bluuebunny/crossref_metadata_2025 huggingface dataset:
Increasing Serious Illness Conversations in Patients at High Risk of One-Year Mortality Using Improvement Science: A Quality Improvement Study
Authors: Sharma Kanishk D. , Godambe Sandip A. , Chavan Prachi P. , Parks-Savage Agatha , Galicia-Castillo Marissa
Published: January 2025

Background: Serious illness conversation (SIC) in an important skillset for clinicians. A review of mortality meetings from an urban academic hospital highlighted the need for early engagement in SICs and advance care planning (ACP) to align medical treatments with patient-centered outcomes. The aim of this study was to increase SICs and their documentation in patients with low one-year survival probability identified by updated Charlson Comorbidity Index (CCI) scores. Methods: This was a quality improvement study with data collected pre- and post-intervention at a large urban level one trauma center in Virginia, which also serves as a primary teaching hospital to about 400 residents and fellows. Patient chart reviews were completed to assess medical records and hospitalization data. Chi square tests were used to identify statistical significance with the alpha level set at <0.05. Integrated care managers were trained to identify and discuss high CCI scores during interdisciplinary rounds. Providers were encouraged to document SICs with identified patients in extent of care (EOC) notes within the hospital’s cloud-based electronic health record known as EPIC. Results: Sixty-two patients with high CCI scores were documented, with 16 (25.81%, p = 0.0001) having EOC notes. Patients with documented EOC notes were significantly more likely to change their focus of care, prompting palliative care (63.04% vs. 50%, p = 0.007) and hospice consults (93.48% vs. 68.75%, p = 0.01), compared to those without. Post-intervention surveys revealed that although 50% of providers conducted SICs, fewer used EOC notes for documentation. Conclusion: This initial intervention suggests that the documentation of SICs increases engagement in ACP, palliative care, hospice consultations, and do not resuscitate decisions.
Psychometric Validation of the Simplified Chinese Version of the Dyspnoea-12 Questionnaire for Patients with Primary Lung Cancer
Authors: Liu Xianliang , Peng Bo , Wang Tao , Molassiotis Alex , Yorke Janelle , Yao Liqun , Zheng Silin , Tan Jing-Yu (Benjamin) , Huang Houqiang
Published: January 2025

Purpose: The simplified Chinese version of the Dyspnoea-12 Questionnaire (D-12) has not yet been translated and validated for patients with primary lung cancer. This study aimed to evaluate the psychometric properties of the simplified Chinese version of the D-12 for patients with primary lung cancer. Methods: This study analysed the baseline data of a randomised controlled trial that used an inspiratory muscle training intervention for patients with thoracic malignancies. The original English version of the D-12 was translated into simplified Chinese according to standard instrument translation and adaptation procedures. The internal consistency reliability of the D-12 was determined by calculating Cronbach’s alpha coefficients. The convergent validity of the D-12 was evaluated by Spearman’s correlation with the Borg CR-10 Scale, Numerical Rating Scale (NRS), Hospital Anxiety and Depression Scale (HADS), and Saint George’s Respiratory Questionnaire (SGRQ). Blood oxygen level, the 6-minute walk test distance, alcohol use, surgery type, cancer stage, exercise level, and educational background were identified to evaluate their discriminating performance. Results: The analysis included 196 participants. The Cronbach’s alpha coefficients for the full D-12 and its physical and emotional function subscales were 0.83, 0.74, and 0.92, respectively. Significantly positive associations were found between the D-12 scores and the Borg CR-10 Scale, the NRS, the HADS, and SGRQ scores (p < 0.01). The participants with insomnia (p < 0.01) and who did not use alcohol (p = 0.019) reported significantly higher D-12 total scores compared with their respective counterparts. The participants at different cancer stages (p < 0.01) and those who had undergone different surgeries (p = 0.033) reported significantly different D-12 total scores. Conclusions: The D-12 simplified Chinese version demonstrated very good psychometric properties and high acceptability in patients with primary lung cancer.
Phygital Experience Platform for Textile Exhibitions in Small Local Museums
Authors: Chai-Arayalert Supaporn , Puttinaovarat Supattra , Saetang Wanida
Published: January 2025

This study introduces a comprehensive phygital framework tailored for small local museums, addressing the unique challenges of textile exhibitions. By seamlessly integrating physical artifacts with advanced digital tools through a user-centered design–thinking approach, the platform transforms traditional museum visits into hybrid experiences. The research addresses challenges faced by small museums, such as limited interactivity, static information presentation, and resource constraints. The findings demonstrate that the phygital platform significantly enhances visitor satisfaction, usability, and engagement. Features like mobile applications, chatbots, and gamification foster dynamic interactions, increasing interest in historical textile collections. The evaluation highlights positive impacts on visitor learning and accessibility, with high usability scores and favorable feedback confirming the platform’s success. By bridging physical and digital realms, the platform empowers small local museums to modernize their exhibition experience offerings while preserving their authenticity and cultural significance. This study contributes to the growing literature on phygital strategies in museum contexts, offering practical recommendations for implementing such platforms in resource-constrained settings. The findings underscore the potential of phygital approaches to foster deeper connections with cultural heritage, ensure broader accessibility, and support sustainable visitor engagement.
Elevated Oxygen Contributes to the Promotion of Polyphenol Biosynthesis and Antioxidant Capacity: A Case Study on Strawberries
Authors: Dong Yingying , Pang Lingling , Mao Mengfei , Zhou Jingjing , Hu Qiannan , Xiang Yizhou , Li Li
Published: January 2025

