bluuebunny/crossref_metadata_2025 huggingface dataset:
Cross-Modal Pedestrian Re-Identification Technique Based on Multi-Scale Feature Attention and Strategy Balancing
Authors: Lai Yiqiang
Published: February 2025

This paper proposes a cross-modal pedestrian re-recognition technique based on the balance of attention and strategy of multi-scale features. The technique improves recognition accuracy by integrating information from different scales, dynamically adjusting attention, and balancing contributions from different modalities. The model architecture includes a multi-scale feature extraction module, an attention mechanism, a strategy balancing mechanism, and a classifier. Experimental results show that the proposed model exhibits superior performance on several public datasets such as Market-1501, DukeMTMC-reID, and CUHK03, especially on the Market-1501 dataset, where MAP and Rank-1 reach 0.83 and 0.89, respectively, which outperforms the existing baseline model and other methods. In addition, by integrating RGB and Thermal modal information, the model's recognition ability is further improved, showing the effectiveness of cross-modal information integration.
Jewish Law and International Law
Authors: Broyde Michael J , Elazar-De Mota Yehonatan
Published: February 2025

This book explores the complex relationship between Jewish law (halakhah) and international law, emphasizing the shared characteristics and potential synergies between these two legal systems. Both systems transcend national boundaries and operate beyond territorial constraints, offering frameworks for justice in a globalized world. The authors delve into how Jewish law incorporates local and international legal principles in areas like war, humanitarian law, copyright law, and governance.

The manuscript is divided into eight chapters, each addressing a specific aspect of Jewish and international law. It begins by introducing both legal systems and their historical contexts, then moves into case studies where Jewish law has either incorporated or resisted international legal norms. The authors analyze key areas such as the ethical considerations in wartime conduct, the role of copyright and intellectual property, and the broader historical dialogue between Jewish law and international legal standards. Furthermore, the book examines the role of Jewish legal thought in navigating antisemitic legal systems and envisions how future developments in both Jewish and international law could promote justice on a global scale.

A major theme of the work is the nonterritorial nature of both legal systems and their reliance on judges and interpretative frameworks. Through this comparative study, the authors encourage scholars from both disciplines to engage in a deeper dialogue, proposing that both legal systems can learn from each other and contribute to a more just global order.
Nanoarchitectonics of Hydrogel-derived Ultrahigh Surface Area Nanoporous Carbon Materials with Enhanced Supercapacitance Performance
Authors: Velychkivska Nadiia , Golunova Anna , Oleksa Viktoria , Brus Jiří , Shinde Pragati A , Sebastian Abin , Ma Renzhi , Ariga Katsuhiko , Yamauchi Yusuke , Hill Jonathan P , Labuta Jan , Shrestha Lok Kumar
Published: February 2025

In the era of the decarbonization economy, supercapacitors offer a realistic solution to the energy storage problem due to their rapidly chargeable electrical double layers. Here, we present the energy performance of ultrahigh surface area nanoporous carbon materials having abundant hierarchical micro/mesopores obtained by in situ potassium carbonate (K2CO3) activation of polyacrylamide (PAM) hydrogel. The resulting nanoporous carbon materials obtained by the carbonization of the hydrogel in the temperature range 600 to 900 °C possess high BET surface areas up to ca. 3038 m2 g-1 for the material prepared at 800 °C (PAM4-K800). Electron microscopy analyses revealed the formation of micro/mesoporous amorphous carbon structures. Surface composition and nitrogen and oxygen doping of the carbon matrix were verified by X-ray photoelectron spectroscopy (XPS). The electrochemical supercapacitance performance was tested using a three-electrode system in an aqueous electrolyte (1M H2SO4). The optimal sample (PAM4-K800) achieved the highest specific capacitance value of 313.3 F g-1 at a current density of 1 A g-1, with excellent capacitance retention of 97.5% after 10,000 charge/discharge cycles. Furthermore, a symmetric supercapacitor device prepared using the optimum material delivered a high energy density of 12.3 Wh kg-1 at a power density of 309.4 W kg-1 and an outstanding cycle life of 95.9% after 10,000 cycles. The outstanding electrochemical performance of PAM hydrogel-derived carbon materials makes them promising candidates for high-performance supercapacitor applications.
Faith and Assimilation: Italian Immigrants in the US
Authors: Gagliarducci Stefano , Tabellini Marco
Published: February 2025

We study the effects of ethnic religious organizations on immigrant assimilation, assembling novel data on Italian Catholic churches across US counties between 1890 and 1920. Exploiting variation in the timing of church entry, we find that Italian churches reduced social and economic assimilation along dimensions that require more inter-group interactions, but had null or positive effects on outcomes for which cross-group coordination is less important. We provide evidence that coordination within the Italian community and natives‚ backlash are plausible pathways for our results. We also document that churches increased literacy and English speaking ability of immigrant children.
Income and work loss in patients with Addison´s disease: a nationwide population-based study
Authors: Stergianos Stavros , Everhov Åsa H , Söderling Jonas , Bergthorsdottir Ragnhildur , Wahlberg Jeanette , Skov Jakob , Bensing Sophie
Published: February 2025

Objective

Autoimmune Addison´s disease (AAD) is associated with reduced health-related quality of life and possibly reduced employability. The aim of this study was to assess differences in income and work loss between patients with AAD and matched comparators.

Design

Nationwide, cross-sectional register-based study.

