bluuebunny/crossref_metadata_2025 huggingface dataset:
Review Article: Albumin and Its Role in Inflammatory Bowel Disease: The Old, the New, and the Future
Authors: Cameron Karla , Nguyen Anke L. , Gibson David J. , Ward Mark G. , Sparrow Miles P. , Gibson Peter R.
Published: February 2025

Background

Circulating albumin concentrations are frequently measured in clinical practice. This review explores biochemical properties and physiological roles of albumin, its place in nutritional assessment, current understanding of perturbed circulating concentrations, and role in clinical management, with special focus on patients with inflammatory bowel disease (IBD).

Methods

A detailed literature search was performed.

Results

Albumin is synthesized by hepatocytes and comprises 3% of total body protein. It has a prolonged intravascular half‐life (17–19 h) due to neonatal Fc‐receptor‐mediated salvage and has a multitude of physiological functions. Albumin homeostasis is affected in disease states often resulting in reduced level, which is not a direct marker of malnutrition. In patients with IBD, morbid albumin concentrations provide prognostic information, identification of nonintestinal conditions, guidance to the required aggressiveness of therapy and biologic dosage, monitoring of disease activity, and potential need for therapeutic escalation. Barriers to utilization of morbid albumin levels include the lack of consensus regarding cutoff values and the deficiency of high‐quality data in this domain due to the retrospective design of the majority of studies. Serum levels hold greatest clinical potential in prognostication in acute severe ulcerative colitis. The premorbid level in the individual may provide insight into dosing of biologics and potentially enhance interpretation of morbid levels.

Conclusions

Understanding the physiology and pathophysiology of albumin is fundamental to interpreting its circulating levels. The clinical value of its measurement in patients with IBD may be undervalued, as it assists in evaluation of disease severity, prognosis, and therapeutic decision‐making.
Analyst Responses to Changes in Credit Risk
Authors: Isabel Abinzano , Pilar Corredor , Beatriz Martinez
Published: February 2025

Do analysts adjust their recommendations when a company's credit risk changes? Using an extensive sample of 300,145 observations, covering 3722 US firms from 2000 to 2021, we find that analysts revise their recommendations when a firm's credit risk decreases but not when it increases. This result is consistent with analysts’ optimism bias, as previously identified in the literature. However, we further find that this optimism bias disappears for firms with low information asymmetry or good informativeness. The fact that analysts for these firms have less cognitive bias and greater pressure to make accurate recommendations may explain this result. Our research highlights that analyst disclosures should be treated with caution, especially in firms with poor informational characteristics. A proper understanding of analyst recommendations is critical for the decision‐making processes of investors and companies and calls for better regulations.
The afterlife of CoPED: Entanglements and impacts of a participatory learning field school in Sicily
Authors: Lambert‐Pennington Amanda Katherine
Published: February 2025

This paper critically explores the afterlife of CoPED, an international interdisciplinary participatory action field school in eastern Sicily from 2015 to 2022. Drawing on fieldnotes taken during the program reflection sessions, small group discussions, informal conversations during meals, and post‐CoPED debriefings with community partners, I consider the long‐term impact of the field school on the different types of participants—students and faculty from three Universities and members of Participatory Presidium of the Simeto River Agreement and other residents, as well as what anthropology has contributed to the program. The article briefly outlines the background of CoPED and its pedagogical commitments, pointing to some of the benefits and challenges that CoPED practices create for the community and for participants. Then, I explore the benefits, costs, and pressure points of CoPED, from material to organizational, to training and mentoring. The article concludes with a reflection on the complexities of long‐term field school collaborations to suggest the roles that anthropology can and does play in shaping the participants and the field in this interdisciplinary context.
Characteristics and nutrient profiles of foods and beverages on online food delivery systems
Authors: Chin Jia‐Wen , Loh Wendy Mei Ling , Ooi Yasmin Beng Houi , Khor Ban‐Hock
Published: February 2025

Recently, there has been an emerging trend of purchasing foods and beverages via online food delivery systems but there is scarce evidence on the healthfulness of these items, particularly in Southeast Asian countries such as Malaysia. This study aimed to evaluate the characteristics and nutrient profiles of foods and beverages available via online food delivery systems in Malaysia. This cross‐sectional study was conducted from September 2022 to March 2023 to identify foods and beverages available on the Grab Food and Foodpanda mobile applications. The healthfulness of selected foods and beverages was determined based on the Food Standards Agency Nutrient Profiling System. The present study included 3729 foods and 1882 beverages. Most of the foods were cereal‐based dishes (37.4%), followed by cereals with protein‐based dishes (12.8%) and meat or poultry‐based dishes (12.0%), while most of the beverages were local handcrafted beverages (27.8%), followed by bubble milk tea (15.0%) and Western handcrafted beverages (14.6%). For protein dishes, deep‐frying or battered‐frying was the most common preparation method (33.8%) while most of the cereal‐based dishes were stir‐fried (76.7%). Out of 23 common foods, 15 foods (65%) were categorised as less healthy based on the nutrient profile score while 19 out of 24 (79%) common beverages were categorised as less healthy. The online food delivery systems feature predominantly local foods and beverages that are less healthy, potentially contributing to the development of an obesogenic environment.
An autopsy report of a long‐survival case of familial amyotrophic lateral sclerosis with SOD1 G93S gene mutation: Lack of SOD1‐positive inclusion in the remaining neurons
Authors: Funai Asuka , Hayashi Kentaro , Kawata Akihiro , Nakayama Yuki , Matsuda Chiharu , Haraguchi Michiko , Takahashi Kazushi , Komori Takashi
Published: February 2025