Elevated oxygen is regarded as an effective approach to maintaining the quality of fresh plant products. To elucidate the role of elevated oxygen in polyphenol biosynthesis and antioxidant capacity, we evaluated the impact of different concentrations of oxygen on polyphenol metabolism, individual polyphenol contents, and antioxidant levels of strawberries during storage. Elevated oxygen (40%, 60%, and 80%) promoted the accumulation of polyphenols, including tannin, flavone, and anthocyanin. At the end of storage, total polyphenol contents of strawberries treated with 60% and 80% oxygen were 1.11 and 1.13 times higher, respectively, than the control group. In addition, elevated oxygen effectively enhanced DPPH and FRAP, which was consistent with the observed changes in polyphenol contents. Additionally, most genes involved in polyphenol biosynthesis were found to be upregulated during storage, with elevated oxygen resulting in higher expression levels compared to controls. These findings show that presumably, the main reason for the improvement in the commercial and edible quality of strawberries is physical treatments, such as elevated oxygen.
A Qualitative Descriptive Study of Rural Primary Healthcare Professionals’ Capacity for Disaster Health Management Before and During the COVID-19 Pandemic
Authors: Al qaf’an Ehmaidy , Alford Stewart , Mack Holly A. , Sekhon Ravneet , Gray Samuel , Song Kiara , Willson Katie , Kelly Glynn , Lim David
Published: January 2025

Introduction: Rural areas face additional challenges in preventing, preparing for, responding to, and recovering from disasters. This study aimed to understand how rural primary healthcare professionals (PHCPs) perceive their roles, involvement, and capacity in disaster health management. Methods: For this qualitative descriptive research, semi-structured interviews were carried out with convenience and purposive samples of rural PHCPs before and during the COVID-19 pandemic. Open, axial, and selective coding were employed to analyse the data inductively. Results: Five interviews were conducted before the pandemic, and ten interviews were conducted during the second and third waves of the COVID-19 pandemic in Australia. The themes identified were similar between the two periods. Rural PHCPs were underutilised due to a lack of awareness of their capacity and a lack of infrastructure and support for greater involvement. Conclusions: Rural PHCPs can be better integrated and supported in readiness for a whole-system response to future disasters. This study recommends empowering PHCPs in disaster management to promote the health and continuity of care in rural communities.
Prospective Associations Between Preschool Exposure to Violent Televiewing and Externalizing Behavior in Middle Adolescent Boys and Girls
Authors: Pagani Linda S. , Gilker Beauchamp Amélie , Kosak Laurie-Anne , Harandian Kianoush , Longobardi Claudio , Dubow Eric
Published: January 2025

Objective. Early childhood exposure to violent media content represents an actionable target for preventive intervention. The associated risks for later aggressive behavior have been established in childhood, but few studies have explored widespread long-term associations with antisocial behavior. We investigate prospective associations between exposure to violent television content in early childhood and subsequent antisocial behavior in mid-adolescence. Method. Participants are 963 girls and 982 boys from the Quebec Longitudinal Study of Child Development (QLSCD) birth cohort. Parents reported the frequency of their child’s exposure to violent television content at ages 3.5 and 4.5 years. Four indicators of antisocial behavior were self-reported by participants at age 15 years. These indicators were linearly regressed on exposure to violent television content at ages 3.5 and 4.5 years. All analyses, stratified by sex, controlled for pre-existing and concurrent potential individual and family confounding variables. Results. For boys, preschool violent televiewing was associated with increases in proactive aggression (β = 0.065; 95% CI, 0.001 to 0.089), physical aggression (β = 0.074; 95% CI, 0.040 to 0.487), and antisocial behavior (β = 0.076; 95% CI, 0.013 to 0.140) by mid-adolescence. No prospective associations were found for girls. Conclusions. This study of typically developing children demonstrates long-term perils associated with early exposure to violent content in childhood. We observed risks for aggressive and delinquent behavior in boys, more than a decade later. Preventive intervention campaigns that target knowledge transfer to parents and communities regarding the potential insidious consequences of preschool exposure promise more optimal development in youth.
In Vitro Insights into Bacteriocin-Mediated Modulation of Chicken Cecal Microbiota
Authors: Mamjoud Amal , Zirah Séverine , Biron Eric , Fliss Omar , Fliss Ismail
Published: January 2025

Reducing the use of antibiotics in animal husbandry is essential to limit the spread of resistance. A promising alternative to antibiotics resides in bacteriocins, which are antimicrobial peptides produced by bacteria showing a great diversity in terms of spectrum of activity, structure, and mechanism of action. In this study, the effects of diverse bacteriocins on the composition and metabolic activity of chicken cecal microbiota were examined in vitro, in comparison with antibiotics. Different impacts on microbiota composition were revealed by 16S metabarcoding, with colistin having the most dramatic impact on diversity. Bacteriocins produced by Gram-negative bacteria, microcins J25 and E492, did not significantly influence the microbiota composition. In contrast, bacteriocins from Gram-positive bacteria impacted the abundance of lactic acid bacteria, with nisin Z showing the most impact while pediocin PA-1 (M31L) exhibited a moderate effect at the highest concentration tested. This study emphasizes the potential of bacteriocins as alternatives to antibiotics in poultry to protect from pathogens such as Salmonella, Clostridium, and Enterococcus.
Cytosine Methylation Changes the Preferred Cis-Regulatory Configuration of Arabidopsis WUSCHEL-Related Homeobox 14
Authors: Jiang Dingkun , Zhang Xinfeng , Luo Lin , Li Tian , Chen Hao , Ma Nana , Fu Lufeng , Tian Peng , Mao Fei , Lü Peitao , Guo Honghong , Zhu Fangjie
Published: January 2025

