bluuebunny/crossref_metadata_2025 huggingface dataset:
New treatments for type 2 diabetes
Authors: Kos K , Wilding JPH
Published: January 2025

Controlling blood glucose in type 2 diabetes remains challenging. All existing drugs have significant limitations and side effects, with some causing weight gain and thereby exacerbating the condition. This short review looks at new groups of drugs on the market and under development, and discusses their potential in the management of type 2 diabetes.
HEPARIN-INDUCED THROMBOCYTOPENIA AND THROMBOSIS
Authors: Oo Thein H
Published: January 2025

I read with interest the article ‘The diagnosis and treatment of acute pulmonary thromboembolism’ (TN Martin, AJB Brady. J R Coll Physicians Edinb 2009; 39: 107–12) and would like to give some comments.

Firstly, the authors did not mention important hereditary and acquired thrombophilic conditions such as antiphospholipid antibody syndrome, factor V Leiden and prothrombin gene mutations, protein C, protein S, antithrombin III deficiencies as risk factors for venous thromboembolism. In my opinion, they are worth mentioning.

Secondly, with increasing prophylactic and therapeutic use of heparin, I would like to point out that development of heparin-induced thrombocytopenia (HIT) and thrombosis (HITT) is not rare. The incidence for HIT ranges from 0.1% to 5% depending on the type of heparin used and the risk group of patients. Approximately 40% of patients with HIT subsequently develop thrombosis. Of note, 26% of patients are noted to have concurrent thrombocytopenia and thrombosis.1

The condition is usually typical in that thrombocytopenia (either below 150,000/mm3 or 50% decline in baseline platelet count) develops within 5–10 days of heparin use in patients who have had no heparin exposure or who have had remote history of exposure (more than 100 days). Rarely, precipitous fall in platelet count can occur within hours if there is recent exposure to heparin.1

The management of acute pulmonary embolism due to HITT is entirely different. In those patients, heparin must be avoided. Anticoagulation is commenced with direct thrombin inhibitors such as lepirudin or argatroban. Warfarin therapy should be postponed until there has been substantial resolution of thrombocytopenia as warfarin therapy is associated with a severe reduction in the natural anticoagulant protein C, making the hypercoaguable state worse during the acute phase of HITT.2
Authors’ reply
Authors: Thomas N Martin , Brady Adrian JB
Published: January 2025

We welcome Dr Oo’s comments on our review. His suggestion to check for genetic and acquired abnormalities of coagulation, for example factor V Leiden mutation and others, is worthwhile, particularly if there is no obvious precipitating factor causing the venous thrombosis. Of course, initial management is unaffected by these investigations, the results of which would not be available until long after the acute phase of therapy. This is addressed in the pre-penultimate paragraph of our review, together with a list of special situations that includes heparin-induced thrombocytopenia, which directs the reader to the full discussion in the European Society of Cardiology guideline.1 The overriding aim of our review is to highlight the crucial importance of immediate determination of risk of death from pulmonary thromboembolism, with appropriately directed treatment.
Lyme borreliosis in Scotland during two peak periods
Authors: Milner RM , Mavin S , Ho-Yen DO
Published: January 2025

The epidemiology of Lyme borreliosis (LB) and climatic conditions in Scotland were studied. Questionnaire data from all new seropositive patients from July to September 2007 and 2008 were examined along with demographic data from seropositive patients, rainfall and temperature data for these years. There were significantly more samples, seropositive patients and seropositive patients per patients tested in July to September 2008 than 2007. The average annual incidence rate for 2007 and 2008 was estimated at 5.9/100,000 population for Scotland and 43.4/100,000 population for the Highlands of Scotland, increasing to 10.6 and 81.0/100,000 population respectively for the peak months July to September. January to April 2008 was significantly wetter and May to July 2008 significantly drier than in 2007. The number of cases of LB in Scotland is increasing annually as a result of many different factors including increased awareness, improved laboratory techniques and a complex relationship between climatic factors, tick behaviour and human behaviour.
Morgagni hernia – a cause of opacification on a chest radiograph
Authors: Wallis AG , Arora J , Bishop NL
Published: January 2025

Morgagni hernias are often misdiagnosed as a consolidation or collapse of the right middle lobe, and should be considered in the differential diagnosis of opacification at the right cardiophrenic angle. They are a form of congenital diaphragmatic hernia and are best demonstrated on multidetector computed tomography. Medical management will help alleviate gastrointestinal symptoms, but curative management is usually surgical to prevent the complication of strangulation.
Dermatological discovery: the frontiers between genetics, pharmacology and the patient
Authors: Walsh SA
Published: January 2025

Advances in the fields of genetics and pharmacology and the understanding of disease mechanisms have occurred apace in recent years in dermatology. As the pathophysiology of skin diseases become clearer, treatments have become more focused and effective, but new treatments bring new sideeffect profiles and further considerations for the prescribing physician. The diagnostics of skin disease have also progressed and the role of automated systems in the recognition of skin lesions is being explored. Integration of new knowledge and old is a challenge to the modern physician treating patients with dermatological disease.
THE ROLE OF VENOMETERS IN THE DIAGNOSIS OF DEEP VEIN THROMBOSIS
Authors: Dwarakanath Akshay
Published: January 2025

I read with interest the recent paper entitled Venous thromboembolism: the role of the clinician (N Curry, D Keeling. J R Coll Physicians Edinb 2009; 39:243-6). It does not highlight the role of the venometer in the diagnosis of venous thromboembolism.

