bluuebunny/crossref_metadata_2025 huggingface dataset:
Mexiletine dosing and tolerability in refractory chronic migraine: Insights from post-lidocaine infusion treatment
Authors: Liao Lucia , Yuan Hsiangkuo , Selbst Dylan , Casaletto Emily , Liao Jiangang , Lauritsen Clinton G.
Published: February 2025

Background

Mexiletine is used as a preventive medication for refractory chronic migraine (rCM) and to prolong migraine improvement following intravenous lidocaine infusion. However, published evidence supporting its use in migraine remains limited. This retrospective study describes the dosing, treatment duration, and adverse effects of mexiletine in a group of patients with rCM following lidocaine infusion.

Methods

Electronic medical records were reviewed at the Jefferson Headache Center. Baseline pain intensity and monthly headache days were collected at baseline and up to 6 office visits within 1-year post-discharge. The duration of mexiletine treatment was evaluated for up to 40 months post-discharge.

Results

The study included 329 rCM patients who were prescribed a daily dose of 450 mg. At the last follow-up, the median daily dose was 600 mg (450 mg–750 mg). Mexiletine was discontinued in 36.4% (120/329) of patients due to side effects and in 11.2% (37/329) due to insufficient treatment response.

Conclusion

In our population, 37% (104/329) remained on mexiletine for over 500 days, indicating a favorable safety profile. While mexiletine can be safely administered in outpatient settings, its use should be reserved for patients with the most refractory cases unless stronger evidence supporting its efficacy in migraine becomes available.
Linking physics-based regional-scale numerical seismic simulations with local finite-element analysis to evaluate soil–structure interaction of ground motions
Authors: Saxena Swasti , Boushehri Reza , Motamed Ramin , Ryan Keri L
Published: February 2025

Source-to-site simulations form a strong basis for risk-based probabilistic seismic hazard analysis. With an emerging database of synthetic ground motions, there is a growing need to assess the feasibility of the application of these motions for structural analysis. This article evaluates the robustness of a numerical framework to link high-fidelity geophysics models with local finite element (FE) models to perform site response analysis (SRA) and soil–structure interaction (SSI) evaluation. The regional-scale simulations are carried out in SW4, a physics-based finite difference scheme for seismic wave propagation, from which synthetic ground motions are extracted to be applied at the base of a local FE model of a nuclear reactor building in Livermore Software Technology Corporation (LSTC) Dynamic Analysis (LS-DYNA), an advanced multiphysics simulation software package. The seismic event chosen for simulation is an aftershock from the 2007 Niigata Chuetsu-Oki earthquake. Ground motions recorded at Kashiwazaki Kariwa Nuclear Power Plant (KKNPP) in Japan are used to validate the numerical simulations conducted with both the finite difference and FE methods. Moreover, an inter-code comparison is made between the free-field motions generated by SW4 and LS-DYNA to assess the consistency between these two simulation codes. The simulations conducted in this study focus on horizontal ground motions resolved up to a maximum of 3 Hz. The conclusions recognize the importance of compatibility of near-surface properties when employing simulated ground motions toward SRA and SSI for a successful linking approach.
Activity of silver-zinc nanozeolite-based antibiofilm wound dressings in an in vitro biofilm model and comparison with commercial dressings
Authors: Alobaid Sarah Abdulaziz , Shrestha Sweta , Tasseff Morgan , Wang Bo , van Hoek Monique L. , Dutta Prabir K.
Published: February 2025

Background

Infected wounds are a major health problem as infection can delay wound healing. Wound dressings play an important part in wound care by maintaining a suitable environment that promotes healing. Silver sulfadiazine dressings have been used to prevent infection in burn wounds. Presently, many commercial silver dressings have obtained FDA clearance.

Results

In this study, we report on a novel silver dressing using microporous aluminosilicate zeolites, termed ABF-XenoMEM. Silver and zinc ions are encapsulated in the zeolite supercages. We show that the silver-zinc zeolite (AM30) alone is effective at inhibiting biofilm formation. The encapsulation protects the silver from rapidly precipitating in biological fluids. We exploit the negatively charged zeolite surface to associate positively charged quaternary ammonium ions (quat) with the zeolite. The combination of the AM30 with the quat enhances the antimicrobial activity. The colloidal nature of the zeolite materials makes it possible to make uniform deposits on a commercial extracellular matrix membrane to develop the final dressing (ABF-XenoMEM). The optimum loading of silver, zinc, and quat on the dressing was found to be 30, 3.7, and 221 µg/cm2. Using a colony biofilm model, the activity of ABF-XenoMEM is compared with four well-studied silver-based commercial dressings towards mature biofilms of Pseudomonas aeruginosa PAO1 (ATCC 4708) and methicillin-resistant Staphylococcus aureus (ATCC 33592). Cytotoxicity of the dressings was examined in HepG2 cells using the MTT assay.

Conclusion

This study shows that the ABF-XenoMEM is competitive with extensively used commercial wound dressings in a colony biofilm model. Nanozeolite-entrapped silver/zinc antimicrobials in association with quat have the potential for application in biofilm-infected wounds and require animal and clinical studies for definitive proof.

