bluuebunny/crossref_metadata_2025 huggingface dataset:
Flex-ability - a key concept to promote occupational health in everyday life beyond sick leave
Authors: Karlsson Louise , Erlandsson Lena-Karin , Cregård Anna , Nordgren Lena , Lydell Marie
Published: February 2025

Background

Sick leave and ill health due to stress are significant concerns today and negatively affect the individual, the organisations, and the community. High demands, multitasking, and inexplicit boundaries between different occupations contribute to an explanation. However, research shows that more qualitative studies are needed to better understand this issue and how to promote health in the working population.

Objective

The study aims to explore participants’ experiences of maintaining or regaining occupational health in their everyday life, including paid work, several years after sick leave.

Method

Nine semi-structured interviews were conducted and analysed using inductive content analysis. The analysis resulted in one major theme and three categories describing the current experiences handling their everyday life and work situations.

Results

The result showed that returning to work and maintaining occupational health after sick leave due to occupational ill health calls for “flex-ability”. The term describes that individuals need to be open to change and adapt to new challenges at work and in everyday life.

Conclusion

The findings highlight the importance of health-promotive organisations where the individual factor is more considered. Furthermore, a broader view of health-promotive work in society where work is included in everyday life, instead of divided into and outside of work, is needed.
Furrow Irrigated Long-Term No-Till and Conventional-Till Soil Evaluation in the Mid-South USA
Authors: Mubvumba Partson , Tyler Heather L. , Anapalli Saseendran S. , Pinnamaneni Srinivasa R. , Reddy Krishna N.
Published: February 2025

Despite being environmentally harmful, conventional tillage’s (CT) importance under furrow irrigation for ridge-making (RM) and furrow maintenance (FM) cannot be overemphasized. No-till (NT) practices’ soil health and sustainable production benefits are well documented. The Lower Mississippi Delta (LMD) region’s 70% land is furrow irrigated. Therefore, skepticism over NT synergy with furrow irrigation standard practices hinders NT adoption. RM and FM are crucial for judicious surface water application for row crop production and expediting drainage following precipitation to curb flash flooding and avert undesirable water logging conditions. The impact of adopting a long-term NT practice compared to the CT prevalent in the LMD region was evaluated from 2019 to 2022. NT increased soil total nitrogen, organic matter, organic sulfur, magnesium, calcium, cation exchange capacity, and stored soil water compared to CT during 4 years of soybean production following 11 years under corn. Phosphatase enzyme activity was 27% higher under NT than CT in the top 10 cm depth. NT and CT had no significant differences in wet aggregate stability and soybean yields. The loss in nutrients observed under CT in the top 10 cm manifests the impact of disturbing the surface soil and exposing it to denudation processes and consequent nutrient losses. CT developed a 5-cm thick plow pan at 10 cm depth. This was possibly due to the excess land preparation operations count, 83% higher for CT than NT for the 4-year study period. NT adoption coupled with shallow occasional FM operations is a viable conservation practice under furrow irrigation.
Identifying and Designing Evidence-Informed Practice, in Practice: The Case for Pragmatic Evidence Synthesis Matrices (PESM)
Authors: Knight Simon
Published: February 2025

Across sectors, including education, there are a confluence of pressures towards integration of research and evidence into practice. These include a focus on evidence quality in practice and policy, inclusion of research and evidence evaluation in professional training, and development of implementation standards and translational resources to support evidence mobilisation. However, while current approaches to evidence synthesis support many purposes, there is a gap in approaches to identify and design for evidence-informed practice ‘from within’ those practices. That is, current approaches may not adequately reflect the ways that practices: emerge and may be seen as ‘in need of evidence’; make use of proto-theories; and give rise to a need for clear alignment (or relevance) with evidence, and designed features of intervention contexts. This narrative review draws on an instrumental case to describe a novel method for Pragmatic Evidence Synthesis Matrices (PESM). PESM emerged from a body of work, particularly in educational technology (edtech), with one instrumental case briefly described to motivate its development. PESM: draws on extant evidence synthesis approaches, particularly best fit realist synthesis; integrates design artefacts including theory of change or logic model approaches and persuasive design; and is stakeholder oriented through use of narrative scenario-based methods. Through use of approaches such as PESM, evidence synthesis and systematised approaches to their development and use may be more readily developed across domains.
Antimonumentos and other aesthetic interventions amidst generalized violence: Seeds in the “political subsoil” of central Mexico
Authors: Hernández Lara Oliver Gabriel , Crane Nicholas Jon , Tapia Martínez David
Published: February 2025

