bluuebunny/crossref_metadata_2025 huggingface dataset:
Aerodynamic analysis of new low-wind-pressure conductors by numerical simulation
Authors: Qi Lexin , Liu Jiang , Weng Peifen , Qin Dezhao , Fu Zaiguo , Jiang Weiting
Published: January 2025

Low-wind-pressure conductor design aims to reduce the impact of wind on transmission lines and improve the stability and safety of the line so that the transmission system can operate more reliably in harsh climatic conditions. This paper is inspired by the golf ball surface pit structure, the surface structure of the conductor design, the design of a Roman column type low wind pressure conductor, and an imitation golf ball type low wind pressure conductor. The computational fluid dynamics (CFD) method based on the large eddy simulation (LES) is used to study the aerodynamic characteristics of the new low-wind pressure conductor and the mechanism of wind resistance reduction. The results show that the new low wind pressure conductor can reduce the wind resistance by 15%∼20% compared with the traditional cylindrical conductor due to the surface’s pit structure delaying the flow separation and lowering the differential pressure resistance to achieve the effect of resistance reduction.
Anchoring Authority
Authors: Queloz Matthieu
Published: January 2025

This chapter reviews extant attempts to anchor the authority of concepts and argues that they present us with a trilemma between foundationalism, ironism, and holism. It is argued that the first, when suitably generalized to cover thick normative concepts, has become incredible; the second results in indiscriminate disengagement from our concepts; and the third results in undiscriminating acceptance of them. To escape this trilemma and find more critical leverage with which to discriminate between concepts that merit confidence and concepts that do not, two things are required: first, the picture of our conceptual apparatus as something harmonious, largely tensionless, and inherently static must be replaced with a kaleidoscopic picture on which our conceptual apparatus is tension-ridden and dynamic; second, the critical leverage of local needs must be harnessed by recognizing that the contingency of our concepts extends also to the standards that these concepts must meet.
Concepts and Concerns
Authors: Queloz Matthieu
Published: January 2025

This chapter argues that concept appraisal should look beyond theoretical virtues and consider how our concepts relate to the concerns that animate their use. Using a little-known debate between Ronald Dworkin and Bernard Williams over the aspiration to eliminate theoretical vices in concepts as a springboard to the needs-based account to be developed, the chapter draws out three general lessons for conceptual ethics: that the merits of a concept have to be judged based on a prior understanding of the concerns it serves; that these concerns cannot be redirected at the drop of a definition; and that if some proposed concept realizes theoretical virtues at the cost of severing its ties to more important concerns, this will not be an improvement. If we are mindful of these lessons, we can appreciate the practical virtues of theoretical vices. Yet tying concepts back to concerns raises four problems of its own.
The Politics of Conflicting Concerns
Authors: Queloz Matthieu
Published: January 2025

This chapter considers how the needs-based approach accommodates the politics of pluralistic and conflicting concerns. Applying the approach to the political concept of liberty, it rounds out the reconstruction of the Dworkin–Williams debate, showing how Williams indicates two needs-based arguments for a conception of liberty on which its realization conflicts with the realization of equality. But the needs-based approach can also be used to come to Dworkin’s defence, revealing that there is a place in politics for the tidy-minded pursuit of theoretical virtues: there is a need for public reasoning to take a thinner and more theoretically virtuous form than personal reasoning. This serves the concern to hold public decision-makers accountable. Once this ideal of public reasoning shapes people’s conception of rationality in personal reasoning, however, it threatens to entrain a loss of substance in personal thought.
Crisis of Liberalism
Authors: Trencsényi Balázs
Published: January 2025

The chapter points to the links of the discourses of spiritual, economic, and societal crisis to the debate on the decline of liberalism—one of the most heated intellectual and political controversies of the interwar years. While the period is usually perceived as marked by the rise of illiberal ideologies, the chapter also shows that in the early 1920s there seemed to be a relatively broad consensus about the hegemony of the liberal democratic ideological script in most European countries. However, this seeming consensus quickly dissolved, and liberalism became a target of radical left- and right-wing criticism. In this context, critics of the liberal democratic framework opted for setting democracy and liberalism against each other, advocating an “illiberal democracy” or an “anti-democratic liberalism” as a way out of the crisis of the political system. From this perspective, the chapter seeks to situate the rise of neoliberalism in the period as a result of a complex and open-ended negotiation both with the nineteenth-century classical liberal tradition and with the different new ideological streams challenging the liberal position.
Crisis of Democracy
Authors: Trencsényi Balázs
Published: January 2025

This chapter looks at the growing discontent with representative democracy from the early 1920s onward, gradually turning into a diagnosis of a “general crisis” of democracy. Democratic institutions were often bitterly criticized for failing to provide an adequate manifestation of the common good, becoming instead the instruments of the uncontrollable and irrational masses. Critics pointed to the opening rift between liberalism and democracy, the lack of underlying absolute values to sustain a liberal democratic system, and the contradiction of formal versus substantial democracy. A central point of contention was that of the pros and cons of majoritarianism and plebiscitary forms of democracy. Liberal critics pointed out that such a reduction of the democratic principle to the act of legitimizing political rule opened the gates to tyranny, while leftist and rightist anti-liberals turned to these instruments as the basis of a more authentic form of popular rule, often combining it with a vision of charismatic leadership, embodying the general will.
Crisis of the Nation-State and the International System
Authors: Trencsényi Balázs
Published: January 2025