The Arabidopsis transcription factor WUSCHEL-related homeobox 14 (AtWOX14) plays versatile roles in plant growth and development. However, its biochemical specificity of DNA binding, its genome-wide regulatory targets, and how these are affected by DNA methylation remain uncharacterized. To clarify the biochemistry underlying the regulatory function of AtWOX14, using the recently developed 5mC-incorporation strategy, this study performed SELEX and DAP-seq for AtWOX14 both in the presence and absence of cytosine methylation, systematically curated 65 motif models and identified 51,039 genomic binding sites for AtWOX14, and examined how 5mC affects DNA binding of AtWOX14 through bioinformatic analyses. Overall, 5mC represses the DNA binding of AtWOX14 monomers but facilitates the binding of its dimers, and the methylation effect on a cytosine’s affinity to AtWOX14 is position-dependent. Notably, we found that the most preferred homodimeric configuration of AtWOX14 has changed from ER1 to ER0 upon methylation. This change has the potential to rewire the regulatory network downstream of AtWOX14, as suggested by the GO analyses and the strength changes in the DAP-seq peaks upon methylation. Therefore, this work comprehensively illustrates the specificity and targets of AtWOX14 and reports a previously unrecognized effect of DNA methylation on transcription factor binding.
Advances in Protein Kinase Regulation of Stress Responses in Fruits and Vegetables
Authors: Song Yanan , Li Fujun , Ali Maratab , Li Xiaoan , Zhang Xinhua , Ahmed Zienab F. R.
Published: January 2025

Fruits and vegetables (F&Vs) are essential in daily life and industrial production. These perishable produces are vulnerable to various biotic and abiotic stresses during their growth, postharvest storage, and handling. As the fruit detaches from the plant, these stresses become more intense. This unique biological process involves substantial changes in a variety of cellular metabolisms. To counter these stresses, plants have evolved complex physiological defense mechanisms, including regulating cellular activities through reversible phosphorylation of proteins. Protein kinases, key components of reversible protein phosphorylation, facilitate the transfer of the γ-phosphate group from adenosine triphosphate (ATP) to specific amino acid residues on substrates. This phosphorylation alters proteins’ structure, function, and interactions, thereby playing a crucial role in regulating cellular activity. Recent studies have identified various protein kinases in F&Vs, underscoring their significant roles in plant growth, development, and stress responses. This article reviews the various types of protein kinases found in F&Vs, emphasizing their roles and regulatory mechanisms in managing stress responses. This research sheds light on the involvement of protein kinases in metabolic regulation, offering key insights to advance the quality characteristics of F&Vs.
Immunohistochemical Profiling of Histone Modification Biomarkers Identifies Subtype-Specific Epigenetic Signatures and Potential Drug Targets in Breast Cancer
Authors: Huo Zirong , Zhang Sitong , Su Guodong , Cai Yu , Chen Rui , Jiang Mengju , Yang Dongyan , Zhang Shengchao , Xiong Yuyan , Zhang Xi
Published: January 2025

Breast cancer (BC) subtypes exhibit distinct epigenetic landscapes, with triple-negative breast cancer (TNBC) lacking effective targeted therapies. This study investigates histone biomarkers and therapeutic vulnerabilities across BC subtypes. The immunohistochemical profiling of >20 histone biomarkers, including histone modifications, modifiers, and oncohistone mutations, was conducted on a discovery cohort and a validation cohort of BC tissues, healthy controls, and cell line models. Transcriptomic and cell growth analyses were conducted to evaluate the effects of the small-molecule G9a inhibitor in diverse BC models. Key histone biomarkers, including H3K9me2, H3K36me2, and H3K79me, were differentially expressed across BC subtypes. H3K9me2 emerged as an independent predictor for distinguishing TNBC from other less-aggressive BC subtypes, with elevated expression correlating with higher tumor grade and stage. G9a inhibition impaired cell proliferation and modulated epithelial–mesenchymal transition pathways, with the strongest impact in basal-like TNBC. The disruption of the oncogene and tumor suppressor regulation (e.g., TP53, SATB1) was observed in TNBC. This study highlights G9a’s context-dependent roles in BC, supporting its potential as a therapeutic target. The findings provide a foundation for subtype-specific epigenetic therapies to improve outcomes in aggressive BC subtypes.
HGS Promotes Tumor Growth, Whereas the Coiled-Coil Domain and Its Oligopeptide of HGS Suppress It
Authors: Ogura Kiyoshi , Kawashima Ikuo , Kasahara Kohji
Published: January 2025

