bluuebunny/crossref_metadata_2025 huggingface dataset:
From Forest to Fork: A Systematic Review of Mushroom-Based Meat Analogues
Authors: Fetriyuna Fetriyuna , Rafi Afif Ziyadi , Zaida Zaida , Purwestri Ratna Chrismiari , Sikin Adi Md
Published: February 2025

The consumption of meat analogues is steadily increasing due to factors such as concerns about protein intake, meat availability, health, and environmental issues. Mushrooms provide a potential solution for substituting or replacing animal protein due to their high nutritional value and unique sensory properties. This review examines the differences in physical characteristics, organoleptic qualities, amino acid profiles, and dietary fibre content of meat analogues derived from various mushroom species. The review employed a textual narrative synthesis approach and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive analysis of 38 relevant publications reveals that the incorporation of mushrooms can influence the colour and texture of meat analogues. Additionally, the review highlights the impact of mushroom addition or substitution on the amino acid and dietary fibre content of meat analogues. It underscores the potential of mushrooms to create meat analogues with enhanced nutritional profiles, benefiting consumers, particularly those facing nutritional challenges like stunting. This paper emphasizes the importance of considering the specific mushroom species and processing techniques to optimize the quality of meat analogues.
Induced Subdivisions in K
s,s-Free Graphs With Polynomial Average Degree
Authors: Girão António , Hunter Zach
Published: February 2025

In this paper we prove that for every $s\geqslant 2$ and every graph $H$ the following holds. Let $G$ be a graph with average degree $\Omega _{H}(s^{A|H|^{2}})$, for some absolute constant $A>0$, then $G$ either contains a $K_{s,s}$ or an induced subdivision of $H$. This is essentially tight and confirms a conjecture of Bonamy, Bousquet, Pilipczuk, Rz kaŻewski, Thomassé, and Walczak in [2]. A slightly weaker form of this has been independently proved by Bourneuf, Bucić, Cook, and Davies [3]. We actually prove a much more general result, which implies the above (with worse dependence on $|H|$). We show that for every $ k\geqslant 2$ there is $A_{k}>0$ such that any graph $G$ with average degree $s^{A_{k}}$ either contains a $K_{s,s}$ or an induced subgraph $G^{\prime}\subseteq G$ without $C_{4}$’s and with average degree at least $k$. Finally, using similar methods we can prove the following. For every $k,t\geqslant 2$ every graph $G$ with average degree at least $B_{t}k^{\Omega (t)}$ must contain either a $K_{k}$, an induced $K_{t,t}$ or an induced subdivision of $K_{k}$. This is again essentially tight up to the implied constants and answers in a strong form a question of Davies.
“Peacekeeping Proneness”: Which Type of International System Is Most Likely to Enhance the Supply of Peacekeepers?
Authors: Cunliffe Philip
Published: February 2025

Abstracts

The Russian invasion of Ukraine has escalated geopolitical rivalry and debate about the demise of the liberal international order and the changing distribution of power within the international system. Peacekeeping has been a key component of the liberal international order at least since the end of the Cold War, if not before. Peacekeeping boomed in the era of US unipolarity, with twenty new United Nations (UN) operations alone launched between 1989 and 1994. At the time of writing, c. 60,000 blue helmets are deployed around the world, and a peacekeeping operation is being mooted for postwar Gaza. Given the growing geopolitical rivalry between East and West, a relative erosion of US power, and much talk of a new age of multipolarity, where does this leave peace operations and peacekeeping? This paper explores the impact of different distributions of power in the international system (namely, multipolarity, bipolarity, and unipolarity) on peace operations. The paper goes through relevant military interventions beginning with the post-1815 Congress system and reaching up to the present day. The paper shows that a multipolar distribution of power is most propitious for the global deployment of peacekeepers, and suggests that peace operations may in future express international cooperation more than unipolar power.
Comparison of trimethoprim-sulfamethoxazole versus minocycline monotherapy for treatment of Stenotrophomonas maltophilia pneumonia
Authors: Graves Emily T , Wardlow Lynn , Ogake Stella , Bazan Jose A , Coe Kelci , Kuntz Kaitlyn , Elefritz Jessica L
Published: February 2025

Objective

To compare the rate of clinical cure and adverse effects in patients receiving definitive treatment with trimethoprim-sulfamethoxazole versus minocycline monotherapy for Stenotrophomonas maltophilia pneumonia.

Methods

A single-centre, retrospective cohort study of patients with S. maltophilia pneumonia admitted 1 March 2018—30 September 2023 was conducted comparing treatment with trimethoprim-sulfamethoxazole versus minocycline monotherapy. The primary outcome was the rate of clinical cure, defined as meeting two of the three prespecified criteria for a period of 48 hours while on definitive therapy: normalization of white blood cell count, absence of fever and hypothermia and decreased oxygen support. Secondary outcomes evaluated included time to clinical cure, infection-related and in-hospital mortality, pneumonia recurrence and incidence of adverse effects, which was a composite of acute kidney injury (AKI), hyperkalaemia and thrombocytopenia.

