bluuebunny/crossref_metadata_2025 huggingface dataset:
Eponymous doctors associated with Edinburgh – Thomas Addison, Richard Bright, Dominic Corrigan,Thomas Addis, and Thomas Hodgkin
Authors: Doyle D
Published: January 2025

Medical eponyms were a colourful feature of medical teaching and practice in past generations but are now seldom used or awarded. This paper(and two that follow) looks at the doctors, all associated with Edinburgh, behind some of the best known eponyms and at those who bestowed or encouraged them. It asks why some discoveries or inventions were eponymised, and asks what purpose they served and why they are losing favour.
Attention deficit hyperactivity disorder (ADHD)
Authors: Forbes F
Published: January 2025

Attention deficit hyperactivity disorder has attracted considerable media attention, in particular questioning its validity as a diagnostic concept and the use of stimulant medication in its treatment. This does especial disservice to the children and young people with ADHD and their parents:ADHD is a common, chronic neurodevelopmental disorder affecting many areas of a child’s life, with a high rate of secondary problems and a high risk of associated disorders. It requires multi-modal assessment and management, usually including medication..
The man who can’t run: a case of tumoral calcinosis
Authors: Jawad ASM , Saeed IT
Published: January 2025

A 26-year-old white man presented with a several-year history of inability to run, a slowly enlarging lump on the left olecranon, and increasing stiffness at the back of both ankles. Physical examination showed a firm, nontender, freely mobile mass on the left olecranon. Each Achilles tendon was surrounded by a firm oblong subcutaneous mass extending to the mid calf. X-rays of the left elbow showed a lobulated calcified mass over the olecranon; each Achilles tendon was surrounded by a large, lobulated calcified mass overlying and encasing the tendon. The calcified deposits were surgically removed from the elbow and each Achilles tendon was surgically debulked. The histology was typical of tumoral calcinosis. Primary tumoral calcinosis is an unusual benign condition characterised by the presence of slow-growing calcified periarticular soft tissue masses composed of calcium salts and usually located around the large joints. The exact cause is unknown.
International benchmarking of 500 admissions with a fractured hip in Australia using the Standard Audit of Hip Fractures in Europe and the Scottish Intercollegiate Guidelines Network
Authors: Stride P , Houston A , Ratnapala D , Perron J
Published: January 2025

The aim of this study was to audit our management of hip fracture and to compare the results with the Scottish Hip Fracture Audits of both 2004 and 2006. We present data utilising a subset of the SAHFE proforma on 500 consecutive admissions to Redcliffe Hospital with a fractured hip, a review of progress at four months post-operatively and a comparison of outcomes in orthopaedic units in Scottish hospitals. We outline how the audit helped us to detect long emergency department door-to-operating theatre times plus a high re-operation rate and subsequently identify the steps required to improve the quality of care and clinical governance of patients sustaining a hip fracture.
Hypomagnesaemia induced Parkinsonism?
Authors: Chua MPW , McLaughlin KM , Rochow SB
Published: January 2025

We report an unusual presentation in an elderly woman with a previous diagnosis of benign tremulous Parkinson’s disease who developed a severe Parkinsonian-like syndrome with profound immobility following small bowel resection. Her Parkinsonism was largely unresponsive to conventional medical therapy. However, she was found to be profoundly hypomagnesaemic and a dramatic improvement in her symptoms and functional ability was achieved after correction of the severe hypomagnesaemia. A brief discussion is included.
Obesity and infertility
Authors: Zachariah M , Acharya U
Published: January 2025

Obesity has reached epidemic proportions and is widely known to be associated with a number of wide-ranging health complications, including heart disease and cancer; but to what extent does obesity cause infertility and cause complications in pregnancy? This paper reviews the evidence.
Exploring Scotland’s influenza pandemic of 1918–19: lest we forget
Authors: Butler AR , Hogg JL
Published: January 2025

