bluuebunny/crossref_metadata_2025 huggingface dataset:
Increased risk of dementia associated with herpes simplex virus infections: Evidence from a retrospective cohort study using U.S. electronic health records
Authors: Araya Katherine , Watson Riley , Khanipov Kamil , Golovko George , Taglialatela Giulio
Published: February 2025

Background:

Alzheimer's disease is the most common age-related dementia. Recent compelling evidence from previous retrospective electronic health record (EHRs) studies suggests that herpes simplex virus (HSV) infections may be a risk factor for developing dementia. However, no age and propensity score matched studies have been published in a United States general population cohort study to date.

Objective:

We aimed to identify whether HSV infection shows a significantly increased risk of the development of dementia in a sizable and heterogeneous cohort. We investigated whether herpes simplex virus type 1 (HSV1), herpes simplex virus type 2 (HSV2), or coinfections with both serotypes pose a greater risk of developing dementia across different biological sexes and racial groups.

Methods:

EHRs from patients with a history of HSV or specific serotypes (HSV1 or HSV2) infection were selected for analysis. These records were compared to a propensity-matched control group and analyzed for hazard and odds ratios through TriNetX.

Results:

There was a significant difference in dementia incidence in the HSV-infected group versus the control. Individuals with a history of HSV, HSV1, HSV2, and coinfection all showed a significant risk of developing dementia compared to controls. Males with HSV2 are at a higher risk of dementia outcome than females with HSV2.

Conclusions:

While consistent with previous reports, these findings are the first to establish a higher risk of developing dementia in patients who have any HSV diagnosis using a nationwide, population-based matched cohort study in the United States.
Navigating the blurred boundary: Neuropathologic changes versus clinical symptoms in Alzheimer’s disease, and its consequences for research in genetics
Authors: Xavier Catarina , Pinto Nádia
Published: February 2025

During decades scientists tried to unveil the genetic architecture of Alzheimer's disease (AD), recurring to increasingly larger sample numbers for genome-wide association studies (GWAS) in hope for higher statistical gains. Here, a retrospective look on the most prominent GWAS was performed, focusing on the quality of the diagnosis associated with the used data and databases. Different methods for AD diagnosis (or absence) carry different levels of accuracy and certainty applied to both subsets of cases and controls. Furthermore, the different phenotypes included in these databases were explored, as several incorporate other ageing comorbidities and might be encompassing many confounding agents as well. Age of the samples’ donors and origin populations were also investigated as these could be biasing factors in posterior analyses. A tendency for looser diagnostic methods in more recent GWAS was observed, where greater datasets of individuals are analyzed, which may have been hampering the discovery of associated genetic variants. Specifically for AD, a diagnostic method conveying a clinical outcome may be distinct from the disease neuropathological assessment, since the first has a practical perspective that not necessarily needs a confirmation. Due to its properties and complex diagnosis, this work highlights the importance of the neuropathological confirmation of AD (or its absence) in the subjects considered for research purposes to avoid reaching statistically weak and/or misleading conclusions that may trigger further studies with powerless groundwork.
GABA-activated slow spontaneous inhibitory postsynaptic currents are decreased in dorsal hippocampal dentate gyrus granule cells in an aged mouse model of Alzheimer's disease
Authors: Netsyk Olga , Korol Sergiy V , Li Jin-Ping , Birnir Bryndis , Jin Zhe
Published: February 2025

Background

Synaptic transmission dysfunction is associated with a range of neurological disorders, including Alzheimer's disease (AD). However, the role of γ-aminobutyric acid (GABA)-mediated synaptic inhibition in AD has not been fully explored.

Objective

We studied basal, GABA-activated slow spontaneous synaptic currents (sIPSCs) in dentate gyrus (DG) granule cells in the dorsal hippocampus of an AD mouse model (tg-APPSwe) and investigated insulin's modulatory effects.

Methods

GABA-activated slow sIPSCs were recorded in the DG granule cells by whole-cell patch­-clamp recordings in dorsal hippocampal brain slices from 5–6 (adult) and 10–12 (aged) months old wild-type (WT) and AD mice, in the presence or absence of insulin (1 nM).

Results

The median 10–90% rise time of slow sIPSCs significantly decreased with age (10–12 months vs. 5–6 months) only in AD mice. The median amplitude of the slow sIPSCs was decreased in adult and aged AD mice as compared to WT mice whereas the slow sIPSCs frequency was only reduced in the aged WT mice. The median 63% decay time and total current density of the slow IPSCs was significantly decreased in the aged AD mice as compared to both WT mice and to the adult AD mice. Insulin application exerted no effect on slow sIPSCs properties in any of the animal groups.

Conclusions

The characteristics of the slow sIPSCs recorded in DG granule cells of dorsal hippocampus from WT and AD mice are altered by age- and disease-state, whereas insulin has negligible effects.
Uncovering nutrition needs in dyads of caregivers and persons with dementia
Authors: Gibbs Heather D , Taylor Matthew K , Gibson Cheryl , Mount Rebecca R , Sullivan Austin , Williams Kristine , Sullivan Debra K
Published: February 2025

Background

Nutrition risk is common in Alzheimer's disease and is associated with symptoms of dementia, cognitive decline, institutionalization, and mortality. Family caregivers who increasingly manage nutrition needs of persons with dementia (PWD) experience high caregiver burden, low health literacy, and nutrition risk. Few interventions for informal caregivers have included nutrition.

