bluuebunny/crossref_metadata_2025 huggingface dataset:
How economic instruments address sustainable nutrient use: the example of phosphorus governance
Authors: Garske Beatrice , Heyl Katharine , Ekardt Felix
Published: January 2025

Background

The widely inefficient agricultural use of phosphorus (P) causes environmental damage. At the same time, an uneven resource distribution risks supply shortages for this essential nutritional element. Effective governance solutions help to stimulate a more sustainable P management and fulfil the human right to food. This article applies a qualitative governance analysis to develop an integrated governance solution for the multi-layered problems of agricultural P use primarily by economic instruments. Based on P-related challenges and the cornerstones of sustainable P management, an assessment scheme for economic instruments for P is conceptualized and applied.

Results

Results show that there is no ‘one fits all’ solution for all problems associated with agricultural P use. We find a combination of (1) an economic instrument for rock phosphate-based fertilizers with (2) a tax for P surpluses and (3) a regulation on contaminant levels in fertilizers addresses all P-related problems effectively.

Conclusions

The optimal P governance combines economic and regulatory policy instruments. Besides addressing sustainable P management and thus contributing to the implementation of the right to food, the policy mix also positively impacts further ecological challenges such as disrupted N cycles, climate change and biodiversity loss.
The C-MAC video laryngoscope helps presbyopic anesthetists to overcome difficulty in neonatal and infantile intubation: a randomized controlled trial
Authors: Abdalla Ashraf E. , Eissa Mohsen M. , Elbasyouny Mohamed R. , Zomra Mahmoud R. , Elnaggar Ahmed M. , Elsayed Mahmoud M.
Published: January 2025

Background

Endotracheal intubation (ETI) is a life-saving procedure that must be accurately carried on to guard against complications. Presbyopia leads to difficulty in viewing close objects and may obstacle proper intubation even with the best hands.

Purpose

This study supposed that the use of video-laryngoscope (VL) may provide better intubation conditions for presbyopic anesthetists and targets to evaluate the neonates and infants’ intubation success rates (ISR) by anesthetists aged ≥ 45 years using the C-MAC VL compared to the standard laryngoscope (SL).

Methods

Thirty-one neonates with an age of 18.2 ± 5.2 days and a body weight of 4.5 ± 0.3 kg and 103 infants aged 8.6 ± 1 months and weighing 9.4 ± 1.5 kg were randomly categorized into the SL group that received ETI using the SL and the VL group had intubated using the C-MAC® (Karl Storz, Germany) VL with the standard Miller blade and flexible Stylet (2 mm PORTEX® stylet; Smiths Medical International Ltd., UK) to strengthen the endotracheal tube (ETT) and adjust its curvature as C-shaped. The study outcomes included the frequency of successful intubation and the number of intubation attempts.

Results

The ISR was significantly (P < 0.001) higher with significantly (P = 0.0037) lower frequency of using assistance maneuvers with VL. The mean score of the anesthetist’s difficulty rating was significantly (P < 0.001) higher with SL (2.7 ± 2) than with VL (1.27 ± 1.27). Times for the full intubation process were significantly (P < 0.001) shorter with VL than SL. The 1st attempt success rate was significantly (P = 0.0195) higher with VL than SL (86.6% vs. 67.2%). The frequency of maneuver-related complications was insignificantly (P = 0.116) reduced with the use of VL (4.5%) than with SL (12%). The ISR showed a negative significant correlation (r=−0.973, P = 0.005) with the anesthetist’s age.

Conclusion

Neonatal and infantile intubation using VL is feasible and easy to handle by aged anesthetists and allows higher ISR and 1st attempt rate with minimal need for external assistant maneuvers and maneuver-related complications. VL might be more appropriate for the presbyopic pediatric anesthetists than the SL.

Limitations

The limitations of the study are the small sample size of anesthetists and the use of one type of VLs.
Assessing the physical activity training needs and preferences of community health workers in South Africa
Authors: Stoutenberg Mark , Esquives Blanca S. Noriega , St Fleur Ruth G. , Koen Susanna S. , Watson Estelle D. , Portacio Francia G. , Torres Georgia
Published: January 2025

Background

Emerging work highlights the potential of community health workers (CHWs) to promote physical activity (PA) as a part of their role in preventing and managing non-communicable diseases. However, little is known about CHW preferences and desires towards receiving PA training.

Methods

Community health promoters (CHPs), a type of CHWs in South Africa, from seven health districts in Johannesburg participated in a day-long in-service training on PA and healthy eating. Prior to the training, CHPs completed a 22-item questionnaire assessing their PA attitudes, beliefs, past promotion efforts, and previous PA training. CHPs were divided into small focus groups to discuss their roles, amount and type of PA training they had received, perceived PA knowledge, and desire for future PA training. A mixed methods approach triangulated data from the questionnaire and the focus groups.

Results

Seventy-six CHPs attended the in-service training, completed the questionnaire, and participated in one of ten focus groups. CHPs were 38.5 (± 9.2) years of age, 58.7% were male, and 85.3% had > 2 years of experience. Nearly all felt PA was beneficial for health (89.5%) and that promoting it was a part of their job (85.3%). Most CHPs felt that they had sufficient PA knowledge (93.1%) and reported knowing global PA guidelines (90.5%). However, only 10.5% correctly identified the guidelines for aerobic activity or muscle-strengthening, and none correctly identified both. CHPs expressed great interest in receiving additional PA training (98.5%) and applying it in their work (97.1%). Five themes emerged from the focus groups: (1) roles and responsibilities in health promotion and disease prevention; (2) receiving ongoing training to enhance knowledge and skills; (3) increasing their PA training to foster healthier lifestyles in their communities; (4) desired structure of future PA trainings; and (5) strategies for applying the PA training.