The 1918–1919 influenza pandemic resulted in more deaths than any other medical event in human history; the most recent scholarship puts the death toll worldwide at 100 million. Scotland suffered a proportionate loss of life but it was little reported at the time and has been little studied by social historians since. The Great War had been such a traumatic experience that the authorities, and the general public, could take no more tragic news and the result was an uncanny silence. There is little information on the way in which people were affected by the pandemic. Such information could now be valuable as we plan a response to a pandemic of avian flu. This article aims to initiate study of an important episode in healthcare in Scotland.
Benjamin Franklin’s place in the history of medicine
Authors: Huth EJ
Published: January 2025

Benjamin Franklin's seemingly endless curiosity and his prolific contributions in diplomacy, politics, literature, and science may well justify calling him the most eminent man in eighteenth-century American life. One portion of these contributions still striking for the insights and productivity it shows was in medicine. He saw the value in inoculation against smallpox. He was aware of the placebo effect. He, in effect, launched the first American medical school. He devised a flexible urethral catheter. He identified lead poisoning as a cause of abdominal pain and peripheral neuropathy. He accurately described psoriasis well before Robert Willan. These contributions in medicine of his time were not then notably influential, but they certainly illustrate the versatility of his intellect.
Lipomatous hypertrophy of the interatrial septum
Authors: Innasimuthu AL , Rao GK , Clarke KW
Published: January 2025

Lipomatous hypertrophy of the interatrial septum is an uncommon condition characterised by the excessive deposition of adipose tissue in the interatrial septum. It is diagnosed by the characteristic thickening of the inter atrial septum with sparing of the formen ovale giving rise to a dumbbell shape appearance. Surgical excision is indicated in patients with intractable symptoms due to severely thickened septum. We report a patient who presented with atrial arrhythmia possible due to lipomatous hypertrophy of interatrial septum.
Is the College an Asklepieion?
Authors: Smith D Emslie
Published: January 2025

After an annual introduction of new Fellows one of them viewed the neckties on display and, referring to their sagittary motif, was heard to say, ‘I suppose it is the College crest.’ Of course, it is precisely not that.The only crest the College has is that of its arms, which is completely different.However, one can sympathise with the new Fellow, for in the College he was surrounded by confusing reminders of the medical mythology of ancient Greece.This account is offered as a refresher course on the dramatis personae of the pantheon and some of their activities and attributes.
Sleep apnoea: diagnosis and treatment
Authors: Mackay TW
Published: January 2025

While many people take sleep for granted, sleep disorders are common and can have serious health consequences, including causing fatal road traffic accidents. And yet such disorders are both under-diagnosed and under-treated. In this article, Dr Tom Mackay provides an overview of the diagnosis and treatment of sleep apnoea, the most common cause of excessive daytime sleepiness.
St Kilda, the neonatal tetanus tragedy of the nineteenth century and some twenty-first century answers
Authors: Stride P
Published: January 2025

Neonatal tetanus was the cause of death of two thirds of newborn babies on the archipelago of St Kilda in the Outer Hebrides for at least 150 years. This was a major factor in the community becoming non-viable.While the cause of the tetanus infections has never been clearly established, modern bacteriological evidence suggests an alternative source of infection to the previously established theory.
Falls in the elderly
Authors: Anderson KE
Published: January 2025

With a rapidly ageing population, doctors in all specialties are likely to encounter older people with falls. Falls in the elderly are common and associated with major morbidity and mortality. Falls cause injuries, fractures, loss of confidence and independence, depression and death. Recurrent falls and fear of falling are the most common reasons for an older person to require nursing home care. An initial fall may be a manifestation of an acute illness and may be the only presenting feature. However, it is known that an index fall is a risk for future falls and approximately half of those who fall once are likely to do so again.

