bluuebunny/crossref_metadata_2025 huggingface dataset:
Perioperative Chemo-Immunotherapy in Non-Oncogene-Addicted Resectable Non-Small Cell Lung Cancer (NSCLC): Italian Expert Panel Meeting
Authors: de Marinis Filippo , Ardizzoni Andrea , Attili Ilaria , Bonanno Laura , Bria Emilio , Cortinovis Diego Luigi , Margaritora Stefano , Mazzoni Francesca , Mercadante Edoardo , Morabito Alessandro , Petrella Francesco , Rea Federico , Salvi Rosario , Solli Piergiorgio , Spaggiari Lorenzo , Voltolini Luca , Gridelli Cesare
Published: February 2025

Background: Immunotherapy (IO)-based strategies have been demonstrated to significantly prolong survival in the perioperative setting of non-oncogene-addicted non-small cell lung cancer (NSCLC). The adoption of such strategies in clinical practice depends on heterogeneous regulatory approvals and on the agreement between medical oncologists and thoracic surgeons on patients’ selection. Methods: An Expert Panel Meeting of medical oncologists and thoracic surgeons was held virtually by the Italian Association of Thoracic Oncology (AIOT) to discuss results of pivotal clinical trials with perioperative chemo-immunotherapy and reach agreement on open issues for the topic, formulating specific statements based on initially proposed discussion questions. Results: Overall, panelists found agreement on seven statements. With regard to tissue and biomarker analysis, the role of increasing PD-L1 expression in predicting IO efficacy was recognized, whereas ctDNA and pCR were mainly attributed a prognostic role, in the absence of dedicated studies. The panelists acknowledged direct relationship between the benefit of neoadjuvant chemo-immunotherapy approaches and the local burden of disease/mediastinal node involvement, supporting the inclusion of these factors, together with PD-L1, in selecting upfront surgery or induction treatment. The panelists agreed that the current literature data do not answer the issue of assessing the role of the adjuvant phase within a perioperative treatment strategy. Surgical considerations on the role of pneumonectomy and other approaches were also discussed. Conclusions: This experience highlights the importance of a synergistic approach between oncologists and surgeons to leverage the unmet needs in translating results of IO-perioperative clinical trials into clinical practice in patients with resectable NSCLC.
Overview of Marine Protected Areas and Sites of Particular Biodiversity Value in the Adriatic—Ionian Region (EUSAIR)
Authors: Sovinc Andrej , Kržič Anja
Published: February 2025

Marine protected areas (MPAs) are an important tool for conserving biodiversity and ensuring the sustainable use of marine ecosystem services. This study examines the extent of MPAs in the Adriatic-Ionian region (EUSAIR). The analysis focuses on nationally designated marine protected areas and Natura 2000 sites (their marine parts), as well as areas of biodiversity importance that are not officially protected. With a marine area of 484,017 km2, the EUSAIR region has 46 nationally designated marine protected areas and 348 Natura 2000 marine protected areas as of 2021, which together represent a protected area of 16,347 km2 or 3.4% of the region’s total marine area. However, strictly protected areas of IUCN categories I and II account for only 0.07% of the region’s marine area, highlighting a significant gap in achieving global and EU biodiversity targets. In addition, around 30.75% of the marine area is classified as important for biodiversity based on various conservation instruments, but is not legally protected. These findings underline the urgent need for enhanced protection, improved management and stricter conservation measures to achieve the targets of the Kunmingand Montreal Global Biodiversity Frameworks and the EU Biodiversity Strategy 2030, which aims to have 30% of marine areas protected and 10% under strict protection by 2030. Achieving the EU biodiversity targets by 2030 will require a significant expansion of MPAs in the EUSAIR region and intensified efforts to designate new MPAs, integrate existing areas of high biodiversity and ensure effective management consistent with biodiversity conservation objectives.
Role of Pelvic Ultrasound in Predicting the Response to Neoadjuvant Chemotherapy in Locally Advanced Cervical Cancer
Authors: Perniola Giorgia , Paoni Saccone Giulia , Tonti Noemi , Tanzi Federica , Palaia Innocenza , Di Donato Violante , Tomao Federica , Muzii Ludovico , Bogani Giorgio , Cuccu Ilaria , Ciminello Enrico , Battaglia Francesco Antonio , Santangelo Giusi
Published: February 2025

Background/Objectives: The optimal treatment for locally advanced cervical cancer (LACC) is debated. The proposed treatments are concomitant chemoradiotherapy plus brachytherapy (cCTRT-B) or neoadjuvant chemotherapy (NACT) followed by radical surgery (RS). The prediction NACT response is crucial for identifying responder patients who may benefit from subsequent radical surgery. The aim of this study was to find ultrasound characteristics to predict the response to NACT in patients with LACC. Methods: Consecutive patients with diagnoses of LACC were prospectively enrolled. According to FIGO staging criteria, all IB2-IIIC patients underwent three cycles of platinum-based NACT followed by radical surgery. Patients were evaluated by pelvic ultrasound one week before NACT (T0) and three weeks after the last cycle of chemotherapy (T1). The parameters analysed were volume of the lesion, tumor/uterus volume ratio, parametrial infiltration, color score, resistance (RIUA) and pulsatility (PIUA) indices of uterine arteries (UA). Results: From July 2019 to April 2023, 40 patients were enrolled. A significant decrease in tumor volume (p < 0.01) and a reduced parametrial infiltration after NACT were observed (p < 0.01). The results of the unadjusted and adjusted logistic models showed that age and RIUA positively affect the estimated probability of treatment response (p < 0.01). According to the univariate and multivariate model, RIUA greater than 0.72 ensures 87% sensitivity and 70% specificity with 82.5% accuracy in predicting tumor reduction. Conclusions: Patients over 54 with a RIUA above 0.72 are more likely to respond to NACT. Pelvic ultrasound proved to be a useful tool for predicting NACT response in LACC patients.
Comparative Performance Evaluation of Continuous Monitoring Blood Culture Systems Using Simulated Septic Specimen
Authors: Ahn Kwangjin , Lee Taesic , Hwang Sangwon , Seo Dong Min , Uh Young
Published: February 2025

