bluuebunny/crossref_metadata_2025 huggingface dataset:
Diagnostic Accuracy of Golgi Protein 73 (GP73) for Liver Fibrosis Staging in Metabolic Dysfunction-Associated Steatotic Liver Disease: A Scoping Review and Cohort Study
Authors: Pecoraro Valentina , Nascimbeni Fabio , Cuccorese Michela , Gabrielli Filippo , Fasano Tommaso , Trenti Tommaso
Published: February 2025

Background/Objectives: Golgi protein 73 (GP73) is a transmembrane protein expressed by epithelial cells of the bile duct in the normal liver. High serum levels of GP73 have been detected in patients with acute or chronic liver diseases, MASLD, and its measurement has been suggested as a potential biomarker for liver fibrosis staging. We evaluated the utility of GP73 in the diagnosis of MASLD, MASH, and for liver fibrosis staging. Methods: We performed a literature scoping review to map the current evidence about the accuracy of GP73 in patients with MASLD. We searched in Medline and EMBASE for English studies reporting an AUC value of GP73 in diagnosing MASLD and MASH and evaluating GP73 for fibrosis staging. A narrative synthesis of the evidence was conducted. Moreover, we performed an observational study including 84 patients with MASLD, of which 60 were biopsy-confirmed MASH, and different liver fibrosis stages, and 15 healthy controls. Serum GP73 levels were determined using a chemiluminescent assay and reported as mean and standard deviation (SD). Sensitivity (SE), specificity (SP), the area under the receiver operating characteristic (AUROC) curve, and the optimal cut-off value were calculated. Data were considered statistically significant when p < 0.05. Results: Available studies evaluating GP73 in MASLD reported the ability to discriminate MASH from simple steatosis and distinguish patients at different fibrotic stages, but the evidence is still scarce. Our experimental study showed that the serum levels of GP73 were 30 ± 12 ng/mL in MASLD and 32 ± 12 ng/mL in MASH patients and were statistically higher than those of the control group (19 ± 30 ng/mL), increasing from liver fibrosis stage F0 to F4. GP73 levels were significantly higher in patients with significant and advanced fibrosis than controls and no significant fibrosis (p > 0.05). ROC analysis demonstrated that serum GP73 had a good diagnostic potential for MASLD (AUROC 0.85; SE 90%; SP 73%), MASH (AUROC 0.75; SE 82%; SP64%), and significant fibrosis (AUROC 0.7; SE 56%; SP 79%) and was better than other biomarkers for chronic liver diseases. Conclusions: Serum GP73 could support clinicians in the evaluation of patients with MASH and significant fibrosis.
An Open Quantum System Interacting with an Interference Engineering Environment
Authors: Wang He , Wang Jin
Published: February 2025

In this paper, we investigate the interference engineering of the open quantum system, where the environment is made indefinite either through the use of an interferometer or the introduction of auxiliary qubits. The environments are modeled by fully connected qubit baths with exact analytical dynamics. As the system passes through the interferometer or is controlled by auxiliary qubits, it is propagated along different paths or their superpositions, leading to distinct interactions with the environment in each path. This results in the superposition of the environments, which can be detected through specific measurements that retain certain coherent information about the paths. Our results demonstrate that the indefiniteness of the environment can significantly enhance the quantum correlations. However, only the statistical mixture of the influences from the environments is preserve provided that the path coherence is destructed. We also examine the serviceability of the indefiniteness as a resource for teleportation and quantum parameter estimation. Additionally, we discuss how to quantify the indefiniteness and the ways in which it affects the system’s dynamics from the perspective of wave–particle-entanglement-ignorance complementarity. Our study highlights the potential benefits of an indefinite environment in quantum information processing and sheds light on the fundamental principles underlying its effects.
Adsorption Kinetics Model of Hydrogen on Graphite
Authors: Simon Jean-Marc , Carneiro Queiroz da Silva Guilherme
Published: February 2025

A new kinetic equation for the adsorption and desorption of H2 on graphite is derived based on the adsorption and desorption equilibrium rates obtained from the molecular dynamics. These rates are proportional to the activity in the gas and the adsorbed phase and thus do not obey Langmuir kinetics. The new equation offers a new route for understanding experimental results. It is used to simulate the kinetics under different thermodynamic conditions, both isothermal and non-isothermal. The characteristic times of adsorption and desorption are in good agreement with the data from the literature. The relation between the kinetics and the mass flow equation is discussed within the framework of the non-equilibrium thermodynamics of heterogeneous systems. Finally, expressions for the transport coefficients are proposed for both the transfer of mass and the coupling between the mass and heat fluxes.
Evaluating Methods for Detrending Time Series Using Ordinal Patterns, with an Application to Air Transport Delays
Authors: Olivares Felipe , Marín-Rodríguez F. Javier , Acharya Kishor , Zanin Massimiliano
Published: February 2025

