bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluating the Use of Artificial Intelligence as a Study Tool for Preclinical Medical School Exams
Authors: Sakelaris Peyton G. , Novotny Kaitlyn V. , Borvick Miriam S. , Lagasca Gemma G. , Simanton Edward G.
Published: February 2025

BACKGROUND

The purpose of this 2024 study was to determine if there is an association between the usage of artificial intelligence (AI) to study and exam scores of medical students in the preclinical phase of their schooling.

METHODS

We created and distributed a survey via an unbiased third-party to students in the class of 2027 at the Kirk Kerkorian School of Medicine at UNLV to evaluate students AI use to study for their preclinical system-based exams. Students were categorized into two groups, those that use AI to study and those who do not. Two-sample t-tests were run to compare the mean exam scores of both groups on six different organ system exams as well as the cumulative final exam score for each group. The group that did use AI was further asked about which AI tools they use and how exactly they use these tools to study for preclinical examinations.

RESULTS

The results of the study showed that there is no statistically significant difference in exam scores between students who use AI for study purposes and students who do not. It was also found that most AI users studied with ChatGPT. The most common way users studied was by using AI to simplify and clarify topics they did not understand.

CONCLUSIONS

Based on the results of this study, we concluded that usage of AI programs for students for medical examinations did not yield a positive or negative effect on students’ organ system-based exam scores.
Bilateral Sequential Ocular Vascular Occlusions With Subsequent Unilateral Acute Retinal Necrosis in a Patient With HIV Infection
Authors: Vemulapalli Diana , Basu Soumyava , Nayak Sameera , Sahoo Niroj Kumar
Published: February 2025

Purpose: To report a case of bilateral ocular vascular occlusion with subsequent development of unilateral acute retinal necrosis in a patient with HIV infection. Methods: A single case was evaluated. Results: A 40-year-old woman presented with a sudden decrease in vision in the right eye for a 1-month duration. Disc pallor, arteriolar attenuation, and blot hemorrhages were seen in the midperiphery of the fundus of the right eye. On follow-up, the patient presented with reduced vision in the left eye for a 10-day duration. A fundus examination of the right eye showed extensive retinitis patches, and a cherry-red spot, boxcarring, and multiple sclerosed arterioles were seen in the left eye. The patient was later found to be positive for HIV infection but had never started therapy. Conclusions: A sequential progression from the occlusive event to retinitis should be kept in mind to customize follow-up for patients with HIV infection.
Empowerment and Post-disaster Poverty Reduction by a Local Community Organisation in Indonesia
Authors: Nugroho Fentiny , Alifa Syadza
Published: February 2025

This article aims to discuss empowerment carried out by the Kampung Sablon Association (KSA) to reduce post-disaster poverty. The study was located in Pandes Village, Central Java, Indonesia. Following a qualitative approach, data were collected through document study, in-depth interviews and observations. Fifteen community members participated in the study. The analysis shows that local community initiative/organisation or internal community work provided employment opportunities, which empowered people and helped reduce poverty. Highlighting the significance of cooperation and network, it adds a fourth stage of empowerment towards realising a sustainable economy. It argues that while most studies show the external agents’ essential role in the post-disaster recovery context, it is critical to focus on the internal community organisation and practices, such as gotong royong, the Indonesian local wisdom, which was used by KSA to creating jobs and producing new confection entrepreneurs. The research implication is that the community should also be trained in the spirit and skills of entrepreneurship. It is a key to success in running a business and reducing poverty.
Multifocal brown tumors: A case report and literature review
Authors: Roy Mainak , Dwidmuthe Samir
Published: February 2025

Brown tumors, though rare, are significant manifestations of hyperparathyroidism, often presenting with multifocal osteolytic lesions and occasionally leading to pathological fractures. This case report details the presentation and management of a 38-year-old male with multifocal brown tumors, including a right tibial fracture, and provides a comprehensive literature review. The patient exhibited multiple osteolytic lesions in the legs, thighs, and forearms, alongside elevated serum calcium and parathyroid hormone (PTH) levels. Management included conservative fracture treatment, surgical resection of the parathyroid adenoma, and postoperative rehabilitation. Follow-up revealed significant tibial fracture healing and reduction in the size of osteolytic lesions. This report underscores the importance of timely diagnosis and comprehensive management to prevent complications and improve outcomes in patients with multifocal brown tumors.
From China to India: Navigating the Global Sourcing Landscape
Authors: Ahluwalia Gursimran Kaur , Kanupriya Miss
Published: February 2025

This article examines the transition of global sourcing hubs from China to India, driven by economic, political and social factors. A mixed methods approach using trade data and existing literature including relevant policies of the Government of India is employed for the purpose of analysis in this study. As per the findings of this work, the key drivers of this shift are India’s competitive labour costs due to an abundant labour force, favourable government policies and improving infrastructural facilities. The study concludes that while challenges on the fronts of customs, infrastructure, international shipments, logistical quality and competence, tracking and tracing and timeliness remain, India is poised to become a major player when it comes to global sourcing. These insights are crucial for businesses and policymakers aiming to navigate the evolving landscape of global trade sourcing. In sum, challenges and opportunities linked with India’s infrastructure and scalability for trade and logistics are crucial in determining its global role. As India strives to compete with China in becoming the next global sourcing hub, the importance of robust logistics and shipping networks cannot be ignored.
CRISPR-Cas9-mediated deletions of FvMYB46 in Fragaria vesca reveal its role in regulation of fruit set and phenylpropanoid biosynthesis
Authors: Rai Arti , Skårn Magne Nordang , Elameen Abdelhameed , Tengs Torstein , Amundsen Mathias Rudolf , Bjorå Oskar S. , Haugland Lisa K. , Yakovlev Igor A. , Brurberg May Bente , Thorstensen Tage
Published: February 2025