Background/Objectives: Continuous monitoring blood culture systems (CMBCSs) are revolutionary automated instruments that facilitate the rapid identification of pathogens in blood samples from patients with sepsis. However, with only a few CMBCSs being widely used as references, user dependency on these limited options has grown. In response, a new CMBCS was developed and compared with existing systems to evaluate microbial growth. Methods: HubCentra84 was compared to BacT/Alert® 3D and BACTEC™ FX. Staphylococcus aureus, Streptococcus pneumoniae, Escherichia coli, Pseudomonas aeruginosa, Bacteroides fragilis, and Candida albicans were selected as representative clinically infectious microorganisms. Colonies from pure cultures were diluted with 0.9% saline to create simulated sepsis specimens (SSSs). The SSSs were injected into dedicated culture bottles for each instrument. Thirty paired tests were performed for each strain. Results: Colony-forming units of the added SSSs were consistent according to bacteria, and all strains demonstrated robust growth in three CMBCSs. Time-to-positivity was uniformly observed according to the instruments used. The novel CMBCS detected the growth of the clinically significant bacteria S. aureus, S. pneumoniae, E. coli, and P. aeruginosa approximately 2 h faster than the other two systems. However, it was approximately 200 min slower for C. albicans and 3000 min for B. fragilis. Conclusions: The novel CMBCS demonstrates advantages in detecting the growth of common clinical bacteria. Although slow growth was detected for certain microorganisms, it successfully captured the growth of all tested microorganisms.
Determination and Comparison of the Pathogen Spectrum Evaluated by Microbial Culture and Multiplex PCR During Bronchoscopy with Regard to Clinical Utility of Routine Bronchial Wash in Patients with Various Pulmonary Diseases
Authors: Milacek Christopher , Bal Christina , Starzengruber Peter , Zehetmayer Sonja , Idzko Marco , Gompelmann Daniela
Published: February 2025

Background/Objectives: Bronchial wash for microbiological cultivation and/or multiplex polymerase chain reaction (PCR) is often routinely performed during bronchoscopy independent of the indication for bronchoscopy. This study aimed to determine and compare the pathogen spectrum evaluated by culture and PCR in bronchial secretion samples with regard to the underlying lung pathology. Methods: In this retrospective analysis, microbiological results from bronchial washes performed from February 2022 to September 2022 were collected in 245 patients (48.2% male, mean age 63.0 ± 13.9 years). Samples were assessed for bacteria/fungi culture and reported depending on the underlying pathology. Additional PCR was performed in 216 patients and compared to the results of the culture. Results: Cultivation and PCR revealed positive results in 20% and 24.5% of the cases, respectively. Microbiological culture most likely revealed a positive result in patients with hemoptysis (44.4%) and pulmonary infections (29.6%) among various indications for bronchoscopy, and PCR most likely identified a pathogen in patients with hemoptysis (66.7%) and COPD (36.4%). Active smoking and an increased CRP were revealed as significant predictors for a positive culture (p < 0.0001 and p = 0.021). The concordance rate between culture and PCR for identifying pathogenic microorganisms was 84.3%, resulting in a moderate agreement (kappa coefficient 0.54 [95% CI: 0.34–0.68]). Conclusion: PCR and culture moderately agreed, showing additional PCR testing only to be beneficial if restricted to proper indications, providing rapid diagnosis and therefore leading to immediate therapeutic decisions.
Paradoxical Reaction to Antituberculosis Therapy Mimicking Tumor Progression in Lung Cancer Patient
Authors: Choi Eunkyoung , Chung Yong-An , Kim Ju Sang , Oh Jinkyoung
Published: February 2025

We describe the case of a 67-year-old man with lung cancer, who developed pulmonary tuberculosis (TB) following chemotherapy and subsequently exhibited a paradoxical reaction on positron emission tomography/computed tomography (PET/CT) after initiating antituberculosis therapy. While pulmonary consolidations improved with antituberculosis treatment, newly detected hypermetabolic mediastinal lymph nodes appeared on PET/CT. Based on the clinical course, we provisionally concluded that the mediastinal lymphadenopathy represented a paradoxical reaction. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) confirmed the diagnosis of TB. Clinicians added steroids and continued the antituberculosis medication, and follow-up PET/CT showed complete resolution of these lesions. This case highlights the importance of recognizing paradoxical reactions to antituberculosis therapy, when restaging PET/CT reveals divergent findings, with some tumor foci responding and other lesions appearing to be progressing.
Nutritional Status of Adult People Living with HIV: A Narrative Review
Authors: Proikaki Stella , Georgiadis Nikolaos , Sergentanis Theodoros N. , Kornarou Eleni , Vassilakou Tonia
Published: February 2025

