bluuebunny/crossref_metadata_2025 huggingface dataset:
Progressive extra-articular ankylosis secondary to chronic unilateral dislocation of the temporomandibular joint
Authors: George Johnson Akkarapatty , Kumar Saurabh , Charlu Arun Paul , Koshy Santosh
Published: February 2025

Dislocation of the temporomandibular joint (TMJ) may be due to various reasons. Long-standing dislocation is a rare condition as it is a sequela of unrecognised dislocation, which can lead to ankylosis of TMJ, a rare clinical representation. A male patient in his late 30s reported with a deviated mandible to the left side, occlusal derangement and reduced mouth opening of 1 cm. The radiological investigation showed a bony mass above the normal condylar appearance within the glenoid fossa and extending medially to the base of the skull. Ankylosis release was done with right condylotomy, and removal of the bony mass and right coronoidectomy was done and reconstructed with prosthetic condyle.
Unicentric Castleman disease-associated paraneoplastic pemphigus successfully managed with surgical resection and rituximab
Authors: Kaur Sarabjeet , Singh Charanpreet , Bal Amanjit , Jain Arihant
Published: February 2025

We report a case of a woman in her early 20s who presented with chronic and refractory oro-oesophageal ulcers and significant weight loss. The common causes of refractory ulcers were ruled out. Biopsy from the oesophageal ulcers was suggestive of paraneoplastic pemphigus (PNP). The patient underwent a PET scan that revealed an incidental mass. PET-guided biopsy from the infrarenal mass was suggestive of unicentric Castleman disease (UCD). She was managed with local surgical resection, steroids and rituximab. The current case highlights that PNP can be the presenting manifestation of an underlying UCD. In addition, it also highlights the adjunctive role of rituximab in the management of UCD-associated PNP in patients with suboptimal response to steroids and surgical resection.
Quantification of the relation between continuous glucose monitoring observation period and the estimation error in assessing long-term glucose regulation
Authors: Zoet Stennie , Urgert Thomas , Veldhuis Anouk , van Beijnum Bert-Jan , Laverman Gozewijn D
Published: February 2025

Introduction

The integration of continuous glucose monitoring (CGM) into clinical practice has rapidly emerged in the last decade, changing the evaluation of long-term glucose regulation in patients with diabetes. When using CGM-derived metrics to evaluate long-term glucose regulation, it is essential to determine the minimal observation period necessary for a reliable estimate. The approach of this study was to calculate mean absolute errors (MAEs) for varying window lengths, with the goal of demonstrating how the CGM observation period influences the accuracy of the estimation of 90-day glycemic control.

Research design and methods

CGM data were collected from the DIABASE cohort (ZGT hospital, The Netherlands). Trailing aggregates (TAs) were calculated for four CGM-derived metrics: time in range (TIR), time below range (TBR), glucose management indicator (GMI) and glycemic variability (GV). Arbitrary MAEs for each patient were compared between the TAs of window lengths from 1 to 89 days and a reference TA of 90 days, which is assumed to reflect long-term glycemic regulation.

Results

Using 14 days of CGM data resulted in 65% of subjects having their TIR estimation being below a MAE threshold of 5%. In order to have 90% of the subjects below a TIR MAE threshold of 5%, the observation period needs to be 29 days.

Conclusions

Although there is currently no consensus on what is an acceptable MAE, this study provides insight into how MAEs of CGM-derived metrics change according to the used observation period within a population and may thus be helpful for clinical decision-making.
Systematic review of the barriers and facilitators to the implementation of non-pneumatic antishock garments in low- and middle-income countries: lessons for global health
Authors: Ng Qin Xiang , Yaow Clyve Yu Leon , Tan Hiang Khoon , Ong Marcus Eng Hock , Kosonen Heta , Karlström Jonas
Published: February 2025

Background

Obstetric haemorrhage is a leading global cause of maternal mortality, particularly in rural and resource-poor settings where delays in care are common. Non-pneumatic antishock garments (NASGs) have been proposed as a temporising measure to reduce blood loss and improve survival rates. Despite positive outcomes from clinical trials, the uptake of the NASG has been slow and faced various implementation challenges. This review thus aims to identify and analyse the barriers and facilitators of NASG implementation in low- and middle-income countries (LMICs) using the Consolidated Framework for Implementation Research (CFIR).

Methods

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a comprehensive search strategy was developed to search for studies related to NASG use in Medline, Embase, CINAHL and the Cochrane Library from inception up to August 2024. Grey literature was also reviewed. Two independent reviewers screened identified records using Covidence, assessing relevant studies for inclusion. Data were synthesised using a narrative approach structured around the CFIR’s five domains.

Results

A total of 17 studies were reviewed. Common barriers included high initial procurement costs. Inadequate training and knowledge among healthcare providers were another obstacle, resulting in low confidence in the proper use of NASG. Logistical issues, such as inconsistent supply chains and difficulties in maintaining NASG devices, were highlighted, alongside the challenges posed by under-resourced health infrastructures. Facilitators included effective training programmes, support from health authorities, advocacy by local and national champions, and successful integration into clinical protocols and health systems.