Methods

By linking the Swedish Addison Register and national health registers, we identified working age (18–64 years) individuals with AAD and general population comparators (matched 1:5 by sex, age and county of residence). We assessed differences in taxable earnings and disposable income through quantile regression and differences in work loss through linear regression during 2019.

Results

We identified 1,140 cases with AAD and 5,700 comparators (mean age 46.1 years, 48.4% men). Type 1 diabetes was prevalent in 15.7% and 1.1%, respectively. Work loss was higher in AAD; adjusted mean difference 14.4 days; 95% CI, 8.6–20. The adjusted median differences in taxable earnings and disposable income were non-significant overall at -617 (95% CI; -2,317 to 1,083) and -405 (95% CI; -1,417 to 607) €. However, significantly lower taxable earnings and disposable income were found among patients with short education: -5,303 (95% CI; -9,603 to -992) and -3,754 (95% CI; -6,486 to -1,022) €, or concomitant type 1 diabetes: -5,808 (95% CI; -9,937 to -1,690) and -3,349 (95% CI; -6,203 to -506) €.

Conclusion

Patients with AAD had more work loss, yet overall similar taxable earnings and disposable incomes versus comparators. Patients with AAD with shorter education or type 1 diabetes were most socioeconomically vulnerable.
Door decals for wayfinding and redirection: a quality improvement project involving the use of clinical real-time location systems for evaluation of environmental design changes
Authors: Shum Leia C , Arora Twinkle , Karam Yasser , Cockburn Amy , Khan Shehroz S , Iaboni Andrea
Published: February 2025

Background and Objectives

Environmental design modifications are important non-pharmacological interventions for people with dementia in older adult residential care, but their effects are difficult to measure objectively. In this paper, we present the assessment of the impact of door decals installed on patient rooms, offices, and exit doors on patient movements as an example of the uses of location data in evaluating environmental design interventions.

Research Design and Methods

We undertook a quality improvement project in an inpatient specialized dementia unit using de-identified data from a clinical location monitoring system from 79 individuals with dementia admitted over time to 15 patient rooms to measure patient movements. In the first phase, decals were applied to one office and six patient room doors, and doors with and without decals were compared. In the second phase, patient movements were compared before and after a decal was applied to the remaining exit, office and nine patient doors. Main outcomes of interest were the number of daily approaches to concealed doors and daily approaches and entrances to patients’ own and others’ rooms.

Results

Using location data, we identified a significant reduction in the number of approaches to and dwell time at office doors and exits. No differences were found in patient movements in relation to their own or others’ rooms in either phase, although patients assigned a room with a decal tended to approach others’ rooms with decals less often than those with a plain door.

Discussion and Implications

Door decals successfully reduced patient contact with staff-only doors and exits but did not have a large impact on patient movement with respect to wayfinding. Location tracking systems provide an important opportunity to evaluate the impact of design interventions in situ in specific older adult care contexts.
Aphis gossypii (Hemiptera: Aphididae) feeding responses to double virus infections in melon
Authors: Galán-Cubero Rocio , Fereres Alberto , Moreno Aránzazu
Published: February 2025

Virus infections cause economic losses in crops worldwide and their management and control present major challenges. In the field, double infections of two or more viruses are the rule, not the exception. The presence of several viruses in a plant makes it difficult to interpret virus–insect vector–plant interactions. Mixed infections can alter plant symptoms compared with single infections and may also impact their vectors. We describe plant-mediated indirect effects of virus double-infection on feeding behavior of an aphid vector (Aphis gossypii Glover) and virus transmission in melon (Cucumis melo L.). The viruses we used were a circulative cucurbit aphid-borne yellows virus (CABYV, Solemoviridae:Polerovirus) and a non-circulative cucumber mosaic virus (CMV, Bromoviridae:Cucumovirus). When melon plants were CMV-infected, indirect plant-mediated effects on A. gossypii feeding were like those reported on other plant species; specifically, intracellular punctures (pd) were more frequent and longer than on mock-inoculated plants, which enhanced CMV transmission. Similarly, when plants were CABYV-infected, we observed a statistically non-significant trend for increases in extended salivation (E1) and ingestion (E2) activities in phloem compared with mock-inoculated plants, which also enhanced CABYV transmission. When aphids fed on CMV-CABYV double-infected plants feeding behavior activities related to the transmission of both viruses were enhanced even more than when feeding on single-infected plants. Nevertheless, the virus transmission rate was the same on single-infected or double-infected plants. Thus, our results suggest that double infections do not modify viral dispersion compared with single infections since the indirect effect of CMV and CABYV in single infections is already optimized to favor virus transmission.
Prediction for close approaches with terrestrial planets of asteroids from the main belt
Authors: Zhou Yufan Fane , Li Zhiyuan , Li Hailiang , Zhou Liyong
Published: February 2025

