bluuebunny/crossref_metadata_2025 huggingface dataset:
Pulmonary thromboembolism masquerading as bronchial asthma in a remote medical setup at extreme high altitude
Authors: Singh Arashdeep , Ramamurthy Ravi H , Goyal Rahul , Rajpal Drishti
Published: December 2024

Pulmonary thromboembolism (PTE) is a life-threatening illness. It is a great masquerader that mimics many respiratory illnesses, warranting a high index of suspicion for diagnosis. It should be suspected when respiratory illnesses do not respond to the expected course of treatment. At this point, additional imaging modalities such as echocardiography and CT scans can assist with the diagnosis; however, these facilities are usually not available in remote medical setups such as mountainous regions in the Himalayas. The definitive diagnosis is delayed until the patient is brought down to a well-equipped hospital at a lower altitude. Making an early provisional diagnosis is hence crucial for timely evacuation and optimal first-line management to circumvent associated morbidity and mortality.

We present a case of PTE in a remote medical establishment whose initial evaluation pointed towards an episode of severe asthma. The poor response to standard management prompted us to undertake bedside echocardiography to diagnose features of PTE.
Refractive result after clear lens extraction in posterior microphthalmos with high hyperopia
Authors: Thanathanee Onsiri , Navapathanapong Patharika , Anutarapongpan Orapin , Suwan-apichon Olan
Published: December 2024

A man in his early 20s was referred for refractive surgery evaluation. His best corrected distance visual acuity was 20/60 in both eyes. Preoperative manifest refraction was +13.00 sphere with a 0.75 cylinder in both eyes. Posterior segment examination revealed bilateral pseudopapilloedema with a papillomacular retinal fold and a chorioretinal fold. Numerous formulas for intraocular lens (IOL) power were calculated. Bilateral clear lens extraction was performed, resulting in residual spherical equivalents of +4.50 in the right eye and +3.375 in the left eye. There was no accurate IOL power formula for posterior microphthalmos with extremely high hyperopia; however, the Hoffer Q formula may yield the least error in IOL power.
Isolated cisternal third cranial nerve schwannoma: an insight into a clinico-radiological features
Authors: Parida Shrutakirty , Sachdeva Virender , Warkad Vivekanand Uttamrao
Published: December 2024

A young adult female in her 20s presented with gradually progressive exodeviation of the left eyeball from the last 3 years. She had mild ptosis and proptosis in her left eye with 3 mm of anisocoria. On examination, she was found to have 60 prism dioptres exotropia with minimal motility limitation (−1 adduction, elevation and depression) in the left eye. With a provisional diagnosis of acquired third nerve palsy, she underwent MRI brain and orbit with contrast, which showed enhancing nodular lesion along the course of the left oculomotor nerve in the prepontine cistern which was hyperintense on T1 post-contrast and hypointense on T2/3D Fast Imaging Employing Steady-state Acquisition-weighted images at interpeduncular cistern suggestive of a schwannoma. This led to the final diagnosis of acquired third nerve palsy in the setting of oculomotor schwannoma. The patient opted for observation in view of the small size, isolated and slowly progressive nature of the tumour.
Integrating accelerometry, GPS, GIS and molecular data to investigate mechanistic pathways of the urban environmental exposome and cognitive outcomes in older adults: a longitudinal study protocol
Authors: Hunter Ruth F , Cleland Claire , Trott Mike , O’Neill Sean , Küçükali Hüseyin , Mullineaux Shay , Kee Frank , McKinley Jennifer M , Neville Charlotte , O'Hara Leeanne , Marr Calum , McAlinden Michael , Ellis Geraint , McKnight Amy , Schipperijn Jasper , McHugh Power Joanna , Duong Trung , McGuinness Bernadette
Published: December 2024

Introduction

Maintaining cognitive health in later life is a global priority. Encouraging individuals to make health behaviour changes, such as regular physical activity, and providing supportive urban environments can help maintain cognitive health, thereby preventing or delaying the progress of dementia and cognitive decline. However, the mechanistic pathways by which the urban environmental exposome influences cognitive health outcomes are poorly understood. The aim of this study is to use granular measures of the urban environment exposome (encompassing the built, natural and social environment) and physical activity to explore how these interact with a person’s biology to ultimately influence cognitive health outcomes.

Methods and analysis

This ongoing study uses a cohort design, recruiting participants from the Northern Ireland Cohort for the Longitudinal study of Ageing and the Harmonised Cognitive Assessment Protocol study. Participants (n=400 at each wave) will be aged ≥65 years and have the capacity to provide written informed consent. Measures include device-measured physical activity (Actigraph wGT3XP-BT), environmental location data (Global Positioning System, Qstarz BT-Q1000XT), linked to a battery of neuropsychological tests, including the Mini Mental State Examination and the Centre for Epidemiological Studies Depression Scale. Blood-derived biochemical, genetic and epigenetic data will be included in multimodal analyses. These data will be integrated with urban environment Geographic Information System data and analysed using causal inference and mediation methods to investigate plausible mechanistic pathways.

