bluuebunny/crossref_metadata_2025 huggingface dataset:
The financial relationship network and ESG value creation: A study of multiple networks considering the coupling effect
Authors: Ji Yuanpu , Zhang Chen , Zhu Jing , Zhao Jingsong
Published: February 2025

Resources and pressure from shareholders or creditors are important influencing factors and opportunities for enterprises to achieve excellence in Environmental, Social and Governance (ESG) value creation. This study constructs multiple networks to characterize the financial relationships among enterprises, shareholders, and creditors, examining their impact and coupling effect on ESG value creation. We find that financial relationship networks are crucial for ESG value creation, with local and global network characteristics affecting ESG outcomes in opposing ways and varying across ESG dimensions. Notably, the ESG value effect of the shareholder network is more significant than that of the creditor network. Increasing interaction between shareholder and creditor relations in multiple networks positively impacts ESG value creation, similar to the effect in a single network. Financing constraints play an indirect role in the relationship, with the value creation impact depending on agency costs. For enterprises with low market competitiveness, the ESG value effect of multiple financial networks is more pronounced than for those with high market competitiveness. This study provides a decision reference for enterprises to build relationship networks with shareholders and creditors and to fulfill the positive ESG governance role of the network.
Prognostic impact of oligometastases in orthopaedic surgery for metastatic bone disease
Authors: Weschenfelder Wolfram , Weschenfelder Friederike , Spiegel Christian , Schrenk Karin Gabriela , Ernst Thomas , Hofmann Gunther Olaf
Published: February 2025

Introduction

The rising number of cancer patients with metastatic bone disease (MBD) reflects advancements in treatment. The concept of oligometastatic disease, associated with improved prognosis, has emerged. This study evaluated prognostic factors, including oligometastases, in patients undergoing urgent orthopaedic surgery for MBD to inform preoperative decision-making and reduce morbidity and mortality from immobilization.

Materials and Methods

We retrospectively analysed records of patients who underwent surgery for MBD between 2005 and 2022. Data included medical history, tumour type, metastatic status, surgical method, lesion location, imaging, and survival outcomes. Multivariate survival analyses were conducted.

Results

The number of metastases and presence of visceral metastases significantly influenced survival. Patients with single metastases had a median survival of 65 months, oligometastases 25 months, and polymetastases 11 months. Visceral metastases were associated with a median survival of 9 months versus 27 months without. Tumour type also impacted prognosis, with thyroid cancer patients having the highest median survival and lung cancer patients the lowest. Pathological fractures reduced survival significantly (11 months vs 36 months without fractures).

Conclusion

Oligometastatic disease is a strong prognostic factor for MBD patients undergoing orthopaedic surgery, with better outcomes compared to polymetastatic disease. Other key factors include tumour type, visceral metastases, and pathological fractures. Improved staging, risk assessment, and early interdisciplinary collaboration could mitigate pathological fractures and improve outcomes.
Understanding Unique Phenomena in Real Life
Authors: Lewis-Hunstiger Marty
Published: February 2025

We begin this journal issue by honoring the late nursing pioneer Marie Manthey, founder of Creative Nursing, with our remembrances of her as a colleague, mentor, inspiration, and friend. A review of the intense topics addressed in Creative Nursing 2024 includes a Supplemental File listing all the articles published. In 2025, with our overarching theme of Amplifying Seldom-Heard Voices and Dismantling Oppressive Structures, we continue to confront complex issues, listening for narratives that are often suppressed or discounted, and contravening the forces and policies that act to stifle them. In this issue, The Value of Case Studies, we highlight a methodology that is ideal for studying, working to understand, and supporting advocacy for people whose voices are seldom heard. We highlight ways to strengthen scholarly rigor, the uniqueness of each individual as the main character in their own story, exemplars of studies that present in a coherent way the experiences of members of distinctive groups that are often misunderstood and discounted, and the use of tools based on qualitative research to enhance care. We also announce the recipient of the first annual Creative Nursing Student Article of the Year Award.
Encephalopathy at High Altitude: Hyponatremia or High Altitude Cerebral Edema?
Authors: Brant-Zawadzki Graham , Hew-Butler Tamara , Youngquist Drew C. , Fiore David , Hackett Peter
Published: February 2025

Objective

Brain dysfunction at high altitudes can be caused by both high altitude cerebral edema (HACE) and hyponatremic encephalopathy. Differentiating them is important for proper treatment but can be difficult. We present a case series of 11 patients with hyponatremic encephalopathy, all initially misdiagnosed as HACE, and we discuss key signs and symptoms that will help clinicians differentiate the 2 pathologies.

Methods

We compiled 11 cases of patients with severe hyponatremia who were diagnosed with HACE, verified through direct patient care or referral consultation.

Results

Patients included 5 males and 6 females aged 19 to 65 y, exercising between 2100 and 4300 m. Serum Na+ concentration ranged from 112 to 127 mmol·L–1. Features included ataxia, confusion, and progression to coma without the hallmark imaging features of HACE. Clinically, the rapid progression of symptoms, moderate altitude, short duration of altitude exposure, and seizure activity suggested hyponatremia rather than HACE. All but 1 patient shared classic risk factors for exercise-associated hyponatremia: moderate to extreme exercise, rapid high volume (>5 L) fluid intake, clamminess, pallor, and nausea. Five patients suffered seizures, 4 used nonsteroidal anti-inflammatory medications, 4 had pulmonary edema, and 3 showed features of the syndrome of antidiuretic hormone secretion.