There is good evidence to support a multidisciplinary risk factor assessment and approach to the prevention of falls. Up to 30% of falls in community-dwelling older adults may be prevented if this standardised approach is applied. In addition, falls of hospital inpatients are difficult for patients and staff. Carers in environments where specialist medicine for the elderly services are not routinely available often struggle to minimise and manage falls. While arguably more problematic to manage, a simple structured approach to these falls can also reduce risk.

This article will cover the recommended approach to the management of older people presenting with a fall and give some guidance about managing falls of hospital inpatients.
Surgery for severe obesity: an effective cure for a difficult problem
Authors: Witherspoon P , Galloway DJ
Published: January 2025

Obesity levels continue to rise around the world, leading to a multitude of health problems. While many ‘medical’ attempts at managing obesity have proven ineffective in the long term, some types of surgery for weight control have been shown to result in significant and sustained weight loss. In this article Mr David Galloway and Mr Paul Witherspoon outline the different procedures and their risks and benefits.
Specialist palliative care provision in a major teaching hospital and cancer centre – an eight-year experience
Authors: Levack P , Buchanan D , Dryden H , Baker L
Published: January 2025

If hospital patients are to have access to specialist palliative care, specialist palliative medicine must operate successfully in a busy hospital setting. This paper evaluates prospective data from 3,523 patients referred to a hospital specialist palliative care service over eight years (1999–2006). The number, age and frailty (determined by the palliative performance scale) of referred patients increased every year. The median time from referral to death was 27 days. Referrals specifically for symptom control doubled (80% versus 40%). The service responded by providing a shorter, more intensive service: more joint (nurse/ doctor) consultations, a 300% increase in medical consultations and more discharges back to the referring team. Co-management between palliative medicine and other consultants has increased, and attention is focused on the management of difficult symptoms. For some patients the referring specialist will lead management, while for others with predominantly palliative care needs, management will be led by palliative medicine specialists. For patients with the most complex needs, intensive symptom control and palliative care may be most effectively delivered in a dedicated hospital unit.
The James Lind Library: explaining and illustrating the evolution of fair tests of medical treatments
Authors: Chalmers I , Milne I , Tröhler U , Vandenbroucke J , Morabia A , Tait G , Dukan E
Published: January 2025

The James Lind Library (www.jameslindlibrary.org) has been established to improve public and professional general knowledge about fair tests of treatments in healthcare and their history. Its foundation was laid ten years ago at the Royal College of Physicians of Edinburgh, and its administrative centre is in the College’s Sibbald Library, one of the most important collections of historic medical manuscripts, papers and books in the world. The James Lind Library is a website that introduces visitors to the principles of fair tests of treatments, with a series of short, illustrated essays, which are currently available in English, Arabic, Chinese, French, Portuguese, Russian and Spanish. A 100-page book – Testing Treatments – is now available free through the website, both in English and in Arabic and Spanish translations. To illustrate the evolution of ideas related to fair tests of treatments from 2000 BC to the present, the James Lind Library contains key passages and images from manuscripts, books and journal articles, many of them accompanied by commentaries, biographies, portraits and other relevant documents and images, including audio and video files. New material is being added to the website continuously, as relevant new records are identified and as methods for testing treatments evolve. A multinational, multilingual editorial team oversees the development of the website, which currently receives tens of thousands of visitors every month.
Management of patients with irritable bowel syndrome
Authors: Bray B , Ford M
Published: January 2025

Irritable bowel syndrome is a common condition in primary care and accounts for more than 30% of hospital gastroenterological outpatient consultations. It is characterised by abdominal pain and accompanied by altered bowel habit and often extra-intestinal symptoms such as tiredness and urinary frequency. A positive diagnosis can be made with confidence given the typical history and the absence of ‘alarm features’, supported by a small number of appropriate investigations. Managing patients with irritable bowel syndrome can be challenging but should be based on an empathic appreciation of the psychosocial context of their symptoms. Pharmacological treatment should be symptom-based and may include dietary manipulation, antidiarrhoeals, laxatives, tricyclic antidepressants and selective serotonin reuptake inhibitors.
New approaches to paediatric epilepsy
Authors: Kurian MA
Published: January 2025

