bluuebunny/crossref_metadata_2025 huggingface dataset:
Harnessing pre-trained models for accurate prediction of protein-ligand binding affinity
Authors: Li Jiashan , Gong Xinqi
Published: February 2025

Background

The binding between proteins and ligands plays a crucial role in the field of drug discovery. However, this area currently faces numerous challenges. On one hand, existing methods are constrained by the limited availability of labeled data, often performing inadequately when addressing complex protein-ligand interactions. On the other hand, many models struggle to effectively capture the flexible variations and relative spatial relationships between proteins and ligands. These issues not only significantly hinder the advancement of protein-ligand binding research but also adversely affect the accuracy and efficiency of drug discovery. Therefore, in response to these challenges, our study aims to enhance predictive capabilities through innovative approaches, providing more reliable support for drug discovery efforts.

Methods

This study leverages a pre-trained model with spatial awareness to enhance the prediction of protein-ligand binding affinity. By perturbing the structures of small molecules in a manner consistent with physical constraints and employing self-supervised tasks, we improve the representation of small molecule structures, allowing for better adaptation to affinity predictions. Meanwhile, our approach enables the identification of potential binding sites on proteins.

Results

Our model demonstrates a significantly higher correlation coefficient in binding affinity predictions. Extensive evaluation on the PDBBind v2019 refined set, CASF, and Merck FEP benchmarks confirms the model’s robustness and strong generalization across diverse datasets. Additionally, the model achieves over 95% in classification ROC for binding site identification, underscoring its high accuracy in pinpointing protein-ligand interaction regions.

Conclusion

This research presents a novel approach that not only enhances the accuracy of binding affinity predictions but also facilitates the identification of binding sites, showcasing the potential of pre-trained models in computational drug design. Data and code are available at https://github.com/MIALAB-RUC/SableBind.
Insights from draft genomes of Heterodera species isolated from field soil samples
Authors: Jain Akshita , Li Tongda , Huston Daniel C. , Kaur Jatinder , Trollip Conrad , Wainer John , Hodda Mike , Linsell Katherine , Riley Ian T. , Toktay Halil , Olowu Eniola Ajibola , Edwards Jacqueline , Rodoni Brendan , Sawbridge Timothy
Published: February 2025

Background

The nematode phylum includes many species key to soil food webs with trophic behaviours extending from feeding on microbes to macrofauna and plant roots. Among these, the plant parasitic cyst nematodes retain their eggs in protective cysts prolonging their survival under harsh conditions. These nematodes, including those from the genus Heterodera, cause significant economic losses in agricultural systems. Understanding of nematode diversity and ecology has expanded through application of genomic research, however, for Heterodera species there are very few available whole genome sequences. Sequencing and assembling Heterodera genomes is challenging due to various technical limitations imposed by the biology of Heterodera. Overcoming these limitations is essential for comprehensive insights into Heterodera parasitic interactions with plants, population studies, and for Australian biosecurity implications.

Results

We hereby present draft genomes of six species of which Heterodera australis, H. humuli, H. mani and H. trifolii are presently recorded in Australia and two species, H. avenae and H. filipjevi, currently absent from Australia. The draft genomes were sequenced from genomic DNA isolated from 50 cysts each using an Illumina NovaSeq short read sequencing platform. The data revealed disparity in sequencing yield between species. What was previously identified as H. avenae in Australia using morphological traits is now confirmed as H. australis and may have consequences for wheat breeding programs in Australia that are breeding for resistance to H. avenae. A multigene phylogeny placed the sequenced species into taxonomic phylogenetic perspective. Genomic comparisons within the Avenae species group revealed orthologous gene clusters within the species, emphasising the shared and unique features of the group. The data also revealed the presence of a Wolbachia species, a putative bacterial endosymbiont from Heterodera humuli short read sequencing data.

Conclusion

Genomic research holds immense significance for agriculture, for understanding pest species diversity and the development of effective management strategies. This study provides insight into Heterodera, cyst nematode genomics and the associated symbionts and this work will serve as a baseline for further genomic analyses in this economically important nematode group.
Early cytokine signatures and clinical phenotypes discriminate persistent from resolving MRSA bacteremia
Authors: Bergersen Kristina V. , Zheng Ying , Rossetti Maura , Ruffin Felicia , Pickering Harry , Parmar Rajesh , Sunga Gemalene , Chan Liana C. , Gjertson David , Fowler Vance G. , Yeaman Michael R. , Reed Elaine F. ,   the MRSA Systems Immunobiology Group, Hoffmann Alexander , Medie Felix , Sharma Batu , Thaden Joshua
Published: February 2025

Background

Staphylococcus aureus bacteremia (SAB) is a prevalent life-threatening infection often caused by methicillin-resistant S. aureus (MRSA). Up to 30% of SAB patients fail to clear infection even with gold-standard anti-MRSA antibiotics. This phenomenon is termed antibiotic-persistent MRSA bacteremia (APMB). The mechanisms driving APMB are complex and involve host phenotypes significantly impacting the immune response. Thus, defining early immune signatures and clinical phenotypes that differentiate APMB from antibiotic resolving (AR)MB could aid therapeutic success.

