bluuebunny/crossref_metadata_2025 huggingface dataset:
On-The-Job Training: Enhance Experience and Increase Success for the Student Community in Vietnam
Authors: Loc Tran Ba , Thanh Ngan Nguyen Thi , Linh Le Duy , Luan Nguyen Trong
Published: January 2025

On-the-job training (OJT) programs at private universities play an essential role in providing students with real-world experiences, equipping them with the skills and knowledge needed for future career. Researching the factors that affect the effectiveness of OJT is extremely necessary to complete and improve the quality of this training program. The researchers conducted a quantitative study using nonprobability sampling to collect data from 335 people via the Google platform. After having data from respondents, the researcher coded the data in Microsoft Excel and analyze it in SPSS and Amos such as descriptive statistics, Cronbach’s Alpha, Exploratory Factor Analysis (EFA), structural equation modelling (SEM). The study found that OJT is affected by factors such as job characteristics, work environment, contextual factors, and university support. Besides, OJT affects various factors such as job satisfaction, career development, job involvement, and motivation to learn.
Applying a Dignity Lens in Migration and Displacement
Authors: Perrin Paul Clayton
Published: January 2025

Executive Summary

Recognizing that migration and displacement are longstanding elements of human history, the paper emphasizes the critical role of respecting the inherent dignity of migrating persons as an important part of the right-to-stay dialogue. Although international frameworks, such as the Sphere Handbook, the Paris Declaration, and UNHCR’s Durable Solutions, have provided a critical foundation for addressing many of the basic needs of migrating populations, they largely focus on material aspects of well-being, overshadowing the equally essential need for other aspects of one’s dignity — a recognition of the inherent equal value that each human being possesses — to be respected and upheld. This approach positions dignity as a luxury to be addressed only after other basic needs are met. However, evidence shows that ensuring physical safety, food, and shelter alone does not fulfill the complex needs of migrating individuals, who often experience emotional distress and social marginalization when their dignity is ignored. By framing dignity as an intrinsic human right that is not contingent on external conditions or something that can be distributed out of the back of a truck, the paper argues that organizations can foster deeper engagement with migrant communities.

Two case studies — Georgia and Afghanistan — highlight the consequences of placing primacy on biophysical needs over respect for dignity. In Georgia, despite robust efforts to provide for material well-being, displaced persons reported significant emotional distress due to a sense of being marginalized and ignored. In Afghanistan, a disconnect between international aid organizations and local communities fostered resentment, exacerbating insecurity and undermining trust in humanitarian efforts. Both these cases underscore that fulfilling physical needs alone does not equate to a life with dignity.

To improve our ability to uphold human dignity in the right-to-stay debate and in supporting migrating communities, three recommendations are proposed: (1) adopt a dignity-centered approach that values the immaterial aspects of human existence, (2) integrate dignity into accountability measures, and (3) tailor dignity-affirming practices to local needs. Only by elevating dignity to a core operational principle can humanitarian efforts more holistically address the complex challenges faced by displaced populations.

In conclusion, this paper underscores the need for a transformative approach to humanitarian response that centers human dignity as a fundamental principle. As humanitarian organizations increasingly recognize the importance of dignity in displacement contexts, there is an opportunity to deepen engagement with affected communities, ensuring that their voices and values inform interventions. By embedding dignity within humanitarian frameworks, we can create responses that truly support displaced populations’ well-being, facilitating resilience and restoring agency in the face of displacement.
Prediabetes and diabetes mellitus type II after ischemic stroke
Authors: Moelgg Kurt , Karisik Anel , Scherer Lukas , Buergi Lucie , Dejakum Benjamin , Komarek Silvia , Granna Julian , Boehme Christian , Pechlaner Raimund , Toell Thomas , Knoflach Michael , Kiechl Stefan , Kaser Susanne , Egger Alexander , Griesmacher Andrea , Mayer-Suess Lukas
Published: January 2025

Introduction:

The progression of diabetes status in post-stroke patients remains under-investigated, particularly regarding new treatments for type II diabetes mellitus (DM II), like glucagon-like peptide 1 receptor agonists (GLP-1-RA) and sodium-glucose co-transporter-2 (SGLT-2) inhibitors, which have not been studied in the post-stroke setting.

Patients and methods:

Eight hundred eighty-four consecutive ischemic stroke patients recruited to our prospective STROKE-CARD Registry were assessed concerning their glycemic status at baseline (normoglycemia, prediabetes, DM II) and change over time within 1 year follow-up. Multivariate logistic regression was performed to identify factors associated with transitioning from normoglycemia to prediabetes or DM II. Additionally, we reviewed ongoing clinical trials for GLP-1-RA and SGLT-2 inhibitors in the context of acute ischemic stroke.

Results:

At baseline, 44.6% ( n = 394) of individuals had normoglycemia, 33.9% ( n = 300) were prediabetic, and 21.5% had DM II ( n = 190). After 1 year, normoglycemia decreased by 12.1 percentage points ( n = 107), whereas prediabetes and DM II increased by 10.2 percentage ( n = 90) points and 1.9 percentage points ( n = 17), respectively. Statin therapy was the only significant risk factor for progression. 23.4% ( n = 207) of our cohort would have met eligibility criteria for a recent trial on semaglutide in obese non-diabetics with prior cardiovascular disease. However, only one ongoing trial aims at evaluating short-term cardiovascular risk reduction in stroke patients.