Conclusions

This work provides further evidence for the potential of CHWs to take on a greater role in disease prevention, such as promoting PA. However, future research needs to explore strategies to: provide regular, ongoing PA training, enhance internal team dynamics, and integrate PA promotion as a regular part of their clinical responsibilities and community outreach.
A plug-and-play system for polycyclic tetramate macrolactam production and functionalization
Authors: Glöckle Anna , Schuler Sebastian , Einsiedler Manuel , Gulder Tobias A. M.
Published: January 2025

Background

The biosynthesis of the natural product family of the polycyclic tetramate macrolactams (PoTeMs) employs an uncommon iterative polyketide synthase/non-ribosomal peptide synthetase (iPKS/NRPS). This machinery produces a universal PoTeM biosynthetic precursor that contains a tetramic acid moiety connected to two unsaturated polyene side chains. The enormous structural and hence functional diversity of PoTeMs is enabled by pathway-specific tailoring enzymes, particularly cyclization-catalyzing oxidases that process the polyene chains to form distinct ring systems, and further modifying enzymes.

Results

Ikarugamycin is the first discovered PoTeM and is formed by the three enzymes IkaABC. Utilizing the iPKS/NRPS IkaA, we established a genetic plug-and-play system by screening eight different strong promoters downstream of ikaA to facilitate high-level heterologous expression of PoTeMs in different Streptomyces host systems. Furthermore, we applied the system on three different PoTeM modifying genes (ptmD, ikaD, and cftA), showing the general utility of this approach to study PoTeM post-PKS/NRPS processing of diverse tailoring enzymes.

Conclusion

By employing our plug-and-play system for PoTeMs, we reconstructed the ikarugamycin biosynthesis and generated five derivatives of ikarugamycin. This platform will generally facilitate the investigation of new PoTeM biosynthetic cyclization and tailoring reactions in the future.
Evaluation of the role of unconventional prefoldin RPB5 interactor (URI1) in hepatitis B virus infection
Authors: Štaflová Karolína , Zábranský Aleš , Pichová Iva
Published: January 2025

Hepatitis B virus (HBV) infection can cause liver disease and lead to hepatocellular carcinoma (HCC). To better understand the factors involved in viral infection and pathogenesis and to develop novel therapies, it is crucial to investigate virus–host interactions. HBV infection has been shown to increase the expression of the unconventional prefoldin RPB5 interactor (URI1), a cellular protein that promotes liver tumorigenesis and HCC metastasis. Our study investigated the role of URI1 in HBV infection in vitro. Although previous reports have suggested that URI1 may act as an HBV restriction factor, our results showed that URI1 silencing or overexpression did not affect HBV replication in HepG2-NTCP cells. In primary human hepatocytes, URI1 knockdown modestly reduced HBV markers but did not significantly alter acute infection. Supporting the premise that URI1 is a promising therapeutic target for HCC, our findings show that URI1 knockdown does not enhance HBV infection in an acute infection model. This suggests that URI1 may be a viable therapeutic target for patients with HBV-associated HCC without increasing HBV-related complications.
Prioritizing attributes of approaches to analyzing patient-centered outcomes that are truncated due to death in critical care clinical trials: a Delphi study
Authors: Bahti Melanie , Kahan Brennan C. , Li Fan , Harhay Michael O. , Auriemma Catherine L.
Published: January 2025

Background

A key challenge for many critical care clinical trials is that some patients will die before their outcome is fully measured. This is referred to as “truncation due to death” and must be accounted for in both the treatment effect definition (i.e. the estimand), as well as the statistical analysis approach. It is unknown which analytic approaches to this challenge are most relevant to stakeholders.

Methods

Using a modified Delphi process, we sought to identify critical attributes of analytic methods used to account for truncation due to death in critical care clinical trials. The Delphi panel included stakeholders with diverse professional or personal experience in critical care-focused clinical trials. The research team generated an initial list of attributes and associated definitions. The attribute list and definitions were refined through two Delphi rounds. Panelists ranked and scored attributes and provided open-ended rationales for responses. A consensus threshold was set as ≥ 70% of respondents rating an attribute as “Critical” (i.e., score ≥ 7 on a 9-point Likert scale) and ≤ 15% of respondents rating the measure as “Not Important” (i.e., a score of ≤ 3).

Results

Thirty-one (91%) of 34 invited individuals participated in one or both rounds. The response rate was 82% in Round 1 and 85% in Round 2. Participants included eight (26%) personal experience experts and 26 (84%) professional experience experts. After two Delphi rounds, four attributes met the criteria for consensus: accuracy (the approach will identify effects if they exist, but will not if they do not), interpretability (the approach enables a straightforward interpretation of the intervention’s effect), clinical relevance (the approach can directly inform patient care), and patient-centeredness (the approach is relevant to patients and/or their families). Attributes that did not meet the consensus threshold included sensitivity, comparability, familiarity, mechanistic plausibility, and statistical simplicity.