Conclusions

Severe hyponatremia should be considered in persons with encephalopathy at high altitudes. Although there is no established causal link between hypobaric hypoxia and hyponatremia, the potential for high altitude exposure to exacerbate exercise-associated hyponatremia warrants further investigation because the consequences of developing or misdiagnosing this process may be severe.
Comparative study of peripheral intravenous catheter insertions with capillary, notched, and a grooved needle flashback design
Authors: Moureau Nancy , Kaufman Lois
Published: February 2025

Evidence of the costly effects of first-attempt peripheral intravenous catheter (PIVC) insertion failures continues to mount. This study was conducted to determine if a unique catheter design can improve operative error, promote PIVC first-stick success and reduce the costs of first-attempt failures. In Phase One of this comparative simulation use in vitro study, 16 nurses from acute care hospitals inserted four PIVC types into a training model, each type characterized by distinct timing of flashback occurrence and needle design. Each nurse performed three attempts per catheter type (12 total per inserter). Insertions were video-recorded and analyzed for the effect of the needle on a vessel during insertion, double punctures and catheter placement failure or success. In Phase Two, 100 nurses and 25 purchasing agents nationwide identified items used and associated costs for PIVC insertions. In Phase One, nurses using a grooved needle flashback with a thin-tipped needle were 20% more successful with catheter placement than those using a notched needle flashback and 22% more successful than those placing a capillary flashback design. Catheter placement success with a grooved needle flashback was 15% higher than with a capillary flashback and 13% higher than with a notched needle flashback. Double punctures were highest among nurses using a capillary flashback catheter, and catheter placement failure was highest among nurses using notched needle flashback. In Phase Two, nurses reported an average of 51% first-attempt success. The authors calculated the estimated annual cost of first-stick failure to be $US 35,919.15 per nurse, including labor and materials used in the second and third attempts. In this study, the authors found the insertion technique with grooved flashback needle design reduced operative error, double punctures and improved first-attempt success. This flashback needle design could significantly improve patient outcomes, speed time to treatment and reduce hospital costs.
A Moral Obligation: An Interview With Claude Fischer, Founding Editor of Contexts
Authors: Ghaziani Amin
Published: February 2025

Amin Ghaziani speaks with Claude Fischer, founding editor of Contexts, about his vision for the magazine and the importance of continued investments in public sociology.
Election Reflections—and What Comes Next
Authors: Ghaziani Amin , Abrutyn Seth , Laurison Daniel , Romero Mary , Perrin Andrew J. , Spencer-Blume Amienne , Menjivar Cecilia , Bonilla-Silva Eduardo
Published: February 2025

A curated collection of essays tracking the pulse of American democracy as the second Trump Administration comes into power, this special section considers the campaigns that were waged and previews the battles yet to come.
Blending Western and Australian Aboriginal Approaches: A Study Protocol for Codesign of Bicultural Teleoncology Models of Care in Remote Australian Communities
Authors: Webster Emma , Purcell-Khodr Gemma , Townsend Billie , Hall Allan , Hill Yvonne , See Cecil , Ward Katrina , Honeyball Florian
Published: February 2025

Cancer treatments have failed to reach people who live in rural and remote Australia. Geographic constraints on service delivery are exacerbated for Aboriginal and Torres Strait Islander peoples who continue to be marginalised by a colonial legacy that drives disparities in access to healthcare. This is particularly evident in the remote communities of Bourke and Brewarrina which are home to significant Aboriginal populations. They are located 100 km apart and 400 km from the nearest cancer centre. We aim to codesign bicultural models of care to deliver a bespoke cancer service, enabling administration of low and medium risk chemotherapies via teleoncology in two remote Australian communities. Aboriginal philosophy and pedagogy will be used with Community-Led participatory research methods. Maximum variation and snowball sampling will ensure diversity of participants in the codesign. Up to 100 participants will contribute, with multiple data collection events held in each monthly data collection cycle. Data will be collected in individual or small group yarning style sessions and recorded on a visual template. Framework analysis will be used to map each round of data collection to consolidate visual models of cancer care for each town. This incremental data collection involves participants in cycles of analysis and interpretation. Both communities have study-specific Research Governance Groups with representation from Aboriginal and non-Aboriginal community members to guide investigators. This study approaches codesign by following Aboriginal cultural protocols. Ethical (axiology) and relational (ontological) processes precede intellectual (epistemology) and operational (methodology) processes. A direct outcome of this research will be provision of teleoncology aligned with the models in each community supported by the nearest regional cancer centre (Western Cancer Centre Dubbo). Another novel aspect is use of the Australian Bicultural Model of care which was first described in an alcohol treatment context and is tested here for transferability to other settings.
Insights From the Ground: Perspectives from a Refugee Center Community
Authors: Mahmoud Mahmoud Kariman
Published: February 2025