Background: The interaction between HIV infection, nutrition and immune system functioning is intricate, leading, in many cases, to a cycle of poor health outcomes. Despite the widespread use of highly active antiretroviral therapy (HAART) since the late 1990s and the concomitant increase in the life expectancy of people living with HIV (PLHIV), malnutrition and HIV-associated wasting continue to pose significant challenges, particularly in developing countries. Additionally, metabolic adverse effects associated with HAART, such as alterations in bone and lipid metabolism, as well as the impact on cardiovascular health, add further complexity to patient care. Methods: We conducted a comprehensive literature review of relevant studies involving adults diagnosed with HIV. The studies, published between 2000 and 2023, were identified using the Medline/PubMed, Scopus and Google Scholar databases. Results: Accumulating evidence in the literature indicates that careful monitoring and appropriate nutritional interventions can significantly enhance clinical outcomes in malnourished HIV-positive persons. The importance of addressing the prevalent deficiencies in certain micronutrients discussed in many of the studies is clearly underlined. However, challenges remain, particularly in low-income settings, where limited resources and infrastructure can impede effective implementation. Conclusions: There are critical research gaps with regard to the interaction between ART and nutrition, as well as the development of tailored nutritional approaches that aim to improve patient outcomes. Future research directions and policy strategies should focus on the development of sustainable programmes aimed at enhancing the quality of life for PLHIV.
Combined Surgical and Orthodontic Treatment of Complex Odontoma in Growing Patients: Presentation of Two Cases
Authors: Muczkowska Natalia , Czochrowska Ewa , Masłowska Klaudia , Wojtowicz Andrzej , Popowski Wojciech
Published: February 2025

Background/Objectives: Odontomas are the most common mixed odontogenic tumors and may cause impaction of adjacent teeth and masticatory disorders. Treatment of tooth impaction caused by the presence of odontomas is related to their stages of root development and their positions in the alveolar bone. The aim of this case report is to present the combined surgical and orthodontic treatment in growing patients with odontomas and to discuss the treatment outcomes. Methods: Two growing patients, an 8-year-old boy and a 17-year-old girl, with large odontomas in the posterior maxillary region of the maxilla were presented. The tumors were found during a radiological examination, and the first molars on the affected sides were impacted due to the presence of odontomas. Results: The treatment plans included the surgical removal of the tumors. In the case of the younger patient, the impacted developing molar erupted spontaneously in the oral cavity one year and two months after surgery. An orthodontic traction of the impacted molar was successfully applied in the older patient. Conclusions: The presence of a large odontoma in the posterior segments may lead to a displacement and impaction of neighboring molars and malformation of their roots. Spontaneous eruption of the affected molar can be expected if the tumor is diagnosed and removed early before its root formation is completed; otherwise, an orthodontic extrusion is needed. Interdisciplinary cooperation is important to diagnose and plan the dental treatment in young patients with odontomas.
SAluMC: Thwarting Side-Channel Attacks via Random Number Injection in RISC-V
Authors: Dang Shibo , Shao Yunlong , Li Zhida , Makanju Adetokunbo , Gulliver Thomas Aaron
Published: February 2025

As processor performance advances, the cache has become an essential component of computer architecture. Moreover, the rapid digital transformation of daily life has resulted in electronic devices storing greater amounts of sensitive information. Thus, device users are becoming more concerned about the security of their personal information, so improving processor performance is no longer the sole priority. Hardware vulnerabilities are generally more difficult to detect and address compared to software viruses and related threats. A common technique for exploiting hardware vulnerabilities is through side-channel attacks. They can bypass software security to extract personal information directly from hardware components like the cache or registers. This paper introduces a novel architecture for the arithmetic logic unit (ALU) and associated memory controller (MC) based on the RISC-V microarchitecture to mitigate side-channel attacks. The proposed approach employs hardware-generated random numbers and has minimal design costs, negligible impact on the original system structure, seamless integration, and easy modification of internal components. Results are presented that show it is effective against side-channel attacks.
Quantum Thermometry for Ultra-Low Temperatures Using Probe and Ancilla Qubit Chains
Authors: Ullah Asghar , Upadhyay Vipul , Müstecaplıoğlu Özgür E.
Published: February 2025

We propose a scheme to enhance the range and precision of ultra-low temperature measurements by employing a probe qubit coupled to a chain of ancilla qubits. Specifically, we analyze a qubit chain governed by Heisenberg XX and Dzyaloshinskii–Moriya (DM) interactions. The precision limits of temperature measurements are characterized by evaluating quantum Fisher information (QFI). Our findings demonstrate that the achievable precision bounds, as well as the number of peaks in the QFI as a function of temperature, can be controlled by adjusting the number of ancilla qubits and the system’s model parameters. These results are interpreted in terms of the influence of energy transitions on the range and the number of QFI peaks as a function of temperature. This study highlights the potential of the probe qubit–ancilla chain system as a powerful and precise tool for quantum thermometry in the ultra-low temperature regime.
Mastery Motivation, Mastery Pleasure, and Self-Concept in Singing of Students in Specialized and Non-Specialized Music Classes
Authors: Kovács Katalin , Janurik Márta , Oo Tun Zaw , Szabó Norbert , Józsa Krisztián
Published: February 2025