Conclusions

We found that methods used to account for truncation due to death in the treatment effect definition and statistical approach in critical care trials should meet at least four defined criteria: accuracy, interpretability, clinical relevance, and patient-centeredness. Future work is needed to derive objective criteria to quantify how well existing estimands and analytic approaches encompass these attributes.
Do you know your PSMA-tracer? Variability in the biodistribution of different PSMA ligands and its potential impact on defining PSMA-positivity prior to PSMA-targeted therapy
Authors: Heilinger Jan , Roth Katrin Sabine , Weis Henning , Fink Antonis , Weindler Jasmin , Dietlein Felix , Krapf Philipp , Schomäcker Klaus , Neumaier Bernd , Dietlein Markus , Drzezga Alexander , Kobe Carsten
Published: January 2025

Background

In clinical practice, several radiopharmaceuticals are used for PSMA-PET imaging, each with distinct biodistribution patterns. This may impact treatment decisions and outcomes, as eligibility for PSMA-directed radioligand therapy is usually assessed by comparing tumoral uptake to normal liver uptake as a reference. In this study, we aimed to compare tracer uptake intraindividually in various reference regions including liver, parotid gland and spleen as well as the respective tumor-to-background ratios (TBR) of different 18F-labeled PSMA ligands to today’s standard radiopharmaceutical 68Ga-PSMA-11 in a series of patients with biochemical recurrence of prostate cancer who underwent a dual PSMA-PET examination as part of an individualized diagnostic approach.

Results

Differences in background activity among different PSMA-PET tracers lead to variations in tumor-to-background ratios (TBR). In [18F]F-DCFPyL-PET, TBR with the liver as the reference organ (TBRliver) was comparable to [68Ga]Ga-PSMA-11-PET, while [18F]F-PSMA-1007-PET and [18F]F-JK-PSMA-7-PET showed significantly lower values. Using the parotid gland as the reference (TBRparotidgland), [18F]F-DCFPyL-PET exhibited significantly higher values, whereas [18F]F-PSMA-1007-PET and [18F]F-JK-PSMA-7-PET were comparable. For the spleen (TBRspleen), [18F]F-JK-PSMA-7-PET was comparable, but [18F]F-DCFPyL-PET and [18F]F-PSMA-1007-PET showed significantly higher and lower values, respectively. An additional Bland-Altman analyses revealed low bias for [18F]F-DCFPyL-PET in TBRparotidgland, whereas significant differences in TBRliver and TBRspleen for the other tracers resulted in higher bias.

Conclusion

Different PSMA-PET tracers exhibit distinct biodistribution patterns, leading to variations in tumor-to-background ratios (TBR) in reference organs such as the liver, parotid gland, and spleen. Patient selection for PSMA-directed radioligand therapy is currently based on a semiquantitative approach using the liver as a reference region in [68Ga]Ga-PSMA-11-PET. Thus, the use of alternative [18F]-labeled tracers may result in under- or overestimation of a patient’s suitability for therapy. This highlights the importance of a comprehensive understanding of the differences in tracer-specific uptake behavior for accurate decisions regarding PSMA-expression levels. However, as the patient cohort in this study is at earlier disease stages, the generalizability of these findings to later-stage patients remains unclear and requires further investigation.
Phenotypic plasticity and genetic variation of Prosopis juliflora (Sw.) DC. across diverse rangelands in northeastern Ethiopia
Authors: Tilahun Minyahel , Angassa Ayana , Bora Zinabu , Mengistu Shimelis , Wu Jianshuang
Published: January 2025

Introduction

Prosopis juliflora (Sw.) DC. substantially threatens dry rangelands due to its invasive attributes, exacerbated by climate change, land-use practices, and anthropogenic activities. Despite the urgent need to understand its ecological impacts, comprehensive studies examining the relationship between its functional traits and reproductive fitness across diverse habitats and land-use scenarios are lacking. This study investigated the functional traits and fitness of Prosopis juliflora in the Afar region of Ethiopia, focusing on three land-use types: dry-season grazing lands, wet-season grazing lands, and wildlife reserves.

Methods

Plant samples were collected from 192 plots to assess their adaptive potential and genetic variation, alongside relevant physiographic and climatic data. This approach aims to elucidate the contributions of these factors to the observed variation and plasticity of Prosopis juliflora across three rangeland types differing in land use intensity. Generalized linear mixed models and co-occurrence networks were employed to analyze the complex interaction.

Results

Our findings revealed significant variation in fruiting onset and duration, with wet-season grazing lands demonstrating a shorter duration compared to dry-season grazing lands and wildlife reserves. Genetic variation was significant for total seed mass and number, indicating robust adaptability. The relative growth rate was higher in wildlife reserves compared to dry-season grazing lands, highlighting adaptive advantages in nutrient-rich environments. Additionally, climatic and physiographic analysis identified soil type as a critical factor influencing trait performance.