Discussion:

GPrediabetes and DM II are frequent in ischemic stroke patients. Even within an intensified post-stroke disease management setting, a considerable amount of stroke survivors convert to prediabetes or DM II within the first year. Our results demonstrate a notable proportion of patients qualifying inclusion in studies examining the efficacy of GLP-1-RA agonists and SGLT-2 inhibitors in secondary prevention.

Conclusion:

Given the high prevalence and progression of prediabetes and DM II in stroke survivors, there is a need for clinical trials evaluating the use of GLP-1-RA and SGLT-2 inhibitors in this population.
A Systematic Review on Safety and Efficacy of Ayurvedic Interventions in Hemiplegia (Pakshaghata)
Authors: M. Akashlal , Nair Pratibha P , Nair Devi R , Ahmad Azeem , Chandrasekhararao B , Sudhakar D , Narayanam Srikanth , Acharya Rabinarayan
Published: January 2025

The study's objective is to conduct a comprehensive systematic review for assessing the safety and efficacy of Ayurvedic interventions in managing hemiplegia/Pakshaghata. The study involved a search across multiple online databases and online clinical trial registries. Additionally, major Ayurveda postgraduate institutes were contacted to acquire unpublished trial data related to hemiplegia/Pakshaghata. The review covered articles published until July 2023. Two reviewers independently performed data extraction and risk of bias assessment. The risk of bias assessment utilised the RoB 2 tool for randomised trials and the ROBINS-I tool for non-randomised trials. The screening process identified 28 articles from online databases and two dissertations from online repositories. However, practical challenges prevented access to grey literature from Ayurveda institutes. The 30 studies selected for this review, comprises nine randomised controlled trials (RCTs), eight non-randomised comparative trials, and thirteen pre-post studies. Quantitative analysis was unfeasible due to inadequate studies, leading to a qualitative analysis. All studies, except one, exhibited substantial bias upon risk of bias assessment. Moreover, most studies demonstrated methodological weaknesses attributed to a lack of masking, improper sampling techniques, non-validated outcome measurement tools, inadequate follow-up procedures, and confounding factors. The trials frequently did not document safety parameters, adverse events (AE), and adverse drug reactions (ADR). Current review could not definitively establish the efficacy and safety of Ayurvedic interventions in hemiplegia/Pakshaghata. Hence, the authors strongly advocate for good quality research incorporating proper methodology.
The potential of active technologies to enhance the sustainability of existing buildings
Authors: Mariano-Hernández Deyslen , Aybar-Mejía Miguel , Sbriz-Zeitun Giuseppe , Taveras Cruz Armando J , Ruiz-Rosa Yanay
Published: January 2025

The total electrical energy consumption of buildings has garnered the interest of scholars. Efforts have been undertaken to establish near-low-consumption edifices to ensure comfort and optimize resource management. Building energy modeling is a notably adaptable method for enhancing energy efficiency. This tool assists energy managers in selecting technology to minimize energy consumption. This research seeks to evaluate the implementation of diverse, active technologies in traditional buildings by utilizing building energy models to develop net-zero emission structures in response to the circumstances above. A comprehensive energy model of the building utilizing EnergyPlus was employed to examine the potential energy savings from implementing diverse, active technologies. An analysis of a solar system addressing building demand was conducted using the PV*SOL tool. The results of the digital building model demonstrated that the active technologies implemented would substantially reduce electricity consumption in electrical equipment and air conditioning systems. Nevertheless, even with the implementation of best practices, the lighting system did not realize the expected energy savings.
Colonial Experiences and Contemporary Laws
Authors: Chang Yun-chien , Chilton Adam , Garoupa Nuno , Versteeg Mila
Published: January 2025

Although research suggests that countries’ colonial experiences are associated with a range of contemporary outcomes, the link between colonial experiences and the substance of countries’ laws remains unclear. We explore this question while making four improvements over past research. First, we use more detailed data on both countries’ colonial experiences and contemporary substantive laws. Second, we directly assess whether countries’ shared legal origins—that is, whether they had a common law or civil law system—or their colonial origins—that is, which country had previously colonized them—are more associated with differences in their contemporary laws. Third, we use a research design that makes it possible to assess the relationship between countries’ colonial experiences across different areas while accounting for differences in the measurement and coding of those laws. Fourth, we explore how the evolution of these relationships over time. We find that countries with shared colonial experiences have greater agreement in the substance of their contemporary laws compared to countries without shared colonial experiences; however, the effect is roughly twice as large for countries with shared colonial origins compared to those with shared legal origins. Moreover, this relationship is largely consistent across types of legal origins and groups of former colonies.
Management of acute ischemic stroke in the emergency department: optimizing the brain
Authors: Ganti Latha
Published: January 2025

Acute ischemic stroke is a devastating condition that afflicts more than 12 million people every year. Globally, stroke is the 2nd leading cause of death and 3rd leading cause of disability worldwide. While not all patients can avail themselves of existing acute therapies, all patients can benefit from brain optimization measures. This paper details the 12 steps in the management of acute ischemic stroke in the emergency department.
Clinical profile, treatment, and outcomes of testicular cancer in a resource-limited setting: a study from Sudan
Authors: Eltahir Eltahir Ahmed , Awad Sami Mahjoub Taha , Osman Yassin Mohammed , Ahmed Mohammed El Imam Mohammed , Elhassan Moawia Mohammed Ali
Published: January 2025

Background

Testicular cancer is a rare malignancy, with limited data on its clinical characteristics and outcomes in Africa. This study aims to provide baseline information on the clinical presentation, treatment, and outcomes of testicular cancer in Sudan, a low-income African nation.