Clinical and basic research in paediatric epilepsy continues to have a direct impact on the diagnosis and treatment of children with seizures. In recent years, advances in molecular biology are beginning to unravel the molecular processes underlying childhood epilepsy, and there is increased understanding of the role of ion channels (and their interacting proteins) in the pathophysiology of epilepsy. Clinical trials and Cochrane reviews of diagnosis, treatment and outcome have also contributed to the management of paediatric epilepsy. This symposium provided an excellent forum for the presentation of such advances in the molecular pathogenesis, diagnosis and management of childhood epilepsies and related co-morbidities. Lectures were interspersed with interactive case presentations that illustrated contemporary approaches to paediatric epilepsy and allowed current controversies in this field to be debated.
The specialty of spinal injuries in the UK
Authors: Silver JR
Published: January 2025

At the outset of the Second World War, spinal units were established in the UK, but they were little more than hospitals where patients with spinal injuries were received. The treatment was deplorable, with patients typically suffering from pressure sores and renal sepsis. In the south of England, a spinal unit was not established until the appointment in 1944 of Ludwig Guttmann, who was trained in rehabilitation, neurology, neurosurgery, psychiatry and research. Guttmann devoted himself single-handedly to the care of his patients, turning and catheterising them himself. Within six months, he demonstrated that he could cure their sores and discharge them to a meaningful life. Recognition followed immediately, and doctors came from other units to learn Guttmann’s methods and set up rehabilitation centres for spinal patients in the UK.
Hyperemesis gravidarum-induced Wernicke’s encephalopathy
Authors: Anoop TM , Rose L , Sathy MS , Kumar A , Radha TR , Thomas M
Published: January 2025

Wernicke’s encephalopathy is a potentially fatal but readily reversible medical emergency caused by thiamine deficiency. A 30-year-old, 14 weeks pregnant South Indian woman presented with confusion, diplopia, blurring of vision, gait ataxia, nystagmus and conjugate gaze palsy with a background of intractable hyperemesis gravidarum. With clinical suspicion and radiological confirmation, she was diagnosed to have Wernicke’s encephalopathy. Immediate intervention with parenteral thiamine restored her neurological status with amelioration of nystagmus, diplopia and ataxia without any neurological sequelae. Here we report this case to illustrate the importance of early recognition of this extremely rare illness in order to avoid permanent neurological deficit.
The Greenock medical martyrs of 1864–65
Authors: Thomson JE
Published: January 2025

In the nineteenth century it was not uncommon for doctors to die from infectious diseases, but the death of five young physicians in Greenock – one third of the medical profession in a medium-sized Scottish town – from epidemic typhus, during four consecutive months in 1864–65, was an unusual event. This paper describes the lives and backgrounds of these five doctors, whose deaths in the line of duty earned them the description ‘medical martyrs’.
Author’s reply
Authors: Eadie MJ
Published: January 2025

The various publications that Drs Luauté and Lachenmeier have cited in their letter provide persuasive evidence that specimens of some absinthes that have survived intact from as long ago as 1895 did originally contain concentrations of the convulsant thujone that would be considered acceptably safe today. However, as far as I can make out, the publications do not seem to provide data for the thujone concentrations that were present in the absinthes that Magnan’s patients actually imbibed at an earlier time, in the decade centred on 1870, the period when his investigational work was done. Such absinthes may have differed from later ones in thujone content, and involved sources which have long ceased to exist. As yet, there seems no way of being sure.

Moreover, thujone concentration in absinthe is unlikely to be the sole determinant of any tendency to epileptic seizures associated with absinthe exposure. There is also the issue of the inherent epileptogenicity of the sufferers’ brains, hence the suggestion that a predisposition to juvenile myoclonic epilepsy may have been expected to increase any risk of thujone-associated seizures. A second issue, probably, is the thujone concentration present at the cerebral sites of seizure genesis. Among other factors, this concentration would probably depend not only on the thujone concentration in the absinthe ingested, but on the volume of absinthe swallowed and the period of time involved in the intake. No information appears to be available concerning the latter two matters in Magnan’s subjects.

