bluuebunny/crossref_metadata_2025 huggingface dataset:
Temporal trends of prescription rates, oral anticoagulants dose, clinical outcomes, and factors associated with non-anticoagulation in patients with incident atrial fibrillation
Authors: Liao Jo-Nan , Chan Yi-Hsin , Kuo Ling , Tsai Chuan-Tsai , Liu Chih-Min , Chen Tzeng-Ji , Lip Gregory Y H , Chen Shih-Ann , Chao Tze-Fan
Published: January 2025

Aims

To analyse the temporal trends of oral anticoagulant (OAC) prescription, direct oral anticoagulant (DOAC) dose, clinical outcomes, and factors associated with non-anticoagulation in patients with incident atrial fibrillation (AF).

Methods and results

During 1 January 2011–31 December 2020, a total of 249 107 patients with newly diagnosed AF were identified, and the 1-year risks of ischaemic stroke, intracranial haemorrhage (ICH), and all-cause mortality were analysed. OAC prescription increased from 22.1% in 2011 to 57.7% in 2020 with DOAC accounting for 91.0% of overall OAC prescriptions. Compared to patients with incident AF diagnosed in 2011, there were increasing trends for a greater decrease in the risks of ischaemic stroke during 2012–2020 and mortality during 2014–2020, while the risk of ICH did not change significantly. For DOAC users, higher dose use increased from 11.04% in 2012 to 44.29% in 2019–2020 temporally associated with a lower risk of ischaemic stroke in the years 2015–2017 and 2018–2020 compared to 2012–2014. Determining factors refraining from OAC use included some ‘patient-related factors’ and ‘non-patient’ factors (AF diagnosed at clinics by physicians other than cardiologist/neurologist/internal medicine and citizens outside municipalities).

Conclusion

There was an increasing trend of OAC prescription, temporally associated with a decreased risk of ischaemic stroke and mortality. Among DOACs users, the risk of ischaemic stroke declined gradually, partly explained by the increasing prescriptions of higher dose DOACs. Both patient and non-patient factors were associated with non-anticoagulation. Further efforts are required to increase OAC prescription.
Analysis and optimization of seismic monitoring networks with Bayesian optimal experimental design
Authors: Callahan Jake , Monogue Kevin , Villarreal Ruben , Catanach Tommie
Published: January 2025

Monitoring networks increasingly aim to assimilate data from a large number of diverse sensors covering many sensing modalities. Bayesian optimal experimental design (OED) seeks to identify data, sensor configurations or experiments which can optimally reduce uncertainty and hence increase the performance of a monitoring network. Information theory guides OED by formulating the choice of experiment or sensor placement as an optimization problem that maximizes the expected information gain (EIG) about quantities of interest given prior knowledge and models of expected observation data. Therefore, within the context of seismo-acoustic monitoring, we can use Bayesian OED to configure sensor networks by choosing sensor locations, types and fidelity in order to improve our ability to identify and locate seismic sources. In this work, we develop the framework necessary to use Bayesian OED to optimize a sensor network’s ability to locate seismic events from arrival time data of detected seismic phases at the regional-scale. This framework requires five elements: (i) A likelihood function that describes the distribution of detection and traveltime data from the sensor network, (ii) A prior distribution that describes a priori belief about seismic events, (iii) A Bayesian solver that uses a prior and likelihood to identify the posterior distribution of seismic events given the data, (iv) An algorithm to compute EIG about seismic events over a data set of hypothetical prior events, (v) An optimizer that finds a sensor network which maximizes EIG. Once we have developed this framework, we explore many relevant questions to monitoring such as: how to trade off sensor fidelity and earth model uncertainty; how sensor types, number and locations influence uncertainty; and how prior models and constraints influence sensor placement.
Endovascular therapy and minimally invasive coronary artery bypass grafting for Leriche syndrome with ischaemic heart disease
Authors: Moriuchi Hiroki , Orii Mamoru , Shimabukuro Nobuhiro , Yamauchi Akihiko
Published: January 2025

In patients with Leriche syndrome and coronary artery disease, the operative strategy is very important because the internal thoracic artery often provides important collateral blood flow to the lower extremities. A 65-year-old man with diabetes mellitus was admitted with heart failure and bilateral claudication. We successfully performed endovascular therapy for aortoiliac occlusive disease, followed by minimally invasive coronary artery bypass grafting for ischaemic heart disease. Postoperative course was uneventful. This is the first report of using minimally invasive coronary artery bypass grafting and endovascular therapy to treat Leriche syndrome with ischaemic heart disease.
The development of opioid vaccines as a novel strategy for the treatment of opioid use disorder and overdose prevention
Authors: Tuncturk Mustafa , Kushwaha Shikha , Heider Robin M , Oesterle Tyler , Weinshilboum Richard , Ho Ming-Fen
Published: January 2025