The phenylpropanoid pathway, regulated by transcription factors of the MYB family, produces secondary metabolites that play important roles in fertilization and early phase of fruit development. The MYB46 transcription factor is a key regulator of secondary cell wall structure, lignin and flavonoid biosynthesis in many plants, but little is known about its activity in flowers and berries in F. vesca. For functional analysis of FvMYB46, we designed a CRISPR-Cas9 construct with an endogenous F. vesca-specific U6 promoter for efficient and specific expression of two gRNAs targeting the first exon of FvMYB46. This generated mutants with an in-frame 81-bp deletion of the first conserved MYB domain or an out-of-frame 82-bp deletion potentially knocking out gene function. In both types of mutant plants, pollen germination and fruit set were significantly reduced compared to wild type. Transcriptomic analysis of flowers revealed that FvMYB46 positively regulates the expression of genes involved in processes like xylan biosynthesis and metabolism, homeostasis of reactive oxygen species (ROS) and the phenylpropanoid pathway, including secondary cell wall biosynthesis and flavonoid biosynthesis. Genes regulating carbohydrate metabolism and signalling were also deregulated, suggesting that FvMYB46 might regulate the crosstalk between carbohydrate metabolism and phenylpropanoid biosynthesis. In the FvMYB46-mutant flowers, the flavanol and flavan-3-ol contents, especially epicatechin, quercetin-glucoside and kaempferol-3-coumaroylhexoside, were reduced, and we observed a local reduction in the lignin content in the anthers. Together, these results suggest that FvMYB46 controls fertility and efficient fruit set by regulating the cell wall structure, flavonoid biosynthesis, carbohydrate metabolism, and sugar and ROS signalling in flowers and early fruit development in F. vesca.
Prevalence of HPV genotypes and their association with reproductive tract inflammation and pregnancy outcomes among reproductive-age women in Ningbo, China: a retrospective cohort study (2016–2020)
Authors: He Nana , Song Xuejing , Song Qifa , Ding Huiqing
Published: February 2025

Background

The comprehensive impact of human papillomavirus (HPV) infection on reproductive tract inflammation and adverse pregnancy outcomes among women of reproductive age has not been fully investigated.

Methods

A retrospective cohort study was conducted among women presenting to the gynecological departments of specialized women’s hospitals in Ningbo, China, between 2016 and 2020. A total of 6506 women, with an average age of 28.7 years, who had undergone HPV testing and genotyping were included in the study.

Results

Overall, the most prevalent HPV types were HPV 52 (25.8%), HPV 16 (17.9%), and HPV 58 (7.7%). Vaginitis and cervicitis were significantly more prevalent in women with high-risk HPV (HR-HPV) compared to those with low-risk HPV(LR-HPV) (9.0% vs. 4.7%; 10.8% vs.7.1%; P < 0.05). Moreover, the incidence of cervicitis in patients with persistent HPV infection for more than two years was significantly higher than in those with HPV infection for one year (21.8% vs. 11.8%; P < 0.05). Pregnant women with HR-HPV infection had a significantly increased risk of miscarriage (9.7% vs. 6.1%; P < 0.05). Our cross-sectional analysis of potential risk factors for HPV infection during pregnancy revealed that higher pregnancy glucose levels (prevalence, 4.23%; OR, 1.10; 95% CI, 1.10–1.20; P < 0.05) significantly increased the risk of HPV infection. Women with persistent HR-HPV infection had a significantly higher risk of reproductive tract inflammation and adverse pregnancy outcomes. The analysis revealed significant associations between HPV infection and several pregnancy outcomes, including an increased risk of miscarriage, reduced live birth rate, and a higher cesarean section rate.

Conclusions

This highlights the need to monitor gestational glucose levels, reproductive tract inflammation, and HPV infection to reduce the risk of adverse pregnancy outcomes among pregnant women.
Reaching priority populations with different HIV self-testing distribution models in South Africa: an analysis of programme data
Authors: Majam Mohammed , Hatzold Karin , Mavhu Webster , Tembo Angela , Zishiri Vincent , Phiri Jane , Conserve Donaldson , Haile Zelalem , Chidarikire Thato , Johnson Cheryl C. , Moyo Sangiwe , Meyer-Rath Gesine , Venter Francois
Published: February 2025

Background

As in much of sub-Saharan Africa, substantial HIV testing gaps remain in South Africa, particularly among adult men ages 20–35, young people ages 15–24 and key populations. Innovative strategies, such as HIV self-testing (HIVST), are needed to reach such under-served populations. We evaluated a range of HIV self-test kit distribution models’ potential to reach adult men, young people and key populations in South Africa, to inform targeted approaches.