Objective

To inform design of a future caregiver nutrition intervention.

Methods

This cross-sectional study used a convergent mixed methods approach to 1) assess nutrition status among PWD and caregiver dyads (measures in common included Mini Nutrition Assessment, skin carotenoid, and handgrip strength), and 2) interview caregivers to identify needs and barriers for nutrition intervention. We hypothesized caregiver nutrition literacy is associated with PWD nutrition risk. Data collected in nutrition assessment and interviews were analyzed separately then side-by-side for comparison.

Results

Of 50 dyads, 48% had at least one individual exhibiting nutrition risk, and nutrition status categories (χ2 = 6.25, p = 0.012) between caregivers and PWD were related. Caregiver nutrition literacy was associated with 1) PWD factors including nutrition risk (rho = 0.244), body mass index (BMI) (rho = 0.421), handgrip strength (rho = 0.283), and skin carotenoid (rho = 0.351), and 2) Caregiver factors including nutrition risk (rho = 0.304), diet quality (rho = 0.304), and BMI (rho = 0.333). Interviews with 18 caregivers found caregivers prioritize PWD nutrition, provide more PWD nutrition care since diagnosis, experience social isolation, and would attend nutrition interventions if PWD are included.

Conclusions

Nutrition risk was more common among caregivers when PWD demonstrated nutrition risk. Factors present in individuals within the dyad were associated with partner nutrition risk. Future research should identify effective approaches for intervening on dyadic nutrition risk.
Relationship between development trajectories of leisure activity and sleep time on incident cognitive impairment: A study based on the Chinese Longitudinal Healthy Longevity Survey (CLHLS)
Authors: Li Qi , Huo Jian-meng , Jia Cun-xian , Jia Fei-fei
Published: February 2025

Background

Leisure activity and sleep time are key factors in cognitive impairment, but the impact of their long-term trajectories on incident cognitive impairment remains unclear.

Objective

To examine the association of leisure activity trajectories, sleep time trajectories and their combined effects with incident cognitive impairment in older adults.

Methods

Data from the Chinese Longitudinal Healthy Longevity Survey (2008–2018) were analyzed, including adults aged ≥65 who participated in at least three surveys. Group-based trajectory modeling explored leisure activity and sleep time patterns. Cox proportional-hazards regression model assessed the association of leisure activity trajectories and sleep time trajectories and their combined effects with incident cognitive impairment.

Results

We included 3094 participants with a median follow-up of 6.07 years. The optimal trajectory groups for leisure activity and sleep time were four and three, respectively. The low-level leisure activity group were associated with an increased risk of cognitive impairment (HR, 95%CI: 2.07, 1.37–3.13), whereas the high-level leisure activity group were associated with a reduced risk of cognitive impairment (HR, 95%CI: 0.60, 0.36–0.99). Short sleep time group was associated with a reduced risk of cognitive impairment (HR, 95%CI: 0.62, 0.41–0.92). In the combined effect, leisure activity belonging to the low-level group and sleep time belonging to the moderate sleep time group or the long sleep time group were associated with an increased risk of cognitive impairment.

Conclusions

Long-term high-level leisure activity and short sleep time are associated with a reduced risk of cognitive impairment in older adults.
Earlier diagnosis of Alzheimer's disease by dynamic light scattering spectroscopy
Authors: Weiss Jeffrey N , Eber Daryl
Published: February 2025

Dynamic light scattering (DLS) spectroscopy measures changes in the Brownian movement of particles at the molecular level. Since the retina of the eye is a neural tissue and an outgrowth of the brain, a clinical instrument was developed capable of making DLS measurements from the retina in patients with mild cognitive impairment undergoing positron emission tomography nuclide imaging for the presence of cerebral amyloid.
Vibration reduction of lightweight structures through adjustable damping and stiffness properties at their interfaces
Authors: Heyden Emil , Hüttich Philipp , Bunk Lukas , Krause Dieter
Published: February 2025

This paper presents the vibration reduction of lightweight components by adjusting the mechanical properties of their boundary conditions in vibration test rigs. The variable boundary conditions are achieved by adjustable impedance elements, which are mechanical elements that can change their stiffness and damping behavior separately and are designed for use in vibration testing. A new generation of an adjustable impedance element is presented in this publication and its use in a large component test environment. The influence of the adjustable mechanical properties of the interfaces on an aircraft partition is shown. A holistic finite element model is presented to predict the interactions between the adjustable interfaces and the test object. A vibration reduction of about 65% compared to current rigidly designed joints is achieved. The influence of vibration on the partition is investigated experimentally for different stiffness and damping ranges and the corresponding simulation model is validated.
Automated transcoloration? Skin tone classification algorithms and the prominence of non-epidermic features in the Mexican racial schema
Authors: Rejón René
Published: February 2025