Opioid use disorder (OUD) affects over 40 million people worldwide, creating significant social and economic burdens. Medication for opioid use disorder (MOUD) is often considered the primary treatment approach for OUD. MOUD, including methadone, buprenorphine, and naltrexone, is effective for some, but its benefits may be limited by poor adherence to treatment recommendations. Immunopharmacotherapy offers an innovative approach by using vaccines to generate antibodies that neutralize opioids, blocking them from crossing the blood-brain barrier and reducing their psychoactive effects. To date, only 3 clinical trials for opioid vaccines have been published. While these studies demonstrated the potential of opioid vaccines for relapse prevention, there is currently no standardized protocol for evaluating their effectiveness. We have reviewed recent preclinical studies that demonstrated the efficacy of vaccines targeting opioids, including heroin, morphine, oxycodone, hydrocodone, and fentanyl. These studies showed that vaccines against opioids reduced drug reinforcement, decreased opioid-induced antinociception, and increased survival rates against lethal opioid doses. These studies also demonstrated the importance of vaccine formulation and the use of adjuvants in enhancing antibody production and specificity. Finally, we highlighted the strengths and concerns associated with the opioid vaccine treatment, including ethical considerations.
Rationale and Ethical Assessment of an Oropharyngeal Gonorrhea Controlled Human Infection Model
Authors: Williams Eloise , Hocking Jane S , Fairley Christopher K , Chen Marcus Y , Williamson Deborah A , McCarthy James S , Jamrozik Euzebiusz
Published: January 2025

Infection with Neisseria gonorrhoeae, the causative agent of gonorrhea, causes significant morbidity worldwide and can have long-term impacts on reproductive health. The greatest global burden of gonorrhea occurs in low- and middle-income settings. Global public health significance is increasing due to rising antimicrobial resistance, which threatens future gonorrhea management. The oropharynx is an important asymptomatic reservoir for gonorrhea transmission and a high-risk site for development of antimicrobial resistance and treatment failure. Controlled human infection model (CHIM) studies using N gonorrhoeae may provide a means to accelerate the development of urgently needed therapeutics, vaccines, and other biomedical prevention strategies. A gonorrhea urethritis CHIM has been used since the 1980s with no reported serious adverse events. Here, we describe the rationale for an oropharyngeal gonorrhea CHIM, including analysis of potential ethical issues that should inform the development of this novel study design.
Performance of mp-tNGS in Bronchoalveolar Lavage Fluid for the Diagnosis of Invasive Pulmonary Aspergillosis in Nonneutropenic Patients
Authors: Wang Hansheng , Chen Xiao , You Hui , Wang Yunyun , Xia Xianru , Tang Yijun , Ren Tao , Wang Meifang
Published: January 2025

Background

Multiplex polymerase chain reaction (PCR)-based targeted next-generation sequencing (tNGS) is a promising tool for distinguishing lower respiratory tract infections in clinical practice, and its detectable pathogen spectrum can cover more than 95% of clinical cases, but there is limited information on systematic evaluation of the clinical use of multiplex PCR-based tNGS (mp-tNGS) in invasive pulmonary aspergillosis (IPA) cases. We aim to assess mp-tNGS in bronchoalveolar lavage fluid (BALF) for Aspergillus detection in patients with suspected IPA to provide a reliable basis for initiating antifungal therapy without microbiological or histopathological evidence.

Methods

We prospectively enrolled a cohort of consecutive patients with suspected IPA; all had undergone serum/BALF galactomannan antigen (GM), BALF mp-tNGS, and traditional tests (direct smear and culture of respiratory specimens). EORTC/MSG and FUDICU criteria or clinical compound diagnosis were used for IPA diagnosis.

Results

Thirty-two patients were diagnosed with IPA and 42 with non-IPA. Compared with the final diagnosis, the sensitivity of BALF mp-tNGS was 87.5%, while the sensitivities of traditional tests, serum GM, and BALF GM assay were 43.8%, 21.9%, and 62.5%, respectively. The specificity of BALF mp-tNGS was 90.5%, which was similar to traditional tests. The average turnaround time for Aspergillus detection by BALF mp-tNGS was 22.10 hours (SD 2.49 hours), which was significantly faster than traditional tests.

Conclusions

BALF mp-tNGS showed good performance in identification of Aspergillus in nonneutropenic IPA patients. Importantly, positive mp-tNGS in BALF can provide a basis for early antifungal therapy before microbiological evidence is available.
Prophage-encoded chitinase gene supports growth of its bacterial host isolated from deep-sea sediments
Authors: Middelboe Mathias , Traving Sachia J , Castillo Daniel , Kalatzis Panos G , Glud Ronnie N
Published: January 2025

Auxiliary metabolic genes encoded by bacteriophages can influence host metabolic function during infection. In temperate phages, auxiliary metabolic genes (AMGs) may increase host fitness when integrated as prophages into the host genome. However, little is known about the contribution of prophage-encoded AMGs to host metabolic properties. In this study, we examined a temperate bacteriophage, and its piezotolerant Pseudomonas sp. host obtained from sediment samples collected from the Kermadec Trench at ~10 000 m water depth. Both the phage and host were present throughout the sediment profiles from the surface to 30 cm into the sediment, covering large gradients of environmental conditions. The host and phage each carried one chitinase gene, which differed from each other, suggesting that chitin degradation plays a role in their substrate supply. We demonstrated that prophage-encoded chitinase supported host chitin degradation and growth in the presence of chitin. Furthermore, prophage induction dynamics were strongly substrate-dependent, suggesting that the host controls the lysis-lysogeny switch in response to the presence of chitin, thus optimizing the trade-off between the loss of cells from prophage induction and prophage enhancement of host performance. Overall, the results demonstrate prophage-encoded AMGs as collaborative goods for their hosts and emphasize the potential role of phage-host interactions in benthic biogeochemical cycling, as well as for the capability of deep-sea bacteria to efficiently adapt and thrive at a wide range of environmental conditions.
The no-hair theorems at work in M87*
Authors: Iorio Lorenzo
Published: January 2025

