their continuing operation, many existing biogas plants must close down to ensure their continuous operation. A detailed spatial register of biogas plant sites must be developed to evaluate the potential for further operation (and thereby promote Germany’s sustainable energy transition). In particular, Lower Saxony, a German federal state, was hit hardest by the expiry of subsidies, as there is a lack of spatially high-resolution information to identify which biogas plants have P2G potential as an end-of-subsidy strategy. This study discusses the development of a geographic information system-based register for these plants.

Methods

A register was developed using geographic information system (GIS). Spatial data on existing biogas plants in Lower Saxony were selected from the Digital Landscape Model (DLM) data, with additional information coming inter alia from the Marktstammdatenregister, the Germany-wide core energy market data register. The data were merged into a single register for Lower Saxony, and aerial photographs were used to validate the biogas plant site.

Results

A total of 1704 biogas plant sites were identified throughout Lower Saxony. Spatially resolved plant information on production capacity suggests that three quarters are suitable for inclusion in a methanization concept. Because plants at 85% of the sites will no longer be subsidised by 2035, end-of-subsidy strategies will soon become relevant.

Conclusions

The GIS-based analysis is a reliable and low-error method for identifying biogas plant sites in Lower Saxony. Almost all plants were included in the registry. The greatest advantages over existing registers and at the same time the unique characteristics of our register were the exact spatial localisation of the plants and the highly up-to-date nature of the data. The register enables the initial (spatial) identification, characterisation, and analysis of potential sites for P2G end-of-subsidy strategies. Overall, the register has significant potential as an advisory basis.
Market-based or policy strategies to increase the cultivation of legumes for livestock? Effects on the cropping pattern and economic performance
Authors: Michalis Efstratios , Ragkos Athanasios , Malesios Chrysovalantis
Published: January 2025

Legume crops, the production of which is related to their use in animal nutrition (referred to in this study as “legumes for livestock—LL” and include species such as bean, lupin, pea, vetch and clover), have positive effects on the economic performance of farms and environmental outcomes, although their relation to sustainable weed management practices (SWMP) has received limited attention. The expansion of LL in Europe is limited due to market constraints, despite important policy incentives. This study was designed to investigate whether a policy-oriented Scenario (S1) or a market-based Scenario (S2) could induce the expansion of the cultivation of LL as well as to examine the possible impact on the economic performance of farming systems, including cost savings related to pest management. A farm typology was developed according to the level of expenses of farms for crop protection and their implemented SWMP. Using technical and economic data from 45 farms that cultivate annual arable crops in Greece, with special emphasis on LL, a Linear Programming model was constructed to examine the potential role of each one of the three identified farm types in the expansion of LL in Central Greece (Baseline Solution—BS). Following the BS, the effects of the two Scenarios were examined through a Price Parametric Programming approach. The solutions revealed that the valorization of LL had a significant economic potential for all farm types. In addition, it was found that a substantial policy incentive of increasing the coupled payments of LL by 128% (S1) can have an equivalent impact on the expansion of LL as modest levels of market interventions—through the achievement of higher yields or/and higher selling prices—to increase the revenues of LL by 59% (S2). Farms that relied more on chemical pesticides could play a more decisive role in expanding LL. The novel aspect is related to the investigation of the economic performance of different farm types cultivating LL with a specific focus on potentially higher profitability related to SWMP. Furthermore, this study contributed to the “policy versus market solutions” debate toward the expansion of LL.
Exploring consumer preferences and policy implications in local food systems: Does taste or labeling matter in honey?
Authors: Lopéz-Galán Belinda , de-Magistris Tiziana
Published: January 2025

This study analyses the influence of geographical origin and taste on honey consumer behavior. First, we explore the influence of geographical origin on consumers’ hedonic evaluation of honey. We then assess the influence of geographical origin and taste on their willingness to pay (WTP) for honey. We conducted a field experiment at a real supermarket. The participants were exposed to two treatments (blind and informed treatment). The findings showed that knowledge about the geographical origin of honey influences consumers’ hedonic evaluations and that the WTP for honey is more strongly influenced by geographical origin than by taste.
Simultaneous transcatheter aortic valve implantation and femoral osteosynthesis: a case report
Authors: Mitsuta Yuki , Okamura Yukiko , Miyamoto Yosuke , Tanahira Dai
Published: January 2025

Background

Simultaneous cardiac and non-cardiac surgeries can be beneficial for patients, but there are still few reports on this approach.