Methods

We assessed 38 circulating cytokines and chemokines using affinity proteomics in 74 matched pairs of vancomycin-treated SAB cases identified as ARMB or APMB after 5 days of blood culture.

Results

Unsupervised hierarchical clustering segregated APMB from ARMB based on differential levels of IL-10, IL-12p40, IL-13, CCL4, and TGFα. Additionally, CXCL1, CCL22 and IL-17A significantly differed between APMB and ARMB when correlated with diabetes, dialysis, metastatic infection, or cardiac vegetation. Combining immune signatures with these relevant clinical phenotypes sharply increased accuracy of discriminating APMB outcome to 79.1% via logistic regression modeling. Finally, classification-regression tree analysis revealed explicit analyte thresholds associated with APMB outcome at presentation especially in patients with metastatic infection.

Conclusions

Collectively, this study identifies previously unrecognized cytokine and chemokine signatures that distinguish APMB and ARMB at presentation and in the context of host clinical characteristics associated with increased disease severity. Validation of a biomarker signature that accurately predicts outcomes could guide early therapeutic strategies and interventions to reduce risks of persistent SAB that are associated with worsened morbidity and mortality.
Parenting involvement of Thai expectant fathers during the last trimester pregnancy of their spouses exhibiting depressive symptoms: a qualitative study
Authors: Lundberg Pranee C. , Phoosuwan Nitikorn
Published: February 2025

Background

Becoming a father is a challenging process that starts during pregnancy. During the late pregnancy period, depressive symptoms are the most common mental disorders among women. Engaged fatherhood is a strategy for gender equality that is good for the health outcomes of men, their spouses and their children. This study aims to explore the involvement of Thai expectant fathers during the last trimester of their partners’ pregnancy when the mothers exhibit depressive symptoms.

Methods

A qualitative study with semi-structured interviews was conducted by use of an interview guide. All data were transcribed and subjected to content analysis.

Results

Twenty-seven expectant fathers at seven antenatal care clinics of public hospitals in a province of north-eastern Thailand participated. Six categories emerged: Having mixed emotional feelings, Adapting to spouse’s emotional mood swings, Getting into challenges of fatherhood, Taking increased responsibility in the role of father, Receiving social support, and Wishing improvement of maternity care service. The expectant fathers experienced different psychological and physical situations and received support from family members and social networks, but they had not been encouraged to engage in parental education. Some were satisfied with healthcare service and some would like to be more involved.

Conclusions

On the basis of these findings, it is suggested that an intervention program should be developed that aims to engage expectant fathers in maternity health services. This could be done most effectively by starting with men who wish themselves to be involved in the healthcare of their spouses and continuing with men who do not have such wish. Professional support for nurses/midwives should be not only informative but also emotional and practical when needed.
The image of autism in the Polish press 2009–2020 and the role of first-person testimonies
Authors: Wodziński Maciej , Kamińska Natalia , Moskalewicz Marcin
Published: February 2025

This study examines the representation of autism in Polish press discourse from 2009 to 2020 in five major Polish daily newspapers, specifically focusing on the influence of first-person testimonies of autistic individuals. Quantitative discourse analysis was conducted using deductive coding of 1352 press articles concerning ASC. In analyzed press reports, autism was primarily portrayed as a negative and deficit-laden phenomenon that should be addressed by bringing autistic people in line with the neurotypical majority, reinforcing social stereotypes and stigma. Autistic people’s perspective was mostly neglected. However, when autistic people’s voice and first-person perspective was presented, as in the case of 3.7% of the analyzed media, such stereotypical and negative perspectives on ASC significantly changed for the better.

Research outcomes highlight the disparities in autism portrayal, particularly contrasting the deficit-driven narratives with perspectives emerging from the inclusion of first-person narratives. The latter can mitigate harmful stereotypes and promote a more accurate and positive understanding of autism. Treating autistic people as an essential source of information about themselves significantly changes the press image of autism and may indirectly contribute to their quality of life.
Workload in antenatal care before and after implementation of an electronic decision support system: an observed time-motion study of healthcare providers in Nepal
Authors: Radovich Emma , Das Seema , Karki Sulata , Bottomley Christian , McCarthy Ona L. , Shrestha Abha , Penn-Kekana Loveday , Shakya Rajani , Karmacharya Biraj Man , Shrestha Abha , Campbell Oona M. R. , Gon Giorgia
Published: February 2025

Background

Healthcare interventions are shaped by the resources needed to implement them, including staff time. This study, part of a process evaluation, aims to compare time spent on antenatal care (ANC) and related recordkeeping in two rural primary-level health facilities in Nepal, before and after implementation of an electronic decision support system intervention to improve ANC quality that required additional electronic documentation.

Methods

The study is a before-and-after, observational time-motion assessment. Researchers used the WOMBAT (Work Observation Method By Activity Timing) software to observe and record activities performed by auxiliary nurse midwives providing ANC in two rounds of data collection. We summed the observation time (in minutes) spent on activity categories for each day of observation, in each round of data collection. For each auxiliary nurse midwife, we estimated the proportion of total observation time spent on activities and compared these proportions before and after intervention implementation. We also compared the mean minutes per day spent on ANC and recordkeeping in the two rounds.