The scale of anti-racist research employing independent measures for skin tone (i.e., classification algorithms and colorimeters) is increasingly growing. However, recent studies reveal that non-epidermic traits (i.e., hair, lips, gender) contribute to the transcoloration –whitening or darkening– of perceived skin tone, signaling that their importance in the racialization process has been underestimated. The magnitude of this effect of non-epidermic features is critical, and the appropriateness of technology-based anti-racist research hinges on it. To what extent are independent measures of skin tone a good approximation to the study of racial discrimination in Mexico? Examining a novel dataset (n = 3000), I compare two different skin color variables (one coded by humans and other by an automated algorithm), finding little agreement about exact estimates but substantial —and statistically significant— agreement on the general direction of the variables. These findings corroborate that non-epidermic features slightly alter people’s perception of skin tone, without causing a major digression from independent skin color assessments. The results validate and encourage research employing these technological methods, which tend to be more accessible and feasible than their alternatives.
Beyond the Portal: Increasing Citizen Understanding of OGD With Storytelling
Authors: Kempeneer Shirley , Wolswinkel Johan , van Maanen Gijs
Published: February 2025

The open government data (OGD) movement claims to contribute to transparency and increased citizen understanding of government action. However, the literature so far shows these goals are not being reached, as ‘common’ (non-expert) citizens fail to access and understand OGD. This research makes an empirical contribution to this debate through a design experiment in the form of a field lab with a governmental agency, data visualization experts, and non-expert citizens in the Netherlands. In this field lab, the current practice of disseminating OGD by a regional water authority on the issue of drought was redesigned based on non-expert citizens’ needs. Our findings show that non-expert citizens prefer data storytelling techniques over OGD portals or traditional OGD visualizations such as graphs or dashboards. This is informative for the current shift from OGD geared at expert users, to OGD geared at fostering effective transparency with non-expert users. We also build on existing research to develop new evaluation criteria for OGD visualizations, and find that completeness and usability seem more important than objectivity in disseminating OGD with non-expert citizens when communicating about complex policy problems.
Two-staged aortic repair for acute type A aortic dissection in patients refusing blood transfusion
Authors: Watanabe Tatsuya , Ota Takeyoshi , Milner Ross , Jeevanandam Valluvan
Published: February 2025

Background

It is still challenging to perform high-risk cases, such as acute type A dissection, which frequently require blood transfusions. We created perioperative bloodless protocol, but it includes an optimization to increase the preoperative hemoglobin level enough to tolerate cardiopulmonary bypass. However, it would be impossible to optimize such patients using the strategy in the setting of emergent surgery. We sought to create a surgical strategy in an effort to reduce blood loss for acute type A dissection patients refusing blood transfusion.

Methods

We reviewed the records of two patients in our aortic surgery database who presented with acute aortic dissection and refused blood transfusion. These patients underwent two-staged aortic repair with ascending aortic replacement with debranching to the innominate and left common carotid arteries, followed by thoracic endovascular aortic repair (TEVAR).

Results

: The two-staged procedure was successfully completed in two patients without any significant complication. The postoperative course was uneventful for both patients.

Conclusion

Two-staged aortic repair in patients refusing blood transfusion can avoid circulatory arrest requiring deep hypothermia so as to reduce the risk of coagulopathy and blood loss.
‘I thought I was screwed before I started that program’: The impact on self-belief of the Peace Education Program at Adelaide Women’s Prison
Authors: Turner Anne , Menih Helena , Thomas Natalie
Published: February 2025

The Peace Education Program, created in 2012, is a complementary programme supplementing official rehabilitation interventions offered in correctional centres across the globe. It is a mixed media programme with 10 modules that aims to encourage participants’ appreciation of their inner resources. Findings presented are based on the qualitative research undertaken at Adelaide Women’s Prison with 15 participants who completed the programme, and six facilitators. This article focuses on one of the key aspects of this study: the impact of the programme on the self-belief of the participants and how this related to their confidence in their ability to desist from offending, as described in their words. Participants described how this relatively new, complementary programme had assisted them in discovering their inner resources, promoting self-belief and self-confidence. This was inter-related with an enhanced realisation of their own agency in their desistance journey.
Palliative care for chronic respiratory diseases in low- and middle-income countries: a narrative review
Authors: Al Achkar Zeina , Chaaban Toufic
Published: February 2025