We describe the case of a 70‐year‐old Japanese man with familial amyotrophic lateral sclerosis (fALS) associated with a p.Gly93Ser mutation in the copper/zinc superoxide dismutase (SOD1) gene. This mutation is one of the relatively rare SOD1 mutations, with only one previous autopsy report, and is known for its longer disease duration. As previously reported, the patient had weakness in the lower limbs at age 33, followed by dysphagia, dysesthesia in the lower limbs, and autonomic dysfunction. He required mechanical ventilation at age 44 and died of acute pancreatitis at age 70. Neuropathologically, multisystem degeneration was observed beyond lesions typical of familial ALS with posterior column involvement. In addition, there was no SOD1‐positive inclusion in the remaining motor neurons. The absence of SOD1‐positive inclusion is a rare feature observed predominantly in long survival cases with SOD1 gene mutations. We hypothesize that the considerably lower amount of abnormal SOD1 protein in the motor neuron cells might explain our patient's extraordinarily long clinical course.
Topical Photodynamic Therapy in a Medical Centre: The Scottish Dermatology Experience
Authors: Chaiyabutr Chayada , Dawe Robert , Lesar Andrea , Ibbotson Sally H.
Published: February 2025

Background

Topical photodynamic therapy (PDT) is widely used in dermatology for treating superficial non‐melanoma skin cancer (NMSC) and dysplasia. This study aims to assess real‐world outcomes of PDT in a Scottish dermatology service.

Methods

We retrospectively reviewed patients with superficial NMSC and dysplasia who underwent conventional and daylight PDT at the Photobiology Unit, Dundee, Scotland.

Results

A total of 705 patients with 2108 NMSC and precancerous skin lesions underwent conventional PDT. Clearance at 12 months was achieved in 53.4% of actinic keratoses (AK), 71.3% of Bowenoid AK, 86.4% of Bowen's disease (BD), 89.0% of superficial basal cell carcinoma (BCC), and 89.7% of nodular BCC. On multivariate analysis, small lesion size and thin histological tumour thickness of superficial BCC were features, which were associated with likelihood of achieving clearance after PDT. Female sex, head/neck sites, larger lesion size, strong pre‐treatment fluorescence intensity, fluorescence specificity, prominent treatment‐induced erythema and an urticarial reaction were associated with moderate to severe pain during PDT. Daylight PDT for 77 AK patients (158 treatments) showed excellent or good outcomes in 63.3% of lesions. Higher visible light exposure is correlated with better treatment outcomes.

Conclusions

In real‐life settings, whilst the PDT response rates of BD and selected BCC are high and consistent with clinical trial outcomes, the efficacy rates for AK appear lower than expected. This emphasizes the need for realistic expectations in chronic disease management. Through review over a prolonged period, factors associated with PDT tolerability and outcomes were identified, allowing predictive utilisation for optimizing patient‐centred PDT regimens.
Clinicopathological study of squamoid morules in nineteen conventional colorectal adenomas
Authors: Perez Dana , Wu Tong , Bhalla Ritu , Fu Zhiyan , Centeno Barbara A. , Ghayouri Masoumeh , Jiang Kun , Lauwers Gregory , Nakanishi Yukihiro
Published: February 2025

Squamoid morules are an intriguing finding rarely seen in colorectal adenomas, mimicking foci of microinvasion or neuroendocrine differentiation. We identified nineteen colorectal adenomas with squamoid morules and collected clinicopathological data. A representative block was chosen for immunohistochemistry. The expression of p40, p63, CK5/6, beta‐catenin, synaptophysin, chromogranin, and Ki‐67 in squamoid morules were examined immunohistochemically. The nineteen patients comprised fifteen males (79%) and four females (21%) ranging in age from 45 to 85 years (average: 59.4 years old). Fourteen adenomas were tubulovillous adenomas (average: 3.4 cm, ranging 1.0 to 6.0 cm) and five were tubular adenomas (average: 2.6 cm, ranging 1.6 to 3.0 cm). All foci of squamoid morules showed beta‐catenin nuclear positivity and CK5/6 expression. Squamoid morules were focally positive for p63 in four adenomas and focally positive for p40 in two adenomas. In two adenomas squamoid morules are focally positive for synaptophysin, and in one adenoma chromogranin was focally positive. In all nineteen adenomas squamoid morules were negative for Ki‐67. Squamoid morules are characterized by strong male predominance, large adenoma size, beta‐catenin nuclear positivity, CK5/6 expression, and no Ki‐67 expression. Beta‐catenin nuclear expression is helpful in distinguishing squamoid morules from foci of microinvasion and neuroendocrine differentiation.
Development of a novel multivariate germination index to quantify seed hydration memory
Authors: Lima A. T. , Almeida T. S. , de Santana D. G. , Meiado M. V.
Published: February 2025

In recent decades, the concept of memory has gained significant attention in plant ecophysiology research. When memory is expressed during germination, it is referred to as ‘seed hydration memory’. Although numerous metrics relate to different aspects of germination, the literature lacks a method for quantifying seed hydration memory. This study aimed to develop a Germination Memory Index (GMI); a mathematical tool designed to quantify seed memory. The GMI enables comparisons of different native or cultivated species germinating under various conditions following discontinuous hydration.