Mexico faces a situation of generalized violence, expressed in diverse forms of violence that facilitate and intensify the exploitation of productive and reproductive labor. The government of the “Fourth Transformation” (4T) has made insufficient efforts to deliver justice to sectors of Mexican society made most vulnerable by this situation. In this sense, the 4T does not represent a radical change in the situation of generalized violence that Mexico has experienced since 2006 with the PAN and PRI administrations. Indeed, 4T officials preside over an ongoing production of geographical forms, including “landscapes of disappearance,” that facilitate impunity. Highly visible proponents of the 4T simultaneously seek to delegitimize the justice claims of communities and collectives identified as environmentalist, feminist, Indigenous, or all of the above, which, from a position of exclusion, seek to shape what Luis Tapia would call the “political subsoil”—relations of sociality that exceed the totalizing logic of capitalist and state-territorial projects, reproduced through autonomous forms of solidarity and communication. We argue that aesthetic interventions produced from this position, including “anti-monuments,” express a spatial politics by which activists and community representatives engage in place-making in response to experiences that otherwise are insufficiently recognized by institutionalized power. We focus on the Mexico City megalopolis, in geographies where generalized violence is acutely and variably felt. We understand these aesthetic interventions as signposts that guide—without a pre-established route—a transversal struggle in defense of life.
Smaller Width Quadriceps Tendon Grafts Maintain Advantageous Biomechanical Properties for ACL Reconstruction
Authors: Lee Richard C. , Voinier Steven D. , McCarthy Conor F. , Colantonio Donald F. , Gee Shawn M. , Tucker Christopher J. , Helgeson Melvin D. , Lopreiato Nicholas P.
Published: February 2025

Background:

Despite clinical evidence of risks in knee arthrofibrosis and graft impingement with larger grafts, the optimal size for quadriceps tendon (QT) autografts in anterior cruciate ligament reconstruction (ACLR) has not been established.

Purpose/Hypothesis:

This study aimed to evaluate the mechanical properties of full-thickness 6-mm and 8-mm wide QT grafts compared with 10-mm patellar tendon (PT) and 10-mm QT grafts. The hypothesis was that both the 6- and 8-mm QT grafts would exhibit similar or superior ultimate tensile strength compared with the 10-mm PT graft.

Study Design:

Controlled laboratory study.

Methods:

A total of 18 matched pairs of cadaveric knees were used in this study. From each pair, a 10–mm wide full-thickness QT was harvested from 1 knee. Based on randomization, a 6–mm wide or 8–mm wide full-thickness QT along with a 10–mm wide PT were harvested from the contralateral knee. Each tendon was clamped, tensioned, and cycled on a servohydraulic testing machine before final loading to failure.

Results:

The ultimate failure load was 1286 ± 237.3 N for the 10-mm QT, 1056 ± 226.7 N for the 8-mm QT, 935.1 ± 283.8 N for the 6-mm QT, and 816 ± 192.7 N for the 10-mm PT. Ultimate tensile strength differed significantly between the 10-mm and 8-mm QT ( P = .004), 10-mm and 6-mm QT ( P < .001), 10-mm QT and 10-mm PT ( P < .001), and 8-mm QT and 10-mm PT grafts ( P < .001), but not between the 6-mm QT and 10-mm PT grafts ( P = .152).

Conclusion:

The 8-mm QT had higher ultimate tensile strength than the 10-mm PT, and the 6-mm QT was comparable to the 10-mm PT. Full-thickness QT grafts <10 mm in width may maintain sufficient tensile strength for ACLR.

Clinical Relevance:

Given these biomechanical properties, smaller QT graft sizes may be advantageous in minimizing arthrofibrosis risk while maintaining graft strength.
Type 3 diabetes and metabolic reprogramming of brain neurons: causes and therapeutic strategies
Authors: Meng Xiangyuan , Zhang Hui , Zhao Zhenhu , li Siyao , Zhang Xin , Guo Ruihan , Liu Huimin , Yuan Yiling , Li Wanrui , Song Qi , Liu Jinyu
Published: February 2025

Abnormal glucose metabolism inevitably disrupts normal neuronal function, a phenomenon widely observed in Alzheimer’s disease (AD). Investigating the mechanisms of metabolic adaptation during disease progression has become a central focus of research. Considering that impaired glucose metabolism is closely related to decreased insulin signaling and insulin resistance, a new concept "type 3 diabetes mellitus (T3DM)" has been coined. T3DM specifically refers to the brain’s neurons becoming unresponsive to insulin, underscoring the strong link between diabetes and AD. Recent studies reveal that during brain insulin resistance, neurons exhibit mitochondrial dysfunction, reduced glucose metabolism, and elevated lactate levels. These findings suggest that impaired insulin signaling caused by T3DM may lead to a compensatory metabolic shift in neurons toward glycolysis. Consequently, this review aims to explore the underlying causes of T3DM and elucidate how insulin resistance drives metabolic reprogramming in neurons during AD progression. Additionally, it highlights therapeutic strategies targeting insulin sensitivity and mitochondrial function as promising avenues for the successful development of AD treatments.
Preoperative semen quality is superior to the quality shortly after orchiectomy in patients with testicular germ cell tumour – a retrospective study from two centres in Germany
Authors: Dieckmann Klaus-Peter , Hochmuth-Tisch Johanna , Salzbrunn Andrea , Matthies Cord , von Kopylow Kathrein , Wülfing Christian , Pichlmeier Uwe , Soave Armin , Ruf Christian Guido
Published: February 2025

Background

Sperm cryopreservation in patients with testicular germ cell tumours (GCTs) is traditionally performed after orchiectomy. But, some evidence suggests preoperative semen quality to be superior. We aimed to clarify the optimal time-point of cryopreservation.In a retrospective study, semen quality of 163 patients analysed preoperatively was compared with 242 patients analysed shortly after orchiectomy. Descriptive statistical methods with standard tests for comparisons were employed along with stratified analyses regarding the influence of clinical factors.