Conclusions

The implementation experience of NASG in LMICs highlights important lessons for stakeholders in the global health space, with challenges such as high initial costs and inadequate training being common obstacles in LMICs. Addressing these barriers and leveraging facilitators (eg, through comprehensive training, garnering local and international support and active sourcing for locally produced materials to reduce costs) across multilevel contexts influence implementation.
Outcomes from the Victorian Healthy Homes Program: a randomised control trial of home energy upgrades
Authors: Page Katie , Hossain Lutfun , Liu Dan , Kim Yo Han , Wilmot Kerryn , Kenny Patricia , Campbell Margaret , Cumming Toby , Kelly Scott , Longden Thomas , van Gool Kees , Viney Rosalie
Published: February 2025

Objectives

The Victorian Healthy Homes Program investigated the impact of thermal home upgrades on energy and health outcomes in vulnerable, older individuals over winter in Victoria, Australia.

Design

A staggered parallel-group randomised control trial design of 984 (764 per protocol (PP)) vulnerable households and 1313 (1015 PP) individuals. The intervention group received their upgrade prior to their winter of recruitment, and the control group received their upgrade after the winter of their recruitment.

Setting

Western Melbourne (metropolitan) and the Goulburn Valley (regional) in Victoria, Australia.

Participants

1000 households were recruited: 800 from western Melbourne (metropolitan) and 200 from the Goulburn Valley (regional).

Intervention

A thermal comfort and home energy efficiency upgrade of up to $AUD3500 per household.

Primary and secondary outcome measures

The primary outcome was the change in indoor temperature over winter and the secondary outcomes were changes in quality of life, healthcare use and costs, self-reported health measures, energy use and costs and humidity.

Results

A relatively low-cost and simple home upgrade (average cost $A2809) resulted in reduced gas consumption (−25.5 MJ/day) and increased indoor winter temperatures (average daily increase of 0.33°C), and a reduction of exposure to cold conditions (<18°C) by an average of 0.71 hours (43 min) per day. The intervention group experienced improved mental health as measured by the short-form 36 mental component summary and social care related quality of life measured by the Adult Social Care Outcomes Toolkit, less breathlessness and lower overall healthcare costs (an average of $A887 per person) over the winter period.

Conclusions

The home upgrades significantly increased average winter indoor temperature, improved mental health and social care-related quality of life and made householders more comfortable while yielding reductions in overall healthcare use and costs.

Trial registration number

Australian and New Zealand Clinical Trials Registry: ACTRN12618000160235.
Postdischarge health information tools and information needs for mothers of vulnerable newborns in low- and middle-income countries: a scoping review
Authors: Rababeh Asma , Paton Chris , Grewal Gulraj , Maina Jackson Michuki , English Mike , Oluoch Dorothy , Fuller Sebastian S , Papoutsi Chrysanthi
Published: February 2025

Objectives

The postdischarge period is crucial for vulnerable newborns at risk of morbidity, readmission and mortality in low- and middle-income countries (LMICs). Addressing gaps in care during this period could improve outcomes. This review consolidates evidence on caregiver information needs and relevant information tools used in postdischarge care for vulnerable newborns in LMICs.

Design

Scoping review using the methodological framework developed by Arksey and O’Malley.

Data sources

We searched six databases for relevant articles published in English between 2001 and 2021. Additional articles were identified through citation and reference checking.

Eligibility criteria

Articles on postdischarge care for newborns in LMICs, excluding economic and technical development studies, discharge to other healthcare facilities (rather than to home) and maternal-focused studies.

Data extraction and synthesis

Data extraction followed Arksey and O’Malley’s data charting method. Using a descriptive synthesis approach, heterogeneous data were collated in narrative format.

Results

From 5190 articles, 22 were included. Only a small number of articles discussed caregiver challenges, like receiving insufficient information at discharge which led to uncertainty in caring for vulnerable newborns. Caregivers had a number of needs in relation to maternal and newborn care, including in terms of coordination of follow-up care. Although a number of tools have been used to support relevant needs (for postnatal care in general rather than specifically for postdischarge care of vulnerable newborns), these have shown mixed effectiveness due to challenges with completeness, lack of training and support, supply chain issues and cultural barriers to adoption, such as preference for alternative providers.

Conclusion

Our understanding of postdischarge information needs for those looking after vulnerable newborns in LMICs remains limited. More effective use of information tools could help address some of these needs and contribute towards reducing neonatal mortality rates.
Sodium valproate, a potential repurposed treatment for the neurodegeneration in Wolfram syndrome (TREATWOLFRAM): trial protocol for a pivotal multicentre, randomised double-blind controlled trial
Authors: Dias Renuka P , Brock Kristian , Hu Kun , Gupta Rajat , Martin Una , Peet Andrew , Wilson Martin , Yu-Wai-Man Patrick , Wright Benjamin , Mollan Susan , Kulkarni Archana , Meunier Isabelle , Billingham Lucinda , Nagy Zsuzsanna , Rose Heather , Koks Sulev , Zatyka Malgorzata , Astuti Dewi , Lynch Tracy , Morrison Karen E , Barton Darren , Cronier Sabrina , Malpass Rebecca , Evans Ruth , Malhi Amandip , Takhar Pooja , Lamb Amy , Esteban-Bueno Gema , Młynarski Wojciech , Orssaud Christophe , Roubertie Agathe , Homer Victoria , Barrett Timothy
Published: February 2025

Introduction

Wolfram syndrome (WFS1-Spectrum Disorder) is an ultra-rare monogenic form of progressive neurodegeneration and diabetes mellitus. In common with most rare diseases, there are no therapies to slow or stop disease progression. Sodium valproate, an anticonvulsant with neuroprotective properties, is anticipated to mediate its effect via alteration of cell cycle kinetics, increases in p21cip1expression levels and reduction in apoptosis and increase in Wolframin protein expression. To date, there have been no multicentre randomised controlled trials investigating the efficacy of treatments for neurodegeneration in patients with Wolfram syndrome.