We tested the GMI using data from an experiment that evaluated germination of Cereus jamacaru seeds subjected to water deficit after undergoing hydration and dehydration cycles (HD cycles). The index is calculated as the arithmetic mean of gains, if any, in germination capacity, expressed as germinability, that is time to reach 50% germination, mean germination rate, uniformity of germination, synchrony and germination uncertainty, obtained from discontinuous hydration of the seeds.

The memory ranges from 0 ≤ GMI ≤1. Gains are observed when HD cycles enhance germination capacity, germination rate and synchrony while reducing time to reach 50% germination, uniformity and uncertainty compared to their reference values. The absence of memory occurs when GMI ≤0, indicating that the germination process is favourable without undergoing HD cycles. When germination only occurs after discontinuous hydration, GMI = 1.

Using the GMI, we can accurately measure gains in germinative behaviour provided by HD cycles, as this index reflects changes not only in germination capacity but also in germination time, speed, uniformity, synchrony and uncertainty.
Monitoring Virulence Phenotypes of Bremia lactucae in South and Southeast Brazil
Authors: da Silva Carvalho Lívia Tálita , Vargas Pablo Forlan , Okuma Izabella Garbeline , Marin Marcus Vinícius , de Mello Prado Renato , da Silva Neto Jorge Moreira , Jacinto Ana Carolina Pires , Castoldi Renata
Published: February 2025

Lettuce downy mildew (Bremia lactucae) is one of the most important diseases of lettuce, especially in conditions of mild temperatures and high humidity. The great variability of B. lactucae makes the use of genetic control complex, as resistance to different virulence phenotypes requires different resistance factors. Dm (“Downy mildew”) genes or resistance factors, have been widely used in lettuce cultivars, providing a high level of resistance to downy mildew. The objective of this work was to monitor and study the virulence phenotypes of B. lactucae in the south and southeast regions of Brazil. Samples with downy mildew symptoms were collected in the main producing areas of the states of São Paulo, Rio de Janeiro, Rio Grande do Sul, Santa Catarina and Paraná. Subsequently, a race differentiation test was carried out by inoculating differentiating cultivars and observing the pathogen's response, and a sextet code was assigned to each isolate according to its virulence phenotype (EU‐C). Frequency (%), virulence complexity index by isolate and by phenotype, and Gleason index were calculated. A total of 117 isolates were evaluated and 61 virulence phenotypes were identified. The sextet code 31‐00‐00 was the most frequent and could be used for the evaluation of resistant cultivars in the states of the south and southeast regions of Brazil. The resistance factor of lettuce cultivar Balesta provided resistance to all evaluated isolates, while RYZ2164 was resistant to all isolates except those from Paraná. Additionally, Kibrille conferred resistance to isolates from Santa Catarina.
Media Attributions and Public's Responses to Russia–Ukraine War: The Role of Emotions Toward Nation and Individuals
Authors: Kim Young‐eun , Kim Kayoung , Hwang Yoori , Jeong Se‐Hoon
Published: February 2025

Objective

Based on Weiner's attribution model, this research examined how attributions regarding an international conflict (e.g., Russia‐Ukraine war) lead to the public's responses (e.g., helping vs. punishment), mediated by their emotions toward nations (e.g., Russia vs. Ukraine) and individuals (e.g., Russians vs. Ukrainians).

Methods

In Study 1, we conducted a content analysis of 253 news articles about Russia‐Ukraine war that were published in Korea. In Study 2, we conducted a survey of 400 Korean adults regarding their attributions and responses to Russia and Ukraine.

Results

Study 1 showed that the Korean news media attributed more responsibility to Russia and less responsibility to Ukraine. Study 2 found that greater attributions of Russia responsibility increased willingness to punish the nation, mediated by anger toward Russia as a nation but not toward Russian individuals. In addition, results showed that the lower attributions of Ukraine responsibility increased willingness to help the nation, mediated by sympathy toward Ukrainian individuals, and also anger toward Russia as a nation.

Conclusion

This study extends existing theory by (a) incorporating intermedia agenda setting at the international level (Study 1) and (b) including emotions toward the nation as well as individuals in attributions (Study 2).
Evaluation of oclacitinib maleate and prednisolone combined therapy for the control of atopic dermatitis in dogs: A controlled clinical trial
Authors: Ferreira Tássia Sell , Villalobos Wendy Roldán , Gmyterco Vanessa Cunningham , Fonseca Diogo Simões , de Farias Marconi Rodrigues
Published: February 2025

Background

Canine atopic dermatitis (cAD) is a chronic inflammatory and pruritic dermatopathy requiring a multimodal therapeutic approach.

Objective

To assess the effectiveness, safety and cost of oclacitinib and prednisolone treatment in dogs with AD.

Animals

Twenty‐three client‐owned dogs with cAD.

Materials and Methods

Dogs were randomly assigned to one of two groups: Group 1 received prednisolone (0.5 mg/kg every 24 h) for 7 days, then oclacitinib (0.5 mg/kg) and prednisolone (0.5 mg/kg), were administered alternately with a 1 day pause between each drug, for 7 additional weeks. Group 2 received oclacitinib (0.5 mg/kg every 12 h for 14 days, then every 24 h) for 8 weeks. Assessments included the Canine Atopic Dermatitis Extent and Severity Index, 4th iteration (CADESI‐04) and pruritus Visual Analog Scale (PVAS) on Day (D)0, D7, D14, D30, D45 and D60.

Results

Both groups showed significant CADESI and PVAS reductions on D7 (p < 0.001). From D14 to D60, mean scores remained stable compared to D7, with no significant differences between groups. Adverse events included two dogs with polyuria and polydipsia, and three with polyphagia in Group 1, all of which resolved by D14. In Group 2, one dog experienced polyphagia, and two had self‐limiting vomiting. Three dogs in Group 1 and one dog in Group 2 had mild increases in liver enzyme concentrations.