Results

Of 93 patients included, 48 received trimethoprim-sulfamethoxazole and 45 received minocycline. There was no difference in the primary outcome of clinical cure between the trimethoprim-sulfamethoxazole and minocycline groups (72.9% versus 66.7%, P = 0.51). S. maltophilia pneumonia recurrence was more common in the minocycline group compared to the trimethoprim-sulfamethoxazole group (35.6% versus 10.4%, P = 0.006). In-hospital mortality was higher in the trimethoprim-sulfamethoxazole group although there was no difference in infection-related in-hospital mortality (6.3% versus 2.3%, P = 0.62). The incidence of AKI, hyperkalaemia and thrombocytopenia did not differ between groups.

Conclusion

There was no difference in clinical cure rate for S. maltophilia pneumonia treatment between trimethoprim-sulfamethoxazole and minocycline monotherapy although higher rates of recurrent pneumonia were observed in patients treated with minocycline. Rates of adverse effects were similar between groups.
The Prevalence of Xylazine in Patient Urine Samples That Were Positive for Fentanyl in Western New York
Authors: Young Brandy L , Gqamana Putuma P , Qiu Yinghua , Nacca Nicholas E , Zhang Y Victoria
Published: February 2025

Background

Xylazine, a veterinary sedative, is increasingly being discovered in the illegal drug supply across the United States and is associated with overdose fatalities. Not approved for human use, xylazine poses life-threatening risks, particularly when used in conjunction with opioids such as fentanyl. This study evaluates the prevalence of xylazine in urine samples that screened positive for fentanyl. The evaluation involved measuring the parent drug xylazine and its metabolites, xylazine glucuronide and hydroxy-xylazine, as well as finding their correlation with fentanyl and norfentanyl concentrations in patient samples.

Methods

Samples were collected over a one-month period. Urine samples were analyzed for fentanyl, norfentanyl, and 3 xylazine-specific analytes (i.e., xylazine, xylazine glucuronide, and hydroxy-xylazine). Briefly, reverse-phase chromatographic separation was performed on a Bonshell Phenyl-Hexyl column utilizing a binary mobile phase gradient. The eluents were detected through positive electrospray ionization and multiple reaction monitoring analysis on a triple quadrupole mass spectrometer.

Results

Out of a total of 230 urine samples, 184 were confirmed positive for fentanyl. Xylazine was detected in 56 out of the 184 fentanyl-positive samples, accounting for 30% of the fentanyl-positive confirmatory test. Xylazine (or its metabolites) was not observed in fentanyl-negative samples. Furthermore, the parent xylazine drug was detected in all 56 samples, whereas the metabolite glucuronide and hydroxy forms were only detected in 28 and 6 samples, respectively.

Conclusions

This study estimated a xylazine prevalence of 30% in fentanyl-positive urine samples within our local Western New York population. This study represents the first report within our clinical population.
Extended repertoire of CXC chemokines acting as agonists and antagonists of the human and murine atypical chemokine receptor ACKR2
Authors: Luís Rafael , Volkman Brian F , Szpakowska Martyna , Chevigné Andy
Published: February 2025

Atypical chemokine receptors (ACKRs) are a subfamily of important regulators of chemokine functions. Among them, ACKR2 has long been considered as a scavenger of multiple inflammatory chemokines exclusively from the CC family. Recently, we demonstrated the ability of ACKR2 to scavenge the CXC chemokine CXCL10, previously reported to bind solely the classical receptor CXCR3. This discovery emphasized the need for systematic reassessments of chemokine–receptor pairings. In this work, we established a highly sensitive NanoBRET-based competition binding assay using a novel proprietary ACKR2 modulator (LIH222) and applied it in a comprehensive reassessment of the pairings between human and murine chemokines and their respective ACKR2 orthologues. We confirmed CXCL10 as a ligand for the human but also the mouse ACKR2. We also identified CXCL5, CXCL11 and CXCL12 as new CXC chemokines for both ACKR2 orthologues. Furthermore, we showed that CXCL2 is a ligand for the human but not the mouse ACKR2, whereas CXCL1 binds the mouse but not the human receptor. Finally, we found that N-terminally truncated CXCL5 (CXCL58-78) loses its capacity to bind ACKR2, whereas the removal of the first two residues of CXCL11 (CXCL113-73) enhances its antagonist potency, showing a tendency towards a reduction of the receptor basal interactions with β-arrestins. Altogether, this study demonstrates that ACKR2 is not exclusive to CC chemokines and although with a weaker affinity it can also bind and scavenge a subset of inflammatory and homeostatic CXC chemokines important for the regulation of the immune system.
Horses for courses: A fresh look at the horse-kick data
Authors: Unwin Antony , Venables Bill
Published: February 2025

Familiar to all students of statistics, the Prussian army horse-kick data set teaches us not only about the Poisson distribution, but also the importance of background information in statistical modelling. Antony Unwin and Bill Venables take a fresh look at this famous resource
The Convergent Evolution of Hummingbird Pollination Results in Repeated Floral Scent Loss Through Gene Downregulation
Authors: Darragh Kathy , Kay Kathleen M , Ramírez Santiago R
Published: February 2025