Results

Six auxiliary nurse midwives were observed over two data collection rounds (41 total observation days). Prior to intervention, providers spent 7% of their workday on ANC and 6% on related recordkeeping, and time spent on these activities did not change after intervention implementation. Only one of the six auxiliary nurse midwives demonstrated a statistically significant increase in time spent on ANC and recordkeeping after implementation. There was considerable day-to-day variation in ANC time, and substantial periods of “non-work” time (on break or not engaged in work-related activity). Non-work time reduced from 42% in the first round to 26% in the second round of data collection.

Conclusions

Time spent on ANC and related recordkeeping was low and did not change after implementation of the electronic decision support system. ANC and recordkeeping time was sensitive to day-to-day fluctuations in numbers of women attending for ANC at these rural facilities, which may have masked the intervention’s effects. However, the large amount of non-work time observed suggests time constraints during the workday were not a major factor inhibiting use of the electronic decision support system.
The people-centered care and inpatients’ perceived experience in China: a nationwide cross-sectional study
Authors: Wang Zhixing , Wang Xueyao , Chiu Herng-Chia , Kong Xiangrong , Li Qingfeng , Ran Xu , Liu Yang , Liang Hailun , Shi Leiyu
Published: February 2025

Background

The concept of People-Centered Care (PCC) is a prominent concept around the world, which is considered as an important concept and practice to promote health equity especially in China. Nevertheless, the association between PCC and the perceived experience of patients remains unclear, particularly from the perspective of the entire nation. This study examined the relationship between PCC and inpatients’ perceived experience in China.

Methods

The study utilized nationwide data collected from 351 healthcare facilities in 31 provinces representing all facility levels and types using proportional odds models. The five attributes of PCC encompass the following categories: continuity of care, information sharing, enhanced access, effectiveness, and respect, each contributing to improving health equity. Inpatients’ perceived experience includes the following factors: inpatients’ satisfaction with the hospitalization, the recognition of the hospital, and the recommendation of the hospital.

Results

Concerning inpatients’ overall satisfaction with the hospitalization, all PCC attributes had a positive effect on satisfaction, especially for inpatients with higher levels of care continuity and respect, contributing to health equity. Inpatients with a higher level of continuity were 3.66 times more likely to ameliorate their level of satisfaction from “very unsatisfied” to “unsatisfied.” Meanwhile, all PCC attributes had significantly positive effects on inpatients’ recognition, with effectiveness and respect showing an even stronger association with health equity. Regarding inpatients’ recommendation measures, all PCC attributes were positively associated, especially with higher levels of care continuity and effectiveness.

Conclusion

People-centered care is positively associated with inpatients’ perceived experience, and enhancing health equity through PCC attributes can further improve this experience. Further reform and practice should focus on the amelioration of continuity of care, promotion of information sharing between medical staff and patients, access and effectiveness of care, and respect for patients, all contributing to health equity.
Fasciitis-panniculitis syndrome with autoantibodies reacting to adipocyte pericellular fibers: a case report
Authors: Uehara Yu , Enya Takuji , Miyazaki Kohei , Hakata Yoshiyuki , Kawahara Sachiyo , Miyazawa Masaaki , Sugimoto Keisuke
Published: February 2025

Background

Fasciitis-panniculitis syndrome (FPS) typically presents with swelling and skin hardening. Its histopathological characteristics include inflammatory cell infiltration and fibrous thickening of the subcutaneous tissue and fascia. Panniculitides in children are rare and only a small number of juvenile FPS cases have been reported. We encountered a case of a 10-year-old boy in which autoantibodies reactive to adipocyte pericellular fibers were detected in relapsing FPS.

Case presentation

The patient developed a high fever and skin swelling with pain and erythema on the right side of his body following an abrasion injury on his right wrist at the age of 5 years, and was suspected of having streptococcal toxic shock-like syndrome, for which he received antimicrobials, immunoglobulin therapy, debridement, and plasma exchange. The same manifestations with similar magnetic resonance imaging (MRI) findings of high signal on short tau inversion recovery showing the spread of inflammation in the fat tissue and fascia was observed twice at the age of 6 years. Serological analyses for conventional autoantibodies, bone marrow aspiration, and whole-exome sequencing examination were non-remarkable. Prednisolone was effective in ameliorating the above putative autoinflammatory syndrome. The patient was admitted at the age of 10 years with similar clinical and MRI findings indicative of recurrence of the same disease. En bloc biopsy from the skin to the fascia showed thickening of collagen fibers, infiltration of inflammatory cells composed mainly of neutrophils and lymphocytes, and necrotizing vasculitis in the fat tissue and fascia. Immunohistochemical staining of the en bloc biopsy sections indicated infiltration of T lymphocytes and macrophages in the perivascular connective tissue and fibrinoid necrosis, supporting the diagnosis of FPS. Induction therapy with prednisolone resulted in a remission. IgG purified from the patient’s serum reacted with pericellular basement membranes in the subcutaneous fat tissue by immunohistochemistry. The patient is currently taking famotidine to prevent relapses and is making good progress in his recovery.