Conclusions

This study underscores the urgent need for targeted management strategies to mitigate the ecological impacts of Prosopis juliflora, emphasizing the critical role of soil nutrients in reproductive fitness. Our findings offer valuable insights into the dynamics of invasive species in dry ecosystems and inform conservation efforts.
“It’s more than a ride” veteran perceptions of peer specialist qualities and activities that were most valuable for post-incarceration reentry: a qualitative analysis
Authors: Richardson Eric , Flike Kimberlee , Hyde Justeen , Petrakis Beth Ann , McInnes D. Keith , Kim Bo
Published: January 2025

Background

Reentry veterans experience many barriers to achieving physical and psychological well-being. While peer specialists can provide important support to veterans as they readjust to life post-incarceration, their specific activities and qualities most valued by veterans are not well known. The Post-Incarceration Engagement (PIE) intervention, coordinated with VA’s Health Care for Reentry Veterans (HCRV) program, links reentry veterans with a peer specialist who provides connection to services and social-emotional support during the reentry process. We conducted a qualitative examination of veterans’ perceptions regarding the key qualities and activities of peer specialists that were most valued during their reentry process.

Methods

We interviewed 25 veterans engaged in PIE about their experiences working with a PIE peer specialist. We conducted a thematic analysis. Two project team members independently coded interviews and identified emergent themes that were refined with input from other members.

Results

Veterans found the peer specialist’s physical and emotional availability, shared lived experience, and connection to resources to be invaluable for successful reentry post-incarceration. Veterans emphasized how important it was that the peer was consistently available and provided social, emotional, and logistical support. Secondly, veterans found it valuable to work with another veteran familiar with the VA system and to be able to share lived experiences. It provided an instant connection with the peer specialist. Finally, the personalized connections to VA and community resources equipped the reentry veterans with the essential resources to ensure continued success post-incarceration.

Conclusion

Reentry veterans identified several key qualities and activities of the peer specialist that were vital to their reentry success. Our results may be used to inform other interventions aimed at improving the lives of reentry veterans along with other reentry populations.
Financial performance evaluation of firms in BIST 100 index with ITARA and COBRA methods
Authors: Katrancı Ali , Kundakcı Nilsen , Pamucar Dragan
Published: January 2025

Evaluating firms’ financial performance is important for survival in the competitive environment arising from technological advancements and gaining a competitive advantage. This study aims to assess the financial performances of firms traded on the Istanbul Stock Exchange 100 Index (Borsa Istanbul (BIST) 100 Index) between 2018 and 2022 using an integrated multi-criteria decision-making (MCDM) method. This is the first study to use a new combined approach proposed based on the indifference threshold-based attribute ratio analysis (ITARA) and cost estimation, benchmarking, and risk assessment (COBRA) methods, which have not been applied to corporate performance assessment. The ITARA method is used to find the weights of the criteria, and the ranking of the firms in terms of financial performance is obtained using the COBRA method. The results show that the firms with the highest financial performance are ISMEN, ALGYO, PGSUS, KOZAA, and IPEKE. The companies with the lowest financial performance are AKFGY, BAGFS, MGROS, KOZAL, and GOZDE. The results of this ranking provide important information for firms to recognize their position and for investors who want to invest in firms in the BIST 100 Index. Additionally, sensitivity analyses are performed to assess the impact of changes in the criteria on the ranking of the firms and to validate the results of the proposed method. A comparative analysis is made with different MCDM methods like the technique for order preference by similarity to ideal solution (TOPSIS), and combined compromise solution (CoCoSo) methods and Spearman’s rank correlation test results are presented. This approach leads to the conclusion that the proposed approach can be a useful and effective tool for assessing the financial performance of firms.
Nutritional changes in patients undergoing hemodialysis who develop COVID-19
Authors: Kitabayashi Kou , Yamamoto Suguru , Goto Shin
Published: January 2025

Background

Coronavirus disease 2019 (COVID-19) is known to deteriorate nutrition in the general population. However, the influence of COVID-19 on the nutritional status of patients undergoing maintenance hemodialysis remains unclear.

Methods

A retrospective study was conducted in a hospital that had an outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. COVID-19 was diagnosed using an antigen test, and the subjects were divided into COVID-19 and control groups. Data on body mass index, biochemistry measurements, geriatric nutritional risk index (GNRI), functional oral intake scale, and nutritional intake were collected from medical records. A generalized linear mixed model was used to analyze the interaction of time × group for these parameters between the two groups.

Results

The study included 28 participants, 16 of whom belonged to the COVID-19 group. There were no significant differences in baseline characteristics, except for serum creatinine level, among the groups. In the COVID-19 group, 63% exhibited anorexia and 50% experienced vomiting/nausea. Nutritional support or dietary consultations were provided to nine patients. Significant declines were observed in serum albumin level, total iron binding capacity, energy intake, and GNRI in the COVID-19 group, and these nutritional parameters recovered within 1 month following the resolution of the infection.

Conclusions

COVID-19 deteriorated nutritional status in patients undergoing hemodialysis. More proactive nutritional support may help maintain the nutritional status of patients undergoing hemodialysis during COVID-19 infection and could lead to a better prognosis.
Development of a brief screening measure of unmet supportive care needs (SCNS-P&C-6) in caregivers of people with high-grade glioma
Authors: Chen Jill , Shaw Joanne M. , Dhillon Haryana M. , Halkett Georgia K. B. , McDougall Emma , Nowak Anna K. , Campbell Rachel ,   for the BRAINs Program Investigators
Published: January 2025

Purpose

Informal caregivers of people with high grade glioma (HGG) often have high levels of unmet support needs. Routine screening for unmet needs can facilitate appropriate and timely access to supportive care. We aimed to develop a brief screening tool for HGG caregiver unmet needs, based on the Supportive Care Needs Survey—Partners & Caregivers (SCNS-P&C).