Mahatma Gandhi famously said that serving others without expecting anything in return is the most meaningful approach to find one’s own self. As I volunteered as an ELI (English Language Instruction) teaching assistant and learned more about the distinctive culture of the non-profit interfaith and refugee center community, this remark struck a chord with me. This reflection paper serves two purposes: it sheds light on my first refugee volunteer experience in the US as a new immigrant and PhD student in adult education (with international and non-profit experience), with the aim of enhancing my integration into the host country. Moreover, it offers insights into certain features of the refugee center that necessitate improvement, particularly regarding the physical learning environment. The significance lies in the fact that a secure and private atmosphere facilitates adult learners’ undivided attention to the subject matter and engagement with peers.
Delineating the Role of Inter-Repetition Interval in the Relationship between Maximum Repetitions to Failure or Repetitions in Reserve and Movement Velocity
Authors: Martínez-Rubio Carlos , Baena-Raya Andrés , Quidel-Catrilelbún Mauricio Elías Leandro , Rodríguez-Pérez Manuel A. , Pérez-Castilla Alejandro
Published: February 2025

Background:

Maximum repetitions to failure (RTF) and repetitions in reserve (RIR) can be estimated through fastest mean velocity (MVfastest) and mean velocity (MV), respectively. However, the impact of inter-repetition intervals (IRI) on these relationships in free-weight back squat and bench press exercises is unclear.

Hypothesis:

The IRI would affect RTF-MVfastest and RIR-MV relationships, with a higher goodness-of-fit using self-selected IRI (SSIRI) compared with 0 seconds (IRI0) and 3 seconds (IRI3).

Study Design:

Crossover study design.

Level of Evidence:

Level 3.

Methods:

Eighteen male participants completed 1 session per IRI configuration, consisting of 3 single sets of RTF (65%-75%-85% of the 1-repetition maximum) during the free-weight back squat and bench press exercises.

Results:

Individualized RTF-MVfastest and RIR-MV relationships were stronger than generalized (median R2 = 0.98 vs 0.65 and 0.84 vs 0.40, respectively). The goodness-of-fit of the relationships was stronger for SSIRI than for IRI0 during back squat ( P < .01) and comparable between IRIs during bench press ( P ≥ .28). During back squat, MVfastest values were higher for IRI0 than for IRI3 and SSIRI (eighth-fifteenth repetitions; P ≤ .07), whereas during the bench press, they were higher for IRI0 than for IRI3 (eleventh-fifteenth repetitions; P ≥ .28). Overall, MV values associated with each RIR were higher for IRI0 than for SSIRI (10 out of 18 comparisons) during back squat, and for IRI0 than for IRI3 and SSIRI (16 and 14 out of 18 comparisons) during bench press.

Conclusion:

These results highlight the importance of standardizing the IRI during set-to-failure to establish RTF-MVfastest and RIR-MV relationships, with SSIRI recommended as a more accurate and effective procedure.

Clinical Relevance:

This information may provide practitioners with a valuable tool to objectively quantify the level of effort being exerted during resistance training sets by measuring movement velocity in free-weight exercises.
Novel Noninvasive Imaging Techniques to Assess Structural, Functional, and Material Properties of Tendon, Ligament, and Cartilage: A Narrative Review of Current Concepts
Authors: Retzky Julia S. , Koff Matthew F. , Nwawka Ogonna K. , Rodeo Scott A.
Published: February 2025

Background:

Novel noninvasive imaging modalities such as quantitative magnetic resonance imaging (qMRI) and shear wave elastography (SWE) allow for assessment of soft tissue microstructure and composition, which ultimately may be associated with functional and material properties.

Purpose:

To provide a narrative review of the scientific techniques and clinical applications of qMRI and SWE for the evaluation of soft tissue about the knee and shoulder, including the meniscus, the anterior cruciate ligament (ACL), and the rotator cuff.

Study Design:

Review.

Methods:

A literature search was performed in October 2022 via PubMed using the following keywords: “quantitative MRI tendon,” quantitative MRI ligament,”“quantitative MRI cartilage,” or “shear wave elastography tendon.” Only articles related to clinical applications were included in this review.

Results:

Conventional imaging techniques, including standard morphologic magnetic resonance imaging (MRI) and ultrasound imaging, have limited ability to evaluate the material and functional properties of soft tissue; qMRI builds on the limitations of conventional morphologic MRI by allowing for detection of early articular cartilage changes, differentiation of healed versus unhealed meniscal tissue, and quantification of ACL graft maturity. SWE can evaluate the material properties of rotator cuff and Achilles tendons after injury, which may provide insight into both the chronicity and the healing status of the aforementioned injuries.

Conclusion:

Our review of the literature showed that quantitative imaging techniques, including qMRI and SWE, may both improve early detection of pathology and aid in comprehensive evaluation after treatment.
New Graduate Nurses’ Transition to Practice During the COVID-19 Pandemic: Voices of Clinical Nurse Educators From the Front Lines
Authors: Djukic Maja , Pine Rosemary , Short Yashamika , Jackson Joy , McVey Caitlin , Cline Daniel D.
Published: February 2025

Introduction

Although COVID-19 may no longer be a global public health emergency, it is imperative to continue to reflect on the lessons learned from it, especially from the front-line nurses and nurse educators, to ensure effective nursing workforce response to disasters and emergencies of all kinds. The COVID-19 pandemic has disproportionately affected the new graduate nurses (NGNs) by altering their transition to practice (TTP) experiences. Many studies have examined perceptions and voices of educators from nursing education programs and NGNs about their experiences of transitioning to practice during the pandemic. However, clinical nurse educators’ voices are lacking.

Method

This qualitative descriptive study explored clinical nurse educators’ perspectives on the differences in TTP before and during the pandemic.

