bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of kidney volume on incidence of in-hospital kidney-related adverse outcomes in patients with acute heart failure
Authors: Saito Akira , Asano Taku , Komiyama Nobuyuki , Ohde Sachiko
Published: January 2025

Background

Recent studies revealed an association between small kidney volume and progression of kidney dysfunction in particular settings such as kidney transplantation and transcatheter aortic valve implantation. We hypothesized that kidney volume was associated with the incidence of kidney-related adverse outcomes such as worsening renal function (WRF) in patients with acute heart failure (AHF).

Methods

This study was a single-center retrospective cohort study. It included patients admitted for AHF treatment between 2011 and 2021 and who underwent computed tomography (CT) that included images of the kidneys on the date of admission. We measured the volume of the right and left kidneys using dedicated volume analyzing software for 3D-CT (SYNAPSE VINCENT, Fuji Film, Tokyo, Japan) and determined the total kidney volume by adding the volumes of the left and right kidneys. We defined the composite of death from any cause, initiating renal replacement therapy, and WRF during hospitalization as major adverse kidney events (MAKE). We conducted multivariate logistic regression analysis to evaluate the impact of MAKE and each component of MAKE adjusted for age, sex, body surface area, estimated Glomerular Filtration Rate (eGFR) on admission date and the factors that were significantly associated with the incidence of MAKE by bivariate analysis.

Results

In the 229 patients enrolled in the analysis, death from any cause, initiating RRT, and WRF occurred in 30 (13.1%), 10 (4.4%), and 85 (37.3%) patients, respectively. It was found that small kidney volume (≤ 250 ml) was independently associated with the increased incidence of MAKE (odds ratio 3.92, 95% confidence interval [1.18–13.08], p = 0.026) and WRF (odds ratio 6.58, 95%confidence interval [1.85–23.42] p = 0.004). The area under the receiver operating characteristic curve for multivariate logistic regression analysis of MAKE was 0.71.

Conclusions

Kidney volume on admission was independently associated with the increased incidence of kidney-related adverse outcomes during hospitalization in patients with AHF.
Identification of patient demographic, clinical, and SARS-CoV-2 genomic factors associated with severe COVID-19 using supervised machine learning: a retrospective multicenter study
Authors: Nirmalarajah Kuganya , Aftanas Patryk , Barati Shiva , Chien Emily , Crowl Gloria , Faheem Amna , Farooqi Lubna , Jamal Alainna J. , Khan Saman , Kotwa Jonathon D. , Li Angel X. , Mozafarihashjin Mohammad , Nasir Jalees A. , Shigayeva Altynay , Yim Winfield , Yip Lily , Zhong Xi Zoe , Katz Kevin , Kozak Robert , McArthur Andrew G. , Daneman Nick , Maguire Finlay , McGeer Allison J. , Duvvuri Venkata R. , Mubareka Samira
Published: January 2025

Background

Drivers of COVID-19 severity are multifactorial and include multidimensional and potentially interacting factors encompassing viral determinants and host-related factors (i.e., demographics, pre-existing conditions and/or genetics), thus complicating the prediction of clinical outcomes for different severe acute respiratory syndrome coronavirus (SARS-CoV-2) variants. Although millions of SARS-CoV-2 genomes have been publicly shared in global databases, linkages with detailed clinical data are scarce. Therefore, we aimed to establish a COVID-19 patient dataset with linked clinical and viral genomic data to then examine associations between SARS-CoV-2 genomic signatures and clinical disease phenotypes.

Methods

A cohort of adult patients with laboratory confirmed SARS-CoV-2 from 11 participating healthcare institutions in the Greater Toronto Area (GTA) were recruited from March 2020 to April 2022. Supervised machine learning (ML) models were developed to predict hospitalization using SARS-CoV-2 lineage-specific genomic signatures, patient demographics, symptoms, and pre-existing comorbidities. The relative importance of these features was then evaluated.

Results

Complete clinical data and viral whole genome level information were obtained from 617 patients, 50.4% of whom were hospitalized. Notably, inpatients were older with a mean age of 66.67 years (SD ± 17.64 years), whereas outpatients had a mean age of 44.89 years (SD ± 16.00 years). SHapley Additive exPlanations (SHAP) analyses revealed that underlying vascular disease, underlying pulmonary disease, and fever were the most significant clinical features associated with hospitalization. In models built on the amino acid sequences of functional regions including spike, nucleocapsid, ORF3a, and ORF8 proteins, variants preceding the emergence of variants of concern (VOCs) or pre-VOC variants, were associated with hospitalization.

Conclusions

Viral genomic features have limited utility in predicting hospitalization across SARS-CoV-2 diversity. Combining clinical and viral genomic datasets provides perspective on patient specific and virus-related factors that impact COVID-19 disease severity. Overall, clinical features had greater discriminatory power than viral genomic features in predicting hospitalization.
Addressing racial and ethnic disparities in premature exits from permanent supportive housing among residents with substance use disorders
Authors: Panadero Talia J. , Gabrielian Sonya , Seamans Marissa J. , Gelberg Lillian , Tsai Jack , Harris Taylor
Published: January 2025

Background

Permanent supportive housing (PSH) is an evidence-based practice for reducing homelessness that subsidizes permanent, independent housing and provides case management—including linkages to health services. Substance use disorders (SUDs) are common contributing factors towards premature, unwanted (“negative”) PSH exits; little is known about racial/ethnic differences in negative PSH exits among residents with SUDs. Within the nation’s largest PSH program at the Department of Veterans Affairs (VA), we examined relationships among SUDs and negative PSH exits (for up to five years post-PSH move-in) across racial/ethnic subgroups.