This study aimed to investigate differences in mastery motivation (MM), mastery pleasure (MP), and self-concept (SC) in singing based on class type (specialized non-specialized music classes) and gender across four grades: 1, 3, 5, and 7. It also explored the relationships between students’ demographic variables and the fundamental motivational factors in music education such as MM, MP, and SC. A survey questionnaire was administered to 586 elementary students in grades 1, 3, 5, and 7 in Hungary. The findings showed that the students from specialized music classes had higher MM, MP, and SC compared to those from non-specialized classes. Female students demonstrated higher MM, MP, and SC in signing across all grades, 1, 3, 5, and 7. Moreover, a negative correlation between grade and these factors showed that the younger students had higher MM, MP, and SC in singing than the older students. Demographic factors such as gender, grade, and class type, except for parental education, significantly influenced students’ development in MM, MP, and SC in singing. This study highlights the importance of specialized music education and early engagement in developing MM, MP, and SC in singing, suggesting that appropriate approaches based on age and gender could enhance students’ musical development.
Stage- and Tissue-Specific Expression of MET1 and CMT2 Genes During Germination in Abies koreana E.H.Wilson
Authors: Hong Sun-cheon , Jeon Koeun , Kang Kyu-suk
Published: February 2025

Abies koreana E.H.Wilson (Korean fir), an endangered high-altitude conifer native to South Korea, is facing severe population decline due to climate change and low germination rates. While ecological factors have been studied, the genetic and epigenetic mechanisms underlying its seed development are still poorly understood. DNA methylation, regulated by MET1 and CMT2, plays a critical role in the stability of gene expression during seed development. This study investigates the expression patterns of MET1 and CMT2 across 12 developmental stages, from pre-germination to post-germination, with a focus on shoot and root tissues. RNA-seq data were analyzed to identify MET1 and CMT2, and expression patterns were validated using RT-qPCR. MET1 showed high sequence conservation with conifers such as Pinus sylvestris, indicating potential conservation of CG methylation mechanisms among conifer species. CMT2 showed lower sequence conservation across species, indicating reduced evolutionary conservation compared to MET1. Tissue-specific analysis showed MET1 being predominantly active in shoots during cotyledon development, while CMT2 was upregulated in roots at later stages. These findings highlight the dynamic and tissue-specific roles of DNA methylation in the seed development of A. koreana, contributing to a better understanding of the genetic and epigenetic mechanisms involved in its germination and early growth.
Wildfire Impacts Pinus tabulaeformis Forests on Soil Properties, Actinobacteriota, and Enzyme Activity in Northern China: Direct Effects or Mutual Interactions?
Authors: Liu Guanhong , Li Bingyi , Li Jia , Gu Ze , Liu Xiaodong
Published: February 2025

Wildfires are significant disturbances that reshape soil ecosystems, impacting soil properties, microbial communities, and enzyme activities. In Pinus tabulaeformis forests in northern China, the effects of wildfire on soil health, particularly on Actinobacteriota and enzymatic functions, remain poorly understood. This study investigates both the direct and indirect effects of fire severity on these factors and examines how fire-induced changes in soil properties mediate microbial and enzymatic responses. Our findings show that wildfire significantly alters soil chemical properties, including an increase in soil pH and a reduction in organic carbon and water content, particularly under high fire severities. These changes directly impact microbial communities, with Actinobacteriota showing resilience under light and moderate fire intensities but declining under high severity, especially in subsoil layers. Soil enzymes, such as urease and protease, played a crucial role in mitigating the negative impacts of fire on nutrient cycling. Their activity promoted nutrient availability, aiding ecosystem recovery, even as fire intensity reduced overall soil fertility. Structural Equation Modeling (SEM) further revealed that the relationships between fire severity, soil properties, Actinobacteriota, and enzyme activity are shaped by both direct thermal effects and complex indirect interactions mediated by changes in soil moisture and nutrient levels. This study underscores the importance of considering both direct fire effects and the mutual interactions between soil properties, microbial communities, and enzymatic activities in post-fire recovery. The findings highlight that while high-severity fires disrupt soil health and microbial dynamics, soil enzymes can help regulate these impacts by enhancing nutrient cycling and supporting ecosystem stability. These insights contribute to a better understanding of wildfire-induced soil degradation and provide actionable strategies for enhancing post-fire soil restoration and microbial management in fire-prone ecosystems.
Digestion Characteristics and Probiotic Activity of An Tea Polysaccharides: Promoting Lactobacillus and Bifidobacterium In Vitro and In Vivo
Authors: Sun Yuning , Li Sichen , Cao Jie , Peng Huihui , Liu Yuexin , Bai Fuqing , Peng Chuanyi , Cai Huimei , Xie Zhongwen , Li Daxiang , Chen Guijie
Published: February 2025