Results

All major semen parameters were significantly better in the preoperative group: median ejaculate volume (3 ml preoperatively vs. 2 ml postoperatively); median total sperm count (56.9 x106vs.13 x 106), median progressive motility (40% vs. 25%); azoospermia (4.9% vs. 14.9%). Stratified analysis of subgroups did not reveal significant impact of particular clinical factors on the superiority of preoperative semen quality. Limitations relate to the design of group comparison rather than intraindividual longitudinal comparisons and to selective inclusion of patients opting for cryopreservation.

Conclusions

In GCT patients, semen quality before orchiectomy is significantly superior to that found immediately after surgery. This superiority encompasses all major semen quality parameters. Of particular note is a threefold increase of azoospermia postoperatively. GCT patients are best advised to have cryopreservation performed before orchiectomy.
Adherence to pharmacological therapy for hypertension in Portugal: a health professionals focus groups study
Authors: Rosendo-Silva Beatriz , Gonçalves João , Prazeres Filipe , Santiago Luiz Miguel , Rosendo Inês
Published: February 2025

Introduction

The perspectives of local healthcare professionals for developing effective strategies to enhance medication adherence in arterial Hypertension as well as its barriers have not yet been explored through qualitative research in Portugal.

Objectives

This study aimed to assess the views of healthcare professionals including general practitioners/family physicians, nurses, and community pharmacists, from Portugal on effective strategies to improve medication adherence in Hypertension, and to identify factors hindering pharmacological adherence.

Methods and analyses

This was a qualitative study with synchronous online focus groups, in which, the participants were general practitioners/family physicians, family nurses, or community pharmacists in Portugal with experience managing patients with Hypertension. They were selected based on age, sex, and geographical region with the number of focus groups determined by theoretical saturation. Recruitment was facilitated through specific mailing lists. Purposive and snowball sampling techniques were employed. Focus group discussions were recorded and transcribed. Two researchers conducted content analyses via MAXQDA®2023, applying comparative analysis and reaching consensus. The results are described narratively.

Results

Three focus group discussions revealed a multifaceted approach to improving medication adherence for Hypertension. Key strategies to enhance coordination and communication among healthcare professionals, patients, and caregivers were identified. These included shared informatics software among healthcare professionals; using mobile applications and wearables; health literacy initiatives and patient empowerment; preprepared medication in pillboxes; involving family and the concept of a “family pharmacist”. Participants highlighted barriers to medication adherence such as the lack of communication with patients concerning issues like medication adherence.

Conclusions

This qualitative study outlines strategies to improve medication adherence among patients with Hypertension in Portugal. These involve improving healthcare coordination and communication, patient empowerment, and involving family and “family pharmacists” in supporting adherence. These strategies are based on the insights of healthcare professionals and could be implemented following robust intervention studies.

Clinical trial number

Not applicable.
Knowledge, attitudes, and self-reported practices regarding cholera among six MENA countries following cholera outbreaks in the region
Authors: Bekhit Salma A. , Rafei Rayane , Elnaggar Fatma , AL-Sakkaf Omar Zain , Seif Hussein Kamal , Samardali Dana , Alabead Yara Turkmani , Sanosi Mohammed Osman Omer , Abdou Marwa Shawky , Elbanna Eman H. , Khalil Doaa Mahmoud
Published: February 2025

Background

Cholera persists as a global public health threat, endangering the lives of vulnerable societies including the MENA region where many countries are facing recent cholera outbreaks. The present study aimed to characterize the knowledge, attitude, and practices status related to cholera in six MENA countries in the MENA region.

Methods

A cross-sectional study was conducted using a structured, validated questionnaire and distributed across different social media platforms in Egypt, Sudan, Jordan, Syria, Lebanon, and Yemen between December 2022 and January 2023. Univariate and multivariate analyses were used to determine factors associated with knowledge, attitudes, and practices related to cholera.

Results

A total of 2971 participants were included in the study, of which 62.5% were females; with a mean age of 34.8 ± 12.3 years; 85.4% heard about cholera; and 1.9% experienced cholera infection during cholera outbreaks in their countries. Among those who heard about cholera, 50.7% had adequate knowledge, 67.3% had desirable attitudes, and 50.3% reported good practices. Multivariate analysis revealed that being older, highly educated, employed, working in the medical field, and living in an outbreak country were the significant predictors affecting good knowledge. Additionally, good attitudes were significantly increased by older ages, females, those working in the medical sector, and those living in an outbreak country. Whereas working in the medical sector and having a larger number of people living in the same house significantly decreased the practice scores.

Conclusions

Raising community awareness about fecal-oral diseases transmitted via contaminated food or water, such as cholera, is crucial. This can be achieved by organizing targeted awareness campaigns for the whole community. Furthermore, mandatory educational workshops and programs for medical professionals are essential, as they serve as role models for the community.
Association between visceral fat area and metabolic syndrome in individuals with normal body weight: insights from a Chinese health screening dataset
Authors: Sun Yongbing , Lin Xinbei , Zou Zhi , Zhou Yang , Liu Ao , Li Xin , Du Yawei , Ji Xiaoqi , Li Zhonglin , Wu Xiaoling , Wang Yong , Lv Xue , Li Tao , Zhang Jiancheng , Guo Zhiping , Li Hao , Li Yongli
Published: February 2025

Background

Metabolic syndrome (MetS) is increasingly diagnosed in individuals with normal body weight, and visceral fat emerges as a significant risk factor. However, the relationship between visceral fat area (VFA) and MetS within this population remains inadequately explored, and the diagnostic threshold for MetS in normal-weight individuals is yet to be established.