Conclusions

Although pathogenic autoantibodies have not been described in FPS, our results suggest that fat-tissue-reactive autoantibodies may be involved in the pathogenesis of FPS.
Efficacy of atypical antipsychotics in schizophrenia patients: effects of 5-HTR SNPs
Authors: Liu Keying , Zhang Bide , Chen Zhoufangyuan , Chen Fukun , Li Zexu , Gao Yunzhi , Zhao Yuechao , Liu Yihao , Wang Yanlong
Published: February 2025

The 5-hydroxytryptamine receptor (5-HTR) is a key protein responsible for the effects of 5-hydroxytryptamine (5-HT) and an important target for many antipsychotics. 5-HTR has a high degree of genetic polymorphism, and atypical antipsychotics are 5-HTR antagonists widely used in treating schizophrenia. With the increasing development of medical technology, antipsychotics are being updated rapidly, and their efficacy and safety are being optimised. However, owing to the complexity of patients’ genetic polymorphisms and psychiatric disorders, there are still individual differences in clinical efficacy. This article reviews the typing of 5-HTR, a common target of clinical atypical antipsychotics, and the effects of 5-HTR gene single nucleotide polymorphisms (SNPs) on the efficacy of atypical antipsychotics. Specific genotypes of six types of 5-HTR genes are associated with differential responses to atypical antipsychotics, which may help guide the development of individualized clinical treatments for patients with schizophrenia.
Evaluation of collaborative oral health care planning between older adults and personnel from public dental care and municipal care organizations: a study protocol for a cluster-randomized controlled study in Sweden
Authors: Persson Kylén Jessica , Björns Sara , Hägglin Catharina , Bellander Lisa , Brattbäck Atzori Annsofi , Persson Kylén Sven , Baar Ann-Christine , Wijk Helle
Published: February 2025

Background

Patient participation is key in person-centred care, emphasizing individual choices in treatment. Oral health, integral to overall well-being, is sometimes a neglected part of health. This intervention introduces a novel approach to strengthen person-centred care in homecare settings, employing collaborative, interprofessional teamwork and shared documentation across care organizations. This protocol outlines the design of a cluster-randomized controlled trial (RCT) in Sweden, comparing traditional oral assessments with an interorganizational, team-based oral health care planning model facilitated by a shared digital platform for documentation. The overall aim is to evaluate a person-centred interprofessional and interorganizational model for oral health care planning supported by a digital platform to enable healthy ageing.

Methods/design

The intervention, co-designed with older adults, academic institutions, healthcare providers in public dental care, and municipal organizations, will undergo ethical approval. The RCT will randomize older adults, dental hygienists (DHs) and nursing assistants (NAs) into two groups. The intervention group will attend a two-day workshop on a person-centred, three-step team-based model, while the control group will continue using standard procedures. Thereafter, the three-step collaborative model will be compared to standard procedures. Primary outcomes will be measured using the Revised Oral Assessment Guide (ROAG) and the General Oral Health Assessment Index (GOHAI). Secondary outcomes include health economic evaluations, participation rates and quality of care assessments. Qualitative studies from theoretical perspectives of change and learning based on interviews with key stakeholders will be conducted in both the test and control groups.

Discussion

Taking a co-produced approach where theory and practice shape the research iteratively, a person-centred health care planning model supported by a shared digital platform for home settings is evaluated. Anticipated outcomes include improved oral assessments and a deeper understanding of effective person-centred care practices. The co-produced approach of the intervention is also expected to further develop knowledge regarding co-production within domains of healthy ageing from an oral health perspective. As such, the intervention shapes and fosters co-produced person-centred care and healthy ageing.

Trial registration

ClinicalTrials.gov NCT06310798. Registered on 13 March 2024.
Elevated levels of PAI-1 precede the occurrence of type 2 diabetes mellitus
Authors: Hernestål-Boman Jenny , Öhman Tina , Jansson Jan-Håkan , Lind Marcus M. , Rolandsson Olov , Bergdahl Ingvar A. , Johansson Lars
Published: February 2025

Aims

Plasminogen activator inhibitor-1 (PAI-1) is the main inhibitor of the fibrinolytic system and is mainly secreted from adipose tissue. It is associated with cardiovascular disease and has also been considered a possible early risk marker for type 2 diabetes. Here, we present the results of a large prospective study investigating PAI-1 levels in relation to incident type 2 diabetes mellitus.

Methods

We conducted a prospective incident case-referent study within the Västerbotten Intervention Programme (VIP). Data on cardiovascular risk factors, fasting plasma glucose (FPG) and 2-hour plasma glucose (2-hPG) were collected at baseline health examination 1990–2005. Blood samples were collected and stored for future analyses. Participants were followed and 484 cases developed type 2 diabetes. Referents without type 2 diabetes were matched for sex, age, and year of participation, n = 484. Baseline plasma samples were analysed for PAI-1. Subgroup analysis was performed for 201 cases and 201 matched referents with normal baseline glucose levels (FPG < 6.1 and 2hPG < 8.9 mmol/L).

Results

Elevated baseline levels of PAI-1 were associated with incident type 2 diabetes after adjustments for BMI, family history of diabetes, smoking status, hypertension, FPG and 2hPG (PAI-1; OR = 1.87, 95% CI: 1.06–3.29). A similar result was shown in the subgroup analysis with 201 participants who had normal glucose levels at time of the health examination (PAI-1; OR = 2.68, 95% CI: 1.03–6.95).