An tea is highly valued for its unique post-fermentation process, which enriches its flavor and aroma. In this study, the digestion and fermentation characteristics of An tea polysaccharides (ATPSs) were investigated in vitro. The results indicated that the molecular weight and sugar content of ATPSs remained unchanged during simulated saliva, gastric, and small intestinal digestion but were reduced during fermentation, suggesting that ATPSs could pass the digestive system and be metabolized by the gut microbiota. Notably, ATPSs modulated the gut microbiota, reducing pathogenic bacteria such as Desulfovibrio and Escherichia, while enhancing beneficial genera like Lactobacillus, Bifidobacterium, and Prevotella, alongside an increase in short-chain fatty acids (SCFAs). In vivo experiments on C57BL/6J mice demonstrated that ATPSs promoted the levels of Lactobacillus and Bifidobacterium. These findings suggest that ATPSs could serve as a potential prebiotic to improve human health by modulating the gut microbiota.
Effect of Food Matrix on Regulation of Intestinal Barrier and Microbiota Homeostasis by Polysaccharides Sulfated Carrageenan
Authors: Shang Xuke , Guo Juanjuan , Chen Peilin
Published: February 2025

Carrageenan (CGN) has side effects on the intestinal barrier. Damage to the intestinal barrier is associated with exposure to sulfate groups. Food matrix has significant influence on the exposure quantity of sulfate groups and conformation in κ-CGN, but the corresponding side effects are not reported specifically. This study aimed to explore the regulatory effect of κ-CGN dissolved in aqueous (κ-CGN) and in 3% casein (κ-carrageenan-casein, κ-CC) on the intestinal barrier and microbiota homeostasis. Research has shown that both κ-CGN and κ-CC can induce different extents of intestinal barrier damage through disrupting microbiota homeostasis. Importantly, κ-CGN in casein with lower sulfate groups content was found to repair the intestinal barrier injury induced by an equivalent dose of κ-CGN aqueous through increasing the abundance of Oscillibacter and decreasing Weissella. These alleviating effects were reflected in lower levels of tumor necrosis factor (TNF)-α and C-reaction protein (CRP), higher levels of interleukin (IL)-10, raised secretion of mucus and goblet cells, and improved expression of epithelial cell compact proteins zonula occluden (ZO)-1 and mucin protein 2 (MUC2). This study states that κ-CGN in casein has a positive regulatory effect on the intestinal barrier damage compared to in aqueous solution, which can provide guidance for processing and utilization of CGN.
Tau Imaging: Use and Implementation in New Diagnostic and Therapeutic Paradigms for Alzheimer’s Disease
Authors: Gogola Alexandra , Lopresti Brian J. , Minhas Davneet S. , Lopez Oscar , Cohen Ann , Villemagne Victor L.
Published: February 2025

Alzheimer’s disease (AD) affects an estimated 6.9 million older adults in the United States and is projected to impact as many as 13.8 million people by 2060. As studies continue to search for ways to combat the development and progression of AD, it is imperative to ensure that confident diagnoses can be made before the onset of severe clinical symptoms and new therapies can be evaluated effectively. Tau positron emission tomography (PET) has emerged as one method that may be capable of both, given its ability to recognize the presence of tau, a primary pathologic hallmark of AD; its usefulness in determining the spatial distribution of tau, which is necessary for differentiating AD from other tauopathies; and its association with measures of cognition. This review aims to evaluate the scope of tau PET’s utility in clinical trials and practice. Firstly, the potential of using tau PET for differential diagnoses, distinguishing AD from other dementias, is considered. Next, the value of tau PET as a tool for staging disease progression is investigated. Finally, tau PET as a prognostic method for identifying the individuals most at risk of cognitive decline and, therefore, most in need of, and likely to benefit from, intervention, is discussed.
The Association Between Preoperative Physical Activity and Postoperative Surgical Outcomes and Survival Following Pelvic Exenteration
Authors: Campbell Patrick , Solomon Michael , Koh Cherry , Lee Peter , Austin Kirk , Whitehead Lilian , Pillinger Neil , Karunaratne Sascha , Steffens Daniel
Published: February 2025

Introduction: Pelvic cancers present significant health challenges and often require aggressive treatment strategies. Pelvic exenteration, which involves the resection of multiple pelvic organs, is currently the only curative option for advanced or recurrent pelvic malignancies. Due to its extensive nature, it carries a high risk for postoperative complications and extended hospital stays. Current evidence suggest that improved preoperative fitness is associated with better postoperative outcomes. This study explored the relationship between preoperative self-reported physical activity levels and surgical outcomes following pelvic exenteration. Methods: This retrospective cohort study included consecutive adult patients undergoing pelvic exenteration at Royal Prince Alfred Hospital between May 2017 and December 2023. Eligible participants completed the International Physical Activity Questionnaire—Short Form (IPAQ-SF) preoperatively. Primary outcomes included postoperative morbidity, length of hospital stay, and survival. Univariate and multivariate logistic regression analyses explored the association between preoperative physical activity and postoperative outcomes. Results: A total of 256 participants were included, of which 115 (44.9%) were classified as active. Active patients experienced fewer postoperative complications (p = 0.047) and shorter hospital stays (p = 0.007), compared to inactive participants. There was no significant association between preoperative physical activity levels and survival outcomes (p = 0.749). Younger age, preoperative physical activity level, and advanced primary malignancy were significantly associated with fewer complications and shorter hospital stays. Conclusions: Higher levels of preoperative physical activity is associated with fewer postoperative complications and shorter hospital stays in patients undergoing pelvic exenteration. These findings support the potential benefits of incorporating prehabilitation programs to improve surgical outcomes and reduce healthcare costs.
Screening for Left Ventricular Hypertrophy Using Artificial Intelligence Algorithms Based on 12 Leads of the Electrocardiogram—Applicable in Clinical Practice?—Critical Literature Review with Meta-Analysis
Authors: Makowska Agata , Ananthakrishnan Gayathri , Christ Michael , Dehmer Matthias
Published: February 2025