Methods

Secondary analysis was performed on responses to the SCNS-P&C from 188 HGG caregivers, who participated in the Care-IS trial. SCNS-P&C items were assessed against four criteria: factor loadings; prevalence; variation in domain score; diagnostic accuracy. Supplementary analysis was conducted at two timepoints (T1 & T2) on the final selected items to identify caregivers indicating no needs on the screening items but reported a need on the original SCNS-P&C, suggesting they would be “missed” by the screening items.

Results

Six items performed best against psychometric criteria, capturing two domains: Cancer impact needs and Information and communication needs. Supplementary analysis showed screening items failed to identify only 7.4% (14/188) of caregivers with other unmet needs at T1 and 11.4% (18/158) at T2. Of those missed at T1, only four were missed again at T2.

Conclusions

We identified six-items for inclusion in a brief screening tool, the SCNS-P&C-6, demonstrating good sensitivity in detecting unmet needs of caregivers of people with HGG. Use of this tool in clinical practice has the potential to improve access to care and the cancer experience for both the caregiver and person with brain tumor.
Cryptanalysis of IAR-CTR and IAR-CFB and a fixing method
Authors: Zhu Xueqi , Liu Fangzhou , Jia Yan , Xu Jun , Wang Peng
Published: January 2025

We present practical attacks on IAR-CTR and IAR-CFB, AE modes proposed by Hwang and Gope to offer both privacy and authenticity in a single pass. Then we use the idea of iCOFB, which is originally defined with a tweakable random function, to fix the IAR-CTR mode using the tweakable block cipher, and propose the TIAR-CTR mode, which is a one-pass AEAD mode with provable security. However, the same fixed method does not work for the IAR-CFB mode.
Formulation and evaluation of hyaluronic acid and adipic acid dihydrazide modified graphene quantum dot-based nanotherapeutics for paclitaxel-targeted delivery in breast cancer
Authors: Morani Dilip O. , Patil Pravin O.
Published: January 2025

Background

Paclitaxel (PAC) was the first-ever natural chemotherapeutic agent for the treatment of breast cancer. However, it has some drawbacks like low water solubility, a long half-life, an unregulated rate of discharge, etc. Thus, this research paper aimed to develop PAC-loaded nanoparticles to lessen toxicity and boost PAC's solubility in water. In this case, hyaluronic acid (HA), graphene quantum dots (GQDs), and adipic acid dihydrazide (ADH) have been combined in a unique way to suggest pH-responsive nanoconjugates that can improve the therapeutic effect of medicinal molecule PAC with fluorescence and breast cancer targeting.

Results

The investigation of the particle dimensions revealed that the majority of the particles were discovered to be between 25–50 nm. Additionally, the loading efficiency of PAC in PAC@HA-ADH-GQDs nanoconjugates was 93.56% and the release of PAC was around 70% at pH 5 and 20% at pH 7.4 in 24 h. The MTT test's risk-free methodology successfully supports the classification of HA-ADH-GQD as a biocompatible substance as it demonstrates cell viability of more than 75%. Additionally, cellular uptake research has shown that MCF7 cancer cells absorbed more PAC@HA-ADH-GQDs than GQDs alone due to the presence of targeting agent HA.

Conclusion

In this study, we have investigated the potential of the hyaluronic acid motif (HA-ADH-GQDs)-attached nanotherapeutics (NTCs) as a carrier for simultaneous fluorescence imaging and pH-triggered targeted administration of anticancer medication for the treatment of breast cancer. The suggested study is innovative since anticancer drug delivery using HA-GQDs NTCs with adhesive capabilities of ADH has not been previously described.

Graphical Abstract
Audio-vestibular dysfunction in rheumatoid arthritis associated secondary Sjogren syndrome, and its correlation to serum level of anticardiolipin and muscarinic type 3 receptors antibodies: a cross-sectional observational study
Authors: Nada Doaa Waseem , Almokadem Heba Ahmed , Elkholy Rania Elsaied , El-Gharib Amani Mohamed , Abdelwahab Marwa Ahmed , Soliman Nema Ali , Alsalawy Alaa Mohamed
Published: January 2025

Background

In secondary Sjogren syndrome (sSS), the presence and extent of hearing and vestibular abnormalities are controversial. Hence, to ascertain if individuals with Rheumatoid arthritis (RA) associated secondary Sjogren syndrome (sSS) had subclinical audio-vestibular impairment as well as to investigate whether serum anticardiolipin and muscarinic receptors type 3 antibodies had a role in its pathogenesis, this cross-sectional study was conducted on 50 RA patients with secondary Sjogren syndrome manifestations and 50 RA patients without such manifestations were included, along with 50 apparently healthy volunteers who were aged, and sex-matched as controls. Full history taking, Otologic examination, Immunologic evaluation, and Audio-vestibular assessment were done for all subjects.