We previously isolated a cDNA clone for galactosylceramide expression factor 1, which is the rat homologue of hepatocyte-growth-factor-regulated tyrosine kinase substrate (HGS) and induces galactosylceramide expression and morphological changes in COS-7 cells, and reported that overexpression of HGS induced morphological changes in canine kidney epithelial MDCK cells. HGS is a component of the endosomal sorting complexes required for transport machinery that mediates endosomal multivesicle body formation. In this study, the overexpression of HGS induced epithelial–mesenchymal transition and caused transformation in MDCK cells, whereas the overexpression of a coiled-coil domain of HGS inhibited induction of epithelial–mesenchymal transition by HGF stimulation. The overexpression of HGS in mouse melanoma B16 cells and human colorectal cancer COLO205 cells promoted cancer characteristic anchorage-independent cell growth ability and tumor growth, whereas the overexpression of the coiled-coil domain of HGS in these cells suppressed them. The oligopeptide OP12-462 constituting the coiled-coil domain suppressed the anchorage-independent cell growth ability and tumor growth of COLO205 cells. The coiled-coil domain of HGS and OP12-462 are novel tumor growth inhibitors that do not directly destroy cancer cells but rather inhibit only the anchorage-independent cell growth ability of cancer cells.
Cellular Senescence in Hepatocellular Carcinoma: Immune Microenvironment Insights via Machine Learning and In Vitro Experiments
Authors: Lu Xinhe , Luo Yuhang , Huang Yun , Zhu Zhiqiang , Yin Hongyan , Xu Shunqing
Published: January 2025

Hepatocellular carcinoma (HCC), a leading liver tumor globally, is influenced by diverse risk factors. Cellular senescence, marked by permanent cell cycle arrest, plays a crucial role in cancer biology, but its markers and roles in the HCC immune microenvironment remain unclear. Three machine learning methods, namely k nearest neighbor (KNN), support vector machine (SVM), and random forest (RF), are utilized to identify eight key HCC cell senescence markers (HCC-CSMs). Consensus clustering revealed molecular subtypes. The single-cell analysis explored the tumor microenvironment, immune checkpoints, and immunotherapy responses. In vitro, RNA interference mediated BIRC5 knockdown, and co-culture experiments assessed its impact. Cellular senescence-related genes predicted HCC survival information better than differential expression genes (DEGs). Eight key HCC-CSMs were identified, which revealed two distinct clusters with different clinical characteristics and mutation patterns. By single-cell RNA-seq data, we investigated the immunological microenvironment and observed that increasing immune cells allow hepatocytes to regain population dominance. This phenomenon may be associated with the HCC-CSMs identified in our study. By combining bulk RNA sequencing and single-cell RNA sequencing data, we identified the key gene BIRC5 and the natural killer (NK) cells that express BIRC5 at the highest levels. BIRC5 knockdown increased NK cell proliferation but reduced function, potentially aiding tumor survival. These findings provide insights into senescence-driven HCC progression and potential therapeutic targets.
Botulinum Toxin: A Comprehensive Review of Its Molecular Architecture and Mechanistic Action
Authors: Kumar Raj , Singh Bal Ram
Published: January 2025

Botulinum toxin (BoNT), the most potent substance known to humans, likely evolved not to kill but to serve other biological purposes. While its use in cosmetic applications is well known, its medical utility has become increasingly significant due to the intricacies of its structure and function. The toxin’s structural complexity enables it to target specific cellular processes with remarkable precision, making it an invaluable tool in both basic and applied biomedical research. BoNT’s potency stems from its unique structural features, which include domains responsible for receptor recognition, membrane binding, internalization, and enzymatic cleavage. This division of labor within the toxin’s structure allows it to specifically recognize and interact with synaptic proteins, leading to precise cleavage at targeted sites within neurons. The toxin’s mechanism of action involves a multi-step process: recognition, binding, and catalysis, ultimately blocking neurotransmitter release by cleaving proteins like SNAP-25, VAMP, and syntaxin. This disruption in synaptic vesicle fusion causes paralysis, typically in peripheral neurons. However, emerging evidence suggests that BoNT also affects the central nervous system (CNS), influencing presynaptic functions and distant neuronal systems. The evolutionary history of BoNT reveals that its neurotoxic properties likely provided a selective advantage in certain ecological contexts. Interestingly, the very features that make BoNT a potent toxin also enable its therapeutic applications, offering precision in treating neurological disorders like dystonia, spasticity, and chronic pain. In this review, we highlight the toxin’s structural, functional, and evolutionary aspects, explore its clinical uses, and identify key research gaps, such as BoNT’s central effects and its long-term cellular impact. A clear understanding of these aspects could facilitate the representation of BoNT as a unique scientific paradigm for studying neuronal processes and developing targeted therapeutic strategies.
Comparison of Respiratory Microbiomes in Influenza Versus Other Respiratory Infections: Systematic Review and Analysis
Authors: Hao Yunrui , Lee Ying-Jou , Yap Kihan , Samuel Miny , Chow Vincent T.
Published: January 2025