Methods

A retrospective review was conducted at two tertiary care centers in central Sudan. Data were extracted for patients > 15 years of age diagnosed with testicular cancer from 2007 to 2015, with a follow-up of up to 5 years. Patients were identified from hospital records at the National Cancer Institute and Gezira Hospital for Renal disease and Surgery.

Results

The study included 50 patients with a mean age of 41.9 years (SD = 18.9). Testicular swelling was the most common presenting symptom, reported in 70% of patients (n = 35). The median time from the initial complaint to diagnosis was 6 months (range: 1–36). Seminoma was the predominant histopathological subtype accounting for 68% of cases, and 64% of patients presented with advanced-stage disease (stage III). Radical orchidectomy was performed in 86% of patients. Chemotherapy was administered to 88% of patients, while 10% received radiotherapy. At the last follow-up, 44% of patients were in remission, 18% were alive with disease progression, and 36% had died.

Conclusions

This study highlights the high mortality rate associated with testicular cancer in this resource-limited setting, which is likely due to delayed diagnosis and the advanced stage at presentation. Enhancing health education is crucial to promote early detection and ensure timely access to care, ultimately improving patient outcomes.
Analytical performance of OncoPrism-HNSCC, an RNA-based assay to inform immune checkpoint inhibitor treatment decisions for recurrent/metastatic head and neck squamous cell carcinoma
Authors: Hiken Jeffrey , Earls Jon , Flanagan Kevin C. , Wellinghoff Rachel L. , Ponder Michelle , Messina David N. , Glasscock Jarret I. , Duncavage Eric J.
Published: January 2025

Background

While immune checkpoint inhibitor (ICI) therapies can significantly improve outcomes for patients with recurrent/metastatic head and neck squamous cell carcinoma (RM-HNSCC), only about 15–20% benefit from such treatments. Clinical tests that guide the use of ICIs are therefore critically needed. OncoPrism-HNSCC was developed to address this need. The assay combines next generation RNA sequencing-based immunomodulatory gene expression signatures with machine learning algorithms to generate an OncoPrism score that classifies patients as having low, medium, or high likelihood of disease control in response to ICI treatment. Also, OncoPrism-HNSCC leverages the same FFPE patient tumor RNA used for ICI response prediction to identify rare cases where oncogenic rearrangements in NTRK1/2/3 or ALK genes may occur, and which may indicate the use of potentially highly effective targeted therapies. The clinical performance of OncoPrism-HNSCC has been validated. Here, we report its analytical performance in the presence of potentially confounding sources of variation.

Methods

The assay’s analytical sensitivity was assessed by varying RNA input quantity and quality, observing the effect on ICI response prediction scores. Analytical specificity was tested by spiking increasing percentages of genomic DNA into input RNA. Intra-assay and inter-assay precision were evaluated, and the analytical sensitivity, specificity, and precision of gene fusion detection were assessed. Concordance with orthogonal methods of gene fusion detection was tested on 67 FFPE clinical samples.

Results

Varying RNA inputs as low as four-fold below the nominal input amount had little effect on ICI response prediction scores. RNA quality levels below the test threshold had no significant effect. Genomic DNA spike-ins up to 30% had only a small effect on scores. The pooled standard deviation for multiple operators, reagent lots, batches, and sequencers yielded an overall variance represented by just 0.87% of the score range of the test (0–100). NTRK and ALK gene fusion detection was 100% concordant with orthogonal methods.

Conclusions

Robust and reliable analytical performance of the OncoPrism-HNSCC assay supports its clinical use, even in the presence of variation typically encountered in the laboratory setting.
Changes and continuities in gambling careers during the COVID-19 pandemic: a longitudinal qualitative study of regular sports bettors in Britain
Authors: Brown Ashley , Donnachie Craig , Critchlow Nathan , Bunn Christopher , Dobbie Fiona , Gray Cindy M , Purves Richard , Reith Gerda , Wardle Heather , Hunt Kate
Published: January 2025

Background

To explore continuities and changes in gambling behaviour during the COVID-19 pandemic and the factors that influenced these among a sample of regular sports bettors.

Methods

A longitudinal qualitative study using in-depth interviews. Sixteen sports bettors living in Britain took part in the first interviews in July-November 2020, and 13 in the follow-up interviews in March-September 2021.