Case presentation

A 90-year-old woman was diagnosed with a femoral trochanteric fracture and severe aortic stenosis. A heart team conference decided to perform transcatheter aortic valve implantation (TAVI) and femoral osteosynthesis under general anesthesia on the same day. A preoperative simulation was conducted to review the surgical procedure and confirm the arrangement of the operating table and instruments. Preoperative management was carried out with attention to the risk of myocardial ischemia caused by bleeding or pain from the fracture. Transfemoral TAVI was completed without trouble, and after the patient was moved to the traction table, osteosynthesis was started. Back-up pacing with a temporary pacemaker was activated for atrioventricular block and bradycardia. After completing the surgery, the patient recovered from anesthesia, and extubation was performed after confirming the absence of paralysis. The patient had no noticeable postoperative complications and successfully underwent rehabilitation.

Conclusions

Through meticulous preparation and perioperative management, we were able to perform TAVI and femoral osteosynthesis simultaneously, achieving a favorable outcome.
IRMAOC: an interpretable role mining algorithm based on overlapping clustering
Authors: Yang Yaqi , Li Jun’e , Zhang Tao , Chen Lu , Huang Guirong , Lv Zhuo
Published: January 2025

The Industrial Internet motivates the research and development of Zero-Trust Architecture (ZTA). Role-Based Access Control (RBAC) as one of the key technologies for ZTA has become a hot topic. Role mining algorithms are crucial for RBAC and interpretable role mining receives wide attention due to its virtue of mining meaningful roles. However, the roles generated by existing algorithms have low interpretability and high time complexity, limiting their application in practice. This paper proposes an Interpretable Role Mining Algorithm Based on Overlapping Clustering (IRMAOC). It evaluates the interpretability of a role based on user similarity calculated on the permission and attribute of the role, and employs policy interpretability as the metric of a role set. IRMAOC creates a user association graph and clusters to generate candidate roles based on the graph. Then it remains the roles whose interpretability is higher than the preset threshold and re-clusters the users belonging to the other roles until the interpretability of all roles are higher than the threshold. Experimental results show that our algorithm significantly improves the interpretability of roles, reduces the Weighted Structure Complexity (WSC), and decreases time complexity compared to previous works.
Surveying the aftermath: a qualitative and semiquantitative study of post-COVID-19 sequelae in the lungs
Authors: Eapen Kurian C. , Vimala Leena Robinson , Isaac Barney , Irodi Aparna
Published: January 2025

Background

In this period following the COVID-19 pandemic, there is increasing evidence to indicate the presence of long-term sequelae in individuals who were infected with COVID-19. This study was performed to assess the proportion of CT abnormalities in patients who underwent CT imaging of the thorax at least 4 weeks after the date of RT-PCR confirmation of COVID-19 infection and to assess the severity of lung involvement using a semiquantitative CT scoring system in the above population.

Methods

Institutional Review Board approval was obtained for this study. We conducted a retrospective study to assess the post-COVID-19 findings on CT imaging of thorax. The cases for analysis were obtained from the radiology department database of our Institution by performing a RIS-PACS search. The CT images were analyzed both in a qualitative manner and by using a semiquantitative score, which was correlated with spirometry.

Results

A total of 192 CT imaging studies of various patients were reviewed as part of this study. The mean age of the study population was 50. The predominant CT abnormalities included ground glass opacities (87%), reticulations (77%), consolidations (52%), subpleural bands (65%), tractional bronchiectasis (59%), and air trapping (19%). The mean semiquantitative score obtained was 35.08 (range 0-80). There was a significantly higher score among diabetics and those with multiple comorbidities. There was a significant correlation between spirometric variables (FVC, FEV1) and the semiquantitative score.

Conclusion

We qualitatively assessed the spectrum of post-COVID-19 sequelae in the lungs. The common findings included ground glass opacities, reticulations, and consolidations. The severity of post-COVID-19 sequelae quantified by the semiquantitative score showed a weak to moderate correlation with spirometry.
Let us be heard: critical analysis and debate of collaborative research approaches used in implementation science research with equity-deserving populations
Authors: Gallant Sarah Madeline , Mann Cynthia , Benoit Britney , Aston Megan , Curran Janet , Cassidy Christine
Published: January 2025

Background

Implementation Science research completed with equity-deserving populations is not well understood or explored. The current opioid epidemic challenges healthcare systems to improve existing practices through implementation of evidence-based interventions. Pregnant persons diagnosed with opioid use disorder (OUD) is an equity-deserving population that continues to experience stigmatization within our healthcare system. Efforts are being made to implement novel approaches to care for this population; however, the implementation research continues to leave the voices of pregnant persons unheard, compounding the existing stigma and marginalization experienced.