Recently, a perturbative calculation to the first post-Newtonian order has shown that the analytically worked out Lense–Thirring precession of the orbital angular momentum of a test particle following a circular path around a massive spinning primary is able to explain the measured features of the jet precession of the supermassive black hole at the centre of the giant elliptical galaxy M87. It is shown that also the hole’s mass quadrupole moment $Q_2$, as given by the no-hair theorems, has a dynamical effect, which cannot be neglected, as, instead, done so far in the literature. New allowed regions for the hole’s dimensionless spin parameter $a^\ast$ and the effective radius $r_0$ of the accretion disc, assumed tightly coupled with the jet, are obtained by including both the Lense–Thirring and the quadrupole effects in the dynamics of the effective test particle modelling the accretion disc. One obtains that, by numerically integrating the resulting averaged equations for the rates of change of the angles $\eta$ and $\phi$ characterizing the orientation of the orbital angular momentum with $a^\ast = +0.98$ and $r_0=14.1$ gravitational radii, it is possible to reproduce, both quantitatively and qualitatively, the time series for them recently measured with the Very Long Baseline Interferometry technique. Instead, the resulting time series produced with $a^\ast = -0.95$ and $r_0=16$ gravitational radii turn out to be out of phase with respect to the observationally determined ones, while maintaining the same amplitudes.
AI-guided virtual biopsy: Automated differentiation of cerebral gliomas from other benign and malignant MRI findings using deep learning
Authors: Holtkamp Mathias , Parmar Vicky , Hosch René , Salhöfer Luca , Styczen Hanna , Li Yan , Opitz Marcel , Glas Martin , Guberina Nika , Wrede Karsten , Deuschl Cornelius , Forsting Michael , Nensa Felix , Umutlu Lale , Haubold Johannes
Published: January 2025

Background

This study aimed to develop an automated algorithm to noninvasively distinguish gliomas from other intracranial pathologies, preventing misdiagnosis and ensuring accurate analysis before further glioma assessment.

Methods

A cohort of 1280 patients with a variety of intracranial pathologies was included. It comprised 218 gliomas (mean age 54.76 ± 13.74 years; 136 males, 82 females), 514 patients with brain metastases (mean age 59.28 ± 12.36 years; 228 males, 286 females), 366 patients with inflammatory lesions (mean age 41.94 ± 14.57 years; 142 males, 224 females), 99 intracerebral hemorrhages (mean age 62.68 ± 16.64 years; 56 males, 43 females), and 83 meningiomas (mean age 63.99 ± 13.31 years; 25 males, 58 females). Radiomic features were extracted from fluid-attenuated inversion recovery (FLAIR), contrast-enhanced, and noncontrast T1-weighted MR sequences. Subcohorts, with 80% for training and 20% for testing, were established for model validation. Machine learning models, primarily XGBoost, were trained to distinguish gliomas from other pathologies.

Results

The study demonstrated promising results in distinguishing gliomas from various intracranial pathologies. The best-performing model consistently achieved high area-under-the-curve (AUC) values, indicating strong discriminatory power across multiple distinctions, including gliomas versus metastases (AUC = 0.96), gliomas versus inflammatory lesions (AUC = 1.0), gliomas versus intracerebral hemorrhages (AUC = 0.99), gliomas versus meningiomas (AUC = 0.98). Additionally, across all these entities, gliomas had an AUC of 0.94.

Conclusions

The study presents an automated approach that effectively distinguishes gliomas from common intracranial pathologies. This can serve as a quality control upstream to further artificial-intelligence-based genetic analysis of cerebral gliomas.
Effects of Infant Formula Supplemented With Prebiotics on the Gut Microbiome, Gut Environment, Growth Parameters, and Safety and Tolerance: A Systematic Review and Meta-Analysis
Authors: Kebbe Maryam , Leung Kennedy , Perrett Ben , Reimer Raylene A , Adamo Kristi , Redman Leanne M
Published: January 2025

Context

Prebiotics are often added to infant formulas to mimic the benefits of oligosaccharides found in human milk.

Objective

This systematic review and meta-analysis evaluated the effects of prebiotic-supplemented cow’s milk–based formula on the gut microbiota, gut environment, growth parameters, and safety and tolerance in infants ≤6 months old, compared with a standard formula or human milk comparator.

Data Sources

Searches were performed in the PubMed, Embase, Cochrane Central Register of Controlled Trials, and ProQuest Dissertations & Theses databases. Articles were included that reported on randomized controlled trials, were published from inception until April 2024, and met prespecified inclusion and exclusion criteria.

Data Extraction

Outcomes included gut microbiota (eg, diversity; taxa at phylum, family, genus and species levels), gut environment (eg, pH, secretory immunoglobulin A, fecal calprotectin, fecal metabolites), growth parameters (eg, z scores), and safety and tolerance. Fixed or random effects models were used and mean differences (MDs) with 95% CIs were calculated to assess pooled effects. Risk of bias was assessed using the Cochrane Collaboration Tool (RoB 2).

Data Analysis

A total of 30 articles met inclusion criteria, with 5290 infants included. Whereas effects on Lactobacillus were inconsistent, prebiotic formula supplementation increased Bifidobacterium counts (k = 7 [MD: 0.49; 95% CI, 0.27-0.71]; I2 = 13%; P < .00001) and decreased fecal pH (k = 7 [MD: –0.39; 95% CI, –0.57 to –0.20]; I2 = 0%; P < .0001) compared with standard formula. Prebiotic formula supplementation increased total bacteria compared with human milk (MD: 0.41 [95% CI, 0.17-0.65]; I2 = 8%; P = .0006). In terms of growth parameters, weight-for-age z scores favored the prebiotic formula group compared with the human milk group (k = 2 [MD: 0.23; 95% CI, 0.04-0.42]; I2 = 7%; P = .02).