The repeated evolution of the same trait in different lineages provides powerful natural experiments to study the phenotypic and genotypic predictability of trait gain and loss. A fascinating example is the repeated evolution of hummingbird pollination in plant lineages in the Americas, a widespread and often unidirectional phenomenon. The spiral gingers in the genus Costus are ancestrally bee pollinated, and hummingbird pollination has evolved multiple times independently in the tropical Americas. These pollinator transitions are accompanied by predictable morphological and color changes, but the changes in floral scent have not been described. In this study, we describe the floral scent composition of 30 species of Costus sampled across the phylogeny to understand how floral scent has evolved across the genus with respect to pollinator transitions. We then combine transcriptomics and genomics to identify gene expression differences and gene family evolution associated with pollinator transitions. We show that hummingbird-pollinated species have mostly lost their floral scent, whereas bee-pollinated species exhibit either floral scent maintenance or, in some cases, gains of more diverse scent profiles. We find the floral scent loss appears to be due to gene downregulation rather than pseudogenization. The remarkable consistency of scent loss in hummingbird-pollinated species highlights the shared strong selection pressures experienced by these lineages. Even species with more recent transitions from bee to hummingbird pollination exhibit scent loss, highlighting the rapid breakdown of scent emission following pollinator transitions. This research highlights the capacity for rapid changes when selection pressures are strong through downregulation of floral scent genes.
Mango (Mangifera indica L.) By-products in Food Processing and Health Promotion
Authors: Duarte Lidiane Gonsalves , Laurindo Lucas Fornari , Bishayee Ankur , Casarcia Nicolette , Detregiachi Claudia Rucco P , Otoboni Alda Maria M , de Alvares Goulart Ricardo , Catharin Virgínia Maria Cavallari Strozze , Baldi Edgar , Catharin Vitor Cavallari Strozze , Guiguer Elen Landgraf , Sanches Silva Ana , Barbalho Sandra Maria , Bishayee Anupam
Published: February 2025

The edible and nonedible parts of the mango (Mangifera indica L.) contain vitamins, phytocompounds, fiber, and fatty acids. This review highlights the uses of mango by-products in the food industry and their effects on human health. The literature offers many new possibilities for the usage of mango secondary products in the food industry, such as the production of functional foods and bakery products, in addition to the potential for extraction of antioxidants and enzymes. Furthermore, due to their antioxidant and anti-inflammatory properties, the consumption of various mango by-products, in the form of peel and leaf (powder or extract), can improve glycemia, plasma lipid levels, satiety, and endothelial function, suggesting that these compounds can prevent or improve various risk factors for cardiovascular complications and metabolic syndrome. Clinical trials show that the discarded parts of mango fruits and leaves can be used to treat diabetes mellitus, obesity, and cardiovascular disorders. Moreover, mango by-products can be utilized to improve the functional characteristics of foods, may be incorporated as fat replacers, and have the potential to leverage agribusiness and reduce environmental damage resulting from the disposal of discarded materials, in addition to reducing waste and the complex chain of environmental damage. Mango by-products also have the potential to produce nutraceutical food items. The use of new technologies can bring to light the production of numerous products made from by-products, contributing to the development of industrial functional foods. In addition, products for the pharmaceutical and cosmetics industries may also be developed. Nutraceutical and pharmaceutical products could have lower prices and could, therefore, be used by low-income populations. The utilization of mango by-products meets the current trend and growing market for better and healthier products. However, more clinical trials are necessary to evaluate the effectiveness of mango by-products on human health, and new technologies can improve industrial applications.
National Trends in Antibiotic Prescribing for Adults Hospitalized With Coronavirus Disease 2019 and Other Viral Respiratory Infections
Authors: Pulia Michael S , Griffin Meggie , Schwei Rebecca J , Pop-Vicas Aurora , Schulz Lucas , Shieh Meng-Shiou , Pekow Penelope , Lindenauer Peter K
Published: February 2025

Background

Significant concerns have been raised regarding the overuse of antibiotics among patients hospitalized for coronavirus disease 2019 (COVID-19) and the broad impact of the pandemic on antimicrobial stewardship in acute care. We sought to compare potentially unnecessary antibiotic prescribing over time among patients admitted with symptomatic COVID-19 and non–COVID-19 viral acute respiratory tract infections (ARTIs).

Methods

We conducted a repeated cross-sectional analysis of the monthly antibiotic prescribing rate from March 2020 to December 2023 for COVID-19 admissions and from January 2019 to December 2023 for other viral ARTI admissions to 803 acute care hospitals in the United States that contributed data to the Premier Healthcare Database. Our primary outcome was the receipt of ≥1 dose of an antibiotic during the first 5 days of the admission. Secondary outcomes included days and duration of antibiotic therapy.

Results

This study included 513 698 COVID-19 and 106 932 non–COVID-19 viral ARTI admissions from March 2020 to December 2023. At the onset of the pandemic, >80% of patients admitted for COVID-19 received antibiotics, and antibiotic prescribing for other viral ARTIs increased to nearly 70%. Antibiotic prescribing for these viral infections declined over time, with prescribing for COVID-19 stabilizing around 35% in 2022–2023 and prescribing for other viral ARTIs returning to 2019 seasonal patterns in 2023, with average monthly prescribing around 50%.