Potentially Hazardous Asteroids (PHAs), a special subset of Near-Earth Objects, are both dangerous and scientifically valuable. PHAs that truly undergo close approaches with the Earth (dubbed CAPHAs) are of particular interest and extensively studied. The concept and study of CAPHA can be extended to other Solar System planets, which have significant implications for future planet-based observations and explorations. In this work, we conduct numerical simulations that incorporate the Yarkovsky effect to study the transformation of main belt asteroids into CAPHAs of terrestrial planets, using precise nominal timesteps, especially to ensure the reliability of the results for Mercury and Venus. Our simulations predict a total of 1893 Mercury-CAPHAs, 3014 Venus-CAPHAs, 3791 Earth-CAPHAs and 18066 Mars-CAPHAs, with an occurrence frequency of about 1, 9, 15 and 66 per year, respectively. The values for Mars-CAPHAs are consistent with our previous work, which were based on simulations with a larger nominal timestep. The predicted occurrence frequency and velocity distribution of Earth-CAPHAs are in reasonable agreement with the observed population of Earth-CAPHAs. We also find that certain asteroids can be caught in close approach with different planets at different times, raising an interesting possibility of using them as transportation between terrestrial planets in the future.
Association with immorality explains HIV stigma in the USA
Authors: Davoudpour Shahin , Salvador Rommel O , Phillips Gregory
Published: February 2025

Four decades after the first reported case of HIV, the stigma surrounding an HIV diagnosis remains a significant challenge. This persistence, even amid numerous destigmatization efforts, has posed a puzzle for both scholars and policymakers. In this study, we explore the concept of morality attached to HIV status to shed light on this ongoing stigma. Utilizing data from the 2021 and 2022 waves of the General Social Survey, we examined the relationship between comfort in proximity to people with HIV (PWH) and moral beliefs associated with HIV status. Our findings suggest that individuals who ‘strongly agree’ that PWH engage in immoral activities are over 13 times more likely to reject proximity to PWH compared with those who ‘strongly disagree’. This finding is robust, even after taking to account factors such as the individual’s moral belief that same-sex sexual activity is wrong, and their awareness of discrimination against PWH. Overall, our results suggest that stigmatization is more likely when immorality is associated with the stigmatized status. We encourage destigmatization campaigns to consider these findings and integrate the dissociation of morality from HIV status into their messaging frames.
Is it Possible To Identify Patients After Their First Hospitalization for a Psychotic Disorder Who Do Not Use Anti-Psychotics and are Not Later Rehospitalized?
Authors: Krivoy Amir , Tiihonen Jari , Nissan Johnatan , Dotan Arad , Arnheim Dana , Menkes-Caspi Noa , Taub Sharon , Tuppurainen Heli , Mittendorfer-Rutz Ellenor , Davidson Michael , Davis John M , Weiser Mark , Taipale Heidi
Published: February 2025

Background

Guidelines issued by professional organizations recommend that all patients with psychotic disorders who have had several psychotic relapses, continue maintenance anti-psychotic treatment. However, some patients discontinue anti-psychotics and do not later relapse. This study attempted to characterize those patients with psychotic disorders early in their disease not taking maintenance antipsychotics, who were not later hospitalized.

Study Design

This population-based cohort study combined registry data on patients diagnosed in their first psychotic episode (ICD 10 code: F20-29) from Sweden (n = 20 848), and Israel (n = 10 045), and followed them for up to 7 years for re-hospitalization or death. Multivariate analyses assessed sociodemographic and clinical risk factors predicting rehospitalization or death in patients with one hospitalization and did not fill prescriptions for antipsychotics; results from Sweden and Israel were then meta-analyzed.

Study Results

The main analysis of this paper included 1611 patients from Sweden and 1607 from Israel. Male gender (adjusted hazard ratio [aHR], 1.57; 95% confidence interval [CI], 1.16-2.13) and a diagnosis of narrowly defined schizophrenia (F20.0-F20.9; aHR, 1.85; 95% CI, 1.55-2.2) were associated with increased risk of a second hospitalization or death among those who did not use antipsychotics. No sociodemographic or clinical characteristics were associated with a decreased risk of a second hospitalization or death.

Conclusions

Based on registry data, it was not possible to characterize, in a clinically meaningful way, those patients who can safely discontinue anti-psychotic medications and not be re-hospitalized or die. Male gender and a diagnosis of narrowly defined schizophrenia were associated with an increased risk of later relapse.
Four antimicrobial compounds and ISR induction are involved in biocontrol of crown gall disease by the plant beneficial rhizobacterium Bacillus velezensis FZB42
Authors: Qin Xu , Xiao Yueting , Xiong Qin , Kong Wei-Liang , Borriss Rainer , Gao Zhaoliang , Fan Ben
Published: February 2025

Crown gall disease (CGD), which is caused by the bacterium Agrobacterium, is a common plant disease that often results in significant economic losses. Biocontrol offers an environmentally friendly and sustainable method to control CGD. In this study, we investigated the biocontrol effect and mechanism of CGD in Japanese cherry trees by B. velezensis FZB42, a prototype strain of the plant growth promoting rhizobacteria (PGPR). We found that the B. velezensis FZB42 mutants unable to produce one or a combination of four antimicrobial compounds (surfactin, macrolactin, bacilysin, and difficidin) significantly reduced their inhibitory activities against A. tumefaciens XYT-58 and their ability of controlling the occurrence of CGD. Using the purified compounds, we further demonstrated that bacilysin and surfactin can inhibit the growth of XYT-58 in vitro. Inoculation with B. velezensis FZB42 significantly increased the expression of genes related to the jasmonic acid (JA), ethylene (ET), and salicylic acid (SA) pathways in cherry seedlings when they were infected with XYT-58. To our knowledge, this is the first report that bacilysin and difficidin can also suppress the growth of Agrobacterium. Furthermore, our results indicate that multiple antimicrobial compounds and induced systemic resistance (ISR) are involved in the biocontrol of CGD by B. velezensis. The mechanism elucidated here provides guidance for the development and application of this type of PGPR strain in the biocontrol of CGD.
Hapto-robotic Assisted Total Hip Replacement for Hip Near Ankylosis
Authors: Dabel Angelique , Damron Timothy A.
Published: February 2025

Objective:

Robotic-assisted total hip surgery is most used for primary total joint surgery to remove outliers in cup positioning that affect motion and stability. However, they may also have value in difficult primary total hips. In this case report, this method was used for a patient with severe pseudoarthrosis.