Functional networks have become a standard tool for the analysis of complex systems, allowing the unveiling of their internal connectivity structure while only requiring the observation of the system’s constituent dynamics. To obtain reliable results, one (often overlooked) prerequisite involves the stationarity of an analyzed time series, without which spurious functional connections may emerge. Here, we show how ordinal patterns and metrics derived from them can be used to assess the effectiveness of detrending methods. We apply this approach to data representing the evolution of delays in major European and US airports, and to synthetic versions of the same, obtaining operational conclusions about how these propagate in the two systems.
Relationship Between the Water Vapor Transport from the Amazon Basin and the Rainfall Regime over a Watershed on Brazil’s Southern Border
Authors: Santiago Maicon Moraes , Nunes André Becker , Couto Flavio Tiago , Almeida Bressiani Danielle de , Freitas Rose Ane Pereira de , Cardoso Iulli Pitone
Published: February 2025

The climate of the south of Brazil is characterized by northern winds in a hegemonic way for the transfer of moisture. Thus, the goal here is to verify the impact of the meridional water vapor transport on the rainfall of the Mirim–São Gonçalo Watershed (MSGW), located in the extreme south of Brazil and essential for regional development. The study is based on the precipitation data from MSGW weather stations and ERA5 reanalysis data for the period 1981–2020, which allowed the analysis of the interactions between different climatological variables. The water vapor transport was analyzed using the vertically integrated water vapor flux (VIVF). Coefficients were obtained according to the VIVF values in two locations placed between the Amazon basin and southern Brazil, namely in Bolivia and Paraguay. The results show that the MSGW is directly impacted by moisture transport from the north in all seasons, and this transport is most significant at the 850 hPa level. In addition, the moisture and rainfall in the MSGW are also influenced by changes in the magnitude and direction of this flow, with an increase in transport in periods of El Niño, especially during spring. Therefore, the study brings insights into how changes in tropical South American climate, through a cascading effect, may affect the Mirim–São Gonçalo Watershed development in the middle latitudes from changes in the meridional water vapor transport, highlighting the importance of studying the tropical and extratropical interactions in South America for the MSGW management and sustainable development.
Autism Knowledge, Perceptions of Potential Outcomes and Attitudes About Autism Education in Greece
Authors: Papoudi Despina , Antonopoulou Katerina
Published: February 2025

The present study examines professionals’ knowledge of autism as well as perceptions of potential outcomes and attitudes about education and the inclusion of autistic children in Greece. One hundred and eighty mainstream school teachers, special needs teachers and health/social care professionals, all working in the education sector, responded to self-reported questionnaires. Results showed between-group differences in the knowledge of autism prognosis and in self-efficacy in supporting autistic children, with health/social care professionals outperforming teachers. Mainstream school teachers, however, achieved higher scores compared to health/social care professionals in their perceptions of life and literacy outcomes and in their attitudes about the use of modified assessment methods for autistic children. The present findings support the need for improving perceptions for autistic children, promoting inclusive practices and a multi-disciplinary shared understanding of autism among professionals within the education sector and beyond.
Renewable Energy, Resilience, Digitalization, and Industrial Policies in Seaborne Transport
Authors: Barbieri Elisa , Capoani Luigi
Published: February 2025

This paper delves into sustainability and energy policies influencing the governance and dynamics of global maritime trade. Resilience and sustainability are also discussed, along with the obstacles encountered and strategies to overcome them. The analysis underscores the importance of developing long-term strategies and participatory processes, focusing on government involvement in promoting structural changes towards a more sustainable seaborne transport system. Part of our research is also dedicated to outlining the different factors influencing this industry among different continents, highlighting the need for increasingly unified governance frameworks internationally. By incorporating resilience theory and new technologies, with a high potential in terms of GHG emission reduction, governments and firms can better engage stakeholders, ensure business resilience, and address climate change risks. This study concludes that ports have significant power in driving structural change, and modernization across various areas—such as digitalization, energy policies, safety, green fuels, environmental sustainability, and effective coordination—is essential for their continued development.
Testing the Radial Increment and Climate–Growth Relationship Between Swiss Stone Pine European Provenances in the Romanian Carpathians
Authors: Budeanu Marius , Besliu Emanuel , Pepelea Dan
Published: February 2025

Swiss stone pine (Pinus cembra L.) may represent a vital species for afforestation at the upper altitudinal limits of forests due to its adaptability to challenging environmental conditions. In this study, we aimed to analyze the variability in ring width (radial growth, RW, earlywood, EW, latewood, LW, and latewood proportion, LWP) and the influence of different sites on the climatic resilience of twelve European provenances of Swiss stone pine to identify the best-adapted provenances. Five provenances from the Alps and seven from the Carpathians were tested across two 27-year-old field trials conducted in the Eastern and Southern Carpathians. Moderate genetic differentiation among the provenances was noted, which could ensure the success of breeding programs. Based on ring width and latewood proportion, we successfully selected the 25% best-performing provenances and recommend them for use in the provenance regions where have performed. The significant influence of the testing site and the different outcomes of the provenances necessitate extreme attention during the transfer of forest reproductive materials. Additionally, the breeding strategies applied in the two trials differed, consisting in individual selection in the Cugir trial and provenance selection in the Cârlibaba trial. The low resistance of all provenances shown in both trials, particularly in the Cugir trial, is worrying in the context of global warming.
Spectral Estimation of Carotenoid Density in Populus pruinosa Leaves
Authors: Sun Shaoying , Wang Jiaqiang , Cai Chongfa
Published: February 2025