Background/Objectives: The increasing utilization of artificial intelligence (AI) in the medical field holds the potential to address the global shortage of doctors. However, various challenges, such as usability, privacy, inequality, and misdiagnosis, complicate its application. This literature review focuses on AI’s role in cardiology, specifically its impact on the diagnostic accuracy of AI algorithms analyzing 12-lead electrocardiograms (ECGs) to detect left ventricular hypertrophy (LVH). Methods: Following PRISMA 2020 guidelines, we conducted a comprehensive search of PubMed, CENTRAL, Google Scholar, Web of Science, and Cochrane Library. Eligible studies included randomized controlled trials (RCTs), observational studies, and case–control studies across various settings. This review is registered in the PROSPERO database (registration number 531468). Results: Seven significant studies were selected and included in our review. Meta-analysis was performed using RevMan. Co-CNN (with incorporated demographic data and clinical variables) demonstrated the highest weighted average sensitivity at 0.84. 2D-CNN models (with demographic features) showed a balanced performance with good sensitivity (0.62) and high specificity (0.82); Co-CNN models excelled in sensitivity (0.84) but had lower specificity (0.71). Traditional ECG criteria (SLV and CV) maintained high specificities but low sensitivities. Scatter plots revealed trends between demographic factors and performance metrics. Conclusions: AI algorithms can rapidly analyze ECG data with high sensitivity. The diagnostic accuracy of AI models is variable but generally comparable to classical criteria. Clinical data and the training population of AI algorithms play a critical role in their efficacy. Future research should focus on collecting diverse ECG data across different populations to improve the generalizability of AI algorithms.
The Role of Nurses Caring for Children Diagnosed with Sickle Cell Anemia and Their Families in a Hospital Setting: A Rapid Review of the Recent Literature
Authors: Freitas Eduarda , Loura David , Inês Mariana , Martins Carla , Duarte Inês
Published: February 2025

Background: Sickle cell anemia (SCA) affects a significant number of children worldwide, for whom the progression of the disease can lead to functional disability-impaired development. Nurses are pivotal in providing holistic care to these children and their families. This review aims to identify recent evidence on the role of nurses in intervening with children with SCA and their families in a hospital setting. Methods: A rapid review reported under the PRISMA methodology was carried out in the CINAHL, MEDLINE, and Scopus databases with the expression (sickle cell anemia OR sickle cell disease) AND (child* OR family OR pediatric*) AND (nurs* OR “nursing interventions” OR “pediatric nursing”) AND (hospital*), considering studies between 2019 and 2024, written in English, identifying articles with insights about the role of nurses in this context. Articles other than primary or secondary studies were excluded. Data were analyzed through a rapid qualitative approach. Results: Fifty-two studies were identified and seventeen articles were included. The nurse’s role is key and multidisciplinary, focusing on the child and family (care management and therapeutic education), the team (training, and the promotion of safety and quality of care), and the health system (optimizing access to care and promoting adequate resources for its implementation). Such a role is important for short-term clinical problems and to prevent long-term complications. Conclusions: Nurses play a central role in empowering families and coordinating multidisciplinary care. Greater investment is needed at a clinical level, through a more effective response to the needs of these patients, and in research, through experimental studies and other designs focused on multidisciplinary interventions.
Knowledge, Attitudes, and Practices of Occupational Therapists in Promoting Oral Health: A Protocol for Mixed-Methods Systematic Review
Authors: Tse Ming Nam , Coxon Kristy , Chandio Navira , Nair Shruti , George Ajesh , Bye Rosalind , Wong Grace , Tran Carol , O'Reilly Maria , Ekanayake Kanchana , Arora Amit
Published: February 2025

Background/Objectives: Poor oral health is a significant global public health concern that adversely affects an individuals’ overall health and general well-being. Occupational therapists are well-suited to promote oral health by supporting activities of daily living (ADLs), thereby improving clients’ oral health outcomes. However, there is limited evidence on the knowledge, attitudes, and practices (KAPs) of occupational therapists regarding oral health, as well as the barriers and facilitators they face in delivering oral healthcare. Methods: This paper outlines a protocol for a mixed-methods systematic review aimed at synthesizing the current evidence on the KAPs of occupational therapists related to oral health, as well as the barriers and facilitators they encounter in promoting it. The upcoming systematic review will follow the Joanna Briggs Institute (JBI) methodology for mixed-methods systematic reviews using a convergent integrated approach to synthesis and integration. The review will include quantitative, qualitative, and mixed-methods studies that report on KAP, barriers, and facilitators associated with occupational therapists’ involvement in oral healthcare. A comprehensive search will be conducted across multiple databases, including MEDLINE (Ovid), CINAHL (EBSCO), SCOPUS, EMBASE (Ovid), and OTseeker to identify relevant studies. Two reviewers will independently screen the studies for eligibility, assess their methodological quality, and extract key data for synthesis. The protocol adheres to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines and is registered with PROSPERO (CRD42024522136). Results: The findings from the planned systematic review are expected to provide valuable insights into the role of occupational therapists in promoting oral health, addressing barriers and facilitators, and shaping policies, training programs, and clinical practices. Conclusions: Ultimately, these findings aim to enhance the integration of oral health into occupational therapy and improve client outcomes.
Virtual 3D Reconstruction Hypothesis of the Mural Decorations in the Sala de los Amores, Castulo Archeological Site (Linares, Jaén, Spain)
Authors: Carrasco-Huertas Ana , Calero-Castillo Ana I. , Domínguez Rubio David , López-Martínez Teresa
Published: February 2025