Results

Individual patterns of gambling were episodic: it was common for gambling to increase during some periods of the pandemic and to decrease during others, reflecting the dynamic and (often) challenging circumstances which people were living through at the time. Changes and continuities in gambling during the pandemic were influenced by a range of factors which we have grouped into two main themes relating to ‘gambling and the sports landscape’ and ‘disruption to day-to-day life’. It was common for a constellation of factors to influence gambling behaviour rather than a single factor. These constellations of factors varied from person to person and at different times during the pandemic.

Conclusions

Findings of the present study are consistent with earlier literature examining gambling careers before the advent of COVID-19 showing that gambling trajectories are non-linear. Our research suggests that ‘typical’ patterns of gambling behaviour (e.g. being episodic), and the broader known risk and protective factors within individuals, families, communities and societies have been amplified during the pandemic. Findings highlight the adaptability of the gambling industry to continue to reach consumers through product offerings and marketing even in a period of unprecedented restrictions on supply, and show the potential resulting harms of these actions among gamblers at risk of experiencing gambling problems. Taken together, findings from this study provide important new insights relevant to discussions about gambling regulation, and support calls for multifaceted and comprehensive policy, regulatory, and treatment approaches, to minimise gambling-related harms.
The effectiveness of a 10-week family-focused e-Health healthy lifestyle program for school-aged children with overweight or obesity: a randomised control trial
Authors: Zhu Diana , Dordevic Aimee L. , Gibson Simone , Davidson Zoe E.
Published: January 2025

Background

Electronic health (e-Health) interventions may increase effectiveness and address limitations of conventional in-person childhood obesity treatment programs. This study evaluates the effectiveness of a 10-week e-Health (web-based) healthy lifestyle program for school-aged children with overweight/obesity.

Methods

In this randomised control trial (RCT), families with children aged 7–13 years with overweight/obesity (body mass index, BMI ≥ 85th percentile), living in Victoria, Australia, were recruited. Families were randomised to intervention or waitlist control and received the 10-week web-based program. The primary outcome was the change in children’s BMI z-score over 10 weeks. Other outcomes included change in children’s waist circumference, dietary intake, physical activity, and quality of life over 10 weeks.

Results

Of 148 children (125 families) recruited, 102 children (85 families) completed the RCT. A significant decrease in children’s BMI z-scores was observed in the intervention compared to the control group over 10 weeks (mean difference 0.11; 95% CI, 0.02–0.20). The web-based program was also effective in improving children’s quality of life and lifestyle behaviour changes over 10 weeks. In the intervention group, there was a significant increase in children’s quality of life scores (intervention versus control: median change (IQR) = 11 (3, 17) versus 1 (-3, 7); p = 0.034), overall diet quality scores (6 (2, 10) versus 2 (-3, 5); p < 0.001), and daily physical activity levels (5.2 (-2.6, 12.8) versus − 0.2 (-8.2, 4.5); p = 0.022) compared to the control group.

Conclusions

A web-based healthy lifestyle program effectively improved short-term health-related outcomes in children with overweight/obesity. Further research is needed to identify determinants of program effectiveness, evaluate sustained effects, and equitably tailor childhood obesity e-Health interventions to diverse populations.

Trial registration

This study was registered with the Australian New Zealand Clinical Trial Registry (ACTRN12621001762842) on November 11, 2021, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=383053.
Consumer perspectives on the national electronic health record and barriers to its adoption in Germany: does health policy require a change in communication?
Authors: Kröner Saskia , Schreiweis Björn , Strotbaum Veronika , Brandl Lea Christine , Pobiruchin Monika , Wiesner Martin
Published: January 2025

Background

The national health record (ePA) was introduced January 1st, 2021 in Germany and is available to every person insured under statutory health insurance. This study investigated the acceptance and expectations of the national health record in Germany, focusing on consumer perspectives, expectations, barriers, information needs, and communication aspects.

Methods

An exploratory, observational, cross-sectional online survey was conducted one year after ePA introduction, followed by descriptive statistical analysis.

Results

The top three ePA use cases were medical document collection, simplified data exchange between medical institutions, and emergency medical information. Adoption barriers included lack of information and access, privacy concerns, and perceived lack of necessity. Participants that felt informed about the ePA, reported they received information primarily from health insurances, the media, and educational or professional sources, mainly through printed brochures, social media, or via emails. Most participants (86.5%) preferred being informed through conversations, particularly with health insurance providers (81.5%) and doctors (61.0%). Written information was highly desired (94.5%), preferably via email or information letters/flyers. However, more than half of the participants (55.6%) reported being uninformed about the ePA introduction.

Conclusion

The study revealed a communication gap between providers and consumers, leading to a low acceptance rate of digital health technologies. Comparisons with other countries showed low adoption rates for opt-in systems. The authors suggest changing communication strategies, given users prefer direct information from doctors or health insurance companies. Adopting an opt-out system with professional social media and marketing campaigns could increase nationwide ePA adoption.
The costs and logistics of distributing ‘forest packs’ containing novel vector control tools to forest-exposed populations in Cambodia
Authors: Yukich Joshua , Doum Dyna , McIver David J. , Richardson Jason H. , Sovannaroth Siv , Lobo Neil F. , Tatarsky Allison
Published: January 2025

Background

Malaria incidence in the Greater Mekong Subregion has been on the decline, and most remaining malaria risk in the region is concentrated among hard-to-reach populations, especially those with exposure to forested areas. New vector control tools focused on outdoor protection in forest settings are needed for these populations.