Conclusions

Prebiotic supplementation in infant formula can positively alter the gut microbiota, particularly Bifidobacterium, without negative impacts on growth. Standardized, high-quality research is needed to confirm the study findings and inform guidelines for prebiotic use in infant nutrition.

Systematic Review Registration

PROSPERO registration no. CRD42021253589.
Machine learning models for predicting postoperative peritoneal metastasis after hepatocellular carcinoma rupture: a multicenter cohort study in China
Authors: Xia Feng , Chen Qian , Liu Zhicheng , Zhang Qiao , Guo Bin , Fan Feimu , Huang Zhiyuan , Zheng Jun , Gao Hengyi , Xia Guobing , Ren Li , Mei Hongliang , Chen Xiaoping , Cheng Qi , Zhang Bixiang , Zhu Peng
Published: January 2025

Background

Peritoneal metastasis (PM) after the rupture of hepatocellular carcinoma (HCC) is a critical issue that negatively affects patient prognosis. Machine learning models have shown great potential in predicting clinical outcomes; however, the optimal model for this specific problem remains unclear.

Methods

Clinical data were collected and analyzed from 522 patients with ruptured HCC who underwent surgery at 7 different medical centers. Patients were assigned to the training, validation, and test groups in a random manner, with a distribution ratio of 7:1.5:1.5. Overall, 78 (14.9%) patients experienced postoperative PM. Five different types of models, including logistic regression, support vector machines, classification trees, random forests, and deep learning (DL) models, were trained using these data and evaluated based on their receiver operating characteristic curve and area under the curve (AUC) values and F1 scores.

Results

The DL models achieved the highest AUC values (10-fold training cohort: 0.943, validation set: 0.928, and test set: 0.892) and F1 scores (10-fold training set: 0.917, validation cohort: 0.908, and test set:0.899) The results of the analysis indicate that tumor size, timing of hepatectomy, alpha-fetoprotein levels, and microvascular invasion are the most important predictive factors closely associated with the incidence of postoperative PM.

Conclusion

The DL model outperformed all other machine learning models in predicting postoperative PM after the rupture of HCC based on clinical data. This model provides valuable information for clinicians to formulate individualized treatment plans that can improve patient outcomes.
Radiotherapy and surgery: can this combination be further optimized for patients with metastatic spine disease?
Authors: Amelink Jantijn J G J , Bindels Bas J J , Kasperts Nicolien , MacDonald Shannon M , Tobert Daniel G , Verlaan Jorrit-Jan
Published: January 2025

This narrative review provides a comprehensive overview of the current status, recent advancements, and future directions in the management of metastatic spine disease using both radiotherapy and surgery. Emphasis has been put on the integrated use of radiotherapy and surgery, incorporating recent developments such as separation surgery, active dose sparing of the surgical field, and the implementation of carbon fiber-reinforced polymer implants. Future studies should explore the effects of minimizing the time between radiotherapy and surgery and investigate the potential of vertebral re-ossification after radiotherapy to obviate the need for stabilization surgery. Concerted efforts should be directed toward fostering multidisciplinary collaboration among radiation oncologists, spine surgeons, and medical oncologists.
Phototherapy in lymphoproliferative and inflammatory diseases associated with human T-lymphotropic virus
Authors: de Lima Lobato Brena Andrade , de Brito João Augusto Gomes de Souza Monteiro , Abreu Junior José Maria de Castro , de Sousa Maísa Silva , Silva Carlos Augusto Moreira , Carneiro Thiago Xavier , Sousa Rita Catarina Medeiros , Xavier Marília Brasil
Published: January 2025

Background

Dermatological manifestations affect 5% of patients with human T-lymphotropic virus (HTLV).

Methods

Thirteen patients with inflammatory or lymphoproliferative dermatological diseases, both HTLV-positive and HTLV-negative, were selected for treatment with ultraviolet B narrowband (UVB-NB) phototherapy. Clinical and histopathological evaluations were conducted before and after 120 d of phototherapy.

Results

All seven HTLV-positive patients evaluated were type 1. Clinical evaluation showed improvement in all 13 patients. In the histopathological examination, all patients with lymphoproliferative diseases and five with inflammatory diseases showed regression in most of the assessed parameters.

Conclusions

The present research suggests that UVB-NB phototherapy is a promising treatment for lymphoproliferative and inflammatory skin diseases in HTLV-1 patients.
Anemonin suppresses sepsis‐induced acute lung injury by inactivation of nuclear factor‐kappa B and activation of nuclear factor erythroid 2‐related factor‐2/heme oxygenase‐1 pathway
Authors: Xia Qingping , Liu Guohao , Zhang Liangqing , Xie Baodong , Deng Li
Published: January 2025