Methods

This cross-sectional study used data from community and facility-based HIV self-test kit distribution models implemented from October 2017 to April 2020. Self-test kits were distributed as part of the Unitaid-funded Self-Testing AfRica (STAR) programme. Data were collected from individuals who obtained self-test kits through five distribution models. Frequencies and proportions were used to describe the characteristics of the study populations and self-test kit distribution approaches.

Results

Over 2.5 years, 1 071 065 self-test kits were distributed across the five models. Community-based distribution accounted for 63% of total kits distributed, while the private sector (primarily workplace) accounted for 26%. Distribution at public sector health facilities accounted for 7% and distribution through the key population and secondary distribution models accounted for 2% each. Of those obtaining kits, and for whom we collected previous testing data (n = 771 612, 72%), 11% had never tested for HIV, 29% had not tested for at least a year, 41% had tested within the last 4–12 months and 19% had tested within the preceding three months. More men (64%) than women obtained self-test kits across all distribution models. The majority (80%) of men obtaining self-test kits were aged 20–40 years, and primarily received these at public transport terminals (36%), workplaces (18%) and hotspots (14%). A small proportion of men was reached through female sex workers.

Conclusions

This analysis of programme data enabled us to identify HIV self-test kit distribution models that are best suited to reach specific priority and under-tested populations, particularly adult men and young people. Models/sub-models that reach self-test users where they live, work and spend time, are likely to result in higher HIVST uptake. Study findings can inform future HIVST scale-up in South Africa.
Incidence and predictors of acute kidney injury among traumatic brain injury patients in Northwest Ethiopia: a cohort study using survival analysis
Authors: Anteneh Zelalem Alamrew , Kebede Semew Kassa , Azene Abebaw Gedef
Published: February 2025

Background

Acute kidney injury (AKI) is a sudden and reversible decrease in kidney function, causing the retention of waste products in the blood and potentially resulting in severe complications or death if not timely managed. Studies on AKI among traumatic brain injury patients in low-income nations like Ethiopia is very critical due to the limited healthcare resources, high burden of trauma-related injuries, and lack of robust data on the incidence and risk factors of AKI in such settings, which hinders effective prevention and treatment strategies tailored to these vulnerable populations Therefore, this study aimed to assess the incidence and predictors of AKI among traumatic brain injury patients.

Methods

A retrospective cohort study was conducted among 450 adult patients with traumatic brain injuries admitted to Tibebe-Ghion Specialized Hospital in Ethiopia. Kaplan- Meir curve and Log rank test were used to estimate and compare survival probability of different categories. A multivariable Cox proportional hazards model was used to identify determinants of acute kidney injury (AKI).

Results

The incidence of AKI was 10.9%, with a median follow-up period of 42 days. Significant predictors of AKI among traumatic brain injury patients included age (AHR: 1.05, 95% CI: 1.02–1.07), severe head injury (AHR: 1.46, 95% CI: 1.02–2.09), unreactive pupillary response (AHR: 4.82, 95% CI: 1.82–12.72), and hypotension (AHR: 3.45, 95% CI: 1.71–6.96).

Conclusions

The study found that AKI occurs in more than one in ten patients with traumatic brain injuries, with significant predictors including older age, severe head injury, unreactive pupillary response, and hypotension. These findings highlight the need for careful monitoring and early intervention for high-risk patients to prevent AKI and improve overall outcomes. Implementing targeted prevention and treatment strategies in settings with limited resources can help mitigate the burden of AKI and enhance patient care in vulnerable populations.
Workplace bullying among medical laboratory professionals in Ghana: insights from self-reported experiences, challenges to mitigation structures, and coping strategies
Authors: Duah Evans , Ephraim Richard Kobina Dadzie , Kotam Gabriel Pezahso , Kumordzi Samuel Mawuli , Amoah Samuel , Addy Nii Armah , Kwashie Solomon Dzidzornu Yao , Rahamani Abu Abudu
Published: February 2025

Background

Workplace bullying is a major concern in Ghana’s healthcare sector, often arising from power imbalances and an excessive emphasis on achieving results at the cost of employee well-being. While bullying among healthcare professionals like doctors and nurses is well-documented, little is known about its prevalence among medical laboratory professionals, who play a vital role in patient care. We assessed bullying in this group to inform strategies for mitigation.

Methods

We conducted a cross-sectional survey involving 378 medical laboratory professionals. The survey included demographic information, workplace characteristics, the Revised Negative Acts Questionnaire (NAQ-R), and questions about bullying perpetrators, mental health breaks, and anti-bullying policies. Data analysis involved descriptive statistics, the Kruskal-Wallis test, and logistic regression. Results were reported as frequencies, percentages, and odds ratios with 95% confidence intervals (CIs), and statistical significance set at p < 0.05.

Results

44% of the medical laboratory professionals reported experiencing bullying; 29% faced frequent bullying, while 71% encountered it occasionally. Common issues included ignored opinions, unmanageable workloads, gossip, and exclusion. Non-clinical administrative managers were the most frequent perpetrators. Diploma and bachelor’s degree holders had higher odds of being bullied compared to master’s degree holders (AOR = 6.13, p = 0.013; AOR = 2.56, p = 0.007). Rural professionals had higher odds than urban counterparts (AOR = 2.23, p = 0.007).