Conclusions

Despite improvements since the early part of the COVID-19 pandemic, potentially unnecessary antibiotic prescribing for inpatients with COVID-19 and non–COVID-19 viral ARTIs remains an important antibiotic stewardship target.
Is thoron a problem in radon measurements with NRPB/SSI passive radon detectors—experimental study
Authors: Wasikiewicz J M , Dimitrova I , Ibrahimi Z-F , Georgiev S , Mitev K , Daraktchieva Z
Published: February 2025

The UKHSA radon detectors with polyallyldiglycol carbonate sensing material produced from 2010 onward were used to confirm that they are purely radon detectors only with negligible interference from thoron presence. The statistical analysis of results, after following standard detector processing procedures, showed that such devices can only detect 2.4% ± 0.3% of the total thoron activity concentration compared to the calibrated reference device. It was also demonstrated that thoron, unlike radon, can only travel a very short distance from the source to be effectively measured. Based on the above, it has been concluded that interference of thoron in radon measurement is negligible (within the statistical measurement error), and hence can be ignored in standard indoor and outdoor measurements.
Online Hearing Voices Peer Support Groups: Assessing Feasibility and Acceptability within UK NHS Settings
Authors: Branitsky Alison , Bowe Samantha , Morrison Anthony P , Longden Eleanor , Bucci Sandra , Mulligan Lee D , Varese Filippo
Published: February 2025

Background

User-led hearing voices groups (HVGs) have existed for the past 40 years, but little research has been conducted into if and how this approach can be implemented in statutory mental health settings, and whether they can be delivered effectively when held online. The aim of this study was to conduct a feasibility and acceptability trial of an online HVG for the UK National Health Service (NHS) users who hear voices, to inform a future larger-scale trial.

Methods

A mixed-methods non-randomised feasibility study of an online HVG was conducted with nine participants. Participants attended weekly online meetings for six months, and completed measures of social connectedness, voice hearing, personal recovery, as well as semi-structured interviews, at baseline and 6-months follow-up. Primary outcomes were qualitative and quantitative assessments of feasibility and acceptability.

Results

38 participants were referred to the trial, nine of whom were recruited (100% of target sample). The trial had high retention (100%) and engagement (mean = 13.2 groups attended). Participants reported positive features of attending this digital intervention, with 85% reporting it was helpful to meet other voice hearers, that the group helped them make sense of voice hearing experiences, that they received positive messages about recovery, and that the group represented a form of support they could not get elsewhere.

Discussion

The findings indicate it is feasible and acceptable to run an online HVG within an NHS setting. A larger trial is needed to further investigate the utility, efficacy and cost-effectiveness of running online HVGs in the NHS.
Family background and life cycle earnings volatility: evidence from brother correlations in Denmark, Germany, and the United States
Authors: Gioachin Filippo , Karlson Kristian Bernt
Published: February 2025

While stratification scholars have extensively examined intergenerational associations in lifetime income, they have mostly disregarded how family background affects exposure to income volatility over the life course. As exposure to volatility represents a non-desirable outcome associated with negative shocks to individuals’ welfare, studying the link between family background and volatility is key to further advancing the understanding of how family-based inequalities impact lifelong economic prospects. This article fills this gap by providing a comprehensive analysis of the role of family background in shaping exposure to earnings volatility across the life course in Denmark, Germany, and the United States. We find that brother correlations in volatility exposure—a broad measure of family background’s impact—are much lower in Denmark than in Germany and the United States. Further analyses indicate that in Germany and the United States, family background exerts a considerable influence particularly around the period of occupational maturity, while in Denmark, its impact remains consistent over time. We also find that family background impacts volatility exposure net of individuals’ position in the overall earnings distribution, indicating that family background has a direct impact on volatility experiences and thus constitutes a nonnegligible component in intergenerational inequality.
Exploring the molecular interface of gene expression dynamics and prostate cancer susceptibility in response to HBCD exposure
Authors: Ni Ying , Wang Wenkai , Jiang Lihua , Shao Qinghua
Published: February 2025

Hexabromocyclododecane (HBCD), a brominated flame retardant, is linked to various health implications, including prostate cancer. This study explored the molecular mechanisms and potential biomarkers associated with HBCD exposure using data from the Comparative Toxicogenomics Database (CTD) and The Cancer Genome Atlas (TCGA). A total of 7,147 differentially expressed genes (DEGs) and 46 differentially expressed miRNAs were identified, with significant enrichment in cancer-related pathways and xenobiotic metabolism. Protein–protein interaction (PPI) network construction and enrichment analyses revealed four hub genes: DNAJC12, PKMYT1, RRM2, and SLC12A5. These genes displayed notable expression changes in response to HBCD exposure and were strongly correlated with survival outcomes in prostate cancer patients, as demonstrated by Cox regression and ROC curve analyses. Additionally, miRNA correlation analyses indicated robust positive associations, highlighting a coordinated regulatory network. Experimental expression analyses on HBCD-treated cell lines further validated these findings. This study sheds light on the significant impact of HBCD on gene and miRNA expression in prostate cancer, emphasizing the potential of the identified hub genes and miRNAs as prognostic biomarkers and therapeutic targets. By elucidating the pathways and regulatory networks influenced by HBCD, the findings provide a foundation for developing strategies to mitigate its carcinogenic effects and improve outcomes for prostate cancer patients.
Developmental immunotoxicity study of tris(chloropropyl) phosphate in Hsd:Sprague Dawley SD rats exposed through dosed feed
Authors: Johnson Victor J , Ryan Kristen , Luster Michael I , Pandiri Arun , Hobbie Kristen , Cora Michelle , Shockley Keith R , Burleson Gary R , Xie Guanhua , Germolec Dori R
Published: February 2025