The end of the First World War and the ensuing framework of peace treaties could be considered a triumph of the principle of national self-determination and thus the universalization of the model of nation-statehood. However, the postwar polities proved to be increasingly conflict-ridden and the nation-state came to be affected by a deepening crisis of legitimacy. The experience of the Great Depression exposed the problem of economic nationalism and protectionism, while the geopolitical reconfiguration of the 1930s made the discourse of national self-determination increasingly problematic, if not completely illusory. The extensive discussion on the crisis of European civilization, and especially on the specific European combination of the principle of nation-statehood and transcontinental imperialism/colonialism, put all of this into an even more encompassing “global” perspective. This feeling of crisis also opened the space for alternative projects, such as federalism, which reemerged in the 1930s as an alternative to the self-destructive fragmentation, skillfully instrumentalized by the totalitarian powers.
Comprehensive Single-Cell Chromatin and Transcriptomic Profiling of Peripheral Immune Cells in Non-Segmental Vitiligo
Authors: Gay-Mimbrera Jesus , Lozano-Ojalvo Daniel , Gómez-Arias Pedro J , Rivera-Ruiz Irene , Aguilar-Luque Macarena , Mochón-Jiménez Carmen , Andújar Pulido Eloísa , Pérez-Alegre Mónica , Guttman-Yassky Emma , Ruano Juan
Published: January 2025

Introduction

Non-segmental vitiligo (NSV) is an autoimmune condition characterized by melanocyte loss. While skin-specific mechanisms are well-studied, systemic immune dysregulation contributing to NSV pathogenesis remains unclear.

Objective

This study employs a multi-omic single-cell approach to investigate circulating immune cells in NSV, integrating transcriptional and chromatin accessibility data.

Methods

An integrative scRNA-seq/scATAC-seq analysis was conducted on PBMCs from NSV patients (n=11) and controls (n=5), identifying transcriptional markers, cell-cell interactions, chromatin accessibility, and transcription factor (TF) dynamics. Key findings were validated in an expanded cohort (NSV, n=16; controls, n=9) using spectral flow cytometry, with additional stratification by sex, age, disease activity, severity, and duration.

Results

Analysis of 59,192 PBMCs identified 8,204 gene expression markers and 13,925 ATAC peaks across 25 immune cell subtypes. A broadly activated immune response was observed, characterized by cytotoxicity, antigen presentation, cell exhaustion, and stress, predominantly in monocytes, NK cells, CD8+ T cells, and dendritic cells (DCs). Multi-omic integration revealed Th1/Th17 polarization and dysfunctional regulatory T cell (Treg/mTreg) responses. Chromatin accessibility highlighted enriched TF binding sites for FOXO3, SP1, AP1, STAT1/STAT3, IRF1, and IRF4, regulating pathways linked to cytotoxicity, antigen processing, NF-κB, Toll-like receptor, and JAK-STAT signaling.

Flow cytometry validated these findings, showing that disease activity and shorter duration were associated with heightened immune dysregulation. Robust TCR activation drove Th1/Th17 polarization and elevated IFN-γ and TNF-α production in CD4+ and CD8+ T cells. CLA+ skin-homing Th1/Th17-polarized CD4+ T cells, CD8+ T cells, and mTregs exhibited persistent activation, marked by basal PD1+ expression. OX40/OX40L-mediated interactions between monocytes and effector T cells amplified inflammation. Regulatory dysfunction, including reduced IL-4 and IL-13 production in mTregs, was prominent in moderate-severe and active disease.

Conclusion

This is the first multi-omic single-cell study in PBMCs of NSV patients, revealing systemic immune dysregulation driven by cytotoxicity, antigen presentation, exhaustion, and regulatory failure. Disease severity, activity, and evolution influence these pathways, highlighting the OX40/OX40L axis as a potential therapeutic target to mitigate immune dysregulation and relapse risk.
Research progress on the role of fascia in skin wound healing
Authors: Xu Jiamin , Zhang Hongyan , Ye Haifeng
Published: January 2025

The skin, the human body’s largest organ, is perpetually exposed to environmental factors, rendering it vulnerable to potential injuries. Fascia, a vital connective tissue that is extensively distributed throughout the body, fulfils multiple functions, including support, compartmentalization, and force transmission. The role of fascia in skin wound healing has recently attracted considerable attention. In addition to providing mechanical support, fascia significantly contributes to intercellular signalling and tissue repair, establishing itself as a crucial participant in wound healing. This review synthesises the latest advancements in fascia research and its implications for skin wound healing.
Combination of white-light imaging–based and narrow-band imaging–based artificial intelligence models during colonoscopy in patients with ulcerative colitis
Authors: Kuroki Takanori , Maeda Yasuharu , Kudo Shin-Ei , Ogata Noriyuki , Takabayashi Kaoru , Takenaka Kento , Kawashima Jiro , Kawabata Yurie , Iwasaki Shunto , Shiina Osamu , Morita Yuriko , Kouyama Yuta , Sakurai Tatsuya , Ogawa Yushi , Baba Toshiyuki , Mori Yuichi , Iacucci Marietta , Ogata Haruhiko , Ohtsuka Kazuo , Misawa Masashi
Published: January 2025

Background and Aims

The long-term treat-to-target (T2T) approach in ulcerative colitis (UC) aims for endoscopic remission, but variability among endoscopists and a lack of precision in relapse prediction both limit its clinical usefulness. A recently reported white-light imaging (WLI) artificial intelligence (AI) model helps standardize diagnosis, although challenges remain. Therefore, we attempted to combine a narrow-band imaging (NBI) AI model with the WLI AI model to determine whether these challenges can be overcome.