Studies have indicated the potential importance of the human nasal and respiratory microbiomes in health and disease. However, the roles of these microbiomes in the pathogenesis of influenza and its complications are not fully understood. Therefore, the objective of this systematic review and analysis is to identify the patterns of nasal and respiratory microbiome dysbiosis and to define the unique signature bacteria associated with influenza compared with other respiratory tract infections. We compared the respiratory microbiome composition between influenza patients and healthy controls; across different influenza severities; in adult versus pediatric influenza patients; as well as influenza versus other respiratory infections. The desired outcomes include the signature bacteria in each cohort and the Shannon index to reflect the alpha diversity. Of the 2269 articles identified, 31 studies fulfilled the inclusion criteria. These studies investigated the respiratory tract microbiomes of patients with influenza, COVID-19, pneumonia, other respiratory infections, and chronic rhinosinusitis (CRS). Our review revealed that the phylum Firmicutes and Actinobacteria, genus Actinomyces, Streptococcus and Granulicatella, and species Neisseria are more prominent in severe influenza than mild to moderate influenza. Reduced microbiome alpha diversity is noted in influenza patients compared to healthy controls. There are some similarities and differences between the signature bacteria in pediatric and adult influenza patients, e.g., Streptococcus is common in both age groups, whereas Pseudomonas is associated with adults. Intriguingly, there is a common predominance of Streptococcus and Firmicutes among influenza and pneumonia patients. COVID-19 patients exhibit an increased abundance of Firmicutes as well as Pseudomonas. In CRS patients, Proteobacteria and Haemophilus are found in high abundance. This review highlights some similarities and differences in the respiratory microbiomes and their signature organisms in influenza of varying severity and in different age groups compared with other respiratory infections. The dysbiosis of the respiratory microbiomes in these respiratory infections enhances our understanding of their underlying pathogenic mechanisms.
Cyber Insurance Adoption and Digitalisation in Small and Medium-Sized Enterprises
Authors: Taskin Nazim , Özkeleş Yıldırım Aslı , Ercan Handan Derya , Wynn Martin , Metin Bilgin
Published: January 2025

Digitalisation has significantly increased cybersecurity risks in organisations, notably for small to medium-sized enterprises (SMEs), in which IT departments often have relatively small teams and limited resources. Cyber insurance enables SMEs to navigate cybersecurity risks more economically, providing an essential risk transfer alternative to costly reduction strategies. This article examines the antecedents, emergence, and application of cyber insurance as a solution to cybersecurity concerns against the backdrop of increasing digitalisation. The research adopts a quantitative deductive approach, with an analysis of relevant literature providing the basis for the development of 12 hypotheses, which are then tested via a survey of 168 SMEs in Turkey. Using the Technology–Organisation–Environment–Individual (TOE-I) model as a top-line conceptual framework, the article finds that cyber insurance policy adoption has facilitated a more rapid and secure digitalisation process and that the mitigation of financial risk associated with cyberattacks has allowed companies to invest more widely in information technologies and systems. The article clearly has its limitations, in that it is based on primary research in one European country, but the authors believe that it nevertheless provides some new insights into the potential benefits of cyber insurance, and the key issues SMEs must consider when considering adopting a cyber insurance policy. The findings will be of practical relevance to SMEs and other organisations reviewing their cybersecurity strategy and are also of relevance to the wider debate around the costs and benefits of digitalisation.
Cool Mix Asphalt—Redefining Warm Mix Asphalt with Implementations in Korea, Italy and Vietnam
Authors: Lee Hosin (David) , Nguyen Lan Ngoc , Sturlini Elena , Kim Young-ik
Published: January 2025

During the past decades, to minimize Greenhouse Gas (GHG) emissions and asphalt fumes during the asphalt mix production and construction process, various warm mix asphalt (WMA) additives have been developed and successfully applied. Currently, as production of WMA reaches close to that of Hot Mix Asphalt (HMA) in the US, the varied definition of WMA is questioned in this paper. Not only are the temperature reduction ranges from HMA defined by various studies too wide, but also the minimum threshold to be classified as WMA is often too small. In this paper, a new category of “Cool Mix Asphalt (CMA)” is proposed to distinguish it from the newly defined WMA based not on the reduction amount from HMA temperature but its actual production temperature. It is proposed that HMA should be defined as asphalt mixtures produced at temperatures between 140 and 160 °C (between 284 and 320 °F), WMA as production temperatures between 120 and 140 °C (between 248 and 284 °F), and CMA as production temperatures between 100 and 120 °C (212 to 248 °F). By defining their actual production temperatures rather than reduction temperatures from HMA, WMA and CMA will be clearly defined. This paper then presents a new Polymer Cool Mix Asphalt (PCMA) additive called “Zero-M”, which was developed to lower the mixing temperature to around 110 °C (203 °F). Recently, test sections using Zero-M were successfully constructed in Korea, Italy and Vietnam, and their laboratory test results of field cores and production and construction experiences are described in this paper. The chemistry and compositions of Zero-M are discussed along with its mechanism to significantly lower the production temperature of PCMA. All test sections constructed in three countries met the in-place compaction density requirements of their respective countries, which were close to or higher than those of the control HMA test sections.
Morphological Comparisons of Adult Worker Bees Developed in Chinese and Italian Honey Bee Combs
Authors: Yang Shunhua , Li Hui , Wu Pingqing , Yue Dan , Guo Yulong , Zhao Wenzheng , Dong Kun
Published: January 2025