Graphical abstract
HarmonizR: blocking and singular feature data adjustment improve runtime efficiency and data preservation
Authors: Schlumbohm Simon , Neumann Julia E. , Neumann Philipp
Published: February 2025

Background

Data adjustment is an essential tool for increasing statistical power during analysis, for example in case of complex multi-experiment data from (single-cell) RNA, proteomics and other omics data. Despite its benefits, data integration introduces internal biases—so-called batch effects. Due to the inherent presence of missing values by such methods and their additional introduction by means of data integration, renowned algorithms such as ComBat and limma are unable to perform batch effect adjustment. Recently, the HarmonizR framework was presented for these cases, which is a tool for missing value tolerant data adjustment.

Results

In this contribution, we provide significant improvements to the HarmonizR approach. A novel blocking strategy is introduced to severely reduce runtime, while still supporting parallel architectures. Additionally, a “unique removal” strategy has been integrated into HarmonizR to maintain even more features for adjustment in datasets, showing a feature rescue of up to 103.9% for our tested datasets. In this work, we show (1) severely improved runtime for both small and large, real datasets and (2) the ability retain more features from the integrated dataset during adjustment, showing a feature rescue of up to 103.9% for our tested datasets.

Conclusion

The proposed improvements tackle the previous shortcomings of the published HarmonizR version. Since HarmonizR was mainly developed for dataset integration on rare tumor entities, it did not include runtime improvements beyond parallelization, which has been addressed in this update. An additionally welcome update regarding improved feature rescue furthermore enhances the algorithms ability to quickly and robustly perform batch effect reduction.
Predicting substrates for orphan solute carrier proteins using multi-omics datasets
Authors: Zhang Y. , Newstead S. , Sarkies P.
Published: February 2025

Solute carriers (SLC) are integral membrane proteins responsible for transporting a wide variety of metabolites, signaling molecules and drugs across cellular membranes. Despite key roles in metabolism, signaling and pharmacology, around one third of SLC proteins are ‘orphans’ whose substrates are unknown. Experimental determination of SLC substrates is technically challenging, given the wide range of possible physiological candidates. Here, we develop a predictive algorithm to identify correlations between SLC expression levels and intracellular metabolite concentrations by leveraging existing cancer multi-omics datasets. Our predictions recovered known SLC-substrate pairs with high sensitivity and specificity compared to simulated random pairs. CRISPR-Cas9 dependency screen data and metabolic pathway adjacency data further improved the performance of our algorithm. In parallel, we combined drug sensitivity data with SLC expression profiles to predict new SLC-drug interactions. Together, we provide a novel bioinformatic pipeline to predict new substrate predictions for SLCs, offering new opportunities to de-orphanise SLCs with important implications for understanding their roles in health and disease.
Life after medicalised conception: an interpretative phenomenological analysis study exploring the experiences of pregnancy and transition to parenthood
Authors: Foyston Z. , Higgins L. E. , Smith D. M. , Wittkowski A
Published: February 2025

Background

Pregnancy resulting from Medicalised Conception (MAC) is increasingly prevalent. In-Vitro Fertilisation (IVF) is the most common type of treatment which has been linked to increased pregnancy-specific anxiety and different approaches to parenting. This study explored the experiences of pregnancy and the transition to parenthood in individuals who conceived via IVF, identifying how they coped with any psychological difficulties.

Method

Participants who successfully achieved pregnancy via IVF and had given birth to an infant aged 12 weeks to two years old, were interviewed. Interviews were audio-recorded, transcribed and analysed using Interpretative Phenomenological Analysis.

Results

Based on data from 12 British participants, three superordinate themes were identified: (1) The lasting imprint of IVF: unidentified and unmet psychological needs. The resultant loss, grief and powerlessness associated with the IVF treatment left individuals emotionally vulnerable entering pregnancy. The lasting impact of IVF was evident, influencing birth preferences and feeding choices. (2) The fragility of pregnancy: helpless and existing in a world of uncertainty. Pregnancy was often approached with caution and trepidation, leading to methods of self-protection, such as difficulties in believing the existence of the pregnancy. (3) The parental function of healthcare systems: needing an anchor and a sense of safety highlighted the pivotal role of health systems and their ability to perpetuate or alleviate distress.

Conclusions

The psychological vulnerability of parents after IVF needs to be considered throughout the perinatal period. Monitoring of psychological well-being and the implementation of specialist services and peer support for individuals who conceive via IVF are recommended.
Body mass index and risk of connective and soft tissue cancer: results from a large cohort of 1.7 million individuals in Norway
Authors: Aune Dagfinn , Nordsletten Marie , Myklebust Tor Åge , Robsahm Trude Eid , Skålhegg Bjørn Steen , Mala Tom , Yaqub Sheraz , Saeed Usman
Published: February 2025

Background

Few studies have investigated the association between adiposity and connective and soft tissue cancer, a rare and understudied cancer entity. We investigated this association in a large cohort of more than 1.7 million individuals in Norway.

Methods

The study cohort included 1,723,692 men and women aged 16–75 years at baseline in 1963–1975. Data on weight and height measurements from the Norwegian Tuberculosis Screening Programme were linked to the Cancer Registry. We estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations between body mass index (BMI) and risk of connective and soft tissue cancer, adjusting for age and sex.