Methods

This post hoc analysis of a prospective study evaluated the efficacy of combining AI-assisted WLI and NBI models in predicting clinical relapse in patients with UC over a 12-month follow-up period. A total of 102 patients with UC in clinical remission were included, and the combined AI models were used during colonoscopy to assess relapse risk.

Results

The study found that within the same AI-based Mayo endoscopic subscore category, patients with vascular activity were more likely to experience clinical relapse than those with vascular healing. Compared with the WLI model alone, the specificity of the combined method significantly increased from 42.2% (95% confidence interval [CI]: 32.1%–52.9%) to 61.5% (95% CI: 50.7%–71.2%) (P = .013) with its sensitivity being maintained.

Conclusions

The sequential use of WLI and NBI AI models can provide better stratification of relapse risk compared with using either model alone, offering a more accurate and personalized approach to treatment intensification. This dual-model AI approach aligns with the T2T approach in UC management.
Estrogenic activity of alkylcyclohexanones and alkylcyclohexanols in rainbow trout estrogen receptor binding and liver slices Vtg mRNA expression assays
Authors: Tapper Mark A , Denny Jeffrey S , Sheedy Barbara R , Kolanczyk Richard C , Saari Gavin , Hammermeister Dean E , Backe Will , Serrano Jose
Published: January 2025

Alkylcyclohexanones and alkylcyclohexanols are industrial chemicals produced in large volumes. Little is known regarding estrogenic activity of these chemicals in aquatic species. A series of para-alkyl subsituted hexanones and hexanols with varying chain length and branching were tested in a suite of in vitro rainbow trout binding assays and in an ex vivo rainbow trout liver slice/vitellogenin (Vtg) expression assay to assess estrogenic potential. Furthermore, the extent of biotransformation of these chemicals under test conditions was monitored. Cyclohexane, cyclohexanol, and 4-ethylcyclohexanol had no detectable estrogenic activity in these assays. Para substituted alkylcyclohexanones and alkylcyclohexanols with side chains containing three to six carbons were active in both assays. Alkylcyclohexanones and alkylcyclohexanols with other than para substitution were also estrogenic when tested in these assays. The binding affinity relative to estradiol in cytosol of active chemicals was low, ranging from 0.0016 to 0.000029%. Biotransformation of alkylcyclohexanones to alkylcyclohexanols occurred in the cytosol binding assay and in the liver slice assay, thus making those exposures a mixture of alcohol and ketone forms. Biotransformation did not occur in rainbow trout nuclear extract and recombinant binding assays, thus the exposure in these assays was to only the dosed chemical. Both alkylcyclohexanones and alkylcyclohexanols bound to the estrogen receptor in these metabolically limited assays. Significant induction of Vtg mRNA expression was seen in slice exposed to chemicals with measurable binding affinities. Often the induction levels were below maximum efficacy and occurred at concentrations slightly lower than toxic concentrations. Therefore, while these chemicals produced an estrogenic effect, it is considerably weaker than that of the endogenous hormone and occurred at concentrations close to those which produce toxicity.
Investigating the role of adipose tissue in mobility and aging: design and methods of the Adipose Tissue ancillary to the Study of Muscle, Mobility and Aging (SOMMA-AT)
Authors: Yeo Reichelle X , Mau Theresa , Ross Zana M , Edenhoffer Nicholas P , Liu Jingfang , Barnes Haley N , Lui Li-Yung , Adkins Joshua N , Sanford James A , Seldin Marcus M , Viesi Carlos H , Zhou Mingqi , Gregory Heather L , Toledo Frederico G S , Stefanovic-Racic Maja , Lyles Mary , Wood Ashlee N , Mattila Polly E , Blakley Elizabeth A , Miljkovic Iva , Cawthon Peggy M , Newman Anne B , Kritchevsky Stephen B , Cummings Steven R , Goodpaster Bret H , Justice Jamie N , Kershaw Erin E , Sparks Lauren M
Published: January 2025

Background

Age-related changes in adipose tissue impact chronic medical diseases and mobility disability but mechanism remains poorly understood. The goal of this study is to define methods for phenotyping unique characteristics of adipose tissue from older adults.

Methods

Older adults enrolled in Study of Muscle, Mobility and Aging selected for the adipose tissue ancillary (SOMMA-AT; N=210, 52.38% women, 76.12±4.37 years) were assessed for regional adiposity by whole-body magnetic resonance (AMRA) and underwent a needle-aspiration biopsy of abdominal subcutaneous adipose tissue (ASAT). ASAT biopsies were flash frozen, fixed, or processed for downstream applications and deposited at the biorepository. Biopsy yields, qualitative features, adipocyte sizes, and concentration of adipokines secreted in ASAT explant conditioned media were measured. Inter-measure Spearman correlations were determined.

Results

Regional, but not total, adiposity differed by sex: women had greater ASAT mass (8.20±2.73kg, p<0.001) and biopsy yield (3.44±1.81g, p<0.001) than men (ASAT=5.95±2.30kg, biopsy=2.30±1.40g). ASAT mass correlated with leptin (r=0.54, p<0.001) and not resistin (p=0.248) and adiponectin (p=0.353). Adipocyte area correlated with ASAT mass (r=0.34, p<0.001), BMI (r=0.33, p<0.001), adiponectin (r=-0.22, p=0.005) and leptin (r=0.18, p=0.024) but not with resistin (p=0.490).