Methods

We used VA administrative data to identify a cohort of homeless-experienced Veterans (HEVs) (n = 2,712) who were housed through VA Greater Los Angeles’ PSH program from 2016–2019. We analyzed negative PSH exits by HEVs with and without SUDs across racial/ethnic subgroups (i.e., African American/Black, Non-Hispanic White, Hispanic/Latino, and Other/Mixed [Asian, American Indian or Alaskan Native, and Native Hawaiian or Other Pacific Islander, and mixed race/ethnicity]) in controlled models and accounting for competing risk of death.

Results

In competing risk models, HEVs with at least one SUD had 1.3 times the hazard of negative PSH exits compared to those without SUDs (95% CI: 1.00, 1.61). When stratifying by race/ethnicity, Other/Mixed race residents with at least one SUD had 6.4 times the hazard of negative PSH exits compared to their peers without SUDs (95% CI: 1.61–25.50). Hispanic/Latino residents with at least one SUD had 1.9 times the hazard compared to those without SUDs; however, this association was not statistically significant (95% CI: 0.85–4.37). African American/Black residents with at least one SUD had 1.2 times the hazard compared to those without SUDs (95% CI: 0.85–1.64), indicating no evidence of an association with negative PSH exits. Non-Hispanic White residents with at least one SUD had 1.1 times the hazard compared to those without SUDs (95% CI: 0.75–1.66), similarly indicating no evidence to suggest an association with negative PSH exits.

Conclusions

These findings suggest relationships between SUDs and negative PSH exits differ between racial/ethnic groups and suggest there may be value in culturally specific tailoring and implementation of SUD services for these subgroups.
Experiences, perceptions and ethical considerations of the malaria infection study in Thailand
Authors: Naemiratch Bhensri , Kulpijit Natinee , Ruangkajorn Supanat , Day Nicholas P. J. , Prachumsri Jetsumon , Cheah Phaik Yeong
Published: January 2025

Background

Thailand has made significant progress in malaria control efforts in the past decade, with a decline in the number of reported cases. However, due to cross-border movements over the past 5 years, reported malaria cases in Thailand have risen. The Malaria Infection Study in Thailand (MIST) involves deliberate infection of healthy volunteers with Plasmodium vivax malaria parasites, and the assessment of the efficacy of potential vaccine and drug candidates in order to understand acquired protection against malaria parasites.

Methods

This paper drew from ethics and social science qualitative study called MIST-ETHICS embedded within the MIST studies. MIST-ETHICS aimed to describe and understand the experiences, perceptions and ethical considerations of the MIST studies. Data were obtained from semi-structured interviews and a focus group discussion. A total of 46 participants participated in MIST-ETHICS .

Results

Three major themes emerged: experiences and perceptions of MIST, reasons for joining MIST, and ethical considerations. We found that although compensation was a motivation for participation, this was secondary to it being beneficial to self (health checks; link to health networks; building merit) and others (medical research contribution; altruism). Participants expressed varied opinions regarding the requirement of a university degree as one of the inclusion criteria for MIST.

Conclusions

Our study revealed widespread concerns about long-term health effects and safety. Ethical considerations, including obtaining valid informed consent and ensuring participant inclusivitiy, were deem essential. Despite some debate regarding eligibility criteria, most participants agreed that the informed consent process was robust, accompanied by a strong sense of responsibility to contribute to the greater good. We emphasize the importance of continuously gathering participants’ feedback for quality control, such as improving information materials to clarify the purpose of initial phases, their contributing to later phases, and the rationale behind each selection criterion.

Trial registration

This manuscript is part of the clinical trials registered under ClinicalTrials.gov IDs NCT04083508 (MIST1) registered on 5 Sep 2019 and NCT05071079 (MIST2) registered on 28 July 2021. However, the manuscript pertains to a qualitative study that does not require trial registration.
Knowledge and attitude of nosocomial infection prevention and control precautions among healthcare personnel at Kiruddu Referral Hospital in Kampala, Uganda
Authors: Ekakoro Newton , Nakayinga Ritah , Kaddumukasa Martha A. , Mbatudde Maria
Published: January 2025

Background

A key concern for global public health is nosocomial infections. Essential to the fight against nosocomial infection, is healthcare professionals’ knowledge and attitudes. Therefore, this study investigated healthcare professionals’ knowledge and attitudes toward nosocomial infection at the Kiruddu Referral Hospital, Kampala, Uganda.

Methods

A facility-based cross-sectional study was carried out at Kiruddu Referral Hospital in Kampala, Uganda. We selected the participants using simple random sampling. Data were collected from a total of 78 healthcare personnel using pretested, structured, self-administered questionnaires. We used SPSS version 20.0 for data analysis and applied descriptive statistics to present the frequencies and percentages. Pearson’s Chi-square test was used to evaluate the association between independent factors and knowledge and attitude (KA) ratings on hospital-acquired infection (HAI) prevention. P-values less than 0.05 were regarded as statistically significant.