Methods

The delivery of a ‘forest pack’ containing a volatile pyrethroid spatial repellent (VPSR), a topical repellent, and pyrethroid treatment of clothing was evaluated in an operational study in Cambodia. Costs were collected using micro-costing approaches and the cost of distribution for the ‘forest pack’ was estimated using standard economic evaluation approaches and examined in sensitivity analyses.

Results

The cost per eligible person (the target population) per malaria season for the whole pack was estimated to be 138 USD, which was nearly entirely driven by the cost of the products.

Conclusions

Modifications to the ‘forest pack’ including adding a longer-lasting spatial repellent product or a reduced-cost topical repellent could significantly reduce the cost of pack distribution over the course of a malaria season.
Combining an internal tension relieving technique with anterior cruciate ligament reconstruction (ACLR) reduces graft failure rate and improves functional outcomes: a systematic review and meta-analysis
Authors: Wen Yixin , Huang Wei , Li Minghui , Jiang Yong , Tong Yibo , Mei Hongjun , Tan Junfeng
Published: January 2025

Purpose

Graft rupture is a significant cause of graft failure in anterior cruciate ligament reconstruction (ACLR). To address this issue, clinicians have combined the internal tension relieving technique (ITRT) with ACLR to improve graft stiffness, aiming to reduce the risk of graft failure. The purpose of this study is to compare the graft failure rates and clinical functional outcomes between ITRT-assisted ACLR and conventional ACLR.

Methods

Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a search was conducted in databases including Ovid, PubMed, Web of Science, Embase, Cochrane Library, Wanfang Data, CNKI, and VIP Medical Database for clinical controlled trials comparing the ITRT combined with ACLR to conventional ACLR. The search period spanned from the establishment of the databases to September 2024. Studies meeting the inclusion and exclusion criteria were selected, with two independent reviewers conducting literature screening, quality assessment, and data extraction. Data analysis was performed using RevMan 5.4 software. The evaluated outcomes included graft failure rate, Lysholm Knee Scoring Scale, Tegner activity score, Knee injury and Osteoarthritis Outcome Score (KOOS), International Knee Documentation Committee (IKDC) score, Visual Analog Scale (VAS) score, Single Assessment Numeric Evaluation (SANE), return to sport (RTS) rate, and knee joint laxity.

Results

A total of 11 studies were included in the final analysis, with 1,339 patients (592 patients with ITRT-assisted ACLR and 747 patients with conventional ACLR). The combined analysis results indicated that, compared to conventional ACLR, ITRT-assisted ACLR showed significant advantages in reducing graft failure rates (RR = 0.44; 95% CI: 0.23, 0.83; P = 0.01), increasing return-to-sport rates (MD = 1.75; 95% CI: 1.05, 2.91; P = 0.03), and improving knee scores (including KOOS score and Tegner activity score) (all P values < 0.05). However, no significant differences were observed between the two approaches in terms of Lysholm knee score, VAS score, IKDC score, and knee joint laxity.

Conclusions

This meta-analysis highlighted the significance and superiority of combining ITRT with ACLR compared to conventional ACLR, particularly in reducing graft failure rate and improving knee function outcomes. The ITRT-assisted ACLR procedure may represent the optimal approach for minimizing graft failure. However, given the limitations of short-term follow-up and reliance on retrospective studies, more randomized controlled trials and longer follow-up periods are needed to further evaluate the long-term graft failure rates and functional outcomes.
Lateral costal artery as a culprit for the steal phenomenon after coronary artery bypass grafting: a case report and review of the literature
Authors: Trebišovský Michal , Homola Marián , Kolesár Adrián , Lukačin Štefan , Bereš Anton
Published: January 2025

Background

The left internal thoracic artery (LITA) has been widely accepted as the standard for revascularizing the left anterior descending artery during coronary artery bypass grafting (CABG) surgery. However, in 10–20% of cases, the LITA may lead to unsecured side branches to the chest wall, particularly the lateral costal artery (LCA), potentially resulting in postoperative chest angina.

Case presentation

We report the case of a 58-year-old patient who experienced persistent angina eight months after having undergone coronary artery bypass grafting (CABG) due to the steal phenomenon caused by a thick lateral costal artery (LCA). The LCA was found to be 2/3 the diameter of the left internal thoracic artery (LITA) with the decision to obliterate the LCA. Following LCA obliteration, the patient’s exertional angina was resolved.

Conclusions

LCA may pose a potential issue in terms of coronary steal after CABG. Understanding the anatomy of the LITA with LCA variation and widening the opening of the pleura may be beneficial in preventing postoperative steal in selected cases.
Multimodal management and complete resection of invasive Type B3 thymoma with vascular reconstruction: a case report
Authors: Chan Puiyee Sophia , Patel Akshay J. , Lucchese Gianluca , Bille Andrea
Published: January 2025

Introduction

Thymomas and thymic carcinomas are rare anterior mediastinal tumours, accounting for 0.2–1.5% of all cancers. Surgical resection is key to treatment, though invasion of surrounding structures like great vessels can complicate this. This case report details the management of a type B3 thymoma (T4 N0 M0) in a 41-year-old male.