Conclusions

Elevated PAI-1 levels in non-diabetic persons precede the manifestation of type 2 diabetes and can be detected before an elevation of FPG or 2-hPG is observed.
Sufficiency-driven business models for rare earth recycling: integrating stakeholder collaboration and customer discovery for sustainable innovation
Authors: Chinwego Chinenye , Garcia Rosanna , Sehar Daniel McArthur , MacGregor Evan , Tate Steven , Savage Kenneth , Zuber Thaddaeus , Sseruwagi Benjamin , Dietrich Daniel , Opoku Emmanuel , Smith David , Powell Adam , Mishra Brajendra
Published: February 2025

This paper explores the development of a collaborative and customer-centric business model for sustainable innovation in rare earth magnet recycling. Rare earth elements have become crucial to various electronics and renewable energy systems. Due to their finite nature and the supply risk they pose as they are available in a few countries, recycling these magnets is becoming increasingly important as demand increases. This study highlights the importance of developing business models that prioritize resource sufficiency, economic viability and environmental conservation. It emphasizes customer discovery, a critical component in understanding market needs and consumer behavior. Through detailed case studies as part of the NSF I-Corps program, this paper presents evidence from over 130 stakeholder interviews, completed with individuals from rare earth magnet companies, rare earth magnet recycling companies, National laboratories, metal alloy companies, and metal recycling companies. These case studies highlight best practices, challenges, and lessons learned, providing a comprehensive blueprint for other businesses to follow. In addition, this paper explores policy implications, advocating for regulatory frameworks that support sustainable practices and incentivize recycling initiatives. Ultimately, this research aims to contribute to the circular economy by demonstrating how sufficiency-driven business models can lead to sustainable growth and resilience in the rare earth recycling industry. By integrating stakeholder collaboration and customer discovery, businesses can innovate effectively, ensuring the sustainability of both their operations and the environment.
Harnessing precision nutrition to individualize weight restoration in anorexia nervosa
Authors: Rodriguez Isabel , Huckins Laura M. , Bulik Cynthia M. , Xu Jiayi , Igudesman Daria
Published: February 2025

Anorexia nervosa (AN) is a severe psychiatric disorder for which effective treatment and sustained recovery are contingent upon successful weight restoration, yet the efficacy of existing treatments is suboptimal. This narrative review considers the potential of precision nutrition for tailoring dietary interventions to individual characteristics to enhance acute and longer-term weight outcomes in AN. We review key factors that drive variation in nutritional requirements, including energy expenditure, fecal energy loss, the gut microbiota, genetic factors, and psychiatric comorbidities. Although scientific evidence supporting precision nutrition in AN is limited, preliminary findings suggest that individualized nutrition therapies, particularly those considering duration of illness and the gut microbiota, may augment weight gain. Some patients may benefit from microbiota-directed dietary plans that focus on restoring microbial diversity, keystone taxa, or functions that promote energy absorption, which could enhance weight restoration—although stronger evidence is needed to support this approach. Furthermore, accounting for psychiatric comorbidities such as depression and anxiety as well as genetic factors influencing metabolism may help refine nutrition prescriptions improving upon existing energy estimation equations, which were not developed for patients with AN. Given the reliance on large sample sizes, costly data collection, and the need for computationally intensive artificial intelligence algorithms to assimilate deep phenotypes into personalized interventions, we highlight practical considerations related to the implementation of precision nutrition approaches in clinical practice. More research is needed to identify which factors, including metabolic profiles, genetic markers, demographics, and habitual lifestyle behaviors, are most critical to target for individualizing weight restoration, and whether personalized recommendations can be practicably applied to improve and sustain patient recovery from this debilitating disorder with high relapse and mortality rates.
Factors affecting free vancomycin concentration and target attainment of free area under the concentration-time curve
Authors: Urakami Toshiharu , Oka Yusuke , Matono Takashi , Aoki Yosuke
Published: February 2025

Background

It has been reported that the protein binding rate of vancomycin (VCM) varies among individual patients. So, the authors investigated relevant factors that may affect free VCM concentration and target attainment of free area under the concentration-time curve (fAUC).

Methods

Thirty-nine patients were included. Multiple regression analysis was performed to determine the valuable factors in the free VCM concentration, and the target attainment of area under the concentration-time curve (AUC) 400–600 mg・h/L and fAUC200-300 mg・h/L was calculated.

Results

We found total protein was significant covariate for free VCM. Among 18 patients who were investigated for AUC and fAUC estimation, 9 patients (50.0%) and 12 patients (66.7%) reached AUC > 600 mg・h/L, and fAUC > 300 mg・h/L (p = 0.310), respectively.

Conclusions

Total protein is a significant predictor for free VCM estimation. And the fAUC-guided TDM for VCM TDM may contribute to more strict dosing than the AUC-guided TDM in hyper- or hypo-proteinemic population.

Trial registration

Retrospectively registered.
CT lymphangiography of the thoracic duct in mice: direct mesenteric versus popliteal lymph node puncture
Authors: Kato Shimpei , Sugawara Haruto , Furuta Toshihiro , Abe Osamu , Akai Hiroyuki
Published: February 2025

Background

To evaluate the efficacy of computed tomography (CT) lymphangiography after direct mesenteric lymph node injection for thoracic duct (TD) visualization in mice.

