bluuebunny/crossref_metadata_2025 huggingface dataset:
Acute upper gastrointestinal bleeding: Analysis of 462 hospitalized Chinese patients in Shanghai
Authors: Zhou Jian-Ping , Wu Min , Wang Mei-Tang
Published: January 2025

While acute upper gastrointestinal bleeding (AUGIB) remains clinically critical, the etiology of bleeding and risk factors for mortality remain uncertain. This study aimed to evaluate the underlying causes of AUGIB and identify risk factors associated with fatality. A retrospective survey was conducted in a major clinical hospital in Shanghai, where inpatients diagnosed with AUGIB were meticulously collected and analyzed. This retrospective, single-center study encompassed 462 patients diagnosed with AUGIB from the emergency department of Changhai Hospital between January 1, 2019 to November 30, 2021. The analysis involved various aspects including epidemiology, gastroscopy, imaging, laboratory tests and data, clinical features, and hospital mortality. Among the 462 patients studied, 87% (400 out of 462) were afflicted with noncirrhotic hemorrhage (up to 38% with peptic ulcer), and 4 patients required digital subtraction angiography embolization (two died). The mortality rate was 12% (49/400), of which 49% (24/49) of patients died of malignant tumors. Mortality did not differ according to sex (χ
2 = 0. 851, P = .356) but was significantly influenced by age (χ
2 = 18.292, P = .001), hemoglobin levels (χ
2 = 22.908, P = .001), and comorbidity (χ
2 = 17.355, P = .001). In patients with esophageal and gastric variceal bleeding, the mortality rate was as high as 25% (16/62). Their mortality did not vary with sex (χ
2 = 0.318, P = .573), hemoglobin levels (χ
2 = 4.139, P = .247), or age (χ
2 = 7.674, P = .087), but was predominantly associated with hemorrhagic shock (88%, 14/16). Esophageal and gastric variceal bleeding and noncirrhotic hemorrhage patients observed significantly different mortality rates (P = .004). Peptic ulcers remained the primary cause of AUGIB. Old age, low hemoglobin levels, and comorbidities were the main risk factors contributing to mortality; nearly half of the patients died from malignant tumors. Hemorrhagic shock was independently associated with a high risk of in-hospital mortality in patients with cirrhotic hemorrhage.
Efficacy of modified posterior shoulder stretching exercises on shoulder function in subacromial impingement syndrome: A comprehensive meta-analysis
Authors: Guo Rui , Luo Yujun , Xu Yang , Lan Kang , Zhao Yan
Published: January 2025

Background:

Subacromial impingement syndrome (SIS) is a common cause of shoulder pain and dysfunction. Modified posterior shoulder stretching exercises have been proposed as a treatment method aimed at improving shoulder function and reducing pain in patients with SIS. However, the efficacy of these exercises remains controversial, necessitating a systematic meta-analysis to comprehensively evaluate their effectiveness.

Methods:

A systematic search was conducted across PubMed, Cochrane Library, Embase, and Web of Science databases to identify randomized controlled trials (RCTs) and observational studies evaluating the efficacy of modified posterior shoulder stretching exercises in patients with SIS. Inclusion criteria required that participants be diagnosed with SIS, the intervention be modified posterior shoulder stretching exercises, and key outcomes such as shoulder function improvement and pain relief be reported. Meta-analysis was performed using RevMan 5.3 software, calculating standardized mean differences (SMD) with 95% confidence intervals (CI), and heterogeneity and bias risk were assessed.

Results:

A total of 10 RCTs with 628 patients were included. The modified posterior shoulder stretching exercises demonstrated significant effects in reducing pain at rest (SMD = –1.00, 95% CI: −1.85 to −0.15, P = .02) and during activity (SMD = –1.45, 95% CI: −2.49 to −0.41, P = .006). Additionally, the exercises showed positive effects in improving internal rotation (SMD = 0.49, 95% CI: 0.22–0.75, P = .0003) and external rotation range of motion (SMD = 0.29, 95% CI: 0.00–0.58, P = .05), as well as enhancing shoulder function (CMS score: SMD = 0.95, 95% CI: 0.64–1.25, P < .00001) and reducing disability (quick DASH score: SMD = –0.85, 95% CI: −1.12 to −0.58, P < .00001). Sensitivity analysis indicated high robustness of the results, and Egger test did not reveal significant publication bias (P > .05).

Conclusion:

Modified posterior shoulder stretching exercises are significantly effective in improving shoulder function and reducing pain in patients with SIS, with the study results showing high robustness and low risk of bias. However, further high-quality research is needed to validate these findings.
Comparative analysis of general and regional anesthesia applications in geriatric hip fracture surgery
Authors: Li Ping , Li Xi , Peng Guiying , Deng Jun , Li Qiang
Published: January 2025

Background:

This study compares the outcomes of general anesthesia (GA) and regional anesthesia (RA) in geriatric hip fracture surgery to determine optimal anesthesia strategies for this population.

Methods:

A comprehensive literature review was conducted, analyzing studies comparing GA and RA in elderly patients undergoing hip fracture surgery. Studies encompassed various designs, including randomized controlled trials, cohort studies, and meta-analyses. Key analytical techniques included comparative analysis of intraoperative complications, postoperative outcomes, mortality rates, and physiological impacts.