Ethics and dissemination

This study has been approved by the Queen’s University Belfast, Faculty of Medicine, Health and Life Sciences Research Ethics Committee (MHLS 21_72). Alongside peer-reviewed publications in high-ranking international journals, dissemination activities include conference presentations, project videos, working papers, policy briefing papers, newsletters, summaries and case study stories.
Trends in disease characteristics and premature mortality among hospitalised middle-aged patients in Anhui Southern Area, China, between 2011 and 2020: a cross-sectional study
Authors: Yuanying Yao , Lei Chen , Ma Lijuan
Published: December 2024

Objectives

We aimed to explore the characteristics of age, disease and premature mortality among middle-aged inpatients.

Design

Cross-sectional.

Setting

Data were gathered from the electronic medical records system of the hospitals between 2011 and 2020: a regional study.

Participants

A total of 151 320 patients, aged 45–59 years, underwent hospitalisation.

Primary outcome measures

We analysed the characteristics of age and disease using the database from the electronic medical record system. Moreover, a binary logistic regression model was adopted to investigate the risk factors for premature mortality.

Results

We identified 151 320 eligible inpatients, 53.0% of whom were female. The proportion of middle-aged inpatients increased alarmingly over a decade from 6.4% in 2011 to 28.3% in 2020. The incidence rate of inpatients aged 45 to 50 years increased perpendicularly, with its peak observed at the age of 50. The prevalence tended to decrease after the age of 50; however, it increased at the age of 59. Overall, cancer had the highest incidence rate (22.7%), followed by accidental injury, digestive system disease, cardiovascular disease and cerebrovascular disease (9.0%, 7.9%, 6.3% and 4.5%, respectively). The overall mortality among the middle-aged inpatients was 0.5%. Logistic regression analysis showed that sex, marital status and comorbidity were the factors contributing to mortality in hospitalised patients, with male, divorced and more than two comorbidities being risk factors for death.

Conclusions

A rising trend in the number of middle-aged inpatients was observed during the study period. The number of hospitalisations reaches its peak at the age of 50. Being male, divorced and having more than two comorbidities are risk factors for premature mortality. So prevention, early detection and appropriate treatment of comorbidities are beneficial in improving health and reducing mortality.
Mother–newborn couplet care and the expectations, concerns and educational needs of healthcare professionals: a qualitative study
Authors: Larsen Joan Neergaard , Navne Laura Emdal , Hansson Helena , Maastrup Ragnhild , Poorisrisak Porntiva , Sørensen Jette Led , Broberg Lotte
Published: December 2024

Objectives

Our aim was to explore healthcare professionals’ (HCPs) expectations, concerns and educational needs regarding preparing for implementing the concept of couplet care, keeping newborns in need of intensive care together with their mothers in need of obstetrical care.

Design

A qualitative focus group study based on semistructured interviews. We analysed the data using reflexive thematic analysis. This study is part of a comprehensive research project and pre-implementation based on curriculum development principles and implementation theory.

Setting

We conducted four focus group interviews from May to June 2023 at a tertiary referral university hospital in Denmark.

Participants

Neonatologists, obstetricians, midwives and nurses (n=21) were recruited from neonatal and obstetric departments. Inclusion criteria: Neonatologists, obstetricians, midwives and nurses with various levels of postgraduate experience.

Results

We identified the overarching theme of building bridges in relation to HCPs’ expectations, concerns and educational needs and five subthemes: Enhancing meaningfulness through increased teamwork; compromising or improving patient safety; challenging professional comfort zones; encountering other cultural and ethical values; and recognising educational requirements.

Conclusions

HCPs widely support mother–newborn couplet care and emphasise the need for closer collaboration between neonatal and obstetric departments. Implementing couplet care is seen as meaningful, potentially enhancing the well-being of mothers and newborns and positively impacting HCPs’ job satisfaction. Key concerns include patient safety, quality of treatment and care and the well-being of HCPs navigating their skills, psychological safety and professional boundaries. While the importance of couplet care for early closeness and connection is acknowledged, challenges arise in meeting diverse maternal and neonatal needs. Additional research, especially in highly specialised settings, is necessary to understand the complexities associated with changing the care paradigm for newborns and mothers to be cared for together and in implementing couplet care. We found focus groups useful as a tool for needs assessment and uncovering and adapting practices to address challenges in implementing couplet care.
Transition experiences of UK junior doctors who leave clinical practice to pursue careers in medical education: a qualitative study
Authors: Coldicutt Olivia , Owen Katherine
Published: December 2024

Objectives

The increasing complexity and scale of medical education in the UK demands increasing numbers of medical educators. A small proportion of educators are qualified doctors, but did not reach completion of clinical training (CCT) to become consultants or general practitioners before pursuing a career exclusively in education. This study aimed to (1) explore the experiences of medical educators who left clinical practice as junior doctors and (2) identify the barriers to professional identity formation in this group.

Design

In this constructivist qualitative study, semi-structured interviews were conducted with medical educators. Audio data was recorded, transcribed and iteratively interpreted through the lens of reflexive thematic analysis.

Setting and participants

Nine UK-based educators were recruited using purposive and snowball sampling. Participants self-identified as medical educators who have experience of the transition from working as junior clinicians to holding positions exclusively in medical education. Participants had not completed clinical training before transitioning into medical education.