Carotenoids play a crucial role in the photosynthesis process in plants. Estimating and modeling the carotenoid content in Populus pruinosa leaves via high-spectrum technology is highly important for health status monitoring. This study involved acquiring the spectral reflectance of Populus pruinosa leaves at different times, followed by smoothing the data with a Savitzky—Golay filter, and then using methods such as first derivative (FD), continuous wavelet transform (CWT), and first-order derivative combined with continuous wavelet transform (CWT+FD), creating three spectral transformation methods. Two- and three-dimensional vegetation indices were then constructed in a unified manner. Two modeling methods, backpropagation neural network (BPNN) and support vector regression (SVR), were employed to estimate the leaf carotenoid density by combining the vegetation indices. The results show that after the spectral reflectance of the canopy of Populus pruinosa is processed by FD, CWT, and CWT+FD on the basis of SG smoothing, it can effectively highlight the spectral characteristics of Populus pruinosa leaves, and the local spectral absorption features are more significant. Compared with the three spectral preprocessing methods, the results showed that the correlation between the values processed by the FD + CWT method and the leaf carotenoid density is the highest. The constructed three-band vegetation index exhibited a 4.26% stronger correlation with carotenoid density than did the two-band vegetation index. Among the three-band index-based models, the SVR model outperforms the BPNN model. For chlorophyll density, the SVR model based on the three-band index processed using CWT+FD achieves the best performance. The coefficient of determination (R2) for the SVR model set was 0.782, the root-mean-square error (RMSE) was 0.022, and the relative percentage deviation (RPD) was 0.206. For the validation set, the (R2) value was 0.648, the RMSE was 0.023, and the RPD was 1.526, indicating the best model accuracy.
Distributional Responses of Five Betula (Betulaceae) Species to Future Climate Change in China
Authors: Huang Zhilong , Fu Chenlong , Li Chenyang , Yang Xinle , Shuai Binyu , Li Meng , Wang Zefu , Yang Xiaoyue
Published: February 2025

Global climate change has the potential to modify the habitats of plant species, thereby exerting a direct impact on biodiversity. Betula species, belonging to the Betulaceae family and commonly known as birch trees, are widely distributed in China. They possess crucial ecological and economic value. However, few studies have examined the potentially suitable distribution of Betula species in China under the influence of climate change. Therefore, it is of great significance to explore the biodiversity patterns of Betula species in China in response to future climate change. In this study, we selected five representative Betula species and collected their distribution records from China. Based on 19 climate variables, the main environmental factors for each species were identified and optimal parameter combinations were determined. The MaxEnt model was employed to construct potentially suitable distribution models for these Betula species, both currently and in the future. The results indicated that the AUC and TSS values for the five species models were greater than 0.903, suggesting a high level of accuracy. The most important climate variable impacting the distribution of Betula species is the temperature seasonality standard deviation. Among the five species, Betula utilis possesses the largest total suitable distribution area, covering 313.42 × 104 km2. Additionally, under future climate warming, the distribution of the studied Betula species will shift toward higher latitudes and altitudes. Species in the southwestern region may migrate toward habitats where the effects of climate change are mitigated, whereas Betula species in the low-latitude southern regions face a substantial threat due to climate change. In the northern areas, under high greenhouse gas emission scenarios, the region experiencing species expansion was much smaller compared to the area of species contraction predicted. Our findings reveal the responses of Betula species to future climate change and provide valuable insights for guiding the future conservation and utilization of Betula forest resources.
Existence of Solutions to the Variable Order Caputo Fractional Thermistor Problem
Authors: Graef John R. , Maazouz Kadda , Pinelas Sandra , Bellabes Zineb , Boussekkine Naima
Published: February 2025

The thermistor model captures the complex interaction between heat dissipation, electrical current conduction, and Joule heat generation. Our research examines the diverse properties and implications of employing fractional calculus in the analysis with a focus on fixed-point principles. This paper addresses the existence and uniqueness of solutions to a variable order Caputo fractional thermistor problem by applying Schauder’s fixed-point theorem.
Removal of Divalent Cations from Produced Water and Its Impact on Rheological Properties and Proppant Settling Velocity
Authors: Zhang Yanze , Ali Wajid , Dehghanpour Hassan
Published: February 2025

The petroleum industry seeks to optimize the reuse of flowback and produced water (FPW) in hydraulic fracturing to reduce environmental impacts and costs. This study investigates how controlling divalent cations in FPW influences its rheological properties and proppant carrying capacity, both of which are crucial for efficient fracturing. Synthetic FPW, modified to simulate treated and untreated conditions, was analyzed to determine the impact of gel-based additives such as anionic polyacrylamide-based friction reducers (FRs). Results indicate that removing divalent cations increases relaxation times from 0.12 s in untreated FPW to 1.00 s in a 1 gallon per thousand gallons (gpt) FR solution, demonstrating improved viscoelastic gel characteristics. However, these changes do not significantly increase proppant carrying capacity. Even with relaxation times increasing to 4.5 s at higher FR dosages (3 gpt), the treated FPW still does not achieve the relaxation time observed in FR solutions using deionized (DI) water, which remain above 10 s. The removal of divalent cations from FPW resulted in only minor changes to its shear viscosity, with a modest 15% increase that was not enough to significantly affect the settling velocity of the proppant. Thus, removal of divalent cations can positively influence rheological behavior; it does not necessarily improve proppant transport efficiency in hydraulic fracturing operations.
The Impact of Tween 20 on the Physical Properties and Structure of Agar Gel
Authors: Jakubczyk Ewa , Kamińska-Dwórznicka Anna , Kot Anna
Published: February 2025