Results:

GA was associated with higher risks of intraoperative cardiovascular events, respiratory depression, and postoperative complications such as cognitive dysfunction and delirium. In contrast, RA demonstrated superior outcomes in pain management, early mobilization, and reduced incidences of complications like postoperative nausea and vomiting. RA also correlated with shorter hospital stays and lower mortality rates within the first 30 days post-surgery.

Conclusion:

RA emerges as a preferable choice for geriatric hip fracture surgery, offering improved safety profiles, enhanced recovery trajectories, and better postoperative cognitive outcomes compared to GA. These findings underscore the importance of anesthesia selection in optimizing surgical outcomes and patient safety in elderly populations. Future research should focus on prospective trials to validate these results and refine anesthesia protocols tailored to elderly hip fracture patients.
Hypothetical criteria and types for cochlear migraine
Authors: Lai Jen-Tsung , Liu Tien-Chen , Hwang Juen-Haur
Published: January 2025

Cochlear migraine (CM) and cochleovestibular migraine were first reported in 2018. However, the diagnostic criteria and types of CM were still undefined. We proposed a hypothetical criteria for CM as below: A. At least 2 episodes with cochlear symptoms with or without recovery. B. Current or previous history of migraine with or without aura according to the International Classification of Headache Disorders-3. C. One or more migraine features with at least 50% of the cochlear episodes. D. No current or previous history of vestibular symptoms. E. Not better accounted for by another cochlear or International Classification of Headache Disorders-3 diagnosis. Patients who were fitted with all 5 points could be diagnosed as CM. The clinical presentations of 62 adults with CM were included for descriptive and cluster analysis. There were 20 men and 42 women, with an age range of 27 to 72 years (mean, 50 years). 6 patients had migraine with aura, and the other 56 had migraine without aura. 4 types of CM could be categorized by cluster analysis. Type 1: unilateral fluctuating sensorineural hearing loss (SNHL) with or without tinnitus (35.5%). Type 2: repeated idiopathic sudden SNHL with or without tinnitus, with good recovery (22.6%). Type 3: idiopathic sudden SNHL with or without tinnitus, but deteriorated over time (21.0%). Type 4: unilateral fluctuating tinnitus with or without aural fullness, otalgia or mild SNHL (21.0%). We hope to raise more discussion about the criteria and clinical types of CM and/or cochleovestibular migraine.
Retrospective analysis of clinical characteristics and treatment differences between severe and non-severe neonatal types of pneumonia with RSV infection
Authors: Lei Chunxia , Wan Chunhui
Published: January 2025

Understanding the differences between children with severe and non-severe types of neonatal pneumonia is crucial for clinical treatment and disease management. In this study, we retrospectively analyzed the clinical data of infants with neonatal pneumonia diagnosed as respiratory syncytial virus infection at Wuhan Children’s Hospital between December 1, 2022 and November 30, 2023. Further, the recruited subjects were categorized into severe and non-severe groups based on the severity score. The collected data included general information, symptoms and signs, chest imaging results, and examination indices of the children. Finally, the data between the groups were statistically analyzed using the R software. The data showed no significant differences between the critical and noncritical groups on several dimensions. The critical group presented a longer hospital stay, a higher percentage of cesarean deliveries, as well as a significantly higher incidence of shortness of breath and cyanosis than the noncritical group. Concerning the laboratory indices, the critical group exhibited lower hemoglobin levels and a faster heart rate than the noncritical group. In terms of life-saving measures, respiratory support and drugs were more frequently required in the critical group than in the noncritical group. The utilization of some specific antibiotics was higher in the critically ill group than in the noncritically ill group. In summary, the study clarified the differences between critically and noncritically ill children with neonatal pneumonia, which could lead to the development of individualized treatment plans and improved quality of life and prognosis of children.
Analysis of risk factors for postoperative thrombosis in patients with hematological diseases undergoing PICC surgery
Authors: Chang Meifang , Zhu Xiaming , Liu Minghong , Mao Yanqin , Wu Qian
Published: January 2025

This study analyzes the prognostic factors of thrombosis in patients with hematological diseases after peripherally inserted central catheter (PICC) surgery. We conducted a retrospective analysis of 223 patients with hematological diseases who underwent PICC catheterization between January 2017 and June 2021. These patients were categorized into the thrombotic group and non-thrombotic group based on the occurrence of thrombosis following PICC catheterization. Subsequently, we identified influencing factors for thrombosis in patients with hematological diseases after PICC catheterization using univariate and multivariate logistic regression. Furthermore, we drew the ROC curve and calculated the AUC value to obtain the ideal critical value for predicting thrombosis risk in these patients. After PICC catheterization in 223 patients with hematological tumors, 107 cases developed thrombosis. The univariate analysis revealed significant differences in age, catheter placement, catheter-related complications (infection), the proportion of underlying diseases, and coagulation-related indicators between the 2 groups. Furthermore, the multivariate analysis demonstrated that catheter infection, diabetes, history of thrombosis, fibrinogen degradation products (FDP), antithrombin III (AT-III) and D-dimer were all independent factors of thrombosis in patients with hematological diseases after PICC. The AUC areas of the working characteristic curves of FDP, AT-III, and D-dimer in predicting post PICC thrombosis in patients with hematological diseases were 0.744, 0.651, and 0.595, respectively. Hematological diseases patients with catheter infection, diabetes, history of thrombosis, FDP > 3.24 mg/L, AT-III < 93%, or D-dimer > 2.41 µg/mL are prone to thrombosis after PICC surgery.
Laparoscopic peritoneal mucinous cystadenoma debulking: A case report
Authors: Guo Zhitang , Long Kui , Chen Zhanbin , Zhang Wei , Chu Quanxian
Published: January 2025