Palliative care is essential for patients with chronic pulmonary diseases, especially in low- and middle-income countries (LMICs). Chronic respiratory diseases (CRDs), such as chronic obstructive pulmonary disease and interstitial lung diseases, cause significant morbidity and mortality globally, with a heavy burden in LMICs. Despite the need, access to palliative care in LMICs is limited, leading to inadequate symptom management and support. Palliative care benefits include improved quality of life, reduced healthcare costs, and increased patient and family satisfaction. However, barriers in LMICs, including limited resources, infrastructure, and trained providers, as well as cultural and regulatory challenges, hinder care delivery. Early integration of palliative care for patients with CRDs can enhance outcomes and reduce healthcare utilization, yet it remains underutilized in these regions. This review highlights the challenges and impact of palliative care for CRDs in these regions. Addressing these issues requires regulatory reforms, provider education, and investments in healthcare infrastructure. Solutions include national policies, training healthcare professionals, telemedicine, and research collaborations. Understanding and addressing barriers to palliative care in LMICs is crucial for improving care quality and outcomes for patients with CRDs.
Exploring the connection between erythrocyte membrane fatty acid composition and oxidative stress in patients undergoing the Crohn’s disease Therapeutic Diet Intervention (CD-TDI)
Authors: Haskey Natasha , Letef Clara , Sousa James A. , Yousuf Munazza , Taylor Lorian M. , McKay Derek M. , Ma Christopher , Ghosh Subrata , Gibson Deanna L. , Raman Maitreyi
Published: February 2025

Background:

Dietary fatty acids (FA) are crucial to the pathophysiology of inflammatory bowel disease (IBD), influencing systemic and gut inflammatory responses. Dietary FA intake influences the fatty acid profiles of vital cell membranes, which might be a source of inflammatory mediators. Despite their significance, research on dietary FA subtypes and their effects on inflammation and oxidative stress in IBD is limited.

Objective:

We investigated the association between dietary FA intake, the erythrocyte membrane FA composition (EMFA), and inflammation and oxidative stress markers in patients with mild–moderate luminal Crohn’s Disease (CD) participating in the CD Therapeutic Dietary Intervention (CD-TDI).

Design:

A cross-sectional analysis was performed on 24 participants (13 CD-TDI, 11 habitual diet controls) from a 13-week randomized controlled trial assessing the efficacy of CD-TDI in inducing clinical and biomarker remission in CD.

Methods:

EMFA was analyzed using direct-injection gas chromatography, and dietary FA intake was assessed using the ASA 24-h Dietary Assessment Tool®.

Results:

The CD-TDI group showed a significant increase in dietary n-3 polyunsaturated fatty acids (PUFA) at Week 13 ( p = 0.04) compared to no changes in the control group. Participants on the CD-TDI also demonstrated a significant reduction in total fat, saturated fat, and arachidonic acid (AA) ( p < 0.01). EMFA analysis revealed lower percentages of AA ( p = 0.03) in the CD-TDI group. Positive correlations were observed between C-reactive protein, fecal calprotectin, and dietary stearic acid ( p < 0.05). Inverse correlations were found between malondialdehyde (MDA) and the Mediterranean Diet Score ( r = −0.67) as well as MDA and the intake of whole fruit, legumes, and nuts/seeds ( r > −0.50).

Conclusion:

The CD-TDI significantly increased dietary n-3 PUFA intake, reduced pro-inflammatory n-6 PUFA (AA), and improved markers of oxidative stress, supporting its potential in CD management. The cell membrane fatty acid profile might be a therapeutic target in CD.

Trial registration:

NCT04596566.
Rethinking ethics in policymaking: Dharma, reversibility and the imperatives of environmental policymaking
Authors: Mehrotra Divyali
Published: February 2025

Since the age of Enlightenment, some philosophical traditions have assumed that human actions are ethically neutral, based on the belief that the non-human world is self-regulating and capable of maintaining balance regardless of human impact. However, with increasing human interference in the climate system and the accelerating rate of species extinction driven by human activity, this assumption appears to be flawed. Given the current environmental realities, the consequences of these actions are becoming increasingly difficult to manage, which demonstrates the need to challenge these frameworks. This paper outlines a framework for analysing political action by shifting the focus away from a solely human-centred perspective in ethics and decision-making, drawing on the concepts of reversibility and dharma. Reversibility integrates normative theory, political practice and policymaking, offering a way to address contemporary political challenges in a complex and pluralistic world. It emphasises that the human and non-human worlds are deeply interconnected and cannot be treated as separate. This perspective aligns with the principles of dharma, which advocate for the maintenance and preservation of cosmic order. Both reversibility and dharma highlight the responsibility humans have towards both the human and non-human realms, emphasising our interconnectedness. By bringing these approaches together, this paper proposes a novel framework for critically assessing the ethical dimensions of policies in today's uncertain and contingent world.
The effect of multifloral honey on cytotoxicity and the mitochondrial apoptotic pathway in ovarian cancer cell
Authors: Rasulova Khayala , Kavak Deniz Evrim , Kavak Fikriye Fulya , Irtegun Kandemir Sevgi , Kizildag Sefa
Published: February 2025

Background

Ovarian cancer is one of the most common malignancies in the female reproductive system. Honey has a range of medical properties. It has been shown to have anticancer properties, especially for breast, cervical, etc. cancers.

Objective

In our study, we aimed to investigate the cytotoxic, anti-migratory, and mitochondrial apoptotic pathway effects of Multifloral honey on the Ovarian Adenocarcinoma SKOV3 cell line.