Results

Among the different categories of health workers, doctors exhibited the highest level of knowledge. There was a significant association between knowledge scores and occupation (χ2LR = 25.610; P = 0.000). The mean knowledge scores across different infection prevention aspects were as follows: hand hygiene (82.2 ± 18.9), PPE use (71.8 ± 23.1), sharp disposal and sharp injuries (59.2 ± 25.7), and waste management (57.4 ± 29.9). Notably, 20.5% of participants did not change PPE between patients, and 44.9% indicated that their workload negatively impacted their ability to follow infection prevention standards.

Conclusion

The study highlighted gaps in healthcare personnel’s knowledge and attitudes toward infection prevention. It is therefore important to provide regular targeted training programs emphasizing underrepresented areas, PPE availability, strengthen policy enforcement, and integrate infection prevention education into medical and nursing curricula.
Inhibition of NLRP3 enhances pro-apoptotic effects of FLT3 inhibition in AML
Authors: Sieberer Helene , Luciano Michela , Amend Diana , Blöchl Constantin , Eglseer Anna , Steinkellner Alina , Rieser Sebastian , Andosch Ancuela , Steiner Philip , Hummer Laura , Krenn Peter W. , Dang Hieu-Hoa , Huber Christian G. , Aberger Fritz , Neuper Theresa , Horejs-Hoeck Jutta
Published: January 2025

FLT3 mutations occur in approximately 25% of all acute myeloid leukemia (AML) patients. While several FLT3 inhibitors have received FDA approval, their use is currently limited to combination therapies with chemotherapy, as resistance occurs, and efficacy decreases when the inhibitors are used alone. Given the highly heterogeneous nature of AML, there is an urgent need for novel targeted therapies that address the disease from multiple angles. Recent research has identified the NLRP3 inflammasome as a potential new driver in AML. Here, we investigated the efficacy of different NLRP3 inhibitors in targeting AML cells in vitro. Our findings reveal that NLRP3 inhibition induces cell cycle arrest as well as signs of senescence in multiple AML cell lines. In contrast, NLRP3 inhibition selectively induced apoptosis in FLT3 mutant AML cell lines, but not in FLT3 wild-type AML cells. Moreover, we show that NLRP3 inhibition impairs FLT3 signaling by reducing both FLT3 expression as well as downstream signaling in FLT3 mutant cells. A database analysis revealed a strong positive correlation between FLT3 and NLRP3 in cancer, which was particularly evident in AML patients. Strikingly, the simultaneous inhibition of NLRP3 and FLT3 markedly enhanced apoptosis in FLT3-ITD mutant AML cells, but not in FLT3 wild-type cells. In summary, this study reveals a promising combined therapeutic strategy specifically targeting NLRP3/FLT3-ITD positive AML blasts in vitro, highlighting a potential new avenue for AML treatment.
Gastrointestinal complications of hepatic glycogen storage disease: a national survey questionnaire study in China
Authors: Zhang Xiaoyan , Su Zexiong , Wu Jiaxing , Zeng Hanshi , Jiang Xun , Wang Ying , Shen Huiqing , Xie Xiaoli , Xiao Yuan , Tang Qing , Luo Xiaoping , Zhong Xuemei , Chen Huan , Lan Jiaoli , Chen Yongxin , Zeng Xiaolu , Zhang Huiqiong , Li Zhiling , Zhang Yuxin , Yang Min
Published: January 2025

Background

Hepatic glycogen storage diseases (GSD) are inborn errors of metabolism with abnormal storage or utilization of glycogen, a complex disease with significant genetic heterogeneity and similar clinical manifestations. This study aimed to describe the gastrointestinal symptoms and endoscopic features of hepatic GSD, including types Ia, Ib, III, VI, and IX, to provide evidence for etiology and treatment.

Methods

A national cohort survey questionnaire was distributed to patients diagnosed with GSD type Ia, Ib, III, VI, and IX through genetic testing or their parents in mainland China in May 2022. Expert gastroendoscopists performed endoscopic examinations and evaluations in 10 hospitals. Descriptive statistics were used for analysis.

Results

A total of 315 patients with hepatic GSD were included in the study, including 191 males and 124 females, the median age at diagnosis was 1.42 years (range = 0.08–36.08 years), with a median age of 5.42 years at the time of investigation (range = 0.58–38.08 years). 95% of patients relied on uncooked corn starch (UCCS) for blood glucose maintenance, and the median age of initiation was 18.5 months (range = 4-360 months). The common characteristics of these GSDs were hypoglycemia, lactic acidosis, anemia, liver enlargement, hyperlipidemia, hyperuricemia, and weakness. More than 60% of patients reported gastrointestinal symptom including anorexia, nausea/vomiting, abdominal pain, abdominal bloating, diarrhea, and mucus or bloody stool. The incidence of gastrointestinal symptoms in patients with GSD type Ia, Ib, III, VI and IX were 68%, 68%, 48%, 59% and 48%, respectively. A total of 48 GSD patients underwent gastroenteroscopy, 54% (26/48, 24 patients with type Ib, 1 patient with type Ia and 1 with III) were diagnosed with GSD-associated inflammatory bowel disease (IBD), the endoscopic images showed mucosal edema, erythema, erosions, single or scattered multiple large, deep, round ulcers and strictures, without linear ulcers and cobblestone mucosal lesions.