Results

Three broad themes were identified: (1) push factors away from clinical medicine; (2) pull factors towards medical education; (3) navigating professional identity formation as an educator. Educators reported that medical education offered positives such as improved work-life balance, professional development opportunities and a sense of being more ‘upstream’ in the world of education. Significant barriers to successful transition were reported, including: a lack of guidance; low respect for medical education by the wider medical profession; and disparity between the educational opportunities afforded to consultant colleagues compared with educators who left medicine before CCT.

Conclusions

Educators who leave clinical medicine before CCT perceive themselves as being disadvantaged in their education careers. This study highlights that more could be done to tackle stigmatising perceptions of a medical education career and present medical education as a viable option to junior doctors.
Decisions to decline breast screening and/or breast cancer treatment based on the potential harms of overdiagnosis and overtreatment: a qualitative study
Authors: Jeffers Shavez , Pilnick Alison , Armstrong Natalie
Published: December 2024

Objectives

To explore the experiences of women who have made the decision to decline breast screening and/or breast cancer treatment for overdiagnosis/overtreatment reasons after being invited to the National Health Service Breast Screening Programme (NHS BSP).

Design

Qualitative interview study using reflexive thematic analysis.

Setting

Participants were recruited via social media, online forums and word of mouth. Semi-structured interviews were conducted between May 2021 and April 2022.

Participants

20 women aged between 49 and 76 years old who had declined one or more of the following after receiving an invitation to participate in the NHS BSP: (1) screening investigation, that is, mammogram; (2) further investigations, for example, biopsy, ultrasound; (3) treatment, for example, mastectomy, chemotherapy, radiotherapy and (4) any other medical intervention, for example, ongoing medication.

Results

The three main themes were as follows: (1) the perception that the NHS BSP information was biased towards uptake and so constrained choice; (2) taking an active role in decision-making by considering the benefits and harms of the NHS BSP and (3) navigating potential regret for having declined.

Conclusions

In-depth understanding of the potential harms of overdiagnosis and overtreatment influenced the decision to decline for these participants and contributed to their dissatisfactions with the way that information was presented in the invitation to the NHS BSP and the women felt confident in their assessments of the benefits and harms. These findings differ from previous studies, which have suggested that the vast majority lack knowledge and understanding of what overdiagnosis and overtreatment are whereas the participants in this study demonstrated high levels of health literacy. Findings have implications for the way informed choice is considered and constructed in relation to the NHS BSP.
Global epidemiological profile in nasopharyngeal carcinoma: a prediction study
Authors: Zhang Yuna , Gu Shanshan , Deng Hongxia , Shen Zhisen
Published: December 2024

Objectives

This study delineates the global nasopharyngeal carcinoma’s (NPC) incidence and mortality across 185 countries in 2020 and projects the disease’s burden by 2040.

Design

A prediction study.

Setting

Countries within the 20 world regions.

Participants

Global NPC population.

Primary and secondary outcome measures

The estimated counts of NPC cases and deaths were retrieved from the GLOBOCAN 2020 database. Age-standardised incidence rates (ASIR) and age-standardised death rates (ASDR) were computed. Projections for NPC by 2040 were derived from global population forecasts.

Results

In the year 2020, East Asia emerged as the epicentre of both NPC incidences and mortalities, encompassing 49.39% (65 866 of the total 133 354 cases) and 45.56% (36 453 of the total 80 008 deaths), respectively, with China’s contribution being the most substantial (46.82% of cases and 43.50% of deaths). The disparity between genders was notable, as the ASIR and ASDR for males were approximately triple those observed in females. The incidence exhibited regional diversity, with South-Eastern Asia and East Asia recording the highest ASIR for males and females (7.7 and 2.5, and 3.9 and 1.5 per 100 000 person-years, respectively). Similarly, South-Eastern Asia also reported the highest ASDR for both genders (5.4 and 1.5 per 100 000 person-years, respectively). Projections for 2040 anticipate a rise in annual cases and deaths to 179 476 (indicating a 34.58% increase from 2020) and 113 851 (reflecting a 42.29% increase), respectively. Further analysis revealed a correlation between the Human Development Index and disease burden.

Conclusions

NPC, primarily impacting East Asia and predominantly affecting men, is poised for a significant increase in incidence and mortality by 2040, especially in Asia.
Bjorken sum rule with analytic coupling
Authors: Gabdrakhmanov I. R. , Gramotkov N. A. , Kotikov A. V. , Teryaev O. V. , Volkova D. A. , Zemlyakov I. A.
Published: December 2024

This study is dedicated to the description of the polarized Bjorken sum rule, based on recently derived formulas within the analytic QCD approach. To accommodate the photoproduction limit and incorporate the Gerasimov–Drell–Hearn and Burkhardt-Cottingham sum rules, we develop a new representation for the twist-2 part of the Bjorken sum rule. The derived results were applied for processing of experimental data. We observed a good agreement between the experimental data and the predictions from analytic QCD. In contrast, there is a significant discrepancy between these data and the fitting curves within the standard perturbative approach.
HCIA: Hierarchical Change Impact Analysis Based on Hierarchy Program Slices
Authors: Chang Jianming , Wang Lulu , Zhang Zaixing
Published: December 2024