Methods

This study used a cross-sectional design combined with longitudinal cohort analysis. Data were collected from 5,944 normal-weight participants who underwent health screenings at Henan Provincial People’s Hospital of China between October 2018 and October 2024. VFA was measured via multislice computed tomography scanning, and VFA-based tertile categorization was applied among the participants. The relationship between VFA and MetS was examined using univariate and multivariate logistic regression analyses. Nonlinear relationship was investigated by restricted cubic spline (RCS) modeling, and diagnostic accuracy was determined by receiver operating characteristic (ROC) curve analysis. Furthermore, data from individuals who completed three or more screenings were used to construct Kaplan–Meier survival curves for MetS events, with significance tested using the log-rank method.

Results

Among the individuals with a normal BMI, elevated VFA was associated with a high incidence of MetS. After the adjustment for confounders, VFA was significantly associated with MetS risk [odds ratio (OR) = 1.13, 95% confidence interval (CI): 1.12–1.25]. The subjects in the highest VFA tertile showed significantly elevated MetS risk (OR = 30.33; 95% CI: 19.00–48.43, P < 0.001) versus those in the lowest tertile. The RCS model demonstrated a nonlinear, positive association between VFA and MetS risk (P for nonlinearity < 0.001), with risk escalation slowing down when the VFA exceeded 100 cm². ROC analysis showed that VFA had the highest diagnostic accuracy for MetS compared with other abdominal fat measures (AUC = 0.844, sensitivity = 0.839, specificity = 0.793, and accuracy = 0.785). In a longitudinal subset of 398 normal-weight participants followed for 6 years, 106 MetS cases occurred, with cumulative incidence rising as VFA increased (log-rank test, P < 0.001).

Conclusion

VFA shows an independent, nonlinear, positive association with MetS risk among normal-weight individuals, with a threshold effect at 100 cm². VFA = 162.85 cm² may serve as an accurate and effective predictor for MetS in this population.
Incidence trends of surgical complications after oesophagectomy for oesophageal cancer: a population-based, nationwide cohort study in Finland over 30 years
Authors: Sirviö Ville E.J. , Räsänen Jari V. , Helminen Olli , Helmiö Mika , Huhta Heikki , Kallio Raija , Koivukangas Vesa , Kokkola Arto , Laine Simo , Lietzen Elina , Meriläinen Sanna , Pohjanen Vesa-Matti , Rantanen Tuomo , Ristimäki Ari , Saarnio Juha , Sihvo Eero , Toikkanen Vesa , Tyrväinen Tuula , Uimonen Mikko , Valtola Antti , Kauppila Joonas H.
Published: February 2025

Background

Knowledge on the incidence of surgical complications after oesophagectomy for oesophageal cancer in nationwide practice is scarce. The aim of this study was to assess complication trends after oesophagectomy in a nationwide, population-based, unselected cohort.

Methods

All patients undergoing oesophagectomy for oesophageal cancer in Finland in 1987–2016 were included. All complications defined by the Esophagectomy Complications Consensus Group (ECCG) were reported in three 10-year periods. Chi-square test and Kruskal-Wallis test were used to compare outcomes in these periods.

Results

A total of 1493 patients were included. From 1987 to 1996 to 2007–2016, improvements were seen in the rate of major complications (49% vs. 43%, p = 0.039), length of hospital stay (19 vs. 14 days, median, p < 0.001), length of ICU-stay (3 vs. 2 days, median, p < 0.001) and 90-day mortality (17.9% vs. 5.4%, p < 0.001), while pneumonia (16% vs. 23%, p = 0.029) and anastomotic leak (8% vs. 12% in total leaks, p = 0.006 for type II leak) increased. The most common complications were pneumonia, pleural effusion requiring drainage (16% vs. 23%, p = 0.080), atrial dysrhythmia (16% vs. 15%, p = 0.464) and anastomotic leak. The most common complication categories defined by ECCG were pulmonary (36% vs. 42%, p = 0.151) and gastrointestinal (21% vs. 23%, p = 0.398) complications.

Conclusions

This study reports high postoperative morbidity after oesophagectomy in nationwide practice. Mortality has significantly improved during the years, and it appears that patients who would have died earlier, can now be rescued. While the relative occurrence of complications has remained constant, overall morbidity has decreased as the more severe outcomes have decreased.
Bilateral lung herniation with parenchymal infarction following clamshell thoracotomy for lobar lung transplantation: a case report
Authors: Tavandžis Janis , Novysedlák René , Pozniak Jiří , Švorcová Monika , Mošna František , Vajter Jaromír , Ozaniak Střížová Zuzana , Suchánek Vojtěch , Šimonek Jan , Vachtenheim Jiří , Lischke Robert
Published: February 2025

Background

Pulmonary hernia is a rare condition characterized by the protrusion of lung tissue through a chest wall defect. Trauma and thoracic surgery are the most common causes of acquired lung hernias. We present an unusual case of (sequential) bilateral lung herniation with parenchymal infarction after bilateral lobar lung transplantation.