Sepsis‐induced acute lung injury (ALI) is a common acute and severe reason of death in the intensive care unit. Although the pathogenesis is complicated and multifactorial, elevated inflammation and oxidative stress are considered as fundamental mechanisms for the progression of ALI. Anemonin is a natural compound with diverse biological properties including anti‐inflammatory and anti‐oxidative effects. To identify whether anemonin has protective effects on sepsis‐induced ALI, a mouse sepsis‐induced ALI model and cellular models using the mouse alveolar macrophage MH‐S cells and mouse lung epithelial MLE‐12 cells were established. Our results showed that anemonin reduced lipopolysaccharide (LPS)‐induced mortality, and improved sepsis‐induced ALI in the mouse model, as shown by improved histopathological changes, decreased lung wet/dry weight ratio, and myeloperoxidase activity. Anemonin alleviated LPS‐induced secretion of tumor necrosis factor‐α (TNF‐α), interleukin‐1β (IL‐1β), and interleukin‐6 (IL‐6) in bronchoalveolar lavage fluid samples, as well as reversed the LPS‐caused increase in malondialdehyde (MDA) content and decrease in activities of the antioxidant enzymes superoxide dismutase (SOD) and catalase (CAT) in lung tissues. In the cellular model, anemonin inhibited the LPS‐induced inflammatory responses and oxidative stress in MH‐S and MLE‐12 cells. In addition, anemonin inhibited LPS‐induced nuclear factor‐kappa B (NF‐κB) pathway, while enhancing the activation of nuclear factor erythroid 2‐related factor‐2 (Nrf2) in lung tissues, MH‐S, and MLE‐12 cells. NF‐κB inhibition enhanced the anti‐inflammatory and anti‐oxidative effects of anemonin, while Nrf2 knockdown attenuated these effects of anemonin, implying the critical roles of NF‐κB and Nrf2. These results indicated that anemonin suppressed sepsis‐induced acute lung injury by inhibition of NF‐κB and activation of Nrf2/heme oxygenase‐1 pathway, suggesting that anemonin might be developed as a new therapeutic agent for the treatment of sepsis‐induced ALI.
Spontaneous ruptured solid pseudopapillary tumor of pancreas: a rare condition identified in a patient presenting with features of shock
Authors: Devkota Shishir , Acharya Kshitiz , Poudel Navin , Shrestha Aron , Bhattarai Abhishek , Kansakar Prasan B.S.
Published: January 2025

Introduction:

Solid pseudopapillary tumor of pancreas are rare benign tumors of pancreas, that typically affects the young women. They are usually asymptomatic or minimally symptomatic, and are usually diagnosed by different imaging modalities.

Case presentation:

We herein present a case of solid pseudopapillary tumor of pancreas in an 18-year-old female patient who presented to our emergency department with features of shock following its spontaneous rupture. Imaging showed features suggestive of solid pseudopapillary tumor of pancreas, and she was managed by exploratory laparotomy following initial resuscitation.

Discussion:

Solid pseudopapillary tumors of pancreas are one of the rare exocrine pancreatic tumors. Their origin is not exactly clear, the most accepted theory states that these tumors originate from the multipotent primordial cells. Preoperative diagnosis can be made showing features distinct from other pancreatic solid/cystic neoplasms. Surgical management is the preferred treatment modality in these tumors.

Conclusion:

These are rare entities of pancreas, and may present with vague abdominal symptoms. Sometimes, these tumors may undergo spontaneous rupture, presenting with features of shock.
Lutembacher syndrome with congenital atrial septal defect in an 18-year-old female: a rare case report
Authors: Astanbouli Sara Mohamed , Othman Abdulrahman Ahmad , Takkem Saleh , Al Aboud Mohammad Yassin , Yousef Hamza , Yousef Haidar , AlRhman Judy Alabd , Abbas Mahmoud Mustafa , Alhasan Mahmoud Mohamad Khair , Jaamour Khaled Taysir , Buz Ahmad Ibraheem , Sleiay Bilal
Published: January 2025

Introduction:

Lutembacher syndrome (LS) is a rare condition with congenital atrial septal defect (ASD) and mitral stenosis (MS), often post-rheumatic illness. Diagnosis uses Doppler echocardiography, and treatment may involve surgery or percutaneous options.

Case presentation:

An 18-year-old female presented with worsening dyspnea, orthopnea, and potential undiagnosed rheumatic fever. Chest X-ray showed cardiomegaly. An echocardiogram revealed left atrial dilation and mitral stenosis with regurgitation, aortic valve showed thickening without stenosis, and the right ventricle was mildly dilated; an interatrial shunt was present. Mitral stenosis worsened left-to-right shunt.

Discussion:

LS results from the balance of ASD and MS. Factors influencing prognosis include pulmonary resistance, ASD size, and mitral stenosis severity. Echocardiography is essential for diagnosis, which revealed left atrial dilation, normal left ventricular function, severe mitral stenosis, and pulmonary valve changes. ECG indicated right ventricular hypertrophy. CXR showed left atrial enlargement and right ventricle enlargement. Treatment included an open heart surgery which replaced the mitral valve and closed the ASD.

Conclusion:

Lutembacher syndrome, a rare condition combining ASD and mitral stenosis, can cause cardiac failure and pulmonary hypertension if untreated. Given the patient’s stable condition in the early stages of the disease, early surgical or percutaneous intervention is advisable.
Perturbation theory for dark–bright solitons of the Manakov system
Authors: Chernyavskiy A. , Frantzeskakis D. J. , Horikis T. P. , Koutsokostas G. N. , Prinari B.
Published: January 2025