Methods and analysis

TREATWOLFRAM is an international, multicentre, double-blind, placebo-controlled, randomised clinical trial designed to investigate whether 36-month treatment with up to 40 mg/kg/day of sodium valproate will slow the rate of loss of visual acuity as a biomarker for neurodegeneration in patients with Wolfram syndrome. Patients who satisfied the eligibility criteria were randomly assigned (2:1) to receive two times per day oral gastro-resistant sodium valproate tablets up to a maximum dose of 800 mg 12 hourly or sodium valproate-matched placebo. Using hierarchical repeated measures analyses with a 5% significance level, 80% power and accounting for an estimated 15% missing data rate, a sample size of 70 was set. The primary outcome measure, visual acuity, will be centrally reviewed and analysed on an intention-to-treat population.

Ethics and dissemination

The protocol was approved by the National Research Ethics Service (West of Scotland; 18/WS/0020) and by the Medicines and Healthcare products Regulatory Agency. Recruitment into TREATWOLFRAM started in January 2019 and ended in November 2021. The treatment follow-up of TREATWOLFRAM participants is ongoing and due to finish in November 2024. Updates on trial progress are disseminated via Wolfram Syndrome UK quarterly newsletters and at family conferences for patient support groups. The findings of this trial will be disseminated through peer-reviewed publications and international presentations.

Trial registration number

NCT03717909.
Evaluating stress management approaches, types of social support and postpartum mental health during the COVID-19 pandemic: a cross-sectional study based in the United States
Authors: Williams Peyton , Campbell Sophia , Gildner Theresa E. , Geisel-Zamora Suzanna , Thayer Zaneta
Published: February 2025

Objective

Reduced psychological well-being during the postnatal period may impair a birthing parent’s ability to care for themselves and their child. We investigated stress management approaches, social support types, and the association between perceived social support and postpartum depression (PPD) and postpartum anxiety (PPA) among a cohort of postpartum individuals in the United States who gave birth during the COVID-19 pandemic.

Design

This study uses Wave 3 data from the COVID-19 and Reproductive Effects study. Qualitative data from previous data collection waves were used to define social support types. Multilinear regression models evaluated the association between perceived social support, PPD and PPA.

Setting

An online convenience sample.

Participants

Participants were approximately 12 months postpartum (mean 11.93 months, SD=2.03). Data were collected between July and September 2021.

Results

Complete data were available from 252 postpartum individuals (mean age=32.2 years). Playing with their children, watching television, connecting with others in person, engaging in social media and exercising were the five most commonly reported stress management strategies. Emotional support was the most commonly reported type of social support. Higher perceived social support was associated with lower PPD (B=−1.3, p value <0.0001, 95% CI=–1.7 to –0.8) and PPA (B=−2.3, p value <0.0001, 95% CI=–3.0 to –1.6).

Conclusion

Social support was an important way through which postpartum individuals managed stress during the COVID-19 pandemic. Playing with children, which may have been facilitated by work-from-home policies, and online interactions emerged as surprising adaptations to stress. Policymakers and healthcare systems should consider ways to increase opportunities for birthing parents to engage in these sorts of interactions (eg, extended parental leave policies and interventions to enhance perceived social support), especially during crises. Doing so may improve health outcomes for birthing parents and their children.
Cross-sectional analysis of e-cigarettes, combustible tobacco and their dual use with binge drinking among college students in the USA
Authors: Thornquist Rose , Qeadan Fares
Published: February 2025

Background

Tobacco use is a long-standing epidemic that has caused millions of premature deaths. Electronic cigarette use is rising among young adults, yet few studies have included combustible tobacco, e-cigarettes and their dual use in an analysis of binge drinking among college students. This study aims to calculate the associations between these three forms of tobacco use and binge drinking among college students.

Methods

This cross-sectional study used data from 332 721 college students from the American College Health Association-National College Health Assessment survey. Tobacco use was organised into four groups: no tobacco use, e-cigarette use only, combustible tobacco use only and dual use of e-cigarettes and combustible tobacco. Binge drinking was a binary indication of whether students had engaged in binge drinking in the last 2 weeks. Multiple logistic regression was employed to examine the relationship between tobacco use and binge drinking, adjusting for demographic factors and constructs of the integrated behavioural model.

Results

Each tobacco use group had significantly higher odds of binge drinking compared with students who did not use tobacco. Students who engaged in dual tobacco use had significantly higher odds of binge drinking compared with exclusive combustible tobacco use (adjusted OR, aOR=2.41, 95% CI: 2.29, 2.53) and exclusive e-cigarette use (aOR=1.79, 95% CI: 1.71, 1.86).

Conclusion

The strong relationship between dual tobacco use and binge drinking among college students warrants further investigation into the aetiology and clinical manifestations of this emerging coupled substance use behaviour among the next generation of adults.
Neighbourhood immigrant density and COVID-19 infection and hospitalisation among healthcare workers in Sweden: a register-based observational study
Authors: Nwaru Chioma , Bonander Carl , Li Huiqi , Santosa Ailiana , Löve Jesper , Nyberg Fredrik
Published: February 2025

Introduction

We investigated whether living in immigrant-dominated neighbourhoods constituted a risk factor for COVID-19 infection and hospitalisation among healthcare workers (HCWs) in Sweden, and if so, whether such exposure exacerbated the risk of COVID-19 among immigrant HCWs.