Case presentation

A 50-year-old female, wait-listed as high-urgency candidate, with a body mass index (BMI) of 29 kg/m2 underwent a bilateral lobar lung transplantation for pulmonary fibrosis through a clamshell thoracotomy approach. Due to a size mismatch, stapler resection of the segment 3 and the middle lobe of the right lung, as well as an upper left lobectomy was required. The chest was closed with 3 braided non-absorbable pericostal sutures on each side. Sternal osteosynthesis was performed with a titanium sternal splint along with 7 self-tapping screws with a length of 18 mm. On the posttransplant day (PTD) 18, patient’s clinical condition deteriorated. Physical examination didn’t reveal any palpable subcutaneous chest resistance. However, a computed tomography (CT) scan showed a herniation of the segment 6 of the right lung. During acute surgical revision, perioperative finding revealed posterior pericostal suture failure. Therefore, a stapler resection was performed due to the infarction of the herniated segment. On the PTD 36, herniation of the left lung parenchyma was detected by acute CT scan. The protruding vital parenchyma was surgically repositioned without necessity of resection. Two posterior pericostal sutures were broken, and distal part of sternal splint detached. Thoracotomy was closed using 5 braided non-absorbable sutures. Sternum was re-osteosynthesized with the STRATOS™ system. After 3 months of intensive postoperative care, the patient was transferred to the rehabilitation department. She was discharged on the PTD 99. After 20 months of follow-up, lung function remains stable without the need for oxygen support.

Conclusion

Clamshell incision remains ultimate approach in thoracic surgery. However, pulmonary herniation after clamshell thoracotomy is a rare complication and may manifest as acute respiratory distress syndrome with an inflammatory response. In these cases, CT scan should be always considered, even if no palpable pathology of chest is present.
Effect of the flavonoid compound glabridin on tachyzoites and bradyzoites of Toxoplasma gondii
Authors: Qiu Yanhua , Wang Weiwei , Wang Qing , Lin Hongling , Bai Yubin , Zhang Jiyu
Published: February 2025

Background

Toxoplasma gondii (T. gondii) is one of the most prevalent parasites worldwide. At present, the majority of drugs used for the treatment of toxoplasmosis target the tachyzoite stage of T. gondii and are largely ineffective against bradyzoites. Furthermore, these treatments are typically accompanied by adverse events. Consequently, there is an urgent need for the development of novel drugs that are both safe and effective against T. gondii.

Methods

A total of 20 flavonoids were preliminarily screened for their anti-T. gondii activity using microscopy. Next, the cell counting kit (CCK)-8 method was employed to assess the toxicity of glabridin (GLA) to host cells, while the RH strain of T.0gondii, which expresses β-galactosidase, was utilized to evaluate the inhibitory, anti-invasive, and antiproliferative effects of GLA on T. gondii. In addition, the Prugniaud (PRU) strain was employed to investigate the impact of GLA on the bradyzoites of T. gondii. Subsequently, the effect of GLA on the ultrastructure of T. gondii was examined via transmission electron microscopy (TEM), followed by an assessment of the influence of GLA on the autophagy and mitochondria of T. gondii through monodansylcadaverine (MDC), MitoTracker™ red CMXRos, and CM-HDCFDA and MitoSOX Red staining.

Results

Among the 20 flavonoids assessed, GLA exhibited the most potent anti-T. gondii activity. Indeed, it significantly inhibited both the invasive and proliferative abilities of T. gondii, thereby disrupting its lytic cycle. Moreover, GLA markedly reduced the number of bradyzoites and concurrently inhibited cyst growth. Meanwhile, ultrastructural analysis revealed that GLA induced mitochondrial swelling, membrane rupture, and autophagy in T. gondii. Finally, fluorescent probe staining provided further evidence that GLA triggers mitochondrial dysfunction and autophagy in this parasite.

Conclusions

Our findings collectively indicate that the flavonoid compound GLA exhibits significant activity against both T. gondii tachyzoites and bradyzoites. The underlying mechanism of action potentially involves the induction of autophagy and mitochondrial dysfunction and the disruption of the membrane of T. gondii, thereby offering new avenues for treating toxoplasmosis and establishing a theoretical reference for future research.

Graphical Abstract
Gut microbiota dysbiosis and associated immune response in systemic lupus erythematosus: impact of disease and treatment
Authors: Ali Aya Y. , Zahran Sara A. , Eissa Mervat , Kashef Mona T. , Ali Amal Emad
Published: February 2025

Background

Gut microbial dysbiosis and leaky gut play a role in systemic lupus erythematosus (SLE). Geographical location and dietary habits affect the microbiome composition in diverse populations. This study explored the gut microbiome dysbiosis, leaky gut, and systemic immune response to gut bacterial consortium in patients with SLE exhibiting mild/moderate and severe disease activity.

Methods

Fecal and blood samples were collected from patients with SLE and healthy volunteers. Genomic DNA was extracted from the stool samples and subjected to 16S rRNA amplicon sequencing and microbiome profiling. Additionally, enzyme-linked immunosorbent assays were employed to determine the serum lipopolysaccharide level, as an assessment of gut permeability, and the systemic immune response against gut bacteria.