Conclusions and Clinical Relevance

The combined protocol was effective and safe for managing itch and inflammation over a 60 day period. It had a 73.3% lower cost compared to oclacitinib alone.
Influence of Groove Texture Parameters on the Friction Performance of Roller Bit Floating Sleeve Bearings
Authors: Wei Gang , Wang Guorong , Zhong Lin , Wang Yang , He Xia , Li Mengyuan , Zhu Dan , Wang Dangfei , Liao Wenling
Published: February 2025

Improving the wear resistance of cone bit bearings is crucial for enhancing bit life and drilling efficiency. This study integrates surface texture lubrication with bit floating sleeve bearings. A ring-block friction experiment was conducted under simulated drilling conditions, examining groove textures with various geometric parameters. The effects of groove texture parameters—depth, area ratio, skew angle, and width—on the tribological performance were analyzed using friction coefficient, wear amount, and surface morphology. Results indicate that optimal texture arrangements significantly enhance wear resistance. The best parameters found were a depth of 40 µm, a texture area ratio of 10%, and a skew angle of 45°, reducing the friction coefficient by over 39%.
Efficient and accurate feature-aided active tracking for underwater small targets in highly cluttered harbor environments using a full motion acoustic flow field solution
Authors: Wei Zhuoqun , Han Yina , Liu Qingyu , Zhao Shuang , Song Jun
Published: February 2025

To address the issue of tracking highly maneuverable small underwater intruders in the dynamic and heavily interfered environment of harbors, a local sparse motion acoustic flow (LSMAF) computation method constrained by robust high-order flux tensor (RHO-FT) feature has been proposed, along with a LSMAF feature-aided active tracking method. First, potential targets are localized from the dense dynamic clutter background of active sonar echographs using RHO-FT feature maps. Subsequently, on the basis of a dense motion acoustic flow calculation method, a local motion consistency criterion is introduced to the potential target area, establishing a method for calculating LSMAF, which updates the precise motion vectors of potential targets in real time. Finally, all measurements obtained from the RHO-FT feature map are iteratively filtered together with their corresponding motion vectors to maintain the kinematic consistency of the potential target's trajectory. Experiments conducted on a series of cooperative targets in real-world harbor environments show that LSMAF-aided tracking method outperforms the latest developments of tracking for underwater targets in terms of both tracking efficiency and trajectory accuracy.
Underwater target classification based on the combination of dolphin click trains and convolutional neural networks
Authors: Xiang Wenjie , Song Zhongchang , Gao Zhanyuan , Zhang Boyu , Fu Weijie , Zhang Chuang , Zhang Yu
Published: February 2025

Sonar remains a major way to detect and discriminate underwater targets by interpreting the echoes. In this study, we used broadband dolphin clicks to detect and classify targets. The peak and notch features of the echo spectra were coded, and echoes were obtained using five-click trains, with the number of clicks changing from 1 to 50. Codes containing the target interpretation were classified by convolutional neural networks (CNNs). Compared to a single click, the increasing number of clicks to 5, 10, 20, and 50 in a train would gradually improve the classification rate of targets by 3%, 6.1%, 8.2%, and 10.5% on average with a signal-to-noise ratio ranging from –10 to 15 dB. The 50-click train outperformed other click trains in target detection and classification. The CNNs achieved an average classification accuracy of 95.2% for a 50-click train, higher than that of the nearest neighbor method by 10.3% across signal-to-noise ratios. Therefore, the usage of dolphin clicks and CNN-based echo encoding technologies constitutes an effective method for enhancing target classification, offering valuable insights for future applications in detecting underwater targets.
Exploring the directivities of whistle in the Indo-Pacific humpback dolphin (Sousa chinensis) and their dependency on the whistles' frequency contour
Authors: Zhang Chuang , Wu Fuxing , Song Zhongchang , Fu Weijie , Xiang Wenjie , Ou Wenzhan , Zhang Yu
Published: February 2025

Directional communication plays a pivotal role in enabling odontocetes to maintain group coordination and social interactions. The fundamental frequency, number of harmonics, and their relative energy distribution in whistles exhibit temporal variation. This study investigated the whistles produced by the Indo-Pacific humpback dolphins (Sousa chinensis) in Xiamen Bay, China. Using computed tomography scanning data, we developed a numerical model of the species and used finite element modeling to examine the beam patterns at both fundamental and harmonic frequencies of whistles, ranging from 3.9 to 64.9 kHz, which corresponds to directivity indices (DIs) between 2.2 and 16.2 dB. We weighted the beams at the fundamental frequencies and harmonics based on their energy distribution to derive composite beam patterns at specific time stamps, allowing us to investigate temporal variations in the corresponding DI within individual whistles. The time-varying properties of DIs were analyzed for various whistle types, including constant, upsweep, downsweep, convex, and sine. Given that harmonics are integer multiples of the fundamental frequency, their contours exhibit similar shapes, whereas the composite DI showed more complexity. These findings indicate that the proportion of energy between the fundamental frequency and harmonics is a key determinant of whistle directivity in Indo-Pacific humpback dolphins.
Phenanthrene degradation by a flavoprotein monooxygenase from
Phanerodontia chrysosporium
Authors: Hayasaka Mika , Hamajima Link , Yoshida Yuki , Mori Reini , Kato Hiroyuki , Suzuki Hiromitsu , Tsurigami Ryoga , Kojima Takaaki , Kato Masashi , Shimizu Motoyuki
Published: February 2025