Rationale:

Peritoneal mucinous cystadenoma is rare in the clinic, lacks specific clinical manifestations, tumor markers, and imaging features, and is easily misdiagnosed and missed. Clinical practitioners should maintain a high level of vigilance. Here, we report a case of laparoscopic peritoneal mucinous cystadenoma stripping to improve our understanding of the disease.

Patient concerns:

A 34-year-old woman was admitted to our hospital with a history of epigastric pain over the past year that had worsened over the previous 4 months. The patient had no history of trauma or surgery.

Diagnoses:

A computed tomography scan of the whole abdomen, as well as hepatobiliary and pancreatic scans and magnetic resonance cholangiopancreatography examinations, showed a low-density mass of approximately 5.8 × 4.8 cm between the right lobe of the liver and the right kidney. The lesion showed no significant enhancement on the enhanced scan, and analysis of tumor markers was normal. The preoperative diagnosis was cholelithiasis with cholecystitis and hepatic cysts.

Interventions:

It was proposed to perform “laparoscopic cholecystectomy + hepatic cyst decapitation and decompression” under general anesthesia; however, intraoperative exploration revealed that the abdominal cyst had originated from the right side of the peritoneum and was located between the liver and kidney. The surgical procedure was thus changed to “laparoscopic abdominal cyst removal + cholecystectomy.”

Outcomes:

The patient recovered well and was discharged on the fourth postoperative day. Postoperative pathological examination (abdominal cyst) showed mostly serous cells partially covered with high columnar mucus cells, which was consistent with mucinous cystadenoma. The postoperative diagnosis was peritoneal mucinous cystadenoma and cholecystolithiasis with cholecystitis.

Lessons:

Clinical diagnosis of mucinous cystadenoma of the abdominal wall is difficult. The possibility of the disease should be considered when a cystic space is found in the abdominal cavity. Diagnosis depends on postoperative pathological examination, and surgery is the preferred treatment option. During the operation, attention should be paid to avoid rupture of the cyst wall and overflow of cyst fluid, and to avoid blind fenestration and drainage or puncture and aspiration sclerotherapy when the diagnosis is unclear.
Bushen-Huoxue-Mingmu-Formula attenuates pressurization-induced retinal ganglion cell damage by reducing mitochondrial autophagy through the inhibition of the Pink1/Parkin pathway
Authors: Wang Wei , Gao Jia , Mu Qianqian , Zhang Dan , Yang Fen , Cheng Wubo
Published: January 2025

Background:

Bushen-Huoxue-Mingmu-Formula (MMF) has achieved definite clinical efficacy. However, its mechanism is still unclear.

Objective:

Investigating the molecular mechanism of MMF to protect retinal ganglion cells (RGCs).

Methods:

This study developed a pressurization-induced model of damaged RGCs, which were then treated with a serum supplemented with MMF. The effects of MMF on proliferation, apoptosis, adenosine 5′-triphosphate content, and mitochondrial structure of RGCs were investigated, and the underlying molecular mechanism was explored by RNA interference experiment.

Results:

In the pressurization-induced RGC injury model, apoptosis rate increased, cell proliferation decreased, adenosine 5′-triphosphate content reduced, mitochondrial structure was disrupted, BCL2-associated X, cleaved caspase-3, and microtubule-associated proteins light chain 3 II/I protein expression enhanced, B cell lymphoma-2 and p62 protein expression decreased, and the Pink1/Parkin pathway was activated. The stress-induced damage to RGCs was, however, reversible following MMF-mediated inhibition of the Pink1/Parkin pathway. Pink1 short-hairpin RNA downregulated Pink1 expression in RGCs, which led to outcomes that aligned with those observed with MMF intervention.

Conclusions:

MMF altered the expression of apoptosis- and autophagy-related proteins and possibly inhibited the Pink1/Parkin signaling pathway, which led to reduced pressurization-induced mitochondrial autophagy in RGCs. This preventive effect of MMF on RGCs can be potentially useful to preserve the viability of RGCs.
Diagnostic stewardship – Optimisation of superficial wound swab cultures can reduce the environmental impact of the microbiology laboratory
Authors: Goolden Callum , Shorten Robert J
Published: January 2025