Materials and Methods:

The posterior approach was planned for the patient. Preoperative CT scan was obtained in preparation for the hapto-robotic MAKOplasty system (Stryker).

Results:

The preoperative 2 cm leg length difference was reduced to 8 mm based on the MAKOplasty display. The patient’s range of motion was improved compared with baseline with flexion of 80 degrees, 10 degrees of internal rotation, 30 degrees of external rotation, and full extension without undue tightening.

Conclusion:

Total hip replacement in the setting of pseudoarthrosis represents a complex primary procedure that can improve range of motion and pain relief. The use of the CT-based hapto-robotic assisted procedure (ie, MAKOplasty) allowed the desired placement of the acetabular implant and assessment of leg length discrepancy but was only possible through the use of the described technique for true acetabular identification used in this case.
Sense and Sensibility: Nerve Tape—A More Efficient Alternative for Nerve Repair in Breast Reconstruction?
Authors: Chinta Malini , Webster Theresa , Huang Hao , Gfrerer Lisa
Published: February 2025

Background:

Current methods of nerve coaptation, ranging from epineural microsuture to fibrin glue, are either technically challenging or inadequate in providing robust repair. Nerve Tape, a novel sutureless nerve coaptation device, addresses these shortcomings by enabling rapid application while still preserving high-quality nerve repair. The purpose of this study was to compare the speed and quality of nerve repair between Nerve Tape and the traditional microsuture in patients who undergo cancer-related and gender-affirming mastectomies with chest/breast reinnervation.

Methods:

Fourteen surgeon participants performed direct coaptations between the lateral cutaneous branches of intercostal nerves and either medial intercostal nerve branch autograft or allograft. Neurorrhaphy was randomized and performed with microsuture on 1 breast/chest and Nerve Tape on the contralateral breast/chest. Repair time and repair quality, graded with a standardized neurorrhaphy grading scale, were compared between the 2 repair methods.

Results:

The mean repair time using Nerve Tape and microsuture was 1.79 and 5.20 minutes, respectively. Nerve Tape repair required less than half the time of microsuture repair for trainees of all postgraduate year levels. The repair quality was excellent or good in 92% of Nerve Tape coaptations and 69% of microsuture repairs.

Conclusions:

Nerve Tape enables faster repair times and higher rates of clinically acceptable nerve coaptation, regardless of the surgeon’s level of experience. This sutureless technology proves to be a potentially promising alternative to traditional microsurgical suture repair, though more studies are needed to establish a correlation with clinical outcomes.
Risk Management and Good Governance Support Organizational Value
Authors: Gattie Sara U.
Published: February 2025

As healthcare faces mounting financial challenges and an uncertain flow of resources, proactive risk officers are working to implement effective operating policies to handle those challenges and uncertainties. Clear governance structures that are fully integrated into the organization’s strategic planning process can provide the framework for effective risk management. At Providence, a large not-for-profit health system, enterprise risk management practices serve to identify, assess, and manage the risks that can affect the entire organization. Armed with a complete view of risks (both taken and those avoided), system executives, core leaders, and board members work together to protect value and advance the corporate mission.
Exploratory Analysis of Urine PO2 Peri-Procedural Kinetics and CI-AKI Prognostic Abilities in Patients Undergoing PCI
Authors: Chalikias Georgios , Stakos Dimitrios , Kostakis Theodoros , Nalmbant Choulia , Malkots Belkis , Koutroulos Vasilios , Theodoridou Kalliopi , Thomaidis Adina , Tziakas Dimitrios
Published: February 2025

Novel contrast-induced acute kidney injury (CI-AKI) biomarkers are needed to detect earlier and with greater precision the pathophysiological changes in the renal medulla associated with kidney damage. We prospectively assessed the kinetics of urine oxygen tension (PO2) in control healthy individuals and its prognostic ability for CI-AKI in patients undergoing percutaneous coronary intervention (PCI). We enrolled 202 consecutive patients (78% men, mean age 66 ± 10 years) treated with elective or urgent PCI. PO2 was measured using a point-of-care (POC) standard blood gas analyzer at 3 time points (baseline, post—within 3 hours—PCI, and at 24 hours post-PCI) in urine samples. CI-AKI was defined as an increase of ≥25% or ≥0.5 mg/dl in pre-PCI serum creatinine at 48 hours post-PCI. Between baseline and post-PCI measurements, patients without CI-AKI showed a decrease of −37 (36) mm Hg in PO2 urine levels, whereas patients with CI-AKI showed a decrease of only −23 (38) mm Hg. (P = 0.014). Using receiver operating characteristic curve analysis, percentage change in urine PO2 immediately after PCI relative to baseline levels significantly predicted CI-AKI (area under the curve 0.804; 95% confidence interval, 0.717-0.892). A significant drop in urine PO2 appears as a normal response of the kidney medulla to an acute insult (contrast media) immediately post-PCI with recovery to baseline levels 24 hours later. The absence or attenuation of this drop in urine PO2 could predict CI-AKI earlier and more precisely.
Chorioretinitis following Bacillus Calmette-Guerin Treatment for Bladder Cancer
Authors: Boopathiraj Nithya , Wagner Isabella V. , Powers Ross , Mashayekhi Arman
Published: February 2025

Purpose:

To report a rare case of multifocal chorioretinitis subsequent to intravesical Bacillus Calmette-Guerin (BCG) therapy for bladder cancer.