Certainly, the high quality analytical chemical work of Dr Lachenmeier and his colleagues does not support Magnan’s interpretations of the relation between absinthe intake and epileptic seizures. However, by itself, it also does not seem sufficient to refute his conclusions. So many years after the event, it seems unlikely that evidence adequate to fully resolve the issue will ever become available.
OVERDRINKING AND HYPONATRAEMIA
Authors: Lloyd Evan L
Published: January 2025

It is a great pity that in their excellent article on hyponatraemia Thompson and Crowley (Thompson CJ, Crowley RK. Hyponatraemia. J R Coll Phys Edinb 2009; 39:154–7) made no mention of hyponatraemia induced by overdrinking. This is now a widely recognised hazard for athletes, especially distance runners, and has been the cause of many deaths in very fit and healthy young people.1 This is due to the ‘liquid refreshment’ industry trying to translate good laboratory research into the different situation in the field.2 Unfortunately the drinks industry is now so profitable and powerful that they are still pushing people to drink a lot of fluid. This financially driven momentum has now led to hyponatraemia occuring in patients during labour, increasing the hazards of birth.3 It is time this drive to keep everybody drinking at all times is stopped.
Author’s reply
Authors: Eadie Mervyn
Published: January 2025

I am very grateful to Sir Christopher Booth for detecting my mistake in stating that Fothergill’s city of residence was Manchester rather than London, and apologise to any readers who may have been misled by my error. As published in The Journal, the reference to Fothergill’s account of his migraine aura is correct, but Sir Christopher’s letter has explained the circumstances of its delayed appearance in print.
Targeting Nerve Fiber Outgrowth Inhibition After Experimental Spinal Cord Injury: A Systematic Review and Meta-analysis of Chondroitinase ABC
Authors: Khanteymoori Alireza , Peterson Clayton , Atamny Roza , Hohenhaus Marc , Beck Jürgen , Howells David W. , Schwab Jan M. , Watzlawick Ralf
Published: January 2025

Background:

Spinal cord injury (SCI) can impair motor, sensory, and autonomic function. The formation of the glial scar comprises protective as well as inhibitory neurite outgrowth properties operated by the deposition of chondroitin sulfate proteoglycans (CSPG). Chondroitinase ABC (ChABC) can degrade CSPG and foster neuroaxonal plasticity as a therapeutic approach to restore locomotor function after SCI.

Objectives:

To systematically review experimental ChABC treatments after SCI and assess their efficacy for locomotor function a comprehensive literature search was conducted following pre-registered Prospero Study protocol, selecting animal studies evaluating neurobehavioral outcomes after traumatic SCI followed by the calculation of normalized effect sizes applying meta-analysis and meta-regression methodology. Additional analyses were performed to investigate the impact of animal type, strain, sex, sample size, injury models, level of injury, and treatment duration.

Results:

Within the overall analysis of 1066 animals, a considerable amount of heterogeneity was observed. A subgroup analysis comprising experiments applying the same neurobehavioral measurement (blood–brain barrier/Basso-Mouse-Scale [BMS]-subgroup) demonstrated a 15.9% (95% CI = 11.3%-20.6%) improvement in locomotor outcomes. Different experimental characteristics influenced neurological recovery, including sex, level of injury, used anesthetic, reported dosage of ChABC treatment, the timepoint of assessment and perioperative temperature control. Sensitivity analysis applying Trim and Fill identified 19 hypothetical missing experiments suggestive of reporting bias.