Introduction Optimisation of diagnostic testing is essential for the sustainable delivery of laboratory services. To date, little consideration has been given to the potential benefits of diagnostic stewardship to laboratories looking to reduce their environmental footprint. Hypothesis Implementing a pre-analytical diagnostic stewardship intervention for the testing of superficial wound swabs would result in a measurable reduction in the environmental footprint of the microbiology laboratory. Aim To assess the consequential impact of a diagnostic stewardship intervention on test volume, carbon footprint and quantity of non-recyclable plastic waste generated. Methodology Superficial wound swabs received in the absence of clinical details suggestive of active skin and soft tissue infection were rejected by the laboratory. The Carbon footprint of testing was estimated using Publicly available specification (PAS) 2050:2011 methodology in a cradle-grave, attributional life-cycle assessment within a defined system boundary. The mass of laboratory plastic waste was calculated through the accurate weighing of associated laboratory consumables. Results The intervention resulted in a reduction of 35.77 kgCO2e and 9.06kg of unrecyclable plastic waste over an 8-day period without measurable patient harm. Conclusion This study demonstrates, in relation to specific testing pathways, that the optimisation of microbiology laboratory diagnostic testing can result in a reduction in greenhouse gas emissions and non-recyclable plastic waste generation without negatively impacting patient care.
Cholesterol-Dependent Dimerization and Conformational Dynamics of EphA2 Receptors: Insights from Coarse-Grained and All-Atom Simulations
Authors: Sahoo Amita R. , Bhattarai Nisha , Buck Matthias
Published: January 2025

The EphA2 transmembrane receptor is a key regulator of cellular growth, differentiation, and motility, and its overexpression in various cancers positions it as a promising biomarker for clinical cancer management. EphA2 signaling is mediated through ligand-induced dimerization, which stabilizes its dimeric state via conformational changes in the extracellular region and is linked to the intracellular kinase region via the transmembrane (TM) domain. Similar to many receptor tyrosine kinases, the juxtamembrane (JM) region, located between the TM and catalytic domains, coordinates with the TM domain to facilitate signal transduction. Electrostatic interactions between basic residues of the JM region and signaling lipids, such as PIP2 and PIP3, play a critical role by sequestration thereby inhibiting phosphorylation of the JM and other intracellular tyrosines. Cholesterol’s potential role in allosterically modulating EphA2 activation has remained unclear. Therefore, elucidating the structural mechanism of EphA2 dimerization and its membrane interactions is essential for understanding the influence of these lipids. In this study, we modeled the TM-full JM peptide of the EphA2 receptor and employed both coarse-grain (CG) and all-atom (AA) simulations to investigate the conformational transitions of the EphA2 transmembrane region dimer in cholesterol-rich and cholesterol-deficient membranes. Our study reveals that cholesterol stabilizes specific EphA2 TM dimers and TM-JM PIP2 interactions, highlighting the critical role of membrane composition in regulating EphA2 dimerization, oligomerization, and clustering.
Exploring the Impact of Aphasia Severity on Employment, Social Participation, and Quality of Life
Authors: Konishi Mika , Funayama Michitaka , Saito Fumie , Nakagawa Yoshitaka , Fujinaga Naomi , Urano Masayo , Osumi Masanori , Harayama Shu , Tateishi Masako , Tanemura Jun , Mimura Masaru
Published: January 2025

Background

The primary challenge faced by patients with aphasia is their difficulties in communicating, which likely contributes to lower employment rates, decreased social participation, and a decline in quality of life. Surprisingly, few studies have investigated the relationship between aphasia severity and these outcomes, particularly employment status. In this study, we addressed this gap by examining these socio-occupational outcomes as well as quality of life in individuals with chronic aphasia.

Methods

A cohort of 136 individuals with chronic aphasia following cerebrovascular diseases was recruited and investigated in a cross-sectional study. A multiple logistic regression model was used for employment status, and multiple linear regression models were used for both social participation levels and quality of life. Explanatory variables included both individual’s functions, such as aphasia severity, non-linguistic cognitive function, apathy levels, and mobility, as well as levels of social environmental barriers.

Results

Aphasia severity had a significant negative impact on two outcomes: employment status and quality of life. Additionally, social environmental barriers negatively affected quality of life. Lower mobility, male gender, and older age were related to reduced social participation levels. Employment status was not related to social participation levels nor quality of life.

Conclusion

This study found that the severity of aphasia significantly impacts individuals’ occupational engagement, as well as their quality of life. Our findings shed light on potential treatment options during acute phases of stroke, linguistic rehabilitation, and occupational support for individuals with aphasia.
Initial Estimates of the Minimal Clinically Important Difference (MCID) for the Neuropathic Pain Symptom Inventory (NPSI): A Systematic Meta-Analysis
Authors: Canori Alexandra , Howard Rebecca , Bower Jeffrey , Putrino David , Tabacof Laura
Published: January 2025

Objective

The Neuropathic Pain Symptom Inventory (NPSI) is commonly used assessment in Neuropathic Pain (NP) trials, yet a Minimal Clinically Important Difference (MCID) has not been established. A MCID would enhance the interpretability of NPSI scores, guiding clinicians and researchers in assessing clinically important improvements in NP symptoms. The aim of this study was to calculate an MCID from the available scientific research that used the NPSI.

Methods

We conducted a systematic review and meta-analysis of NP trials reporting the NPSI. Three distributional approaches were applied to estimate the MCID: pooled standard deviation (SD) of change scores, pooled baseline SD, and a random-effects meta-analytic approach. Only treatments arms within RTCs were examined. Treatment arms were grouped by NP etiology, enabling etiology-specific MCID estimates. Bias for each included study was assessed using the Cochrane tool for quality assessment of randomized controlled trials.