Conclusion

Patients with GSD type Ia, Ib, III, VI and IX had different degrees of gastrointestinal complications, among which patients with type Ia, Ib and III were the most prominent, and the proportion of GSD-Ib patients had a higher proportion of GSD-associated IBD.
Improving Earthquake Location Resolution through Dynamic Time Warping-Based Cross-correlation
Authors: Guo Xuebao , Yu Youqiang , Sun Muchen
Published: January 2025

Cross-correlation methods for seismic event location utilize the differential travel time of the signals presented in the cross-correlation records for positioning, eliminating the necessity for scanning the earthquake occurrence time, thereby ensuring efficient calculation of event locations. The finite-frequency characteristics of the signal can cause a decrease in the time resolution of the correlation recordings, resulting in a decrease in the spatial resolution of the location. Exploration of various combinations of station pairs, often referred to as imaging conditions, have been commonly employed to enhance the positioning resolution. Instead of modifying the imaging conditions, we developed a dynamic time warping-based cross-correlation method aimed at enhancing the time resolution of the cross-correlation records. This innovative approach utilizes the Pearson correlation coefficient as a distance metric to conduct a global search to obtain time shifts for different seismic signals, providing an optimal correlation coefficient. The proposed workflow enables the transformation of the differential time and the Pearson correlation coefficients into high-resolution cross-correlation records. It not only enhances the time resolution of individual seismic event cross-correlation records but also captures the time differences of distinct signals across multiple events. Simulations show that the proposed method markedly improves both the time resolution of cross-correlation records and the spatial resolution of locations, effectively handling multievent locations with varying magnitudes. A case study reveals that the new method is effective in handling complex waveforms from regional seismic networks and serves as a significant improvement in the precision of seismic event location.
The effect of freezing temperature on the attenuation characteristics of stress waves in water-saturated granite in freezing environments
Authors: Wang Zhiqiang , Yang Qihao , Li Guangyao , Fan Lifeng , Du Xiuli
Published: January 2025

The investigation of stress wave propagation in frozen rock masses is of great significance for dynamic stability analysis of rock masses in cold regions. This paper investigates the attenuation of stress waves in water-saturated granite with different freezing temperatures. The water-saturated granite was frozen at different temperatures (−2°C, −10°C, −20°C, −30°C) and then impacted with different pendulum angles at those temperatures. The amplitude attenuation ratio, wave velocity and spectrum of stress waves in frozen granite were investigated. The effects of freezing temperature on the propagation coefficients (attenuation coefficient and wave number) and phase velocity of stress waves were investigated. Furthermore, the effects of the pendulum angle on the amplitude attenuation ratio, wave velocity, propagation coefficient and phase velocity at different freezing temperatures were discussed. The results show that the amplitude attenuation ratio of stress waves decreases as the temperature decreases. The wave velocity increases as the temperature decreases. The Fourier amplitudes of both the incident wave and the reflected wave decrease as the temperature decreases. The attenuation coefficient and wave number decrease sharply and then decrease slightly as the temperature decreases. The phase velocity increases as the temperature decreases. The amplitude attenuation ratio, wave velocity, phase velocity and propagation coefficients approximately keep constant under different pendulum angles. The present investigation can be applied to predict the amplitude attenuation and energy dissipation of stress waves within rock masses in freezing environments.
Evaluating Computerised Assessment of Motor Imitation (CAMI) for identifying autism-specific difficulties not observed for attention-deficit hyperactivity disorder or neurotypical development
Authors: Santra Romila , Pacheco Carolina , Crocetti Deana , Vidal René , Mostofsky Stewart H. , Tunçgenç Bahar
Published: January 2025

Background

Reliable and specific biomarkers that can distinguish autism spectrum disorders (ASDs) from commonly co-occurring attention-deficit/hyperactivity disorder (ADHD) are lacking, causing misses and delays in diagnosis, and reducing access to interventions and quality of life.

Aims

To examine whether an innovative, brief (1-min), videogame method called Computerised Assessment of Motor Imitation (CAMI), can identify ASD-specific imitation differences compared with neurotypical children and children with ADHD.

Method

This cross-sectional study used CAMI alongside standardised parent-report (Social Responsiveness Scale, Second Edition) and observational measures of autism (Autism Diagnostic Observation Schedule-Second Edition; ADOS-2), ADHD (Conners) and motor ability (Physical and Neurological Examination for Soft Signs). The sample comprised 183 children aged 7–13 years, with ADHD (without ASD), with ASD (with and without ADHD) and who were neurotypical.

Results

Regardless of co-occurring ADHD, children with ASD showed poorer CAMI performance than neurotypical children (P < 0.0001; adjusted R2 = 0.28), whereas children with ADHD and neurotypical children showed similar CAMI performance. Receiver operating curve and support vector machine analyses showed that CAMI distinguishes ASD from both neurotypical children (80% true positive rate) and children with ADHD (70% true positive rate), with a high success rate significantly above chance. Among children with ASD, poor CAMI performance was associated with increased autism traits, particularly ADOS-2 measures of social affect and restricted and repetitive behaviours (adjusted R2 = 0.23), but not with ADHD traits or motor ability.

Conclusions

Four levels of analyses confirm that poor imitation measured by the low-cost and scalable CAMI method specifically distinguishes ASD not only from neurotypical development, but also from commonly co-occurring ADHD.
Coding Variants of the Genitourinary Development Gene
WNT9B
Carry High Risk for Prostate Cancer
Authors: Dupont William D. , Jones Angela L. ,   VA Million Veteran Program, Smith Jeffrey R.
Published: January 2025

PURPOSE

Considerable genetic heterogeneity is currently thought to underlie hereditary prostate cancer (HPC). Most families meeting criteria for HPC cannot be attributed to currently known pathogenic variants.