Methods:

Case report.

Results:

A 74-year-old man presented with ill-defined visual changes in his right eye (RE), along with constitutional symptoms such as low-grade fever, chills with rigors, night sweats, headache, dry cough, memory problems, and unintentional weight loss. These symptoms occurred 11 months after receiving intravesical BCG treatment for bladder cancer. His visual acuity in the RE was 20/30. Examination of his RE revealed multiple yellow white chorioretinal lesions, and optical coherence tomography imaging showed focal involvement of the choroid and overlying neurosensory retina. Blood-based testing utilizing next generation sequencing for detection of microbial cell free DNA (Karius test ®) was positive for Mycobacterium tuberculosis complex. The patient was treated with 12 months of triple therapy consisting of isoniazid, rifampin, and ethambutol. The chorioretinal lesions showed complete regression to flat scars, with no evidence of recurrence 15 months after discontinuation of systemic treatment.

Conclusion:

Despite being rare, the possibility of mycobacterial chorioretinitis should be considered in patients with new-onset visual symptoms following intravesical BCG for treatment of bladder cancer.
Benzothiazole Derivatives in Cancer Treatment: Synthesis and Therapeutic Potential: Review
Authors: Hamad Hasan Tuhmaz
Published: February 2025

Benzothiazole derivatives have emerged as promising candidates in the field of cancer treatment due to their unique chemical properties and potent biological activities. This review comprehensively examines the synthetic methodologies employed in the development of benzothiazole derivatives and explores their mechanisms of anticancer action, including cell cycle arrest, apoptosis induction, and inhibition of angiogenesis and metastasis. Additionally, the review highlights recent preclinical and clinical studies that underscore the therapeutic potential of these compounds. By comparing benzothiazole derivatives with existing anticancer agents and discussing future research directions, this review aims to provide a detailed understanding of their role in cancer therapy and their potential for drug development.
Serum and Urine Gadolinium Reference Intervals in Patients With Normal Renal Function Following Gadobutrol Administration
Authors: McDonald Jennifer S. , Day Patrick L. , Spears Grant M. , Bornhorst Joshua A. , McDonald Robert J. , Jannetto Paul J.
Published: February 2025

Background

Gadolinium-based contrast agents (GBCAs) increase the sensitivity and clinical utility of magnetic resonance imaging (MRI) examinations and are used extensively worldwide. While concerns remain regarding the potential toxicity of retained gadolinium (Gd) based on “elevated” serum or urinary Gd concentrations, current Gd reference intervals were established in GBCA-naive patients with normal renal function. Therefore, the aim of this study was to determine the serum and urine Gd clearance in patients with normal renal function after being administered intravenous gadobutrol for a contrast-enhanced MRI examination.

Methods

Patients with normal renal function (estimated glomerular filtration rate ≥60 mL/min) with no prior GBCA exposure in the past 6 months were enrolled and had blood and urine collected before and ~1, 3, 7, 14, 28, 56, and 84 days after their gadobutrol-enhanced MRI examination to measure Gd at each time point. Serum and urine Gd were quantified using a clinically validated inductively coupled plasma mass spectrometry–based assay with a limit of quantitation of 0.1 ng/mL (μg/L).

Results

Thirty-one patients who underwent a gadobutrol-enhanced MRI were enrolled, and 24 completed all collection time points. The pharmacokinetic data suggested a multicompartment (5 phase) model of elimination where 95% of patient's serum Gd fell below the unexposed reference interval (<0.5 ng/mL) at ~56 days and 95% of urine Gd would fall below the unexposed reference interval (<0.8 μg/g creatinine) at ~132 days. Based on review of the electronic medical record, none of the patients self-reported any Gd-related toxicity.

Conclusions

Current reference intervals for serum and urinary gadolinium clearance are not applicable for patients in the 5 months following intravenous gadobutrol exposure.
Lung Ultrasound for the Assessment of Patients With Acute Respiratory Failure
Authors: Greenwall Kelly , Kobes Kevin , Buchanan Brian , Fung Christopher
Published: February 2025

Lung ultrasound has become a standard practice in acute care as an adjunct to the physical exam, providing valuable insights to guide clinical decision making at the point of care. Lung ultrasound can rapidly uncover anatomic detail, help resolve undifferentiated respiratory failure, and delineate equivocal findings on standard plain film without the need for transport to access additional diagnostic imaging. In the following review, basic concepts of lung ultrasound are reviewed including its role in detecting and assessing a variety of common problems.
RarePANK2Variants and Pantothenate Kinase-Associated Neurodegeneration in the Dominican Republic
Authors: Vardarajan Badri N. , Sanchez-Rao Pedro , Kim Christine Y. , Stoeter Peter , Mejia Diones Rivera , Houck Alexander , Chan Amanda , Reyes-Dumeyer Dolly , Piriz Angel , Fee Robert , Blanco-Abinader Francisco , Rice Elizabeth , Christenson Samantha , Chiu Rebecca , Gunasekaran Tamil I , Lantigua Rafael A. , Dalgard Clifton , Przedborski Serge , Mayeux Richard
Published: February 2025

Pantothenate kinase-associated neurodegeneration (PKAN) is a rare, autosomal recessive neurological disorder characterized by the progressive degeneration of specific regions in the brain and is invariably fatal. Several individuals in families affected by PKAN were known to live in an isolated region in a southwestern province of the Dominican Republic and had been previously studied.