Methods

Twelve female BALB/c mice were injected with 35 μL of iodinated contrast medium (iomeprol 350 mgI/mL) into the mesenteric (mesenteric group) or popliteal (popliteal group) lymph nodes. CT images were acquired before injection and 1 min, 3 min, 5 min, 10 min, and 15 min after injection using a micro-CT scanner. Contrast ratios (CRs) were measured at the cisterna chyli and three levels of the TD (diaphragm, carina, and venous angle). Two experienced radiologists qualitatively assessed images as good, fair, or poor.

Results

The mesenteric group had significantly higher mean (± standard deviation) CRs than the popliteal group for all examined regions at 1 min after injection: cisterna chyli (14.01 ± 4.77 versus 1.47 ± 1.21, p < 0.001), diaphragm (7.28 ± 2.50 versus 0.85 ± 0.61, p = 0.0011), carina (10.33 ± 3.42 versus 0.44 ± 0.40, p < 0.001), and venous angle (6.26 ± 2.02 versus 0.79 ± 0.75, p < 0.001). For the TD between the cisterna chyli and the diaphragm, 6/6 mice in the mesenteric group showed strong enhancement, whereas 5/6 mice in the popliteal group showed minimal or no enhancement. The visual scores of the mesenteric group were significantly higher than those of the popliteal group for all the evaluated regions (p = 0.002).

Conclusion

CT lymphangiography via mesenteric lymph node injection provides better imaging of the TD in mice than popliteal lymph node injection.

Relevance statement

This study enhances TD visualization in mice, advancing preclinical research on lymphatic disorders and improving translational applications for better clinical diagnostics and treatments.

Key Points

Mesenteric lymph node injection improved the efficacy of TD CT lymphangiography in mice.

Mesenteric injection provided significantly better TD visualization than popliteal injection.

Enhanced TD visualization in mice advances preclinical research on lymphatic diseases.

Graphical Abstract
Can ChatGPT and Gemini justify brain CT referrals? A comparative study with human experts and a custom prediction model
Authors: Potočnik Jaka , Thomas Edel , Kearney Dearbhla , Killeen Ronan P. , Heffernan Eric J. , Foley Shane J.
Published: February 2025

Background

The poor uptake of imaging referral guidelines in Europe results in a substantial amount of inappropriate computed tomography (CT) scans. Publicly available chatbots, ChatGPT and Gemini, offer an alternative for justifying real-world referrals. Recent research reports high ChatGPT accuracy when analysing American College of Radiology Appropriateness Criteria variants. We compared the chatbots’ performance in interpreting, justifying, and suggesting alternative imaging for unstructured adult brain CT referrals in accordance with the European Society of Radiology iGuide. Our prediction model for automated iGuide categorisation of referrals was also compared against the chatbots.

Methods

The iGuide justification of 143 real-world CT brain referrals, used to evaluate a prediction model, was analysed by two radiographers and radiologists. ChatGPT-4’s and Gemini’s imaging recommendations and pathology suspicions were compared with those of humans, with respect to referral completeness. Inter-rater reliability with κ statistics determined the agreement between entities.

Results

Chatbots’ performance was limited (κ = 0.3) but improved for more complete referrals. The prediction model outperformed the chatbots in justification analysis (κ = 0.853). The chatbots’ interpretations of complete referrals were highly consistent (49/52, 94.2%). The agreement regarding alternative imaging was high for both complete and ambiguous referrals, with ChatGPT and Gemini correctly identifying imaging modality and anatomical region in 83/96 (86.5%) and 81/96 (84.4%) cases, respectively.

Conclusion

The chatbots’ ability to analyse the justification of adult brain CT referrals is limited to complete referrals, unlike our prediction model. Further research is needed to confirm these findings for other types of CT scans and modalities.

Relevance statement

ChatGPT and Gemini exhibit potential in justifying free text brain CT referrals; however, further improvements are required to handle real-world referrals of varying quality.

Key Points

Custom prediction model’s justification analysis strongly aligns with iGuide and surpasses chatbots.

Chatbots incorrectly justified almost one-half of all CT brain referrals.

Chatbots have limited performance in justifying ambiguous CT brain referrals.

Chatbot performance improved when referrals were detailed and included suspected pathology.

Graphical Abstract
Pattern of traumatic brain injury in multiply injured patients at a Nigerian tertiary hospital: a 5-year retrospective study
Authors: Adedire Adejare , Rabiu Taopheeq Bamidele , Faniyi Akinwale John , Oyeniyi Adebukola Ganiyu , Ojewuyi Olajide Olufemi , Ogungbemi Ayodeji Oluwaseun
Published: February 2025

Introduction

Head injuries represent a significant global health concern, particularly among multiply injured patients, often leading to high morbidity and mortality rates. The UNIOSUN Teaching Hospital in Osogbo serves a diverse patient population, many of whom suffer from traumatic injuries. Therefore, a thorough examination of head injury patterns in this context is essential.

Aim

This study aimed to retrospectively analyze the patterns of head injuries among multiply injured patients at UNIOSUN Teaching Hospital over a five-year period, from January 2017 to January 2022.