This study aimed to evaluate the effect of different concentrations of Tween 20 on various physical properties of agar gel as a model material. The effects of other sources of agar-agar powder on the gel properties were also evaluated. The pure gels were prepared with agar powders obtained from two suppliers. Also, agar gels with Tween 20 in the 0.10 to 0.70% range were produced. The measurement of density, water activity, maximal force at fracture and gelling temperature, and the agar gels’ rheological properties, showed that the gels prepared with different agar powders had similar properties. The syneresis and stability indexes, gas hold-up, mechanical and acoustic attributes, and structure of foamed gels with Tween 20 were measured. The addition of Tween 20 in amounts ranging from 0.10 to 0.35% contributed to a gradual decrease in the stability and mechanical parameters of the gels. Using a concentration of 0.7%, Tween was able to obtain foamed gels with a uniform structure and small pore size, but low hardness and gumminess. Application of a lower concentration of Tween of 0.1% produced more rigid gels with limited gel syneresis. Adding Tween 20 at the appropriate level can be a factor in obtaining gels with a tailored structure and texture.
Genetics Investigation of Idiopathic Premature Ovarian Insufficiency: Contribution of Array-CGH and Next-Generation Sequencing
Authors: Cozette Claire , Pujalte Mathilde , Celton Noémie , Bosquet Dorian , Copin Henri , Cabry Rosalie , Garçon Loic , Benkhalifa Moncef , Scheffler Florence , Jedraszak Guillaume
Published: February 2025

Objective(s): Premature ovarian insufficiency (POI), affecting 1% of women, is characterized by the loss of ovarian activity with amenorrhea or oligomenorrhea and increased gonadotropins occurring before the age of 40 years. Iatrogenic, autoimmune, and genetic causes are known to be involved in POI, but nearly 70% of all forms remain unexplained. Recent and new genetic analyses promote the identification of new candidate genes. The aim of this study was to evaluate the contribution of array-CGH and next-generation sequencing (NGS) in the diagnosis of POI. Study design: Twenty-eight idiopathic POI patients with primary or secondary amenorrhea underwent genetic screening by array-CGH and NGS using a custom capture design of 163 genes known or suspected to be involved in ovarian function. The clinical, biological, and ultrasound characteristics of the patients were also recorded. Results: Four of the twenty-eight patients had primary amenorrhea (14.3%), and twenty-four (85.7%) had secondary amenorrhea, with an average age at diagnosis of 27.7. Eleven patients (39.3%) had a family history of POI. Our study identified a genetic anomaly in 16 of 28 patients (57.1%): one patient carried a causal copy number variation (CNV), eight patients carried a causal single nucleotide variation (SNV)/indel variation (28.6%), and seven other patients carried variants of uncertain significance. Conclusions: Our study was the first to combine genetic analyses by using both array-CGH and NGS in the same patients. It confirmed the usefulness of both analyses in the identification of pathogenic variations responsible for idiopathic POI. Early genetic diagnosis plays a major role in the management of complications and the screening of relatives.
Rapid Detection of Epinephelus Species Substitution in the Greek Market Using High-Resolution Melting Analysis
Authors: Chatzoglou Evanthia , Tsaousi Nefeli , Spetsieri Ariadni , Malandrakis Emmanouil E. , Miliou Helen
Published: February 2025

Background/Objectives: Fish are vital in the Mediterranean diet, offering protein, nutrients, and ω-3 fatty acids. Greek consumers favor wild-caught, high-value fish like the dusky grouper (Epinephelus marginatus) classified as “vulnerable” and the white grouper (Epinephelus aeneus) classified as “near threatened” species, according to the IUCN Red List. Due to their premium prices and complex supply chains, these species are susceptible to fraud, especially through mislabeling. This practice not only deceives consumers but also poses health risks and encourages illegal fishing. DNA-based methods have shown effectiveness in accurately identifying species, even in processed samples. The aim of this study is to apply high-resolution melting analysis (HRM) as a rapid, effective method for monitoring the appropriate labeling of the two Epinephelus species in the Greek market. Methods: In this study, fresh fish from Greek catches as well as cooked, frozen, and filleted samples collected from the Greek market were identified using DNA barcoding. HRM analysis based on single nucleotide polymorphisms (SNPs) was used to differentiate between locally sourced E. marginatus and E. aeneus from their imported counterparts or from other species available in the Greek market that could be used in substitution incidents. Results: Using HRM analysis, cases of species mislabeling were identified and were also confirmed using sequencing. Conclusions: HRM analysis proved to be an accurate and cost-effective method for rapidly processing a large number of samples; therefore, it could serve as a valuable tool in extensive market controls as well as for bio-diversity conservation monitoring.
Etiologies of Early-Onset Hearing Impairment in Rwanda
Authors: Uwibambe Esther , Mutesa Leon , Muhizi Charles , Ncogoza Isaie , Twumasi Aboagye Elvis , Dukuze Norbert , Adadey Samuel M. , DeKock Carmen , Wonkam Ambroise
Published: February 2025