Tris(chloropropyl) phosphate (TCPP) is a member of organophosphate flame retardants used commonly as a replacement for polybrominated diphenyl ethers in consumer and commercial products. Flame retardants have been shown to modulate immune function in vivo and in vitro and there is evidence that at least some related compounds such as organophosphate pesticides can cause developmental immunotoxicity. Developmental immunotoxicology studies were conducted by administering 0, 2500, 5000, or 10,000 ppm TCPP in feed to pregnant Hsd:Sprague Dawley SD rats from gestation day 6 through weaning on postnatal day 28. Feed exposure to TCPP was continued in the F1 offspring until terminal euthanasia at ∼16 to 21 weeks of age when assessments for developmental immunotoxicity were conducted. Innate, humoral, and cell-mediated immune function were assessed in the F1 adults. The antibody-forming cells (AFCs) response to sheep red blood cells was reduced in male and female F1 rats in the 10,000 ppm treatment group but coincided with reduced bodyweights. The AFC response was also significantly reduced in male rats exposed to 5000 ppm where only moderate effects on bodyweights occurred. TCPP exposure affected baseline T-cell proliferation without stimulation; however, the relevance of this change for immunotoxicity risk is unknown. TCPP exposure did not affect cytotoxic T-lymphocyte activity. Only minor and inconsistent treatment-related effects on hematology, innate NK cell function, and immune cell population distributions in the spleen were observed. Taken together, these data indicate that TCPP has the potential to impact humoral immune responses following developmental exposure.
Clinical study of the ‘U’-shaped staple-guided growth technique in the treatment of congenital anterolateral bowing of the tibia in children
Authors: Zhou XiaoYu , Liu YaoXi , Chen Hao , Hu Xiongke , Zhu GuangHui , Liu Kun , Jiang ZeXi , Xiao Han , Mei HaiBo
Published: February 2025

The aim of this study was to investigate the early effectiveness of guided growth techniques for managing congenital anterolateral bowing of the tibia (ALBT) in children. A retrospective analysis was performed involving 18 patients with ALBT treated with the ‘U’-shaped staple-guided growth technique between January 2020 and October 2022 at two centres. Anteroposterior and lateral radiographs of both lower limbs and the tibia as well as the fibula were collected before surgery, at the time of implant removal, or at the last follow-up. Changes in the coronal tibial diaphyseal angulation, sagittal tibial diaphyseal angulation, anatomical medial proximal tibial angle (aMPTA) and anatomical lateral distal tibial angle (aLDTA) were statistically analysed to evaluate the correction effect of the ALBT. All patients were followed up for an average of 23.36 months (range: 14.53–37.2 months). All 18 patients demonstrated an improvement in the coronal plane tibial shaft angle, with an average correction of 17.94° (range: 5.54°–33.52°). Fourteen patients displayed an improvement in the sagittal plane tibial shaft angle, with an average correction of 13.44° (range: 1.89°–32.6°). Both the aMPTA and aLDTA levels decreased after treatment. No tibial pseudarthrosis occurred in any of the 18 patients during the follow-up. The guided growth technique is effective in improving the ALBT, preventing further angular deformities of the tibia, and may delay or prevent tibial pseudarthrosis. Moreover, the guided growth technique is simple to perform, minimally invasive and associated with few complications.
Outcomes of displaced mid-shaft radius/ulna fractures in children treated with the Rang method: a pilot study
Authors: Chen Joshua , Peiffer Sarah , Dressler Sam , Hennrikus William
Published: February 2025

Pediatric forearm fractures of the radius and ulna are common. Previous literature suggests that conservatively managed mid-shaft radius and ulna forearm fractures have a remanipulation rate of 10–70%. The purpose of this study is to compare the re-displacement rate of closed displaced mid-shaft both-bone forearm fractures (BBFF) in children treated with closed reduction and casting with a loop and sling applied proximal to the fracture site (Rang method) compared with a standard sling. A retrospective review was performed of 42 patients under the age of 14 with BBFF treated over a 4-year period. The average patient age was 7 years. Data analyzed included demographics, mechanism of injury, presence of a pulse, presence of nerve injury, incidence of compartment syndrome, sling type, loss of reduction, remanipulation, and need for surgical fixation. Loss of reduction was defined as a final number of >15° angulation if age <10 years old and >10° angulation if >10 years old. Fifteen patients (36%) were treated with the Rang method. Twenty-seven patients (64%) were given a standard sling. Only one patient (7%) managed with the Rang method lost reduction, whereas 17/27 patients (63%) given a regular sling lost reduction and required remanipulation (P = 0.0004). Treatment of a BBFF in a child aged <14 years typically involves closed reduction and casting. The ‘Rang’ method of placing a loop and attached sling proximal to the fracture site is a casting pearl that helps to minimize fracture redisplacement.
Comparative efficacy of cetuximab combined with FOLFOX or CAPEOX in first-line treatment of RAS/BRAF wild-type metastatic colorectal cancer: a multicenter case-control study
Authors: Xu Chang , Ren Jing , Liu Changqing , Gai Yi , Cheng Xiangyu , Wang Yusheng , Wang Guangyu
Published: February 2025