Results

Twenty-five percent of our patients experienced subjective audio-vestibular symptoms. In the audiogram, 30 (60%) of the 50 RA patients with sSS and 5 (10%) of RA patients without sSS had abnormal hearing loss compared to only 4 (8%) of the controls (p ≤ 0.001) with a predominance of high-frequency sensorineural hearing loss. Also, 20% of our patients experienced a higher frequency of head-shaking nystagmus than they did (p ≤ 0.001). 30% had a statistically significant increase in the frequency of abnormal caloric test results as compared to either controls (0%) or RA patients without sSS (0%); p ≤ 0.001 Finally, all audio-vestibular symptoms and tests exhibit a strong positive correlation with muscarinic receptors type 3 and anticardiolipin antibodies.

Conclusion

The use of muscarinic receptors type 3 and anticardiolipin antibodies are beneficial for early diagnosis of audio-vestibular dysfunction in RA-associated secondary Sjogren syndrome patients. Therefore, this study is important since it justifies rheumatologists’ screening for inner ear damage in their RA patients especially if associated with secondary Sjogren.
Positive associations between mean ambient temperature and involuntary admissions to psychiatric facilities
Authors: Joore Noah L. , van der Horst Marte Z. , Noorthoorn Eric O. , Strous Jurriaan F.M. , Vruwink Fleur J. , Guloksuz Sinan , Siegmund Peter C. , Luykx Jurjen J.
Published: January 2025

Background

Temperature increases in the context of climate change affect numerous mental health outcomes. One such relevant outcome is involuntary admissions as these often relate to severe (life)threatening psychiatric conditions. Due to a shortage of studies into this topic, relationships between mean ambient temperature and involuntary admissions have remained largely elusive.

Aims

To examine associations between involuntary admissions to psychiatric institutions and various meteorological variables.

Methods

Involuntary admissions data from 23 psychiatric institutions in the Netherlands were linked to meteorological data from their respective weather stations. Generalized additive models were used, integrating a restricted maximum likelihood method and thin plate regression splines to preserve generalizability and minimize the risk of overfitting. We thus conducted univariable, seasonally stratified, multivariable, and lagged analyses.

Results

A total of 13,746 involuntary admissions were included over 21,549 days. In univariable and multivariable models, we found significant positive associations with involuntary admissions for ambient temperature and windspeed, with projected increases of up to 0.94% in involuntary admissions per degree Celsius temperature elevation. In the univariable analyses using all data, the strongest associations in terms of significance and explained variance were found for mean ambient temperature (p = 2.5 × 10−6, Variance Explained [r2] = 0.096%) and maximum ambient temperature (p = 8.65 × 10−4, r2 = 0.072%). We did not find evidence that the lagged associations explain the associations for ambient temperature better than the direct associations.

Conclusion

Mean ambient temperature is consistently but weakly associated with involuntary psychiatric admissions. Our findings set the stage for further epidemiological and mechanistic studies into this topic, as well as for modeling studies examining future involuntary psychiatric admissions.
Use of psychedelic treatments in psychiatric clinical practice: an EPA policy paper
Authors: Destoop M. , Mohr P. , Butlen F. , Kéri P. , Samochowiec J. , De Picker L. , Fiorillo A. , Kuypers K.P.C. , Dom G.
Published: January 2025

Background

Recent years show an exponential increased interest (“renaissance”) in the use of psychedelics for the treatment of mental disorders and broader. Some of these treatments, such as psilocybin for depression, are in the process of formal regulation by regulatory bodies in the US (FDA) and Europe (EMA), and as such on the brink of real-world implementation. In the slipstream of these developments increasing commercial initiatives are taking shape. The European Psychiatric Association (EPA) acknowledges both the therapeutic potential of psychedelic substances and the challenges for both research and clinical implementation. Steps need to be taken toward a well-balanced policy based upon sound scientific evidence and research, aiming at safe, ethical responsible integration of psychedelic therapy available for all patients who can potentially benefit.

Methods

In this EPA policy paper, we highlight the potential benefits, and also the challenges of psychedelic treatments, which can be relevant for the future real-world implementation of these treatments.

Results

In addition to an overview of the current evidence and hypotheses of working mechanisms of psychedelic treatment, this policy paper specifically highlights the importance of the psychosocial components of the treatment as well as the ethical and professional aspects playing a role in real-world implementation.

Conclusions

Four recommendations are formulated for further research and clinical implementation.
Cost Conversations to Mitigate the Effects of Financial Toxicity in Oncology: Current State, Opportunities, and Barriers
Authors: Littman Dalia , Lam Anh B. , Chino Fumiko
Published: January 2025

The direct and indirect financial burden of cancer care, from medication costs to lost wages, results in financial toxicity for patients. Despite the growing recognition of financial toxicity as a problem for patients, there are few solutions available at the point of care. Structured cost conversations between oncologists and patients to help identify financial toxicity and intervene early when it is recognized have been posited as a patient facing intervention. Cost conversations fit into a framework of shared decision making within cancer care. Although more than 90% of patients with cancer express a desire to discuss the costs of their care, <15% report that such conversations occurred. This contrasts with oncologists who self-report that they discuss costs with patients up to 60% of the time. Poor utilization of cost conversations may be due to both patient and oncologist reluctance of discussing money; this can be driven by fear that lower cost care is less effective and lack of training/guidance for oncologists on how to effectively conduct cost conversations. Currently, there is an abundance of small, pilot studies showing benefits of cost conversation or other decision aids in meaningfully reducing financial toxicity. However, no large randomized prospective study has assessed the role of structured conversations designed exclusively to address costs in cancer care. This review suggests a framework for cost conversations in oncology and outlines the steps necessary to develop a full cost conversation guide.
Development and Validation of a Simplified Financial Toxicity Screening Tool for Use in Clinical Practice
Authors: Thom Bridgette , Tin Amy L. , Chino Fumiko , Vickers Andrew J. , Aviki Emeline M.
Published: January 2025

PURPOSE

Cancer-related financial toxicity occurs frequently and is a key driver of inequities in access to care and disparities in treatment outcomes. Current practices to screen for financial toxicity are inconsistent because of the lack of a validated and clinically integrated screening tool. This analysis aimed to create and assess an abbreviated version of the validated Comprehensive Score for Financial Toxicity (COST) tool, a measure of financial toxicity used for research purposes, which could easily be added into often-lengthy clinical screening workflows.