We present a direct perturbation method to study the dynamics of dark–bright (DB) solitons of the Manakov system under the influence of perturbations. Our methodology combines a multi-scale expansion method, perturbed conservation laws and a boundary-layer approach, which breaks the problem into an inner region, pertinent to the soliton core and an outer region, which evolves independently of the dark–bright soliton. We find that a shelf emerges around the dark soliton component, which propagates with a speed depending on the background intensity. Conserved quantities of the Manakov system are employed to determine the properties of the perturbed solutions. We focus on dissipative perturbations, such as diffusion, as well as linear and nonlinear loss, and show that the effect of the bright (filling) soliton component is to partially stabilize ‘bare’ dark solitons of the scalar case against perturbation-induced dissipation. Our analytical predictions are corroborated by results of direct numerical simulations.
Whole genome sequencing-based analysis of genetic predisposition to adult glioblastoma
Authors: van Opijnen Mark P. , van Valkengoed Devin R. , de Ligt Joep , de Vos Filip Y.F. , Broekman Marike L.D. , Cuppen Edwin , Koster Roelof
Published: January 2025

Background

Glioblastoma is most commonly reported in the second (pediatric form) and seventh (adult form) decade of life. Pathogenic germline variants (PGVs) and its association to late onset glioblastoma remains unclear. This study aimed to investigate the genetic predisposition to adult glioblastoma.

Methods

We performed an in-depth analysis of whole genome sequencing (WGS) data of tumor-normal tissue pairs of 98 glioma WHO grade 4 patients for potential presence of PGVs, in a comprehensive set of 170 genes associated with cancer predisposition. All candidate pathogenic events were also assessed for second-hit somatic events.

Results

In 11 patients (11%), PGVs were observed that were considered relevant by clinical experts in the context of glioblastoma. In these patients, 13 PGVs were found in genes known for a strong association with familial glioblastoma (MSH6(3x),PMS2(5x),MSH2,TP53,NF1andBRCA1) or with medulloblastoma (SUFU). In eight of these patients (73%) causality was supported by a second (somatic) event and/or a matching genome-wide mutational signature.

Conclusions

Germline predisposition does also play a role in the development of adult glioblastoma, with mismatch repair deficiency being the main mechanism. Our results do illustrate benefits of tumor-normal WGS for glioblastoma patients and their relatives beyond the identification of potentially actionable mutations for therapy guidance.

Key points

Pathogenic germline variants occur in more than 10% of adult glioblastoma

Mismatch repair deficiency is the main predisposition mechanism

Pathogenic germline variants could be used for (targeted) treatment selection

Importance of the Study

The hereditary of adult glioblastoma is still largely unexplored. With the option of broad molecular testing, it is crucial that clinicians are aware of the a priori probability of finding germline predisposition in a glioblastoma patient. Here, we studied the genetic predisposition to adult glioblastoma in an unselected, average cohort. We observed that pathogenic germline variants occurred in about 1 out of 10 patients, with mismatch repair deficiency being the main predisposition mechanism. This information should be kept in mind when broad molecular testing, like WGS, is discussed with the patient. Clinicians and patients should discuss the probability of finding evidence of heredity of the tumor and potential consequences for relatives.
Coping with dual roles: a case of adolescent student mothers in Tanzania’s secondary schools
Authors: Mwakililo Pendo Samson , Mauki Chris Mungubariki , Lyakurwa Suitbert Emil
Published: January 2025

Purpose

This paper aims to examine adolescent student mothers in Tanzania’s secondary schools’ unique coping strategies. It intends to explore strategies adolescent student mothers use in coping with the challenges of managing motherhood concurrent with schooling in the context of Tanzania’s secondary schools.

Design/methodology/approach

The study employed a qualitative single-case study design, involving 35 adolescent student mothers and 5 class teachers selected through purposive sampling. Data collection methods included focus group discussions for adolescent student mothers and semi-structured interviews for class teachers, facilitating insights into their coping strategies, and the contextual factors guiding their choices of certain coping strategies. Thematic analysis ensured systematic analysis of the data.

Findings

The findings indicate that adolescent student mothers use coping strategies like relying on interpersonal support systems, skipping schooling for some days, bringing with them their children to school, getting into convenience marriages, involving in income-generating ventures, ignoring and relying on faith and spiritual support.

Research limitations/implications

This research will be beneficial to adolescent student mothers, parents and schools and will add a contribution to this field. However, the coping strategies identified were limited to a small sample from a selected region and schools, hence cannot be used for generalization to a larger population.

Practical implications

This research will assist policymakers in evaluating and reassessing the re-admission policy to create more conducive environments that suit adolescent student mothers’ situations. This will create a supportive environment that fosters the well-being of adolescent student mothers and their children.

Social implications

The findings of this paper will be useful in understanding the coping strategies employed by student mothers and how educational modifications can be implemented to suit adolescent student mothers’ situations.

Originality/value

The research was conducted after introducing the re-admission circular to primary and secondary schools in Tanzania, and the findings derived from it are original.
Corporate social innovation communication and institutionalisation: a cement multinational’s sustainability journey
Authors: Sebastiao Sonia Pedro , Melchiades Soares Andreia
Published: January 2025

Purpose

This study examines how Secil, a multinational cement company headquartered in Portugal, communicates and institutionalises its corporate social innovation (CSI) initiatives through various communication channels, focusing on its sustainability priorities established in 2022.

Design/methodology/approach

A deductive and mixed-method, predominantly qualitative approach is used to understand how Secil utilises various communication tools to highlight its sustainability priorities and integrate CSI within its messages, using the dimensions of The Rutgers Institute Corporate Social Innovation Model (RICSI) presented by Wirtenberg (2021). Thematic and frame analysis are employed to interpret Secil’s articulation of its sustainability and innovation priorities. The generic frame of responsibility serves as a lens through which we can comprehend the institutionalisation of CSI within Secil’s narratives. Through a meticulous examination of journalistic and advertising materials depicting sustainable practices, the study elucidates their correspondence with the foundational pillars of RICSI.