FOLFOX combined with cetuximab is a recommended first-line treatment regimen for RAS/BRAF wild-type metastatic colorectal cancer (mCRC). CAPEOX combined with cetuximab differs from the FOLFOX regimen by using oral capecitabine instead of continuous infusion of fluorouracil, offering greater convenience and cost-effectiveness with higher patient acceptance. However, the comparative efficacy of these two regimens remains debatable, necessitating further evidence to explore any differences in their efficacy. This study collected medical records of mCRC patients who were treated with CAPEOX or FOLFOX combined with cetuximab from 1 October 2021 to 16 October 2023 at Harbin Medical University Cancer Hospital and the First Hospital of Shanxi Medical University. Eligible patients were selected based on inclusion criteria and followed up through the hospital’s follow-up system and telephone interviews. Kaplan–Meier survival analysis and Cox proportional hazards regression analysis were used to assess patients’ progression-free survival (PFS) and overall survival (OS). A total of 71 eligible patients were enrolled in this study; 43 patients received CAPEOX combined with cetuximab (Group A, n = 43), and 28 patients received FOLFOX combined with cetuximab (Group B, n = 28). The two groups achieved similar median PFS (mPFS) and median OS (mOS), with mPFS of 18 months and 12 months, respectively (P = 0.23), and mOS of 33 months and 20 months, respectively (P = 0.21), with no statistically significant differences. The results of this study demonstrated that CAPEOX combined with cetuximab is an equally viable option for first-line treatment of RAS/BRAF wild-type mCRC as FOLFOX combined with cetuximab.
Innovative logic “AND” gate gene circuits for bladder cancer treatment: preclinical study
Authors: Xu Chaojie , Dong Ying , Pei Dongchen , Zhang Xintao , Han Xiaohong , Cao Congcong , Wu Baorui , Lv Changning , Kang Zhengjun , Zhou Liqun , Liu Yuchen , Yao Lin
Published: February 2025

In the evolving field of precision oncology, the synthesis of gene circuits that specifically target cancer cells while preserving normal tissue marks a significant breakthrough. However, traditional approaches typically concentrate on single-gene targets, lacking the directed recognition and control among the intricate networks of signaling pathways. Our study presents a synthetic gene circuit, the Logic “AND” Gate Dual-Target Genetic Circuit (LAG-DTGC), which integrates multiple signals to achieve comprehensive reprogramming of various signaling pathways in bladder cancer (BC) cells. This circuit’s development hinged on detailed bioinformatics analysis, pinpointing more unique biomarkers with similar expression pattern in BC. LAG-DTGC is engineered to selectively activate in cells where these biomarkers are abnormally expressed. Its precision and the remodeling cell behavior capability are further enhanced by incorporating a logic “AND” gate, triggering the circuit only in the presence of these aberrant cancer-specific biomarkers. LAG-DTGC exhibits an extraordinary ability to reprogram cancer cell signaling pathways, turning the cells’ own mechanisms against them for therapeutic effect. This work highlights the potential of synthetic biology in developing precise, less toxic treatments for BC. The LAG-DTGC represents a promising new paradigm in cancer therapy.
Essential components and validation of multi-specialty robotic surgical training curricula: a systematic review
Authors: Walshaw Josephine , Fadel Michael G , Boal Matthew , Yiasemidou Marina , Elhadi Muhammed , Pecchini Francesca , Carrano Francesco Maria , Massey Lisa H , Fehervari Matyas , Khan Omar , Antoniou Stavros A , Nickel Felix , Perretta Silvana , Fuchs Hans F , Hanna George B , Francis Nader K , Kontovounisios Christos
Published: February 2025

Introduction:

The rapid adoption of robotic surgical systems has overtook the development of standardised training and competency assessment for surgeons, resulting in an unmet educational need in this field. This systematic review aims to identify the essential components and evaluate the validity of current robotic training curricula across all surgical specialties.

Methods:

A systematic search of MEDLINE, EMBASE, Emcare, and CINAHL databases was conducted to identify studies reporting on multi-specialty or specialty-specific surgical robotic training curricula, between January 2000 and January 2024. We extracted data according to Kirkpatrick’s curriculum evaluation model and Messick’s concept of validity. The quality of studies was assessed using the Medical Education Research Study Quality Instrument (MERSQI).

Results:

From the 3,687 studies retrieved, 66 articles were included. The majority of studies were single-centre (n = 52, 78.8%) and observational (n = 58, 87.9%) in nature. The most commonly reported curriculum components included didactic teaching (n = 48, 72.7%), dry laboratory skills (n = 46, 69.7%), and virtual reality (VR) simulation (n = 44, 66.7%). Curricula assessment methods varied, including direct observation (n = 44, 66.7%), video assessment (n = 26, 39.4%), and self-assessment (6.1%). Objective outcome measures were used in 44 studies (66.7%). None of the studies were fully evaluated according to Kirkpatrick’s model, and five studies (7.6%) were fully evaluated according to Messick’s framework. The studies were generally found to have moderate methodological quality with a median MERSQI of 11.

Conclusions:

Essential components in robotic training curricula identified include didactic teaching, dry laboratory skills, and VR simulation. However, variability in assessment methods used and notable gaps in curricula validation remain evident. This highlights the need for standardised, evidence-based development, evaluation, and reporting of robotic curricula to ensure the effective and safe adoption of robotic surgical systems.
Effect of parecoxib on postoperative delirium in patients with hyperlipidemia: a randomized, double-blind, single-center, superiority trial
Authors: Daojun Zeng , Yuling Tang , Yingzhe Xu , Kowark Ana , Coburn Mark , Yue Zhao , Qixin Zhang , Daiying Zhang , Tao Peng , Xiaoxia Duan
Published: February 2025

Background:

Hyperlipidemia has been implicated in the higher risk of developing postoperative delirium. Prostaglandin endoperoxide synthase-2 mediates neuroinflammatory processes in postoperative delirium. This study aims to investigate whether preoperative administration of parecoxib is more efficient than a placebo in averting postoperative delirium in patients with hyperlipidemia.