METHODS

To discover pathogenic variants predisposing to prostate cancer, we conducted a familial case-control association study using both genome-wide single-allele and identity-by-descent analytic approaches. Sequence of high-risk haplotype carriers was used for variant detection. Candidate pathogenic variants were tested for association with prostate cancer across independent biobanks for replication of observations.

RESULTS

Pathogenic variants within
WNT9B
were associated with familial prostate cancer and observations replicated within four of four independent biobanks.
WNT9B
E152K carried 2.5-fold risk and reached genome-wide significance under meta-analysis, collectively encompassing a half million patients.
WNT9B
Q47R was also associated with prostate cancer with genome-wide significance among Finns, for which identity-by-descent analyses confirmed a founder effect.
WNT9B
shares an unexpected commonality with the previously established prostate cancer risk genes
HOXB13
and
HNF1B
: they are each required for embryonic prostate development. With this recognition, we further evaluated two additional genes known to cause Mendelian genitourinary developmental defects,
KMT2D
and
DHCR7
. These too were nominally associated with prostate cancer under meta-analyses.

CONCLUSION

WNT9B
and additional genes that are required for early genitourinary development are also involved in the later development of prostate cancer.
Glucose Metabolic Abnormalities and Their Interaction With Defective Phosphate Homeostasis in Tumor-induced Osteomalacia
Authors: Zhou RuoTong , Jiajue Ruizhi , Ni Xiaolin , Pang Qianqian , Chi Yue , Jiang Yan , Wang Ou , Li Mei , Xing Xiaoping , Cui Lijia , Li Xiang , Liu Yong , Wu Huanwen , Jin Jin , Lv Wei , Xia Yu , Huo Li , Zhou Lian , Yu Wei , Meng XunWu , Xia Weibo
Published: January 2025

Context

Phosphate homeostasis was compromised in tumor-induced osteomalacia (TIO) due to increased fibroblast growth factor 23 (FGF23) secretion. Nevertheless, the glucose metabolic profile in TIO patients has not been investigated.

Objectives

This work aimed to clarify the glucose metabolic profiles in TIO patients and explore their interaction with impaired phosphate homeostasis.

Methods

20 TIO patients, 20 individuals with normal glucose tolerance, and 20 patients with type 2 diabetes mellitus (DM) were enrolled and underwent an oral glucose tolerance test (OGTT). Serum phosphate and FGF23 concentration were monitored during OGTT.

Results

In patients with TIO, 60% (12/20) exhibited impaired glucose tolerance (IGT) and 5% (1/20) had type 2 DM. Those with IGT or type 2 DM experienced more ambulatory difficulties (69.2% vs 42.9%), lower phosphate concentrations (0.43 ± 0.10 vs 0.53 ± 0.10, P = .042), and lower calcium concentrations (2.20 ± 0.08 vs 2.30 ± 0.40, P = .001) compared to TIO patients without these conditions. According to correlation analysis, serum phosphate levels were negatively correlated with plasma glucose levels at 60 minutes (P < .001), fasting plasma insulin levels (P < .05), and homeostasis model assessment for insulin resistance (P < .05). Those with high FGF23 levels had a higher glucose level at 60 minutes (10.5 [9.3, 12.3] vs 7.3 [6.4, 10.1], P = .048) than that of low group. After glucose loading, both FGF23 and phosphate levels exhibited a decreasing trend.

Conclusion

The development of diabetes in TIO patients may be predisposed by ambulatory issues, low phosphate, and elevated FGF23 levels. Dysglycemia might further aggravate hypophosphatemia.
Diagnostic Value of 11C-Methionine PET-CT Imaging in Persistent or Recurrent Cushing Disease After Surgery
Authors: Furnica Raluca Maria , Devuyst France , Mathey Céline , Constantinescu Stefan Matei , De Herdt Carlien , Alexopoulou Orsalia , Lhommel Renaud , Maiter Dominique
Published: January 2025

Context

Equivocal or negative pituitary magnetic resonance imaging (MRI) findings pose a significant challenge in the management of persistent or recurrent Cushing disease (CD), compromising the chances of success of further transsphenoidal surgery (TSS).

Objective

To determine the diagnostic utility of 11C-methionine (11C-MET) positron emission tomography/computerized tomography (PET/CT) in localizing residual or relapsing corticotroph adenoma.

Methods

We retrospectively analyzed the results of all 11C-MET PET/CT performed at 2 tertiary medical centers between May 2002 and November 2023 in 22 patients with persistent/recurrent CD after initial TSS and equivocal/negative pituitary MRI. In 15 cases, 11C-MET PET/CT images were also co-registered with high-resolution 3D T1 or FLAIR MRI pituitary imaging.

Results

Of 22 patients (18 female; mean age 36 years at diagnosis; mean initial tumor maximum diameter 6.5 mm), 13 had a suspect anomaly on conventional MRI and 9 had a negative MRI. Maximal metabolic activity in the suspect area (SUVmaxT) was found in 14 patients (63.5%; 5/9 patients with negative pituitary MRI and 9/13 with equivocal findings). Based on positive imaging, 12 patients underwent repeat TSS, successful in 7, while 2 patients underwent Gamma Knife radiosurgery (GKRS), both resulting in remission (total remission rate of 64%). Among the 5 patients not cured by TSS, the presence of corticotroph adenoma in the resected tissue was found in 3 cases. Positive 11C-MET PET/CT had a detection rate accuracy of 86% (12/14). Of the 8 PET-negative patients, 2 underwent exploratory TSS, with no remission, and 2 underwent GKRS, with 1 long-term remission.