Conclusion

The high prevalence of workplace bullying among medical laboratory professionals highlights the need for effective policies to enhance workplace conditions and patient care.
Novel lipid profiles and atherosclerotic cardiovascular disease risk: insights from a latent profile analysis
Authors: Wan Hongli , Wu Haisheng , Wei Yuxi , Wang Simin , Ji Yuqiang
Published: February 2025

Background

Dyslipidemia is a key contributor to atherosclerotic cardiovascular disease (ASCVD). Despite the well-established correlation between abnormal lipid metabolism and ASCVD, existing diagnostic and predictive models based on lipid indices alone or in combination often exhibit suboptimal sensitivity and specificity. There is an urgent need for improved lipid indicators or novel combinations thereof.

Methods

The study included 898 cardiology inpatients who underwent coronary angiography (CAG). A latent profile analysis (LPA) was utilized to delineate lipid profiles on the basis of four routine lipid indices (total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides (TG)) and the triglyceride‒glucose (TyG) index as a proxy for the TG. Logistic regression models were used to assess the correlations between lipid profiles and the occurrence and severity of coronary artery stenosis (CAS and severe CAS), as well as the occurrence of coronary heart disease (CHD). Predictive modeling subsequently validated the predictive power of the lipid profiles for cardiovascular outcomes.

Results

The LPA delineated four distinct lipid profiles: Profile 1 (relatively high HDL with the lowest TC, LDL and TyG, 41.20%), Profile 2 (relatively high TC, LDL, and TyG with the lowest HDL, 36.42%), Profile 3 (relatively low TC, LDL and TyG with relatively high HDL, 18.93%), and Profile 4 (the highest TC, LDL, and TyG with the highest HDL, 3.45%). Profile 1 was associated with the lowest ASCVD risk, whereas Profile 2 posed the highest risk for all adverse outcomes. The risk associated with Profile 3 and Profile 4 varied depending on the outcome. Profile 4 presented a lower odds ratio (OR) for CAS than did Profile 3, whereas Profile 3 presented a lower OR for severe CAS and CHD. The lipid profile variable substantially outperformed individual lipid indices or their combinations in predicting cardiovascular outcomes.

Conclusions

Four distinct lipid profiles were identified among patients, with a particular profile characterized by lower levels of TC, LDL, and TyG, as well as a lower HDL, emerging as the most predictive of adverse cardiovascular outcomes. This underscores the critical need for a thorough lipid profile analysis to pinpoint individuals at heightened risk for adverse cardiovascular outcomes.
Designing stepped wedge trials to evaluate physical activity interventions in schools: methodological considerations
Authors: Salway Ruth , House Danielle , Kent-Saisch Simona , Walker Robert , Emm-Collison Lydia , Porter Alice , Lubans David R , Beets Michael , de Vocht Frank , Jago Russell
Published: February 2025

Background

In a stepped wedge design, schools are randomised to a sequence of measurements, with each sequence transitioning to intervention status at a different time. There are several advantages to such designs, including increased statistical power, logistical benefits and the ability to explore change over time. However, stepped wedge designs have not previously been used to evaluate school-based physical activity interventions in children. This paper aimed to explore the feasibility of this design, by identifying school constraints, balancing these with statistical considerations and exploring the power of this chosen design under different scenarios.

Methods

We conducted three interlinked studies, with the results from one informing the next. Study 1 was a qualitative study to identify school constraints that inform the choice of stepped wedge configuration. Study 2 used simulation to choose a configuration that balanced these school constraints and statistical properties. Study 3 explored the statistical power for the chosen design for different school and pupil sample sizes, using an open cohort design (a mixture of new and repeated pupils).

Results

School staff considered the proposed data collection feasible, and supported a maximum of 3–4 measurements per year and an implementation period of one school term. Study 2 therefore considered incomplete stepped wedge designs with five steps. Statistically, the best designs had a mix of control and intervention measurements in terms 2–4 and a spread of measurements across the whole study duration. Power depended on a combination of the overall recruitment rate and the retention rate. For 20 schools with an eligible class size of 30 pupils, we would be able to detect a 6 min difference in average weekday moderate-to-vigorous physical activity with 80% power, provided there were > 50% of pupils measured per school at each time. A similarly powered cluster randomised controlled trial would require 42 schools.

Conclusion

Stepped wedge trials are a viable design for evaluating school-based physical activity interventions. Incomplete designs, where not all schools are measured at each point, offer the flexibility to work around practical constraints.
Epidemiology of inherited metabolic disorders in newborn screening: insights from three years of experience in Southern Iran
Authors: Salarian Leila , Ilkhanipoor Homa , Amirhakimi Anis , Afshar Zhila , Nahid Saman , Moradi Ardekani Fariba , Rahimi Nazila , Yazdani Negar , Nikravesh Abdolhossein , Beyzaei Zahra , Moravej Hossein
Published: February 2025

Background

Newborn screening is essential for the early detection of congenital genetic and metabolic disorders, enabling timely intervention to prevent morbidity, mortality, and disabilities associated with inherited metabolic disorders (IMDs). The Iranian Neonatal Screening Program piloted in Fars Province, screening nearly 100% of neonates for 20 disorders. This study aimed to assess the epidemiology of these metabolic diseases. From March 2019 to September 2021, 138,689 neonates were screened using tandem mass spectrometry (MS/MS) on dried blood spots. Those with abnormal results were referred to pediatric endocrinology and metabolism specialists for confirmatory testing per American College of Medical Genetics guidelines.