Clinical diagnosis for deep vein thrombosis (DVT) is notoriously unreliable because the external symptoms of a DVT are so equivocal. The venometer is a simple bedside non-invasive test that uses automated strain-gauge plethysmography to detect DVT1,2. Although there have been no randomised controlled trials to support the role of venometers, they play a major role in the safe screening of patients and are used successfully in the DVT protocols of many UK hospitals, providing an efficient and a cost-effective way to manage DVT.

The definitive characteristic of a DVT is that it blocks normal blood flow. This feature is exploited by the venometer. It determines the likelihood of a thrombosis by objectively measuring the rate at which blood drains under gravity from the patient’s calf. The venometer automatically calculates the likelihood of a DVT based on the measurement taken by the sensor on the calf, while a blood pressure cuff is inflated on the thigh during this brief test. The results, either positive or negative, can help in the diagnosis of venous thromboembolism.

A portable device operated by a trained nurse or technician, the venometer is suitable for use in medical admissions units, community health centres or patients’ homes. The test is quick and simple, taking up to l5 minutes for the complete interpretation. The venometer software is extremely user-friendly and guides the operator precisely through every step in the test sequence.

Venometers decrease the risk and cost of unnecessary anticoagulation and reduce waiting times and the number of ultrasound tests, thus providing 24-hour DVT care in the NHS.
Global Hotspots and Trends of Diabetic Foot Ulcer Therapy: A Bibliometric Analysis from 2004 and 2023
Authors: Hu Yungang , Zhao Yaling , Wu Huimin , Li Xiaolin , Zeng Qi
Published: January 2025

Diabetic foot ulcer (DFU) is a common complication of diabetes, associated with increased rates of amputation and mortality. In recent years, great progress has been made in the treatment of DFU, but there is still a lack of bibliometric research on the treatment of DFU.DFU therapy publications published between 1 January 2004 and 31 December 2023 were retrieved from the Web of Science Core Collection (WoSCC) database for analysis using VOSviewer and CiteSpace analytics. A total of 4833 publications on DFU from 2004 to 2023 were included in the WoSCC database. The United States had the highest productivity with 1463 papers, accounting for 30.27% of the total production, followed by China with 907 papers (18.77%) and England with 438 papers (9.06%). In terms of research institutions and journals, the University of Texas System and Journal of Wound Care published the highest number of papers. High-frequency keywords in the field of DFU therapy mainly concentrated on management, wound healing, and amputation. This study conducted a systematic bibliometric analysis of DFU therapy publications from 2004 and 2025. Improving DFU management, promoting wound healing, and reducing amputation rates are the hotspots and future trends in this field. Our work provides valuable insights into the research trajectory and future avenues of exploration in the field of DFU therapy. These findings provide strong support for academic research and clinical practice.
Acute and Longitudinal Effects of Concussion on Reactive Balance in Collegiate Athletes
Authors: Monoli Cecilia , Morris Amanda J. , Crofts Regan , Fino Nora F. , Petersell Tessa L. , Jameson Trevor , Dibble Leland E. , Fino Peter C.
Published: January 2025

Background

Postural instability is a common observation after concussions, with balance assessments playing a crucial role in clinical evaluations. Widely used post-concussion balance tests focus primarily on static and dynamic balance, excluding the critical aspect of reactive balance.

Objectives

This study investigated the acute and longitudinal effects of concussion on reactive balance in collegiate athletes.

Methods

Concussed and healthy matched controls NCAA division I athletes were assessed at pre-season baseline and 4 post-concussion timepoints: acute, pre-return-to-play (RTP), post-RTP, and 6 months post-concussion. The instrumented-modified Push and Release test measured reactive balance during single- and dual-task conditions. Longitudinal effects of concussions on time to stability and step latency metrics were investigated applying Generalized Estimating Equations.

Results

Acutely after concussion, athletes demonstrated impaired reactive balance, indicated by longer times to stability, in dual-task conditions ( P = .004). These acute impairments were transient and recovered over time. Exploratory analyses revealed that athletes who sustained their first lifetime concussion exhibited both acute ( P = .037) and longitudinal ( P = .004 at post-RTP) impairments in single- and dual-task compared to controls with no lifetime concussion.

Conclusions

This comprehensive evaluation provides insights into the multifaceted nature of post-concussion impairments and emphasizes the importance of considering cognitive demand and history of concussions in assessing athletes’ balance.
Monitoring the Response of Treatment in Major Depressive Disorder with EEG: Could it be an Indicator of Returning to Health in Responders
Authors: Arıkan Mehmet Kemal , Gıca Şakir , İlhan Reyhan , Orhan Özden , Kalaba Öznur , Günver Mehmet Güven
Published: January 2025