Methods

We used population-based register data from HCWs aged 20–62 years (N=86 187) resident in 14 Swedish municipalities (3 of which are Sweden’s largest metropolitan cities) on 1 January 2020. Residential neighbourhoods of the HCWs were categorised into three groups: Swedish-dominated, mixed and immigrant-dominated. Multilevel mixed-effects survival regression was used for the association analyses, with control for relevant confounding variables. The results are reported as HRs, with 95% CIs.

Results

From 1 January 2020 to 30 September 2022, we recorded 39 746 COVID-19 infections and 860 COVID-19-related hospitalisations. Except during the first wave of the pandemic, living in immigrant-dominated (adjusted HR 0.98; 95% CI 0.94 to 1.01) or mixed (adjusted HR 1.02; 95% CI 0.99 to 1.05) neighbourhoods was not associated with COVID-19 infection, but living in these areas was associated with an increased risk of having COVID-19-related hospitalisation throughout the study period. Immigrant HCWs, regardless of their neighbourhood of residence, had approximately 2-fold higher risk of being hospitalised for COVID-19 than non-immigrant HCWs living in Swedish-dominated neighbourhoods.

Conclusions

Among HCWs in Sweden, neighbourhood immigrant density constituted a risk factor for COVID-19-related hospitalisation. However, immigrant HCWs had an elevated risk of COVID-19-related hospitalisation regardless of where they lived.
Childhood socioeconomic position and healthy ageing: results from five harmonised cohort studies in the ATHLOS consortium
Authors: Wu Yu-Tzu , Gnanapragasam Sam , Sanchez-Niubo Albert , Hossin Muhammad Zakir , Grünberger Ilona , Koskinen Seppo , Cooper Rachel , Prina Matthew
Published: February 2025

Introduction

Childhood socioeconomic position (SEP) has been identified as a key determinant of health. However, earlier literature is largely from high-income countries and provides limited evidence on the prolonging impacts of childhood disadvantage on healthy ageing across diverse settings and populations. The aim of this study is to investigate the associations between childhood SEP and healthy ageing across multiple countries and the mediation effects of adult SEP, individual education and wealth, on these associations.

Methods

Using the harmonised dataset of five cohort studies in the Ageing Trajectories of Health-Longitudinal Opportunities and Synergies (ATHLOS) project, this study was based on 57 956 people aged ≥50 years (women: 53.3%) living in China, Finland, UK, Poland, South Africa and Mexico. The associations between childhood SEP (parental education and occupation) and healthy ageing scores were examined using linear regression modelling. Causal mediation analysis was carried out to estimate the percentage of indirect effects via adult SEP (individual education and wealth).

Results

Higher levels of childhood SEP were associated with higher healthy ageing scores by up to five points and similar patterns were observed across populations from different countries. The associations were mediated by adult SEP and the range of mediation effects was between 21% and 78%.

Conclusions

This study found childhood SEP was associated with poor health in later life across high-income, middle-income and low-income countries. Addressing socioeconomic disadvantage, such as improving education attainment, may moderate the impacts of adversity in early life and support health and functioning in later life.
Experiences of abortion in the UK Armed Forces: a cross-sectional survey
Authors: Kinkaid Victoria Elizabeth , Guest Ruth , Willman Antony , King Kate
Published: February 2025

Background

Abortion is a common pregnancy outcome; in the UK one in three women will have an abortion by age 45 years. Despite women making up 11.7% of the UK Armed Forces (UKAF), anecdotal voices from patient groups and clinicians highlight their gender-specific health needs not being addressed by the UKAF. There is a worldwide absence of literature and policy on abortion care in the AF, including rates and experiences. This survey addresses the paucity of data on abortion experiences in UK servicewomen to ensure the UKAF is providing the best possible care for them.

Methods

A REDCap survey was circulated among UK servicewomen via email and social media networks, and snowball distribution was utilised to widen participation. Quantitative data were used for descriptive statistics and qualitative data were analysed iteratively by the authors, with regular meetings to agree on themes.

Results

A total of 427 servicewomen responded: 124 (29%) declared they previously had an abortion, with 102 (23.9%) being in service. Twelve (11.8%) of these abortions were required when on deployment. Four key themes emerged: ‘Trust in information holders’, ‘Influencers, barriers and access’, ‘Systemic lack of awareness’ and ‘Life in the military’.

Conclusions

This is the first study to collect data on UK servicewomen’s experience around abortion care, and highlights a complex interplay of factors which may influence abortion care decisions. Stigma and judgement were pervasive threads running through all themes, negatively impacting UKAF women. Evidence-based policies and information on abortion are recommended for both servicepeople and healthcare professionals to facilitate access to abortion and begin to destigmatise it in the AF.
Exploring the association between a periodic safe-ride program and urban alcohol-impaired driving crashes in Quebec, Canada: a cross-sectional time-series analysis
Authors: Mamri Asma , Nazif-Munoz José Ignacio , Brown Thomas Gordon , Ouimet Marie Claude
Published: February 2025

Introduction

In Canada, alcohol-impaired driving is a persistent public health concern in need of effective community-based prevention strategies. This study examined the association between the number of rides offered by a safe-ride program in the province of Quebec every December and alcohol-related injury crashes during the 2000–2019 period.