Case report

A 41-year-old male presented with myasthenic symptoms and was diagnosed with a large thymic mass involving the brachiocephalic vein and superior vena cava. After 4 cycles of neoadjuvant chemotherapy, partial resection was performed, followed by radiotherapy. Residual disease led to a second surgery, during which tumour resection and vascular reconstruction using cardiopulmonary bypass were successfully completed. Postoperative recovery was uneventful.

Discussion

Complete resection, including re-resection, when necessary, is crucial for improved outcomes in thymoma patients. Even with great vessel invasion, aggressive surgery, coupled with chemotherapy and vascular reconstruction, can achieve good survival outcomes.

Conclusion

Multimodal management, including chemotherapy, complete resection, and vascular reconstruction, offers the best prognosis for invasive thymomas, even with great vessel involvement.
Construction of machine learning-based models for screening the high-risk patients with gastric precancerous lesions
Authors: Yu Shuxian , Jiang Haiyang , Xia Jing , Gu Jie , Chen Mengting , Wang Yan , Zhao Xiaohong , Liao Zehua , Zeng Puhua , Xie Tian , Sui Xinbing
Published: January 2025

Background

The individualized prediction and discrimination of precancerous lesions of gastric cancer (PLGC) is critical for the early prevention of gastric cancer (GC). However, accurate non-invasive methods for distinguishing between PLGC and GC are currently lacking. This study therefore aimed to develop a risk prediction model by machine learning and deep learning techniques to aid the early diagnosis of GC.

Methods

In this study, a total of 2229 subjects were recruited from nine tertiary hospitals between October 2022 and November 2023. We designed a comprehensive questionnaire, identified statistically significant factors, and created a web-based column chart. Then, a risk prediction model was subsequently developed by machine learning techniques. In addition, a tongue image-based risk prediction model was established by deep learning algorithms.

Results

Based on logistic regression analysis, a dynamic web-based nomogram was developed and it is freely accessible at: https://yz6677.shinyapps.io/GC67/. Then, the prediction model was established using ten different machine learning algorithms and the Random Forest (RF) model achieved the highest accuracy at 85.65%. According with the predictive results, the top 10 key risk factors were age, traditional Chinese medicine (TCM) constitution type, tongue coating color, tongue color, irregular meals, pickled food, greasy fur, over-hot eating habit, anxiety and sleep onset latency. These factors are all significant risk indicators for the progression of PLGC patients to GC patients. Subsequently, the Swin Transformer architecture was used to develop a tongue image-based model for predicting the risk for progression of PLGC. The verification set showed an accuracy of 73.33% and an area under curve (AUC) greater than 0.8 across all models.

Conclusions

Our study developed machine learning and deep learning-based models for predicting the risk for progression of PLGC to GC, which will offer the assistance to determine the high-risk patients from PLGC and improve the early diagnosis of GC.

Graphical Abstract
Single-nucleus RNA sequencing reveals distinct pathophysiological trophoblast signatures in spontaneous preterm birth subtypes
Authors: Uhm Cherilyn , Gu Jianlei , Ju Weina , Pizzella Stephanie , Oktay Hande , Peng Joyce Yao-Chun , Guariglia Sararose , Liu Yong , Zhao Hongyu , Wang Yong , Menon Ramkumar , Zhong Nanbert
Published: January 2025

Spontaneous preterm birth (sPTB) poses significant challenges, affecting neonatal health and neurodevelopmental outcomes worldwide. The specific effects of placental trophoblasts on the pathological development of sPTB subtypes—preterm premature rupture of fetal membranes (pPROM) and spontaneous preterm labor (sPTL)—are not fully understood, making it crucial to uncover these impacts for the development of effective therapeutic strategies. Using single-nucleus RNA sequencing, we investigated transcriptomic and cellular differences at the maternal–fetal interface in pPROM and sPTL placentas. Our findings revealed distinct trophoblast compositions with pPROM characterized predominantly by extravillous trophoblasts (EVTs), while sPTL showed an abundance of syncytiotrophoblasts (STBs). Through cell differentiation and cell-to-cell communication analyses, other distinguishing factors were also found. In pPROM, heightened inflammation, oxidative stress, and vascular dysregulation with key pathways including tumor necrosis factor signaling, matrix metalloproteinase activation, and integrin-mediated cell adhesion, highlighted an invasive EVT profile potentially driven by hypoxic conditions and immune cell recruitment. In contrast, sPTL was marked by increased smooth muscle contraction, vascular remodeling, and altered signaling dynamics involving fibroblasts, including TGF-β and WNT pathways. Our study highlights the critical need to distinguish sPTB subtypes to improve diagnostic precision and therapeutic targeting. The molecular insights gained provide a foundation for future investigations aimed at functional validation of key pathways and exploration of trophoblasts on the development of sPTB. Ultimately, these findings pave the way for more personalized and effective interventions to mitigate adverse outcomes associated with preterm birth.
A cohort-based multi-omics identifies nuclear translocation of eIF5B /PD-L1/CD44 complex as the target to overcome Osimertinib resistance of ARID1A-deficient lung adenocarcinoma
Authors: Sun Dantong , Hou Helei , Feng Feiyue , Wu Weizheng , Tan Jingyu , Xie Tongji , Liu Jiayu , Wang Jinsong , Qian Haili , Li Junling , Xing Puyuan
Published: January 2025

Background

Osimertinib has emerged as a critical element in the treatment landscape following recent clinical trials. Further investigation into the mechanisms driving resistance to Osimertinib is necessary to address the restricted treatment options and survival advantages that are compromised by resistance in patients with EGFR-mutated lung adenocarcinoma (LUAD).