Background: Quantitative electroencephalography (qEEG) data can facilitate the monitoring of treatment progress and the evaluation of therapeutic responses in patients with Major Depressive Disorder (MDD). This study aims to compare the qEEG data of MDD patients and healthy controls, both before and after treatment, to assess the effect of treatment response on neural activity. Methods: A total of 72 patients, aged 18–60, who had not used any psychopharmacological medication for at least two weeks, were included in the study. Based on a minimum 50% reduction in scores on the Hamilton Depression Rating Scale (HDRS-17) and Hamilton Anxiety Rating Scale (HARS), the patients were divided into two groups: responders (n = 51) and non-responders (n = 21). qEEG data were recorded before and after treatment. Results: Responders exhibited a significant shift in cortical activity—particularly in theta, alpha, and high-beta power—toward patterns resembling those observed in the healthy control group (improvement range: 15% to 67%). In contrast, non-responders showed minimal changes in cortical activity (improvement range: 38% to 46%). These findings suggest that while qEEG spectral data reflect marked neural changes in responders, no significant alterations occur in non-responders. Conclusion: The use of qEEG spectral analysis to monitor MDD patients provides valuable insights into treatment efficacy. The distinct patterns of cortical activity observed across most brain regions before treatment, compared to healthy individuals, highlight the potential of qEEG to predict treatment outcomes.
Numerical study of low-velocity impact performance of hybrid carbon/Twaron woven fabric
Authors: Huang Canyi , Tang Lin , Zheng Xiaofang , Cui Lina , Liu Yajun
Published: January 2025

In the present study, a finite element impact model of plain-woven fabric was developed and analyzed using commercial FEM code ANSYS® and then validated via a drop-weight impact experiment. Then numerical analysis was carried out to investigate the low-velocity impact performance of hybrid carbon/Twaron fabric. During the analysis, several factors were considered, such as different hybrid ratios of plain fabric, hybrid fabric with different weaves, and the case of a hybrid multi-layer fabric panel. The results show that among the different types of hybrid plain fabric, the impact scenario of plain fabric with a hybrid ratio of 1:1, where carbon yarns are only in the warp direction and Twaron yarns are only in the weft direction (M4-2), has the best impact resistance performance. The impact scenario M4-2 performed excellently in other weaves, such as twill weave, while impact scenario M4-1 (plain fabric with a hybrid ratio of 1:1, one carbon yarns interval with one Twaron yarn) in basket weave showed high suitability for body armor in terms of impact protection. Additionally, arranging Twaron fabric in the top layers of a hybrid multi-layer carbon/Twaron fabric panel yielded superior impact resistance performance during low-velocity impact events compared to other layer arrangements.
Global challenges in the access of endovascular treatment for acute ischemic stroke (global MT access)
Authors: Nasreldein Ahmed , Asyraf Wan , Nguyen Thanh N , Martins Sheila , Lioutas Vasileios-Arsenios , Elbassiouny Ahmed , Ton Mai Duy , Sacco Simona , Micdhadhu Mohamed A , Chen Yimin , Akinyemi Rufus , Kristoffersen Espen Saxhaug , Huo Xiaochuan , Miao Zhongrong , Abdalkader Mohamad , Nagel Simon , Puetz Volker , Thomalla Gotz , Yamagami Hiroshi , Qiu Zhongming , Demeestere Jelle , Qureshi Adnan I , Michel Patrik , Strbian Daniel , Campbell Bruce CV , Yan Bernard , Olorukooba Abdulhakeem , Masoud Hesham E , Haussen Diogo C , Frankel Michael , Mohammaden Mahmoud H
Published: January 2025

Background:

Mechanical thrombectomy (MT) is the standard of care for eligible acute ischemic stroke (AIS) patients with large vessel occlusion (LVO) since 2015.

Aim:

Our aim was to determine the key challenges for MT implementation and access worldwide.

Methods:

We conducted an international online survey consisting of 37 questions, distributed through the World Stroke Organization network and as invited by co-authors between December 2022 and March 2023. The survey included a preamble outlining its purpose, questions on respondent demographics, imaging availability, MT service availability, MT selection criteria, barriers to MT, and training status in each country.

Results:

We received 526 responses from 89 countries distributed across 7 continents. One hundred and sixteen (22.1%) respondents did not have available MT service, 43 (8.2%) had available MT only during working hours, 362 (68.8%) had 24/7 MT availability. Regarding neuroimaging protocols, 13.5% used non-contrast computed tomography (NCCT) only, 40.1% used NCCT/CT angiography, 37.5% used NCCT/CT angiography/CT perfusion), 0.4% used magnetic resonance imaging (MRI) only, and 7.8% used MRI/MR angiography. The most common reasons for not receiving MT were cost, late presentation, and lack of availability of qualified neurointerventional services within reasonable distance. There were 59.1% of respondents who reported having a well-structured MT training program. Lack of qualified trainers, financial support, support from higher authorities, and lack of collaboration between departments were the most common obstacles against developing a training program.

Conclusion:

Our study highlights significant variations in MT availability, accessibility, patient selection criteria, and MT service training programs worldwide. Financial costs and a shortage of trained neurointerventionalists were the main challenges in low- and middle-income countries.
Open Ecosystem Through Secure Plug and Play Interoperability: An Overview
Authors: Fischer Christoph
Published: January 2025

Background:

Interoperability is a critical enabler for integrated Personalized Diabetes Management (iPDM), automated insulin delivery (AID), and the digital transformation of healthcare in general. However, manufacturers still create closed ecosystems (ie, solutions designed to work end-to-end minimizing collaboration with other organizations) with proprietary interfaces because of various interoperability challenges. Therefore, the aim of this article is to provide an overview of how to achieve organizational interoperability in an open ecosystem (ie, solutions designed to integrate different organizations via interoperability standards) for diabetes management.