Method

Safe-ride programs in four cities were examined (Montreal, Quebec, Sherbrooke and Trois-Rivières) using an ecological approach. The data set was structured as a balanced cross-sectional time series. Random-effects negative binomial regression modelled the relationship between the number of rides provided by the safe-ride program and night-time alcohol-related crashes involving serious injuries and fatalities, with individual city population as an offset variable.

Results

The median number of night-time alcohol-related crashes for the months of December for the 2000–2019 period was 3.0 (IQR=1.5–4.5). The median number of rides offered was 16 894 (IQR=15 586–18 391). The association between the number of rides provided by the safe-ride program and night-time alcohol-related crashes (IRR=1.0002; 95% CI 0.9999, 1.0005) was not significant.

Conclusion

The role of the number of rides provided by the safe-ride program in reducing night-time alcohol-related crashes was inconclusive. Specific program features may influence the findings. Future research is needed to understand the specific characteristics of safe-ride programs that could influence their putative benefits.
Targeting pyroptosis reverses KIAA1199-mediated immunotherapy resistance in colorectal cancer
Authors: Li Lisha , Zhao Lei , Zhou Diwei , Yu Yuanhang , Zhang Peiyi , Zheng Jinge , Lin Zhenyu , Yu Dandan , Ren Jinghua , Zhang Jing , Zhou Pengfei , Zhang Dejun , Zhang Tao
Published: February 2025

Background

Despite advancements in treatment modalities, several patients with colorectal cancer (CRC) remain unresponsive to immune checkpoint inhibitor therapy. Pyroptosis, an inflammatory programmed cell death process, holds substantial promise for tumor immunotherapy. In this study, we explored the use of pyroptosis to overcome immunotherapy resistance in CRC.

Methods

We used a pyroptosis-related gene panel to construct an immunotherapy efficacy evaluation model and validated its performance by immunohistochemical staining of CRC patient samples. Pyroptosis and its underlying mechanisms were examined both in vitro and in vivo using PCR, western blotting, lactate dehydrogenase release assay, ELISA, co-immunoprecipitation, immunohistochemistry, fluorescence cell assays, microscopic imaging, flow cytometry analysis and bioinformatics approaches.

Results

We established a model to define high or low levels of pyroptosis in CRC, revealed that low pyroptosis led to immunotherapy resistance, and identified KIAA1199 as a characteristic protein of low pyroptosis CRC. We further demonstrated that KIAA1199 contributes to low pyroptosis, resulting in resistance to immunotherapy. Mechanistically, KIAA1199 bound to and stabilized DNA methyltransferase-1 (DNMT1), thereby inhibiting GSDME-mediated pyroptosis. Importantly, our study highlighted that decitabine reversed KIAA1199-mediated immunotherapy resistance by enhancing pyroptosis to restore IL-1B release and CD8+T cell infiltration.

Conclusions

We found a critical role of KIAA1199 in promoting immunotherapy resistance by suppressing pyroptosis via the DNMT1/GSDME pathway in CRC. Decitabine has emerged as a promising therapeutic agent for reversing KIAA1199-mediated immunotherapy resistance by enhancing pyroptosis. Our findings provide valuable insights for enhancing the efficacy of immunotherapy in patients with CRC who exhibit resistance to conventional immunotherapy approaches.
Comparison of drug-coated balloon with bare-metal stent in patients with symptomatic intracranial atherosclerotic stenosis: the AcoArt sICAS randomized clinical trial
Authors: Ma Gaoting , Sun Dapeng , Jia BaiXue , Ling Li , Nguyen Thanh N , Sun Xuan , Yu Bo , Wen Changming , Cheng Tao , Chen Wenhuo , Han Ju , Han Hongxing , Guo Geng , Yu Jianghua , Wei Liping , Huang Rui , Mao Gengsheng , Shen Qingyu , Yang Xinguang , Wang Bo , Luo Gang , Huo Xiaochuan , Gao Feng , Mo Dapeng , Ma Ning , Miao Zhongrong
Published: February 2025

Background

Restenosis after stenting with a standard bare-metal stent (BMS) is the main cause of stroke recurrence for symptomatic intracranial atherosclerotic stenosis (sICAS). Whether a drug-coated balloon (DCB) could reduce the risk of restenosis for such patients is unknown. We aimed to investigate the efficacy and safety of DCB in reducing 6 month restenosis in patients with sICAS.

Methods

A prospective, multicenter, randomized, open-label, blinded endpoint clinical trial was conducted at 13 stroke centers across China. Eligible patients aged 18–80 years with sICAS defined as a recent transient ischemic attack (<180 days) or ischemic stroke (14–180 days) before enrollment attributed to a 70–99% atherosclerotic stenosis of a major intracranial artery were recruited between June 4, 2021 and September 15, 2022 (final follow-up: April 13, 2023). Patients were randomly assigned to receive a DCB (n=90) or BMS at a 1:1 ratio. The primary outcome was the post-procedure incidence of restenosis in the target lesion at 6 months (165–225 days). The safety outcome was post-procedure target vessel-related stroke (hemorrhage or ischemia) or death at 30 days.