Change impact analysis (CIA) is an essential method in software maintenance and evolution. Its accuracy and usability play a crucial role in its application. However, most CIAs are coarse-grained and limited to class and method levels. Despite the fine-grained CIAs’ success in giving the statement-level impact set, they are still limited without the sub-statement level dependency analysis, leading to low precision. Additionally, their unstructured impact sets make it challenging for users to comprehend the impact content. This paper proposes Hierarchical Change Impact Analysis (HCIA), a Hierarchical CIA technique based on the sub-statement level dependence graph. HCIA can perform a forward hierarchy program slicing on the change set from five levels: sub-statement, statement, method, class, and package. Based on the program slices, HCIA calculates the impact factor of the impact sets at the five levels to generate the final impact set. In the experiment, we evaluate the relationship between the impact factor and the actual affected codes and assess the most appropriate size of HCIA impact sets. Furthermore, we evaluate HCIA on 10 open-source projects by comparing our approach with popular CIAs at the five levels. The experimental result shows that HCIA is more accurate than the popular CIAs.
Some properties of grid homology for MOY graphs
Authors: Kubota Hajime
Published: December 2024

Grid homology, a combinatorial version of link Floer homology introduced by Manolescu, Ozsváth, Szabó, Thurston [On combinatorial link Floer homology, Geom. Topol. 11 (2007) 2339–2412, MR 2372850], has been extended to transverse spatial graphs by Harvey and O’Donnol [Heegaard Floer homology of spatial graphs, Algebr. Geom. Topol. 17(3) (2017) 1445–1525, MR 3677933]. In this paper, we define grid homology for MOY graphs, a specific class of transverse spatial graphs, and show properties such as the oriented skein relation, the effect of contracting an edge, and the effect of uniting parallel edges with the same orientation.
Tensor product of irreducible characters of GL2(𝔽q)
Authors: Gupta Archita , Hassain M.
Published: December 2024

We decompose the tensor product of two irreducible representations of [Formula: see text] for odd [Formula: see text] and classify the pairs such that their tensor product is multiplicity free. We also classify the pairs such that their tensor product has unique decomposition property. We additionally characterize the self-dual irreducible representations of [Formula: see text]
Dynamic behaviors of a receptor-based model
Authors: Zhang Conghui , Hou 0000-0001-8482-7301 Lingling , Lu 0009-0009-5448-696X Yongkang
Published: December 2024

In this paper, we consider a diffusion equation coupled to an ordinary differential equation, modeling the interaction between receptors and ligands. We first prove the existence of global-in-time solutions for all bounded and non-negative initial conditions. Then large-time behavior of solutions is studied. Our result shows that each positive solution converges to the constant solutions as time [Formula: see text] tends to infinity. Finally, we construct both traveling back and traveling front solutions by applying the blow up method.
Bounds on Sombor index of graph operations
Authors: Sarkar Ishita , Nanjappa Manjunath , Cangul Ismail Naci
Published: December 2024

Operations in graph theory have a significant influence in the theoretical and application aspect of the domain. Topological indices serve as a crucial component in chemical graph theory linked with some molecular structure. Recently, Gutman initiated the study on the Sombor index. In this paper, the computation of some bounds for Sombor index of graph operation notably join, cartesian product, corona product, lexicographic product, tensor product and strong product is carried out. The computation has been utilized to determine the upper bounds of the index for the specified graph operations for some standard graphs like the path and cycle graphs.
Enhancing Time-Series Classification with InceptionResNet: Integrating Deep Learning Techniques for Improved Performance
Authors: Dang Nguyen Thanh , Chau Nguyen Dong , Linh Vu Thi Thai , Minh Duong Hon , Thao Nguyen Ngoc , Nguyen Thanh Q.
Published: December 2024

In the domain of deep learning, several architectures have been extensively used for time series data analysis and mining, including recurrent neural network (RNN)-based architectures such as gated recurrent units (GRUs) and long short-term memory (LSTM). Despite their effectiveness, these models face challenges in analyzing long-range dependencies due to their reliance on current time-step data. To address this limitation, the integration of convolutional neural networks (CNNs) into time-series analysis has been explored, enhancing model performance and accuracy. This paper focuses on addressing these challenges by applying a modified InceptionTime model for time-series classification (TSC). Our study conducts an in-depth review and evaluation of existing deep learning techniques for TSC, exploring potential model combinations to improve accuracy. Specifically, we investigate the integration of CNN and RNN models, leveraging their strengths for both TSC and image processing tasks. Our proposed model, evaluated in the UCR-85 data set, shows significant improvements in accuracy and performance, offering a promising approach for complex time series analysis problems.
An Evaluation of Self-Adaptive Mechanisms for Misconfigurations in Small Uncrewed Aerial Systems
Authors: Purandare Salil , Islam Md Nafee Al , Sinha Urjoshi , Cleland-Huang Jane , Cohen Myra B.
Published: December 2024