Phenanthrene (PHEN), a polycyclic aromatic hydrocarbon (PAH), is degraded by white-rot fungi like
Phanerochaete chrysosporium
(the fungus has been renamed as
Phanerodontia chrysosporium
). PHEN is metabolized by
P. chrysosporium
and transformed into various monohydroxylated and dihydroxylated products. These intermediates are further degraded by cleavage of the aromatic ring. However, the enzymes involved in PHEN conversion in
P. chrysosporium
remain largely unidentified. We aimed to identify and characterize the
P. chrysosporium
enzymes involved in the degradation of PHEN and its intermediates. Recombinant
P. chrysosporium
flavoprotein monooxygenase 11 (FPMO11), a homolog of the salicylate 1-monooxygenase from the naphthalene-degrading bacterium
Pseudomonas putida
G7, was overexpressed in
Escherichia coli
. FPMO11 catalyzes the oxidative decarboxylation of 1-hydroxy-2-naphthoate (1H2N) and 2-hydroxy-1-naphthoate (2H1N) to 1,2-dihydroxynaphthalene (1,2DHN). To the best of our knowledge, this is the first study to identify and characterize enzymes with 1H2N and 2H1N monooxygenase activities in members of the FPMO superfamily. Additionally, our search for a dioxygenase with the ability to catalyze the aromatic ring cleavage of 1,2DHN led to the identification of intradiol dioxygenase (IDD) 1 and IDD2 from
P. chrysosporium
, which catalyzes the ring cleavage of 1,2DHN. Thus, this study also identified, for the first time, intradiol 1,2DHN dioxygenase activity in members of the IDD superfamily. The findings highlight the unique substrate spectra of FPMO11 and IDDs, rendering them attractive candidates for biotechnological applications, especially mitigation of environmental and health risks associated with PAH pollution.

IMPORTANCE

Phenanthrene (PHEN), a polycyclic aromatic hydrocarbon (PAH), is a widely studied pollutant in environmental science and toxicology due to its presence in fossil fuels, tobacco smoke, and as a byproduct of incomplete combustion processes. White-rot fungi like
P. chrysosporium
can degrade PHEN through the production of extracellular oxidative enzymes. We investigated the properties of PHEN-degrading enzymes in
P. chrysosporium
, specifically one flavoprotein monooxygenase (FPMO11) and two intradiol dioxygenases (IDD1 and IDD2). Our findings indicate that the enzymes catalyze the aromatic ring cleavage of PHEN, using the intermediates as substrates, transforming them into less harmful and more biodegradable compounds. This could help reduce environmental pollution and mitigate health risks associated with PAH exposure. The potential of these enzymes for biotechnological applications is also highlighted, emphasizing their critical role in understanding PAH degradation by white-rot fungi.
A fatal case of chronic
Cryptococcus neoformans
meningitis progressing over a 4-year period following cladribine therapy
Authors: Ekenberg Christina , Holler Jon Gitz , Stenør Christian Peter Midtgaard , Astvad Karen Marie Thyssen , Helweg-Larsen Jannik , Jepsen Micha Phill Grønholm
Published: February 2025

Background

Globally, cryptococcal meningitis (CM) remains most common in human immunodeficiency virus (HIV)-infected individuals. However,
Cryptococcus neoformans
increasingly causes CM in patients with non-HIV immunosuppression due to glucocorticoid treatment, organ transplantation, and hematological cancer, among others. The clinical presentations of cryptococcal disease are highly host dependent, resulting in varying disease presentations in immunocompromised patients.

Case Summary

Here, we report a fatal case of CM in a patient previously treated with cladribine due to hairy cell leukemia. The patient had an atypical presentation, and the disease progressed slowly over a 4-year period, hampering timely diagnostics and treatment. Retrospective analyses of the cerebrospinal fluid and blood revealed that the cryptococcal antigen (CrAg) test was already positive when the patient initially presented with pleocytosis 3 years prior to the CM diagnosis.

Conclusion

This case adds valuable knowledge to our current understanding of CM due to the unusual time course and furthermore demonstrates important pitfalls associated with cryptococcosis in HIV-negative patients, including the atypical disease presentation and diagnostic challenges which resulted in a diagnostic delay of 3 years. Morbidity and mortality remain high, and with a growing population of non-HIV immunocompromised patients, increased awareness of CM and low threshold to screen these patients for CrAg are warranted.
Diversifying T-cell responses: safeguarding against pandemic influenza with mosaic nucleoprotein
Authors: Park Hongtae , Kingstad-Bakke Brock , Cleven Thomas , Jung Myunghwan , Kawaoka Yoshihiro , Suresh M.
Published: February 2025

Pre-existing T-cell responses have been linked to reduced disease severity and better clinical outcomes during the 2009 influenza pandemic and the recent COVID-19 pandemic. We hypothesized that diversifying T-cell responses, particularly targeting conserved viral proteins such as the influenza A virus (IAV) nucleoprotein (NP), could protect against both epidemic and pandemic IAV strains. To test this, we created a mosaic nucleoprotein (MNP) by synthesizing a sequence that maximized the representation of 9-mer epitopes from 7422 NP sequences across human, swine, and avian IAVs. Notably, the MNP sequence showed high homology with the NP of the H5N1 strain affecting dairy cows in the ongoing outbreak. Mucosal immunization with the adjuvanted MNP vaccine induced robust CD8 and CD4 T-cell responses against both known immunodominant and
in silico
predicted subdominant epitopes. MNP-vaccinated mice challenged with epidemic H1N1 and H3N2 strains, which shared immunodominant CD8 and/or CD4 T-cell epitopes, showed a significant (~4 log) reduction in lung viral load. Importantly, MNP-vaccinated mice challenged with a pandemic H1N1 strain lacking shared immunodominant CD8 or CD4 epitopes exhibited a superior reduction in lung viral load, linked to T-cell responses targeting subdominant epitopes present in both the MNP and pandemic strain NP. These results suggest that a diversified T-cell response induced by the MNP vaccine could provide broad protection against severe disease from both current and emerging IAV strains.