Methods

Spatial transcriptomic and proteomic analyses were utilized to investigate the mechanisms of Osimertinib resistance. Co-IP, MS, RNA-seq, ChIP-seq, RIP-seq, and ATAC-seq were performed in cell lines to further explore the mechanism. To validate the findings, in vitro and in vivo molecular experiments were conducted.

Results

We found that the ARID1A deficiency results in resistance to Osimertinib by hindering programmed cell death through the EZH2/PTEN/E2F1 axis. This altered axis influences PD-L1 transcription through E2F1-mediated promoter activation and PD-L1 translation via the MDM2/eIF5B/PD-L1 axis. Subsequently, ARID1A deficiency results in increased expression of eIF5B and Importin-β1, promoting PD-L1 nuclear-translocation. The nuclear PD-L1 (nPD-L1) interacts with CD44, leading to nPD-L1 complex formation, activation of the RASGEF1A promoter, initiation of the Ras pathway, and contributing to Osimertinib resistance. Targeting the transcription, translation and nuclear-translocation of PD-L1 using lipid nanoparticles (LNPs) overcomes ARID1A deficiency-induced resistance.

Conclusion

ARID1A deficiency promotes PD-L1 nuclear translocation and induces Osimertinib resistance.
A germline FLT3 variant in aplastic anemia
Authors: Amaeshi Lemchukwu C. , Sofianidi Amalia A. , Shastri Aditi , Goldfinger Mendel , Konopleva Marina , Verma Amit K. , Chaitowitz Mark , Mantzaris Ioannis
Published: January 2025

FMS-like tyrosine kinase 3 (FLT3) genetic variants are commonly seen in high-grade myeloid neoplasms and are typically gain-of-function mutations associated with a proliferative disease phenotype. Inactivating FLT3 variants have been less frequently described in non-malignant, autoimmune disorders and are uncommon in aplastic anemia (AA). Herein, we report the first to our knowledge, and unusual case of a germline, gain-of-function, FLT3 variant in a patient with severe AA treated successfully with immunosuppressive therapy. Although a proposed link between dysregulated FLT3 signaling and autoimmunity has been described and could be speculated in the case of AA, it is currently unknown whether a pathogenetic connection between an activating germline FLT3 variant and AA truly exists and whether the mutation signifies a lifelong risk of disease recurrence and/or clonal evolution. However, the recognition of the FLT3 gene as subject not only to somatic but also germline mutations is the first step in interrogating its functional implications. Further study of unusual genotype-phenotype combinations, such as in the case presented, may shed light on a potential pathogenetic link.
Field study on the suitability of oral fluid samples for monitoring of Lawsonia intracellularis and Brachyspira hyodysenteriae by multiplex qPCR under field conditions
Authors: Eddicks Matthias , Reiner Gerald , Junker Sigena , Willems Hermann , Becker Sabrina , Stadler Julia , Hagn Josefine , Ritzmann Mathias
Published: January 2025

Background

Monitoring or surveillance of infectious diseases is crucial in terms of herd health management of livestock. Investigations of oral fluids have become an animal friendly routine strategy to monitor respiratory pathogens in pigs. Less is known about the suitability of oral fluids for the detection of enteric pathogens in swine. In the present study we evaluated the use of oral fluids to monitor B. hyodysenteriae and L. intracellularis compared to pooled fecal samples by multiplex qPCR in a pen-wise follow-up of fattening pigs. Therefore, we collected oral fluids at an age of 12, 16 and 20 weeks of life and compared them to pooled fecal samples collected from the same pens on two fattening farms.

Results

Cohen´s Kappa analysis revealed a substantial agreement between oral fluids and pooled fecal samples on pen level (Cohen´s Kappa: 0.745; p < 0.001). DNA-loads of L. intracellularis were tendentially higher (p = 0.053) in pooled fecal samples than in the corresponding OFs.

Conclusions

The present study shows that oral fluids are an appropriate tool to monitor B. hyodysenteriae and L. intracellularis on conventional fattening farms under field conditions. However, multiple pen testing should be conducted to increase the diagnostic performance and sensitivity.
Identification of ketamine and norketamine in dried bloodstains on crime-scene surfaces
Authors: Nathan Risha Jasmine , Okeleye Babajide , Abdullahi Rabiu , Oyebode Waliyu
Published: January 2025

Background

Toxicological analysis of dried bloodstains (DBS) provides critical information for reconstructing the sequence of events at a crime scene. Drugs have higher stability in DBS relative to liquid blood owing to the arrest of enzymatic reactions in dehydrated samples. However, literature on the identification of ketamine and its metabolites in DBS is limited and is mostly focussed on the analysis of bloodstains collected on paper cards. The present study has analysed the stability of ketamine and norketamine in DBS aged on common crime scene surfaces under various storage temperatures. Coloured linen fabric and glass slide, representing porous and non-porous surfaces, respectively, were stained with a defined volume of drug-fortified whole blood and stored at room temperature (20 °C), in the refrigerator (4 °C), and freezer (− 20 °C) for 1, 7, and 14 days. Analytes were solvent-extracted using a dichloromethane: hexane (1:3 v/v) mixture, followed by gas chromatography-mass spectrometry (GC–MS) analysis with ketamine-d4 as the internal standard.