Results

The preliminary results encompassed two themes No hands on and Used to interacting with mannequins that point to root causes of greater struggles NGNs who transitioned to practice during the pandemic faced compared to their pre-pandemic counterparts.

Conclusion

Safely maintaining clinical access to learners during public health emergencies will be imperative to ensure NGNs enter practice prepared to provide safe and high-quality care.
Program Evaluation in Competence by Design: A Mixed-Methods Study
Authors: Milosek Jenna , Eady Kaylee , Moreau Katherine A.
Published: February 2025

BACKGROUND

The evaluation of Competence by Design (CBD) residency programs is crucial for enhancing program effectiveness. However, literature on evaluating CBD programs is limited. We conducted a 2-phase mixed-methods study to (a) assess the extent of program evaluation activities in CBD residency programs in Canada, (b) explore reasons for engaging or not engaging in these activities, (c) examine how CBD programs are conducting program evaluations, and (d) identify ways to build capacity for program evaluation.

METHODS

Phase 1 involved surveying 149 program directors from specialty/subspecialty programs that transitioned to CBD between 2017 and 2020. We calculated descriptive statistics for 22 closed-ended survey items. Phase 2 comprised interviews with a subset of program directors from Phase 1. Data analysis followed a 3-step iterative process: data condensation, data display, and drawing and verifying conclusions.

RESULTS

In Phase 1, we received 149 responses, with a 33.5% response rate. Of these, 127 (85.2%) indicated their programs engage in evaluation, while 22 (14.8%) do not. Among the 127 programs that engage in evaluation, 29 (22.8%) frequently or always develop evaluation questions, and 23 (18.1%) design evaluation proposals/plans. Reasons for engaging in evaluation included decision-making and stimulating changes in educational practices. Conversely, reasons for not engaging included lack of knowledge, personnel, and funding. In Phase 2, 15 program directors were interviewed. They reported that CBD programs face challenges such as limited resources and buy-in, rely on ad hoc evaluation methods, and use a team-based evaluation format. To enhance evaluation capacities, interviewees suggested (a) developing expertise in program evaluation, (b) acquiring evaluation resources, and (c) advocating for clear evaluation expectations.

CONCLUSIONS

Most CBD residency programs are engaged in program evaluations, but the quality is often questionable. To fully realize the potential of program evaluation, CBD programs need additional resources and support to improve evaluation practices and outcomes.
Bioelectric profiling of Rickettsia montanensis in Vero cells utilizing dielectrophoresis
Authors: Doost Negar Farhang , Yaram Sai Deepika Reddy , Wagner Kayla , Garg Harshit , Srivastava Soumya K.
Published: February 2025

Rickettsia is an intracellular bacteria transmitted to humans through ticks, lice, fleas, or their feces, causing acute symptoms such as fever, headache, rashes, and muscle aches. Detecting rickettsial diseases is challenging due to limitations in current methods such as negative results, low sensitivity, and high cost. These limitations highlight the need for improved detection methods. Dielectrophoresis (DEP) offers a promising alternative to develop a point-of-care economical, label-free, and sensitive diagnostic tool. By exposing cells to non-uniform electric fields one can measure the electrical properties of the cells which are different and unique based on the cell type. By comparing the dielectric profiles of healthy and infected cells, DEP could be utilized to design a rapid, cost-effective diagnostic tool. Initial steps involve characterizing the electrophysiological properties of Vero cells infected with Rickettsia montanensis to develop this new detection tool. This study found significant differences in electrical parameters between healthy and Rickettsia spp. infected Vero cells, particularly at a medium conductivity of 500 µS/cm. Moreover, we found that the dielectric spectrum showed the greatest differences between healthy and Rickettsia spp. infected Vero cells at medium conductivity of 500 µS/cm, with significantly different dielectrophoretic crossover frequencies (no DEP force region). These findings suggest that dielectrophoretic detection of infected cells could serve as a quick, cost-effective, label-free, and sensitive alternative for developing a point-of-care diagnostic tool for Rickettsial infections.
Retraction Note: N6 -methyladenosine modification of circMARK2 enhances cytoplasmic export and stabilizes LIN28B, contributing to the progression of Wilms tumor
Authors: Shu Guannan , Zhao Zhang , Zhao Tianxin , Deng Changmi , Zhu Jiangquan , Han Yufeng , Chen Minyu , Jing Jiajia , Bai Gaochen , Li Dian , Li Feng , He Jing , Fu Wen , Liu Guochang
Published: February 2025

This article has been retracted. Please see the Retraction Notice for more detail: https://doi.org/10.1186/s13046-024-03113-9.
Mosquito mutations F290V and F331W expressed in acetylcholinesterase of the sand fly Phlebotomus papatasi (Scopoli): biochemical properties and inhibitor sensitivity
Authors: Temeyer Kevin B. , Tong Fan , Schlechte Kristie G. , Chen Qiao-hong , Carlier Paul R. , Pérez de León Adalberto Á. , Bloomquist Jeffrey R.
Published: February 2025

Background

The Old World sand fly, Phlebotomus papatasi (Scopoli), a vector of zoonotic cutaneous leishmaniasis, is usually controlled by insecticides, including anticholinesterases. Previous studies have revealed 85% amino acid sequence identity of recombinant P. papatasi acetylcholinesterase (rPpAChE1) to mosquito AChE. They identified synthetic carbamates that selectively inhibited rPpAChE1 and circumvented the G119S mutation responsible for high-level resistance to anticholinesterases. This study reports the construction, baculovirus expression, and biochemical properties of rPpAChE1 containing the F290V and F331W orthologous mutations from mosquitoes.