Forty-six individuals with PKAN in 34 families were evaluated for disease manifestations using the PKAN-Disease Rating Scale and the Leiter-3 Cognitive and Neuropsychological assessment. We completed whole genome sequencing in the 46 affected individuals and their 80 unaffected relatives. Haplotype analysis was used to identify shared genetic patterns among individuals with the mutation to identify common ancestral and founder effects.

The classical form of PKAN was observed in 22 individuals with moderate to severe oromandibular dystonia and limb dystonia and onset in early childhood. The atypical form was observed in 24 individuals with parkinsonism, dystonia, and cognitive impairment and later onset of disease. APANK2variant, chr20:3907977: A:G(c.680A>G, p.Y227C),was homozygous among 42 affected individuals equally divided by disease form. There were 59 heterozygous carriers of this variant among parents and relatives of the affected individuals. Four individuals from two families were compound heterozygotes forc.680A>Gand chr20:3918728: C:T (c.1594C>T).Haplotype analyses revealed shared patterns across families and of African origin consistent with founder effects forc.680A>Gandc.1594C>T, likely introduced to the island 25 to 35 generations earlier. The frequency of heterozygous carriers ofc.680A>Gallele among individuals of Dominican ancestry living in New York was 0.18% but was 0.8% among individuals living in the Dominican Republic, significantly higher than the reported frequency for all causalPANK2mutations worldwide.

This investigation confirmed likely founder mutations inPANK2associated with the classical and atypical forms of PKAN in 34 families in an isolated region of the Dominican Republic. Compound heterozygosity was observed in four individuals from two families. The heterozygous frequency ofc.680A>Gwas exceptionally high in the Dominican population compared with worldwide data. Founder mutations in such communities offer a unique opportunity to set up relevant, affordable and accessible genetic counseling and screening.
Algorithm for a multidisciplinary diagnostic and therapeutic approach to abdominal lymphatic malformations
Authors: Holm Annegret , Marckmann Dorian , Tan Jerry Wei Heng , Lagrèze Susanne , Uller Wibke , Puzik Alexander , Misgeld Rainer , Blattmann Claudia , Fichtner-Feigl Stefan , Niemeyer Charlotte M. , Kapp Friedrich G.
Published: February 2025

Objective

Abdominal lymphatic malformations (ALM) are benign macro-, microcystic or mixed lesions that originate from defects in vascular development. Depending on size and location, clinical symptoms vary from asymptomatic to potentially life-threatening. Standardized diagnostic and therapeutic guidelines for ALM do not exist. Current literature focuses on imaging characteristics rather than symptoms for indication of invasive treatment strategies, including sclerotherapy and surgery. Sirolimus is evolving as a medical treatment option, while a watchful waiting approach for asymptomatic and low-risk ALM patients is not yet established as a conservative strategy.

Methods

We retrospectively characterized a multicenter cohort of 21 ALM treated 1996 - 2024. Items included clinical symptoms, imaging findings, and management strategies, including resection, sclerotherapy, sirolimus or a watchful waiting approach.

Results

ALM patients were categorized based on symptoms and lesion characteristics with potentially associated complications depending on lesion size and anatomical location: 9/21 (43%) patients were observed in the asymptomatic and low-risk group with regular clinical and radiological follow-up intervals. Acutely symptomatic (7/21; 33%), symptomatic or high-risk patients (5/21; 24%) underwent resection (10/21; 48%), sclerotherapy (1/21, 5%), or were treated with sirolimus (1/21, 5%). All patients had favorable long-term outcomes.

Conclusions

We developed a multidisciplinary diagnostic and therapeutic algorithm for ALM based on clinical presentation and lesion characteristics to ensure a standardized, yet patient-centered symptom- and risk-based approach for the most beneficial treatment and outcome. Importantly, our study is the first to demonstrate that watchful waiting is an adequate strategy for asymptomatic ALM patients with a low anticipated risk for complications. Validation of our proposed algorithm is warranted in a prospective study.
Evaluating the inclusion of lesbian, gay, bisexual, transgender, and queer-related content in graduate medical education: a national survey of program directors
Authors: Pregnall Andrew M. , Pesantes Joshua A. , Vulakh Gennady , Chung Youvin , Gooshvar Setareh , Dine C. Jessica
Published: February 2025

Background

National organizations have identified incorporation of LGBTQ-health content into graduate medical education programs as key action items; however, there has been no systematic study of LGBTQ-health content in these programs.

Objective

The primary objective of this study was to systematically evaluate the quantity of LGBTQ-related didactic and clinical education in graduate medical education programs.

Methods

A cross-sectional, internet-based survey study of programs participating in the 2023-2024 Electronic Residency Application System, performed from September 2023-August 2024.