Results

323 trials were examined, 12 were selected for inclusion for a total of 17 treatment arms. The calculated MCID estimates for the NPSI total score were 7.95 using pooled SD of change scores, 7.73 using pooled baseline SD, and 6.85 using the random-effects method. Etiology-specific MCIDs varied, with Post-Infectious conditions and Diabetic Peripheral Neuropathy showing higher values than other NP types.

Conclusion

This study provides preliminary MCID estimates for the NPSI. Limitations include limited data for certain NP subtypes, highlighting the need for additional anchor-based and etiology-specific MCID research to refine these estimates. These findings can aid in future NP trial design and the interpretation of results.
High-Frequency vs. Low-Frequency Music Therapy in Psychiatric Inpatients: A Randomized Controlled Trial
Authors: Esteban-Cárdenas Manuel , Gómez-Puentes Ana , Torres-Delgado Carlos , Hidalgo-Valbuena Adrián , Ferro Eugenio
Published: January 2025

Introduction

Music therapy is an evidence-based clinical intervention with demonstrated efficacy in reducing anxiety and depression and in neuromodulation that promotes well-being. Sessions are usually delivered weekly. Psychiatric hospital stays are progressively shorter, requiring interventions to be delivered in brief intensive schemes. Our objective was to evaluate the effectiveness of a high-frequency intervention music therapy (5 sessions/week) compared to a low-frequency (1 session/week) control group.

Materials and methods

This is a randomized controlled clinical trial in patients with mental disorders under in-hospital psychiatric treatment. A computer-based random generator created a random allocation sequence to guarantee equal group assignment probability. The primary outcome was symptoms in the Depression/Anxiety/Stress Scale of 21 items (DAS-21). Secondary outcomes were the impact of music therapy sessions on adult patients measured with the CISMA questionnaire (CISMA by Spanish acronyms), and global life satisfaction with the single item for measuring overall life satisfaction (SWLS). To mitigate risks associated with the interventions, at least one healthcare professional will attend each session, alongside a certified music therapist.

The Shapiro-Wilk test was used to test the distribution of variables. We used the Mann-Whitney U test to prove differences between groups and the Wilcoxon signed-rank test differences within groups. Spearman’s test was performed to determine the correlation between continuous variables. Statistical analysis was performed with Jamovi (version 2.6, 2024).

Results

Patients in the intervention group had a significant stress level reduction compared to the control group (p=0.033). Both groups experienced significant improvements in anxiety, depression, and global life satisfaction. In addition, positive expectations towards music therapy were associated with greater symptom reduction (r=-0.33, p=0.004).

Discussion

To the best of our knowledge, this study is the first randomized controlled trial comparing high-frequency and low-frequency music therapy for psychiatric inpatients. Although both groups demonstrated significant improvement in all the outcomes measured, only the high-frequency group demonstrated greater benefit for stress symptoms. Changes in physiological stress have been reported previously, concordant with our psychological findings. Music therapy had a probable suggestive effect on symptom reduction. These findings highlight the potential of music therapy for stress management in psychiatric hospitals but emphasize the need for further research to standardize session intensity and treatment duration.

Trial Registration:ISRCTN registry:ISRCTN87861817(https://www.isrctn.com/ISRCTN87861817)
Impaired oxidative phosphorylation drives primary tumor escape and metastasis
Authors: Arner Emily N. , Jennings Erin Q. , Crooks Daniel R. , Ricketts Christopher J. , Wolf Melissa M. , Cottam Matthew A. , Fisher-Gupta Emilie L. , Lang Martin , Maio Nunziata , Shibata Yuki , Krystofiak Evan S. , Vlach Logan M. , Hatem Zaid , Blatt Alexander M. , Heintzman Darren R. , Sewell Allison E. , Hathaway Emma S. , Steiner KayLee K. , Ye Xiang , Schaefer Samuel , Bacigalupa Zachary A. , Linehan W. Marston , Beckermann Kathryn E. , Mason Frank M. , Idrees Kamran , Rathmell W. Kimryn , Rathmell Jeffrey C.
Published: January 2025

Metastasis causes most cancer deaths and reflects transitions from primary tumor escape to seeding and growth at metastatic sites. Epithelial-to-mesenchymal transition (EMT) is important early in metastasis to enable cancer cells to detach from neighboring cells, become migratory, and escape the primary tumor. While different phases of metastasis expose cells to variable nutrient environments and demands, the metabolic requirements and plasticity of each step are uncertain. Here we show that EMT and primary tumor escape are stimulated by disrupted oxidative metabolism. Using Renal Cell Carcinoma (RCC) patient samples, we identified the mitochondrial electron transport inhibitor NDUFA4L2 as upregulated in cells undergoing EMT. Deletion of NDUFA4L2 enhanced oxidative metabolism and prevented EMT and metastasis while NDUFA4L2 overexpression enhanced these processes. Mechanistically, NDUFA4L2 suppressed oxidative phosphorylation and caused citric acid cycle intermediates to accumulate, which modified chromatin accessibility of EMT-related loci to drive primary tumor escape. The effect of impaired mitochondrial metabolism to drive EMT appeared general, as renal cell carcinoma patient tumors driven by fumarate hydratase mutations with disrupted oxidative phosphorylation were highly metastatic and also had robust EMT. These findings highlight the importance of dynamic shifts in metabolism for cell migration and metastasis, with mitochondrial impairment driving early phases of this process. Understanding mitochondrial dynamics may have important implications in both basic and translational efforts to prevent cancer deaths.
Addressing the Slippery Slope Argument: Trends in Euthanasia Among Patients with Psychiatric Disorders and Dementia in Belgium, 2002–2023
Authors: Wels Jacques , Hamarat Natasia
Published: January 2025

Background

Assisted suicide of patients with psychiatric disorders or dementia have increased in countries like Belgium, the Netherlands, and Canada and are often mentioned to argue against euthanasia regulations, suggesting they lead to a slippery slope. We examine changes in euthanasia cases for patients with these conditions in Belgium.