Methods:

The proposed interoperability design approach called Secure Plug and Play Interoperability (SPPI) supports building and using interoperable system elements in an open ecosystem. Secure Plug and Play Interoperability enables interoperability over the entire system life cycle with its reference architecture, secure interoperability standards, and organizational capabilities. These standards were developed with participation from healthcare providers, regulatory authorities, payers, academia, and manufacturers. Publicly available information provides examples of implementation support and practical usage.

Results:

Organizational interoperability in an open ecosystem can be achieved through organizational capabilities and a selection of secure interoperability standards. ISO/IEEE 11073, Bluetooth profiles, and HL7 FHIR with test specifications, test tools, software development kits, and quality assurance programs represent a coordinated selection suitable for building an open ecosystem. Practical usage is demonstrated with real-world solutions that build on these standards.

Conclusions:

Secure Plug and Play Interoperability facilitates the end-to-end integration of devices, digital products, and services from partners in an open ecosystem. Moreover, even a single manufacturer, who provides all system elements of a solution, can use and benefit from SPPI.
Primary ovarian peripheral primitive neuroectodermal tumor presented with breast metastasis; Case report
Authors: Rabi Razan , Hamed Allah Majd , Dawabsheh Yusuf
Published: January 2025

Ewing sarcoma family tumors (ESFT) pose diagnostic challenges, which largely depend on the primary site of involvement and tumor stage. Despite advancements in treatment, metastatic ESFTs remain associated with poor outcomes. This case describes a 21-year-old woman who, in July 2022, presented with a left breast mass identified through ultrasound and CT scan, along with abdominal distention. A biopsy of the breast mass confirmed metastatic extraskeletal Ewing sarcoma. Further imaging revealed an ovarian mass, with subsequent biopsy confirming ovarian origin as extraskeletal Ewing sarcoma. The breast mass was identified as metastatic based on imaging features, including irregular margins and CT scan confirmation of widespread metastasis. Histopathology and immunohistochemistry confirmed Ewing sarcoma, consistent with the ovarian mass pathology that was the primary site. She underwent 15 cycles of VDC/IE chemotherapy ((vincristine, doxorubicin, and cyclophosphamide) for 2 days and 5 days IE (ifosfamide etoposide)), resulting in tumor cytoreduction. However, in less than 2 years, she developed metastases to the dura, spine, and bone, with optic nerve involvement. Despite treatment with radiotherapy and two cycles of high-dose Ifosfamide chemotherapy, her condition deteriorated, and she passed away in April 2024. This case underscores the complexity of managing metastatic ESFTs. Further research is needed to improve outcomes and establish treatment protocols for this malignancy.
Cutaneous pseudolymphoma successfully treated with intralesional triamcinolone acetonide: A case report
Authors: Asamoah Nicole , Gunton Lara
Published: January 2025

Cutaneous pseudolymphoma refers to a group of skin conditions that simulate lymphoma either clinically and/or histologically. Cutaneous pseudolymphoma is a benign disorder that can often be misdiagnosed and has a wide range of treatment modalities. Currently, there is no gold standard of treatment, and the literature would benefit from more reports on successful and unsuccessful treatments of cutaneous pseudolymphoma. In this case, we present a 24-year-old female with cutaneous pseudolymphoma successfully treated with intralesional triamcinolone acetonide after misdiagnosis and several failures with other treatments.
Integrating Ambulatory Care Pharmacists Into Value-Based Primary Care: A Scalable Solution to Chronic Disease
Authors: Blood Alexander J. , Saag Harry , Chesler Adam , Ameripour Dalia , Gutierrez Max , Nguyen Van , Richardson Cassandra , Fields Clive , Clair Jen , Yao Aaron , Moodley Sashi
Published: January 2025

Introduction/Objectives:

Patients living with chronic diseases require more medical attention, including more visits to primary care. However, primary care providers are overburdened, and this specialty is attracting fewer new providers than before. Clinical pharmacists can augment these efforts by improving disease state control. In this cohort study, we aimed to demonstrate a retail pharmacy hired and trained clinical pharmacist within a value-based primary care clinic network can improve hypertension (HTN) and type 2 diabetes mellitus (T2DM) control.

Methods:

In this cohort study, a pharmacist, enabled by a collaborative drug therapy management agreement, prescribed and titrated therapies for HTN and T2DM. Primary outcomes were pre- to post-index changes in hemoglobinA1c, systolic, and diastolic blood pressure (BP) measures.

Results:

The HTN cohort consisted of 43 patients and the T2DM cohort consisted of 125 patients. The difference-in-differences (β) in the HTN group was −10.2 mmHg ( P < .01) for systolic BP and −2.0 mmHg ( P = .42) for diastolic BP. The β in the T2DM group was −1.16% ( P < .001).