Results

Patients with SLE showed significantly lower gut bacterial richness and diversity, indicated by observed OTUs (56.6 vs. 74.44; p = 0.0289), Shannon (3.05 vs. 3.45; p = 0.017) and Simpson indices (0.91 vs. 0.94; p = 0.033). A lower Firmicutes-to-Bacteroidetes ratio (1.07 vs. 1.69; p = 0.01) was observed, with reduced genera such as Ruminococcus 2 (0.003 vs. 0.026; p = 0.0009) and Agathobacter (0.003 vs. 0.012; p < 0.0001) and elevated Escherichia-Shigella (0.04 vs. 0.006; p < 0.0001) and Bacteroides (0.206 vs. 0.094; p = 0.033). Disease severity was associated with a higher relative abundance of Prevotella (0.001 vs. 0.0001; p = 0.04). Medication effects included lower Romboutsia (0.0009 vs. 0.011; p = 0.005) with azathioprine and higher Prevotella (0.003 vs. 0.0002; p = 0.038) with cyclophosphamide. Furthermore, categorization by prednisolone dosage revealed significantly higher relative abundances of Slackia (0.0007 vs. 0.00002; p = 0.0088), Romboutsia (0.009 vs. 0.002; p = 0.0366), and Comamonas (0.002 vs. 0.00007; p = 0.0249) in patients receiving high-dose prednisolone (> 10 mg/day). No differences in serum lipopolysaccharide levels were found, but SLE patients exhibited elevated serum gut bacterial antibody levels, suggesting a systemic immune response.

Conclusion

This study confirms the gut microbiome dysbiosis in patients with SLE, influenced by disease severity and specific medication usage.
Are technical performance differences in wheelchair fencing linked to disability categories?
Authors: Borysiuk Zbigniew , Błaszczyszyn Monika , Piechota Katarzyna , Akbaş Anna
Published: February 2025

Background

This study aimed to examine differences in muscle activity and activation timing in wheelchair fencers across disability categories A and B to better understand the neuromuscular dynamics involved in their performance.

Methods

Sixteen right-handed wheelchair fencers from the Polish National Paralympic Team, grouped into categories A and B, participated in the study. Muscle activity and activation timing (reaction time) were recorded during a visual-cue task using a surface electromyography system and a 3D accelerometer. Eight upper body muscles, including the deltoid, triceps, biceps, forearm extensors/flexors, latissimus dorsi, and obliques, were assessed. Data were processed using MyoResearch and MATLAB, and statistical analyses utilized the Wald-Wolfowitz runs test.

Results

Intergroup differences in reaction time and muscle activity were found: category A fencers tended to achieve lower reaction times and higher muscle bioelectric tension values than category B fencers. Significant differences between the groups were found in the activity of the left latissimus dorsi and the deltoid muscles (p < 0.05).

Conclusions

The study indicates the important role of the back and abdominal muscles as stabilizing postural muscles in wheelchair fencing. The significant differences in muscle activity for the back and deltoid muscles suggest distinct neuromuscular profiles between disability categories A and B. These findings could enhance classification accuracy and inform training strategies for para-athletes, optimizing performance and targeting specific muscle groups for improvement.
Cultural tightrope walkers: a qualitative study of being a young refugee in quest for identity and belonging in Norway
Authors: Binder Per-Einar , Heggen Hanna , Vase Elisabeth Buer , Sandal Gro Mjeldheim
Published: February 2025

Background

Refugee experiences significantly challenge personal identity, especially for youth orienting themselves in new cultural contexts. The study explores the complex process of balancing expectations from two cultures: how do formative encounters in Norway mold the self-perception and sense of belonging of those who arrived as child and adolescent refugees?

Methods

A qualitative approach in which life story interviews were conducted with eight young refugees who arrived in Norway between the ages of 8 and 17 years was used. Through thematic analysis grounded in hermeneutical phenomenology, we analyzed their narratives to identify core experiences and perspectives. The interviews lasted 90–150 min, providing insights into personal identity development amid cultural adaptation.

Results

A recurring and overarching theme is that participants grapple with feelings of “outsiderness” both in Norwegian society and within their culture of origin, creating a dual sense of alienation. This experience is painful, but they also perceive that it has given them the opportunity to develop open-mindedness and a unique perspective on cultural existence. Three subthemes were identified that describe various aspects of these narratives in greater detail: (1) Experiences of being a stranger; (2) value conflicts, but value reconciliation is possible; and (3) a unique perspective: navigating between two cultures. The narratives highlight the complex negotiation between maintaining heritage and adapting to Norwegian norms.