METHODS

At an urban comprehensive cancer center with suburban satellite locations, a financial toxicity screening quality improvement project was conducted from June 2022 to August 2023 as part of routine clinical care: 57,526 longitudinal COST surveys were completed by 38,249 patients with cancer. An iterative algorithm selected the items with highest correlation with the total score. Using a separate validation data set, positive and negative predictive values (PPV and NPV, respectively) of the abbreviated tool (two-item) were assessed against the full COST score, with varying risk thresholds.

RESULTS

Inclusion of two COST questions (Q3: “I worry about the financial problems I will have in the future as a result of my illness or treatment”; Q6: “I am satisfied with my current financial situation”) yielded a score that had a correlation of 0.922 with the full instrument score. For the two-item scale, PPV ranged from 74% to 91%, and NPV ranged from 91% to 98% when compared with the full COST tool.

CONCLUSION

This analysis of a large data set finds that a simplified COST tool has high predictive value when compared with the full validated measure. An abbreviated COST measure of two questions is suitable for implementation into clinical screening workflows.
Associations of Financial Hardship and Health Status, Social Functioning, and Mental Health Among Cancer Survivors in the United States: Findings From a Nationally Representative Study
Authors: Chen Min-Hsuan , Zhao Jingxuan , Ogongo Margaret Katana , Han Xuesong , Zheng Zhiyuan , Yabroff K. Robin
Published: January 2025

PURPOSE

Financial hardship is common among cancer survivors and has been associated with worse physical and mental health in selected subpopulations. We comprehensively examined associations of financial hardship with multiple measures of health status, social functioning, and mental health in a large, nationally representative sample of cancer survivors.

MATERIALS AND METHODS

We identified adults with a cancer history (18-64 years: n = 3,157 and ≥65 years: n = 5,991) from the 2019 to 2021 National Health Interview Survey. Associations of financial hardship and health status, social functioning (eg, difficulty doing errands alone), and mental health (eg, feeling worried, nervous, or anxious) were evaluated with separate multivariable logistic regressions stratified by age group (18-64 and ≥65 years) to reflect differences in employment, health insurance coverage, and underlying health, and adjusted percentages were calculated.

RESULTS

Cancer survivors with financial hardship were more likely to report fair/poor health (18-64 years: 34.7%
v
23.2% and ≥65 years: 40.7%
v
27.3%), social functioning limitations (18-64 years: 10.5%
v
5.3% and ≥65 years: 18.1%
v
11.1%), and work limitations (18-64 years: 36.0%
v
26.2% and ≥65 years: 47.3%
v
33.6%) than their counterparts without financial hardship in adjusted analyses (all
P
< .001). Survivors with financial hardship were also more likely to report frequent anxiety (18-64 years: 47.2%
v
27.8% and ≥65 years: 36.2%
v
16.3%) and depression (18-64 years: 21.7%
v
10.8% and ≥65 years: 19.4%
v
7.3%) than survivors without hardship (all
P
< .001).

CONCLUSION

In this large nationally representative sample, cancer survivors with financial hardship were more likely to report poorer health, social functioning limitations, and worse mental health across multiple measures than their counterparts without hardship. Interventions to screen and connect survivors with relevant services are warranted.
YAP1 Is a Prognostic Marker and Its Inhibition Reduces Tumor Progression in Adrenocortical Tumors
Authors: More Candy C B , Bueno Ana Carolina , Rojas César A O , Stecchini Mônica F , Ramalho Fernando S , Brandalise Silvia R , Cardinalli Izilda A , Yunes José Andres , Junqueira Thais , Scrideli Carlos A , Castro Margaret , Antonini Sonir R R
Published: January 2025

Context

Adrenocortical cancer (ACC) is rare and aggressive, with YAP1 overexpression associated with poor outcomes in pediatric patients.

Objective

In this study, we investigated the mechanisms by which YAP1 drives ACC progression and explored it as a potential target therapy.

Methods

YAP1 expression and methylation in ACC were analyzed from pediatric and adult cohorts. The role of YAP1 on ACC progression was examined in vitro using an adrenocortical cell line. Also, was evaluated the YAP1's influence on β-catenin. The effect of YAP1 pharmacological inhibition was assessed on tumor growth in a murine xenograft model of ACC.

Results

High YAP1 expression was associated with lower survival in all cohorts. The YAP1 methylation signature was associated with patients’ prognosis. Inhibition of YAP1 reduced ACC cell viability through cell cycle arrest in the G0/G1 phase, and inhibited the epithelial–mesenchymal transition and cell invasion. YAP1 modulated β-catenin protein levels and transcription activity, whereas β-catenin partially mediated the effect of YAP1 on adrenocortical tumorigenesis. In vivo, verteporfin impaired tumor growth and Ki67 immunoreactivity in xenografts.