Conclusions:

Statistically significant reductions in systolic BP and hemoglobinA1c were observed in the pharmacist-managed group compared with matched controls. These results demonstrate that pharmacist integration into a value based primary care clinic may improve measures of chronic disease associated with morbidity and mortality.
Analysing the Research Development in Green Finance: Performance Analysis and Directions for Future Research
Authors: Desai Rajesh , Patel Siddharth
Published: January 2025

Financial institutions actively consider environmental performance as an important metric for investment evaluation and allocation of financial resources, which is prevalently known as ‘green finance’. The concept of green finance has received global recognition, as illustrated by the growing publications, yet there is a persistent need to synthesize the extant literature in this area to understand how green finance has developed as a distinctive and crucial body of knowledge. The present research aims to systematically review the scholarly articles on the green finance domain published from 1997 to 2024. Using the Scopus database and the SPAR-4-SLR framework, the current research integrates the bibliometric analysis along with a systematic literature review approach. The study discovers seven thematic areas that associate the green finance domain with distinctive knowledge clusters, such as (a) green investments, (b) green economic growth, (c) environmental performance, (d) green innovation, (e) corporate social responsibility, (f) climate risk management and (g) financial development. Such dispersed and multiple themes corroborate the multidimensional outlook of green finance and its universal applicability. Further, the study also describes theme-wise directions of future research to enhance the existing body of knowledge. Finally, the current research enumerates critical implications for academicians, practitioners and policymakers.
Neural Pathways to Equity: Policy Strategies to Reduce Chronic Unsafety for Black Americans
Authors: Alvarez Gabriella M. , Newbill Chloe M.S. , Tchala Yemi L.
Published: January 2025

Black Americans often face chronic exposure to racism, which can undermine psychological safety and alter neural function in regions implicated in processing emotions and regulating the body, potentially contributing to severe health inequities. This review explores the neural mechanisms through which systemic racism may perpetuate chronic stress, influencing physiological dysregulation and exacerbating health inequities. Addressing these deep-rooted issues necessitates dismantling systemic barriers and embedding safety-promoting cues in environments historically shaped by anti-Black racism—particularly within the healthcare and economic sectors. Recommended policies include (1) expanding access to quality healthcare, (2) enhancing cultural representation in healthcare to foster psychological safety, and (3) implementing socioeconomic initiatives aimed at building generational wealth and alleviating chronic stress. This paper presents a range of policy recommendations, spanning from immediate local actions to long-term federal goals, all designed to comprehensively address these challenges comprehensively. Recognizing the varying degrees of feasibility and support, these recommendations are crafted to offer both practical solutions and innovative, evidence-based strategies to significantly advance health equity.
Risk for Ocular Hypertension With Intravitreal Dexamethasone Implants in Black and White Patients With Diabetic Macular Edema
Authors: Leung Ella H. , Alsoudi Amer F. , Skrehot Henry Chang , Burkhead Daniel , Adcock Bradley , Behl India , Chin Yee David
Published: January 2025

Purpose: To compare the effects of intravitreal (IVT) 0.7 mg dexamethasone implants on the intraocular pressure (IOP) in Black patients and White patients with diabetic macular edema (DME). Methods: A retrospective cohort study was performed of Black patients and White patients with DME who received dexamethasone implants with 12 or more months of follow-up. Results: The study included 145 eyes (69 Black; 76 White) with a mean (±SD) of 3.6 ± 3.9 dexamethasone implants and 58 ± 31 months of follow-up. Black patients had higher baseline rates of glaucoma (23% vs 8%; P = .010) but similar rates of ocular hypertension after receiving IVT dexamethasone (20% vs 16%; P = .52). By the last follow-up visit, the mean central subfield thickness had decreased from 387 ± 129 µm to 314 ± 104 µm ( P < .001). Conclusions: IVT dexamethasone implants decreased macular thicknesses in patients with DME; however, there was no difference in the rate of ocular hypertension after IVT dexamethasone between Black patients and White patients.
Dynamics of Contextualization Within Social Entrepreneurship Training in Sub-Saharan Africa
Authors: McDaniel Michael , Kouassi Stephane , Leger Margot
Published: January 2025

Social entrepreneurship is seen as a vehicle to drive development and mitigate social problems. In sub-Saharan Africa, support and training centers have emerged, often funded by government and development agencies, in order to assist social entrepreneurship ventures. However, it is unclear whether these programs are sufficiently adapted to the local context to provide appropriate support. This paper explores contextualization of social entrepreneurship training programs in three countries in sub-Saharan Africa. Through content analysis, surveys, and interviews with training centers in Ghana, Kenya, and South Africa, we investigate how these programs equip entrepreneurs to tackle local social problems. We find that their methods, approach, and content clearly illustrate contextualization in response to socio-economic and entrepreneurial ecosystem dynamics. Resource scarcity and social embeddedness theories help explain our findings. We conclude that the primary drivers of contextualization in these programs in these countries are similar: differences in actors, resources, and bottom lines. By explaining how contextualization manifests itself and how it occurs in these developing countries, our findings can improve the implementation of such programs and help overcome the barriers that context can create.
Multi‑omics identification of a novel signature for serous ovarian carcinoma in the context of 3P medicine and based on twelve programmed cell death patterns: a multi-cohort machine learning study
Authors: Ye Lele , Long Chunhao , Xu Binbing , Yao Xuyang , Yu Jiaye , Luo Yunhui , Xu Yuan , Jiang Zhuofeng , Nian Zekai , Zheng Yawen , Cai Yaoyao , Xue Xiangyang , Guo Gangqiang
Published: January 2025

Background

Predictive, preventive, and personalized medicine (PPPM/3PM) is a strategy aimed at improving the prognosis of cancer, and programmed cell death (PCD) is increasingly recognized as a potential target in cancer therapy and prognosis. However, a PCD-based predictive model for serous ovarian carcinoma (SOC) is lacking. In the present study, we aimed to establish a cell death index (CDI)–based model using PCD-related genes.