IMPORTANCE

The World Health Organization (WHO) estimates that seasonal influenza causes 3–5 million cases of severe illness annually. The influenza virus frequently undergoes genetic changes through antigenic drift and antigenic shift, resulting in annual epidemics and occasional pandemics. Consequently, a major public health objective is to develop a universal influenza vaccine that offers broad protection against both current and pandemic influenza A strains. In this study, we designed a nucleoprotein (NP) antigen (termed mosaic NP) comprising antigenic regions found in thousands of influenza viruses, aiming to use it as a vaccine to induce broad anti-influenza T-cell responses. Our findings indicate that the mosaic NP vaccine provided significant protection against seasonal H1N1 and H3N2, as well as the pandemic H1N1 strain, demonstrating its effectiveness across various influenza subtypes. These findings suggest that the mosaic NP is a potential universal influenza vaccine antigen, capable of protecting against diverse strains of influenza viruses.
Capture of mobile genetic elements following intercellular conjugation promotes the production of ST11-KL64 CR-hvKP
Authors: Huang Shanshan , Wei Dan Dan , Hong Hanxu , Chen Si , Fan Lin-Ping , Huang Qi-Sen , Du Fang-Ling , Xiang Tian-Xin , Li Ping , Zhang Wei , Wan La-Gen , Liu Yang
Published: February 2025

Sequence type (ST)11 carbapenem-resistant hypervirulent
Klebsiella pneumoniae
(CR-hvKP) can cause life-threatening infections and is therefore of global concern. Despite its importance, the evolutionary history and mechanism for the emergence of ST11 CR-hvKP are unclear. In recent years, the detection rate of ST11 CR-hvKP has increased in a teaching hospital. Based on its clonal transmission, a conjugation experiment was performed between a hvKP strain AP8555 and a ST11 CRKP strain, resulting in two ST11 CR-hvKP strains. Research had confirmed that the virulence plasmid pAP855 was horizontally transferred to the CRKP strain to form the conjugant S270-Tc, which was recombined by mobile genetic elements to evolve into the conjugant S270-Tc-R. The S270-Tc-R had high virulence, high plasmid stability, and greater adaptability. Interestingly, it had high homology to clinically prevalent ST11 CR-hvKP strains using pulsed-field gel electrophoresis (PFGE) and whole-genome sequencing (WGS). This is the first demonstration that plasmid recombination in vitro has led to the formation of ST11 CR-hvKP strains. The clinical setting is a multi-factorial and multi-selection pressure environment that may stimulate the evolution of conjugant strains in the transition period to local strains in the stable period, and surveillance is urgently needed for infection control.

IMPORTANCE

The emergence of carbapenem-resistant hypervirulent Klebsiella pneumoniae (CR-hvKP) heralded the onset of a new and rapidly worsening public health disaster on a global scale. More attention has been paid to its evolutionary history and mechanism, which currently remains unclear. In this study, a conjugation experiment was performed between a hvKP strain AP8555 and a ST11 CRKP strain, resulting in two ST11 CR-hvKP strains. We had confirmed that the virulence plasmid pAP855 was horizontally transferred to the CRKP strain to form the conjugant S270-Tc, which was recombined by mobile genetic elements to evolve into the conjugant S270-Tc-R. The S270-Tc-R had high virulence, high plasmid stability, and greater adaptability. Interestingly, it had high homology to clinically prevalent ST11 CR-hvKP strains using pulsed-field gel electrophoresis and whole-genome sequencing.
A Generator of High-Power Nanosecond Pulses of Quasi-Rectangular Shape
Authors: Korotkov S. V. , Zhmodikov A. L. , Korotkov D. A.
Published: February 2025

A generator of powerful nanosecond pulses that contains a storage capacitor, a segment of a coaxial cable, and closing and opening semiconductor switches has been developed. With a storage-capacitor charging voltage of 12 kV, the generator allows switching quasi-rectangular voltage pulses with an amplitude of ~26 kV, a rise time of ~4 ns, and a fall time of ~6 ns into a 75 Ω load. The half-maximum pulse duration is ~45 ns, and the “jitter” relative to an external triggering signal is less than 2 ns. The possibility of increasing the generator output power and the duration of output-voltage pulses is shown.
Four-Photon Josephson Traveling Wave Parametric Amplifier
Authors: Lomonosov A. A. , Kubrakov R. V. , Filippenko L. V. , Kozulin R. K. , Krupenin V. A. , Kornev V. K. , Tarasov M. A.
Published: February 2025