Results

Among the screened neonates, 139 patients of IMDs were identified, yielding an estimated birth prevalence of 1:1000. The positive cases included 55 aminoacidopathies, 47 organic acidemias, 31 fatty acid oxidation disorders, and 6 urea cycle defects were detected. The most prevalent IMDs were phenylalanine metabolism disorders, short-chain acyl-CoA dehydrogenase deficiency, 3-methylcrotonyl-CoA carboxylase deficiency, and methylmalonic acidemia. Notably, the prevalence of IMDs in Fars Province is significantly higher than average global statistics. Additionally, we observed that certain disorders previously deemed very rare exhibit a relatively high prevalence in this region.

Conclusions

Our data highlight the efficiency and robustness of neonatal screening for IMD in Iran. It demonstrates the need for expanded screening efforts across the entire country. One limitation of this study is that the screening was conducted in only one state, which may not reflect the broader population of Iran. Future research should involve nationwide implementation of screening programs to validate our findings and assess the prevalence of IMDs in diverse regions. Furthermore, exploring the applicability of our screening methods in other Middle Eastern countries could help promote early and life-changing diagnoses across the region.
PDG-Arena: an ecophysiological model for characterizing tree-tree interactions in heterogeneous and mixed stands
Authors: Rouet Camille , Davi Hendrik , Druel Arsène , Fady Bruno , Morin Xavier
Published: February 2025

Key message

PDG-Arena, a new individual- and process-based ecophysiological model, was developed to simulate the functioning of mixed-species forests. It was evaluated using annual growth data on beech-fir stands of the French Prealps.

Context

In the context of the ongoing climate and biodiversity crises, mixed forest stands are increasingly considered as a sustainable management alternative to monospecific and even-aged stands.

Aims

We developed a new individual- and process-based forest growth model, PDG-Arena, to simulate mixed forest growth and functioning, and test ecophysiological interactions among trees in mixed stands.

Methods

The model builds upon the validated ecophysiological stand-scale model CASTANEA and integrates tree competition for light and water. We evaluated the performance of PDG-Arena by comparing the simulated growth with annual radial growth data from 37 common beech and silver fir monospecific and mixed plots in the French Prealps.

Results

PDG-Arena performed slightly better than CASTANEA when simulating even-age and monospecific forests (r
2 of 32.1 versus 29.5%). When using structure-diverse and species-diverse inventories, PDG-Arena performed better than CASTANEA in pure beech (38.3 versus 22.9%) and mixed stands (40.5 versus 36.3%), but not in pure fir stands (39.8 versus 42.0%). The new model also showed a significant positive effect of species mixing on gross primary production (+ 5.5%), canopy absorbance (+ 11.1%), and transpiration (+ 15.8%) in the tested stands.

Conclusions

Our results show that tree-level process-based models such as PDG-Arena, formally simulating interspecific interactions, can serve as a valuable tool to understand and simulate the carbon, radiative, and water dynamics of mixed stands.
Molecular profiling of skin cells identifies distinct cellular signatures in radiation-induced skin injury across various stages in the murine dataset
Authors: Yu Hongxuan , Zhong Tao , Xu Ying , Zhang Zengfu , Ma Jiachun , Yuan Jupeng , Wang Minglei , Wu Meng , Yu Jinming , Ma Yuequn , Chen Dawei
Published: February 2025

Background

Radiation-induced skin injury (RISI) commonly manifests in cancer patients undergoing radiotherapy (RT). However, a universally accepted standard for treating radiation injury has not yet been established. Our objective was to provide a detailed molecular overview of skin pre- and post-radiation therapy, aiming to enhance our understanding of the subclusters and molecular mechanisms contributing to radiodermatitis.

Methods

C57BL/6 mice were subjected to a single fraction (20 Gy) of RT targeting the right dorsal skin. We then employed integrated single-cell RNA sequencing (scRNA-seq) to analyze skin samples from mice at 7 and 30 days after radiation exposure, as well as from non-irradiated mice. The Seurat analysis pipeline, Cellchat, SCP, and ssGSEA were used to define the cell types and mechanisms involved in radiation-induced skin injury. Reverse transcription polymerase chain reaction (RT-PCR), multiplex immunofluorescent staining, and other datasets (GSE130183, GSE193564, and GSE193807) were used to validate our findings.

Results

Thirty-two distinct cell clusters encompassing 71,412 cells were identified. We discovered that cycling keratinocytes (KCs), with the BMP signaling pathway enriched, could activate the Wnt pathway, as well as the SMAD pathways, driving the wound healing and fibrosis processes in RISI. Terminally differentiated secretory-papillary fibroblasts (Fibs) are capable of attracting immune cells, which contributes to the pathogenesis of RISI. Lymphatic endothelial cells (ECs) with pro-inflammatory properties play a critical role in the pathogenesis of RISI by facilitating leukocyte migration. Our analysis also highlighted enhanced ligand-receptor interactions, notably the interactions between chemokines like CXCL10, CCL2, and ACKR1, across subclusters of inflammatory KCs, Fibs, ECs, and immune cells, underscoring their pivotal role in leukocyte recruitment in RISI.