Conclusion

YAP1 is a potential novel prognostic marker in patients with ACC. Its deregulation contributes to adrenocortical tumorigenesis partially through crosstalk between Hippo/YAP1 and Wnt/β-catenin pathways. YAP1 inhibition is a new antitumor target.
Does the Diagnosis of Intraoperative Malignant Hyperthermia Require Case Termination? A Case Report
Authors: Riccio Alessandra M. , Gurvitch Dana L.
Published: January 2025

Malignant hyperthermia (MH) is a rare genetic disorder triggered by inhalational anesthetics or depolarizing neuromuscular blocking agents that carries significant mortality if not promptly treated. The following case presents a healthy 39-year-old man who developed MH several hours into an anesthetic exposure. Rapid intraoperative stabilization tactics that paralleled intensive care unit (ICU) level care allowed for continuation of operative management as opposed to case termination given the patient was at high risk for permanent nerve palsy if the case were to be aborted during dissection.
Effectiveness of a Neurocritical Care Course with Problem-Based Learning and Discussion Format in Asia
Authors: Prabhakar Hemanshu , Shrestha Gentle S. , Kapoor Indu , Mahajan Charu , Singhal Vasudha , Luthra Ankur , Gupta Nidhi , Margaretha Ruth Evlin
Published: January 2025

Numerous barriers hinder the effective delivery of neurologic care as well as the education of health care professionals in the low-income and middle-income countries (LMICs). This study assessed the knowledge of the participants after Comprehensive Neurocritical Care Course (CN3C) in the LMICs. Data from 177 participants were collected and analyzed. The pre- and postcourse test scores of the participants were compared. There was improvement in their posttest scores (pretest score: 16.45 ± 5.35 vs posttest score: 24.96 ± 6.74; P < .01). The CN3C course improves the overall knowledge of neurocritical care in the participants, as evident by the posttest scores.
Sounds of Black Switzerland
Authors: Cox Jessie
Published: January 2025

Writing as a scholar, composer, and musician, Jessie Cox foregrounds the experience of Black Swiss through sound and music in his first book, Sounds of Black Switzerland. Cox, himself Black Swiss, affirms the value of Black life through sound while critiquing anti-Blackness as a cause of erasure, silence, and limitation. He examines Swiss Nigerian composer Charles Uzor’s pieces for George Floyd, work by Black Swiss musicians such as DJ Maïté Chénière, clarinetist Jérémie Jolo, and rapper Nativ, as well as his own musical collaborations with the Lucerne Festival. In these analyses, Cox tackles the particularities of anti-Blackness in Switzerland, creating a practice of listening beyond what can be directly heard to explore the radical potential of Black thought and experience in a nation often claimed to be race-free. In so doing, he ultimately shifts thinking about Blackness in relation to citizenship, immigration laws, gender, kinship, and belonging. By listening to Black Swiss and other voices inaudible to the current world, Cox theorizes new ways of practicing scholarly study and general ways of relating to others and the world.
Role of Sulcal Hyperintensity and Web/Net Appearance on MRI in Patients With Chronic Subdural Hematoma Presenting With Transient Neurological Deficits
Authors: Kato Takenori , Hasegawa Toshinori , Mizuno Akihiro , Kuwabara Kyoko , Ohno Masasuke , Kuramitsu Shunichiro , Naito Takehiro , Kageyama Akinori , Niwa Hirotaka , Oishi Hiroyuki
Published: January 2025

BACKGROUND AND OBJECTIVES:

Transient neurological deficits (TNDs) in patients with chronic subdural hematoma (CSDH), such as fluctuating aphasia, hemiparesis, or sensory disturbances, present diagnostic and treatment challenges as their pathophysiology remains unclear. The aim of this study was to investigate the association between specific MRI findings and TNDs in patients with CSDH and explored their relationship through intraoperative observation.

METHODS:

We retrospectively evaluated 72 patients with CSDH who underwent preoperative MRI among 251 CSDH patients treated from January 2020 to December 2023. Sulcal hyperintensity (SHI) on fluid-attenuated inversion recovery images and web/net appearance (W/N) on T2*-weighted images were assessed and their association with TNDs was analyzed. Flexible neuroendoscopic surgery (FNS) was performed on 8 patients with TNDs exhibiting these MRI findings, allowing intraoperative observation of intrahematoma conditions. Histopathological examination was performed on hematoma samples.

RESULTS:

Thirteen patients (5.2%) presented with preoperative TNDs. Diffuse SHI and W/N were strongly associated with preoperative TNDs (odds ratio = 150.0, P < .001). FNS revealed organized hematomas with inflammatory changes corresponding to the SHI and W/N seen on MRI. Patients who underwent FNS experienced complete resolution of TNDs postprocedure, with diffuse SHI disappearing by one month. No recurrence was observed at a mean follow-up of 5.9 months.

CONCLUSION:

This study provided the first evidence that the combination of diffuse SHI and W/N on MRI strongly correlates with TNDs in patients with CSDH, serving as valuable diagnostic indicators. These findings will aid in guiding surgical approach selection and facilitate more personalized treatment strategies for patients with CSDH presenting with TNDs.