Methods

We included 1254 genes from 12 PCD patterns in our analysis. Differentially expressed genes (DEGs) from the Cancer Genome Atlas (TCGA) and Genotype-Tissue Expression (GTEx) were screened. Subsequently, 14 PCD-related genes were included in the PCD-gene-based CDI model. Genomics, single-cell transcriptomes, bulk transcriptomes, spatial transcriptomes, and clinical information from TCGA-OV, GSE26193, GSE63885, and GSE140082 were collected and analyzed to verify the prediction model.

Results

The CDI was recognized as an independent prognostic risk factor for patients with SOC. Patients with SOC and a high CDI had lower survival rates and poorer prognoses than those with a low CDI. Specific clinical parameters and the CDI were combined to establish a nomogram that accurately assessed patient survival. We used the PCD-genes model to observe differences between high and low CDI groups. The results showed that patients with SOC and a high CDI showed immunosuppression and hardly benefited from immunotherapy; therefore, trametinib_1372 and BMS-754807 may be potential therapeutic agents for these patients.

Conclusions

The CDI-based model, which was established using 14 PCD-related genes, accurately predicted the tumor microenvironment, immunotherapy response, and drug sensitivity of patients with SOC. Thus this model may help improve the diagnostic and therapeutic efficacy of PPPM.
Arthroscopic-assisted reduction for Developmental Hip Dysplasia (DDH) through the sub-adductor and anterolateral portals; A 24-month follow-up prospective descriptive study
Authors: Rashwan Amr Samir , El-Desouky Mahmoud , Elbarbary Hassan , Madbouly Mahmoud Abd Elhamid , Khedr Ahmed
Published: January 2025

Background

Developmental dysplasia of the hip (DDH) encompasses a spectrum of pathological conditions, including dislocation, subluxation, and deformities of the femoral head and acetabulum. The optimal surgical approach for DDH remains a subject of debate. Successful treatment aims to achieve a stable concentric reduction and prevent future subluxation or dislocation. This study aims to assess the clinical and radiographic outcomes of arthroscopic-assisted surgical reduction of DDH in children aged from 6 months to 5 years old.

Methods

This prospective study included 57 patients with DDH (68 involved hips) between January 2019 and May 2021. They were treated with arthroscopic-assisted surgical reduction. Dega osteotomy was needed in 22 cases, femoral osteotomy and or shortening was necessary in 11 cases, and combined pelvic and femoral osteotomies were required in nine cases. We evaluated and followed all the patients clinically and radiologically, using Severin, modified Severin scores, Shenton line, and acetabular index measurement up to 24 months postoperatively.

Results

The mean age of the included patients was 26.9 months. The mean operative time was 54.7 (36–90) minutes. Clinical assessment using the modified Severin classification revealed that 53 hips (77.9%) were grade I and 11 hips (16.2%) were grade II at the end of the follow-up. Radiological evaluation using Severin classification revealed that 55 hips (80.9%) were in grade I, and 10 hips (14.7%) were in grade II. There was a statistically significant correlation between clinical and radiological grading (p < 0.001). Hip re-dislocation and avascular necrosis (AVN) were experienced in one and two cases, respectively.

Conclusion

These findings suggest that arthroscopic-assisted reduction for DDH, with or without osteotomies, is a promising technique with satisfactory clinical and radiographic outcomes and a low complication rate. However, given the single-center nature of this study and its relatively small sample size, these results should be interpreted with caution.

Clinical Trial Registration (Retrospectively registered)

Registration number: NCT06520436. 25-7-2024.
High-intensity focused ultrasound: an innovative approach for micro-manipulation of demineralized dentine
Authors: Rajan Sheetal Maria , Shrestha Barsha , Fawzy Amr
Published: January 2025

Background

Treatment of deep carious lesions poses significant challenges in dentistry, as complete lesion removal risks compromising pulp vitality, while selective removal often reduces the longevity of restorations. Herein, we propose a minimally invasive approach using High-Intensity Focused Ultrasound (HIFU) for microscale removal of carious dentine. Concurrently, HIFU’s antimicrobial effects against associated cariogenic biofilms and the corresponding thermal and biological impacts on surrounding tissues were investigated.

Methods

A total of 238 sound human molars were utilized, with 203 samples of artificial carious-simulated dentine (ACSD) prepared for HIFU exposure. HIFU (250 kHz) was applied at 20 W for varying durations (60, 120, and 180 s). The acoustic waves were administered via a collimated cone coupled to the dentine surface using ultrasonic gel.