Conclusion:

Reporting bias in experimental SCI research is prevalent and not limited to a specific intervention. ChABC treatment can exert beneficial effects on locomotor recovery after SCI.
Breaking the Silence on Obesity
Authors: Cepni Aliye B. , Nadeem Fatima K. , Ledoux Tracey A. , Johnston Craig A.
Published: January 2025

Obesity is a significant global public health concern, and health care providers play a crucial role in addressing it by offering healthy lifestyle counseling and weight management support. Evidence demonstrates that even brief counseling on healthy behaviors can lead to meaningful changes and sustained weight management. However, weight consultations are often underutilized in primary care due to various barriers, including biases against patients with obesity, misconception of physicians with obesity, or concerns about stigmatizing them by initiating discussions about weight. This paper explores the impact of biases, misconceptions, and stigma on the communication and treatment of patients with obesity and proposes strategies to overcome these challenges. Practical solutions include fostering inclusive health care environments for individuals of all body sizes and utilizing the 5A model (Ask, Assess, Advise, Agree, Assist) to guide respectful and effective weight management conversations.
Increasing target size and strike percentage in Tenpin bowling: An analysis of the 2017 Weber Cup
Authors: Hooper Curtis George
Published: January 2025

The ability to strike regularly in the sport of tenpin bowling is of paramount importance for bowlers should they wish to obtain high scores and compete at an elite level. Therefore, bowlers and their coaches are often looking to maximise the size of the contact area on pin number one (the head pin) that can be hit such that the chance of getting a strike is high. This effectively increases the margin of error that the bowler has, which could result in them having an advantage over the opposition. To help gain insight into the features of a shot that can potentially increase this area whilst maintaining a high strike percentage, ball tracking data from the 2017 Weber Cup is analysed. The position of the ball as it hits the pins is found to be important. If the ball travels through the pins without much deflection, and the position of the ball towards the last row of pins is close to the centre of the lane, then the target area around the head pin increases significantly. The entry angle and entry speed of the ball are found to be less important.
Correlation of scapular Dyskinesia and hand grip strength in students with smartphone addiction pursuing a bachelor's degree in healthcare profession education
Authors: Shetty Mamta , Sathyadas Sreemaya , Sabu Thomas Aliza , Jayan Veenedathu Liya , Vichare Revati , Thakkar Prathna , Surve Adnyey
Published: January 2025

Background

Hand grip strength is a critical indicator of upper extremity function, especially important in healthcare professions. Effective upper extremity function relies on proximal stability from the scapula and distal mobility from hand actions. This study aimed to examine the relationship between scapular dyskinesia and hand grip strength in healthcare students with smartphone addiction.

Methodology

A descriptive cross-sectional study was conducted with 63 students with smartphone addiction. Scapular dyskinesia was measured using Lateral Scapular Slide Test (LSST) at neutral, 45 and 90 degrees. Hand grip strength was measured using the Jamar Hydraulic hand dynamometer. The Short version of Smartphone Addiction Scale (SAS-SV) questionnaire assessed the severity of smartphone addiction, while the Disability of Arm, Shoulder and Hand (DASH) questionnaire evaluated the impact on upper extremity function.

Results

A negative correlation was found between LSST at 45degrees and hand grip strength. However, no significant correlation was observed between SAS-SV, DASH, and scapular dyskinesia.

Conclusion

Findings of the present study report a negative association between scapular dyskinesia at 45 degrees of LSST and hand grip strength. This suggests greater the scapular dyskinesis, lower will be the hand grip strength.
Real-world effectiveness and safety of second- or third-line pegylated liposomal irinotecan plus 5-fluorouracil and folinic acid in pancreatic ductal adenocarcinoma in Spain
Authors: Álvarez-Gallego Rafael , Pazo-Cid Roberto , López de San Vicente Borja , Macarulla Teresa , Martinez Eva , Garicano Fernando , Hernández Irene , Granja Monica , Ghanem Ismael , Martinez Joaquina , Ribera Paula , Diaz Roberto , Martin Valadés Jose Ignacio , Angeles Maria Cristina , Cubillo Antonio
Published: January 2025