Findings

The analysis reveals that Secil’s CSI initiatives are primarily driven by coercive isomorphic pressures from sector-specific regulations and international bodies such as the European Union and the United Nations. The company develops innovative solutions through strategic partnerships with governmental bodies, local municipalities and cultural associations, aligning these with sustainable development goals. Whilst this approach potentially offers competitive advantages, the institutionalisation of CSI appears to be predominantly shaped by external regulatory requirements rather than voluntary organisational change.

Research limitations/implications

Whilst the study’s reliance on sustainability reports, communication tools and CEO media interviews provides valuable insights, these sources may present an inherently optimistic view of organisational sustainability practices. This limitation suggests several promising avenues for future research. Subsequent studies would benefit from incorporating internal stakeholder interviews to understand communication strategy development, conducting comparative analyses across different market contexts and examining the longitudinal evolution of CSI communication.

Originality/value

This paper enhances the understanding of potential sustainability narratives used by multinational companies involved in traditionally polluting activities. It provides insights into how these companies integrate sustainability, innovation and communication in both theoretical and practical contexts. By applying the RICSI to strategic communication research, this case study highlights the crucial role of alignment, clarity of intent, stakeholder engagement and organisational culture in implementing CSI. This underscores the importance of strategic communication in this area.
Winter survival of a small predator is determined by the amount of food in hoards
Authors: Korpimäki Erkki , Piironen Antti , Laaksonen Toni
Published: January 2025

The hoarding behaviour of animals has evolved to reduce starvation risk when food resources are scarce, but effects of food limitation on survival of hoarding animals is poorly understood.

Eurasian pygmy owls (Glaucidium passerinum) hoard small mammals and birds in natural cavities and nest boxes in late autumn for later use in the following winter. We studied the relative influence of the food biomass in hoards of pygmy owls on their over‐winter and over‐summer apparent survival. We also tested whether this influence is modulated by intrinsic (age, sex) traits or extrinsic factors (winter temperature, snow depth).

We measured biomass of prey items in pygmy owl food‐hoards during autumns 2003–2023 in west‐central Finland. We individually marked and recaptured pygmy owls both at nests in the breeding season and at food‐hoards. Our dataset included a total of 407 pygmy owls, which were all captured from a food‐hoard at least once during their capture history. The mean biomass of the annual food‐hoards associated with one individual was 443 g (SD = 523 g, range from 3.5 to 4505 g) and was markedly higher in autumns of vole abundance than in those of vole scarcity.

Hoard size had a positive effect on apparent survival of owls over consecutive winter, whereas it did not affect apparent survival over next summer. Hoard size was a better predictor of apparent survival than vole abundance (main food of pygmy owls) in the field. Male owls had higher overall apparent survival rates than female owls, particularly when food‐hoards were small.

That hoard size was a better predictor of apparent survival than vole abundance indicates that the hoards are critical for pygmy owls during winter, likely because they are unable to hunt voles below deep snow cover. The positive relationship between apparent survival of owl individuals and their hoard size during winter (when the hoard is being consumed), but not summer, indicates that the hoard size has a true positive effect on survival, and does not only reflect latent inter‐individual differences and/or dissimilarities in their environments. We conclude that food limitation during hoarding essentially regulates apparent over‐winter survival of pygmy owl individuals.
Community‐Led Insights Reveal Hope for Red Colobus Conservation in Cameroon
Authors: Mbile Peter , Elomo Lylliane , Langsi George , Namasoh Pegreen , Motia Wilson
Published: January 2025

Current knowledge situates the natural range of Preuss's red colobus (Piliocolobus preussi) within south‐eastern Nigeria and western Cameroon, with the Korup National Park and its periphery being its stronghold. Nevertheless, some suggest the primate may have become extirpated in parts of the periphery of the Korup National Park. Reports from some nearby communities however suggested otherwise. Meanwhile, because of insecurity caused by a socio‐political crisis affecting the two English‐speaking regions since 2016, very few formal surveys of the species have been carried out. Yet, confirming the presence or absence of the species was considered important for a survey to be designed and carried out. From April to July 2024, we conducted a targeted, community‐based assessment of the presence/absence of Preuss's red colobus in the south‐eastern peripheral zone of Korup National Park, an area where red colobus were reported in past surveys to have been extirpated. While taking security precautions, we relied on local ethnoecological knowledge and wildlife experiences of ex‐rangers and communities to inform geographic information systems‐assisted mental‐mapping of red colobus encounters. Our results suggest that red colobus are still present in the south‐eastern peripheral zone of the Korup National Park. We offer suggestions for their conservation.
Granulocyte and Monocyte Adsorption Therapy in Patients With Sepsis: A Feasibility Study
Authors: Nishida Osamu , Nakamura Tomoyuki , Nakada Takaaki , Takahashi Gaku , Masuda Yoshiki , Tsubouchi Hiroki , Kakihana Yasuyuki , Sakamoto Yuichiro , Takasu Osamu , Suzuki Hiroyuki , Nakazawa Koichi , Kobayashi Iwao , Doi Kent , Uchiyama Sohta , Kitamura Nobuya , Kotani Toru , Kuriyama Naohide , Hattori Noriyuki , Suzuki Yasushi , Tatsumi Hiroomi , Moriyama Kazuhiro
Published: January 2025

Background

The pathogenesis of sepsis is thought to be linked to a dysregulated immune response, particularly that involving neutrophils. We have developed a granulocyte adsorption column as a “decoy organ,” which relocates the massive inflammation in organs in the body to a blood purification column. This study was conducted to assess the safety and experimental effectiveness of granulocyte monocyte adsorption apheresis‐direct hemoperfusion (G1‐DHP) in the treatment of patients with sepsis, using a prospective, multicenter design.