Methods

Recombinant PpAChE1 enzymes with or without the F290V, F331W, and G119S orthologous mosquito mutations were expressed in Sf21cells utilizing the baculoviral system. Ellman assays determined changes in catalytic properties and inhibitor sensitivity resulting from wild type and mutant rPpAChE1 containing single or combinations of orthologous mosquito mutations.

Results

Each of the orthologous mutations (F290V, F331W, and G119S) from mosquito AChE significantly reduced inhibition sensitivity to organophosphate or carbamate pesticides, and catalytic activity was lost when they were expressed in combination. Novel synthetic carbamates were identified that significantly inhibited the rPpAChEs expressing each of the single orthologous mosquito mutations.

Conclusions

These novel carbamates could be developed as efficacious insecticides, with improved specificity and safety for use in sand fly or mosquito populations expressing the mutant AChEs.

Graphical Abstract
Predicting malignant risk of ground-glass nodules using convolutional neural networks based on dual-time-point 18F-FDG PET/CT
Authors: Liu Yuhang , Wang Jian , Du Bulin , Li Yaming , Li Xuena
Published: February 2025

Background

Accurately predicting the malignant risk of ground-glass nodules (GGOs) is crucial for precise treatment planning. This study aims to utilize convolutional neural networks based on dual-time-point 18F-FDG PET/CT to predict the malignant risk of GGOs.

Methods

Retrospectively analyzing 311 patients with 397 GGOs, this study identified 118 low-risk GGOs and 279 high-risk GGOs through pathology and follow-up according to the new WHO classification. The dataset was randomly divided into a training set comprising 239 patients (318 lesions) and a testing set comprising 72 patients (79 lesions), we employed a self-configuring 3D nnU-net convolutional neural network with majority voting method to segment GGOs and predict malignant risk of GGOs. Three independent segmentation prediction models were developed based on thin-section lung CT, early-phase 18F-FDG PET/CT, and dual-time-point 18F-FDG PET/CT, respectively. Simultaneously, the results of the dual-time-point 18F-FDG PET/CT model on the testing set were compared with the diagnostic of nuclear medicine physicians.

Results

The dual-time-point 18F-FDG PET/CT model achieving a Dice coefficient of 0.84 ± 0.02 for GGOs segmentation and demonstrating high accuracy (84.81%), specificity (84.62%), sensitivity (84.91%), and AUC (0.85) in predicting malignant risk. The accuracy of the thin-section CT model is 73.42%, and the accuracy of the early-phase 18F-FDG PET/CT model is 78.48%, both of which are lower than the accuracy of the dual-time-point 18F-FDG PET/CT model. The diagnostic accuracy for resident, junior and expert physicians were 67.09%, 74.68%, and 78.48%, respectively. The accuracy (84.81%) of the dual-time-point 18F-FDG PET/CT model was significantly higher than that of nuclear medicine physicians.

Conclusions

Based on dual-time-point 18F-FDG PET/CT images, the 3D nnU-net with a majority voting method, demonstrates excellent performance in predicting the malignant risk of GGOs. This methodology serves as a valuable adjunct for physicians in the risk prediction and assessment of GGOs.
Cer-ConvN3Unet: an end-to-end multi-parametric MRI-based pipeline for automated detection and segmentation of cervical cancer
Authors: Xia Shao-Jun , Zhao Bo , Li Yingming , Kong Xiangxing , Wang Zhi-Nan , Yang Qingmo , Wu Jia-Qi , Li Haijiao , Cao Kun , Zhu Hai-Tao , Li Xiao-Ting , Zhang Xiao-Yan , Sun Ying-Shi
Published: February 2025

Background

We established and validated an innovative two-phase pipeline for automated detection and segmentation on multi-parametric cervical cancer magnetic resonance imaging (MRI) and investigated the clinical efficacy.

Methods

The retrospective multicenter study included 125 cervical cancer patients enrolled in two hospitals for 14,547 two-dimensional images. All the patients underwent pelvic MRI examinations consisting of diffusion-weighted imaging (DWI), T2-weighted imaging (T2WI), and contrast-enhanced T1-weighted imaging (CE-T1WI). The deep learning framework involved a multiparametric detection module utilizing ConvNeXt blocks and a subsequent segmentation module utilizing 3-channel DoubleU-Nets. The pipeline was trained and tested (80:20 ratio) on 3,077 DWI, 2,990 T2WI, and 8,480 CE-T1WI slices.

Results

In terms of reference standards from gynecologic radiologists, the first automated detection module achieved overall results of 93% accuracy (95% confidence interval 92–94%), 93% precision (92–94%), 93% recall (92–94%), 0.90 κ (0.89–0.91), and 0.93 F1-score (0.92–0.94). The second-stage segmentation exhibited Dice similarity coefficients and Jaccard values of 83% (81–85%) and 71% (69–74%) for DWI, 79% (75–82%), and 65% (61–69%) for T2WI, 74% (71–76%) and 59% (56–62%) for CE-T1WI.

Conclusion

Independent experiments demonstrated that the pipeline could get high recognition and segmentation accuracy without human intervention, thus effectively reducing the delineation burden for radiologists and gynecologists.