Data and methos

We use data on all cases of euthanasia reported to the Federal Commission for the Control and Evaluation of Euthanasia (FCCEE) from 2002 to 2023. Psychiatric disorders (N=427) and dementia (N=310) represent 1.27% and 0.92% of all cases, respectively. Using time-series Poisson regression, we model trends by first examining interactions between euthanasia reasons and year, then extending to three-way interactions with gender and region. We replicate the analyses with an offset to account for demographic changes.

Results

Euthanasia for psychiatric disorders and dementia showed distinct trends over time. Euthanasia for psychiatric disorders followed trends similar to the other types of euthanasia, while euthanasia for dementia showed a slight over-increase. Demographic change explains part of the increase in euthanasia for dementia and other reasons but not psychiatric disorders. While euthanasia rates for psychiatric disorders were initially higher for women, the trend for men is catching up over time. Regional trends indicate higher overall euthanasia rates in the Dutch-speaking population but with faster increases in the French-speaking population.

Discussion

The Belgian experience demonstrates that assisted dying laws can include non-terminal psychiatric conditions with appropriate safeguards and without evidence of significant misuse, addressing concerns about the slippery slope argument.
Direct evidence of alteration to the human neural intracellular trafficking system following exposure to HSV: A systematic review
Authors: Vaughan Michael B. , Bellai Dante J. , Rae Mark G.
Published: January 2025

Abstract

There is a growing interest in the potential role that lifelong chronic viral infections may play in the aetiology of certain neurodegenerative diseases. For example, the disruption of neuronal intracellular trafficking by repeated reactivations of latent herpes viruses has been proposed as a possible inductive agent of Alzheimer’s disease (AD). This systematic review examines the extent of primary data that have examined the effect(s) of herpes viruses on the human intraneuronal trafficking (HINT) system. Three databases (MEDLINE, SCOPUS, and Web of Science), were repeatedly searched. 5782 articles were identified, of which 13 met our eligibility criteria, and five were included for qualitative synthesis. Four of the five collated studies presented data from cell culture experiments, wherein herpes simplex virus 1 (HSV-1) altered lysosomal load, lysosomal function, and activity-regulated cytoskeleton-associated protein (ARC) mRNA/protein expression in a cell-type/species specific manner. One of the five studies was a clinical case study that presented observations on a fatal herpes encephalopathy, wherein the neuronal endoplasmic reticulum and Golgi apparatus were ablated by the rampant infection. Unfortunately, there is an extremely limited amount of primary research examining the effects of herpes viruses on the HINT system, but within that limited pool there is clear evidence of cell type-/stage- specific responses to infection. Future studies investigating herpes infection in neurodegenerative disease need to utilise cell-type and species- specific models if they are to have any hope of extrapolating to a clinical setting.
A Multimodal Vision-text AI Copilot for Brain Disease Diagnosis and Medical Imaging
Authors: Zhang Guoxun , Gao Zebin , Duan Caohui , Liu Jiaxin , Lizhu Yuerong , Liu Yaou , Chen Qian , Wang Ling , Fei Kailun , Wang Tianyun , Chen YuJia , Guo Yanchen , Guo Yuchen , Lou Xin , Dai Qionghai
Published: January 2025

Integrating non-invasive brain imaging techniques, particularly computed tomography (CT) and magnetic resonance imaging (MRI), coupled with the advancement of artificial intelligence, is forging a key pathway for brain disease diagnosis, playing a vital role in safeguarding human health1–4. A robust artificial intelligence copilot is essential for clinical emergencies, functioning as the central processing unit for brain medical imaging systems, aiming to revolutionize the imaging process, expedite the diagnosis of diseases, and support treatment5–7. In this study, we developed an advanced multi-modal brain medical imaging foundational model named Brainfound, utilizing AI-generated content and image-text alignment technology, pre-trained on over 3 million brain CT images and over 7 million brain MRI images with their paired reports. As a clinical brain medical imaging multi-modal model, Brainfound achieved state of the art on seven downstream tasks, including brain disease diagnosis, brain lesion segmentation, MRI image enhancement, MRI cross-modality translation, automatic report generation, zero-shot brain disease classification, and free human-AI conversation. After thorough human-machine validation, Brainfound surpassed the current leading model by 51.75% in automatic report generation for brain imaging. In multiple-choice questions related to brain imaging, the accuracy of Brainfound outstripped GPT-4V by 47.68%, comparable to experienced doctors. We anticipate Brainfound, a clinical model with flexible visual and text input-output capabilities, will provide substantial support in brain medical imaging, clinical education, and human-in-the-loop medical diagnosis.
Evaluating the Effectiveness of International Travel Controls to Identify Monkeypox Virus Infected Travelers
Authors: Ejima Keisuke , Wang Yuqian , Endo Akira , Murayama Hiroaki , Goh Yun Shan , Cook Alex R. , Jeong Yong Dam , Iwami Shingo , Park Hyeongki , Dickens Borame Sue Lee , Jin Shihui , Lim Jue Tao , Chan Conrad En Zuo , Chia Po Ying , Young Barnaby E. , Yang Yang , Chio Martin , Lye David Chien , Ajelli Marco
Published: January 2025