Conclusion

11C-MET PET/CT imaging can provide valuable diagnostic information to detect a corticotroph microadenoma in more than half of patients with persistent/recurrent CD and equivocal or negative MRI findings, allowing targeted TSS or radiosurgery with a global success rate of 64% in the selected subgroup with positive imaging.
Gestational trophoblastic disease: understanding the molecular mechanisms of placental tumours
Authors: Nicheperovich Alina , Schuster-Böckler Benjamin , Ní Leathlobhair Máire
Published: January 2025

Gestational trophoblastic disease (GTD) describes a group of rare benign and cancerous lesions originating from the trophoblast cells of the placenta. These neoplasms are unconventional entities, being one of the few instances in which cancer develops from the cells of another organism, the foetus. Although this condition was first described over 100 years ago, the specific genetic and non-genetic drivers of this disease remain unknown to this day. However, recent findings have provided valuable insights into the potential mechanisms underlying this rare condition. Unlike previous reviews focused primarily on the clinical and diagnostic aspects of disease development, this Review consolidates the latest research concerning the role of genetics, epigenetics and microRNAs in the initiation and progression of GTD. By examining GTD from a molecular perspective, this Review provides a unique framework for understanding the pathogenesis and progression of this rare disease.
The long-term effect of childhood trauma and alexithymia on mental distress during the COVID-19 pandemic in Greece
Authors: Anagnostopoulou Tanya , Kalaitzaki Argyroula , Tsouvelas George , Tamiolaki Alexandra
Published: January 2025

The study investigated the effect of childhood trauma, alexithymia, and other psychological risk and resilience factors on peripandemic mental distress in Greece. Alexithymia was hypothesized to mediate the association between early trauma and COVID-19-related anxiety and depression. A sample of 557 adults was recruited through a web-based study and self-reported questionnaires of childhood trauma, emotional regulation, psychological attributes, depression, and anxiety were collected. Statistical analyses included hierarchical multiple regressions and structural equation modeling. Childhood emotional abuse was associated with higher levels of anxiety and depression and this association was partially mediated by the difficulty to identify feelings. In addition, psychological attributes indicating resilience or vulnerability were associated with higher or lower levels of mental distress, respectively. Pandemic factors were not significant. This research highlights the long-term effects of early trauma and alexithymia compromising mental health during a global health threat, such as COVID-19, and points to the significance of emotion regulation in public health prevention and intervention programs.
Preschool teachers’ views about preschool death education: The role of perceived self-efficacy, perceived competence and death experiences
Authors: Brouskeli Vasiliki , Piperkou Ioanna- Konstantina
Published: January 2025

Preschool educators’ views about preschool death education is researched in this paper. Specifically, we examined preschool educators’ personal perspectives on providing death education in relation to: a) their intra-personal characteristics, such as perceived self-efficacy and perceived professional competence to provide this kind of education, and b) their death experiences in the school environment. The sample consisted of 164 preschool teachers in Greek public schools. Perceived self-efficacy was found to be related to teachers’ perceived competence in dealing with death issues. However, no significant relationship was found between self-efficacy and teachers’ actual dealing with the topic. Death experiences in the school environment were found to relate positively to teachers’ perceived competence in providing death education. However, no significant relationship was found between these experiences and the level of dealing with the topic. The results indicate that preschool teachers realize the need for death education. However, this is difficult to become actual behavior,  since they lack proper preparation. Educators need not only theoretical knowledge but a holistic preparation program that would ensure that they will be able to stand in front of preschoolers with sufficient knowledge, continuous training, increased self-efficacy, and perceived competence in order to be able to provide developmentally appropriate education.
Spoken sexism as a threat to women’s well-being
Authors: Flouli Anastasia , Athanasiades Christina
Published: January 2025

While the consequences of gender-based violence on women’s mental health are well documented, the impact of everyday sexist comments on their psychological well-being is still understudied. For this reason, the present paper aims to explore how women discursively construct spoken sexism as a threat to their well-being, drawing upon a feminist discourse, while sculpting for themselves a subject position of oppression. The study was qualitative in nature and thirty women took part voluntarily in individual semi-structured interviews. Post-structuralism was adopted as an epistemological perspective while a Foucauldian discourse analysis (FDA) was employed for the analyses of the material. At the same time, a feminist viewpoint was upheld throughout the entire research due to its gendered nature, given that spoken sexism is discursively constructed within patriarchal power structures. In their discourse, the participants constructed sexist comments as restrictive and threatening to their mental health while experiencing them as oppressive and abusive.
Parental intentions to vaccinate their daughters for HPV. A cross-sectional nationwide study in Greece using the COM-B model
Authors: Efkarpidis Apostolos , Koulierakis George , Papastilianou Anastasia
Published: January 2025