Treatment with pegylated nanoliposomal irinotecan (nal-IRI) plus 5-fluorouracil/leucovorin (folinic acid; 5-FU/LV) has demonstrated remarkable efficacy for metastatic pancreatic ductal adenocarcinoma (PDAC) in clinical trials. However, real-world data on the effectiveness of nal-IRI+5-FU/LV is heterogeneous and is lacking in Spain. To assess the effectiveness and safety of nal-IRI+5-FU/LV in real-life PDAC patients in Spain. A multicenter retrospective study was conducted. Patients aged ⩾18 years who had received at least one cycle of nal-IRI+5-FU/LV as second- or third-line therapy for PDAC were included. The primary endpoint was overall survival (OS) from nal-IRI+5-FU/LV treatment initiation and OS from the diagnosis of metastatic disease (metOS). Overall, 200 evaluable patients were included (⩾3 metastatic sites: 22%; liver/lung metastases: 71.5%/36.9%; and Eastern Cooperative Oncology Group 0–1: 87% at nal-IRI+5FU/LV treatment initiation). Patients received a median of four cycles of nal-IRI+5FU/LV for 2.8 months (range 1.4–7.2), and the treatment was received in the second line by 80% of the patients. The median OS was 7.2 months (6- and 12-month OS rates: 58.1% and 28.9%, respectively), with 27.2% of the patients achieving OS ⩾12 months. The median metOS was 17.5 months, with 30.2% of the patients experiencing metOS ⩾ 24 months. The median progression-free survival (PFS) was 3.7 months (6- and 12-month PFS rate: 37.6% and 15.3%, respectively). The disease control rate was 35.5%. The median CA 19-9 levels decreased by at least 50% in 28.2% of the cases during treatment. Overall, 36% of the patients experienced at least one grade 3–4 adverse event during treatment, the most common being diarrhea (42.6%) and asthenia (30.9%). This real-world study shows that treatment with nal-IRI+5-FU/LV for advanced or metastatic PDAC affords benefit in terms of survival, radiological and CA 19-9 response, and PFS comparable to that reported in the clinical trial setting with a manageable safety profile.
Analysis and characterization of interhypothalamic adhesions in adults: No longer only a pediatric finding
Authors: Tuncer Onur , Harrell Alan D , Nascene David
Published: January 2025

Background and purpose

Inter-hypothalamic adhesions (IHAs) are parenchymal tissue bridges traversing the third ventricle, previously reported only in the pediatric population. We aim to understand the prevalence of IHA in the adult population, assess their size and location, and ultimately investigate whether IHA volumes correlate with age.

Materials and methods

Patients who underwent routine high-resolution 3D T2WI MRI studies of the temporal bone/internal auditory canal at an otolaryngology clinic between 2008 and 2014 were consecutively selected. The presence of IHAs was confirmed when a parenchymal structure could be traced across the third ventricle, connecting bilateral hypothalamus, and was visible in at least two planes. They were classified based on their location within the third ventricle, considering their connection with hypothalamic nuclei. Patient clinical information were collected from electronic charts. The prevalence and volumes of IHAs were calculated. Associations between age and IHA volume, as well as between IHA type, age, volume, and gender, were analyzed.

Results

779 patients, with a mean age of 54.7 years were included. Among them, 44 IHAs were identified within 41 patients, resulting in a prevalence of 5.26% in our cohort. Type 1 IHA was the most frequently encountered type, comprising 70.5% of all cases. No significant correlation was observed between IHA volumes and age. Additionally, no associations were found between IHA type and age, volume, or gender.