Introduction

In August 2024, the World Health Organization (WHO) declared a public health emergency due to the rapid spread of mpox in African and beyond. International travel controls (ITCs), such as health screening and viral testing, could help avoid/delay the global spread of the monkeypox virus (MPXV), fostering preparedness and response efforts. However, it is not clear whether the viral tests at immigration are sufficient to avoid importation of MPXV and which samples should be used on the viral tests.

Methods

We conducted a simulation study using epidemiological and viral load data to assess the effectiveness of health screening and PCR testing at immigration. This provides estimates of the proportion of infected travelers identified with this policy. Viral dynamics models were used to estimate false-negative rates of PCR tests with different detection limits according to testing regimens at three different sites: oropharynx, saliva, and rectum. We also simulated the effects of these border control methods on the recommended duration of a monitoring period for travelers from mpox-affected regions, during which individuals would self-monitor for symptoms and practice cautionary behavior.

Results

Our results show that the combination of health screening and PCR testing of saliva swabs under an endemic scenario identify only 74% of MPXV infected travelers. The use of rectal swabs combined with health screening allows the identification of a marginally larger share of infected travelers (79%) compared to saliva swabs. A similar identification rate could be achieved by using more sensitive PCR tests (detection limit [DL]: 10 copies/mL vs. 250 copies/mL used in our baseline analysis). We estimated that travelers from mpox-affected areas should monitor themselves and practice precautionary behavior for 16 days.

Conclusion

Health screening and PCR testing at immigration are likely to miss a significant proportion of MPXV-infected travelers, thus a lengthy quarantine period would be required to prevent onward local transmission. Careful consideration on other factors such as economic costs and likelihood of widespread local outbreak will need to be weighed against the adoption of these measures to prevent local mpox transmission given MPXV transmissibility and severity.
Barriers and facilitators to implementing core osteoarthritis treatments in China: a mixed-method study
Authors: Wang Ziru , Duan Shuning , Chen Xier , Deng Huili , Wang Yunqi , Ni Guoxin
Published: January 2025

Objective

To understand current practices and identify barriers and facilitators to implementing guideline recommended core OA treatments in China.

Methods

An exploratory mixed-methods design was employed, involving healthcare professionals managing OA in mainland China. The qualitative phase included semi-structured interviews (n=15) and a qualitative survey (n=181). A quantitative survey (n=302) evaluated the clinical applicability of identified themes, common practices, knowledge, and self-rated confidence in core capabilities about OA. Qualitative data were analyzed through thematic and content analysis using NVivo, and descriptive statistics were applied to quantitative data using RStudio.

Results

Participants representing six professions provided their perspectives qualitatively. Five themes emerged as barriers: widespread misconceptions about OA; limitations in current medical insurance policies; insufficient multidisciplinary collaboration; lack of workplace support; and low patient adherence to self-management. Three themes emerged as facilitators: telehealth and community-based delivery pathways; professional training and patient education resources; and personalized services with positive feedback.

Across 19 provinces in China, participants representing seven different health professions completed the quantitative survey. The most commonly used treatments for OA were physical agent therapy (56%), while exercise therapy was utilized by only 9%. The average OA knowledge score was 31.2 (±8.9) out of 55. Self-rated confidence was lowest for “referrals and interdisciplinary collaboration” (3.4±0.1, “somewhat confident”). The most applicable factors impacting the implementation of core OA treatments included patient comorbidities, knowledge of pain science and exercise therapy, and financial support (all 2.8±0.8, “applicable”).

Conclusion

Core OA treatments recommended by international clinical guidelines are infrequently implemented in China.

SIGNIFICANCE AND INNOVATIONS

This study is the first to explore the barriers and facilitators to implementing core osteoarthritis (OA) treatments in China, providing comprehensive insights into the unique challenges within the Chinese healthcare system.

It highlights the substantial underutilization of exercise therapy in OA care (9%), reflecting a potential mismatch between guideline recommendations and clinical practice, and underscores the need for targeted implementation strategies.

Major barriers include widespread misconceptions about OA, limited multidisciplinary collaboration, and insufficient financial and organizational support for non-pharmacological interventions.

The study emphasizes the potential of telehealth and community-based care to address disparities in OA management and improve access to evidence-based, guideline-recommended OA treatments in diverse clinical settings across China.
Accurate inference methods based on the estimating equation theory for the modified Poisson and least-squares regressions
Authors: Noma Hisashi , Gosho Masahiko
Published: January 2025

Objectives

In clinical and epidemiological studies, the modified Poisson and least-squares regression analyses for binary outcomes have been standard multivariate analysis methods to provide risk ratio and risk difference estimates. However, their ordinary Wald-type confidence intervals can suffer from biases of the robust variance estimators and the coverage probabilities of true effect measures are substantially below the nominal level (usually 95%). To address this issue, new accurate inference methods are needed.