Results

In total 1758 connective and soft tissue cancer cases were registered during 56.1 million person-years of follow-up. The HRs (95% CIs) for the BMI categories of 15-<18.5, 18.5-<25.0 (reference), 25.0-<30.0, 30.0-<35.0, ≥ 35.0 were 0.77 (0.50–1.20), 1.00 (reference), 1.15 (1.03–1.27), 1.28 (1.06–1.54), and 1.69 (1.21–2.37, ptrend<0.0001). The HR per 5 kg/m2 increment in BMI was 1.14 (1.07–1.22) overall, 1.10 (0.99–1.23) in men and 1.17 (1.08–1.27) in women. Obesity in early adulthood (age 16–29 years) showed a suggestive positive association with connective and soft tissue cancer risk with HR (95%CIs) of 1.73 (0.95–3.16), ptrend=0.09) when compared to normal weight. No clear association was observed between BMI and early-onset (age < 50 years at diagnosis) connective and soft tissue cancer. Positive associations were observed between BMI and soft tissue sarcoma, fibrosarcoma, dermatofibroma, and lipoleiomyoma, but no clear associations were observed with fibrous histiocytoma and liposarcoma.

Conclusion

These results suggest that higher BMI overall and in early adulthood may be associated with increased risk of connective and soft tissue cancer, but BMI seems not to influence early-onset disease. Large cohort studies with more detailed information on confounding factors and BMI trajectories over time are needed for further verification before firm conclusions can be made.
A qualitative study into the perceptions and needs of fathers with a migration background on parenting regarding energy balance-related behaviors
Authors: Overman Meredith L. , Hermans Roel C. J. , Loukili Ibrahim , Chinapaw Mai J. M. , Mehraz Abdellah , Ekkelboom Lauren , Kremers Stef P. J. , Renders Carry
Published: February 2025

Background

Overweight among adolescents is worldwide still considered a serious public health problem. Although both parents influence children’s energy balance-related behavior, most studies have predominantly focused on mothers and white populations. Therefore, in this study, we contribute to the research by exploring the perceptions and needs of Dutch fathers with a migration background on parenting, specifically regarding promoting healthy energy balance-related behaviors among their children, and what motivates fathers to participate in parenting programs focused on these behaviors.

Methods

We used a qualitative research design. Informal conversations (n = 2), semi-structured interviews (n = 11) and one focus group (n = 13) were conducted with professionals specialized in intercultural pedagogy and fathers participating in a parenting program organized by these professionals. Interviews and focus group were audio-recorded and transcribed. Atlas.ti 8 was used for theme detection, categorization, and classification using inductive and deductive approaches. The data was analyzed using grounded theory analysis.

Results

Fathers joined parenting programs to improve their parenting skills and knowledge and address health and socio-cultural challenges. Furthermore, intergenerational differences were evident: second-generation fathers were more proactive in tackling parenting challenges related to healthy lifestyles. Fathers highlighted challenges related to parenting in two cultures. Although participating in the parenting program facilitated fathers in adopting a healthier lifestyle for both themselves and their families, improving communication with family members, and experiencing changes regarding gender dynamics within their household, influencing their teenage children, to adopt healthier habits remained a challenge, especially in comparison to younger children.

Conclusions

A deeper understanding of the needs, perceptions, and experiences of migrant populations concerning parenting regarding the promotion of healthy energy balance-related behaviors among their children can lead to better-tailored health promotion programs that prioritize cultural and linguistic inclusivity.
Effectiveness of an integrated cerebral protection protocol in type A aortic dissection surgery: an inverse probability treatment weighting analysis
Authors: Shen Fei-min , Lin Yi-min , Huang Ming-cheng , Liu Jin-ping , Huang Ling-chen , Chen Liang-wan , Dai Xiao-fu
Published: February 2025

Background

Cerebral protection strategies in type A aortic dissection (TAAD) surgery are critical yet inconclusive. We propose an integrated cerebral protection protocol. This study aimed to evaluate the effectiveness of this protocol.

Methods

From January 2020 to December 2022, 85 patients were treated with an integrated protocol incorporating bilateral antegrade cerebral perfusion (ACP) and moderate hypothermia, with measures to prevent the shedding of thrombus or endothelial debris (BACP group), while traditional protocols were applied to 273 additional patients (UACP group). Inverse probability treatment weighting (IPTW) was performed to balance baseline characteristics. Three logistic regression models were used to evaluate the relationship between the two cerebral protection strategies and neurologic complications. Stepwise logistic regression was further employed to identify risk factors for cerebral complications.

Results

Baseline characteristics were balanced after IPTW adjustment. The BACP group had a significantly shorter operative time (364.79 vs. 397.61 min, P = 0.022), significantly fewer neurologic complications (5.6% vs. 15.9%, P = 0.032), and transient neurologic injury (3.0% vs. 12.5%, P = 0.035). Binary multivariable logistic regression analysis showed that the cerebral complication risk was 3.14 times greater with the traditional protocol compared to the integrated protocol (odds ratio[OR]:3.14, 95%confidence interval[CI]:1.19–8.27, P = 0.020). Stepwise logistic regression confirmed that cerebral complications were dramatically increased with unilateral ACP (OR:2.99, 95%CI:1.14–7.82, P = 0.025), while bilateral ACP had a significant impact on decreasing cerebral complications.