Methods

This debate paper highlights a specific case that explores the implementation of the Eat, Sleep, Console (ESC) model of care, a function-based empowerment model used to guide the care for pregnant persons diagnosed with OUD and their infants. We establish our debate within the conceptual discussion of Nguyen and colleagues (2020), and critically analyze the collaborative research approaches, engaged scholarship, Mode 2 research, co-production, participatory research and IKT, within the context of engaging equity-deserving populations in research. We completed a literature search in CINAHL, Google Scholar, PubMed and Embase using keywords including collaborative research, engagement, equity-deserving, marginalized populations, birthparents, substance use and opioid use disorder with Boolean operators, to support our debate.

Discussion

IKT and Community Based Participatory Action Research (CBPR) were deemed the most aligned approaches within the case, and boast many similarities; however, they are fundamentally distinct. Although CBPR’s intentional methods to address social injustices are essential to consider in research with pregnant persons diagnosed with OUD, IKT aligned best within the implementation science inquiry due to its neutral philosophical underpinning and congruent aims in exploring complex implementation science inquiries. A fundamental gap was noted in IKT’s intentional considerations to empowerment and equitable engagement of equity-deserving populations in research; therefore, we proposed informing an IKT approach with Edelman’s Trauma and Resilience Informed Research Principles and Practice (TRIRPP) Framework.
Research on refined UAV inspection method of wind/solar power stations based on YOLOv8
Authors: Pu Jieyi , Zhang Qifeng , Zhao Wenbo , Zhang Wei , Qin Zengren , Zhang Yumeng
Published: January 2025

More and more research is focusing on the unmanned aerial vehicle (UAV) inspection of onshore wind/solar power stations; however, how to balance the contradiction between detection accuracy and efficiency is still a challenge for domestic and international researches. In this paper, for the sparse distribution of inspection targets in onshore wind/solar power stations, the YOLOv8 model is used to quickly extract information such as photovoltaic module contours and key points of wind turbine blades in the wide-angle image of the UAV. By connecting these key points in series, fine route planning of the UAV is realized, and the zoom lens is used to carry out efficient and fine inspection of photovoltaic (PV) modules and wind turbine blades. In order to accelerate the convergence of the PV module contour extraction model, this paper introduces a loss function for the difference in linear angular orientation, which improves the average IOU accuracy of the YOLOv8 model to 93%. In the extraction of key points such as the center and tip of wind turbine blades, this paper firstly adopts serpentine convolution to replace the traditional convolution operator in order to adapt the wind turbine blade features, and secondly incorporates the a priori information of the angle constraints between the blades into the loss function. Finally, multi-angle wind turbine imaging photos in desert, hill, rice field, and other scenes are quickly simulated by computer simulation software to improve the model generalization performance. The experimental results show that the improved model achieves 85.4% on the mAP50 metric, which is a 9.2% improvement over YOLOv8, and 6.2% on the more stringent mAP50:95 metric.
Machine Learning to Predict Mortality in Older Patients With Cancer: Development and External Validation of the Geriatric Cancer Scoring System Using Two Large French Cohorts
Authors: Audureau Etienne , Soubeyran Pierre , Martinez-Tapia Claudia , Bellera Carine , Bastuji-Garin Sylvie , Boudou-Rouquette Pascaline , Chahwakilian Anne , Grellety Thomas , Hanon Olivier , Mathoulin-Pélissier Simone , Paillaud Elena , Canouï-Poitrine Florence
Published: January 2025

PURPOSE

Establishing an accurate prognosis remains challenging in older patients with cancer because of the population's heterogeneity and the current predictive models' reduced ability to capture the complex interactions between oncologic and geriatric predictors. We aim to develop and externally validate a new predictive score (the Geriatric Cancer Scoring System [GCSS]) to refine individualized prognosis for older patients with cancer during the first year after a geriatric assessment (GA).

MATERIALS AND METHODS

Data were collected from two French prospective multicenter cohorts of patients with cancer 70 years and older, referred for GA: ELCAPA (training set January 2007-March 2016) and ONCODAGE (validation set August 2008-March 2010). Candidate predictors included baseline oncologic and geriatric factors and routine biomarkers. We built predictive models using Cox regression, single decision tree (DT), and random survival forest (RSF) methods, comparing their predictive performance for 3-, 6-, and 12-month mortalities by computing time-dependent area under the receiver operator curve (tAUC).