Results

At least 4.3 ng/mL and 8.7 ng/mL ketamine and norketamine, respectively, were detected in dried stains prepared from 5 to 50 µL whole blood corresponding to a concentration range of 10–100 ng/mL. The GC–MS method was linear in this range with a coefficient of determination, R2 > 0.99. Recovery of the analytes was comparable (~ 100–120%) between DBS porous and whole blood, whereas it was considerably lower (~ 50%) in DBS non-porous samples due to the incomplete transfer of the stains from the glass into the extraction solvent mixture. Analyte response in DBS showed a strong correlation with that in whole blood at four concentration levels (0.1–5 µg/mL). Mean precision values (% CV) for biological and technical replicates (n = 5) were 15.0 and 6.5, respectively, and within an acceptable range.

Conclusions

The developed method for the analysis of ketamine and norketamine in DBS is comparable to that in other biological matrices such as whole blood under short-term storage conditions. Lower temperatures are favourable for maintaining the integrity of the samples; however, the bloodstains must be completely dried before storing them in the refrigerator or freezer for short-term (1–7 days) to prevent hydrolytic degradation of drugs.

Graphical Abstract
Molecular genotyping revealed the gene flow of Puccinia striiformis f. sp. tritici clonal lineage from Uzbekistan of Central Asia to Xinjiang of China
Authors: Awais Muhammad , Ma Jinbiao , Chen Wenbing , Zhang Bingbing , Turakulov Khurshid S. , Li Li , Egamberdieva Dilfuza , Karimjonovich Meliev Sodir , Kang Zhensheng , Zhao Jie
Published: January 2025

Wheat stripe rust, caused by Puccinia striiformis f. sp. tritici (Pst), is an air-borne fungal disease, and its spores can be spread far away from its origin to colonize in new territory, causing inter-regional epidemics. Xinjiang not only is an important and independent epidemic region from other stripe rust epidemiological regions in China but also has distinguished Pst genetic structure and spatial features. However, the inoculum source of the rust in Xinjiang has remained unknown. It is not clear whether inocula in Central Asian countries migrate to Xinjiang and whether mutual gene flows possibly occur between both regions. We conducted a comparative population study of Pst populations in Xinjiang and Uzbekistan to better understand the Pst migration pattern and inoculum source of the rust in Xinjiang. Our results revealed high genetic diversity in Xinjiang (0.86, 63 MLGs out of 207 samples), compared with the Uzbekistan population (0.76, 47 MLGs out of 255 samples). Our analyses uncovered the clear migration of Uzbekistan Pst populations to Northwest Xinjiang, which is in proximity to Central Asia. The migration of clonal lineage could cause genetic drift and potential threat changing the genetic structure and virulence pattern of Pst in China. Further studies need to be conducted in the Xinjiang region to understand and evaluate the behavior of foreign genotypes in the local environment and their overall impact on local wheat crops.
How to monitor and discriminate the causes of lower limb swelling during home-based rehabilitation after total knee arthroplasty? A delphi study
Authors: Yang Lin , Li Hui-Wu , Zhai Zan-Jing , Wang Cai-Feng , Wu Bei-Ying , Zhou Jia , Bian Wei-Wei , Ruan Hong
Published: January 2025

Purpose

Swelling in the lower limbs after total knee arthroplasty (TKA) affects surgical outcomes. Prolonged swelling requires monitoring and remote management during home-based rehabilitation. Causes of swelling vary but, so far, no indicators are available to monitor and identify causes of lower limb swelling, making it difficult to implement targeted interventions. This study aimed to find the indicators to monitor and identify the causes of lower limb swelling during home-based rehabilitation after TKA by literature research and consulting experts from various disciplines.

Methods

The Delphi method was used. Based on literature research and analysis, a set of candidate indicators was developed. Fifteen experts from different disciplines evaluated the validity of the indicators and provided modification suggestions.

Results

After two rounds of Delphi consultations, consensus was reached. Agreement scores ranged from 4.40 to 5.00, with low variability (standard deviation 0.00–0.91) and high consistency (coefficient of variation 0.00–0.20). P was less than 0.05 in Kendall’s W with an agreement rate of 80.00–100%. In the final set of indicators, there were five primary indicators (representing four swelling causes and a general category), along with 23 secondary indicators and 40 tertiary indicators.

Conclusions

This study preliminarily established indicators for at-home identification of post-TKA swelling caused by four distinct reasons. Further research is needed to validate the value of these indicators in distinguishing the causes of swelling.