Josephson traveling wave parametric amplifiers can have high gain and wide frequency range, high sensitivity, and low noise, which makes them promising for quantum computing, array receiver readout systems, spectroscopy, single-photon detectors, etc. In this paper, the authors investigate samples of traveling wave parametric amplifiers based on a three-layer Nb/AlO
x
/Nb superconductor–insulator–superconductor (SIS) structure with a SNAIL (Superconducting Nonlinear Asymmetric Inductive Elements) series array. Each SNAIL cell consists of the kinetic inductance of four SIS junctions and the nonlinear inductance of a smaller SIS junction. The cells are alternately connected in antiphase with respect to the magnetic flux, which ensures a change in the sign of the Kerr nonlinearity and a reduction in the phase mismatch for the pump frequency, signal frequency, and idler frequency. The transmission spectra of the samples were measured at temperatures of 4.2 and 2.8 K in the frequency range of 0.1–6 GHz.
May-Thurner syndrome: a forethought for asymptomatic pulmonary embolism
Authors: Hamad Mahmoud Nidal , Rawashdeh Sabir , Khalidi Karim
Published: February 2025

May-Thurner syndrome (MTS) is a clinicopathological condition where the left common iliac vein is compressed by the overlying right common iliac artery, potentially leading to deep vein thrombosis (DVT) or obstruction to venous outflow. Unlike in DVT due to other causes, pulmonary embolism is not a frequent association of MTS. We report a man in his 30s who presented with left lower limb pain and swelling, without chest pain or shortness of breath. A contrast CT angiography of the abdomen and pelvis revealed a left common iliac, external iliac and femoral extensive DVT due to MTS. Incidental bilateral segmental pulmonary emboli were detected at the covered lung bases. He underwent direct catheter thrombolysis of his left side DVT and later a stent placement in the common iliac vein. This report highlights the under-recognised presentation of MTS in patients with DVT and emphasises the role of early endovascular intervention in improving clinical outcomes and preventing long-term complications.
Obstructive uropathy secondary to metastasis from carcinoma of the breast
Authors: Shubhankar Gautam , Panwar Vikas Kumar , Mittal Ankur
Published: February 2025

Obstructive uropathy secondary to malignant ureteral strictures is rare, with carcinoma of the breast accounting for less than 2% of cases. We present the case of a woman in her late 50s with a history of breast cancer who developed bilateral ureteral obstruction. She presented with bilateral flank pain, vomiting, fever and reduced urine output, with a serum creatinine of 12 mg/dL. Imaging showed bilateral hydroureteronephrosis leading to percutaneous nephrostomy placement. Further investigation confirmed metastatic breast cancer causing ureteral strictures. The patient was treated with palliative radiotherapy. This case highlights the importance of considering malignant causes in patients with a history of cancer presenting with obstructive uropathy, emphasising the need for thorough diagnostic workup, including fluorodeoxyglucose-positron emission tomography scans, to guide appropriate management and avoid unnecessary surgical interventions. Early urinary diversion and targeted therapy are crucial for symptom relief and disease control.
RefractorySalmonellainfection resulting in nephrectomy
Authors: Patel Dillon Jay , Spencer Evan , Matthews Gerald , Naim Sameh
Published: February 2025

Non-typhoidalSalmonella(NTS) infections, though commonly associated with gastroenteritis, can demonstrate focal non-gastrointestinal organ involvement. We present the case of a mid-30s woman who presented with long-standing left flank pain and was subsequently diagnosed with refractorySalmonellapyelonephritis in the setting of nephrolithiasis, severe hydronephrosis and parenchymal thinning suggestive of renal atrophy despite normal serum creatinine and a normal appearing contralateral kidney. Despite several guideline-based antibiotic courses, we failed to clear her multidrug-resistantSalmonellaspecies bacteriuria. We then established percutaneous nephrostomy (PCN) drainage but still were unable to clear her infection, and it was noted PCN output dropped below 30 cc per day suggesting a non-functional renal unit.

This patient was successfully managed with minimally invasive laparoscopic robotic-assisted left nephrectomy which finally cleared her bacteriuria. This case illustrates challenges in the management of refractory atypicalSalmonellainfections and highlights the rare indication of nephrectomy in such cases.
Tabes dorsalis: a rare presentation of neurosyphilis in Western Europe
Authors: Bloch Nando , Brugger Florian , Notter Julia
Published: February 2025

We present a case of tabes dorsalis with delayed diagnosis in a carpenter who presented with a VIth cranial nerve palsy, decreased deep tendon reflexes, reduced sense of vibration and an unsteady gait. After deterioration of symptoms with almost complete loss of vision due to bilateral optic atrophy, pronounced relative afferent pupillary defect and severe gait ataxia, and 4 years of extensive diagnostic testing and ineffective treatments, including several MRIs, genetic analysis and eye surgeries, serological testing was positive for syphilis. ElevatedTreponema pallidumactivity markers in the serum and cerebrospinal fluid confirmed the diagnosis. The patient then disclosed a history of syphilis 30 years ago, treated insufficiently with an oral antibiotic. While laboratory results improved, no clinical amelioration was achieved after treatment. This case demonstrates the need for thorough medical history and targeted diagnostic workup to achieve early recognition, diagnosis and treatment of neurosyphilis to prevent irreversible sequelae.
Unlikely presentation of diaphragmatic rupture following local impact trauma
Authors: Snik Anouk R , van der Naald Niels , Blom Rachel , Goslings J Carel
Published: February 2025

A woman in her late 70s presented to the emergency department with acute respiratory distress, four days after localised trauma to the right side of the chest. Diagnostic investigations revealed a diaphragmatic rupture with visceral herniation. Laparoscopic repair was performed with repositioning of ischaemic colon, closure of the diaphragm and a right hemicolectomy with end-to-end ileo-transversostomy. A subsequent empyema required video-assisted thoracoscopic surgery and antibiotic treatment. Eventually, the patient made a full recovery.
Triple trouble: rheumatic heart disease, infective endocarditis, atrial myxoma
Authors: Shah Bhavik Sandip , Lanjewar Ishita C , Sawant Gaurish , Aironi Balaji D
Published: February 2025