The advancement of digital techniques and reduced costs have greatly facilitated their integration into cultural heritage preservation. These technologies are especially valuable in archaeology, where detailed documentation is crucial. However, minimal intervention in restorations often limits public understanding of archaeological spaces, making digital tools essential for enhancing engagement. An example is the study and the virtual hypothesis of the mural decorations in the Sala del Mosaico de los Amores, located in the Castulo Archaeological Site (Linares, Jaén, Spain), dated to the late first and early second centuries AD. The hall originally featured an elaborate wall decoration, now largely lost due to the collapse of its walls, leaving only a few fragments in situ. Using SfM photogrammetry, the hall and the original paintings and cornices—restored in a laboratory—were documented and virtually reassembled. This process employed precise color calibration and dimensional scaling to ensure the faithful recreation of the original appearance. In addition to the anastylosis of the surviving fragments, a virtual reconstruction hypothesis was developed, offering the public an immersive visualization of how the space would have looked in its original state.
What Is New in Altitude- and Cold-Related Illnesses of Travel: Appraisal and Summary of the Updated Guidelines from the Wilderness Medical Society
Authors: Omidi Arghavan , Hawley Gregory D. , Kain Dylan , Jazuli Farah , Meconnen Milca , Polemidiotis Mark , Do Nam Phuong , Egbewumi Olamide , Boggild Andrea K.
Published: February 2025

Wilderness medicine is a rapidly evolving field and has benefited from expanded research efforts. Moreover, with an escalating occurrence of severe and cataclysmic global climatologic events, human illness arising from interaction with wilderness and recreational environments warrants increasing consideration. Within the last decade, the Wilderness Medical Society (WMS) has aggregated research findings and created guidelines on prevention measures and therapeutic options for acute altitude illness, frostbite injuries, and avalanche and non-avalanche snow burials. As new research emerges, some guidelines have been updated to reflect the most current and sound scientific conclusions. In this review, we have synthesized the evidence-based guidelines and have reviewed the quality of the guidelines according to the Appraisal of Guidelines for Research and Evaluation (AGREE) II framework. Further research efforts can expand the scope of evidence-based practice in travel medicine and ideally standardize the implementation of recommendations within both pre-travel and post-travel medical practices.
Why Do Primary Care Patients Change Their Physicians: An Overview of the Literature
Authors: Ribeiro Mariana Cardoso , Martins Elisa , Prazeres Filipe
Published: February 2025

Primary healthcare has an important role in a patient’s long-term health. While patients in most countries are free to change their family physician, fragmented care leads to higher healthcare costs, more preventable hospitalizations, and an increased likelihood of deviation from clinical best practice. This review aims to identify the main reasons patients change family doctors, summarize the factors influencing these decisions, and highlight areas in healthcare that can be improved to increase patient satisfaction and design better services. An electronic search of the literature was conducted in March 2023 in PubMed and Embase databases for articles in English, French, Portuguese, or Spanish published from 1980 to March 2023. A thematic synthesis approach was applied to the included studies, involving systematic analysis of their findings to identify and categorize analytical themes. Nineteen relevant studies were identified. The following themes were identified as reasons to change family physicians: doctor–patient relationship; consultation schedule and convenience; referrals and positive references; medication and treatment issues; practice management and cost; personal preferences and physician characteristics; and accessibility and distance. The identified themes can serve as valuable targets for developing interventions aimed at enhancing the quality of care provided to patients.
The Aryl Hydrocarbon Receptor (AHR): Peacekeeper of the Skin
Authors: Dawe Hannah R. , Di Meglio Paola
Published: February 2025

In the last decade, the aryl hydrocarbon receptor (AHR) has emerged as a critical peacekeeper for the maintenance of healthy skin. The evolutionary conservation of AHR implied physiological functions for this receptor, beyond the detoxification of man-made compounds, a notion further supported by the existence of physiological AHR ligands, notably derivates of tryptophan by the host and host microbiome. The UV light-derived ligand, 6-formylindolo[3,2-b]carbazole (FICZ), anticipated a role for AHR in skin, a UV light-exposed organ, where physiological AHR activation promotes a healthy skin barrier and constrains inflammation. The clinical development of tapinarof, the first topical AHR modulating drug for inflammatory skin disease, approved by the FDA for mild-to-moderate psoriasis and poised for approval in atopic dermatitis, supports the therapeutic targeting of the AHR pathway to harness its beneficial effect in skin inflammation. Here, we describe how a tightly controlled, physiological activation of the AHR pathway maintains skin homeostasis, and discuss how the pathway is dysregulated in psoriasis and atopic dermatitis, identifying areas offering opportunities for alternative therapeutic approaches, for further investigation.
Advances in Host–Pathogen Interactions in Tuberculosis: Emerging Strategies for Therapeutic Intervention
Authors: Nasiri Mohammad J. , Venketaraman Vishwanath
Published: February 2025