Background: Over three-quarters of the people living with hearing impairment (HI) live in low- and middle-income countries. However, Rwanda has limited data on the clinical profile of HI. Aim: We used community-based nationwide recruitment of participants to determine the etiology of early-onset (<7 years of age) HI in Rwanda. Methods: Participants were included after clinical examination, including audiological assessment by pure tone audiometry and/or auditory brainstem response. DNA was extracted from peripheral blood, and the entire coding region of GJB2 was interrogated using Sanger sequencing. Multiplex PCR and Sanger sequencing were used to analyze the prevalence of the GJB6-D3S1830 deletion. Results: The participants were recruited from seven inclusive schools, one university teaching hospital, and four independent communities nationwide. We reviewed the clinical histories of 422 individuals affected by early-onset HI from 348 families and found that 21.18% (n = 89/422) was linked to early childhood meningitis infection while 51.23% (n = 216/422) was categorized as unknown HI etiology. Because of putative genetic causes, 82/348 (23.6%) families were reviewed and identified for genetic testing. Within the 82 families with potential genetic causes, 122 individuals were affected by HI, and 205 were unaffected. The male/female ratio of those enrolled for genetic investigations was 0.79 (n = 145/182). The mean age of diagnosis of HI was 4.3 ± 2.6 years. Most cases (89.36%, n = 109/122) reviewed were prelingual. Pedigree analysis suggested autosomal recessive inheritance in 46.3% (n = 38/82) of families. Most HI participants from familial cases had nonsyndromic HI (94.2%, n = 115/122). Waardenburg syndrome was found in three participants out of seven participants who presented with syndromic HI, while three other participants manifested signs of Usher syndrome and one with suspected Noonan syndrome. Molecular analysis did not find pathogenic variants in GJB2 or GJB6-D3S1830 deletion in any of the probands tested (n = 27/122; 22.13%) or 100 non-affected control participants. Conclusions: This study revealed an overall late diagnosis (mean at 4.3 years) of HI in Rwanda. Most cases were of unknown origin or putative environmental origin (76.4%), with meningitis predominating as the acquired cause of early-onset HI. Among cases of putative genetic etiology, nonsyndromic HI accounted for the large majority (94.2%). However, GJB2 and GJB6 pathogenic variants were not identified in the screened proportion of the cohort. This study calls for the implementation of neonatal hearing screening as well as reinforcement of immunization programs to reduce the burden of acquired early-onset HI in Rwanda. Additional genomic studies, ideally using exome sequencing for familial cases, are needed.
Establishment and Molecular Characterization of a Human Stem Cell Line from a Primary Cell Culture Obtained from an Ectopic Calcified Lesion of a Tumoral Calcinosis Patient Carrying a Novel GALNT3 Mutation
Authors: Donati Simone , Palmini Gaia , Aurilia Cinzia , Falsetti Irene , Marini Francesca , Galli Gianna , Zonefrati Roberto , Iantomasi Teresa , Margheriti Lorenzo , Franchi Alessandro , Beltrami Giovanni , Masi Laura , Moro Arcangelo , Brandi Maria Luisa
Published: February 2025

Background/Objectives: Tumoral calcinosis (TC) is an extremely rare inherited disease characterized by multilobulated, dense ectopic calcified masses, usually in the periarticular soft tissue regions. In a previous study, we isolated a primary cell line from an ectopic lesion of a TC patient carrying a previously undescribed GALNT3 mutation. Here, we researched whether a stem cell (SC) subpopulation, which may play a critical role in TC progression, could be present within these lesions. Methods: A putative SC subpopulation was initially isolated by the sphere assay (marked as TC1-SC line) and characterized for its stem-like phenotype through several cellular and molecular assays, including colony forming unit assay, immunofluorescence staining for mesenchymal SC (MSC) markers, gene expression analyses for embryonic SC (ESC) marker genes, and multidifferentiation capacity. In addition, a preliminary expression pattern of osteogenesis-related pathways miRNAs and genes were assessed in the TC1-SC by quantitative Real-Time PCR (qPCR). Results: These cells were capable of differentiating into both the adipogenic and the osteogenic lineages. Moreover, they showed the presence of the MSC and ESC markers, confirmed respectively by using immunofluorescence and qualitative reverse transcriptase PCR (RT-PCR), and a good rate of clonogenic capacity. Finally, qPCR data revealed a signature of miRNAs (i.e., miR-21, miR-23a-3p, miR-26a, miR-27a-3p, miR-27b-3p, and miR-29b-3p) and osteogenic marker genes (i.e., ALP, RUNX2, COLIA1, OPG, OCN, and CCN2) characteristic for the established TC1-SC line. Conclusions: The establishment of this in vitro cell model system could advance the understanding of mechanisms underlying TC pathogenesis, thereby paving the way for the discovery of new diagnostic and novel gene-targeted therapeutic approaches for TC.
Polysomnography Differences Between Sleepy and Non-Sleepy Obstructive Sleep Apnea (OSA) Patients
Authors: Bouloukaki Izolde , Vouis Theofilos , Velidakis Antonios , Moniaki Violeta , Mavroudi Eleni , Stathakis George , Fanaridis Michail , Schiza Sophia
Published: February 2025