Small uncrewed aerial systems, sUAS, provide an invaluable resource for performing a variety of surveillance, search, and delivery tasks in remote or hostile terrains which may not be accessible by other means. Due to the critical role sUAS play in these situations, it is vital that they are well configured in order to ensure a safe and stable flight. However, it is not uncommon for mistakes to occur in configuration and calibration, leading to failures or incomplete missions. To address this problem, we propose a set of self-adaptive mechanisms and implement them into a self-adaptive framework,
CICADA
, for Controller Instability-preventing Configuration Aware Drone Adaptation.
CICADA
dynamically detects unstable drone behavior during flight and adapts to mitigate this threat. We have built a prototype of
CICADA
using a popular open source sUAS flight control software and experimented with a large number of different configurations in simulation. We then performed a case study with physical drones to determine if our framework will work in practice. Experimental results show that
CICADA’s
adaptations reduce controller instability and enable the sUAS to recover from up to 33.8% of poor configurations. In cases where we cannot complete the intended mission, invoking alternative adaptations may still help by allowing the vehicle to loiter or land safely in place, avoiding potentially catastrophic crashes. These safety-focused adaptations can mitigate unsafe behavior in 52.9% to 64.7% of dangerous configurations. We further show that rule-based approaches can be leveraged to automatically select an appropriate adaptation strategy based on the severity of instability encountered, with up to a 14.2% improvement over direct adaptation. Finally, we introduce a variation of our primary adaptation strategy designed to allow more cautious adaptation with limited configuration information, which gets within 6.7% of our primary adaptation strategy despite not requiring an optimal knowledge base.
Mring: Contactless MR/AR Extended Input Method Based on Magnetic Signal
Authors: Liu Chao , Liu Yipeng , Hong Feng , Guo Zhongwen , Yu Jiguo , Li Feng
Published: December 2024

In recent years, the rapid rise of Mixed Reality (MR) and Augmented Reality (AR) technologies has transformed digital interactions and immersive experiences, as evidenced by their widespread adoption in AR glasses, MR headsets, and mobile AR applications. However, integrating MR and AR into everyday life also presents unique problems, particularly concerning user interactions within limited visual fields and discomfort caused by prolonged arm elevation. To address these challenges, our research introduces an innovative input device utilizing common wearable device magnetometer sensors and a strong magnet as input controls. We employ innovative methods to eliminate environmental magnetic field and soft magnetic offset, achieving trajectory restoration with an error margin of 5.23 mm through machine learning and trajectory smoothing algorithms. This enables our input device to interact with MR and AR devices beyond the user’s visual range, expanding operational space, and enhancing usability.
Piecewise Weighting Function for Collaborative Filtering Recommendation
Authors: Li Jiaye , Song Jiagang , Zhang Shichao
Published: December 2024

The assignment of a fixed weight value to an attribute (or variable) is not always considered reasonable, as it may not effectively preserve user similarity, potentially resulting in a decline in the performance of collaborative filtering recommendation algorithms. In this paper, we introduce a piecewise weighting method that incorporates hyper-class representation to enhance collaborative filtering recommendations. Our approach begins with applying a kernel function to map the original data into a kernel space, facilitating the learning of attribute weights. Subsequently, we construct a hyper-class representation of the data to derive weights for segmented attribute values (hyper-classes) within each attribute, creating a piecewise weighting function. This piecewise weighting function is then utilized to compute user similarities for collaborative filtering recommendations. Finally, we conduct a series of experiments to assess the performance of the collaborative filtering recommendation algorithm. The results demonstrate that the proposed algorithm, employing the piecewise weighting function, outperforms the compared algorithm that uses fixed weight values, as assessed by Root Mean Square Error (RMSE), Mean Absolute Error (MAE), and Precision. The source code for the proposed algorithm is available at
https://github.com/Lijy207/HCPW
.
Navigating Nongenetic Plasticity in Cancer Drug Resistance
Authors: Sun Hanxiao , Kumari Nitu , Melzer Madeline E. , Backman Vadim , Goyal Yogesh
Published: December 2024

Nongenetic plasticity has emerged as a key driver of cancer drug resistance, yet its precise origins, nature, and consequences are not fully clarified. This review examines technological, computational, and conceptual developments in the nongenetic determinants of drug resistance. We begin by proposing refined definitions of cellular state, fate, and plasticity. We subsequently contextualize the findings from multimodal approaches to investigate plasticity, highlighting how new single-cell lineage-tracing methods provide opportunities for quantitatively capturing state transitions, their timescales and heritability, and how they contribute to resistance mechanisms. We also draw parallels with concepts from developmental biology and microbial persistence research. Next, we cover the role that computational approaches have played in revealing the otherwise latent patterns of heterogeneity that underlie plasticity from complex datasets. We conclude by emphasizing the need for standardized terminology in this rapidly evolving field and the path from bench to bedside.
Climate Change and Mental Health
Authors: Clayton Susan , Crandon Tara
Published: December 2024

Climate change negatively threatens mental health through acute, chronic, indirect, and vicarious pathways. Though these psychological consequences will be felt globally, specific populations are at increased risk. This article describes the complex and diverse ways in which climate change can affect mental health and the resulting challenges that health care services will inevitably face. In responding to these threats, both prevention and intervention are urgently needed. Although mitigating the extent of climate change is crucial, we can also foster resilience to climate change—the ability to manage, respond to, and prepare for climate-related adversity—at the systemic, community, and individual levels. The mental health field must prepare for the significant burden that climate change will place on population health and well-being in the long term. In this review, we aim to inform and provide examples of how decision makers, the mental health discipline, and mental health professionals can respond.
Comfort Foods in the Twenty-First Century: Friend or Foe?
Authors: Holt Roberta R. , Schmitz Harold H. , Mhawish Reham , Komarnytsky Slavko , Nguyen Thien , Caveney Patrick M. , Munafo John P.
Published: December 2024