RESULTS

A total of 2,012 and 1,397 patients were included in the training and validation set, respectively (mean age: 81 ± 6 years/78 ± 5 years; women: 47%/70%; metastatic cancer: 50%/34%; 12-month mortality: 43%/16%). Tumor site/metastatic status, cancer treatment, weight loss, ≥five prescription drugs, impaired functional status and mobility, abnormal G-8 score, low creatinine clearance, and elevated C-reactive protein (CRP)/albumin were identified as relevant predictors in the Cox model. DT and RSF identified more complex combinations of features, with G-8 score, tumor site/metastatic status, and CRP/albumin ratio contributing most to the predictions. The RSF approach gave the highest tAUC (12 months: 0.87 [RSF], 0.82 [Cox], 0.82 [DT]) and was retained as the final model.

CONCLUSION

The GCSS on the basis of a machine learning approach applied to two large French cohorts gave an accurate externally validated mortality prediction. The GCSS might improve decision making and counseling in older patients with cancer referred for pretherapeutic GA. GCSS's generalizability must now be confirmed in an international setting.
Strategies for Mitigating Cancer-Related Financial Toxicity in China: A Multiperspective Qualitative Study Based on the Socioecological Framework
Authors: Yuan Xiaoyi , Sun Yanling , Kuang Yi , Qiu Jiajia , Zhu Jing , Gu Haiyan , Xing Weijie
Published: January 2025

PURPOSE

To explore strategies related to cancer-related financial toxicity (FT) from the perspectives of cancer survivors and stakeholders in China and to evaluate their views within the context of the social ecological model (SEM).

METHODS

Between March and July 2022, we conducted a descriptive qualitative study with semistructured interviews of 23 cancer survivors and 14 stakeholders. Qualitative content analysis on the basis of the SEM was used to analyze the data with NVivo 12.

RESULTS

Guided by the SEM, we identified 12 subthemes that described how to mitigate FT. Individual-level strategies included increasing cost-related health literacy, strengthening adherence to standardized treatments, and improving resilience to cancer and financial changes. Interpersonal-level strategies included strengthening family support and social networks. Organizational-level strategies included using evidence-based treatments, effective communication of costs, and providing financial information support. Community-level strategies included improving symptom management throughout survivorship and providing psychosocial support. Policy-level strategies included optimizing health insurance policies and promoting collaboration among medical institutions.

CONCLUSION

Our findings provide a comprehensive understanding of strategies pertaining to FT, offering insights that could support the development of future interventions. This research suggests that interventions that encompass multiple levels—individual, interpersonal, organizational, community, and policy—rather than focusing on only one level might be the most beneficial for managing FT.
Association of Germline Pathogenic Variants in
MUTYH
and Other DNA Damage Response Genes With Lung Cancer Risk Among Non-Hispanic Whites and African Americans
Authors: Trendowski Matthew R. , Lusk Christine M. , Wenzlaff Angela S. , Neslund-Dudas Christine , Purrington Kristen S. , Beebe-Dimmer Jennifer L. , Schwartz Ann G.
Published: January 2025

PURPOSE

Although lung cancer is one of the most common malignancies, the underlying genetics regarding susceptibility remain poorly understood. We characterized the spectrum of pathogenic/likely pathogenic (P/LP) germline variants within DNA damage response (DDR) genes among lung cancer cases and controls in non-Hispanic Whites (NHWs) and African Americans (AAs).

MATERIALS AND METHODS

Rare, germline variants in 67 DDR genes with evidence of pathogenicity were identified using the ClinVar database. These P/LP variants were genotyped in a sample of 3,040 lung cancer cases and controls from the Inflammation, Health, Ancestry, and Lung Epidemiology study (NHW: n = 1,915; AA: n = 1,125) and were tested for their association with lung cancer using multivariate logistic regression adjusting for age, sex, pack-years, and race.

RESULTS

We identified 49 unique rare P/LP variants in 21 genes among 156 carriers. Approximately 5.9% of lung cancer cases and 4.2% of controls carried at least one P/LP variant. P/LP variants in DDR genes were more common in lung cancer cases, particularly those diagnosed with adenocarcinoma (odds ratio [OR], 1.46 [95% CI, 1.00 to 2.14]).
MUTYH
variants were associated with lung cancer overall (OR, 1.82 [95% CI, 1.10 to 3.12]), with the strongest associations among never smokers (OR, 3.37 [95% CI, 1.08 to 10.26]), and in individuals who do not meet current USPSTF screening criteria (OR, 2.85 [95% CI, 1.20 to 7.53]).