Materials and methods:

In this randomized, double-blind, superiority trial, participants with hyperlipidemia were randomized in a 1:1 ratio to receive parecoxib (40 mg parecoxib administered intravenously before anesthesia induction) or placebo (normal saline). The primary outcome was postoperative delirium incidence within three days, with a 5.4% difference set as the superiority threshold. Secondary outcomes were cumulative incidences of emergence delirium and prostaglandin endoperoxide synthase-2 levels, inflammatory cell counts, and pain score on postoperative day 1 and postoperative adverse events.

Results:

This trial conducted between August 2023 and August 2024 at a tertiary hospital in China included 452 adults with hyperlipidemia, with 226 in the parecoxib group and 226 in the placebo group. The incidence of postoperative delirium in the parecoxib group was 13.72%, a reduction of 12.39% compared to the placebo group (hazard ratio, 0.491; 95% confidence interval: 0.318 to 0.759; P < 0.001). The parecoxib group also had a lower incidence of emergence delirium, prostaglandin endoperoxide synthase-2 levels, white blood cell counts and neutrophil, and pain scores on postoperative day 1. The occurrence of adverse events was comparable between the two groups. Prostaglandin endoperoxide synthase-2 expression levels, white blood cell counts, and pain scores mediated the reduction of postoperative delirium incidence by parecoxib.

Conclusion:

Parecoxib may help in reducing the hyperlipidemia-related postoperative delirium incidence. The effective anti-inflammatory activity of prostaglandin endoperoxide synthase-2 inhibition by parecoxib and postoperative pain control may be important mechanisms for preventing postoperative delirium.
Your artificial intelligence will see you now: Why nurse practitioners remain irreplaceable
Authors: Gleasman-DeSimone Sara
Published: February 2025

Artificial intelligence (AI) has transformed health care. Artificial intelligence technologies, such as advanced imaging algorithms, diagnostic tools, and mental health chatbots, have revolutionized patient care by enhancing diagnostic accuracy, personalizing treatment plans, and streamlining administrative tasks. However, despite these advancements, AI falls short in areas where nurse practitioners (NPs) excel. Nurse practitioners possess essential human attributes such as empathy, nuanced understanding, and ethical reasoning that AI cannot currently replicate. They excel at recognizing subtle mood changes, understanding social determinants of health, and navigating complex ethical dilemmas. I argue that although AI can support and enhance health care delivery, it cannot replace the indispensable human touch provided by NPs. The irreplaceable role of NPs in offering holistic, compassionate care underscores the need for a balanced integration of AI, to ensure it complements rather than replaces the human elements crucial to effective patient care.
An updated review of pulmonary radiological features of acute and chronic pulmonary COVID-19
Authors: Tcheroyan Raya , Makhoul Peter , Simpson Scott
Published: February 2025

Purpose of review

Significant progress has been made in our understanding of the acute and chronic clinical and radiological manifestations of coronavirus-19 (COVID-19). This article provides an updated review on pulmonary COVID-19, while highlighting the key imaging features that can identify and distinguish acute COVID-19 pneumonia and its chronic sequelae from other diseases.

Recent findings

Acute COVID-19 pneumonia typically presents with manifestations of organizing pneumonia on computed tomography (CT). In cases of severe disease, patients clinically progress to acute respiratory distress syndrome, which manifests as diffuse alveolar damage on CT. The most common chronic imaging finding is ground-glass opacities, which commonly resolves, as well as subpleural bands and reticulation. Pulmonary fibrosis is an overall rare complication of COVID-19, with characteristic features, including architectural distortion, and traction bronchiectasis.

Chest CT can be a helpful adjunct tool in both diagnosing and managing acute COVID-19 pneumonia and its chronic sequelae. It can identify high-risk cases and guide decision-making, particularly in cases of severe or complicated disease. Follow-up imaging can detect persistent lung abnormalities associated with long COVID and guide appropriate management.
Impact of the Amount of Intravenous Glucose Administration on Hospitalization for Acute Gastroenteritis in a Pediatric Emergency Department
Authors: Santamaria Christina , Péloquin Fannie , Mousseau Sarah , Gravel Jocelyn
Published: February 2025

Introduction:

In case of failure of oral rehydration, children with acute gastroenteritis can be hydrated using intravenous (IV) solution. The choice of the intravenous solution itself (solutions containing dextrose versus crystalloids alone) and the glucose quantities to administer are not well established.

Objectives:

The main objective of this study was to evaluate the association between the amount of intravenous glucose provided and hospitalization for children with acute gastroenteritis. Another objective was to evaluate practice variation regarding the amount of glucose provided for IV rehydration in a pediatric emergency department (ED).