Results

Of 4,512 programs, 1,048 programs responded (23.2%). The median and mean number of didactic hours per year dedicated to LGBTQ-related content was 2.0 (IQR, 1.0–5.0, range, 0.0-200.0) and 4.0 (SD 9.1), respectively. The median and mean number of clinical hours per year dedicated to LGBTQ-related content was 10.0 (IQR, 1.5 – 40.0, range, 0.0 – 2000.0) and 61.0 (SD 188.4), respectively. Multiple programs reported that residents received no exposure to LGBTQ-related health content in either didactic settings (15.8%; 95% CI, 13.5%-18.5%) or clinical settings (19.4%, CI 16.1% – 23.0%). The most covered didactic topics were gender identity (43.6%), sexual orientation (41.6%), and barriers to care (32.0%). The most covered clinical topics were Pre-Exposure Prophylaxis/Post-Exposure Prophylaxis (77.0%) and facial masculinization/feminization surgery (68.4%). The most cited barriers to including LGBTQ-related health topics were the lack of faculty with requisite knowledge/expertise (56.1%, CI 52.3% – 59.9%) and the lack of time (48.3%, CI 44.5% – 52.1%).

Conclusions

Multiple programs provide no didactic or clinical exposure to LGBTQ-related health topics, which does not align with the goals outlined by national organizations.
Parameter Efficient Fine-tuning of Transformer-based Masked Autoencoder Enhances Resource Constrained Neuroimage Analysis
Authors: Dhinagar Nikhil J. , Ozarkar Saket S. , Buwa Ketaki U. , Thomopoulos Sophia I. , Owens-Walton Conor , Laltoo Emily , Jagad Chirag , Chen Yao-Liang , Cook Philip , McMillan Corey , Tsai Chih-Chien , Wang J-J , Wu Yih-Ru , Thompson Paul M.
Published: February 2025

Recent innovations in artificial intelligence (AI) have increasingly focused on large-scale foundational models that are more general purpose in contrast to conventional models trained to perform specialized tasks. Transformer-based architectures have become the standard backbone in foundation models across data modalities (image, text, audio, video). There has been a keen interest in applying parameter-efficient fine-tuning (PEFT) methods to adapt these models to specialized downstream tasks in language and vision. These methods are particularly essential for medical image analysis where the limited availability of training data could lead to overfitting. In this work, we evaluated different types of PEFT methods on pre-trained vision transformers relative to typical training approaches, such as full fine-tuning and training from scratch. We used a transformer-based masked autoencoder (MAE) framework, to pretrain a vision encoder on T1- weighted (T1-w) brain MRIs. The pretrained vision transformers were then fine-tuned using different PEFT methods that reduced the trainable model parameters to as few as 0.04% of the original model size. Our study shows that: 1. PEFT methods were competitive with or outperformed the reference full fine-tuning approach and outperformed training from scratch, with only a fraction of the trainable parameters; 2. PEFT methods with a 32% reduction in model size boosted Alzheimer’s disease (AD) classification by 3% relative to full fine-tuning and 11% relative to a 3D CNN, with only 258 training scans; and 3. PEFT methods performed well on diverse neuroimaging tasks including AD and Parkinson’s disease (PD) classification, and “brain-age” prediction based on T1-w MRI datasets - a standard benchmark for deep learning models in neuroimaging; 4. smaller model sizes were competitive with larger models in test performance. Our results show the value of adapting foundation models to neuroimaging tasks efficiently and effectively in contrast to training stand- alone special purpose models.
Optimization of the prostaglandin F2αreceptor for structural biology
Authors: Salze Marine , Chrétien Sébastien , Boora Tegvir S. , Macovei Madalina , Barbeau Eric , Blais Véronique , Laporte Stéphane A. , Audet Martin
Published: February 2025

Prostaglandin F2ɑ(PGF2ɑ) is a bioactive lipid derived from arachidonic acid and is involved in many physiological and pathophysiological processes such as parturition, vascular tone regulation, glaucoma and inflammation. It acts by binding to the Prostaglandin F2ɑreceptor (FP), a G Protein-Coupled Receptor (GPCR) that mediates signaling events by engaging intracellular heterotrimeric G protein effectors. The orthosteric binding site of lipid-binding receptors displays greater efficacy-dependent plasticity that hinders the design of ligands. Solving the structure of FP with ligands of different efficacies at an atomic level is important to fully understand its mechanism of activation and inhibition. Most purified FP-ligand complexes are unstablein vitro. The development of new X-ray crystallography and single particle cryo-electron (cryoEM) strategies to understand receptors’ signal transduction requires improved purification yield andin vitrostability of the receptor. Here, we present a protein engineering effort to optimize the FP protein sequence for use in structural biology. Strategies involve protein insertion sites in the third intracellular loop (ICL3), N-terminal and C-terminal deletions, and single-point mutations that favorably affect receptor purification yield and stabilityin vitro. The best FP construct displays a yield of 1.5 mg/L and a stability of 59°C that constitute a threefold improvement in purification yield and 9°C increase in stability over the wild-type receptor. These modifications in the receptor are suitable for pursuing alternative strategies for improving FP purification yield and for studying FP binding efficacy to its ligands through structural biology approaches.
Water-mediated interactions between glycans are weakly repulsive and unexpectedly long-ranged
Authors: Shin Sucheol , Mugnai Mauro L. , Thirumalai D.
Published: February 2025