The size of comb cells is a key factor influencing the body size of honey bee workers. Comb cells and the body size of Chinese honey bee workers are smaller than those of Italian honey bee workers. To increase the size of Chinese honey bee workers, this study used newly built combs from Chinese honey bee colonies (control group) and Italian honey bee colonies (treatment group). These combs were provided to Chinese honey bee colonies for queens to lay fertilized eggs with the aim of rearing larger workers. Workers emerging from the control and treatment combs were designated as control and treatment workers, respectively. We compared 13 external morphological traits, including right forewing length and width; linear length of veins a, b, c, and d; proboscis length; right hind femur length; tibia length; metatarsal length and width; and the longitudinal diameters of the third and fourth tergites between the two groups. The results identified six types of cell contents in the combs, excluding empty cells: capped honey (most abundant), followed by capped brood, uncapped honey, and smaller amounts of pollen, larvae, and eggs. Additionally, the average body weights of 6-day-old worker bee larvae, white-eyed pupae, adult worker bees, and honey stomachs containing sucrose solution were significantly higher in the treatment group than in the control group. Except for proboscis length, the average size of 12 out of 13 traits in the treatment group was significantly larger than in the control group, indicating that increasing cell size can produce larger Chinese honey bee workers. In the control group, only the left forewing was significantly shorter than the right, with no significant side-to-side differences in the other morphological traits. In the treatment group, the left forewing width, hind leg femur length, tibia length, and hind leg metatarsus width were significantly smaller than their right-side counterparts, while the other six traits showed no significant side-to-side differences. These findings provide a basis for using Italian honey bee combs to rear larger workers in Chinese honey bee colonies, offering beekeepers a strategy to enhance foraging capacity and improve honey production.
Challenges in Diagnosing Adolescent Goiter: A Case Report with Brief Literature Insights in Juvenile Desmoid-Type Fibromatosis of the Thyroid Gland
Authors: Brad Giorgiana-Flavia , Jugănaru Iulius , Nicoară Delia-Maria , Scutca Alexandra-Cristina , Bugi Meda-Ada , Asproniu Raluca , Chelu Alexandru-Daniel , Basaca Diana-Georgiana , Corneanu Mărioara , Mărginean Otilia
Published: January 2025

The prevalence of goiter, thyroid nodules, and thyroid cancers in the pediatric population has increased. In some rare cases, local conditions such as juvenile desmoid-type fibromatosis (JDTF) can mimic specific thyroid pathology, complicating the diagnostic process. A 17-year-old obese adolescent girl was admitted to the Endocrinology Department with progressive swelling on the left side of the neck, persisting for approximately one year, recently accompanied by dysphonia and inspiratory dyspnea, and ultimately diagnosed as a unilateral nodular goiter associated with compressive phenomena. Despite her euthyroid status, the thyroid ultrasound identified a suspected, large, non-homogeneous, hypoechogenic nodule with calcifications in the left thyroid lobe (TI-RADS score of 4), confirmed by a cervical-region MRI. The biopsy specimens obtained through fine-needle aspiration were classified as Bethesda III (“atypia of undetermined significance” or “follicular lesion of undetermined significance”). Left thyroid lobe removal was performed by a specialized surgeon in thyroid pathology, with histopathological analysis revealing a diagnosis of JDTF in the thyroid gland. Post-surgery, the patient showed favorable progress without any relapse. Pediatric endocrinologists face challenges in diagnosing and managing thyroid nodules in children due to their higher malignancy potential. Familiarity with similar conditions, such as JDTF, is crucial in accurate diagnosis and appropriate pediatric management.
Impact of Resistance Exercise and Nitrate Supplementation on Muscle Function and Clinical Outcomes After Knee Osteoarthritis Surgery in Middle-Aged Women with Sarcopenia: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial
Authors: Park Han-Soo , Yoon Jin-Ho , Oh Jae-Keun
Published: January 2025

Background/Objectives: Sarcopenia, characterized by reduced muscle mass and strength, is associated with osteoarthritis (OA), particularly in middle-aged women, and may worsen postoperatively. Resistance exercise (RE) can resolve sarcopenia; however, recovery is often suboptimal. Nitrate (NO3−) supplementation may enhance muscle recovery and complement RE. We investigated whether NO3− supplementation combined with RE improves thigh muscle mass and strength in middle-aged women during postoperative rehabilitation. Methods: We conducted a prospective randomized placebo-controlled double-blind study including 36 middle-aged women with sarcopenia and cartilage defects undergoing mesenchymal stem cell implantation. Participants were assigned to RE with NO3− supplementation (NG, n = 18) or with placebo (PG, n = 18) groups. Both groups underwent 12 weeks of supervised RE. The primary outcomes were thigh muscle cross-sectional area (CSA) and knee strength, whereas functional and clinical measures, including the Short Physical Performance Battery (SPPB), skeletal muscle index (SMI), International Knee Documentation Committee (IKDC), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, were secondary outcomes. Results: Thigh muscle CSA decreased in the PG but was maintained in the NG. Knee extension strength improved significantly in the NG compared with that in the PG at 6 and 12 weeks. Knee flexion strength also improved rapidly in the NG, with a significant increase at 6 weeks. SPPB and IKDC scores improved significantly in the NG. However, similar improvements were observed for WOMAC scores in both groups. Conclusions: NO3− supplementation combined with RE effectively prevented muscle atrophy and enhanced muscle strength in our study participants, indicating potential for improving postoperative recovery.
Diabetes Mellitus as a Risk Factor for Complicated Urinary Tract Infections in Kidney Transplant Recipients
Authors: Krohmals Severins , de Terwangne Christophe , Devresse Arnaud , Goffin Eric , Darius Tom , Buemi Antoine , Mourad Michel , Rodriguez-Villalobos Hector , Kanaan Nada
Published: January 2025