Results

Among 201 randomized patients, 180 were confirmed eligible (mean age 58 years) and completed the trial. Compared with BMS, DCB was associated with a lower rate of post-procedure incidence of restenosis in the target lesion at 6 months (6.9% vs 32.9%, OR 0.15, 95% CI 0.05 to 0.42, P=0.0003). Regarding the safety outcome, post-procedure target vessel-related stroke (hemorrhage or ischemia) or death at 30 days did not differ between the two groups (4.4% vs 5.6%, OR 0.79, 95%CI 0.21 to 3.05, P=0.73).

Conclusion

DCB was superior to BMS in reducing the incidence of restenosis without increasing the risk of target vessel-related stroke or death within 6 months. Further trials comparing the outcomes of DCB with medical management for sICAS are warranted.

Trial registration number

ClinicalTrials.gov Identifier:NCT04631055.
Rising tide of middle meningeal artery embolization for chronic subdural hematomas: current volumes and future growth compared with cerebral aneurysm and stroke interventions
Authors: Rai Ansaar T , Link Paul S , Lakhani Dhairya A
Published: February 2025

Background

To estimate the current number of middle meningeal artery embolization (MMAE) procedures for subdural hematomas (SDH) and project growth compared with endovascular treatments for cerebral aneurysms and acute ischemic stroke (AIS).

Methods

Estimates of SDH admissions were obtained from the National Inpatient Sample and Medicare Inpatient 100% Standard Analytic Files for 2019–23. MMAE volumes (2019–23) were estimated by cross referencing international classification of diseases, 10th revision, clinical modification (ICD-10 CM) codes for non-acute, non-traumatic SDH with ICD-10 procedure coding system (ICD-10 PCS) codes for surgical and endovascular interventions during the same admission to approximate MMAE volumes. These estimates were compared with volumes of endovascular cerebral aneurysm and AIS treatments, with projections based on historical growth rates.

Results

MMAE procedures increased significantly, from 4014 in 2019 to 20 836 in 2023, representing a 51% compound annual growth rate (CAGR). In comparison, endovascular aneurysm treatments grew from 34 754 to 42 491 (5% CAGR) and AIS procedures from 34 451 to 44 822 (7% CAGR). In the next 5 years, MMAE is projected to surpass other neurovascular procedures, with an estimated 79 483 procedures, compared with 79 405 for AIS and 56 942 for aneurysms, by 2029. Annual SDH admissions remained steady at just over 200 000 from 2019 to 2022, with most (~66%) managed medically. Only an estimated 2% of SDH admissions received an MMAE procedure in 2019, rising to 8% in 2022.

Conclusion

MMAE procedures have seen rapid adoption and may become the dominant neurovascular intervention, with potential implications for healthcare infrastructure and workforce planning.
Impact of fish consumption on disability progression in multiple sclerosis
Authors: Johansson Eva , Guo Jie , Wu Jing , Olsson Tomas , Alfredsson Lars , Hedström Anna Karin
Published: February 2025

Background

Emerging evidence indicates that diet, including fish consumption, may play a role in the development and progression of multiple sclerosis (MS). We aimed to investigate the influence of fish consumption on disability progression in MS.

Methods

Incident cases from the population-based case-control study Epidemiological Investigation of MS (n=2719), with data on fish intake and Expanded Disability Status Scale (EDSS) outcomes, were categorised by fish consumption and followed up to 15 years post-diagnosis through the Swedish MS registry. A digital follow-up questionnaire in 2021 assessed changes in fish intake over time (n=1719). Cox regression models, adjusted for clinical and demographic variables, were used to evaluate 24-week confirmed disability worsening (CDW), and progression to EDSS 3 and EDSS 4.

Results

Higher total consumption of lean and oily fish at diagnosis was associated with a reduced risk of CDW (HR 0.66, 95% CI 0.51 to 0.86), EDSS 3 (HR 0.55, 95% CI 0.39 to 0.79) and EDSS 4 (HR 0.57, 95% CI 0.33 to 0.96) compared with low consumption. These associations showed significant trends and remained consistent after further adjustment for various lifestyle factors. The protective effects were more pronounced among patients who maintained consistent fish consumption during the follow-up period.

Conclusions

Our findings suggest that higher fish consumption is associated with more favourable MS disability progression, supporting diet as a potentially modifiable factor. Replication and validation are needed before transfer to practice.
Mortality patterns of SLE and the associated risk factors in Korean patients: a nationwide cohort study
Authors: Cho Soo-Kyung , Jeon Yena , Kim Jung-hyo , Jang Eun Jin , Jung Sun-Young , Sung Yoon-Kyoung
Published: February 2025

Background

To evaluate the mortality patterns of SLE and the associated risk factors in Koreans.

Methods

Using the National Health Insurance database spanning 2008 to 2018, incident cases of SLE in patients aged 10–79 years were included. We analysed the all-cause mortality and cause-specific mortality, stratifying by sex and age. The mortality rate (MR) was calculated as the number of deaths per 100 000 person-years (PYs). The causes of death were identified by the International Classification of Diseases, 10th Revision codes during hospitalisation or emergency visit prior to death. A generalised estimating equation model was employed for risk factor analysis.

Results

In total, 11 375 incident SLE cases among patients with an average age of 42.3±16.7 years were recruited (86.1% female). During 57 658 PYs, 728 deaths occurred (MR 1262.62/100 000 PYs). The MR among men (2718.86/100 000 PYs) exceeded that among women (1060.57/100 000 PYs). The leading causes of death were SLE-related conditions (381.56/100 000 PYs), cardiovascular disease (CVD) (202.92/100 000 PYs), cancer (175.17/100 000 PYs) and infection (143.95/100 000 PYs). Of the SLE-related mortality, the key risk factors were pulmonary complications, such as pulmonary alveolar haemorrhage (OR 9.93), pulmonary arterial hypertension (OR 3.77) and interstitial lung disease (OR 3.27).