Results

Advanced characterization techniques including scanning electron microscopy (n = 5/group), Raman spectroscopy, atomic force microscopy, and nano-indentation (n = 5/group), demonstrated HIFU’s effectiveness in removing demineralized collagen-fibrils. This was reflected in the increased mineral content, nano-hardness, and reduced elastic-modulus of ACSD lesions. Micro-CT (n = 6/group) confirmed the increase in mineral density post-HIFU exposure. Confocal microscopy of Rhodamine-B stained ACSD (n = 5/group) quantified the depth of dentine microscale removal post-HIFU exposure in a time-dependent manner. HIFU’s potent anti-biofilm effect (n = 9/group) against Streptococcus mutans biofilms was evidenced by microscopic characterizations and significant reductions in metabolic-activity and colony-forming units. Furthermore, HIFU promoted the proliferation of dental pulp stem cells (n = 3/group) while maintaining the associated temperature-rise within the physiological tolerance.

Conclusion

HIFU’s potential as an innovative, minimally invasive, non-ionizing tool for dentine carious lesion micromanipulation was demonstrated through the interaction between focused acoustic waves and dentine, warranting further studies for future clinical translation in restorative and/or preventive dentistry.
Gallic acid alleviates exercise-induced muscle damage by inhibiting mitochondrial oxidative stress and ferroptosis
Authors: Yu Likai , Tian Di , Su Zishan , Zhang Li , Guo Shaobo , Zhu Wenhui , Fang Yuan , Wang Peimin , Zhang Nongshan
Published: January 2025

Background

Skeletal muscle injury caused by excessive exercise is one of the most commonly seen clinical diseases. It is indispensable to explore drugs for treating and relieving skeletal muscle injury. Gallic acid (GA) is a polyphenolic extract that has anti-inflammatory and antioxidant biological activities. However, its function and mechanism in skeletal muscle injury remain unclear.

Methods

We first established a skeletal muscle injury model caused by excessive exercise. Histopathological analysis was used to determine the severity of skeletal muscle injury in mice. Techniques such as ELISA, Western blot, and RT-qPCR were used to measure skeletal muscle injury markers including CK, LDH, IL-6, TNF-α, and ferroptosis-related indicators such as Fe2+, MDA, COX2, and GPX4. Transmission electron microscopy was used to observe the morphology of mitochondria. JC-1, DHE, and C11-BODIPY 581/591 probes were used to detect mitochondrial membrane potential, mitochondrial reactive oxygen species (mtROS), and lipid peroxidation levels.

Results

The results of this study indicate that GA has a positive therapeutic effect on skeletal muscle inflammation and injury induced by excessive exercise. On the one hand, GA can alleviate skeletal muscle mitochondrial injury and redox imbalance by reducing mitochondrial membrane potential level and increasing ATP production. On the other hand, GA can inhibit ferroptosis in skeletal muscle cells induced by excessive exercise through its antioxidant and anti-iron accumulation ability.

Conclusions

In summary, GA protects against skeletal muscle injury induced by excessive exercise by inhibiting mitochondrial oxidative stress and ferroptosis pathways, providing new evidence for GA as a promising therapeutic agent for skeletal muscle injury.
Aortic lumen repair with glue-felt technique before proximal anastomosis in acute type a aortic dissection surgery
Authors: Varol Muhammed , Arapi Berk , Tel Üstünışık Çiğdem , Göksedef Deniz , Ömeroğlu Suat Nail , İpek Gökhan , Balkanay Ozan Onur
Published: January 2025

Objectives

Despite the advances in medicine, aortic dissection remains a cardiac surgery emergency with high mortality and morbidity rates. This study examined the effects of the Glue + Felt technique, which uses biological glue and felt to repair the proximal anastomotic site, on the outcomes of patients with acute type A aortic dissection.

Methods

A total of 108 patients who underwent surgery for acute type A aortic dissection at our clinic between 2007 and 2020 were included in the study. The patients were divided into two groups: the "Glue + Felt Technique" and the "Bentall-De Bono" groups, based on the surgical technique used for the aortic root. The effects of these two techniques on the development of intraoperative and postoperative complications and survival rates were statistically analyzed.

Results

The Glue + Felt technique was used for 76 patients, while the Bentall-De Bono technique was used for 32 patients. The Kaplan–Meier analysis revealed significant differences in survival rates between the two groups over the entire follow-up period, both with and without propensity score matching (p < 0.001 and p = 0.02, respectively). However, no significant differences were observed in comparisons beyond the first 30 days of follow-up, either with or without propensity score matching (p = 0.573 and p = 0.561, respectively). The main factors contributing to this difference were the duration of cardiopulmonary bypass and aortic cross-clamp time (p < 0.05). During the average follow-up period of 46.2 ± 31.6 months, no re-intervention was required in patients from the Glue-Felt technique group.

Conclusions

The mortality rate in aortic dissection surgery is higher with more extensive surgical intervention as the duration of cardiopulmonary bypass and aortic cross-clamp time increases. Repairing the lumen and reducing operation time in suitable patients using the Glue-Felt technique for the proximal anastomotic site positively impacts postoperative complications and improves in-hospital and 30-day survival rates, without increasing long-term re-intervention rates.
Establishment and evaluation of a method for measuring ornithine transcarbamylase activity in micro blood of neonates
Authors: Zhang Zhilei , Wang Xin , Zhang Jingjing , Guan Xianwei , Wang Yanyun , Hong Dongyang , Li Yahong , Yang Peiying , Sun Yun , Jiang Tao
Published: January 2025

Background

Ornithine transcarbamylase deficiency exhibits a high degree of clinical heterogeneity, making its screening and classification challenging in some instances. In this study, we first established a simple and stable method for testing ornithine transcarbamylase activity using micro blood from newborns, rather than relying on venous blood.