Background/Objectives: Factors underlying excessive daytime sleepiness (EDS) in obstructive sleep apnea (OSA) are not fully understood. We investigated whether polysomnography (PSG) parameters differed between non-sleepy and sleepy (based on the Epworth Sleepiness Scale (ESS)) OSA patients with the same disease severity, which may play a role in the presence of EDS. Methods: A total of 1307 patients, without cardiovascular, metabolic, respiratory, or inflammatory comorbidities, diagnosed with OSA (apnea–hypopnea index (AHI) ≥ 5 per hour of sleep) with type 1 PSG were included. Based on the AHI, patients were classified into mild- (AHI 5–14.9, n = 236), moderate- (AHI 15–29.9, n = 367), and severe-OSA (AHI ≥ 30, n = 704) groups. These groups were further divided into two subgroups based on the ESS, the most convenient and widely used tool to assess excessive daytime sleepiness: sleepy (ESS > 10) and non-sleepy (ESS ≤ 10). PSG data were compared between groups, and multivariable logistic regression was used to identify differences after adjustment for confounders. Results: For the entire population, male sex, younger age, obesity, depression, increased wakefulness after sleep onset (WASO), the arousal index, shorter sleep latency, and all indices of OSA severity (AHI, oxygen desaturation index, mean and lowest resting room air pulse oximetry (SpO2), and sleep time with oxygen saturation < 90% (TST90)) were significantly associated with EDS. The arousal index consistently showed a strong association with EDS across all OSA severity groups. Moderate-OSA sleepy patients were younger, with shorter sleep latency and increased indices of OSA severity, excluding the AHI. Severe-OSA sleepy patients were younger, males, and obese; had depression, decreased slow-wave sleep (SWS) and sleep latency, and increased WASO; and presented an increase in all indices of OSA severity. Conclusions: Our results suggest that male sex, younger age, obesity, the presence of depression, WASO, lower sleep efficiency, the arousal index, and all indices of OSA severity may account for the presence or absence of EDS in OSA patients and could be useful for exploring the underlying pathophysiological mechanisms for precision medicine.
A Qualitative Study on the Barriers and Enablers to Effective Hypertension Management in Ghana
Authors: Sambah Francis , McBain-Rigg Kristin , Seidu Abdul-Aziz , Emeto Theophilus I.
Published: February 2025

Background: Hypertension remains a significant public health challenge in Ghana. Understanding the experiences of hypertensive patients can inform strategies to improve their management. This study explored the perceived enablers and barriers to hypertension management among patients in the Ashanti region, Ghana, using the Chronic Care Model as a framework. Methods: In-depth interviews were conducted with 20 hypertensive patients receiving care at Komfo Anokye Teaching Hospital. Inductive thematic analysis was employed to identify key themes and subthemes. Results: Several barriers to hypertension management emerged, including economic constraints, environmental and lifestyle factors, knowledge and awareness deficits, medication-related issues, and policy and provider-level barriers. Conversely, enablers such as patient empowerment, education, healthcare access, and policy and provider support and relationships were identified. Conclusions: Effective hypertension management requires addressing a complex interplay of barriers and enablers. Interventions targeting economic factors, lifestyle modifications, knowledge dissemination, medication adherence, and systemic improvements are crucial. Additionally, empowering patients, enhancing education, improving healthcare access, and fostering strong provider–patient relationships can significantly contribute to better outcomes. Future research should investigate the impact of a multi-level intervention on hypertension management in Ghana.
Pelvic Actinomycosis and Diagnostic Complexity: Case Report with Literature Review
Authors: Restaino Stefano , Gomba Benedetta , Zero Cecilia , Stabile Guglielmo , Ronsini Carlo , Della Corte Luigi , Cianci Stefano , Perelli Federica , Piacenti Ilaria , Driul Lorenza , Terrosu Giovanni , Bordin Filippo , Taliento Cristina , Ripepi Chiara , Greco Pantaleo , Arcieri Martina , Vizzielli Giuseppe
Published: February 2025

Introduction: Actinomyces are commensal bacteria that colonize various sites in the human body. Under certain predisposing conditions, they can proliferate and cause granulomatous inflammation in different tissues. Pelvic actinomycosis is an extremely rare condition; its significance lies in the fact that it can be easily misdiagnosed as gynecological malignancy based on clinical manifestations and imaging findings. According to the literature, this type of inflammatory disease is a common mimic of ovarian cancer. Objective and methods: This paper aims to provide a comprehensive overview of the characteristics of pelvic actinomycosis through a literature review and the description of two cases collected between 2023 and 2024 at Azienda Ospedaliera Universitaria Santa Maria della Misericordia in Udine Italy.
Racial Discrimination as a Traumatic Bedrock of Healthcare Avoidance: A Pathway Through Healthcare Institutional Betrayal and Mistrust
Authors: Rastegar Pedram , Cai L. , Langhinrichsen-Rohling Jennifer
Published: February 2025