Glycans, carbohydrates prevalent at the outer cell membrane, play an essential role in mediating cell-cell interactions as well as immune response. Despite their importance, interactions between them have not been characterized. Here, we reveal, using all-atom molecular dynamics simulations and free energy calculations, that watermediated interactions between a pair of N-glycans without net charge are weakly repulsive with a range that exceeds their sizes. Unexpectedly, the effective glycan–glycan interactions decay logarithmically as the separation between them increases. Strikingly, this finding coincides exactly with the predicted interaction, which is entropic in origin, between two star polymers, consisting of long flexible polymers grafted onto colloidal particles. The weak repulsive interaction, which extends beyond the size of a glycan, is sensitive to the relative orientation of the glycans. The effective long-range repulsive interaction vanishes if the charges on water are turned off, thus establishing that electrostatic interactions, arising in part due to the persistent hydrogen bonds between water and the glycans, are responsible for the inter-glycan repulsion.
High efficiency organoid-derived cyst cultures as a drug discovery platform for polycystic kidney disease
Authors: Vanichapol Thitinee , Wangford Ruby , Takemoto Misao , Uesugi Motonari , Davidson Alan J , Sander Veronika
Published: February 2025

Autosomal dominant polycystic kidney disease (ADPKD) causes the slow, progressive formation of fluid-filled cysts within the kidney that ultimately leads to renal failure. Despite being the most common genetic kidney disease, the range of therapies for ADPKD is limited. Ureteric bud (UB) organoids derived from human pluripotent stem cells (hPSCs) have been used to model ADPKD. Here, we describe a protocol to generate UB organoids in large-scale suspension culture that is amenable to drug discovery. When differentiated fromPKD2-deficient hPSCs, the UB organoids robustly form cysts within 7 days and reach nearly 100% cyst efficiency within ∼20 days. Cystic UB organoids express ADPKD markers and are responsive to cyst-reducing compounds, such as the BET inhibitor JQ1 and the NF-κB inhibitor QNZ, but not tolvaptan. As proof-of-principle of the platform as a drug discovery tool, we screened a small molecule library comprised of nutrient conjugates and identified M1, a palmitate-glucosamine-glycine conjugate, that reduced cyst formation. These results demonstrate that our scalable method of cystic UB organoid production provides a simple and highly efficient platform for ADPKD drug discovery.

TRANSLATIONAL STATEMENT

Autosomal dominant polycystic kidney disease (ADPKD) affects over 12 million people worldwide, yet the currently available therapy tolvaptan only moderately delays disease progression and is burdened with adverse effects. Improved treatments that are well tolerated and effective are urgently needed. We established a human ureteric bud organoid platform that enables ADPKD-like cysts to be cultured at large scale and low cost. These cystic organoids resemble human ADPKD cysts and are suitable for drug discovery. Identification of the nutrient conjugate M1 as a new lead molecule for reducing cyst formation highlights the clinical relevance of this model.
Causal associations between gut microbiota and cancers
Authors: Yue Zihan , Yan Junwei , Shen Linyuan , Zhao Chunguang , Yang Xiaopeng , Yao Yiying , Song Dongmei , Xu Chenyang , Bi Chenchen , Xiong Zhongkui , Ma Hongli , Liu Zheng
Published: February 2025

Background

Emerging evidence suggests that the gut microbiota is associated with various cancer-related outcomes. Recent studies using Mendelian randomization (MR) have indicated a causal relationship between gut microbiota and several types of cancer. However, these conclusions remain controversial. To clarify this relationship, we conducted a systematic review and meta-analysis of MR studies to investigate the potential causal links between gut microbiota and cancer.

Method

In this study, we searched PubMed, Embase, the Cochrane Library, and Web of Science up to May 2024 for eligible MR studies and performed meta-analyses.

Results

Our findings indicate that genetically determined gut microbiota is associated with 12 different types of neoplastic outcomes. We identified nine genera of gut microbiota that are generally associated with a reduced risk of developing cancer. However, we also found that the order Mollicutes RF9 (OR = 1.037, 95% CI 1.013-1.060) may be a potential risk factor for breast and lung cancer. Furthermore, we discovered that the families Alcaligenaceae (OR = 1.034, 95% CI 1.000-1.068), Enterobacteriaceae (OR = 1.077, 95% CI 1.020-1.135), and Lactobacillaceae (OR = 1.033, 95% CI 1.008-1.059) are negatively associated with the risk of breast cancer. On the other hand, the genetically predicted family Lactobacillaceae (OR = 0.892, 95% CI 0.848-0.937), along with other families and genera such as Veillonellaceae, Coprococcus, Dorea, Eubacterium, Lachnospiraceae, Ruminococcus, Ruminococcaceae, and FamilyXIII, were found to be correlated with a lower risk of lung cancer. Additionally, the family Peptostreptococcaceae, Veillonellaceae, Streptococcaceae, and certain genera including Eubacterium, Lachnospiraceae, and Ruminococcaceae, were identified as protective factors against glioblastoma. The evidence from published MR studies supports the notion that the gut microbiota plays a causal role in various neoplastic diseases.

Conclusions

In conclusion, there is a causal relationship between gut microbes and cancer, and it is related to microbial species and tumor type. Further research is necessary to understand the underlying mechanisms and to explore the potential for using gut microbiota in prediction, prevention, and therapeutic strategies for these diseases. Studying changes in the microbiome in cancer has significant implications for developing noninvasive diagnostic tools and innovative interventions that could alter the progression of these diseases.