Methods

The activity of ornithine transcarbamylase was assessed by measuring the concentration of citrulline produced in the reaction with carbamoyl phosphate and ornithine, using serum, plasma or micro blood. Correlation analysis was evaluated using Sangerbox Tools. The Receiver Operating Characteristic curve was used in SPSS Statistics 17.0 to evaluate the diagnostic efficiency of Ornithine transcarbamylase deficiency.

Results

A strong linear relationship was observed between ornithine transcarbamylase activity and both micro blood volume and reaction time (R2 = 0.9793, 0.9922 respectively). The intra-coefficient variation and inter-coefficient variation were 11% and 12.5% with a 1-h reaction time, and 6.77% and 9.58% with a 3-h reaction time, respectively. And the inter-coefficient variation was lower than the most widely used colorimetry method (5.1–21.1%). The Limit of Blank was 0.57 nmol/mL/h. The reference interval for normal newborn population is greater than or equal to 39.6 nmol/mL/h. Notably, the method exhibited a 100% sensitivity, surpassing the sensitivity of colorimetry method (94.3%), along with and a specificity of 96.9% for diagnosing ornithine transcarbamylase deficiency.

Conclusions

We pioneered a method for testing OTC activity that normally carried on venous blood can be effectively performed on microblood heel samples. Meanwhile, our method presents a simpler, more stable and reproducible approach compared to colorimetry.
Development of a non-specialist worker delivered psychological intervention to address alcohol use disorders and psychological distress among conflict-affected populations in Uganda and Ukraine
Authors: Nadkarni Abhijit , Massazza Alessandro , Tol Wietse A. , Bogdanov Sergiy , Andersen Lena S. , Moore Quincy , Roberts Bayard , Weiss Helen A. , Singh Soumya , Neuman Melissa , May Carl , Fuhr Daniela C.
Published: January 2025

Background

Despite the significant burden of alcohol use disorders (AUD), there is a large treatment gap, especially in settings and populations affected by armed conflict. A key barrier to care is the lack of contextually relevant interventions and adequately skilled human resources to deliver them. This paper describes the systematic development of the CHANGE intervention, a potentially scalable psychological intervention for people with co-existing AUD and psychological distress in conflict-affected populations, delivered by non-specialist workers (NSWs).

Methods

CHANGE was developed in sequential steps: (1) identifying potential treatment strategies through a meta-review and Delphi survey with international experts; (2) in-depth interviews (IDIs) with key stakeholders from the study settings in Uganda and Ukraine; and (3) three consultative workshops with international experts and experts from Uganda and Ukraine to develop a theoretical framework for the intervention informed by outputs of the Delphi and IDIs.

Results

In the Delphi survey, experts reached agreement on the acceptability, feasibility and potential effectiveness of the following components: identify high-risk situations, problem solving skills, assessment, handling drinking urges, communication skills, pros and cons of drinking, and identifying high-risk situations. From the IDIs we identified (a) causal attributions for using alcohol e.g., psychosocial stressors; (b) cultural norms related to alcohol consumption such as patriarchal stereotypes; and (c) coping strategies to deal with drinking problems such as distraction. The CHANGE intervention developed through the consultative workshops can be delivered in three sequential phases focussed on assessment, feedback, and information (Phase 1); providing the client with need-based skills for dealing with high-risk situations related to alcohol use (Phase 2), and relapse prevention and management (Phase 3).

Conclusions

CHANGE is a contextually relevant and potentially scalable treatment for co-existing AUD and psychological distress to be delivered by NSWs to conflict-affected populations. Effectiveness and cost-effectiveness of CHANGE will be tested in Uganda and Ukraine.
Virtual machine scheduling and migration management across multi-cloud data centers: blockchain-based versus centralized frameworks
Authors: Altahat Mohammad A. , Daradkeh Tariq , Agarwal Anjali
Published: January 2025

Efficiently managing virtual resources in the cloud is crucial for successful recourse utilization. Scheduling is a vital technique used to manage Virtual Machines (VMs), enabling placement and migration between hosts located in the same or different data centers. Effective scheduling not only ensures better server consolidation but also enhances hardware utilization and reduces power consumption in data centers. However, scheduling VMs across a Wide Area Network (WAN) poses considerable challenges due to connectivity issues, slower communication speeds, and concerns around data integrity and confidentiality. To enable informed scheduling decisions, it is critical to facilitate the exchange of real-time and accurate status information between cloud data centers, ensuring optimal resource allocation and minimizing latency. To address this, we propose a novel distributed cloud management solution that utilizes blockchain technology to facilitate efficient sharing of VM characteristics across multiple data centers. BigchainDB platform has been used as a blockchain-based ledger database to effectively share information required for VM scheduling and migration across different data centers. The proposed framework has been validated and compared with a Virtual Private Network (VPN)-based centralized management solution. The proposed model utilizing blockchain-based solution achieves 41.79% to 49.85% reduction in number of communication messages and 2% to 12% decrease in total communication delay comparing to the centralized model.