Objectives: Experiences of racial discrimination within the healthcare system are potentially traumatic events (PTEs) that have been associated with lowered perceived trust in healthcare providers, ongoing symptoms of PTSD and depression, and anticipated healthcare avoidance. Based on the BITTEN trauma impact model, we test a pathway such that greater past healthcare discrimination would be associated with anticipated future healthcare avoidance among BIPOC college students. We posited that this direct relationship would be sequentially mediated by healthcare institutional betrayal (HIB) during one’s worst healthcare event and subsequently reduced trust in healthcare. Methods: Our model was tested in a subsample of undergraduate students, all of whom self-identified with at least one minoritized racial or ethnic identity (n = 472). Participants reported on their past experiences with racial discrimination in healthcare. Each then chose and described their worst and/or most traumatic previous healthcare experience. Subsequently, they indicated if this experience included acts of HIB and/or led to medical mistrust. Finally, they reported on the degree to which they anticipated engaging in future healthcare avoidance. Results: Our model explained 31% of the variance in anticipated healthcare avoidance. As hypothesized via BITTEN, greater HIB during one’s worst or most traumatic healthcare experience and resulting mistrust in healthcare sequentially mediated the relationship between past experiences of healthcare racial discrimination and anticipated future healthcare avoidance. However, a direct relationship between racial discrimination in healthcare and anticipated healthcare avoidance was retained. Conclusions: Racial discrimination is a potentially traumatic experience associated with deleterious health outcomes. Current results suggest that healthcare discrimination may drive BIPOC college students’ future healthcare avoidance both directly and through experiencing increased healthcare institutional betrayal during one’s worst healthcare experience and resultant mistrust in healthcare. Due to the crucial role both discrimination and HIB experiences may play in healthcare outcomes, greater organizational adoption of anti-racist trauma-informed healthcare and the enactment of deliberate system-level repair strategies post discrimination and/or HIB is critical. Understanding the interplay of racial discrimination, HIB, and medical mistrust is also likely to help us address and repair system-level factors leading to anticipated healthcare avoidance behavior among BIPOC emerging adults.
Quality of Information on Medication Abortion in Private Pharmacies: Results from a Mystery Client Study in Kinshasa, Democratic Republic of Congo
Authors: Ngondo Denise P. , Akilimali Pierre Z. , Tran Nguyen Toan , Lobo Nadia , Kayembe Dynah M. , Kabasubabo Francis K. , Mpoyi Mike , Mulunda Jean-Claude , Sheehy Grace , Lusamba Paul Samson Dikassa
Published: February 2025

Introduction: Pharmacies are important points of access and information for women seeking medication abortion. In the context of the Democratic Republic of Congo [DRC], where the legal conditions for abortion have expanded in recent years and now allow pharmacies to dispense medication abortion with a prescription, little is known about medication abortion counseling and care offered by pharmacy staff. The aim of this study was to explore the quality of information provided by pharmacy staff to customers seeking medication abortion in Kinshasa. Methodology: A cross-sectional study using the mystery client (MC) approach was conducted in 480 pharmacies between April and May 2023. Trained female (n = 9) and male (n = 3) investigators played the role of mystery clients seeking abortion medication for themselves (or their partner or relative), and they asked questions to assess the performance of pharmacy staff and the quality of the provided information. The MCs recorded the results of their visits immediately after they left the pharmacy. Data were analyzed using Stata 17.0 and QGIS. The research protocol received ethical approval from the Kinshasa School of Public Health, and the need for informed consent was waived as pharmacy providers were being observed acting in their professional capacity. Results: Misoprostol was available at 40% of pharmacies visited, while mifepristone–misoprostol was available at less than 2%. Correct dosage information for misoprostol was provided by only 23% of the providers, with the lowest proportion observed in interactions involving male partners (2.4%). During discussions, only 10.6% of the providers explained what to expect during the abortion process. The quality of information differed according to the client profile, the district, and whether the client had a prescription. Conclusions: While medication abortion can provide a safe option for women seeking to manage their own abortion, the lack of adequate information on the correct dosage and administration can hinder the effectiveness of this regimen. To fully realize the potential of this medication for reducing unsafe abortion, it is essential that pharmacy staff are trained and supported to provide high-quality information and services, and that inequities in access to medications are addressed.
Bioreactor-Based Liquid Culture and Production of Konjac Micro-Corm
Authors: Sun Yuqi , Sun Xian , Pan Yufan , Liu Changbin , Su Lingye , Zhang Zongshen
Published: February 2025

Konjac (Amorphophallus konjac K. Koch) has numerous health benefits, but traditional propagation is hindered by long growth periods and soil-borne diseases. This study developed a novel cell liquid culture system to directly produce micro-corms of konjac for large-scale production. The results demonstrated significant improvements in bud induction and rooting compared to solid culture. Under MS + 1.0 mg/L 6-BA + 0.5 mg/L NAA, the induced buds per culture vessel and final fresh weight were 24.87 ± 0.06 and 6.64 ± 0.12 g, respectively, 1.95 and 1.67 times higher than those in solid culture. Rooting experiments showed that 1/2 MS + 0.5 mg/L IBA + 1.0 mg/L NAA resulted in a root length of 25.23 ± 0.04 cm and 18.12 ± 0.01 roots per vessel. Using a 5 L bioreactor for micro-corm induction led to a 2.51-fold increase in fresh weight (52.67 ± 0.01 g) after 31 days, with glucomannan production reaching 0.48 g/g (fresh weight). The optimized culture system also significantly reduced the propagation time and increased the yield of healthy micro-corms. Bioreactor-based cultivation effectively enhances konjac induction efficiency and shortens breeding time, making it a promising approach for commercial production of konjac micro-corms and potentially improving the economic viability of konjac farming.
One-Year Seasonal Variation in the Content of Volatile Compounds in Bay Laurel Leaves
Authors: Kremer Dario , Dunkić Valerija , Milovac Srđan , Inić Suzana , Juretić Lea , Dika Iva Rechner , Petrović Marinko
Published: February 2025