Conclusion

In addition to the detailed ASAT biopsy processing in this report, we found that adipocyte area correlated with ASAT mass, and both measures related to some key adipokines in the explant conditioned media. These results, methods, and biological repositories underscore the potential of this unique cohort to impact the understanding of aging adipose biology on disease, disability, and other aging tissues.
Olfactory Function and Frailty in Older Adults
Authors: Pleasants Hannah , Yuan Yaqun , Chamberlin Keran , Li Chenxi , Couper David , Shrestha Srishti , Kamath Vidyulata , Deal Jennifer A , Mosley Thomas H , Palta Priya , Pinto Jayant M , Chen Honglei , Kucharska-Newton Anna
Published: January 2025

This study investigated the relationship between olfactory impairment and frailty among 5,231 (mean age 75.3 (SD 5.0), 59% women, 22% Black) participants of the Atherosclerosis Risk in Communities (ARIC) Study cohort located in the U.S.. Olfactory function, assessed from the 12-item Sniffin' Sticks Odor Identification Test at Visit 5 (2011-2013), was categorized as poor (0-8), moderate (9-10) and good (11-12). Frailty was assessed using both the Fried Frailty Phenotype and the Cumulative Frailty Index. Findings revealed that good olfaction was significantly associated with lower odds of frailty (OR=0.29, 95% CI [0.22, 0.39]) and prefrailty (OR= 0.52, 95% CI [0.45, 0.61]) in cross-sectional analyses. Results were robust to adjustment for all covariates. Longitudinal analyses, including 1,519 participants who were robust at study baseline, similarly showed a dose-response pattern, with improved olfaction associated with decreased odds of experiencing prefrailty (OR=0.63 95% CI [0.48, 0.83]) or frailty (OR=0.50, 95% CI [0.25, 1.02]). Further research is needed to elucidate the mechanisms linking olfaction and frailty and explore potential interventions.
Employment Status: The Death Throes of the Tests of Mutuality of Obligation and Control
Authors: Collins Hugh , Freedman Judith
Published: January 2025

The UK Supreme Court in HMRC v Professional Game Match Officials Ltd answered two contentious issues about the identification of contracts of employment for the purpose of tax law. The first rejected the claim that ‘mutuality of obligation’ is a necessary feature of contracts of employment unless it is interpreted to mean the same as ‘consideration’, an essential requirement for all legally binding contracts. The second interpreted the meaning of the necessary requirement of control exercised by the employer to require no more than authority granted by a contractual framework backed up with the possibility of imposing sanctions for poor performance. Although the case concerned a question of tax law, the Supreme Court intermingled case law from employment law as well, so that the case is the leading authority on mutuality of obligation and control for employment law as well.
Question and answers on long-acting therapy with cabotegravir and rilpivirine in people with HIV
Authors: Taramasso Lucia , Bonora Stefano , Cingolani Antonella , Di Biagio Antonio , Gianotti Nicola , Guaraldi Giovanni , Lo Caputo Sergio , Madeddu Giordano , Maggi Paolo , Marchetti Giulia , Nozza Silvia , Rusconi Stefano , Maggiolo Franco
Published: January 2025

Modern ART is evolving, allowing the use of new drug formulations and alternative routes of administration to oral therapy. Long-acting (LA) cabotegravir and rilpivirine, the first fully injectable antiretroviral regimen approved for clinical use, is a test case for this new route of administration, and an innovation with implications for the quality of life of people with HIV (PWH). However, its use requires a reorganization of outpatient clinics and outpatient services, and a number of issues remain to be defined regarding the management of PWH on LA drugs, including the correct selection of people who can be treated with LA cabotegravir and rilpivirine. There is also ongoing debate about the best way to monitor both efficacy and tolerability of LA treatment and whether the management of virological failures and blips should be different from that reserved for oral regimens. The present article reviews the data on the use and management of LA cabotegravir and rilpivirine in different settings, with a review of clinical trial data and also the first available real-life experiences. The article focuses on the following: the reasons for the use of LA drugs; the implementation of their use in clinical practice; and the monitoring of treated people over time.
Experimental investigation and simulation of SEM image intensity behaviors for developing thickness-controlled S/TEM lamella preparation via FIB-SEM
Authors: Uzuhashi Jun , Yao Yuanzhao , Ohkubo Tadakatsu , Sekiguchi Takashi
Published: January 2025

High-quality thin lamellae are essential for state-of-the-art scanning transmission electron microscopy (S/TEM) analyses. While the preparation of S/TEM lamellae using focused ion beam (FIB) scanning electron microscopy has been established since the early twenty-first century, two critical factors have only recently been addressed: precise control over lamella thickness and a systematic understanding of FIB-induced damage. This study conducts an experimental investigation and simulation to explore how the intensities of backscattered and secondary electrons (BSEs and SEs, respectively) depend on lamella thickness for semiconductor (Si), insulator (Al2O3), and metallic (stainless-steel) materials. The BSE intensity shows a simple linear relationship with the lamella thickness for all materials below a certain thickness, whereas the relationship between the SE intensity and thickness is more complex. In conclusion, the BSE intensity is a reliable indicator for accurately determining lamella thickness across various materials during FIB thinning processing, while the SE intensity lacks consistency due to material and detector variability. This insight enables the integration of real-time thickness control into S/TEM lamella preparation, significantly enhancing lamella quality and reproducibility. These findings pave the way for more efficient, automated processes in high-quality S/TEM analysis, making the preparation method more reliable for a range of applications.
Academic Freedom, Education and the ‘Trans Debate’: A Response to Suissa and Sullivan
Authors: Bliss Iris , Gatley Jane
Published: January 2025