Tuberculosis (TB) remains one of the most challenging infectious diseases, with Mycobacterium tuberculosis (Mtb) employing sophisticated mechanisms to evade host immunity and establish persistent infections. This review explores recent advances in understanding Mtb’s immune evasion strategies; granuloma dynamics; and emerging immunotherapeutic approaches. Key findings highlight the manipulation of host autophagy; metabolic reprogramming; and cytokine pathways by Mtb to sustain its survival within host cells. Insights into granuloma formation reveal the critical role of bacterial lipids; immune modulation; and hypoxia-driven dormancy in maintaining chronic infection. Innovative therapeutic strategies, including host-directed therapies; epigenetic interventions; and immunomodulators, hold promise for improving TB management and combating drug-resistant strains. Despite these advancements, significant challenges remain, including the development of effective vaccines; addressing latent TB; and ensuring equitable access to novel treatments. The integration of advanced technologies such as artificial intelligence and multi-omics approaches, alongside global collaboration, is essential to overcome these hurdles. This review underscores the importance of a multidisciplinary approach to tackling TB, with the ultimate goal of eradicating this global health threat.
Platelets Modulate Leukocyte Population Composition Within Perivascular Adipose Tissue
Authors: Corken Adam , Weinkopff Tiffany , Wahl Elizabeth C. , Sikes James D. , Thakali Keshari M.
Published: February 2025

Perivascular adipose tissue (PVAT) regulates vascular tone and is composed of adipocytes and several leukocyte subpopulations. Diet can modify PVAT function, as obesogenic diets cause morphological changes to adipocytes and skew the leukocyte phenotype, leading to PVAT dysregulation and impaired vasoregulation. Of note, platelets, the clot-forming cells, also modulate many facets of leukocyte activity, such as tissue infiltration and polarity. We aimed to determine whether platelets regulate the leukocyte populations residing within PVAT. Male C57Bl/6J mice were fed a Western diet (30% kcal sucrose, 40% kcal fat, 8.0% sodium) to develop obesogenic conditions for PVAT leukocyte remodeling. Diet was either administered acutely (2 weeks) or extended (8 weeks) to gauge the length of challenge necessary for remodeling. Additionally, platelet depletion allowed for the assessment of platelet relevance in PVAT leukocyte remodeling. Abdominal PVAT (aPVAT) and thoracic PVAT (tPVAT) were then isolated and leukocyte composition evaluated by flow cytometry. Compared to control, Western diet alone did not significantly impact PVAT leukocyte composition for either diet length. Platelet depletion, independent of diet, significantly disrupted PVAT leukocyte content with monocytes/macrophages most impacted. Furthermore, tPVAT appeared more sensitive to platelet depletion than aPVAT, providing novel evidence of platelet regulation of leukocyte composition within PVAT depots.
OsEL2 Regulates Rice Cold Tolerance by MAPK Signaling Pathway and Ethylene Signaling Pathway
Authors: Wu Jiacheng , Cao Xufeng , Sun Xingzhuo , Chen Yulin , Zhang Peng , Li Yanting , Ma Chuan , Wu Lingli , Liang Xin , Fu Qiuping , Li Lihua , Zhu Jianqing , Jia Xiaomei , Ye Xiaoying , Zhu Jun , Chen Rongjun
Published: February 2025

Low temperature stress represents a significant abiotic stress factor affecting rice yields. While the structure and some of the functions of cell cycle protein-dependent protein kinase inhibitor (CKI) family proteins have been the subject of study, their relevance to cold tolerance in rice has been less investigated. In this study, we cloned OsEL2 (LOC_Os03g01740) and constructed anti-expression lines of this gene. The resulting lines exhibited significant cold sensitivity and displayed greater oxidative damage than wild type Nippobare (Nip). However, the activities of antioxidant enzymes, such as catalase (CAT), were significantly elevated in OsEL2-AX plants in comparison to Nip following exposure to 4 °C stress. RNA sequencing revealed the presence of 18,822 differential genes, with the majority of them being expressed with temporal specificity. The Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis revealed that a considerable number of differentially expressed genes (DEGs) are involved in the metabolism of amino acids, lipids, and terpenoids. Weighted gene co-expression network analysis (WGCNA) revealed a close relationship between the genes in the turquoise and light green modules and rice cold tolerance traits. These genes were predominantly enriched in terpene metabolism and the metabolism of various plant secondary metabolites, suggesting that OsEL2 influences rice cold tolerance through the metabolism of these two classes of substances. An analysis of the genes within these two modules using transcription factor (TF) enrichment and KEGG enrichment revealed that they are predominantly regulated by mitogen-activated protein kinase (MAPK) and ethylene signaling pathways. Furthermore, we found that tryptophan metabolism, phenylalanine metabolism, and monoterpene synthesis were enriched in down-regulated pathway enrichment analysis. In addition, we also found that the MAPK signaling pathway was enriched in the KEGG enrichment analysis of AX2 with Nip. The results demonstrate that anti-expression of OsEL2 is associated with a notable decline in rice tolerance to cold stress.