Conclusions

Our integrated protocol effectively minimizes postoperative cerebral complications. Moderate hypothermia combined with BACP and measures to prevent brain debris could be adopted as an effective strategy for cerebral protection in TAAD surgery.
Classifying and fact-checking health-related information about COVID-19 on Twitter/X using machine learning and deep learning models
Authors: Sharifpoor Elham , Okhovati Maryam , Ghazizadeh-Ahsaee Mostafa , Avaz Beigi Mina
Published: February 2025

Background

Despite recent progress in misinformation detection methods, further investigation is required to develop more robust fact-checking models with particular consideration for the unique challenges of health information sharing. This study aimed to identify the most effective approach for detecting and classifying reliable information versus misinformation health content shared on Twitter/X related to COVID-19.

Methods

We have used 7 different machine learning/deep learning models. Tweets were collected, processed, labeled, and analyzed using relevant keywords and hashtags, then classified into two distinct datasets: “Trustworthy information” versus “Misinformation”, through a labeling process. The cosine similarity metric was employed to address oversampling the minority of the Trustworthy information class, ensuring a more balanced representation of both classes for training and testing purposes. Finally, the performance of the various fact-checking models was analyzed and compared using accuracy, precision, recall, and F1-score ROC curve, and AUC.

Results

For measures of accuracy, precision, F1 score, and recall, the average values of TextConvoNet were found to be 90.28, 90.28, 90.29, and 0.9030, respectively. ROC AUC was 0.901.“Trustworthy information” class achieved an accuracy of 85%, precision of 93%, recall of 86%, and F1 score of 89%. These values were higher than other models. Moreover, its performance in the misinformation category was even more impressive, with an accuracy of 94%, precision of 88%, recall of 94%, and F1 score of 91%.

Conclusion

This study showed that TextConvoNet was the most effective in detecting and classifying trustworthy information V.S misinformation related to health issues that have been shared on Twitter/X.
Harmonizing patient-centric requirements for secure digital health services in heterogeneous settings
Authors: Assom Luigi , Karunaratne Thashmee , Larsson Aron
Published: February 2025

Implementing electronic health services with a patient-centric focus while adapting to the know-how of local contexts is a challenge. This paper addresses this challenge by establishing a template of modular requirements for designing a viable Electronic Health Record (EHR) system that enables transmission and sharing of patient data across primary, secondary, and specialized care, ensuring versatility in diverse healthcare environments and across varying socio-economic landscapes. The research is anchored in design science and employs an action research strategy, using northern Brazil as empirical case. The approach builds on generic requirements from standards established by the European Union, Fast Healthcare Interoperability Resources (FHIR), and the Swedish ePrescription journal system. These requirements are refined and adapted to the Brazilian context through a participatory method, considering development disparities across municipalities and aligning with national policy. A key feature is the integration of knowledge graphs, which, when combined with fieldwork iterations involving healthcare professionals and patient association representatives, facilitated the extraction of patient-centric requirements. Strategies from Brazilian healthcare policies targeting chronic kidney disease, selected as a significant challenge for specialized healthcare in emergent areas, were incorporated to generalize the design of EHR modules aimed at prevention and monitoring of population at risk. Results support that harmonization towards legacy system is strongly advised and discourage the introduction of systems designed from scratch.
Species-specific blood–brain barrier permeability in amphibians
Authors: Antesberger Sophie , Stiening Beate , Forsthofer Michael , Joven Araus Alberto , Eroglu Elif , Huber Jonas , Heß Martin , Straka Hans , Sanchez-Gonzalez Rosario
Published: February 2025

Background

The blood–brain barrier (BBB) is a semipermeable interface that prevents the non-selective transport into the central nervous system. It controls the delivery of macromolecules fueling the brain metabolism and the immunological surveillance. The BBB permeability is locally regulated depending on the physiological requirements, maintaining the tissue homeostasis and influencing pathological conditions. Given its relevance in vertebrate CNS, it is surprising that little is known about the BBB in Amphibians, some of which are capable of adult CNS regeneration.

Results

The BBB size threshold of the anuran Xenopus laevis (African clawed toad), as well as two urodele species, Ambystoma mexicanum (axolotl) and Pleurodeles waltl (Iberian ribbed newt), was evaluated under physiological conditions through the use of synthetic tracers. We detected important differences between the analyzed species. Xenopus exhibited a BBB with characteristics more similar to those observed in mammals, whereas the BBB of axolotl was found to be permeable to the 1 kDa tracer. The permeability of the 1 kDa tracer measured in Pleurodeles showed values in between axolotl and Xenopus vesseks. We confirmed that these differences are species-specific and not related to metamorphosis. In line with these results, the tight junction protein Claudin-5 was absent in axolotl, intermediate in Pleurodeles and showed full-coverage in Xenopus vessels. Interestingly, electron microscopy analysis and the retention pattern of the larger tracers (3 and 70 kDa) demonstrated that axolotl endothelial cells exhibit higher rates of macropinocytosis, a non-regulated type of transcellular transport.