Human papillomavirus (HPV) infection is a common sexually transmitted disease in men and women worldwide. It accounts for the appearance of benign papillomatous or precancerous lesions, which sometimes can be evolved into cancer, especially in the anogenital area. For prevention, a vaccine is available worldwide including Greece, for girls and boys aged 9-18 years. The responsibility for the vaccination usually lies with parents/guardians. This study aimed to measure parental intention to vaccinate their daughters against HPV and identify the determinants that affect it. From September 2021 to March 2022, a cross-sectional nationwide study was carried out among a representative sample of students, and through them their parents/guardians, using multistage stratified sampling. 46 schools in the territory participated, with a representative sample of 3,203 parents/guardians of female students aged 11-18 years, who completed an anonymous questionnaire created based on the Capability, Opportunity, Motivation - Behavior (COM-B) and Theoretical Domain Framework (TDF) models. 905 parents out of the 1358 who hadn’t vaccinated their daughters (66.6%) mentioned that they intended to do so or complete vaccination. Knowledge about the vaccine (p < .001), fear of possible side effects (p < .001), relief that serious diseases could be avoided (p <.001), expert influence (p < .001), and reminders through email (p = .048) were the significant determinates of parents' intention to vaccinate their daughters. The interconnected COM-B and TDF models are suitable frameworks for targeted interventions to foster HPV vaccination.
Turning challenge to opportunity: Clinical psychology investigations into contemporary mental health needs and care
Authors: Georgaca Eugenie
Published: January 2025

This special issue showcases clinical psychological research into contemporary mental health needs and mental health care, with important implications for understanding the impact of contemporary global macro-phenomena on mental health and consequently developing appropriate and effective mental health care and support. Parpoula & Anagnostopoulos investigate trends in Google searches for mental health professionals and treatments over the last 20 years, aiming to identify the impact of the economic crisis and the Covid-19 pandemic on help-seeking for mental health concerns in Greece. This type of research can inform the development of digital content regarding mental health problems and appropriate treatment and support options. Yotsidi and colleagues investigate systemic therapists’ views and experiences of the enforced transition from face-to-face to online therapy during the pandemic. The erosion of the boundaries of the professional therapeutic space during online therapy alters the therapeutic relationship, affecting differentially clients and therapists. Apostolidou et al investigate the associations between intimate partner violence and other risk factors in women visiting community sexually transmitted infections’ prevention and testing centres. The study highlights the potential of intersectional research, that addresses the cumulative adverse effects of several types of vulnerabilities, highlighting the need for appropriate mental health services. It is also a good example of user-led research. All three papers attempt to turn the challenges posed by contemporary global changes to opportunities for developing new ways of understanding and addressing mental health issues, pointing the way for more research in this direction.
Fundamentals of the philosophy of law
Authors: Chernyavsky Alexander
Published: January 2025

The monograph highlights the historical development of the philosophy of law in its most striking and perfect directions. A comparative analysis of the systems of philosophy, which are fundamentally different and negate each other, with the philosophical system of G. Cohen is carried out. It is argued that the fundamental dispute about the sources of knowledge (sensory experience, the mind of intuition) has not yet been resolved, respectively, the dispute of worldviews (materialism, idealism, mysticism), which allows us to state the fact that in the modern state of philosophy there are new variations of the same basic types of philosophical thought. This fact, according to the author, significantly influences the development of the correct direction of the scientific vector of the philosophy of law, respectively, the theory of state and law, and most importantly, that philosophy and theory should move at least in step with the times, and not lag behind and catch up.
It is intended for scientists and specialists, graduate students and law students interested in the philosophy of law.
A Review of the Health Impact of Nicotine Pouches
Authors: Chmiel Radosław , Michałka Daria , Papachristoforou Natalie , Gałuszka Zuzanna , Makar Monika , Bartuś Tomasz , Tekiela Natalia , Bąk Emilia , Głowacka Justyna , Kocjan Aleksandra
Published: January 2025

Introduction and Purpose of Research
Nicotine pouches, popular especially among young people, are smokeless alternatives to traditional tobacco. Placed in the mouth, they release nicotine absorbed through the mucosa, reducing withdrawal symptoms and avoiding harmful tobacco smoke. Often used for smoking cessation, they are considered lower-risk than smoking and may help reduce smoking rates. The aim of this review is to summarize the current knowledge on the impact of nicotine pouches on overall human health.
 
Review Methods
The review is based on 39 articles found in PubMed databases published between 2006–2024. 
Conclusion
While nicotine pouches and snus are marketed as lower-risk alternatives to smoking, their health implications are still significant. These products, popular among young adults and athletes, may help with smoking cessation but carry risks, particularly with long-term use. Research suggests nicotine pouches and snus may have no performance-enhancing effects in sports and could impair physical performance, including endurance and strength. Moreover, their use is linked to various health concerns such as cardiovascular issues, type 2 diabetes, oral mucosal changes, and decreased sperm count. Snus has been associated with a modest increase in cardiovascular disease risk, although the risks are lower than smoking. Additionally, smokeless tobacco use is linked to an increased risk of oral squamous cell carcinoma, especially in women. The use of snus during pregnancy has also been linked to higher risks of post-neonatal mortality and other adverse outcomes. Despite these findings, there is a need for more extensive, well-controlled studies to fully understand the long-term health effects of smokeless tobacco products and their role in public health.
Exploring the Therapeutic Role of Physical Activity in Psychotic Disorders: Cognitive, Somatic, and Mental Health Impacts
Authors: Fikas Klaudia , Chwaliszewski Kamil , Waz Dorota , Mazur Michał , Szarłowicz Jakub , Goliszek Zofia , Sobek Karolina Łucja , Tabin-Barczak Wiktoria , Sokołowska Aldona , Samuła Sebastian
Published: January 2025