Conclusions

The study of participants’ narrative identities reveals ways of coping with these transitions, revealing how participants continuously reconstruct their self-narratives to adapt to their new cultural environment. The findings suggest that while acculturation is a challenging process characterized by psychological tension and existential vulnerability, it can also foster personal resilience and new opportunities for meaning-making. The research contributes to understanding the refugee experience in Norway, emphasizing the need for social support systems that acknowledge both the struggles and potential for growth inherent in cultural integration.
Usage of permeability ratio to check the stability of a pile-soil model with retaining wall support – Huizhou slope failure as a case study
Authors: Khan Muhammad Israr , Fei Jianbo , Chen Xiangsheng , Chen Yue
Published: February 2025

This paper presents a comprehensive investigation into the role of soil permeability variation on the stability of slopes reinforced by retaining walls, with a focus on the Huizhou slope failure as a case study. The study demonstrates that rising groundwater levels diminish the Factor of Safety (FoS) for retaining walls, with stability most compromised under combined loading from adjacent soil and lightweight concrete. These findings emphasize the need for enhanced drainage or structural support in retaining wall designs subjected to elevated groundwater conditions. It integrates advanced numerical simulations, utilizing Abaqus and GeoStudio, with empirical field data to analyze the interactions between soil permeability, pore water pressure, moisture content, shear strength, and the overall stability of the slope. The dynamics of water infiltration are influenced by permeability, moisture content, and the groundwater table. These factors change the pore pressure and decrease shear strength, which causes shear failure in the slope mass. This research also looks at how surcharge loading affects slope stability. Higher permeability soils cause faster infiltration rates, leading to higher pore pressures, lower effective shear strengths, and a higher likelihood of slope failure. The opposite is true for reduced permeability, which makes drainage more difficult and ultimately leads to hydrostatic pressure building up behind retaining walls, which in turn makes the slope even more unstable. This study demonstrates the critical need for optimized drainage systems to reduce the hazards of infiltration-induced failure and the role of precise permeability evaluation in geotechnical design. Geotechnical engineers can use these results to better understand how to construct and maintain slope stabilization systems.
Unveiling the association between long non-coding RNAs (RP5-833A20.1, DYNLRB2-2, and APOA1-AS) and ischemic stroke: exploring biomarkers, and clinical implications
Authors: Bayat Mahnaz , Mokhtari Mahsa , Mokhtari Mohammad Javad , Gharbi Negin , Tabrizi Reza , Salehi Mohammad Saied , Karimi Najmeh , Rahimi Moosa , Hooshmandi Etrat , Zafarmand Seyedeh Shaghayegh , Owjfard Maryam , Lashanizadegan Ramin , Dara Mahintaj , Borhani-Haghighi Afshin
Published: February 2025

Background

RP5-833A20.1, DYNLRB2-2, and APOA1 antisense are pivotal in atherosclerotic plaque pathogenesis. This study examined whether changes in these circulating lncRNAs could serve as biomarkers for high-risk ischemic stroke (IS) patients with intracranial atherosclerotic disease (ICAD).

Methods

Sixty-three IS patients, presenting within the first 24 h after stroke onset, and 60 controls were included in the study. The circulating levels of RP5-833A20.1, DYNLRB2-2, and APOA1 antisense in IS patients were assessed using real-time polymerase chain reaction (RT-PCR).

Results

Significant decreases in the circulating levels of DYNLRB2-2 and RP5-833A20.1 were observed in IS patients compared to controls (P < 0.05). However, no significant difference in APOA1 antisense levels was noted between the two groups. Subgroup analysis revealed higher RP5-833A20.1 expression in IS patients with lower National Institutes of Health Stroke Scale (NIHSS) scores (0–6) compared to those with higher scores (3.59 ± 0.783 vs. 1.05 ± 0.505, P = 0.006). After adjusting for relevant covariates, multiple logistic regression indicated an inverse association between RP5-833A20.1 and the risk of IS (adjusted OR = 0.846, P = 0.028). Linear regression analyses further demonstrated a negative correlation between RP5-833A20.1 expression and NIHSS (beta = − 0.398, P = 0.006), which was confirmed by a significant negative Spearman correlation (r = − 0.41, P = 0.0007). DYNLRB2-2 exhibited a non-significant negative relationship with NIHSS.

Conclusion

The findings suggest a significant decrease in the circulating levels of RP5-833A20.1 and DYNLRB2-2 in IS patients with ICAD, potentially indicating a protective effect against ischemic stroke. These lncRNAs hold promise as valuable biomarkers for identifying high-risk IS patients, emphasizing the need for further exploration and validation in larger cohorts to elucidate their roles in IS pathogenesis and clinical applications.
Assessing the association of rare MDR1 variants (rs944806668, rs1816042256, and rs1295312177) with steroid response in Iraqi children with idiopathic nephrotic syndrome
Authors: Abd Alridha Ali Mohammed , Kadhim Dheyaa Jabbar , Alkhazrajy Ayad Hussein Ali
Published: February 2025

Background

Several studies have linked the development of steroid-resistant nephrotic syndrome (SRNS) to variations in the multidrug resistance 1 gene (MDR1). However, disparities in findings have been noted among children of different ethnic origins.

Objectives

This study aimed to examine the relationship between MDR1 variants [rs944806668 (V1), rs1816042256 (V2), and rs1295312177 (V3)] and the risk of developing SRNS in Iraqi patients with idiopathic nephrotic syndrome (INS).

Methods

This case–control study included children with steroid-sensitive INS (n = 30) and SRNS (n = 30) from the Babylon Hospital for Maternity and Pediatrics. Sanger sequencing was used to determine the participants’ genotypes.