Conclusions

Our study demonstrated that, under physiological conditions, the blood–brain barrier exhibited species-specific variations, including permeability threshold, blood vessel coverage, and macropinocytosis rate. Future studies are needed to test whether the higher permeability observed in salamanders could have metabolic and immunological consequences contributing to their remarkable regenerative capacity.
Building evidences in Public Health Emergency Preparedness (“BePHEP” Project)—a systematic review
Authors: Mercogliano Michelangelo , Spatari Gloria , Noviello Chiara , Di Serafino Francesca , Mormile Maria Elisabetta , Granvillano Giuseppa , Iagnemma Annalisa , Mimmo Riccardo , Schenone Irene , Raso Eleonora , Sanna Andrea , Frasson Enrica , Gallinoro Veronica , Di Pumpo Marcello , Shellah Duha , Rizzo Caterina , Zotti Nunzio
Published: February 2025

Introduction

Humanitarian crises exacerbate the vulnerability of already fragile healthcare systems and significantly increase the risk of infectious disease outbreaks in low- and middle-income countries (LMICs). This systematic review aims to evaluate strategies and interventions implemented in LMICs to prevent and manage infectious diseases outbreaks during humanitarian crises from 2018 to 2023.

Methods

A comprehensive literature search was conducted across Scopus, PubMed, and Web of Science, adhering to the PRISMA guideline and the SPIDER framework to identify relevant studies. The review included studies published between 2018 and 2023 focusing on infectious disease prevention and management in LMICs during humanitarian crises. Study quality was assessed using the Joanna Briggs Institute checklist.

Results

Eleven studies were identified from 1,415 unique articles. These studies addressed diverse interventions, including vaccination campaigns, epidemiologic surveillance, and integrated health services. Cholera outbreaks in Haiti and Mozambique, triggered by gang violence, internal migration, and Cyclone Kenneth, were addressed through epidemiological surveillance, case management, WASH (Water, Sanitation, and Hygiene) service improvements, and oral vaccination campaigns. Mathematical models guided cholera vaccination in Thailand's refugee camps. In India, surveillance and rapid response measures successfully prevented infectious disease outbreaks during the Kumbh Mela gathering. The Philippines improved response times to climate-related disasters using point-of-care testing and spatial care pathways. Despite challenges in Yemen, evaluating malaria surveillance systems led to recommendations for integrating multiple systems. Uganda developed a national multi-hazard emergency plan incorporating vaccination, communication, and risk management, proving useful during the refugee crisis and Ebola outbreak. In South Sudan, integrating immunisation services into nutrition centres increased vaccination coverage among children. Nigeria experienced a rise in measles cases during armed conflicts despite vaccination efforts, while visual communication strategies improved SARS-CoV-2 vaccination rates.

Conclusion

These interventions highlight the importance of multimodal, targeted, and collaborative responses to address complex health crises without relying on unsustainable investments. Despite the effectiveness of these interventions, infrastructure limitations, insecurity, and logistical constraints were noted. These findings emphasize the need for adaptable and resilient healthcare systems and international collaboration to safeguard the right to health during complex humanitarian crises.
Prevalence and recurrence rates of spontaneous pneumothorax in patients with diffuse cystic lung diseases in China
Authors: Wang Rui , Chen Xianmeng , Xu Shicheng , Jiang Xianliang , Liu Jinli , Liu Xuehan , Ryu Jay H. , Hu Xiaowen
Published: February 2025

Objectives

To investigate the prevalence and recurrence rates of spontaneous pneumothorax (SP) in patients with diffuse cystic lung diseases (DCLDs).

Methods

We retrospectively identified and analyzed medical records of patients with DCLDs encountered at the First Affiliated Hospital of University of Science and Technology of China from Jan 1, 2017 to December 31, 2023.

Results

A total of 289 patients were identified with DCLDs; 212 females and 77 males, with a median age of 48 years (range, 18–81 years). Among them, 89 (31%) patients had experienced SP; 59% among 115 patients with Birt-Hogg-Dubé (BHD), 34% of 41 patients with lymphangioleiomyomatosis (LAM, all women), 36% of 11 patients with pulmonary Langerhans cell histiocytosis (PLCH), none of 57 patients with Sjögren’s syndrome-associated diffuse cystic lung disease (SS-DCLD), and 5% of 65 patients with no identifiable underlying disease (χ² = 90.585, P < 0.001). The overall recurrence rate of SP was higher with observation or chest tube placement strategy compared to surgical intervention, 59% vs. 11% (P < 0.001, 95% CI [0.1, -0.4]), respectively. The recurrence rate after surgical management was significantly lower compared to conservative management in patients with BHD (10% vs. 69%, P < 0.001, 95% CI [0.1, 0.3]) and LAM (20% vs. 57%, P = 0.322, 95% CI [0.1, 2.1]). Among patients with BHD, LAM, and PLCH, those who had pneumothorax as the initial presentation were diagnosed of their underlying disease at a significantly younger age (42.2 ± 13.0 years) compared to those without pneumothorax (48.1 ± 11.8 years) (P = 0.032, 95% CI [-8.24, -0.36]). Notably, eight of LAM patients who were treated with sirolimus after the initial SP did not experience recurrence of SP.