Methods

The MTT assay was used to evaluate the anti-proliferative effect of Multifloral honey on SKOV3 and HDF cell lines. Subsequently, differences in the expression of genes involved in mitochondrial apoptosis in the SKOV3 cell were examined using RT-qPCR and Western Blot methods. Finally, the effects of Multifloral honey on migration in SKOV3 cell were observed under a microscope.

Results

It was found that honey did not exhibit a cytotoxic effect on HDF cell, but significantly suppressed SKOV3 cell proliferation, promoting apoptosis. In our study on SKOV3 cells, we observed a significant decrease in the ratio of apoptotic genes Bax/Bcl-2 (P = 0.0043) using the RT-qPCR method, while the expressions of Cyt-C and Bad increased significantly (P = 0.0034 and P < 0.0001, respectively). Western Blot analysis confirmed the decrease in the Bax/Bcl-2 ratio. In our wound healing results, we found that honey inhibited migration in the SKOV3 cell.

Conclusion

Our results provide preliminary evidence that Multifloral honey induces cell death in SKOV3 cell line through involvement in the intrinsic apoptotic pathways, and it demonstrates significant anticancer activity against human ovarian cancer cell lines for the first time.
A rare epidermal growth factor receptor T790M/cis-C797S/L718Q compound mutation in a lung adenocarcinoma patient who did not derive any benefit from combination therapy with afatinib and bevacizumab
Authors: Meng Xiaopeng , Liu Jingyi , Wu Xiaohui , Peng Pei
Published: February 2025

The most common mutations in epidermal growth factor receptor ( EGFR) are exon 19 deletions and exon 21 L858R mutations, both of which respond effectively to EGFR tyrosine kinase inhibitors. However, the efficacy of EGFR tyrosine kinase inhibitors against rare EGFR mutations remains controversial. Many patients eventually develop resistance to EGFR tyrosine kinase inhibitors. Here, we encountered the case of a 62-year-old male with lung adenocarcinoma and a history of hypertension, who harbored a rare EGFR L858R/T790M/cis-C797S/L718Q compound mutation and showed resistance to osimertinib. The patient showed a partial response to treatment with a combination of afatinib and bevacizumab lasting 2 months. Although this case did not demonstrate a clear benefit from dual therapy with afatinib and bevacizumab, it provides a valuable therapeutic reference for patients with rare compound EGFR mutations and offers insights for future studies.
MRpoxNet: An enhanced deep learning approach for early detection of monkeypox using modified ResNet50
Authors: Vandana  , Sharma Chetna , Shah Mohd Asif
Published: February 2025

Objective

To develop an enhanced deep learning model, MRpoxNet, based on a modified ResNet50 architecture for the early detection of monkeypox from digital skin lesion images, ensuring high diagnostic accuracy and clinical reliability.

Methods

The study utilized the Kaggle MSID dataset, initially comprising 1156 images, augmented to 6116 images across three classes: monkeypox, non-monkeypox, and normal skin. MRpoxNet was developed by extending ResNet50 from 177 to 182 layers, incorporating additional convolutional, ReLU, dropout, and batch normalization layers. Performance was evaluated using metrics such as accuracy, precision, recall, F1 score, sensitivity, and specificity. Comparative analyses were conducted against established models like ResNet50, AlexNet, VGG16, and GoogleNet.

Results

MRpoxNet achieved a diagnostic accuracy of 98.1%, outperforming baseline models in all key metrics. The enhanced architecture demonstrated superior robustness in distinguishing monkeypox lesions from other skin conditions, highlighting its potential for reliable clinical application.

Conclusion

MRpoxNet provides a robust and efficient solution for early monkeypox detection. Its superior performance suggests readiness for integration into diagnostic workflows, with future enhancements aimed at dataset expansion and multimodal adaptability to diverse clinical scenarios.
“An Archipelago of Signifiers”: Caribbean Genetic Test Reveal Videos and the Resistance of the Creole Imagination
Authors: Asgarali-Hoffman S. Nisa
Published: February 2025

This article presents an analysis of YouTube videos wherein creators reveal the results of their direct-to-consumer genetic ancestry tests. I analyze these reveal videos, their comment threads, and the role of YouTube in hosting these videos, to capture the popular discourse around the relationship between DNA and racial identity. By employing critical technocultural discourse analysis (CTDA), I explore how Caribbean content creators discuss racial identity, and how online discourses negotiate, codify, or disrupt neoliberal notions of racial authenticity. I focus on videos made by creators who self-identify as being from the Caribbean or of the Caribbean diaspora. By bringing the Caribbean existentialist thought of Stuart Hall and Édouard Glissant into my analysis, I explore how Caribbean creators employ what C. Rhonda Cobham-Sander deems “the Creole imagination” to interrogate notions of racial authenticity while de-/re-constructing racial identity in digital spaces.
Carotid Artery Stenting during Endovascular treatment of acute ischemic Stroke (CASES) study protocol for a multicenter randomized clinical trial
Authors: Maes Louise , Van Elk Theodora , van der Meij Anne , Roelofs Femke , Bogaerts Kris , Bokkers Reinoud PH , de Borst Gert J , den Hertog Heleen M , Dippel Diederik WJ , François Olivier , Ligot Noémie , Lingsma Hester F , Majoie Charles BLM , Peluso Jo PP , Tancredi Illario , van den Wijngaard Ido R , van der Lugt Aad , Yperzeele Laetitia , Zeebregts Clark J , Nederkoorn Paul J , Lemmens Robin , Uyttenboogaart Maarten
Published: February 2025