CONCLUSION

Germline variants in DDR genes appear to be associated with lung cancer, particularly when examined by gene subtype and morphologic subtype.
MUTYH
, a gene historically associated with colorectal and other GI malignancies, emerged as a candidate gene that should be examined in individuals who do not have a significant smoking history.
Genomic Characterization and Prognostic Significance of Human Epidermal Growth Factor Receptor 2–Low, Hormone Receptor–Positive, Early Breast Cancers From the BIG 1-98 and SOFT Clinical Trials
Authors: Luen Stephen J. , Brown Lauren C. , van Geelen Courtney T. , Savas Peter , Kammler Roswitha , Dell'Orto Patrizia , Biasi Olivia , Coates Alan S. , Gelber Richard D. , Thürlimann Beat , Colleoni Marco , Fleming Gini F. , Francis Prudence A. , Regan Meredith M. , Viale Giuseppe , Loi Sherene
Published: January 2025

PURPOSE

To investigate whether hormone receptor–positive, human epidermal growth factor receptor 2–low (HR+HER2-low) versus HR+HER2-zero early breast cancers have distinct genomic and clinical characteristics.

METHODS

This study included HR+, HER2-negative early breast cancers from patients enrolled in the phase III, randomized BIG 1-98 and SOFT clinical trials that had undergone tumor genomic sequencing. Tumors were classified HR+HER2-low if they had a centrally reviewed HER2 immunohistochemistry (IHC) score of 1+ or 2+ with negative in situ hybridization and HR+HER2-zero if they had an HER2 IHC score of 0.

RESULTS

A total of 1,795 tumors were evaluable for this study (BIG 1-98 n = 520, SOFT n = 1,275). The frequency of HER2-low tumors was 37% and 21% in the postmenopausal BIG 1-98 and premenopausal SOFT cohorts, respectively. There were no significant differences in clinicopathologic variables between HER2-low and HER2-zero groups which was consistent across both trials. There was no significant difference in risk of distant recurrence for patients with HER2-low tumors versus HER2-zero tumors (5-year % distant recurrence-free 94.0%
v
92.8%,
P
= .61, in BIG 1-98; 89.4%
v
92.7%,
P
= .31, in SOFT, respectively). Somatic genomic profiles were similar with the exception of
MAP3K1
mutations which were more frequent in HER2-zero tumors (BIG 1-98 19%
v
5%, SOFT 11%
v
6%). Both
ERBB2
copy number and
ERBB2
gene expression abundance were significantly higher in HER2-low tumors compared with HER2-zero tumors; however, the absolute difference was small. Correlation between
ERBB2
copy number values and gene expression was modest (
r
= 0.17).

CONCLUSION

In two large clinical trials with centrally reviewed HER2 IHC, our findings do not support HER2-low breast cancer as a distinct clinical or biologic entity among HR+HER2- early breast cancers. Absolute differences in median
ERBB2
copy number levels or gene expression are small and of unclear biologic relevance.
Panhypopituitarism in Neurosarcoidosis: Pituitary-Hypothalamic Involvement Successfully Managed With Rituximab
Authors: de Miguel Ibañez Regina , Espinosa Cárdenas Pattsy Etual , García Sáenz Manuel Ramón , Sandoval Bonilla Bayron A
Published: January 2025

Neurosarcoidosis (NS) is a rare form of sarcoidosis, with isolated hypothalamic-pituitary involvement being exceptionally uncommon. We report a 20-year-old woman presenting with polyuria, galactorrhea, amenorrhea, and substantial weight loss. Hormonal evaluation revealed hypopituitarism with arginine-vasopressin deficiency and hyperprolactinemia. Magnetic resonance imaging demonstrated pituitary stalk thickening and suprasellar extension, initially suggestive of hypophysitis. High-dose glucocorticoid therapy resulted in partial regression of the pituitary lesion but persistence of suprasellar involvement, prompting a transcranial stereotactic biopsy. Histopathological analysis confirmed isolated NS with noncaseating granulomas. The patient was treated with rituximab after partial response to glucocorticoids, achieving significant clinical and radiological improvement, although hormonal axis recovery was not observed. Hormone replacement therapy remains necessary. The case met the criteria for definitive type b NS, as no extraneural involvement was identified. This case underscores the diagnostic challenges of isolated NS and highlights the importance of considering histopathological confirmation in patients without systemic manifestations to guide treatment. Glucocorticoids are first-line therapy, but rituximab may be effective as a second-line option for refractory cases. Early diagnosis and tailored therapy are essential to improving outcomes in this rare and challenging condition.
Writing Before and Beyond Monolingualism
Authors: Behrend Megan
Published: January 2025