Conclusions

Cycling KCs, secretory-papillary Fibs, and lymphatic ECs play critical roles in RISI progression. Targeting the interactions of these subclusters with immune cells might help improve the severity of RISI. Furthermore, our study provides a valuable resource for understanding the interactions among immune cells in the context of RISI.

Graphical Abstract
Glutathione peroxidase 4 (GPX4) and obesity interact to impact tumor progression and treatment response in triple negative breast cancer
Authors: Devericks Emily N. , Brosnan Bennett H. , Ho Alyssa N. , Glenny Elaine M. , Malian Hannah M. , Teegarden Dorothy , Wendt Michael K. , Coleman Michael F. , Hursting Stephen D.
Published: February 2025

Introduction

Triple-negative breast cancer (TNBC), which tends to be more advanced when diagnosed and more aggressive than other breast cancer subtypes, is accelerated by obesity. Hypertrophic adipocytes and cancer cells exhibit increased oxidative stress and altered redox homeostasis, influencing therapeutic outcomes. Enzymes implicated in both redox regulation and TNBC include glutathione peroxidase 4 (GPX4; reduces lipid peroxides) and pyruvate carboxylase (PC; essential in oxidative stress protection). Using preclinical models, we characterized interactions between GPX4, PC, and oxidative stress in TNBC cells, and established effects of GPX4 suppression on TNBC progression. In TNBC cells, PC knockdown increased GPX4 expression, while GPX4 knockdown increased PC expression. GPX4 inhibition by erastin or RSL3 enhanced TNBC cell death in vitro, and antioxidants mitigated the cytotoxicity. In obese mice, GPX4 knockdown, versus scramble control: (i) reduced tumor burden following orthotopic transplantation of TNBC cells; and (ii) reduced lung metastasis following tail vein injection of TNBC cells in combination with chemotherapy (carboplatin) but not immunotherapy (anti-CTLA4 plus anti-PD1). We conclude that GPX4 and PC expression are inversely related in TNBC cells, and GPX4 and obesity interact to impact TNBC progression and treatment responses. Moreover, GPX4-mediated redox defense, alone or in combination with chemotherapy, is a targetable vulnerability for treating TNBC, including obesity-related TNBC.

Implication

GPX4 suppression, alone or with current TNBC therapies, impacts outcomes in preclinical TNBC models with or without obesity and offers a new, plausible mechanistic target for TNBC treatment.
Survivorship clinic attendance improves completion but not timeliness of cardiac surveillance post anthracyclines
Authors: Forbes Zac , Dunmall Tegan , Tey Amanda , Culligan Dominic , Fedele Pasquale L.
Published: February 2025

Background

Anthracycline induced cardiomyopathy (AIC) is an important complication of cancer management. Recent findings showed that with early identification and intervention, AIC may be fully or partially reversible. European society of cardiology (ESC) guidelines recommend a risk-stratified monitoring approach, including transthoracic echocardiogram (TTE) for all patients within 12 months post-treatment.

Aim

Investigate the impact of a survivorship clinic on TTE follow up for AIC.

Methods

Over a 5 year span, 235 patients with haematological malignancies received anthracycline chemotherapy ≥ 250mg/m2. The electronic medical records of these patients were reviewed. TTE outcomes were compared between survivorship and non-survivorship patients.

Results

Survivorship patients received TTE in 88.6% of cases, whereas non-survivorship patients received TTE in 30.9% of cases. In survivorship patients, TTE was indicated for asymptomatic screening in 92.3% of cases. In non-survivorship patients the majority of TTE were for symptom investigation (78.0%). Chi-squared analysis found these results to be statistically significant (p value < 0.05).

Discussion

Survivorship patients are nearly three times more likely to receive TTE monitoring for AIC. However, due to delayed clinic referral/attendance, only 36.4% received TTE within 1 year of treatment completion, in line with ESC guidelines.

Conclusion

Survivorship clinics improve TTE monitoring for AIC, allowing early identification and potential intervention. However, reliance on this model alone may risk inadequate surveillance for patients who do not attend and delays in referral/attendance may impact monitoring timeliness.
A mixed-methods nutrition, water, sanitation and hygiene knowledge, attitudes, and practices survey of IDPs, returnees, and host community members in four counties of Jonglei state, South Sudan
Authors: Lawry Lynn Lieberman , Gabor Rachel , Katele Jacques , Madut Lazarus Baak , Sommers Katina , Manuel David , Nadolski Claire , Lado Mounir , Koehlmoos Tracey Perez , Clemmer William
Published: February 2025

Background

The humanitarian community in South Sudan estimates that 9.4 million people need humanitarian assistance in 2023. Prior data is unlikely to reflect the current health situation of Jonglei state given the influx of internally displaced persons (IDPs) and returnees.

Methods

We conducted a cross-sectional, randomly sampled, mixed-methods, population-based household study during a 4-week period in June-July 2023 in ten bomas in four counties of Jonglei, South Sudan. Snowball sampled qualitative interviews were used for triangulation of quantitative data. The study was conducted to understand nutrition and water, sanitation, and hygiene knowledge, attitudes, and practices of IDPs, returnees and the host communities.