Relevance statement

The proposed pipeline is potentially an alternative tool in imaging reading and processing cervical cancer. Meanwhile, this can serve as the basis for subsequent work related to tumor lesions. The pipeline contributes to saving the working time of radiologists and gynecologists.

Key Points

An AI-assisted multiparametric MRI-based pipeline can effectively support radiologists in cervical cancer evaluation.

The proposed pipeline shows high recognition and segmentation performance without manual intervention.

The proposed pipeline may become a promising auxiliary tool in gynecological imaging.

Graphical Abstract
Could new mammography techniques be an alternative for dynamic contrast-enhanced breast MRI in the diagnosis and preoperative staging of breast lesions?
Authors: Haggag Marwa A , Helal Maha H , Kamal Rasha M , Mostafa Radwa E , Salama Asmaa I. , Hassan Ahmed E
Published: February 2025

Background

Breast cancer is the most common malignant tumor among women, and all the imaging modalities are used to help in the early detection and accurate diagnosis of breast abnormalities and so led to proper management. Breast tomosynthesis is one of the modifications of digital mammography that obtains 3-dimensional images and so helps in better detection and characterization of the breast lesions. Contrast-enhanced digital mammography and dynamic breast MRI are post-contrast studies that allow the detection of the neovascularization associated with breast cancer, yet MRI is still the most accepted modality that shows the highest sensitivity in the detection and diagnosis of breast cancer.

This study aimed to evaluate the role of new mammographic techniques and compare them with dynamic contrast-enhanced MRI in diagnosis and preoperative staging regarding multiplicity and size assessment of breast lesions.

Results

This prospective study included forty female patients with 53 breast lesions that were referred to the breast unit in our oncology institute. Inclusion criteria included BI-RADS 3, 4, and 5 breast lesions, clinical indication for MRI breast, and no previous histologically proven cancer. Exclusion criteria included pregnancy, allergy to an iodinated contrast agent, renal impairment, and any contraindication for MRI. All patients were scheduled for contrast-enhanced digital mammography, single-view tomosynthesis, and dynamic contrast-enhanced MRI in another separate setting. The final diagnosis was established by pathology. Dynamic contrast-enhanced MRI showed the highest sensitivity and specificity in this study followed by contrast-enhanced digital mammography and then digital breast tomosynthesis. Combined use of the new mammographic techniques (digital breast tomosynthesis and contrast-enhanced digital mammography) increases the sensitivity and negative predictive value approaches that of dynamic contrast-enhanced MRI. Dynamic contrast-enhanced MRI showed agreement with the pathology regarding the detection of lesion multiplicity, followed by contrast-enhanced digital mammography.

Conclusions

The combined use of the new mammographic technique (digital breast tomosynthesis, and contrast-enhanced digital mammography) raises their diagnostic performance approaches of the dynamic contrast-enhanced MRI and may be a reasonable alternative to it; however, dynamic contrast-enhanced MRI remains the technique of the highest diagnostic accuracy in the diagnosis and assessment of breast lesions.
Synthetic biology and parasite genomics: engineering parasite-resistant human microbiomes for sustainable disease prevention
Authors: Al-Malki Esam S.
Published: February 2025

Background

Recent progress in parasite genomics has is enabled for greater understanding of genetic structure of parasites, including the species of Plasmodium, Leishmania, and Trypanosoma. Cutting-edge next-generation sequencing (NGS) techniques, such as high-throughput sequencing, has enabled the discovery of essential genes linked to the metabolic pathways, drug resistance, and life cycle adaptations. Advancements in the field of genomics have enabled the deep understanding of biological processes and evolutionary adaptations of parasites.

Results

Investigating the genomes in various parasite strains has enhanced our understanding of their evolutionary adaptations, enhancing our capacity to predict epidemics and develop therapies that effectively act against various parasitic strains. Synthetic biology has also proposed novel treatment approaches, including the gene therapies and bioengineered microbes, that shows potential in fighting or inhibiting parasite illnesses. Revolutionary genome-editing methods, such as CRISPR-Cas9, have enabled the accurate genetic alterations, expediting the progress of sophisticated medicinal therapies, that are specifically designed for parasite management and eradication.

Conclusion

Microbiome engineering, an emerging area, provides a novel opportunities for disease prevention by integrating the techniques such as transplanting faecal microbiota and genetically tailored bacteria to restore microbial equilibrium and decrease parasite populations. Nevertheless, the enduring stability of modified microbiomes, possible environmental hazards, and ethical concerns related to gene editing emphasise the necessity for stringent safety measures and monitoring by regulatory authorities. Using these technologies responsibly and ethically is crucial to guarantee the continuous therapeutic advancement.