If writing studies today is engaged in a project to remake composition pedagogy apart from modern language ideologies, then medieval writing reminds us that such ideologies were not always dominant. This essay asks how medieval texts, written before monolingualism became normative, might help student writers to imagine possibilities for composing beyond monolingualism. What happens when students are invited to read Dante Alighieri's defense of his Italian vernacular in book 1 of the Convivio alongside contemporary defenses of linguistic diversity more commonly taught in the first-year writing classroom? As this experiment suggests, assigning medieval texts in composition courses offers at least two advantages to student writers in support of linguistic justice and critical language awareness learning goals. For one, contradicting a modern view of translingualism as deviation from a monolingual norm, students learn that writers have had to assume language difference, rather than homogeneity, as a condition of composition for most of history. Second, the juxtaposition of medieval and contemporary, far from flattening historical difference, prompts students to think even more specifically and critically about the conditions for and consequences of translingual practices in particular times and places.
Toward the Limits of Human Ageing Physiology: Characteristics of the 50-, 60- and 70-yr + Male Indoor Rowing World Champions
Authors: Daly Lorcan S.
Published: January 2025

Purpose

To examine the physiological, power-duration, nutritional intake and training characteristics of the recent lightweight (- 75 kg) 50+, 60+ and 70 + yr world champion indoor rowers.

Methods

Laboratory assessments, undertaken over 2 visits, examined body composition, pulmonary function, blood lactate/ventilatory landmarks, efficiency, fat/carbohydrate oxidation, primary component time-constant to steady-state [𝜏pc]) and peak oxygen consumption (V̇O2peak). Training, performance and nutritional intake were also reported.

Results

The athletes’ world championship 2000 m times were 06:34.8, 06:44.0 and 07:15.2, respectively. Their training distribution could be considered pyramidal, with ≈65% in the moderate domain, ≈30% in heavy/severe domains and ≈5% in the extreme domain (rowing ≈67 km.week-1). The athletes demonstrated highly-developed attributes such as fat free mass (FFM; [63.4 to 68.1 kg]), forced vital capacity (4.9 to 5.5 L), 𝜏PC; [13.8 to 17.4 s]), peak power output (550 to 797 W), V̇O2peak (56.2 to 44.7 mL.kg.min-1) and critical power (217 to 288 W). Comparisons with young Olympic champion rowers suggest that age-related 2000 m performance mean power declines of -21.6 to -41.4% in world champions ≈25-, 35-, and 45-years older may be predominantly driven by 'central' factors (e.g., V̇O2peak, critical power; -18.1 to -43.8%). In contrast, 'peripheral' factors (e.g., gross efficiency, τPC; +6.1 to -25.1%) seem to display notable preservation despite ageing, aligning closely with values seen in young Olympic champions.

Conclusions

These results challenge conventional perspectives of age-related physiological capacities and decline trajectories. They also suggest that, commensurate with adequate training and nutritional provision, various physiologic systems can exhibit remarkable adaptability and sustain exceptionally high function during ageing. Finally, large differences among the athletes’ power-duration and physiological characteristics imply that achieving world-class rowing performance can be predicated by diverse cardiovascular, metabolic and neuromuscular attributes.
Acute Effects of a Single Bout of Strength and Endurance Exercise on Vitamin D Metabolites in Young Adults
Authors: Mosti Mats Peder , Aagård Norun , Stunes Astrid Kamilla , Brobakken Cathrine Langlie , Brevig Martin Siksjø , Gustafsson Miriam K. , Thorsby Per Medbøe , Wang Eivind , Syversen Unni
Published: January 2025

Purpose

The effect of exercise on serum concentration of vitamin D metabolites remains inconclusive, with studies reporting deviating results. This study evaluated the acute effect of a single session of two specific exercise forms; strength training (ST) and high-intensity interval training (HIIT), on circulating 25-hydroxyvitamin D (25(OH)D), free25(OH)D and 1,25-dihydroxyvitamin D (1,25(OH)2D), and skeletal muscle vitamin D receptor (VDR) gene expression, in healthy adults.

Methods

Thirty-nine participants (19 women and 20 men, age 21–30 years) completed a single bout of ST and HIIT exercise, separated by two weeks. Serum concentration of total 25(OH)D, free25(OH)D and 1,25(OH)2D were assessed before exercise, immediately after, and 3 hours and 24 hours after each session. Muscle biopsies were obtained at rest (1st visit), and at 3 hours and 24 hours post ST and HIIT, and analyzed for VDR gene expression. Repeated measures ANOVA was used to assess serum concentration across time, while paired samples t-test was used for muscle VDR gene expression analyses.

Results

Serum concentration of 25(OH)D or free 25(OH)D did not change after either exercise mode when correcting for plasma volume alterations. 1,25(OH)2D was reduced by 13.1 ± 18.3 pmol/L and 7.1 ± 9.6 pmol/L immediately after ST and HIIT, respectively (P < 0.001). Muscle VDR mRNA expression increased after ST by 3.1 ± 1.8 (3 hr) and 2.2 ± 1.7 (24 hr) fold change (P < 0.05).