Background:

The optimal acute management of patients with acute ischemic stroke and a tandem lesion, defined as intracranial large vessel occlusion (LVO) with concomitant carotid artery stenosis or occlusion, remains unclear. Our aim is to assess the efficacy and safety of immediate carotid artery stenting (CAS) compared to delayed management in patients undergoing endovascular treatment (EVT) for acute ischemic stroke due to tandem lesions.

Study design:

CASES is a phase 3 multicenter prospective randomized open-label blinded endpoint (PROBE) non-inferiority clinical trial. Patients with a computed tomography angiography proven intracranial LVO in the anterior circulation and ipsilateral proximal carotid artery stenosis (⩾50%) or occlusion of presumed atherosclerotic origin will be randomized to either immediate CAS during EVT or to EVT followed by a deferred strategy, which may include carotid endarterectomy (CEA), CAS, or medical management. CASES will be conducted in 27 EVT centers in Belgium and the Netherlands. A total of 600 patients will be included.

Study outcomes:

The primary outcome is the score on the modified Rankin Scale (mRS) at 90 days. Secondary outcomes include excellent (mRS 0–1) and good (mRS 0–2) functional outcome at 90 days, stroke severity measured with the National Institutes of Health Stroke Scale (NIHSS) at 24 h and 5–7 days, recanalization, infarct volume at 24 h, ischemic stroke recurrence, carotid artery re-occlusion, symptomatic intracranial hemorrhage, and mortality.

This study will provide high-quality randomized data on the efficacy and safety of immediate CAS in patients undergoing EVT for acute ischemic stroke due to a tandem lesion.

Trial registration:

ClinicalTrials.gov NCT06511089; ISRCTN 14956654
Decoding urban policies: NLP-driven concise explanations
Authors: Lu Zhengyang , Wang Weifan , Guo Tianhao , Li Yifan , Wang Feng
Published: February 2025

This study introduces a novel NLP-driven approach for generating accurate explanations of urban policies, addressing the critical need for communication between policymakers and the public. The proposed method integrates policy-specific fine-tuning of large language models, retrieval-augmented generation, and policy-aware prompt engineering. For the policy research, we collect the Zhihu Official Policy Q&A Dataset, a comprehensive collection of 29,151 policy-related questions and answers. Experimental results demonstrate significant improvements in explanation quality, accuracy, and relevance across various policy domains and question types. Human evaluations conducted by urban policy experts and citizens confirm the effectiveness of our method in enhancing the clarity, completeness, and usefulness of policy explanations. The potential implications for urban governance include increased policy transparency, facilitated public participation, and improved policy implementation. While acknowledging limitations such as data bias and model interpretability, this research contributes to the ongoing dialogue on smart city technologies and digital governance, highlighting the potential of NLP-driven approaches to transform urban policy communication.
Exploitation of Up–Down Tapping Washing Method for Removing Different Soil types from Cotton Fabric
Authors: Zhao Xin , Shen Jinsong , Ding Xuemei
Published: February 2025

More gentle washing methods are required in order to maintain the satisfactory appearance of delicate or luxury garments. In the current study, a new washing method with an up–down tapping action was introduced for delicate garments. The influence of tapping washing parameters used in the new washing method on the removal of five different types of IEC soiling from cotton fabrics was investigated. The cleaning performance of the tapping washing method mainly relies on the turbulent flow of the washing liquor and a gentle mechanical tapping action without a friction force being applied to fabrics during laundry. Tapping washing could maintain the good appearance of the fabrics without fibre damage and remove water-soluble soil but it had difficulty removing water-insoluble soil. However, the washing efficiency of water-insoluble soil could be improved by adjusting the levels of washing parameters. Further development and optimisation of the up–down tapping washing method could make a good balance between sufficient washing of soiled fabrics and the maintenance of fabric appearance without causing fibre damage.
Weightbearing Protocols and Outcomes in Open Surgical Management of Haglund Syndrome: A Large Retrospective Analysis
Authors: Hinton Zoe W. , Kutzer Katherine M. , Morrissette Kali J. , Wu Kevin A. , Krez Alexandra N. , Anastasio Albert T. , Hanselman Andrew E. , Schweitzer Karl M. , Adams Samuel B. , Easley Mark E. , Nunley James A. , Amendola Annunziato
Published: February 2025

Background:

Following insertional Achilles tendinopathy debridement and Haglund prominence resection for Haglund syndrome, patients undergo varying degrees of weightbearing limitation (weightbearing as tolerated [WBAT], partial weightbearing [PWB], touchdown weightbearing [TDWB], and nonweightbearing [NWB]). Given the scarcity of large-scale literature on the topic, the purpose of this study is to evaluate the impact of postoperative weightbearing protocols on outcomes after open surgical management of Haglund syndrome.