Judith Suissa and Alice Sullivan’s 2021 paper ‘The Gender Wars, Academic Freedom and Education’ holds that activism associated with the slogan ‘trans women are women’ harms progress towards the goals of shared learning and knowledge production. They hold that shared learning and knowledge production ground the value of the university. In response, we point out that academic freedom is not absolute, and that its contribution to learning and knowledge production is only part of a host of academic goods. Given the hostile environment faced by trans people in the United Kingdom, absolute academic freedom in relation to questions about sex, gender and gender identity should not be taken for granted. The focus of this paper is on the following: (1) Academic freedom is not absolute and should be responsibly curtailed when it causes harm, or hinders other educational goods; (2) public perceptions of ‘gender debates’ in the United Kingdom cause harm and hinder other educational goods; (3) academic debates about sex, gender and gender identity could contribute to this harm and hindrance and should be undertaken only with care.
Nocturnal hemoglobin desaturation (NHD) in chronically transfused adults with sickle cell disease: a retrospective study
Authors: Obadina Mofiyin A , Owens Iman , Chang Ada , Miller Vanessa , Little Jane A
Published: January 2025

Unstructured Abstract

High risk sickle cell disease may be managed with chronic red blood cell exchange transfusions. We examined the prevalence of sleep-associated hypoxemia (≥5 minutes at SpO2 ≤88%), or nocturnal hemoglobin desaturation in chronically transfused adults with sickle cell disease. Of 41 identified participants, 15 (36.6%) had tested positive for nocturnal hemoglobin desaturation at some point prior to enrollment. The median duration of desaturation (SpO2 ≤88%) in those that tested positive was 88.3 minutes (IQR 27.9-226.0 minutes). Participants with and without nocturnal hemoglobin desaturation were compared using non-parametric statistical tests. Compared to participants without nocturnal hemoglobin desaturation, those with nocturnal hemoglobin desaturation had higher absolute reticulocyte counts (p = 0.018) and white blood counts (p = 0.05) and tended to be older. They had more anemia (p = 0.11) and higher lactate dehydrogenase levels (p = 0.072). Older age at initiation of chronic red blood cell transfusions associated the strongest with a longer duration of nocturnal hemoglobin desaturation (ρ =  0.4253, p = 0.0067), while prior history of cerebrovascular events associated with a shorter duration of NHD (p = 0.0315). Our results demonstrate that nocturnal hemoglobin desaturation is common in adults being treated with red blood cell exchange for high-risk sickle cell disease, and associates with laboratory evidence of increased disease activity. Increased awareness of this complication and appropriate screening may provide an additional simple, low cost and physiologically relevant treatment intervention ie oxygen therapy.
What Is Fueling FinTech Lending? The Role of Banking Market Structure
Authors: Balyuk Tetyana , Berger Allen N , Hackney John
Published: January 2025

We study the broad question about the sources of FinTech lending growth by examining a specific representative product for which the technologies of both FinTech and the incumbent competitors can be identified and compared—small business lending. We test whether the presence of incumbents employing different technologies affects FinTech penetration, and find more FinTech lending where large/out-of-market banks are more prevalent. Using stress test exposures and Community Reinvestment Act examinations as instruments, we find that FinTech credit more often substitutes for loans by large/out-of-market banks than small/in-market banks. Results are consistent with FinTech advantages in processing hard information, rather than hardening soft information. (JEL G21, G23, O33)
Workplace Prejudice Toward Nurses (WPtN)
Authors: Kaye Miranda P. , Dellasega Cheryl , Andreae D. Adriana
Published: January 2025

Measuring and understanding experiences of workplace prejudice faced by underrepresented nurses comprise a first step toward workplace equality and enhanced morale and retention. With no existing instruments to measure prejudice directed toward nurses, the primary goal of the current study was to report the results and validation of the newly developed Workplace Prejudice toward Nurses (WPtN) scale. Participants (1692 nurses, 65% whom identified as an underrepresented racial or ethnic group) completed an online survey assessing WPtN. Participants reported on the types and frequency of WPtN they experienced, who directed the prejudice toward them, and the impact it caused on their job satisfaction and retention. Results supported the fit of a 1-factor model assessing general workplace prejudice, and 4-factor model comprising WPtN directed from different groups (ie, patients, their family members, coworkers, and administrators). More than one-third (34%) of participants reported experiencing WPtN. Those reporting WPtN indicated this prejudice was directed toward them from patients (45%), family members (41%), coworkers (42%), and administrators (14%). Experiencing WPtN negatively impacted job satisfaction and retention. Together, findings indicate that the WPtN scale is a reliable measure of WPtN of underrepresented backgrounds. The development of this tool is an important step to combating prejudiced behavior and attitudes, which can often be covert and difficult to validate.
Corticosteroids in Cardiogenic Shock: A Retrospective Analysis of the Medical Information Mart for Intensive Care-IV Database
Authors: Haddad Ghazal , Maslove David M. , Mbuagbaw Lawrence , Belley-Côté Emilie P. , Rochwerg Bram
Published: January 2025

IMPORTANCE:

While corticosteroid administration in septic shock has been shown to result in faster shock reversal and lower short-term mortality, the role of corticosteroids in the management of cardiogenic shock (CS) remains unexplored.

OBJECTIVES:

Determine the impact of corticosteroid administration on 90-day mortality (primary outcome) in patients admitted to a critical care unit with CS.