Background: Urinary tract infections (UTIs) are a common complication after kidney transplantation. The aim of this study was to evaluate the impact of pre-existing diabetes mellitus and post-transplant diabetes mellitus (PTDM) on the occurrence of pyelonephritis in kidney transplant recipients. Methods: We performed a retrospective analysis which included 299 adult patients transplanted with a kidney between 2018 and 2022. Patients were categorized into pre-transplantation diabetics, PTDM, and non-diabetics. Asymptomatic bacteriuria and lower urinary infections were not included. Results: During a median follow-up time of 31 [17–45] months, 100 UTIs were reported in the total cohort, with a mean time from transplantation to the first UTI episode of 10 ± 11 months. At 48 months, the cumulative incidence of UTIs was 34.9%, 56%, and 47.3% for patients without prior diabetes, pre-transplant diabetes, and PTDM, respectively. Pre-transplant diabetes was independently associated with 79% increased risk of UTIs (adjusted HR = 1.79, 95% CI = 1.14–2.81, p = 0.011). The risk associated with female gender increased to 85%. Patient survival was not significantly affected by the interaction between diabetes and UTI occurrence. Conclusions: Pre-transplant diabetes arises as a significant risk factor for UTIs after kidney transplantation.
Multilocular Thymic Cyst with High F18 Fluorodeoxyglucose Uptake and Rheumatoid Arthritis: A Case Report
Authors: Ferrante Francesco , Poggi Camilla , Centofanti Anastasia , Vaz Sousa Rita , Sebastianelli Valerio , Evangelista Antonio Pio , Mattoccia Francesco , Zacchini Beatrice , De Giacomo Tiziano , Anile Marco , Venuta Federico , Bassi Massimiliano
Published: January 2025

Background: multilocular thymic cysts are uncommon acquired cysts in the anterior mediastinum caused by incomplete thymic involution. They may be associated with autoimmune diseases, such as rheumatoid arthritis and systemic sclerosis. Methods: a 61-year-old man with a history of rheumatoid arthritis for 8 years was referred to our unit because of a multiloculated mass in the anterior mediastinum with a high F18 fluorodeoxyglucose uptake at PET-CT scan. Histology showed a multilocular thymic cyst with lymphoid tissue, organized in germinal centers and internodal areas. Results: rheumatoid arthritis-related symptoms progressively disappeared after the excision of the mass. Conclusions: to our knowledge, this is the first report in the English language of rheumatoid arthritis symptoms improvement after multilocular thymic cyst surgical removal.
Sex-Specific Sensory Profiles Discriminate Between Sensitization at Twelve Weeks in Patients with Acute Low Back Pain: A Retrospective Study
Authors: Gräper Pieter J. , Scafoglieri Aldo , Hallegraeff Joannes M.
Published: January 2025

Background/objective: Low back pain (LBP) is the leading cause of disability worldwide, resulting in enormous socio-economic and personal consequences. Sensory profiles during the acute back pain stage will predict central sensitization symptoms in the chronic pain stage, as central sensitization is the main mechanism behind nociplastic pain and pain chronicity. Therefore, our objective was to establish overall and sex-specific sensory profile cut-off points that distinguish symptoms of central sensitization at 12 weeks, using a retrospective prognostic cohort study design. Methods: Two hundred and seventeen patients with acute LBP (<6 weeks) were assessed using Receiver Operator Characteristic analyses. Measurements were taken at baseline using the Adolescent/Adult Sensory Profile and follow-up by the Central Sensitization Inventory at 12 weeks, based on the established Central Sensitization Inventory cut-off points for the overall population at ≥30 and ≥40, female patients at ≥33, and male patients at ≥25. Results: In female patients, a Sensory Sensitive cut-off point of ≥30.5 significantly distinguished central sensitization symptoms at 12 weeks, resulting in the following values: Area Under the Curve = 0.81 (95% CI = 0.73; 0.89), sensitivity = 0.89, specificity = 0.63, prevalence = 0.36, positive predictive value = 0.56, negative predictive value = 0.80, and Youden’s index = 0.52. Conclusions: The Sensory Sensitive profile distinguishes female patients with acute LBP with and without central sensitization symptoms at 12 weeks. This cut-off point may be useful in identifying individual sensory preferences and addressing maladaptive behavioral responses to sensory stimulation in clinical practice to prevent chronicity.
Revolutionizing Cardiology: The Role of Artificial Intelligence in Echocardiography
Authors: Maturi Bhanu , Dulal Subash , Sayana Suresh Babu , Ibrahim Atif , Ramakrishna Manasa , Chinta Viswanath , Sharma Ashwini , Ravipati Harish
Published: January 2025

Background: Artificial intelligence (AI) in echocardiography represents a transformative advancement in cardiology, addressing longstanding challenges in cardiac diagnostics. Echocardiography has traditionally been limited by operator-dependent variability and subjective interpretation, which impact diagnostic reliability. This study evaluates the role of AI, particularly machine learning (ML), in enhancing the accuracy and consistency of echocardiographic image analysis and its potential to complement clinical expertise. Methods: A comprehensive review of existing literature was conducted to analyze the integration of AI into echocardiography. Key AI functionalities, such as image acquisition, standard view classification, cardiac chamber segmentation, structural quantification, and functional assessment, were assessed. Comparisons with traditional imaging modalities like computed tomography (CT), nuclear imaging, and magnetic resonance imaging (MRI) were also explored. Results: AI algorithms demonstrated expert-level accuracy in diagnosing conditions such as cardiomyopathies while reducing operator variability and enhancing diagnostic consistency. The application of ML was particularly effective in automating image analysis and minimizing human error, addressing the limitations of subjective operator expertise. Conclusions: The integration of AI into echocardiography marks a pivotal shift in cardiovascular diagnostics, offering enhanced accuracy, consistency, and reliability. By addressing operator variability and improving diagnostic performance, AI has the potential to elevate patient care and herald a new era in cardiology.
The Balance Between the Natriuretic Peptides and the Renin-Angiotensin-Aldosterone System in the Preservation of Ideal Cardiovascular Health
Authors: Rubattu Speranza , Gallo Giovanna , Volpe Massimo
Published: January 2025