The comfort food (CF) concept emerged during the latter half of the twentieth century. Although not well defined, CF can be described as familiar foods that elicit feelings of well-being and play a role in social interactions and psychological health. These foods are often calorically dense and nutrient-poor, and overconsumption of some CF may contribute to negative metabolic health outcomes. This is particularly relevant when considering the global increase in obesity, leading to the development of therapeutics for improved weight control and metabolic health. In this review, we aim to (a) provide a historical perspective of the CF concept, (b) detail some genetic, developmental, and cultural factors that determine food preference, (c) discuss the influence of diet on the gut–brain connection, hormones, nutrient absorption, and microbiome diversity, and (d) provide a perspective detailing possible future directions in which food technology may enable a new generation of CF with enhanced palatability and nutrient profiles while contributing to well-being and environmental sustainability.
Review—Mn2+-Based Codopant Phosphor System: Fundamentals and Some Representatives
Authors: Adachi Sadao
Published: December 2024

The purpose of this review article is to discuss the photoluminescence properties of Mn2+-activated phosphors codoped with a wide variety of ions. Even though the concepts of intra-3d
5-shell electronic configuration in Mn2+ ion are well understood at present, some of its important properties doped in the various host materials have been hampered by a lack of definite knowledge. This is especially so for codoped phosphors along with Mn2+ ion. Due to the parity and spin-forbidden nature, sensitization of the Mn2+ emission should be required for practical applications. The codopant ions considered here can be classified into five groups: (i) rare-Earth codopant ions characterized by the 4f

n
↔ 4f

n
transitions (Pr3+, Nd3+, Sm3+, Eu3+, Gd3+, Tb3+, Dy3+, Er3+, and Yb3+), (ii) rare-Earth codopant ions characterized by the 4f

n
↔ 4f

n−15d transitions (Ce3+, Eu2+, and Yb2+), (iii) transition metal codopant ion (Cr3+), (iv) ns
2-configurated codopant ions (Sn2+, Sb3+, Pb2+, and Bi3+), and (v) nd
10-configurated codopant ions (Cu+ and Au+). Key expressions for analyzing photoluminescence (PL) and PL excitation spectra are briefly discussed. A detailed discussion is further given of an occurrence of energy transfer (ET), especially resonant ET, between the Mn2+ and codopant ions from academical and applicational points of view.
A Case Report of Angiotensin II Use in the Treatment of Refractory Shock due to Amlodipine and Lisinopril Toxicity
Authors: Keller John H. , Kendric Kayla J. , LeSaint Kathy T.
Published: December 2024

Introduction: Coingestion of cardiovascular drugs with angiotensin‐converting enzyme inhibitors (ACEIs) can be associated with refractory shock derangements complicated by vasopressor resistance, prompting the use of novel, unconventional, or uncommonly used agents.

Case Report: A young adult male presented to the emergency department (ED) 10 h after ingesting lisinopril and amlodipine. On arrival, he was hypotensive with a blood pressure of 72/39 mmHg. In addition to crystalloid fluids, he was incrementally started on four vasopressors including norepinephrine, phenylephrine, epinephrine, and vasopressin without improvement in mean arterial pressure (MAP). He was then administered methylene blue, calcium gluconate, and hyperinsulinemic euglycemia therapy after discussion with medical toxicology. Shortly afterwards, he was started on an angiotensin II infusion with an improvement in MAP to a goal of > 65 mmHg.

Conclusion: Despite evidence of efficacy in refractory vasodilatory shock secondary to sepsis, there is a paucity of data on the use of angiotensin II as an adjunctive vasopressor in drug‐induced shock. We report a case of successful use of angiotensin II in combined lisinopril and amlodipine overdose refractory to conventional vasopressor support. Combined overdose of ACEIs with calcium channel blockers (CCBs) has been shown to cause more significant hypotension and higher vasopressor requirements than overdose of CCBs alone. This may be due to the synergism between CCBs and ACEIs, where the normal homeostatic mechanism of the renin–angiotensin–aldosterone system (RAAS) activation in response to shock is now inhibited, leading to decreased compensatory vasoconstriction via angiotensin II and decreased endogenous catecholamine release. We hypothesize that angiotensin II may have been of particular benefit in this patient given the likelihood that reduced angiotensin II levels were contributing to his refractory shock.
Cavitation Dynamics and Vorticity Analysis of a Clark‐Y Hydrofoil and a Venturi Geometry Based on the DCM
Authors: Li Jing , Liu Chunbao
Published: December 2024