DESIGN, SETTING, AND PARTICIPANTS:

In this retrospective cohort study, we used the critical care database of Medical Information Mart for Intensive Care-IV, and included all adult patients diagnosed with CS excluding repeated admissions, patients with adrenal insufficiency, those receiving baseline corticosteroids, and those requiring extracorporeal life support. We considered exposure based on receiving systemic corticosteroids from 6 hours before to 24 hours post-critical care admission.

MAIN OUTCOMES AND MEASURES:

We calculated Cox proportional hazards using multivariate analysis for 90-day mortality (primary outcome). We also explored the association of corticosteroid use with hospital length of stay, ventilator-free days (VFDs), vasopressor-free days, ventilator-associated pneumonia, central-line-associated bloodstream infections, and hyperglycemia.

RESULTS:

We included 2000 eligible patients, with 143 (7.2%) receiving systemic corticosteroids. Corticosteroid-treated patients were younger (67.7 vs. 71.2 yr; p = 0.006), had higher Sequential Organ Failure Assessment scores at baseline (9.4 vs. 7.8; p < 0.001), and more often required vasopressors (78% vs. 63%; p < 0.001), and invasive mechanical ventilation (73% vs. 45%; p < 0.001). Corticosteroid use was associated with increased 90-day mortality in multivariate analysis (hazard ratio, 1.60; 95% CI, 1.25–2.05) and fewer VFDs (2.8 d fewer; 95% CI, 0.35–5.26) with no effect on other secondary outcomes.

CONCLUSIONS AND RELEVANCE:

Use of corticosteroids may be associated with increased mortality and a reduction in VFDs in patients admitted to critical care with CS. These findings suggesting potential harm of corticosteroids in CS might reflect unmeasured confounding and require corroboration through additional observational studies and ultimately randomized clinical trials.
Injection of Different Concentrations of Recombinant Humanized Type III Collagen Into the Dermis Promotes Type III and Type I Collagen Deposition as Well as Angiogenesis: An In Vivo Study
Authors: Xiang Haibo , Sun Yimou , Chen Yujie , Wang Guanhuier , Xie Hongbin
Published: January 2025

BACKGROUND

Type III recombinant humanized collagen (rhCol III) has a promising future in cosmetic applications.

OBJECTIVE

To investigate the histological changes associated with injection of different concentrations of Type III rhCol III into the dermis.

MATERIALS AND METHODS

Twenty mice were divided into a control, low-dose (LD) group, and high-dose (HD) group. The animals were euthanized 1, 2, 3, and 4 weeks after the injection.

RESULTS

Injections of rhCol III induced an increase in collagen formation in a concentration-dependent manner. Type I collagen (Col I) was upregulated in both HD and LD groups to varying extents, often similar to that of Col III. Fibroblast proliferation plays an important role in the deposition of Col I and Col III. Injections of rhCol III promoted angiogenesis at later stages, regardless of concentration dependency.

CONCLUSION

Intradermal injections of rhCol III can promote fibroblast proliferation, enhancing the deposition of both Col I and Col III, and stimulating angiogenesis. Further studies are required to elucidate the mechanisms.
Scleral Lens Use in the Management of Ocular Cicatricial Pemphigoid
Authors: Severinsky Boris , Chambers Shae , Shafi Aysha , Behshad Soroosh , Kim Joung
Published: January 2025

Purpose:

Symptom management in Ocular Cicatricial Pemphigoid (OCP) is challenging because of the progressive factors of dry eye, scarring, trichiasis, and vision impairment. We set out to evaluate the benefits and therapeutic effects of scleral contact lenses in the management of OCP.

Methods:

A retrospective review was performed over a database of 20 patients (36 eyes) fitted with scleral lenses (SL) at the Department of Ophthalmology, Emory University from May 2018 to April 2021. The fitting indications, time required for ocular surface stabilization, vision rehabilitation success, and ocular complications were evaluated.

Results:

The mean age was 67.4 (range, 43–81) years, with four to one female to male predominance. The mean duration of the follow-up was 16.5 months (range, 1.5–35). The mean wearing time was 9.0±1.9 hr a day, with no overnight wear permitted. All fitted patients reported a subjective improvement in ocular comfort after initiations of SL wear. The mean keratopathy grading improved from 2.1±0.8 to 1.4±0.7 at the last documented visit. The mean visual acuity improved from 0.56±0.51 (logMAR) to 0.34±0.45; in 46% of patient eyes, visual acuity improved by two or more lines. And 96% of fitted eyes responded well to therapy and continued scleral lens wear. Patients who initially presented with fornix shortening, symblepharon, and trichiasis remained stable.

Conclusions:

SL offer ocular surface preservation, symptom relief, and improved visual acuity in patients with ocular pemphigoid. They should be strongly considered as ancillary therapy in patients with OCP.
The Impact of Ramadan Fasting on Dyspeptic Complaints
Authors: Zekey Fethi Sada , Başak Fatih
Published: January 2025

Objective:

Dyspepsia, a common gastrointestinal issue characterized by upper abdominal discomfort, can be influenced by diet, medication, and lifestyle changes. Ramadan fasting involves refraining from food and drink from dawn to sunset, affecting various physiological processes, including digestion. The fasting period can range from 12 to 18 hours depending on the year, potentially impacting the prevalence of dyspeptic symptoms. This study aimed to assess the effect of fasting on dyspeptic symptoms, taking into account demographic and clinical factors.