Graphic abstract
Factors shaping green entrepreneurial intentions towards green innovation: an integrated model
Authors: Al-Mamary Yaser Hasan
Published: February 2025

The primary objectives of this study are to investigate the key determinants of green entrepreneurial intentions (GEI) and to examine how these intentions influence green innovation (GI). The study also aims to develop a comprehensive model that integrates various factors impacting GEI and their relationship with GI, specifically within the Saudi Arabian context. The study employs a quantitative research design, collecting data through an online questionnaire from 389 respondents in Saudi Arabia. Structural equation modelling via SmartPLS software was used to analyse the relationships between the variables and test the proposed hypotheses. The findings demonstrate that attitudes towards green entrepreneurship, green entrepreneurial orientation (GEO), entrepreneurial education (EE) and environmental awareness (EA) substantially affect GEI. Consequently, GEI significantly enhance GI. Nonetheless, subjective norms and perceived behavioural control were not important predictors of GEI. These findings possess significant consequences for research and practice. The integrated model provides academics with a comprehensive framework for examining green entrepreneurship, emphasizing the interaction of key components. Practitioners and politicians can utilize these findings to design targeted educational initiatives and regulations that cultivate a conducive climate for green entrepreneurship. Integrating EA, EE, the entrepreneurial orientation model and planned behaviour theory, the study presents a comprehensive model of green entrepreneurship. The study examines Saudi Arabia-specific information and proposes broadening the scope of the study to include other Gulf nations. This method improves our theoretical knowledge and our practical approaches to GI.
Investigating the recent outbreak of dengue fever in Iran: a systematic review
Authors: Jamal Mahboob Keramati , Sanaei Batool , Naderi Maziar , Past Vida , Abadi Somayeh Hashemi Ali , Khazaei Raziye , Esmaeili Arezoo , Sadrizadeh Sepehr , Moghimi Shadi , Ghiyasi Zahra
Published: February 2025

Background and aim

Dengue fever is a mosquito-borne viral disease that has been recently increasing in incidence in Iran. Understanding the factors contributing to this outbreak is crucial in order to implement effective control measures. The aim of this study was to review the recent outbreak of dengue fever in Iran and identify the contributing factors.

Methods

A systematic search of databases, including PubMed, Web of Science, Scopus, Google Scholar, and SID, was conducted to identify relevant studies on dengue fever in Iran from 2010 to 2024. The quality of the studies was assessed using the Critical Appraisal Skills Program (CASP) tool.

Results

The review revealed a significant increase in the number of dengue fever cases in Iran in recent years, with outbreaks occurring in different regions of the country. The recent outbreak of dengue fever in Iran has been mainly attributed to factors such as increased travel to dengue-endemic regions, climate change, inadequate mosquito control measures, and lack of public awareness. The outbreak has been particularly severe in cities with high population densities and poor sanitation.

Conclusion

The recent outbreak of dengue fever in Iran indicates the need for improved mosquito control measures, increased public awareness, and better surveillance systems. In Iran, preventive measures for dengue fever include eliminating standing water, using mosquito repellent, wearing protective clothing, installing screens, using mosquito nets, seeking medical attention, and staying informed.
Implementation and preliminary validity of the Functional Assessment of Cancer Therapy – Radionuclide Therapy (FACT-RNT) in patients receiving radionuclide therapy for prostate cancer.
Authors: Gudenkauf Lisa Marie , Telli Tugce , Delker Astrid , Simon Danielle F. , Jim Heather S.L. , Oswald Laura B. , Li Xiaoyin , Hoogland Aasha , Dicker Adam P. , Tagawa Scott T. , Cella David , Hofman Michael S. , Czernin Johannes , Calais Jeremie , Unterrainer Lena , Fendler Wolfgang Peter , Herrmann Ken , El-Haddad Ghassan , Gonzalez Brian D.
Published: February 2025

118

Background:
The Functional Assessment of Cancer Therapy-Radionuclide Therapy (FACT-RNT) is used in trials and clinical practice to monitor patient-reported RNT-relevant symptoms and toxicities in advanced metastatic castrate-resistant prostate cancer (mCRPC) patients receiving RNT. This study examined FACT-RNT feasibility and preliminary validity for U.S. patients receiving RNT.
Methods:
Patients scheduled to start 177Lu-PSMA-617 for advanced mCRPC at Moffitt Cancer Center from October 2023 – March 2024 completed patient-reported outcome (PRO) measures before each cycle. PROs included previously validated measures of prostate cancer specific-symptoms (NFPSI-17) and physical function (Scored Patient-Generated Subjective Global Assessment; PG-SGA) and the FACT-RNT, a 15-item measure of symptoms/toxicities with higher total scores (range: 0-60) indicating less symptom burden. Correlations between the FACT-RNT and other PROs were calculated.
Results:
Patients (N=17) were, on average, 69 years old (SD=11, range=43-90) at RNT cycle 1 and mostly non-Hispanic (76%) and White (82%). Gleason scores at diagnosis were 7-8 (30%) or 9-10 (71%). Patients had previously undergone surgery (35%), chemotherapy (94%), radiation (71%), hormone therapy (94%), targeted therapy (88%), and immunotherapy (29%). Fifteen patients (88%) received ≥2 RNT infusions; of these, 1 (6%) died and 1 (6%) discontinued RNT prior to cycle 2. Thirteen (87% of those with ≥2 infusions) completed the FACT-RNT at ≥2 cycles. Cycle 1 FACT-RNT total scores ranged from 31-58 (M=46.5, SD=8). The FACT-RNT was positively associated with symptoms as assessed by NFPSI-17 at cycles 1-3 (
p
s≤.03) and negatively associated with physical function at cycles 1-2 (
p
s≤.05).
Conclusions:
Preliminary results support FACT-RNT validity due to associations with validated PRO measures and the feasibility of FACT-RNT implementation in the U.S. The FACT-RNT may be helpful in clinical management and decision-making with RNT recipients. Future research will replicate and extend these findings in a larger longitudinal sample and examine validity with clinician-rated outcomes and RNT dosimetry.
Safety evaluation of stereotactic body radiation therapy (SBRT) during lutetium-177-PSMA-617 (177Lu-PSMA-617) treatment for patients with metastatic prostate cancer.
Authors: Kessel Adam , Muniz Miguel , O'Byrne Jamie T , Phillips Ryan , Park Sean Sunghun , Davis Brian , Stish Brad J. , Choo Chunhee Richard , Merrell Kenneth , Kwon Eugene D. , Johnson Geoffrey , Quevedo Fernando , Orme Jacob , Childs Daniel S , Wilson Jessica M
Published: February 2025