Conclusion

The risk of SP secondary to DCLDs was highest in patients with BHD, followed by those with PLCH and LAM. It was extremely low in SS-DCLD. Pneumothorax as the initial presentation often facilitated diagnosis of the underlying disease. Surgical treatment was associated with a lower recurrence rate of SP compared to nonsurgical management. In addition, sirolimus therapy may reduce the risk of pneumothorax recurrence in patients with LAM.
Fabrication of zein nanofibrous scaffold containing Scrophularia striata extract for biomedical application
Authors: Salahshour Yasin , Rastegarzadeh Saadat , Motamedi Hossein , Hoveizi Elham
Published: February 2025

Skin wounds have the potential to rapidly become infected, with bacteria having the ability to quickly penetrate to the skin’s deeper layers. Then they enter the lymph nodes and spread throughout the body; therefore, all wounds should be cleaned and have a permanent cover. Modern wound dressings with effective antibacterial and therapeutic properties are required to create a sterile environment for the acceleration of healing. The aim of this work was to prepare zein electrospun nanofibers containing Scrophularia striata extract for wound healing promotion. Electrospun nanofibers made of zein, a natural polymer, have attracted a lot of attention due to their biocompatibility and biodegradability. The prepared nanofibers were characterized by scanning electron microscopy (SEM), energy dispersive X‑ray analysis (EDX), water contact angle test, and Fourier transform infrared spectroscopy (FT-IR). The parameters affected by the electrospinning process were investigated and optimized. The results revealed that the zein nanofibers (25% w/v, zein) containing Scrophularia striata extract (6.7% w/v) had a smooth and bead-free morphology with improved surface hydrophilicity. The measurement of water contact angle confirmed that nanofibers containing extract showed higher wettability (64.9°) compared to fibers without extract (119.8), so the proposed mat adequately moisturizes the wound environment. The antimicrobial studies show that Scrophularia striata extract incorporated nanofibers has the ability to inhibit the growth of both gram-negative and gram-positive bacteria. The biophenols release profile indicated that nanofibrous mat can release more effective substances to promote wound healing. The biocompatibility and biodegradability of nanofibrous scaffold containing Scrophularia striata extract tested in in vivo and in vitro conditions show a significantly higher survival rate of fibroblast cells. In addition, macroscopic and histological observations confirmed that the implanted nanofibers containing the extract did not exhibit any signs of inflammation or redness after a month when inserted beneath the skin of mice surrounded by vessels containing epidermis.

Graphical Abstract
Ixekizumab as a successful treatment in pediatric generalized pustular psoriasis
Authors: Esposito Maria , Antonetti Paolo , Vagnozzi Emanuele , De Berardinis Andrea , Bertelli Roberta , Brancati Francesco , Fargnoli Maria Concetta
Published: February 2025

Background

Generalized Pustular Psoriasis (GPP) is an autoinflammatory, multisystemic disease, characterized by widespread eruption of neutrophilic pustules on erythematous base, accompanied by systemic symptoms such as fever, leukocytosis, arthralgia, and general malaise. Globally, the disease is rare, particularly in children. If not adequately diagnosed and treated, systemic inflammation and multiorgan involvement can be life-threatening. The pathogenesis of GPP mainly involves the innate immune system, with inflammatory processes and neutrophil activation driven primarily by IL-36, but also by IL-1, TNF-alpha, IL-17 A. In particular, IL-17 A acts as a potent inducer of neutrophil recruitment. We report the case of a 7-years-old girl with GPP successfully treated with Ixekizumab, an IL-17 A antagonist.

Case presentation

A 7-years-old girl with an history of plaque psoriasis came to our attention for the sudden appearance of erythematous patches surmounted by pustules on the trunk and lower limbs, following repeated episodes of purulent tonsillitis. We started therapy with cyclosporine at a dosage of 3,5 mg/kg/day, with no clinical benefit and progression of manifestations to a sub-erythrodermic state after 2 weeks. Blood tests showed neutrophilic leukocytosis, and the patient experienced hyperpyrexia and malaise. Since ixekizumab was recently approved for pediatric use in patients with moderate to severe plaque psoriasis, we started therapy with 80 mg Ixekizumab, combined with prednisone at a dosage of 12.5 mg/day, gradually tapered until discontinuation after 15 days. A second dose of Ixekizumab 40 mg was administered at week-4, according to the indication of ixekizumab in pediatric plaque psoriasis. At week-8 the patient achieved complete remission of skin manifestations and normalization of blood count. After achieving a stable remission, at week 36 we decided to increase the administration interval to 6 weeks. The patient is still on therapy with ixekizumab 40 mg every 6 weeks, maintaining complete remission during a 52-week follow-up, without safety concerns.