Conclusions

One single session of ST or HIIT did not alter serum concentration of 25(OH)D and free 25(OH)D when correcting for plasma volume changes. Both exercise modes caused a transient reduction in 1,25(OH)2D suggesting utilization of 1,25(OH)2D by muscle cells following exercise. Elevated VDR gene expression following ST suggests a functional role of VDR in fast-twitch muscle fibers.
Evaluation of β-thalassemias in the premarital hemoglobinopathy screening program: A retrospective study
Authors: Olgun Goktas
Published: January 2025

Objective: To retrospectively evaluate β-thalassemias in the premarital hemoglobinopathy screening program in primary care.
Methods: The retrospective study was carried out in Bursa Uludag University Family Health Center in Turkey between 1-30 September 2023. In the study, the data of individuals who applied to the Family Health Center for premarital health examination within the four years between January 1, 2019, and December 31, 2022, were taken from the database and evaluated retrospectively. Family history of hemoglobinopathy, sociodemographic findings, existing diseases, allergies, cancer, and genetic disease conditions were obtained. Complete blood count, and high-performance liquid chromatography (HPLC) results were examined. P-values below 0.05 were considered statistically significant. Analyzes were made in the SPSS 25.0 program.
Results: A total of 327 people, 171 men (52.3%) and 156 (47.7%) women, participated in the study. It was determined that the age of the individuals was 30.17±6.16. The average Mentzer index levels were found to be 12.95±4.56. Places of birth are Mediterranean with 8.3% and other regions with 91.7%. β-thalassemia type detected in family medicine was suspected with a rate of 1.5% and carrier with a rate of 0.6%. The rate of patients referred to a hematologist was found to be 2.1%. The rate of patients with a definitive diagnosis was determined as 1.8%. It was determined that β-thalassemia definitive diagnosis rates were higher in groups whose place of birth was the Mediterranean region, with a family history of thalassemia, with a diagnosis of cancer, and with a genetic, allergic, and chronic disease diagnosis (p=0.01).
Conclusion: Although it is not located in the Mediterranean region, the high prevalence of β-thalassemia in our population and its relationship with diseases are important. We emphasize the importance of a premarital screening program for the diagnosis of β-thalassemia due to its increasing frequency and complications in the globalizing world.
doi: https://doi.org/10.12669/pjms.41.2.10024
How to cite this: Goktas O. Evaluation of β-thalassemias in the premarital hemoglobinopathy screening program: A retrospective study. Pak J Med Sci. 2025;41(2):590-597. doi: https://doi.org/10.12669/pjms.41.2.10024
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Emergency primary anastomosis with or without intraoperative colonic lavage following sigmoidectomy in sigmoid volvulus: 175-patient experience in a tertiary referral hospital
Authors: Altundas Necip , Peksoz Rifat , Disci Esra , Atamanalp Sabri Selcuk
Published: January 2025

Objectives: Emergency primary anastomosis following sigmoidectomy is one of the main treatment options in sigmoid volvulus (SV). However, during this procedure, the role of intraoperative colonic lavage (ICL) is controversial. Our aim was to evaluate the role of ICL in 175-patient SV series.
Methods: In Ataturk University Faculty of Medicine Department of General Surgery, ICL was applied in 76 cases (43.4%), while it was not used in the remained 99 patients (56.6%) in 58.5-year period. In a partial retrospective (first 20 years, from June 1966 to June 1986) and prospective (later 38.5 years, from June 1986 to December 2024) evaluation, some preoperative, operative, and postoperative findings were utilized.
Results: As preoperative data, mean age (56.4 years vs. 57.1 years, P>0.05), male/female ratio (4.8 vs. 4.2, P>0.05), and rate of shock (5.3% vs. 6.1%, P>0.05) were statistically similar in both groups, while mean ASA score (3.1 vs. 2.9, P<0.05) was significantly lower in ICL group. Among operative findings, rates of bowel gangrene (67.1% vs. 63.6%, P>0.05) and perforation (1.3% vs. 1.0%, P>0.05) were statistically similar in both groups, while mean operation time (205.4 minutes vs. 176.8 minutes, P<0.005) was significantly longer in ICL group. As surgical outcomes, rates of mortality (13.2% vs 12.1%, P>0.05) and morbidity (39.5% vs. 28.3%, P>0.05) were statistically similar in both groups, while mean hospitalization time (14.7 days vs. 9.4 days, P<0.001) was significantly longer and mean cost (3,455.4 USD vs. 2,752.1 USD, P<0.001) was significantly higher in ICL group.
Conclusion: When compared with that of primary anastomosis with ICL, primary anastomosis without ICL provided shorter operation and hospitalization times, and less cost in addition to similar mortality and morbidity rates in the emergency treatment of SV.
doi: https://doi.org/10.12669/pjms.41.2.11399
How to cite this: Altundas N, Peksoz R, Disci E, Atamanalp SS. Emergency primary anastomosis with or without intraoperative colonic lavage following sigmoidectomy in sigmoid volvulus: 175-patient experience in a tertiary referral hospital. Pak J Med Sci. 2025;41(2):603-607.  doi: https://doi.org/10.12669/pjms.41.2.11399
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Empirical studies on economic consequences of accounting standards
Authors: Καλογήρου Φανή
Published: January 2025