Results

Children with the V2 T/C genotype were more likely to develop SRNS [odds ratio (OR) and 95% confidence interval (95% CI): 10.8 (3.26–35.72), p < 0.001] than those with the wild genotype. However, no significant association with steroid response was observed for the V1 genotypes and alleles [OR (95% CI): 0.58 (0.18–1.91) and 0.63 (0.21–1.9), respectively; p > 0.05]. Moreover, children with the wild–variant–variant genotype combination of the V1, V2, and V3 variants exhibited a significantly higher risk of developing SRNS [OR (95% CI) 34 (4.91–235.61), p < 0.001] than those with the wild–wild–wild genotype combination.

Conclusion

These findings highlight the need to incorporate pharmacogenetic screening into the clinical management of SRNS. Children with nephrosis having the V2 T/C and V3 A/T genotypes, whether individually or in combination, are likely to resist prednisolone therapy, implying the need for alternative therapeutic approaches. Further studies are required to elucidate the potential implications of MDR1 variants for personalized drug therapy in children with INS.
Contribution of intravoxel incoherent motion MRI to diffusion-weighted MRI in differentiating benign from malignant breast masses
Authors: Rashed Dina , Settein Magdy Elsayed Mohamed , Batouty Nihal M.
Published: February 2025

Background

The differentiation of benign and malignant breast masses is a critical aspect of breast cancer diagnosis. The aim of this study was to assess the capability of IVIM variables to discriminate between benign and malignant breast lesions by obtaining diffusion and perfusion data from normal tissues of breast and breast lesions through intravoxel incoherent motion (IVIM) imaging utilising biexponentially analysis of multiple b-value diffusion-weighted imaging (DWI) and comparing these variables to the apparent diffusion coefficient (ADC) derived from monoexponentially analysis.

Results

In this prospective work, each subject provided informed consent. Forty-two patients with fifty-two lesions with 31 malignancies and 21 benign lesions were scanned using 1.5 T MRI and DWI with 12 b-values (range 0–1000 s/mm2). Tissue diffusivity (D), perfusion fraction (f), and pseudo-diffusion coefficient (D
p) were determined by segmented biexponentially analysis. The ADC (b = 0 and 1000 s/mm2) was computed using monoexponentially fitting of the DWI information. D, f, D
p, and ADC values have been acquired for normal tissues of the breast, benign lesions, and malignancies. The contrast of these four variables among each pair indicated that the D and ADC values of malignancies had been substantially lower compared female patients of benign tumours and normal tissues (P < 0.001). The f of malignancies was substantially greater contrasted to that of benign lesions (P < 0.001); nevertheless, no substantial variation in D
p was seen between both groups. D, f, and values of ADC exhibited superior sensitivity and specificity in distinguishing benign lesions from malignancies, with areas under the curve (AUC) of 0.945, 0.883, and 0.796, correspondingly. At the same time, D
p showed the lowest AUC of 0.515.

Conclusions

IVIM may play a crucial role in differentiating malignancies and benign lesions of the breast by providing separate quantitative measurements of D for cellularity and D
p and f for vascularity.
Prognosis of p16 and Human Papillomavirus Discordant Oropharyngeal Cancers and the Exploration of Using Natural Language Processing to Analyze Free-Text Pathology Reports
Authors: Shin Ethan , Choi Justin , Hung Tony K.W. , Poon Chester , Riaz Nadeem , Yu Yao , Kang Jung Julie
Published: February 2025

PURPOSE

Treatment deintensification for human papillomavirus–positive (HPV+)-associated oropharyngeal cancer (OPC) has been the catalyst of experts worldwide. In situ hybridization is optimal to identify HPV+ OPC, but immunohistochemistry for its surrogate p16INK4a (p16) is standard-of-care given its availability and sensitivity. HPV testing is not required for clinical management, so treatments are often administered on the basis of p16 status alone. However, the prognosis of p16/HPV discordant tumors is uncertain.

MATERIALS AND METHODS

This cohort study included 727 consecutive patients with OPC with digitized unstructured pathology reports receiving curative radiation therapy at an academic cancer center. Natural language processing (NLP) methods were used to classify biomarker status and compared against manually derived classification. Patients were excluded if either p16 or HPV testing was not performed or equivocal. Primary end points were progression-free survival (PFS), cancer-specific survival (CSS), and overall survival.

RESULTS

NLP classified p16 and HPV status from a majority (91%) of reports. Accuracy, positive predictive value, sensitivity, and
F
-score for NLP-derived p16/HPV were 84%/82%, 91%/87%, 90%/89%, and 90%/88%, respectively. Four groups were identified: p16-positive (p16+)/HPV+ (75%), p16+/HPV-negative (HPV–; 13%), p16-negative (p16–)/HPV– (10%), and p16–/HPV+ (2%). There was no statistically significant difference in outcomes between p16+/HPV– and p16–/HPV– patients (5-year PFS 76.1%
v
68.9%;
P
= .12; 5-year CSS 81.5%
v
84.9%;
P
= .22). Number needed to harm calculations estimated one excess cancer-related death for every 10 p16+/HPV– patients, compared with that expected with p16+/HPV+ patients.

CONCLUSION

NLP classified head and neck cancer pathology reports with high concordance with gold-standard categorization, but a conspicuous portion of reports could not be interpreted. p16/HPV discordant OPC constitutes a noteworthy minority of patients. The inferior prognosis of p16+/HPV– suggests that p16 alone for prognostication is insufficient—especially when considering treatment de-escalation.