The composition of an essential oil (EO) depends on both the plant’s genetic constitution and environmental factors. In this study, the leaves of female bay laurel (Laurus nobilis L., family Lauraceae) plants were collected each month in the period from 15 January to 15 December 2022. Twelve obtained leaf samples were hydrodistilled in a Clevenger apparatus and analyzed using gas chromatography–mass spectrometry (GC-MS). A total of 44 compounds were detected in EO and 39 compounds were identified based on MS spectra and RIs (retention indices), accounting for 99.44–99.94% of the oil. The EO consisted almost entirely of monoterpenes (95.56–99.28%) and small quantities of phenylpropanoids, sesquiterpenes and other compounds. The major volatile compound was 1,8-cineole (49.79–64.94%), followed by α-terpinyl acetate (7.14–11.96%), sabinene (3.16–9.01%), linalool (1.77–8.03%), α-pinene (1.46–4.49%), β-pinene (1.55–3.69%) and α-terpineol (0.99–4.77%). The ANOVA indicated statistically significant changes in the composition of the EO over one year. The contents of eugenol, methyl eugenol and elemicin, which are responsible for the spicy aroma of the leaves, were highest during flowering (March) and at the time of fruit ripening (October, November). The harvest time of the leaves can be adjusted to obtain leaves rich in the desired compounds according to whether they are to be used as a spice, medicine or repellent.
Unveiling Community Vulnerability to COVID-19 Incidence: A Population-Based Spatial Analysis in Clark County, Nevada
Authors: Chien Lung-Chang , Chen L.-W. Antony , Cross Chad L. , Gelaw Edom , Collins Cheryl , Zhang Lei , Mangla Anil T. , Lockett Cassius
Published: February 2025

Community vulnerability is influenced by various determinants beyond socioeconomic status and plays a crucial role in COVID-19 disparities. This study aimed to develop and evaluate a novel community vulnerability index (CVI) related to temporal variations in COVID-19 incidence to provide insights into spatial disparities and inform targeted public health interventions in Clark County, Nevada. Utilizing data from the American Community Survey and other sources, 23 community measures were identified at the census tract level. The CVI was constructed using a lagged weighted quantile sum (LWQS) regression linking these measures to the monthly COVID-19 incidence from March 2020 to November 2021. The Besag–York–Mollié model subsequently evaluated the spatial association between the CVI and COVID-19 incidence, controlling for temporal and spatial autocorrelations. This study identified minority status, housing inadequacy, and inactive commuting as primary contributors to the CVI that consistently influenced COVID-19 vulnerability over time. The CVI demonstrated significant spatial disparities, with higher values found in northern Clark County and the northeastern Las Vegas metropolitan area. Spatial analyses revealed varying associations between COVID-19 incidence and the CVI across census tracts, with significant associations clustered in the northern and eastern regions of the Las Vegas metropolitan area. These findings advance our understanding of the complex interplay between community conditions and COVID-19. The CVI framework may be applied to other COVID-19 outcomes such as testing, vaccination, and hospitalization, offering a valuable tool for assessing and addressing community vulnerability.
Pruritus in Chronic Cholestatic Liver Diseases, Especially in Primary Biliary Cholangitis: A Narrative Review
Authors: Kanda Tatsuo , Sasaki-Tanaka Reina , Kimura Naruhiro , Abe Hiroyuki , Yoshida Tomoaki , Hayashi Kazunao , Sakamaki Akira , Yokoo Takeshi , Kamimura Hiroteru , Tsuchiya Atsunori , Kamimura Kenya , Terai Shuji
Published: February 2025

Patients with chronic cholestatic liver diseases often experience itch and struggle with this symptom. We discuss the mechanism of itch in patients with chronic cholestatic liver diseases, such as primary biliary cholangitis (PBC) and others, and their therapies, including ileal bile acid transporter (IBAT) inhibitors. In patients with PBC, there are high serum/plasma concentrations of multiple factors, including bile salts, bilirubin, endogenous opioids, lysophosphatidic acid (LPA), autotaxin, and histamine. Bile salts, bilirubin, LPA, and autotaxin affect itch mediators in the skin and sensory nerves, while the endogenous opioid balance affects mediators in the spinal cord. Itch is sensitized by both the peripheral and central nervous systems. Both mechanisms are involved in itch in patients with chronic cholestatic liver disease. Although IBAT inhibitors have been approved for use in pediatric cholestatic conditions, such as progressive familial intrahepatic cholestasis and Alagille syndrome, IBAT inhibition seems to be a promising treatment for chronic refractory itch in patients with PBC. A traditional non-systematic review results in this narrative review. Multidisciplinary cooperation, involving hepatologists, dermatologists, and pharmacists, could provide better treatment for PBC patients suffering from refractory itch. In conclusion, we summarized the existing knowledge on itch caused by chronic cholestatic liver diseases, especially in PBC with a focus on the mechanisms and therapies. This narrative review provides the mechanisms and therapeutic options for itch in patients with chronic cholestatic liver diseases.