Methods:

This was a retrospective cohort study of patients who underwent open surgical management for Haglund syndrome between January 2015 and December 2023 at a single academic institution by fellowship-trained foot and ankle surgeons. Patients were excluded if they underwent concurrent operative management of additional foot pathologies. Patient demographics, comorbidities, surgical techniques, and postoperative weightbearing protocols were recorded. Complications (Achilles tendon rupture, wound breakdown/infection, persistent pain, plantarflexion weakness) and revision rates were compared across weightbearing protocols. Statistical analysis was conducted using R with significance set at P <.05.

Results:

Three-hundred eighty-seven patients were included (mean age 55.2 years, 66.1% female) with a mean follow-up of 10.1 (range: 0-86.3) months. The most common regimen was NWB (n = 268; 69.3%) followed by TDWB (n = 56; 14.5%), WBAT (n = 54; 14.0%), and PWB (n = 9; 2.3%). There were no significant differences in complications between the weightbearing protocols ( P = .48354). Complications included persistent pain (n = 40; 10.3%), weakness (n = 6; 1.6%), wound breakdown/infection (n = 33; 8.5%), and rupture (n = 1; 0.3%)]. Revision surgery occurred in 1.8% (n = 7).

Conclusion:

This large cohort study found no significant association between postoperative weightbearing protocols and outcomes following open surgical treatment for Haglund syndrome at a mean follow-up of 10.1 months. This study provides evidence that surgeons can individualize appropriate weightbearing protocols based on patient needs and preferences when treating Haglund syndrome with Achilles debridement and Haglund resection.

Level of Evidence:

Level III, comparative study.
Possibility thinking in higher education contexts
Authors: Álvarez-Huerta Paula , Azkarate-Iturbe Oxel , Muela Alexander , Larrea Inaki
Published: February 2025

Fostering the ability of university students to imagine different possible scenarios in the face of complex challenges is essential for social progress. The main objectives of this study were to examine the influence of creative self-concept and critical thinking disposition on university students’ possibility thinking and to analyse the possible moderating role of the cooperative mindset in these relationships. The sample consisted of 375 students from a university in the Basque Country, aged between 19 and 30 years ( M = 22.06, SD = 1.46; 57.28% women). The obtained results indicate that creative self-concept, critical thinking disposition, and cooperative mindset are all positively linked to enhanced possibility thinking among students. However, no moderating effect of the cooperative mindset was found in these relationships. These findings have practical implications for educational institutions interested in preparing students not only to face the uncertainties of the future, but also to imagine and create new possibilities in the social and professional spheres.
Identifying key areas of ecological protection and restoration oriented to human ecological needs: A case study of Huanghua City
Authors: Peng Yi , Xie Miaomiao , Zhang Cui , Liu Yunxuan
Published: February 2025

Protecting and restoring ecosystems while enhancing residents' sense of ecological access and well-being is an urgent challenge in the current context of ecological protection and restoration of territorial spaces. This study proposes a novel ecological network-based framework for identifying key areas for ecological protection and restoration by incorporating ecological needs into their identification. The results indicate that the distribution of ecological sources in Huanghua City has minimal spatial overlap with areas of high ecological demand. A composite corridor network totaling 801.9 km was constructed, comprising 207.60 and 594.30 km of ecological and demand corridors, respectively, which resulted in extensive coverage. Thirty-two key areas for ecological protection and restoration were identified, including seven ecological nodes, 10 ecological pinch points, and 15 ecological barriers. In addition to these key areas, protecting core ecological sources, enhancing the construction of parks and green spaces, and improving water network connectivity are essential strategies for enhancing residents' ecological access. The identification of key areas for ecological protection and restoration based on the composite network offers insights into how these processes can improve the well-being of residents.
Health-related quality of life in sarcoidosis patients and the effect of occupational exposures: a cross-sectional study
Authors: Vinnikov Denis , Strizhakov Leonid , Rybina Tatsiana , Babanov Sergey
Published: February 2025

Background

Health-related quality of life (HRQL) in patients with sarcoidosis has been related to treatment, symptoms, organ involvement and disease severity, but little is known about its association with occupation. The aim was to quantify HRQL in occupationally exposed sarcoidosis patients compared to their nonexposed counterparts.

Methods

A total of 221 sarcoidosis patients (median age 49 years, interquartile range (IQR) 37–60 years) with a histologically confirmed diagnosis were recruited from university hospitals and outpatient centers in Belarus, Kazakhstan, and the Russian Federation. General (with SF-8) and specific (with K-BILD) HRQL were compared between patients who were ever exposed to 24 occupational factors and nonexposed patients in adjusted multivariable models.