Methodology

A retrospective analysis was conducted on the medical records of multiply injured patients with head injuries admitted to UNIOSUN Teaching Hospital during the specified period. Data on patient demographics, injury characteristics, treatment received, and outcomes (including referrals, mortality rates, and treatment outcomes) were collected and analyzed.

Results

The study included 56 multiply injured patients with head injuries. Among these patients, 10.7% required referral to another healthcare facility or specialist for further evaluation or treatment, while the remaining 89.3% did not necessitate additional referral. Additionally, 7.1% of patients succumbed to their injuries, resulting in mortality, while 92.9% survived. Regarding treatment outcomes, 71.4% of patients experienced favorable outcomes, while 28.6% had unfavorable outcomes.

Conclusion

This study provides valuable insights into the patterns of head injuries among multiply injured patients at UNIOSUN Teaching Hospital over a five-year period. These findings underscore the importance of timely and effective medical interventions in improving patient outcomes.
COSMIC-021 Phase Ib Study of Cabozantinib Plus Atezolizumab: Results from the Locally Advanced or Metastatic Urothelial Carcinoma Cohorts
Authors: Pal Sumanta K. , Loriot Yohann , Necchi Andrea , Singh Parminder , Castellano Daniel , Pagliaro Lance , Suarez Cristina , McGregor Bradley A. , Vaishampayan Ulka N. , Hauke Ralph J. , Powles Thomas , Van Herpen Carla M.L. , Courtney Kevin D. , Dreicer Robert , Sudhagoni Ramu , Schwickart Martin , Andrianova Svetlana , Agarwal Neeraj
Published: February 2025

PURPOSE

The COSMIC-021 study assessed the safety and efficacy of cabozantinib plus atezolizumab in advanced solid tumors. Presented here are results from the expansion cohorts with advanced urothelial carcinoma (UC).

METHODS

This phase Ib study (ClinicalTrials.gov identifier:
NCT03170960
) enrolled patients with inoperable locally advanced/metastatic UC into four tumor cohorts: first-line cisplatin-eligible (cis-eligible), first-line cisplatin-ineligible (cis-ineligible), previous platinum-containing chemotherapy (previous chemotherapy-treated), and previous immune checkpoint inhibitor (ICI)–treated. Patients received oral cabozantinib 40 mg once daily and intravenous atezolizumab 1,200 mg once every 3 weeks. The primary end point was objective response rate (ORR), as assessed by the investigator per RECIST v1.1 every 6 weeks for 12 months and every 12 weeks thereafter; the secondary end point was safety.

RESULTS

A total of 121 patients (previous ICI-treated cohort, n = 31, and each of the other cohorts, n = 30) received study treatment from March 2018 to November 2021. The ORR (95% CI) was 30% (15 to 49) for cis-eligible, 20% (8 to 39) for cis-ineligible, 27% (12 to 46) for previous chemotherapy-treated, and 10% (2 to 26) for previous ICI-treated cohorts. The median progression-free survival (95% CI) was 5.5 (1.6 to 11.6), 5.6 (3.1 to 11.1), 5.4 (1.6 to 7.6), and 3.0 (1.8 to 5.5) months, respectively. Grade 3 or 4 treatment-related adverse events (TRAEs) were experienced by 43%, 67%, 57%, and 45% of patients, respectively. TRAEs led to discontinuation of all treatment components in 17%, 13%, 3%, and 19%, respectively. No grade 5 TRAEs were reported in any cohort.

CONCLUSION

The novel combination of cabozantinib plus atezolizumab exhibited clinical activity in advanced UC that is cis-eligible, cis-ineligible, or previously treated with platinum-containing chemotherapy; clinical activity in previous ICI-treated UC was modest. The toxicity profile was consistent with that previously reported for the combination.
The Unfolding Story of Protein Misfolding Causing Alzheimer Disease in Recipients of Human Pituitary Growth Hormone
Authors: Graber Evan G , Hosseini Sayed M Hadi , Wilson Darrell M , Rogol Alan D
Published: February 2025

Human growth hormone (hGH) has been in clinical use for children with GH deficiency (GHD) since the late 1950s. The original formulations were considered very safe with few adverse events reported. That changed remarkably in 1985 when the first patients with GHD, who had been treated with cadaveric hGH, were diagnosed with Creutzfeldt-Jakob disease (CJD).

Fortunately, that same year a robust supply of recombinant hGH was released to the market whose adverse event profile did not include CJD. Patients who had received National Hormone and Pituitary Program hGH have been continuously followed since 1985.

It is clear that prions are causative for CJD. Within the last 10 years there have been reports that similar preparations of cadaveric hGH may have been contaminated with amyloid β (Aβ) protein, a material that is related to Alzheimer disease. Eight patients in the United Kingdom, who had received cadaveric hGH extracted in an analogous manner to that in the United States, had conditions compatible with Alzheimer disease, although they did not fulfill all of the requirements for that diagnosis. In this report we discuss the findings of both CJD and Alzheimer disease, especially as they relate to a possible transmission of the diseases by prions and Aβ protein.
Time Trends in Survival After Surgery for Esophageal Cancer in a National Population-Based Study in Sweden
Authors: Lundberg Ellinor , Mattsson Fredrik , Gottlieb-Vedi Eivind , Lagergren Jesper
Published: February 2025

Background

The long-term survival after surgery for esophageal cancer has improved over the past few decades, but studies that assess recent survival trends are lacking.