Conclusions

This report supports the use of ixekizumab as a safe and effective option, both in the short and long-term, in the treatment of GPP, even at pediatric age. Larger studies are needed to confirm this positive, real-life experience.
Clinical features of intracardiac thrombotic complication in patients with severe Mycoplasma pneumoniae pneumonia
Authors: Li Xiao , Zhai Bo , Tang Yu , Zhang Lei , Wang Jing , Xu Chunna , Dong Lili , Wang Yanqiong , Su Yanyan , Dong Zhen , Yang Haiming , Shen Yuelin
Published: February 2025

Background

Intracardiac thrombus (ICT) is the rarest yet most severe complication of severe Mycoplasma pneumoniae pneumonia (SMPP) in children. This study aims to elucidate the clinical characteristics of patients with SMPP-related ICT.

Methods

We retrospectively enrolled 68 children with SMPP (18 cases of ICT, 50 cases of non-ICT) who were admitted from January 2014 to January 2024. We compared their demographic data, clinical symptoms, laboratory tests, imaging findings, treatment strategies, and prognoses. Additionally, we summarized data from 33 confirmed SMPP-related ICT cases reported in 12 references.

Results

In our cohort, the ICT group exhibited higher incidences of tachypnea, chest pain, inflammation, and elevated D-dimer levels. They also presented more severe radiological findings and had longer hospital stays compared to the non-ICT group. The chordae tendineae-attached was the most common type (61.1%). Pathological examinations revealed ICT sizes ranging from 480 to 31,500 mm³. A favorable prognosis was observed in 94.4% of ICT patients. Clinical features did not significantly differ between various ICT types. In the overall cohort (51 cases), the right ventricle was the predominant location (68.6%). Notably, 66.7% of patients had concurrent extracardiac thrombosis, with pulmonary thrombosis being the most common subtype (41.2%).

Conclusions

The clinical characteristics of SMPP-related ICT are non-specific, often coexisting with severe pulmonary lesions and significantly elevated inflammatory markers. All ICT types were chordae tendineae or wall-attached, rather than mobile. These findings suggest that an inflammation storm induced by SMPP may play a significant role in the pathogenesis of in situ thrombosis within the heart and major blood vessels.
Early diagnosis of hereditary angioedema in children: genetic testing should be prioritized
Authors: Bocquet A. , Pagnier A. , Boccon-Gibod I. , Defendi F. , Dumestre-Perard C. , Hardy G. , Bouillet Laurence
Published: February 2025

Background

When a member of a family has been diagnosed with hereditary angioedema (HAE) before a child is born, the question of early diagnosis arises. Indeed, the first attacks may occur at birth. Early diagnosis is complicated by biological issues. Due to the immaturity of the complement system, C1 Inhibitor (C1 INH) and C4 levels can be low at birth, generally in the range of 60 to 100% of adult reference values. Like most complement proteins, their levels generally normalize after one year of life. However, this is not always the case, and we report two counter-examples here.

Case presentation

A woman with well-documented HAE due to type II C1 INH deficiency gave birth to two children 4 years apart. Functional C1 INH assays performed at 8 and 7 months of age returned normal C1 INH inhibitory activity. However, a genetic exploration revealed the presence of the mother’s pathogenic gene variant in both children. Subsequent monitoring of C1 INH activity at 3 and 4 years of age confirmed a pathological reduction in C1 INH inhibitory activity.

Conclusion

For the early detection of HAE in children, these cases lead us to recommend genetic testing for the index parent’s pathological variant rather than reliance on results of C1 INH assays.
Stability and Hopf bifurcation of a predator-prey model with Smith growth rate and Monod–Haldane functional response
Authors: Feng Xiaozhou , Li Kunyu , Liu Mengyan , Wang Lin , Wang Tonghui
Published: February 2025

This paper focuses on the qualitative analysis of the diffusive Monod–Haldane predator-prey model with Smith growth rate under Neumann boundary condition. First, the stability of the solution of corresponding ODE system is studied, and then the Hopf divergence direction and the stability of periodic solutions are given. Then considering the non-uniform distribution of populations in nature, by standard linear operator theory and center manifold theorem, the Turing instability and the Hopf bifurcation of the PDE system with diffusion effects is analyzed. Finally, the theoretical calculation results are verified by numerical simulations. It can be observed that the variation of Smith growth rate and diffusion coefficient within a certain range can increase the complexity of the model.
Low-cost extraction of multifaceted biological compounds from citrus waste using enzymes from Aspergillus Niger LBM 134
Authors: Díaz Gabriela Verónica , Coniglio Romina Olga , Ortellado Laura Ester , Zapata Pedro Darío , Martínez María Alejandra , Fonseca María Isabel
Published: February 2025

Agricultural industries search for biotechnological alternatives for waste management as they mean a significant concern and environmental challenge. More importantly, within a circular economy concept, such secondary substrates can be used to produce value-added compounds. This work is aimed at obtaining bioactive compounds from citrus waste by using a homemade enzymatic cocktail from Aspergillus niger LBM 134. The fungal enzymes were produced using raw sugarcane bagasse as substrate, which increased the ecological sustainability and the cost-effectiveness of the bioprocess. As the most relevant enzyme of this cocktail, a β-glucosidase showed to optimally act at 50 °C, retaining up to 70% of residual activity after 72 h. By means of an optimized enzyme-assisted extraction, the crude enzymatic cocktail produced was efficiently employed to extract the phenolics hesperetin, quinic, p-coumaric, and gallic acid, and the bioactive amino acid tryptophan from citrus waste. These assays yielded approximately 112% and 30% of phenolic compounds over alkaline conventional and commercial enzyme extraction methods, respectively.