129

Background:
Few studies have explored the use of focal therapies to address select sites of resistant disease in men receiving 177-Lu-PSMA-617 for metastatic castrate resistant prostate cancer (mCRPC). Our institutional practice is to offer SBRT for patients with up to 5 sites of oligoprogression or non-responding lesions while undergoing 177Lu-PSMA-617 (every 6 weeks for 6 cycles total). This is determined by PSMA or choline PET imaging during the course of 177Lu-PSMA-617. Herein, we evaluated the safety of adding target SBRT during treatment with 177Lu-PSMA-617.
Methods:
This retrospective single institution analysis was conducted via systematic chart review to evaluate for adverse events during or after treatment. Grading of treatment-related adverse events was conducted using Common Terminology Criteria for Adverse Events Version 5.0 (CTCAE v5).
Results:
Thirty-one patients receiving 177Lu-PSMA-617 with 51 sites of oligoprogressive or non-responding metastatic disease were treated with SBRT. The median number of sites treated was 1 (range 1-4). Most patients received SBRT immediately after cycle 6 (32%) or after cycle 3 or 4 (42%). Bone was the most commonly treated site of disease (90%) with the majority (54%) of bone sites being spine or sacrum, followed by lymph nodes (10%). Ultimately, 84% of patients completed all 6 cycles of 177Lu-PSMA-617 (range 4-6). The median follow-up time was 19.1 months (IQR 15.5-22.4) after 177Lu-PSMA-617 therapy start. A total of 2 patients experienced a pathologic fracture within the SBRT treatment field that could possibly be related to radiotherapy. One patient experienced a grade 2 neuropathy which may have been related to radiation therapy. Other potential adverse events are listed (Table).
Conclusions:
Our data demonstrates a low rate of significant toxicity with the use SBRT during treatment with 177Lu-PSMA-617. Further study is indicated to determine the oncologic efficacy and potential late side effects of this treatment strategy.

Adverse events.

Event
All Grades
Grade > 3

Any Adverse Event
104
2

Anemia
29 (94%)
0

Low Platelets
11 (35.5%)
1 (3.2%)

Any Pathologic Fracture
7 (22.5%)
1 (3.2%)

Possible SBRT-related Pathologic Fracture
2 (6.5%)
1 (3.2%)

Bone Pain Flare
3 (9.6%)
0

Neuropathy
1 (3.2%)
0
The significance of androgen receptor signaling pathway in mCRPC patients receiving olaparib monotherapy or combined treatment with abiraterone.
Authors: Yang Bin , Ding Li , Dong Baijun , Chen Wei , Guo Hanxu , Jin Chengqi , Xu Jing , Luo Wentao , Mao Shiyu , Guo Changcheng , Peng Bo , Yao Xudong
Published: February 2025

197

Background:
Our previous research confirmed that for metastatic castration-resistant prostate cancer (mCRPC) patients with DNA damage repair (DDR) deficiency who have developed resistance to prior abiraterone, the combination of olaparib and abiraterone improves survival compared to olaparib monotherapy. However, further research is needed to identify subgroups who may benefit from olaparib alone or in combination with abiraterone, and to pinpoint risk factors significantly associated with poor prognosis in these patients. This study aims to explore the value of androgen receptor (AR) variant and androgen receptor activity (AR-A) at the transcriptomic level in evaluating the prognosis of mCRPC patients treated with olaparib alone or in combination with abiraterone.
Methods:
This study included 142 mCRPC patients who underwent targeted next-generation sequencing. Among them, 73 patients received olaparib monotherapy, while 69 patients received combined therapy. Bulk transcriptome sequencing was performed for 62 patients. Kaplan-Meier analysis was employed to evaluate patients' progression-free survival (PFS) and overall survival (OS). The AR-A score was calculated through a weighted linear sum of nine typical AR transcriptional target genes.
Results:
The combination of olaparib and abiraterone significantly improved PSA response and survival (PFS and OS) compared to olaparib monotherapy. Among mCRPC patients receiving olaparib monotherapy, those without AR pathogenic variant (AR-PV) had superior PFS and OS compared to those with AR-PV (median PFS: 5 months vs 3 months; median OS: 23 months vs 17 months). At the transcriptome level, for mCRPC patients receiving combined therapy, the average AR-A group exhibited better PFS and OS compared to the lower AR-A group (median PFS: 7 months vs 3 months; median OS: 17 months vs 10 months).
Conclusions:
For mCRPC patients treated with olaparib monotherapy, the absence of AR-PV can obtain better survival benefits. For patients treated with combined therapy, the average AR-A indicates a better survival benefit. For mCRPC patients with AR-PV or lower AR-A score, large-scale prospective randomized controlled clinical trials are needed to further explore therapy strategies that can improve their prognosis.