Results

A total of 859 households consented to the study (586 females and 273 males) with a response rate of 96% among females and 94% among males. Forty-two percent of households identified three or more strategies to prevent starvation or malnutrition. Up to a fifth of households were unable to identify any strategies to prevent starvation or malnutrition with the host community having the highest rate (20.2%) when compared to IDPs (13.4%; p = 0.018) or returnees (10.4%; p = 0.006). Only 34% of respondents could name three warning signs for when a child with diarrhea should be seen by a skilled provider. Only 26% of females exclusively breastfeed. Higher odds of breastfeeding included IDPs (aOR 1.11; 95% CI 1.01 to 1.03; p = 0.038), those educated on breastfeeding (aOR 1.18; 95% CI 1.03 to 1.35; p = 0.015) and those with positive nutrition attitudes (aOR 1.32; 95% CI 1.09 to 1.59; p = 005). Estimated household water usage ranged from 7.9 to 10.1 L/person/day. Based on qualitative triangulation, both nutrition and WASH traditional beliefs hinder adequate nutrition and create barriers to improvements in WASH.

Conclusion

Evidence based nutrition interventions should be the priority and include, at a minimum, micronutrient and vitamin supplementation, food fortification and adequate supplemental food for reproductive age females. Immediate and exclusive breastfeeding messaging should be a priority. Improved flood resistant sources for clean water, clean covered water storage container distribution, improved sanitation, oral rehydration solution (ORS) and zinc distribution and education are necessary to decrease diarrheal rates.
Efficacy and safety of mechanical transvenous lead extraction: median follow-up analysis and development of an experimental model for predicting survival post-extraction
Authors: Nasri Shima , Samimi Sahar , Eslami Masoud , Hematpour Khashayar , Eslami Morteza , Yarmohammadi Hirad , Mollazadeh Reza , Rahmanian Mehrzad
Published: February 2025

Background

Cardiac implantable electronic device (CIED) implantation is on the rise, accompanied by an increase in its inevitable complications such as different types of CIED infections that require further therapy and potential device extraction. Ensuring efficacy and safety remains paramount in transvenous lead extraction (TLE), given the complex nature of the procedure. The purpose of this study is to assess the outcomes of relatively low-cost mechanical TLE, including mid-term clinical follow-up, and to develop a predictive model for post-TLE survival. This study included all consecutive patients admitted for TLE at two tertiary medical centers between 2016 and 2021. Baseline characteristics, TLE procedure details complications occurring during and/or after the procedure and follow-up outcomes were collected.

Results

During the 5-year period, 100 consecutive patients underwent TLE. The mean age of the subjects was 61 ± 3 years. The average time from lead implantation to TLE was 69.34 ± 9.36 months, with a total of 216 leads extracted. The most common indication for TLE was infection observed in 87% of subjects with pocket infection seen in the majority (84%). Complete clinical success was achieved in 98% of patients, with major complications occurred in 5% of cases and only one case of peri-procedural death. Proposed experimental model showed that near 50% of the patients will live less than 73.29 months.

Conclusion

TLE demonstrated a high level of safety with low mortality and morbidity rates. Using low cost widely available mechanical tools is useful for treating CIED-related infections.
Investigation of the in vitro biofilm-producing ability of isolated microbes in chronic otitis media
Authors: Mehta Rupa , Nagarkar Nitin M. , Das Padma , Das Jyoti Ranjan , Das Debabrata , Gourh Govind
Published: February 2025

Introduction

A biofilm consists of bacteria or fungi adhered to the mucosal or prosthetic surfaces, surrounded by an extracellular polymeric substance.

Methods

A total of 145 patients were recruited for this prospective observational research. Tissue samples, including hypertrophied mucosa, granulation tissue, cholesteatoma flakes, and matrix, were collected and analyzed for the presence of biofilms, following the protocol outlined by Christensen et al.

Results

The presence of biofilms was detected in 28 cases. Among these, Pseudomonas aeruginosa was identified in 7 cases, Staphylococcus aureus and Coagulase-negative staphylococcus aureus in 5 cases, Proteus mirabilis and Acinetobacter in 3 cases, Citrobacter in 2 cases, and Streptococcus haemolyticus, Escherichia coli, and Moraxella Morganii each in 1 case.

Conclusion

In both outpatient and inpatient settings, the judicious application of topical or systemic antimicrobials is crucial. During surgical procedures, it is essential to distinguish diseased tissues from healthy ones and to conduct biofilm analysis on the latter.
Comprehensive Analysis of TCR and BCR Repertoires: Insights into Methodologies, Challenges, and Applications
Authors: Seo Kayoung , Choi Jung Kyoon
Published: February 2025