Αυτή η διατριβή αποτελείται από τρεις ανεξάρτητες μελέτες για τις οικονομικές συνέπειες των λογιστικών προτύπων. Η πρώτη μελέτη εξετάζει την ενημερωτική αξία της αναγνώρισης των υποχρεώσεων συνταξιοδότησης που έγινε υποχρεωτική στη Γαλλία μετά την εισαγωγή των ΔΠΧΠ και την επίδρασή της στις χρηματοδοτικές αποφάσεις των επιχειρήσεων. Υποστηρίζουμε ότι οι αλλαγές στις πληροφορίες λογιστικής αποτύπωσης των υποχρεώσεων συνταξιοδότησης επηρεάζουν το κόστος κεφαλαίου και/ή τις επενδυτικές αποφάσεις των επιχειρήσεων. Πράγματι, διαπιστώνουμε ότι οι αλλαγές στη χρηματοοικονομική μόχλευση κατά την περίοδο εφαρμογής των ΔΠΧΠ συνδέονται αρνητικά με το απρόβλεπτο μέρος των υποχρεώσεων συνταξιοδότησης των ΔΠΧΠ για επιχειρήσεις με δυσκολίες χρηματοδότησης, υποδεικνύοντας ότι, παρά την χρήση πληροφοριών από τους πρώτους εφαρμοστές του ΔΠΧΠ 19, η καθολική υποχρεωτική εφαρμογή έχει επιπρόσθετη ενημερωτική αξία για τους επενδυτές. Η δεύτερη μελέτη διερευνά την απόδοση του μέτρου λογιστικής συγκρισιμότητας που δημιουργείθηκε από τους De Franco, Kothari και Verdi (2011). Χρησιμοποιώντας προσομοιώσεις Monte Carlo, δείχνουμε ότι το μέτρο των De Franco, Kothari και Verdi (2011) εισάγει αχρείαστη μεταβλητότητα στην εκτιμώμενη συγκρισιμότητα μεταξύ εταιρειών και περιόδων. Επιπλέον, δείχνουμε ότι δεν μπορεί να εντοπίσει με επιτυχία συγκρίσιμα λογιστικά συστήματα όταν η λογιστική ενσωματώνει οικονομικές αποδόσεις με καθυστέρηση, ιδιαίτερα όταν οι εταιρείες διαφέρουν ως προς το κόστος κεφαλαίου τους. Προτείνουμε την ένταξη των παρελθόντων αποδόσεων ως εξηγητικών μεταβλητών στην αρχική σχέση κερδών-αποδόσεων προκειμένου να αυξηθεί η ικανότητα του μέτρου να κατατάσσει τις εταιρείες βάσει της λογιστικής τους συγκρισιμότητας. Η τρίτη μελέτη εξετάζει τη συγκρισιμότητα και τη σημασία των δημοσιευμένων χρηματοοικονομικών καταστάσεων ΔΠΧΠ, μελετώντας το μέγεθος και τη φύση των προσαρμογών των αναλυτών ανά χώρα. Βρίσκουμε ότι η συγκρισιμότητα των λογιστικών κερδών αυξάνεται μεταξύ των εφαρμοστών των ΔΠΧΠ, αλλά ο βαθμός στον οποίο η πραγματική οικονομική απόδοση αποτυπώνεται στα λογιστικά κέρδη εξακολουθεί να διαφέρει σημαντικά μεταξύ χωρών. Η ανάλυσή μας δείχνει επίσης ότι η εφαρμογή των ΔΠΧΠ αύξησε τις προσαρμογές των αναλυτών, αλλά λιγότερο σε χώρες που ήδη απαιτούσαν υψηλό επίπεδο διαφάνειας. Τέλος, διαπιστώνουμε ότι οι αναλυτές αναπροσαρμόζουν τα δημοσιευμένα κέρδη για να αναιρέσουν επιπτώσεις την αναγνωρίσης της εύλογης αξία των χρηματοοικονομικών μέσων και του κόστους έρευνας.