Conclusions

Among Korean patients with SLE, SLE-related conditions were the leading causes of mortality. However, CVD and cancer were also identified as the main causes of mortality. Furthermore, pulmonary manifestations were significantly associated with SLE-related mortality.
Factors associated with poor pain experience after surgery
Authors: Maurice-Szamburski Axel , Rozier Romain , Gridel Victor , Radev Vladimir , Badia Emmanuelle , Loundou Anderson , Auquier Pascal , Capdevila Xavier
Published: February 2025

Objective

To identify factors associated with poor postoperative pain experience by examining patient-related and procedural variables.

Methods

An exploratory secondary analysis was conducted on data from 971 adult patients undergoing elective surgery under general anesthesia across five French teaching hospitals. Preoperative anxiety was assessed using the Amsterdam Preoperative Anxiety and Information Scale (APAIS). Pain, sleep quality and well-being were measured preoperatively and postoperatively using visual analog scales (VAS). The primary endpoint was the patient experience measured by the Evaluation du Vécu de l'Anesthésie Generale (EVAN-G) questionnaire on postoperative day 1, with poor pain experience defined as a score below the 25th percentile on the EVAN-G pain dimension. Univariate and multivariate logistic regression analyses were performed to identify factors associated with poor pain experience.

Results

Poor pain experience was reported by 271 patients (27.9%). Multivariate analysis identified intraoperative use of remifentanil and sufentanil as an independent predictor of poor pain experience with an OR of 26.96 (95% CI 2.17 to 334.23, p=0.01). Additionally, age (OR 0.97, p=0.003), absence of premedication (OR 0.49, p=0.035) and orthopedic surgery (OR 0.29, p=0.005) were associated with a lower likelihood of poor pain experience. Conversely, American Society of Anesthesiologists (ASA) 3 status (OR 5.09, p=0.028), postoperative anxiolytic use (OR 8.20, p<0.001), amnesia (OR 1.58, p=0.001), higher VAS pain (p<0.001) and lower well-being scores (p=0.007) on day 1 were predictors of poor pain experience.

Conclusion

The intraoperative use of remifentanil and sufentanil is independently associated with poorer postoperative pain experience. These findings highlight the need to reassess intraoperative analgesic strategies to enhance patient outcomes and reduce postoperative complications.
WDR4 promotes colorectal cancer progression by activating the GSK3β/β-catenin pathway
Authors: Wang Hongyu , Liang Liyang , Wang Yanfei , Zhong Xuan , Zhang Chao , Liu Zhipeng , Liu Jinzhong , Hu Wanning
Published: February 2025

WD repeat domain 4 (WDR4) has been reported to promote tumor metastasis in various cancers. However, its precise function in colorectal cancer (CRC) have not been reported yet. Herein, the expression pattern of WDR4 in CRC were determined by analyzing Gene Expression Omnibus datasets (GSE110225, GSE127069, GSE156355, and GSE184093) and GEPIA online dataset. In vitro and in vivo experiments, including CCK-8, colony formation, flow cytometry, wound healing, transwell assays, and xenograft mouse models, were used to investigate the role of WDR4 in CRC. Firstly, data from Kaplan-Meier database showed that high expression of WDR4 was associated with the poor prognosis of CRC patients. Then, upregulation of WDR4 was confirmed in clinical CRC tissues. in vitro functional experiments suggested that overexpression of WDR4 promoted cell proliferation, migration and invasion, while knockdown of WDR4 has the opposite effects. Also, the oncogenic role of WDR4 was also verified in in vivo experiments. CO-IP-LC/MS analysis uncovered that GSK3β is the central protein that binds to WDR4. Mechanistically, WDR4 activated the β-catenin pathway by promoting GSK3β phosphorylation. This study demonstrates that WDR4 promotes CRC progression through activating GSK3β/β-catenin pathway, indicating that WDR4 might be a potential therapeutic target for CRC treatment.
A role for NFIB in SOX2 downregulation and epigenome accessibility changes due to long-term estrogen treatment of breast cancer epithelial cells
Authors: Abatti Luis E , Gillespie Zoe E , Lado-Fernández Patricia , Collado Manuel , Mitchell Jennifer A
Published: February 2025

Estrogen (E2) regulates the differentiation and proliferation of mammary progenitor cells by modulating the transcription of multiple genes. One of the genes that is downregulated by E2 is SOX2, a transcription factor associated with stem and progenitor cells that is overexpressed during breast tumourigenesis. To elucidate the mechanisms underlying E2-mediated SOX2 repression, we investigated epigenome and transcriptome changes following short- and long-term E2 exposure in breast cancer cells. We found that short-term E2 exposure reduces chromatin accessibility at the downstream SOX2 SRR134 enhancer, decreasing SOX2 expression. In contrast, long-term E2 exposure completely represses SOX2 transcription while maintaining accessibility at the SRR124–134 enhancer cluster, keeping it poised for reactivation. This repression was accompanied by widespread epigenome and transcriptome changes associated with commitment towards a more differentiated and less invasive luminal phenotype. Finally, we identified a role for the transcription factor NFIB in this process, suggesting it collaborates with the estrogen receptor to mediate SOX2 repression and genome-wide epigenome accessibility changes.
Improvement of the Geotechnical Properties of Remoulded Quick Clay with Recycled Salt Mixtures
Authors: Loshelder Julia Irene , Ånes Eivind W. , Ritter Stefan , Peikli Ingrid , Bergan Simen , Okkenhaug Gudny
Published: February 2025