The diversity of T-cell receptors (TCRs) and B-cell receptors (BCRs) underpins the adaptive immune system’s ability to recognize and respond to a wide array of antigens. Recent advancements in RNA sequencing have expanded its application beyond transcriptomics to include the analysis of immune repertoires, enabling the exploration of TCR and BCR sequences across various physiological and pathological contexts. This review highlights key methodologies and considerations for TCR and BCR repertoire analysis, focusing on the technical aspects of receptor sequence extraction, data processing, and clonotype identification. We compare the use of bulk and single-cell sequencing, discuss computational tools and pipelines, and evaluate the implications of examining specific receptor regions such as CDR3. By integrating immunology, bioinformatics, and clinical research, immune repertoire analysis provides valuable insights into immune function, therapeutic responses, and precision medicine approaches, advancing our understanding of health and disease.
Bone mineral density in patients with congenital adrenal hyperplasia from prepubertal to adult age
Authors: Stancampiano Marianna Rita , Pitea Marco , Maruca Katia , Meroni Silvia Laura Carla , Bucolo Carmen , Russo Gianni , Mora Stefano
Published: February 2025

Context

Patients affected by the classic form of congenital adrenal hyperplasia (CAH) need lifelong glucocorticoid therapy (GC). GC represents one of the primary causes of secondary osteoporosis, however the effect of steroid therapy on bone mineral density (BMD) in patients with CAH is still controversial.

Objective

To evaluate and compare the BMD of a group of prepubertal patients and a subgroup of young adult patients with CAH receiving chronic GC therapy, with healthy controls.

Design

retrospective observational study.

Setting

A referral center for pediatric endocrinology.

Patients and healthy controls

Fifty-six prepubertal children with CAH treated with GC from diagnosis and 60 prepubertal healthy children of comparable age. A subgroup of 36 young patients was studied after the completion of puberty, and their BMD was compared to that of 51 young adult healthy volunteers.

Methods

BMD was measured in the lumbar spine and in the whole body by dual-energy x-ray absorptiometry. Multivariate models were used for the comparison of BMD measurements between patients and control subjects.

Results

Whole-body BMD measurements of patients were significantly lower compared with healthy controls, both in boys and in girls. No differences were found in lumbar spine measurements. BMD expressed as Z-score decreased markedly in CAH patients from prepuberty to adulthood, particularly in young adult males. Men with CAH showed lumbar spine BMD values significantly lower than control subjects.

Conclusions

Boys and young adult men with classic form of CAH have lower bone mineral density values compared with healthy controls. This may put them at risk of developing osteoporosis early in life.
Gonadotropin-releasing hormone and cognition
Authors: Kacimi Loïc , Prevot Vincent
Published: February 2025

Gonadotropin-releasing hormone (GnRH) is traditionally recognized as the central regulator of reproduction through its pulsatile secretion, which governs the hypothalamic-pituitary-gonadal (HPG) axis. However, recent evidence has highlighted its broader role in brain development and function, including in cognitive and higher intellectual processes. GnRH production follows distinct phases, from its early activation during minipuberty – the first postnatal activation of GnRH neurons during the infantile period, its reactivation and stabilization starting at puberty, and its eventual decline with age and the loss of gonadal steroid feedback. This evolution depends on the establishment, maturation and activation of GnRH neurons, a complex process regulated by the cellular and molecular environment of these neurons, including multiple neuronal and glial types as well as a minipubertal “switch” in gene expression, the perturbation of which may have long-term or delayed consequences for both reproductive and cognitive function. The cognitive role of GnRH may be related to its recently revealed involvement in maintaining myelination and synaptic plasticity, while disruptions in its finely tuned rhythmic secretion, either age-related or pathological, are associated with cognitive decline and neurodegenerative disorders. Restoring physiological GnRH levels and pulsatility can reverse age-related cognitive decline and improve sensory functions even in adulthood, suggesting a mobilization of the “cognitive reserve” in both animal models and human patients. This review highlights recent advances in our understanding of the GnRH system and the therapeutic potential of pulsatile GnRH therapy to mitigate age-related cognitive decline and neurodegenerative processes.
Effect of mirabegron on lipid profile (serum cholesterol and triglyceride) in Iraqi patients with overactive bladder
Authors: Hameed Hiba , Ismail Mohammed
Published: February 2025

Background Mirabegron is a β3-adrenergic receptor (β3-AR) agonist indicated for the treatment of overactive bladder. β3-AR agonists are located in urinary bladder and adipose tissue, where they are involved in the regulation of thermogenesis and lipolysis. Objective to evaluate the effect of mirabegron on lipid profile (serum cholesterol and triglyceride) and BMI in patient with OAB. Materials and Methods In medical city complex (Ghazi AL-Hariri hospital) urology outpatient clinic, a prospective study of 40 patient diagnosed with OAB. These patient a took single dose of mirabegron 50 mg for 4 months and asses it’s the effect during this period on weight and fasting serum cholesterol and triglyceride. Results investigation showed that there is astatically significant reduction from baseline after 2 and 4 months’ treatment with mirabegron (P-value=0.001) in fasting Sr. Triglyceride while fasting serum cholesterol level showed increase in level after 2 and 4 months of treatment. However; this increment not statically significant after 2 months(P-value=0.227) and after 4 months(P-value=0.261) BMI showed slightly reduction after 2 and 4 months’ treatment with mirabegron but also this reduction not statically significant after 2month(P-value=0.114) and after 4 months(P-value=0.562) Conclusion Mirabegron is dependable and direct drug for situation of overactive bladder (OAB) causes useful decline in level of triglyceride which responsible for cardiovascular disease.