Methods

This population-based cohort study included 2291 patients who underwent esophagectomy for esophageal cancer in Sweden between 2000 and 2020, with follow-up until 2024. Data came from medical records and national registries. Calendar time was analyzed as a continuous and categorized variable. The main outcome was all-cause 5-year mortality. Secondary outcomes were disease-specific 5-year mortality and 1-year all-cause mortality. Multivariable Cox regression provided hazard ratios (HR) with 95% confidence intervals (CI), adjusted for age, sex, comorbidity, tumor histology, neoadjuvant therapy, hospital volume, and pathological tumor stage.

Results

The study period witnessed increasing resection rates, centralization to fewer hospitals, and improving postoperative 5-year survival. When analyzing calendar time as a continuous variable, the adjusted HR for all-cause 5-year mortality was 0.97 (95% CI 0.95–0.98). In categorized analyses, the HRs decreased for each later time period and was 0.57 (95% CI 0.47–0.69) comparing the surgery period 2015–2020 with 2000–2004. The trends were similar for disease-specific 5-year mortality and all-cause 1-year mortality. In stratified analyses, patients with Charlson comorbidity score ≥2 had the strongest improvement in all-cause 5-year mortality (HR 0.45, 95% CI 0.30–0.69 comparing surgery in 2015–2020 with 2000–2004).

Conclusions

The recent 5-year survival has improved after surgery for esophageal cancer in Sweden. This improvement is not explained by lower surgery rates or selection of surgical candidates of younger age, fewer comorbidities, or earlier tumor stage.
Assessing socioeconomic status through dental and associated tissue characteristics: A cross-sectional study for human identification
Authors: DENNY CEENA , Natarajan Srikant , Jophy Jasmine , KP Nandita , Lewis Amita Juanita , Yellapurkar Shwetha
Published: February 2025

Background Dental identification methods are employed to determine a person’s identity in forensic odontology. Additionally, analyzing a person’s teeth can provide insights into their socioeconomic status, which may assist in the process of identification. Our study aimed to assess the correlation between dental health status and SES among individuals, with a focus on identifying predictors of SES based on dental health indicators Methods A cross-sectional study was conducted to evaluate the correlation between dental health status and socioeconomic status among 135 individuals. who had visited the Department of Oral Medicine for various forms of dental care. SES was measured according to a modified Kuppuswamy scale. The associations between SES and dental health indicators were analyzed using chi-square tests for categorical variables and t-tests for continuous variables. Results Dental caries is more common in lower SES groups, attributed to factors like poor nutrition and hygiene. Partial and complete edentulism are also more prevalent in lower SES populations, often due to financial constraints and lack of awareness, leading to extractions rather than restorations. However, urban populations, regardless of SES, show greater utilization of dental restorations, likely due to the concentration of dentists in cities and access to community-based dental camps offering low-cost treatments. Periodontal diseases further reflect SES disparities. Studies show that individuals from lower SES backgrounds report more severe periodontal issues, such as gingival swelling, while higher SES groups report milder symptoms like gingival bleeding, indicating earlier intervention. Conclusion SES plays a vital role in shaping health and lifestyle outcomes. The findings in our study demonstrate the value of incorporating SES indicators, such as education, occupation, marital status, and residence, into forensic investigations to enhance the precision of identification processes.
EXPERIENCIA DE LOS/AS PROFESIONALES DEL TRABAJO SOCIAL SOBRE LA SITUACIÓN DE LOS/AS JÓVENES EXTUTELADOS/AS POR EL y EXTUTELADAS SISTEMA
Authors: Medina-Armas Andrea , Gutiérrez-Rodríguez Nauzet
Published: February 2025

El objetivo de este estudio se centra en conocer la situación en la que se encuentran los/as jóvenes extutelados/as por el Estado tras cumplir la mayoría de edad y el rol de los/as profe-sionales del Trabajo Social. Se ha partido de un método cualitativo, a través de siete entrevistas individuales a trabajadores/as sociales de la isla de Tenerife, con experiencia previa en la inter-vención con jóvenes extutelados/as. Como resultados se destaca la incapacidad desde los recursos para dar respuesta a las necesidades del colectivo y algunas propuestas de solución, como la mejora de la autonomía, la intervención especializada y el trabajo de la historia de vida y familiar, señalando la importancia de dar respuesta a sus necesidades expresadas. Como conclusiones se destaca la relevancia del Trabajo Social destacando que son una pieza clave para conocer e intervenir sobre la realidad de estos/as jóvenes.
Promoting autonomous practice in pre-registration student nurses
Authors: Heath Shaun
Published: February 2025

General Practice Nurses are autonomous or semi-autonomous practitioners, functioning and working behind closed doors. Shaun Heath looks at how pre-registration students can be helped to experience semi-autonomous practice.

Pre-registration student nurse placements have been increasing over the last few years; there is an expectation that by the time a student reaches their final year that they should be practising (semi) autonomously. This article explores how the General Practice Nurse (GPN) can help students experience semi-autonomous practice; patient safety is paramount, however structured assessments developed reflecting educational theory can provide reassurance in autonomy.