The instability of quick clay is a contributing factor for landslides within Scandinavia, Canada, and Russia. The addition of salts into quick clay is known to improve the remoulded shear strength and liquid limit. In this study, the mixing of salts recycled from waste incineration fly ash into remoulded quick clay was studied and compared with the incorporation of pure salts for applications in salt wells and for excavation applications. The salts were added as solutions at low concentrations and as solids at high concentrations and stored for 1, 28 or 90 days before testing. Nearly all samples with added salts had a liquid limit that exceeded the water content and a remoulded shear strength which exceeded 0.5 kPa. The pure potassium chloride had the largest effect, followed by the recycled chloride mixture with the highest concentration of K+. While a change in the geotechnical properties was immediately evident upon the mixing, the effect on the shear strength increased further with increasing storage time. The findings imply that the recycled salts may be used to improve the geotechnical properties of excavated soft clays during the handling and transport to landfills as a viable and low-emission alternative to cementitious binders.
Evaluation of a decade of management of a North American aquatic invasive species (Nitellopsis obtusa) highlights scale-dependent effectiveness and monitoring gaps
Authors: Glisson Wesley J. , Nault Michelle , Jurek Chris , Fischer Eric , Lund Keegan , Bloodsworth Cattoor Kylie , Londo April , Kovar Nicole , Hauck-Jacobs Emelia , Egdell Rod , McComas Steve , Fieldseth Eric , Larkin Daniel J.
Published: February 2025

Nitellopsis obtusa (starry stonewort) is an invasive macroalga subject to substantial control efforts in the Midwestern United States; however, there has not been systematic evaluation of treatment effectiveness. We synthesized management approaches and outcomes using monitoring performed over a decade-long period across 38 lakes in Indiana, Wisconsin, and Minnesota. Copper-based algaecide treatments were the primary means of control, followed by physical removal methods or combination treatments. Control efforts and associated monitoring data varied by spatial scale, as did surveyors’ N. obtusa sampling methods. At the largest (whole-lake) scale, we found no evidence that algaecide treatments were slowing expansion or reducing abundance of N. obtusa within infested lakes. At smaller, within-lake scales, we found that algaecide and physical treatments could reduce N. obtusa frequency and biomass, but outcomes were highly variable. At the smallest scales, hand pulling was an effective containment strategy for small, localized populations that were detected early. These results highlight the need to set realistic goals for N. obtusa control and develop improved management techniques. There were also critical gaps in monitoring that limited our ability to evaluate treatment effectiveness. In particular, increased monitoring of unmanaged reference lakes and untreated areas within managed lakes is needed.
Modeling N-ary Relational Knowledge Bases with Tensor Decomposition
Authors: Liu Yu , Yao Quanming , Li Yong
Published: February 2025

The binary relational knowledge base (KB, a.k.a. knowledge graph), representing real-world knowledge with binary relations and entities, has been an important research topic in artificial intelligence, while, considerable knowledge also involves beyond-binary relations. Recently, the area proposes to model n-ary relational KBs with both binary and beyond-binary relations included. However, most current models are extended from translational distance and neural network models in binary relational KBs, which suffer from weak expressiveness and high complexity respectively. To overcome such issues, in this work, we propose a novel two-step modeling framework, GETD, generalizing the powerful tensor decomposition technique from binary relational KBs to the n-ary case. For n-ary relational KBs with single-arity relations, the GETD framework introduces Tucker decomposition and Tensor Ring decomposition for expressive and efficient modeling. Furthermore, the framework is technically extended for the representation of n-ary relational KBs with mixed-arity relations. The existing negative sampling technique is also generalized to the n-ary case for GETD. In addition, we theoretically prove that the GETD framework is fully expressive to completely represent any KBs. Empirical results on two representative datasets show that the proposed framework significantly outperforms the state-of-the-art methods, achieving 11%-26% and 4%-7% improvements on Hits@10 for the single-arity and the mixed-arity cases respectively.
FishFormer: Annulus Slicing-based Transformer for Fisheye Rectification
Authors: Yang Shangrong , Lin Chunyu , Liao Kang , Zhao Yao
Published: February 2025

Numerous significant progress on fisheye image rectification has been achieved through CNN. Nevertheless, constrained by a fixed receptive field, the global distribution and the local symmetry of the distortion have not been fully exploited. To leverage these two characteristics, we introduce FishFormer that processes the fisheye image as a sequence to enhance global and local perception. We tune the Transformer according to the structural properties of fisheye images. First, the uneven distortion distribution in patches generated by the existing square slicing method hinders the understanding of the global structure. Therefore, we propose an annulus slicing method to maintain the consistency of the distortion in each patch, thus, the applicability of Transformer is expanded to perceive the distortion distribution efficiently. Second, the distortion of adjacent patches is progressive. Such explicit correlations in local regions need to be rapidly constructed and maintained, but Transformer has a weakness in local area perception. Hence, a novel layer attention mechanism is introduced to enhance the local perception and feature interaction. Our network simultaneously implements global perception and focused local perception. Extensive experiments demonstrate that our method provides superior performance compared with state-of-the-art methods.