Results

Work in the office and office equipment (beta − 3.60 (95% confidence interval (CI) -6.91;-0.29)) was significantly associated with a poorer SF-8 physical component score (PCS) independent of sex, whereas exposure to irritant gases was strongly associated with a worse mental component score (MCS), adjusted for sex and smoking beta − 7.11 (95% CI -12.83;-1.39). Irritant gas (beta − 17.2 (95% CI -29.3;-5.1)) and work in the office (beta − 7.9 (95% CI -14.7;-1.0)) were associated with worse K-BILD total scores, while only the latter was associated with breathlessness and activities (BA) scores. Exposure to flour, irritant gas and office work were associated with the psychological (P) domain. Exposure to flour, irritant gas and work in the office could predict chest symptom (CS) scores.

Conclusions

In patients with sarcoidosis and occupational exposure, patients may exhibit worse HRQL, but further research is needed to ascertain the interplay of individual and occupational factors.
Impact and reception of point-of-care ultrasound training across medical education levels
Authors: Meyer Hendrik Leif , Einloft Jonas , Bedenbender Simon , Russ Philipp , Schlicker Nadine , Ganser Andre , Hirsch Martin Christian , Görg Christian , Grgic Ivica
Published: February 2025

Background

Point-of-care ultrasound (POCUS) is a versatile and cost-effective technology that can significantly enhance medical education and clinical practice. This study examines the acceptance of POCUS among medical students and explores strategies to optimize its integration into their training.

Materials and methods

A total of 318 medical students, spanning both preclinical and clinical semesters, participated in seminars that included POCUS demonstrations and hands-on practice. Their perceptions were assessed through a voluntary questionnaire based on the Technology Acceptance Model (TAM), which furthermore explored the ideal timing and potentially suitable subjects for integrating POCUS into the curriculum, with an emphasis on its role in developing clinical skills and supporting decision-making.

Results

Among preclinical students, 60.7% had no prior ultrasound exposure, while 97% of clinical students reported some experience, albeit often limited. Despite the majority of senior students having some ultrasound experience, many lacked confidence in its use. Confidence in sonography skills was generally low across both groups, with 95.9% of preclinical and 79.4% of clinical students expressing a lack of confidence. Importantly, both preclinical and clinical students recognized the high usefulness of POCUS skills and rated the technology as user-friendly, with clinical students perceiving it as slightly easier to use. When asked to identify the most suitable subjects for POCUS training, students most frequently cited anatomy (35.2%) and internal medicine (16.7%). Additionally, a majority of students (57.7%) advocated for POCUS education to begin as early as the first semester.

Conclusion

This study highlights a significant gap in ultrasound training among medical students, while also underscoring their strong motivation to learn and their positive perception of POCUS as a valuable tool for enhancing clinical skills and decision-making. The findings emphasize that early integration of sonography into the medical curriculum is both highly desired by students and essential for advancing medical education. This is particularly timely and important given the growing role of artificial intelligence in ultrasound technology and the opportunities expected to emerge from this integration.
Cold storage of human precision-cut lung slices in TiProtec preserves cellular composition and transcriptional responses and enables on-demand mechanistic studies
Authors: Melo-Narvaez M. Camila , Gölitz Fee , Jain Eshita , Gote-Schniering Janine , Stoleriu Mircea Gabriel , Bertrams Wilhelm , Schmeck Bernd , Yildirim Ali Önder , Rauen Ursula , Wille Timo , Lehmann Mareike
Published: February 2025

Background

Human precision-cut lung slices (hPCLS) are a unique platform for functional, mechanistic, and drug discovery studies in the field of respiratory research. However, tissue availability, generation, and cultivation time represent important challenges for their usage. Therefore, the present study evaluated the efficacy of a specifically designed tissue preservation solution, TiProtec, complete or in absence (-) of iron chelators, for long-term cold storage of hPCLS.

Methods

hPCLS were generated from peritumor control tissues and stored in DMEM/F-12, TiProtec, or TiProtec (-) for up to 28 days. Viability, metabolic activity, and tissue structure were determined. Moreover, bulk-RNA sequencing was used to study transcriptional changes, regulated signaling pathways, and cellular composition after cold storage. Induction of cold storage-associated senescence was determined by transcriptomics and immunofluorescence (IF). Finally, cold-stored hPCLS were exposed to a fibrotic cocktail and early fibrotic changes were assessed by RT-qPCR and IF.

Results

Here, we found that TiProtec preserves the viability, metabolic activity, transcriptional profile, as well as cellular composition of hPCLS for up to 14 days. Cold storage did not significantly induce cellular senescence in hPCLS. Moreover, TiProtec downregulated pathways associated with cell death, inflammation, and hypoxia while activating pathways protective against oxidative stress. Cold-stored hPCLS remained responsive to fibrotic stimuli and upregulated extracellular matrix-related genes such as fibronectin and collagen 1 as well as alpha-smooth muscle actin, a marker for myofibroblasts.

Conclusions

Optimized long-term cold storage of hPCLS preserves their viability, metabolic activity, transcriptional profile, and cellular composition for up to 14 days, specifically in TiProtec. Finally, our study demonstrated that cold-stored hPCLS can be used for on-demand mechanistic studies relevant for respiratory research.

Graphical Abstract