Method:

We conducted a retrospective cohort study from 2019 to 2022 in a Canadian pediatric ED. We included children with acute gastroenteritis undergoing IV rehydration. Patient with hypoglycemia, metabolic disease, or diabetes were excluded. The IV glucose administered during the initial 4 hours of rehydration was quantified. The primary outcome was hospitalization, and return visit within the following week was a secondary outcome. Ten percent of the charts were evaluated in duplicate to assess interrater reliability. We examined glucose distribution at 1 and 4 hours and utilized multiple logistic regression to relate glucose amounts with hospitalization and second visit, accounting for age, weight, bicarbonate levels, ondansetron use, and amount of liquid infused. It was estimated that the evaluation of 250 cases would have at least 50 admissions.

Results:

Among 6939 children evaluated for potential acute gastroenteritis, 250 met our inclusion/exclusion criteria. All variables included in the analysis had excellent interrater reliability. Notable variations existed in glucose quantities provided, both at 1 hour (first quartile, 87 mg/kg; third quartile, 294 mg/kg) and 4 hours (first quartile, 681 mg/kg; third quartile, 1174 mg/kg) of rehydration. Multiple logistic regression showed a negative association between hospitalization and glucose administration during the initial hour (OR for each 100 mg/kg increment, 0.60; 95% CI, 0.42–0.84) and 4 hours (OR, 0.76; 95% CI, 0.63–0.91) of rehydration. Moreover, children who received more dextrose during the first hour of rehydration were less likely of having a return visit (OR for each 100 mg/kg increment: 0.52; 95% CI, 0.35–0.78), as well as during the first 4 hours (OR for each 100 mg/kg increment, 0.83; 95% CI, 0.73–0.94).

Conclusions:

There was a wide practice variation in intravenous glucose provided to children with acute gastroenteritis. In this population, higher intravenous glucose amount was associated to a lower risk of hospitalization and lower risk of return visit.
Accuracy of Visual Estimation of Left Ventricular Ejection Fraction Compared With Echocardiography in Children
Authors: Zayani Seyfeddine , Thabet Farah , Daya Abir , Chamtouri Ikram , Bennasrallah Cyrine , Chouchane Chokri , Ben Hamda Khaldoun , Chouchane Slaheddine
Published: February 2025

Background:

This study compared visual assessments of left ventricular systolic function in children by pediatric physicians with quantitative measurements using the Simpson method.

Methods:

This was a transverse, cohort study conducted between January and June 2023. Patient’s echocardiography were performed by a certified pediatric cardiologist in the presence of 2 pediatricians: a senior pediatric intensivist (S.Z.) and a pediatric resident (A.D.). Both pediatricians had prior training in cardiac ultrasound. Following the visual assessment of the echocardiography, each pediatrician records their evaluation of the left ventricular ejection fraction (LVEF) as a percentage. We compared the visual assessment of LVEF with that obtained with quantitative measurements using the Simpson method by the pediatric cardiologist. Bland-Altman analysis was performed between the pediatrician and the cardiologist's LVEF evaluation. Besides the correlation coefficients (r) were calculated.

Results:

A total of 136 patients, aged between 0 and 18 years, were enrolled. The mean LVEF measured by the cardiologist was 65.05±14.15. The mean LVEF estimated by the senior pediatrician and the pediatric resident was 64.48±13.59 and 64.87±13.17, respectively. Strong correlations were found between visual estimates by both pediatricians and 2-dimensional LVEF (r=0.832 and r=0.763 respectively, P<0.001). The bland-Altman plot showed that the mean difference of LVEF determined by 2-dimensional LVEF and eyeballing by a senior pediatric intensivist and the junior pediatrician was 0.57±3.64% and 0.18±4.37%, respectively.

Conclusion:

The study suggests that visual assessment of LVEF in children is reliable when conducted by experienced pediatricians familiar with echocardiography. However, the results of this study are primarily applicable to the assessment of normal or near-normal left ventricular function.
Facial Augmentation in Transmasculine and Transfeminine Patients: Customization of Facial Implants and Increase in Facial Masculinization Surgery
Authors: Mundinger Gerhard S.
Published: February 2025

Facial augmentation is a key component of masculinizing and feminizing transgender faces. This article reports a single surgeon's experience with malar, chin, and mandibular angle augmentation in transmen and transwomen. Patients undergoing facial feminization surgery (FFS) and facial masculinization surgery (FMS) were retrospectively evaluated and categorized based on region of facial augmentation and type of facial augmentation as follows: fat grafting, stock silicone implants, and custom titanium implants. Fat grafting cases were limited to the malar region. Over a 2.5-year period, 211 patients underwent FFS or FMS. Of these, 207 (98%) were FFS patients, and 4 (2%) were FMS patients. Of FFS patients, 41 (19%) had facial augmentation. Except for a stock silicone chin implant in 1 patient, all FFS augmentation occurred in the malar region as follows: fat grafting (n=20, 49%), stock silicone implants (n=10, 24%), custom titanium implants (n=10, 24%). Of FMS patients, all had facial augmentation as follows: stock chin implants (n=1, 25%), custom malar and chin implants (n=1, 25%), custom chin and mandibular angle implants (n=2, 50%). In total, 75% of FMS cases occurred in the final 6 months of the study. Augmentation of the malar region is a common component of FFS surgery, while augmentation of the chin, mandibular angles, and malar region is a mainstay of FMS surgery. Custom implants provide the advantages of patient-specific augmentation and precise fixation with increased materials costs. FMS cases are increasing in incidence.