A young college-going male presented with worsening dyspnoea and palpitations for 6 months. He was diagnosed with rheumatic heart disease. The patient’s echocardiogram showed not only rheumatic affection of the mitral valve with restricted leaflet movements, but there was also a calcified hyperechogenic mass attached to the atrial aspect of the anterior mitral leaflet, which signified a probable calcified thrombus or an organised vegetation; and a heterogenous, low-attenuating mass attached to the interatrial septum characterised as an atrial myxoma. Considering the gravity of the situation, the patient underwent a successful removal of intracardiac masses with a bioprosthetic mitral valve replacement urgently. Although reported, the occurrence of atrial myxoma with rheumatic heart disease is a rare phenomenon. Left atrial thrombus and myxoma can mimic each other and pose a diagnostic challenge even in today’s era of multimodality imaging.
Air emboli during neuroendovascular procedure treated with hyperbaric oxygen therapy
Authors: Sanders João Victor , Oliver Marion J , Lopes Demetrius K
Published: February 2025

Air embolism is a rare complication of endovascular procedures with hyperbaric oxygen therapy (HBOT) as a potential treatment. We report a male patient in his 40s presented to the emergency department with the following fluctuating symptoms: headache, aphasia, bilateral arm and hand weakness, numbness and blurry vision. Medical history included remote vertebral artery dissection, hypertension and tobacco use. Initial head CT was normal; CT angiogram revealed bilateral internal carotid artery dissections with significant stenosis. He was taken for emergent carotid intervention. During the intervention, the patient developed agitation, bradycardia and respiratory distress, necessitating intubation. Dyna CT revealed air emboli. HBOT was initiated, leading to complete resolution of air emboli and small haemorrhages after one session. Post-treatment, the patient showed neurological improvement, was extubated and later discharged with mild residual aphasia and dysarthria. This case underscores air emboli as a rare complication in the neurointerventional suite and highlights HBOT as a feasible treatment.
Occult bladder wall injury with pelvic binder
Authors: Heathcote Cameron , Vincent Chandan Noel , Alsousou Joseph
Published: February 2025

Pelvic binders are effective devices used in the prehospital setting to stabilise polytrauma patients with suspected pelvic injuries. They provide circumferential pressure around the pelvis, reducing intrapelvic volume to tamponade any potential bleeding. This case presents a patient who sustained multiple fractures and soft tissue injuries during a road traffic accident. The CT scan reported mild pubic symphysis diastasis but stated that the bladder wall was intact. A postpelvic binder removal X-ray showed extravasation of contrast from the bladder indicating a bladder tear. In this case, the pelvic binder had masked the bladder wall injury during the CT scan. We suggest that plain X-rays should be taken of the pelvis after the pelvic binder is removed, regardless of the CT report. This X-ray surveillance would reduce not only the chances of missing injuries to the bony pelvis but also injuries to the pelvic viscera.
Primary hydatid cyst of psoas muscle in an adolescent
Authors: Sahu Avilash , Naik Deepti , Bal Anandit , Mahalik Santosh Kumar
Published: February 2025

Hydatid disease, a zoonotic infection caused byEchinococcus granulosus, primarily affects the liver and lungs but can involve other areas, including muscle tissue, though muscle involvement is rare. This case describes an adolescent girl with a psoas muscle hydatid cyst presenting with abdominal pain, a palpable mass and polymenorrhoea. Imaging and serology confirmed the diagnosis, and treatment included albendazole therapy and surgical excision via transperitoneal laparotomy, followed by a successful recovery with no recurrence at an 18-month follow-up.

Hydatid disease is transmitted from definitive hosts, like dogs, to humans. Diagnosis can be challenging due to non-specific symptoms, and it typically relies on ultrasound, CT and serology. Surgical removal combined with antiparasitic drugs remains the primary treatment, though newer methods like ultrasound-guided aspiration are emerging. This case underscores the need to consider hydatid disease in differential diagnoses of cystic masses in endemic areas, particularly in paediatric cases.
Pseudomonas aeruginosasepsis with sacroiliitis in X-linked agammaglobulinaemia
Authors: KS Aswanth , Samariya Pallavi , Arun Babu Thirunavukkarasu
Published: February 2025

A boy under 5 years, with recurrent infections since 9 months of age, presented with fever and painful limping. Clinical examination revealed absent tonsils, antalgic gait and mild tenderness in the right hip joint. MRI of the pelvis demonstrated bone marrow oedema in the right sacroiliac joint, indicative of sacroiliitis. Blood cultures identifiedPseudomonas aeruginosaas the causative organism. Immunological evaluation showed panhypogammaglobulinaemia and the absence of CD19-positive B cells in the lymphocyte subset analysis. Next-generation sequencing confirmed a hemizygous mutation (c.1256G>A variant) in theBTKgene at exon 14, establishing a diagnosis of X-linked agammaglobulinaemia (XLA). The child was managed with intravenous immunoglobulin and a 4-week course of antibiotics, resulting in clinical improvement. This case represents the first reported instance ofP. aeruginosasepsis associated with pyogenic sacroiliitis in a child with XLA, highlighting the need for vigilance in diagnosing rare infections in immunocompromised patients.