Literature research has shown that the high turbulent viscosity of original Reynolds‐averaged Navier–Stokes (RANS) models in the wake reduces the cavitation instability, resulting in an unreasonable performance prediction of the cavity generation, shedding, and collapse. Hence, a density‐corrected model (DCM) is utilized to improve the prediction capacity of the RNG k–ε model in the two‐phase flow simulation. Selected results are provided for two cases, namely, a two‐dimensional Clark‐Y hydrofoil and a Venturi geometry associated with the unsteady cavitating flows. We compare hydrodynamic coefficients, cavity characteristics, and time‐averaged velocity with available experimental results. This work is aimed at providing a better physical insight to describe the vortex dynamics and structures during the cavity evolution, explaining the mechanism of the transient cavitating flows by quantifying the force coefficients of the cavity and its surrounding turbulent structures, and revealing the promoting effect of the re‐entrant jet on the cavitation transition. In addition, vorticity transport equations are conducted to analyze the interaction of vortex and cavitation. The results demonstrate that the DCM has sufficient robustness to predict the periodic cavity evolution of generation, breakup, shedding, and collapse. An unsteady cavitation process contains the development of complex vortex structures. Re‐entrant jet near trailing of the attached cavity leads to distinct changes of velocity gradient, which has great influence on production and dissipation of vorticity. Intensive mass transfer between liquid and vapor phases may introduce the volume expansion or contraction as well as the baroclinic torque, which leads to unsteady distribution of vorticity.
Hypoxia-Induced Senescent Fibroblasts Secrete IGF1 to Promote Cancer Stemness in Esophageal Squamous Cell Carcinoma
Authors: Ou Zhengjie , Zhu Liang , Chen Xinjie , Liu Tianyuan , Cheng Guoyu , Liu Rucheng , Zhang Shaosen , Tan Wen , Lin Dongxin , Wu Chen
Published: December 2024

Cancer-associated fibroblasts (CAFs) contribute to cancer initiation and progression and play a pivotal role in therapeutic response and patient prognosis. CAFs exhibit functional and phenotypic heterogeneity, highlighting the need to clarify the specific subtypes of CAFs to facilitate the development of targeted therapies against pro-tumorigenic CAFs. Here, using single-cell RNA sequencing on patient samples of esophageal squamous cell carcinoma (ESCC), we identified a CAF subcluster associated with tumor stemness that was enriched in genes associated with hypoxia and senescence. The CAF subpopulation, termed as hypoxia-induced senescent fibroblasts (hsCAFs), displayed high secretion of insulin-like growth factor 1 (IGF1). The hsCAFs inhibited AMP-activated protein kinase (AMPK) activity in cancer cells via IGF1 to promote tumor stemness. The formation of hsCAFs was induced by the synergetic effect of hypoxia and cancer cells. Activation of nuclear factor erythroid 2-related factor 2 (NRF2) in cancer cells under hypoxia drove interleukin-1 alpha (IL-1α) production to trigger CAF senescence and IGF1 secretion via nuclear factor I A (NFIA). Knockout of IGF1 in CAFs or NRF2 in ESCC cells suppressed the tumor growth and chemotherapy resistance induced by CAFs in vivo. Importantly, patients with high proportions of hsCAFs showed poor survival and a worse response to chemotherapy. In summary, these findings identify a hsCAF subpopulation generated by interplay between cancer cells and CAFs under hypoxic conditions that promotes ESCC stemness and reveal targeting hsCAFs as an effective therapeutic strategy against chemotherapy-resistant ESCC.
A Phase I Study of FHD-609, a Heterobifunctional Degrader of Bromodomain-Containing Protein 9, in Patients with Advanced Synovial Sarcoma or SMARCB1-Deficient Tumors
Authors: Livingston J. Andrew , Blay Jean-Yves , Trent Jonathan , Valverde Claudia , Agulnik Mark , Gounder Mrinal , Le Cesne Axel , McKean Meredith , Wagner Michael J. , Stacchiotti Silvia , Agresta Samuel , Quintás-Cardama Alfonso , Reilly Sarah A. , Healy Kathleen , Hickman Denice , Zhao Tina , Ballesteros-Perez Alex , Khalil Alexis , Collins Michael P. , Piel Jessica , Horrigan Kim , Lefkovith Ariel , Innis Scott , Lazar Alexander J. , Cote Gregory M. , Wagner Andrew J.
Published: December 2024

Purpose:

FHD-609, a potent, selective, heterobifunctional degrader of bromodomain-containing protein 9 (BRD9), was evaluated for treating patients with advanced synovial sarcoma or SMARCB1-deficient tumors.

Patients and Methods:

In this multinational, open-label, phase I study (NCT04965753), patients received FHD-609 intravenously at escalating doses either twice weekly (5–80 mg; n = 40) or once weekly (40–120 mg; n = 15).

Results:

Fifty-five patients received FHD-609 for a median of 43 days. The maximum tolerated doses were 40 mg twice weekly and the equivalent weekly dose, 80 mg once weekly. Dose-limiting toxicities of QTc (heart rate–corrected QT interval) prolongation and syncope were observed at 40 and 60 mg twice weekly. Treatment-related adverse events were predominantly grades 1 to 2 in severity, most commonly dysgeusia (40%), dry mouth (29.1%), fatigue (27.3%), and anemia (25.5%). Eleven (20%) patients had treatment-emergent QTc (Fridericia formula) prolongation preceded by T-wave inversions; 21 (38.2%) patients had T-wave inversions without further cardiac events or ECG abnormalities. FHD-609 showed dose-dependent increases in pharmacokinetic exposure, with no substantial accumulation. Extensive BRD9 degradation in tumor tissue corresponded to the downregulation of cancer cell proliferation gene sets. One (2%) patient achieved a partial response; eight (15%) patients achieved stable disease, which lasted longer than 6 months in two patients.