Methods

The study included patients diagnosed with sepsis and with an APACHE II score ranging from 17 to 34. A total of five G1‐DHP were performed within 3 days of patient enrollment. The primary endpoint was the change in sequential organ failure assessment (SOFA) score from enrollment to 7 days, and the safety endpoints were adverse events and mortality at 28 days.

Results

G1‐DHP was performed on 82 patients. The median (interquartile range) SOFA score decreased from 10 (8–11) to 4 (3–7) after 7 days (n = 70; p < 0.01). Granulocytes, mainly neutrophils, were adsorbed, and the neutrophil‐to‐lymphocyte ratio significantly improved (p < 0.01). Notable improvements were observed in the SOFA scores for circulation and renal function. The acute physiology and chronic health evaluation II score of the 77 patients evaluated for mortality was 27, and the 28‐day mortality rate was 7.8%.

Conclusions

This study confirmed that G1‐DHP can be safely used as an adjunct to standard sepsis treatment regimens. Although further investigations are required, G1‐DHP is a promising supplemental therapy for sepsis.

Trial Registration: jRCT1080225183 (Japan Registry of Clinical Trials identifier)
Long‐Term Monitoring of Hunting Signs Reveals Complex Spatiotemporal Patterns of Hunting Activities in an Unprotected African Rainforest
Authors: Nguimdo Vianny Rodel Vouffo , Abwe Ekwoge Enang , Morgan Bethan J. , Ketchen Marcel Eyong , Mfossa Daniel Mbouombouo , Abwe Abwe Enang , Betobe Nelson Ekole , Whytock Robin C. , Tobler Mathias W. , Kamp Johannes , Balkenhol Niko , Waltert Matthias , Soofi Mahmood
Published: January 2025

Aim

The long‐term survival of many mammal populations relies on how effectively we mitigate the threat from unsustainable hunting. Yet, hunting activities are often cryptic, especially in unprotected forests. Here, we investigate whether hunting signs can help understand the spatiotemporal dynamics of hunting activities in an unprotected African rainforest and examine how landscape characteristics predict various indicators of hunting.

Location

Ebo forest, Cameroon, Central Africa.

Methods

We recorded hunting signs (e.g., shotgun cartridges, wire snares, direct sightings) systematically on 23 parallel recce lines across the Ebo forest from 2008 to 2023. We assigned hunting data and spatial covariates (e.g., elevation, distance to village) to 1 × 1 km grid cells and applied generalised linear mixed models to predict the effects of these covariates on hunting.

Results

We found that hunting was commonplace across the entire Ebo forest. The best‐fitting models for each hunting sign differed considerably. Shotgun cartridges and all hunting signs combined increased significantly from 2016 to 2023 and varied non‐linearly along the village‐distance gradient. We found a progressive inversion of hunting trends along the anthropogenic gradient; between 2016 and 2018, wire snares declined with the distance to road but from 2021, they increased along the road‐distance gradient. Wire snares showed a similar pattern along the river‐distance gradient. Our results also revealed differences between shotgun hunting and snaring along the altitudinal gradient; the effect of elevation was positive on shotgun cartridges and negative on wire snares. Hunting signs and trails decreased significantly with increasing terrain ruggedness.

Main Conclusions

Using long‐term monitoring data, we show how hunting patterns change dynamically with respect to human and landscape‐related features. We also demonstrate complex hunting patterns along the gradient of human influence, therefore questioning the use of proxies such as the distance to human settlements and even topography to account for hunting pressure. Overall, we show that hunting sign data can reveal the spatiotemporal patterns of hunting, crucial in evaluating the effectiveness of conservation interventions and guiding the prioritisation of limited conservation resources.
rarestR: An R Package Using Rarefaction Metrics to Estimate α‐ and β‐Diversity for Incomplete Samples
Authors: Zou Yi , Zhao Peng , Wu Naicheng , Lai Jiangshan , Peres‐Neto Pedro R. , Axmacher Jan C.
Published: January 2025

Aim

Species abundance data is commonly used to study biodiversity patterns. In this context, comparing α‐ and β‐diversity across incomplete samples can lead to biases. Therefore, it is essential to employ methods that enable standardised and accurate comparisons of α‐ and β‐diversity across varying sample sizes. In addition, biodiversity studies also often require robust estimates of the total number of species within a community and the number of species shared by two communities.

Innovation

Rarefaction methods are commonly used to calculate α‐diversity for standardised sample sizes, and they can also serve as the basis for calculating β‐diversity. In this application note, we present rarestR, a new R package designed for calculating abundance‐based α‐ and β‐diversity measures for inconsistent samples using rarefaction‐based metrics. The package also includes parametric extrapolation techniques to estimate the total expected number of species within a community, as well as the total number of species shared between two communities. Additionally, rarestR provides visualisation tools for curve‐fitting associated with these estimators.

Main Conclusions

Overall, the rarestR package is a valuable tool for comparing α‐ and β‐diversity values among incomplete samples, such as those involving highly mobile or species‐rich taxa. In addition, our species estimators offer a complementary approach to non‐parametric methods, including the Chao series of estimators.