Materials and Methods:

A cohort study examined 1258 clinic patients, with 150 meeting specific inclusion criteria. Dyspepsia was diagnosed using Rome IV criteria, with fasting hours taken into consideration. The relationship between dyspepsia, fasting, Non-Steroidal Anti-Inflammatory Drug use, and demographics was analyzed.

Results:

Dyspepsia was more prevalent in females (32%) compared with males (23%), with a higher proportion of non-fasting women among dyspeptic patients. Older patients (>65 y) had a higher prevalence of dyspepsia (P = 0.026). Fasting individuals had a 2.1 times greater likelihood of experiencing dyspeptic symptoms. Although Non-Steroidal Anti-Inflammatory Drug use was lower in fasting patients, no significant association with dyspepsia was observed (P = 0.139).

Conclusion:

Ramadan fasting increases the risk of dyspeptic symptoms, particularly in women and older adults. Factors such as medication timing and dietary changes during fasting may contribute to this risk. Highlighting the importance of the pre-dawn meal (Suhoor) in managing dyspeptic symptoms is essential. Tailored guidance should be provided to individuals at higher risk during Ramadan.
The kinetic parameters of dynamic contrast-enhanced MRI with ultrafast imaging in breast cancer patients receiving neoadjuvant chemotherapy: Prediction of pathologic complete response and correlation with histologic microvessel density
Authors: Choi Sung-Eun , Park Ah Young , Kim Gwang Il , Jung Hae Kyoung , Ko Kyung Hee , Kim Yunju
Published: January 2025

Early prediction of pathologic complete response (pCR) after neoadjuvant chemotherapy (NAC) in breast cancer patients can help forecast prognosis and guide decisions on adjuvant therapy. This study aimed to determine whether the kinetic parameters of dynamic contrast-enhanced MRI (DCE-MRI) with ultrafast imaging can predict pCR following NAC in breast cancer patients and whether these parameters are correlated with histologic microvessel density (MVD). In this retrospective study, 61 breast cancer patients who underwent NAC and surgery between August 2020 and 2022 were analyzed. Ultrafast and conventional DCE-MRI features, along with pathologic results, were compared between the pCR and non-pCR groups. Regression analysis was conducted to identify predictive factors for pCR. Additionally, MRI kinetic parameters were correlated with histologic MVD. Of the 61 patients, 17 (27.9%) achieved pCR. The pCR group exhibited a larger delayed washout component (P = .002) and a smaller angiovolume (P = .02) compared to the non-pCR group; however, these factors lost significance when accounting for tumor size, lymph node status, and molecular subtypes. In a subgroup analysis based on molecular subtype, a low initial enhancement value (≤362.5%) and angiovolume (≤10.3 cc) predicted pCR in human epidermal growth factor receptor 2-enriched breast cancer, with an area under the curve of 0.833. The maximum slope on ultrafast MRI was higher in the high MVD group compared to the low MVD group (P = .049). Human epidermal growth factor receptor 2-enriched breast cancer with low vascularity on DCE-MRI is more likely to achieve pCR, although MRI kinetic parameters were not independent predictors of pCR in all breast cancer subtypes. The maximum slope on ultrafast MRI was the only kinetic parameter that correlated with histologic MVD. Larger studies focused on molecular subtypes are warranted.
Multicentric primary ectopic meningiomas involving lung and cranial bone barrier: A rare case report
Authors: Zhang Huiyang , Li Xiang , Jiang Yan
Published: January 2025

Rationale:

Primary ectopic meningiomas (PEMs) are extremely rare, with limited literature available on the subject. Understanding their clinical and radiological characteristics is crucial for accurate diagnosis and treatment.

Patient concerns:

This study presents a case of a multicentric PEM involving the lungs and cranial bone barrier, aiming to provide new insights into its clinical and diagnostic features.

Diagnoses:

A 46-year-old woman with no prior history of intracranial meningiomas or other tumors was found to have multiple lobulated nodules in the lungs during a routine physical examination. Computed tomography scans revealed well-defined lesions with mild to moderate heterogeneous enhancement. Magnetic resonance imaging showed a lesion at the cranial bone barrier, which presented as a high-signal area on T2-weighted FLAIR images and mild to moderate enhancement on T1-weighted images. The magnetic resonance spectroscopy displayed a broad Lip peak but lacked N-acetylaspartate or creatine peaks. Histopathological and immunohistochemical analyses confirmed the diagnosis of multicentric PEMs.

Interventions:

We performed surgical resection of the lesion on the cranial bone plate and conducted follow-up examinations for the multiple lesions in the lungs.

Outcomes:

This case highlights the diagnostic challenges of multicentric PEMs involving the lungs and cranial bone barrier. Due to their extremely low incidence and nonspecific clinical manifestations, a comprehensive evaluation combining radiological, pathological, and immunophenotypic data is essential for accurate diagnosis.

Lessons:

This case underscores the importance of a thorough, multidisciplinary approach to diagnosis and treatment and provides valuable insights for managing similar rare cases.
Efficacy and mechanism of Qianjinweijing Decoction for asthma: Integrating systematic review with meta-analysis and network pharmacology
Authors: Zhang Limin , Su Jin , Wu Xiaozheng , Chen Yunzhi , Li Wen
Published: January 2025

Background:

Asthma seriously affects people’s survival and quality of life, causing a huge economic burden on society. Modern clinical use of Qianjinweijing Decoction (QJWJ) for the treatment of asthma has achieved good results. However, there is still a lack of research on its efficacy and mechanism of action. Therefore, the purpose of this study is to evaluate the efficacy of QJWJ in the treatment of asthma by systematic review and meta-analysis, and to explore its potential mechanism by network pharmacology.