A healthy lifestyle plays a key role for maintaining the cardiovascular health (CVH) status and prevent cardiovascular disease occurrence. In fact, a healthy lifestyle was included in the AHA Cardiovascular Health score (Life’s Simple 7 [LS7]), subsequently updated to Life’s Simple 8 [LS8]. Apart from the importance of controlling conventional cardiovascular risk factors, increasing evidence supports the contributory role of cardiovascular hormones. Higher levels of natriuretic peptides (NPs) and lower levels of renin and aldosterone were significantly associated to CVH. NT-proBNP levels showed a direct relationship with CVH scores in large general Caucasian populations, being also a marker of CVH changes and a predictor of future adverse events. On the other hand, renin and aldosterone were inversely related to CVH scores. In contrast, the counter-regulatory angiotensins [Ang (1-7) acting through Mas receptor, Ang (1-9) acting through Angiotensin Type 2 receptor, and alamandine] strengthen the beneficial properties of NPs. This evidence can be explained by both the effects on systemic hemodynamic and possible pleiotropic local functions regulating different pathways involved in the maintenance of CVH. Based on the current evidence, circulating levels of NT-proBNP, renin and aldosterone may affect CVH in apparently asymptomatic individuals and represent additional markers of residual cardiovascular risk.
Clinical Outcomes of Catheter Ablation for Atrial Fibrillation in Patients with Acute Decompensated Heart Failure
Authors: Ikeda Yoshifumi , Kato Ritsushi , Mori Hitoshi , Tsutsui Kenta , Matsumoto Kazuhisa , Narita Masataka , Sasaki Wataru , Kudo Daisuke , Tanaka Naomichi , Matsumoto Kazuo
Published: January 2025

Background: The prognosis of acute decompensated heart failure (ADHF) and heart failure (HF) with atrial fibrillation (AF) has been dismal. This study was performed to investigate the clinical outcomes of catheter ablation (CA) performed in patients with concurrent ADHF and AF. Methods: We retrospectively analyzed ADHF patients with AF who were admitted to our institution from 2007 to 2017. Results: In total, 472 patients were included in this study, with a mean follow-up duration of 32.8 ± 32.9 months. The 5-year event-free rate (cardiovascular death and HF hospitalization) was 61.4%, and the 10-year event-free rate was 42.7%. A comparative analysis of the event group and control group revealed that patients in the event group were older (event group vs. control group: 72.1 ± 11.0 vs. 68.8 ± 13.4 years, p = 0.008) and had a higher proportion of Clinical Scenario 3 classifications (event group vs. control group: 24% vs. 12%, p = 0.001). Notably, patients in the event group had a lower sinus rhythm maintenance rate (event group vs. control group: 17% vs. 31%, p < 0.001) and CA rate (event group vs. control group: 9% vs. 21%, p = 0.003). The CA group had a higher event-free rate than the non-CA group, and this trend persisted even after matching the patients’ backgrounds (log-rank test: p < 0.001). Conclusions: Patients presenting with AF at the onset of ADHF showed a poor prognosis, whereas CA demonstrated potential for improving the prognosis for some of these patients.
Comprehensive Review of Lipid Management in Chronic Kidney Disease and Hemodialysis Patients: Conventional Approaches, and Challenges for Cardiovascular Risk Reduction
Authors: Abidor Erica , Achkar Michel , Al Saidi Ibrahim , Lather Tanvi , Jdaidani Jennifer , Agarwal Alaukika , El-Sayegh Suzanne
Published: January 2025

Background/Objectives: Lipid disorders are very prevalent in patients with chronic kidney disease (CKD) and end-stage kidney disease (ESKD), leading to heightened cardiovascular risk. This review examines the effectiveness of lipid-lowering agents in these populations and explores gaps in the current research. The goal of this review is to assess the efficacy of lipid-lowering therapies in CKD and ESRD patients and identify future research needs. It aims to provide a clearer understanding of how these treatments impact cardiovascular risk in high-risk populations. Methods: We conducted a literature search in Embase, PubMed, Cochrane, and Google Scholar databases using keywords including but not limited to: chronic kidney diseases, dialysis, hemodialysis, dyslipidemia, statins, ezetimibe, and lipid-lowering drugs. Findings from included studies were synthetized to provide an overview of the current management of dyslipidemia in ESRD and HD. Results: Statins show mixed results in CKD and ESRD, with limited benefits in reducing cardiovascular events in dialysis patients. Agents like PCSK9 inhibitors show promising results but require further research, while non-statin therapies like fibrates and omega–3 fatty acids have limited evidence for use in this population. Conclusions: The review underscores the need for further research into lipid-lowering agents in CKD and ESRD patients, highlighting the need for tailored lipid management strategies in vulnerable patients with unique risk factors. More studies are needed to refine treatment strategies and assess the role of exercise and accurate risk calculators in managing cardiovascular outcomes.