Methods

We provide two accurate inference methods based on the estimating equation theory for these regression models. A remarkable advantage of these regression models is that we know the correct models to be estimated: the conventional binomial regression models with log and identity links. Utilizing this modeling information, we first derive the quasi-score statistics, whose robust variances are estimated using the correct model information, and propose a confidence interval based on the regression coefficient test usingχ2-approximation. Also, to further improve the large sample approximation, we propose adapting a parametric bootstrap method to estimate the sample distribution of the quasi-score statistic using the correct model information. In addition, we developed an R package,rqlm(https://doi.org/10.32614/CRAN.package.rqlm), that can implement the new methods via simple commands.

Results

In extensive simulation studies, the coverage probabilities of the two new methods clearly outperformed the ordinary Wald-type confidence interval. We also illustrate the proposed methods via applications to an epidemiologic study of epilepsy. The proposed methods provided wider confidence intervals reflecting the statistical uncertainty.

Conclusions

The current standard Wald-type confidence intervals might provide misleading evidence. If erroneous evidence is reported, it can potentially influence clinical practice, public health, and policy making. These possibly inaccurate results should be circumvented through the use of effective statistical methods. The new inference methods would provide more accurate evidence in future medical studies.
Hidden-charm strong decays of the spin-2 partner of
X(3872)
Authors: Ganbold Gurjav , Ivanov M. A.
Published: January 2025

Hidden-charm strong decays of the spin-2 partner X2(4014) of the charmoniumlike state X(3872) have been studied in the framework of the covariant confined quark model. The exotic state X2 has been interpreted as a four-quark state with molecular-type interpolating current. We have considered the decay widths of X2 on the level of two-petal quark loops. The partial widths of the strong decays X2→ωJ/Ψ and X2→ρ0J/Ψ have been calculated and the related branching ratio has been analyzed.

Published by the American Physical Society
2025
Back-to-back dijet production in DIS at next-to-eikonal accuracy and twist-3 gluon TMDs
Authors: Altinoluk Tolga , Beuf Guillaume , Czajka Alina , Marquet Cyrille
Published: January 2025

We consider dijet production in deep inelastic scattering at small x, on a purely gluonic unpolarized target. Starting from earlier results obtained at next-to-eikonal accuracy in the high-energy limit, we perform the expansion in the back-to-back dijet limit, at next-to-leading power accuracy. We rewrite our results in the language of transverse-momentum-dependent (TMD) factorization, in terms of twist-2 and twist-3 TMD gluon distributions (gluon TMDs). Among the next-to-eikonal corrections, we find in particular twist-2 contributions corresponding to the x dependent phase of the twist-2 gluon TMDs. We also find two types of twist-3 unpolarized gluon TMDs, as well as correlators of three gluon field strength tensors.

Published by the American Physical Society
2025
Hadronic light-by-light contribution to the muon anomaly from lattice QCD with infinite volume QED at physical pion mass
Authors: Blum Thomas , Christ Norman , Hayakawa Masashi , Izubuchi Taku , Jin Luchang , Jung Chulwoo , Lehner Christoph , Tu Cheng ,   RBC and UKQCD Collaborations
Published: January 2025

The hadronic light-by-light scattering contribution to the muon anomalous magnetic moment, (g−2)/2, is computed in the infinite volume QED framework with lattice QCD. We report aμHLbL=12.47(1.15)(0.95)×10−10 where the first error is statistical and the second systematic. The result is mainly based on the 2+1 flavor Möbius domain wall fermion ensemble with inverse lattice spacing a−1=1.73  GeV, lattice size L=5.5  fm, and mπ=139  MeV, generated by the RBC-UKQCD collaborations. The leading systematic error of this result comes from the lattice discretization. This result is consistent with previous determinations.

Published by the American Physical Society
2025
General discussions on the SU(2) vector boson dark matter model with a single Higgs multiplet: Lagrangian, discrete subgroups, and scalar classifications
Authors: Yuan Chun-Xue , Zhang Zhao , Cai Chengfeng , Tang Yi-Lei , Zhang Hong-Hao
Published: January 2025

The vector boson dark matter particles which stem from some broken gauge symmetries usually require some unbroken symmetries to keep them stable. In previous literature, some simplest cases have been discussed, in which the unbroken symmetry is provided by a remnant subgroup of the gauge group. It would be interesting to ask whether all the possible remnant subgroups as well as all the possible coupling forms can be enumerated. Classifying all the Higgs components into different mass degenerate representations to simplify the diagonalization processes is also necessary. Rather than the ambitious target of providing a general solution to all kinds of gauge groups configured with all forms of the Higgs multiplets, in this paper, we concentrate on the case of the SU(2)D gauge group together with a single Higgs multiplet. We enumerate all possible discrete subgroups that can survive up to n=21, where n is the dimension of the Higgs multiplet. We also provide the general algorithms to enumerate all possible renormalizable operators, to write the general forms of the vacuum expectation value (VEV) configurations, and to give the detailed results of all the mass degenerate irreducible representations embedded in the Higgs multiplet.

Published by the American Physical Society
2025