Methods:

The meta-analysis was performed to search for studies published before May 2023 in 7 databases, and Revman 5.4 and R language softwares were used for analysis. Network pharmacology was based on open databases and softwares such as Cytoscape, Perl, Autoduck Vina, and R language.

Results:

A total of 14 studies were included, involving 1200 patients. The results of the meta-analysis showed that QJWJ could significantly improve the clinical efficacy of asthma patients compared with routine pharmacotherapy (risk ratio = 1.22, 95% CI [1.16, 1.28], P < .00001), enhance lung function, such as FEV1/FVC (mean difference [MD] = 5.63, 95% CI [1.45, 9.81], P = .008), FEV1% (MD = 5.03, 95% CI [4.32, 5.74], P < .00001), PEF (standardized mean difference = 1.37, 95% CI [1.03, 1.71], P < .00001), and increase traditional Chinese medicine syndrome score (MD = −2.50, 95% CI [−4.81, −0.19], P = .03). The results of network pharmacology suggested that the 4 traditional Chinese medicines in QJWJ included 35 active ingredients and 34 potential targets for the treatment of asthma. The core ingredients involved were stigmasterol, β-sitosterol, hederagenin, and gibberellin 7. The core targets were PTGS2, BCL2, and CASP3. The interaction pathway between QJWJ and asthma was mainly enriched in p53, cyclic guanosine monophosphate–protein kinase G, IL-17, and advanced glycation end products-receptor for advanced glycation end products signaling pathways. Molecular docking showed that the core ingredients had good binding activity with the core targets.

Conclusion:

QJWJ is effective in the treatment of asthma, and the therapeutic mechanism may be related to its regulation of inflammation, immunity, and apoptosis.
Pharmacological treatment of pregnancy complications in adults: An overview of phase IV clinical trials
Authors: Allehyani Rawan F. , Alsehli Atheer A. , Saggat Raghad Z. , Aldurdunji Mohammed M. , Alorfi Nasser M.
Published: January 2025

The aim of this review was to provide a review of the pharmacological treatments for pregnancy complications in adults. This review analyzed medications used for pregnancy complications in phase IV clinical trials based on the ClinicalTrials.gov database. The search included completed trials only. As of September 1, 2023, a total of 29,654 phase IV clinical trials were identified, of which 298 were related to pregnancy complications. Of these, 24 clinical trials met the inclusion criteria for the current study. In the 24 included clinical trials, we found 9 trials for overactive bladder with 5005 participants in total, 236 of which had adverse effects from the drugs used. Six trials for preeclampsia were conducted on 663 participants, with only 1 adverse drug effect reported. Three trials each were conducted on urinary tract infections and gestational diabetes mellitus (115 and 656 participants, respectively) without any adverse drug effects reported. One trial each focused on anemia, dystocia, and placentation disorders (80, 1003, and 14 participants, respectively) without any adverse drug effects reported. The trials reported minimal adverse drug effects, suggesting potential effectiveness and safety in managing these complications. While the trials mentioned minimal adverse effects, close monitoring and individualized patient care are essential, as are evaluating the risk–benefit ratio and the specific circumstances of each patient.
Beating the odds: Rare prolonged survival of truncus arteriosus: A case report with literature review
Authors: Amaewhule Obuoma Umejuru , Otaigbe Barbara Edewele , Tabansi Petronila Nnenna , Uwadiale Rosemary Atsosime , Emeruwa Victoria Ezinne , Daniel Faithful Miebaka
Published: January 2025

Rationale:

Truncus arteriosus is a cyanotic congenital heart disease in which the great vessels of the heart fail to separate in utero. Consequently, a single truncal vessel arises from the heart to supply the systemic, coronary, and pulmonary circulations. This lesion causes the total mixing of oxygenated and deoxygenated blood, with an early onset of pulmonary vascular disease. Patients rarely survive beyond the first year of life. This case report highlights a rare survival without intervention up to the ninth year of life.

Patient concerns:

We present the case of a 9-year-old male child with a history of dark discoloration of the lips and digits, easy fatigability, and fast breathing since birth. The patient is currently small for his age, with a bulging anterior chest wall, displaced apex beat, and cardiac murmur. Oxygen saturation was 57% in room air. A chest radiograph showed peri-hilar lymphadenopathy with prominent pulmonary trunks. Pack cell volume was 62%, and the gene expert test was negative.

Diagnoses:

A diagnosis of cyanotic congenital heart disease, truncus arteriosus type III with pulmonary hypertension, was made after diagnostic evaluation with echocardiography.

Interventions:

To manage congestive heart failure, the patient was put on diuretics, including furosemide and spironolactone. Parents could not carry out a definitive surgical repair due to financial constraints.

Outcomes:

Although the patient was able to survive the past year, the child had developed cardiomegaly, signs of pulmonary congestion, decreased oxygenation, and a compensatory increase in red blood cell volume.

Lessons:

Truncus arteriosus is a critical congenital heart defect that has a high potential for morbidity and mortality within the first year of life. It requires immediate intervention and surgical repair in the immediate neonatal period. In rare cases, patients have been able to survive beyond the first year, especially if they also developed pulmonary stenosis. However, this patient had been a survivor for 9 years without another structural anomaly. Given the unique presentation and its rarity, further research is needed into compensatory mechanisms and possible low-cost and accessible alternatives in resource-constrained settings. It also demonstrates that pharmacologic therapy alone is insufficient to prevent mortality.