Introduction and Purpose:
Psychotic disorders, such as schizophrenia, significantly affect both physical and mental health, often leading to a reduced quality of life. These conditions are commonly associated with somatic symptoms, fatigue, and impaired psychosocial functioning. This review aims to explore the impact of physical activity on psychotic disorders, focusing on its effects on somatic symptoms, fatigue, and overall well-being, while examining the underlying mechanisms and its potential as an adjunctive therapy.
Material and Methods:
This systematic review was based on a comprehensive search of peer-reviewed literature in PubMed, covering studies published between 2020 and 2024. Studies eligible for inclusion were observational research, clinical trials, and meta-analyses that examined the role of physical activity in alleviating somatic symptoms, reducing fatigue, and improving overall well-being in individuals with psychotic disorders.
Results:
The literature review indicates that physical activity has the potential to improve somatic symptoms, reduce fatigue, and enhance overall well-being in individuals with psychotic disorders. Exercise interventions, particularly aerobic and resistance training, seem to benefit both positive and negative symptoms of psychosis, with notable improvements in cognitive function. Further research is necessary to determine the optimal exercise parameters.
Conclusions:
This review underscores the significant therapeutic potential of physical activity in alleviating somatic symptoms and improving the overall quality of life in individuals with psychotic disorders. Studies should investigate the neurobiological mechanisms behind the beneficial effects of physical activity in psychosis, such as stress responses and neuroplasticity. Integrating physical activity into standard treatment regimens could significantly improve patient outcomes in this population.
The Effect of Physical Activity on Alzheimer’s Disease - Systematic Review
Authors: Lachowska Julia , Senior Karolina , Smandek Jerzy , Mielczarek Maja , Sroczyńska Paulina , Sroczyński Jan
Published: January 2025

Dementia, particularly Alzheimer's disease (AD), is a growing global health concern, with an estimated 50 million people affected worldwide. The prevalence of AD is projected to increase significantly with aging populations. Despite the absence of a cure, early intervention during the prodromal phase can slow the progression of AD, highlighting the importance of identifying modifiable risk and protective factors. Physical inactivity is one of the leading modifiable risk factors, contributing to approximately 40% of dementia cases. This review explores the role of physical exercise, particularly resistance training (RET), aerobic exercises, and dance movement interventions (DMI), as therapeutic approaches for AD prevention and treatment. Evidence suggests that regular physical activity enhances cognitive function, reduces neuroinflammation, improves brain structure, and supports neuroplasticity. Both RET and aerobic exercise have been shown to delay the onset of cognitive decline, with RET also reducing amyloid plaque formation and promoting neuroprotection. DMI further benefits individuals with AD by improving cognitive function, mood regulation, social interaction, and physical coordination. Additionally, the review examines the relationship between obesity and AD. Although obesity is traditionally seen as a risk factor for cognitive decline, recent studies suggest that obesity in late life may have protective effects, potentially due to factors like lower amyloid-beta levels and larger hippocampal volume. This review emphasizes the importance of physical exercise and its potential to mitigate cognitive decline and improve quality of life in individuals at risk of or living with Alzheimer’s disease.
Desafíos del feminismo español y marfileño: una mirada en torno a Luciérnagas de Ana María Matute y Rebelle de Fatou Keita.
Authors: Syntor Konan Koffi
Published: January 2025

El estatuto de la mujer en las sociedades
tradicionales en el transcurso de la historia, en
todos los continentes parece igual o análogo,
aunque en periodos diferentes. En efecto,
anteriormente postergadas en el espacio
doméstico, las mujeres vienen reivindicando
su participación plena en la vida de su
comunidad irguiéndose contra el patriarcado
y el dictado machista. En este artículo que
evidencia las realidades sociales del siglo XX
en España y Costa de Marfil por el canal de
un corpus constituido de Luciérnagas de Ana
María Matute y Rebelle de Fatou Keita, nos
proponemos sacar las reivindicaciones de
las mujeres inconformistas por medio de la
escritura como arma de lucha y de protesta.
De lo cual, haremos primero un análisis
estilístico como herramientas de lucha y
después por medio de un estudio sociológico,
analizaremos la evolución de la condición de
la mujer en ambas sociedades con el paso del
tiempo, aunque sea en épocas diferentes por
las posturas de las escritoras activistas.
Crear y trascender. Magarita de Cantelmo y el mecenazgo.
Authors: Ramírez Almazán María Dolores , Vargas Martínez Ana
Published: January 2025

Son muchas las mujeres que encontramos
en la historia de Europa que han ejercido de
mecenas de las letras y las artes, de espacios
religiosos, educativos, culturales y políticos.
El mecenazgo es una labor que se perpetúa a lo
largo de los siglos y desempeñará una función
fundamental entre figuras femeninas de la
aristocracia y la alta burguesía. El mecenazgo
era, además, un modo de intervenir en la
sociedad, de perpetuar la propia memoria;
es decir: un modo de “crear para trascender”.
Tal es el caso de la noble italiana Margarita
Cantelmo (1474-1532). En esta comunicación
nos proponemos ahondar en el conjunto de
su figura y, más en concreto, en su labor como
mecenas, tanto de espacios religiosos como
de obras por la igualdad de los sexos en el
contexto de la Querella de las Mujeres