Conclusions:

FHD-609 showed dose-dependent increases in systemic FHD-609 exposure and pharmacodynamic response profiles. The maximum tolerated doses were identified (40 mg twice weekly/80 mg once weekly) and preliminary clinical activity was observed. Future studies of BRD9 degraders will require strict cardiac monitoring given the QTc prolongation observed in this study.
Table 1 from Kinetics of Nirogacestat-Mediated Increases in B-cell Maturation Antigen on Plasma Cells Inform Therapeutic Combinations in Multiple Myeloma
Authors: Shearer Todd , Comstock Melissa , Williams Rex L. , Johnson Mark C. , Cendrowicz Ewa , Leonowens Cathrine , Smith Margaret , Baughman Todd M. , Breitbach Caroline J. , Cheng Shinta , Green Damian J.
Published: December 2024

In vitro PD parameters of the nirogacestat effect on mbBCMA in multiple myeloma cell lines
Supplemental Table 4 from Kinetics of Nirogacestat-Mediated Increases in B-cell Maturation Antigen on Plasma Cells Inform Therapeutic Combinations in Multiple Myeloma
Authors: Shearer Todd , Comstock Melissa , Williams Rex L. , Johnson Mark C. , Cendrowicz Ewa , Leonowens Cathrine , Smith Margaret , Baughman Todd M. , Breitbach Caroline J. , Cheng Shinta , Green Damian J.
Published: December 2024

Summary of adverse events
Supplemental Table 1 from Kinetics of Nirogacestat-Mediated Increases in B-cell Maturation Antigen on Plasma Cells Inform Therapeutic Combinations in Multiple Myeloma
Authors: Shearer Todd , Comstock Melissa , Williams Rex L. , Johnson Mark C. , Cendrowicz Ewa , Leonowens Cathrine , Smith Margaret , Baughman Todd M. , Breitbach Caroline J. , Cheng Shinta , Green Damian J.
Published: December 2024

Participant demographics and baseline characteristics
Shikonin Inhibits Endoplasmic Reticulum Stress-Induced Apoptosis to Attenuate Renal Ischemia/Reperfusion Injury by Activating the Sirt1/Nrf2/HO-1 Pathway
Authors: Huang Qian , Shi Zilu , Zheng Dandan , Chen Huiqin , Huang Qiuhong
Published: December 2024

Introduction: Shikonin is the major bioactive compound abundant in Lithospermum erythrorhizon and possesses diverse pharmacological properties. This study aimed to examine shikonin roles in experimental renal ischemia/reperfusion (I/R) injury. Methods: Renal tissues and blood were collected from experimental renal I/R injury models. Kidney functions, structural injuries, and cellular death were assessed. Markers of endoplasmic reticulum (ER) stress were evaluated by RT-qPCR and Western blotting. The effect of shikonin on Sirt1/Nrf2/HO-1 signaling was detected by Western blotting and immunofluorescence staining. HK-2 cells that underwent hypoxia/reoxygenation (H/R) process were used to perform CCK-8 and flow cytometry. Results: For in vivo analysis, renal dysfunctions and tissue structural damage induced by I/R were relieved by shikonin. Additionally, shikonin alleviated ER stress-induced apoptosis in I/R mice. For in vitro analysis, shikonin inhibited ER stress-stimulated apoptosis of H/R cells. Mechanistically, shikonin activated Sirt1/Nrf2/HO-1 signaling post-I/R, and inhibition of Sirt1 limited shikonin-mediated protection against ER stress-stimulated apoptosis in both animal and cellular models. Conclusion: By activating Sirt1/Nrf2/HO-1 signaling, shikonin inhibits apoptosis caused by ER stress and relieves renal I/R injury.
Monochorionic pregnancy complicated by selective intrauterine fetal death and severe anemia of the co-twin: the role of intrauterine transfusion. Systematic review of the literature.
Authors: Carlucci Stefania , Scalia Maria Sole , Stabile Guglielmo , Bettocchi Stefano , Stampalija Tamara
Published: December 2024

The management of selective intrauterine demise in monochorionic pregnancies has high rates of adverse outcomes in the surviving co-twin. One of the complications might be severe anemia. The aim of this systematic review was to evaluate the role of intrauterine transfusion in case of selective intrauterine fetal death in monochorionic pregnancies with the surviving co-twin diagnosed with severe anemia.
We carried out literature search from PubMed, Google Scholar and Scopus. Cases with ultrasound signs of severe fetal anemia in the surviving co-twin and treated through fetal IUT alone were included.
We selected 7 articles and 45 cases for our review. After an intrauterine transfusion procedure, the percentage of alive and apparently healthy newborns resulted to be 55,5% (25/45), with 15 premature and 10 full-term newborns. Long-term outcome were not available for the majority of cases.
We provide available evidence on the outcome after the rescue intrauterine transfusion for severe anemia in surviving co-twin in selective intrauterine fetal death in monochorionic pregnancy performed within 24 hours from the diagnosis. Our results suggest a better outcome compared to expectant management, where delivery is not indicated due to prematurity. This is a useful information for physicians managing these cases and for parents’ counseling.