Graphical Abstract
Assessment attendance and treatment engagement with talking and internet-enabled therapies of people with and without a long-term physical health condition: analysis of Talking Therapies service data
Authors: Jenkinson Emma , Hackett Ruth A. , Moss-Morris Rona , Wong Grace , Wheatley Jon , Cirkovic Mirko , Hudson Joanna
Published: February 2025

Background

Research indicates that treatment outcomes are poorer for people with long-term physical health conditions (LTCs) in Talking Therapies services (formerly known as Improving Access to Psychological Therapies). However, the impact of having an LTC on attendance at assessment and treatment appointments within Talking Therapies remains unclear. Internet-enabled therapies may be one way to overcome barriers to treatment engagement in Talking Therapies. However, their effect on engagement and the influence of LTC status on receipt of internet-enabled therapies is unknown.

Aims

To explore the association between LTC status and assessment attendance, treatment engagement and internet-enabled therapy receipt within Talking Therapies services, and whether receipt of internet-enabled treatment bolsters engagement.

Method

We used anonymous patient-level data from two inner London Talking Therapies services during January to December 2022 (n = 17 095 referrals). Binary logistic regression models were constructed to compare differences between LTC and non-LTC groups on (a) assessment attendance, (b) engagement and (c) internet-enabled therapy receipt. In our regression models, we controlled for key clinical and demographic covariates.

Results

There were no differences between patients with or without an LTC in assessment attendance or treatment engagement, after controlling for covariates. Across the whole sample, receiving internet-enabled treatment increased engagement. People with an LTC were less likely to receive an internet-enabled treatment.

Conclusions

Having an LTC does not negatively affect assessment attendance and engagement with talking therapies. However, receiving an internet-enabled treatment bolstered engagement in our regression models. People with an LTC were less likely to receive internet-enabled treatment.
Anti-obesity pharmacotherapy for patients with genetic obesity due to defects in the leptin-melanocortin pathway
Authors: Welling Mila S , van Rossum Elisabeth F C , van den Akker Erica L T
Published: February 2025

Lifestyle interventions are the cornerstone of obesity treatment. However, insufficient long-term effects are observed in patients with genetic obesity disorders, as their hyperphagia remains untreated. Hence, patients with genetic obesity often require additional pharmacotherapy to effectively manage and treat their hyperphagia and obesity. Recent advancements in anti-obesity pharmacotherapy have expanded the range of available anti-obesity medications (AOM). This includes the targeted AOM setmelanotide, approved for specific genetic obesity disorders, as well as non-targeted AOMs such as naltrexone-bupropion and glucagon-like peptide-1 analogues. Targeted AOMs have demonstrated significant weight loss, reduced obesity-related comorbidities, and improved hyperphagia and quality of life in patients with genetic obesity. Small observational studies have shown that similar benefits from non-targeted AOMs or off-label pharmacotherapies can be achieved in patients with specific genetic obesity disorders, compared to common multifactorial obesity. In the future, novel and innovative pharmacotherapeutical options, including combination therapies and possibly gene therapy, will emerge, offering promising effects on body weight, hyperphagia, and, most importantly, quality of life for patients with a variety of genetic obesity disorders.
Enhancing community participation in Disaster Risk Management: Recommendations for an inclusive approach
Authors: Grabmaier Ilona , Bittner Simon , Kainz Sarah , Barrado Cristina , Bagiyan Valeri , Bakunc Saten , Zamora Daoiz
Published: February 2025

The aim of this paper is to provide recommendations for inclusive approaches to community participation in all aspects of disaster risk management (DRM) by elaborating how to best inform, mobilize and organize communities, with a specific focus on vulnerable groups. To this end, a comprehensive literature analysis was conducted, covering key concepts such as participatory governance, community, vulnerability, and resilience. The state-of-the-art of decentralized and participatory governance was analysed in detail, discussing the opportunities and challenges of community-based disaster resilience based on academic discourse and practical evidence. Different modes of community engagement are systematically explored, ranging from simply informing communities to actively empowering them to take ownership. The methodological approach rigorously combines an in-depth literature analysis with qualitative empirical research. Two workshops were organized with seven experts from all over Europe from fields like emergency management, civil protection and disaster research to gather profound and on-the-ground insights and recommendations on how to enhance community participation in DRM. Additionally, a survey was conducted to further capture experiences with the topic. The findings were thoroughly analysed and together with insights from the literature, they are used to develop well-grounded recommendations for an inclusive approach to community engagement. This paper offers a practical framework and actionable guidelines for implementing inclusive community participation programs within DRM. It is our hope that these evidence-based recommendations can crucially guide efforts to actively engage all sections of communities, especially vulnerable groups, across all aspects of disaster preparedness, response, and recovery.