Conclusion

IHAs are not exclusive to the pediatric population; they are also present in adults, with a prevalence of 5.26% in patients undergoing temporal bone/internal auditory canal MRI.
Diagnosis and management of benign secreting pancreatic insulinoma: What’s new? 4 case report
Authors: Bahou Khawla , Achour Youssef , Ilahiane Mehdi , Sekkat Hamza , Bakali Younes , Mhamdi Alaoui Mouna , Raiss Mohammed , Sabbah Farid , Hrora Abdelmalek
Published: January 2025

Introduction and importance: Even though insulinoma is the most frequent neuroendocrine tumor, it represents only 2% of pancreatic 2% of all pancreatic neoplasms. Diagnosis is relatively simple, and surgery after accurate determination of the tumors location within the pancreas is the cornerstone of its treatment. Case presentation: We herein report 4 patients undergoing various surgeries for benign secreting insulinomas, after extensive radiological and endoscopic exploration. Clinical discussion: Diagnosis is relatively simple relying on clinical and biological criteria, it must be followed by an extensive and accurate preoperative determination of the tumors localization. The laparoscopic tumoral enucleation is the treatment of choice for small isolated tumors, but open surgery still has its indications. Conclusion: Pancreatic insulinoma is a rare neuroendocrine tumor that can be life-threatening due to hypoglycemic manifestations. The diagnosis is based on clinical and biological criteria. echo endoscopy and to a lesser extent radiological exploration can precisely determine the tumors location. Laparoscopic surgical enucleation of the tumor remains the preferred curative treatment.
Displaced in a Land of Denial: Who is an IDP in Lebanon’s Reluctant War?
Authors: Diab Jasmin Lilian
Published: January 2025

This study examines the Lebanese government’s strategic indifference towards internally displaced persons (IDPs) from South Lebanon, especially after the October 2023 conflict between Israel and Hezbollah. Using in-depth interviews and participant observations, the research highlights how displaced individuals navigate their precarious situations without formal recognition and support. By not acknowledging IDP status, the government evades legal and moral responsibilities, forcing reliance on informal networks and humanitarian aid. This perpetuates IDPs’ invisibility and marginalisation, hindering their ability to meet basic needs and rebuild lives. The study underscores the power dynamics and state-to-citizen relations shaping IDPs’ treatment in Lebanon.
Ubiquitin specific peptidase 11 knockdown slows Huntington’s disease progression via regulating mitochondrial dysfunction and neuronal damage depending on PTEN-mediated AKT pathway
Authors: Gao Bai , Jing Yuchen , Li Xi , Cong Shuyan
Published: January 2025

Background

Mitochondrial dysfunction and neuronal damage are major sign of cytopathology in Huntington’s disease (HD), a neurodegenerative disease. Ubiquitin specific peptidase 11 (USP11) is a deubiquitinating enzyme involved in various physiological processes through regulating protein degradation. However, its specific role in HD is unclear.

Methods

To interfere with USP11 expression, adeno-associated viruses 2 containing USP11-specific shRNA were injected into the bilateral striatum of 12-week-old R6/1 and WT mice. In vitro, the inducible PC12 cell model of HD was used in which the expression of an N-terminal truncation of huntingtin, with either wild type (Q23) or expanded polyglutamine (Q74) can be induced by the doxycycline. USP11 was knocked down to study its role in HD. The protein expression patterns in Q74 cells were quantified by label-free proteomics to further explore the target protein of USP11. Detecting the association between USP11 and Phosphatase and Tensin Homolog (PTEN) through Co-IP.

Results

Herein, USP11 was found to be upregulated in the striatum of R6/1 mice (an HD model with gradual development of symptoms) in an age-dependent manner. The spontaneous HD was alleviated by silencing USP11, as evidenced by improved locomotor activity and spatial memory, attenuated striatal atrophy in R6/1 mice, reduced accumulation of mutant huntingtin protein, and restored mitochondrial function in vitro and in vivo. The results of label-free proteomics revealed a significant change in the protein expression profile. Through functional enrichment, we focused on PTEN, known as a negative regulator of the AKT pathway. We demonstrated that USP11 downregulation promoted ubiquitination modification of PTEN and activated the AKT pathway, and PTEN overexpression reversed the effects of USP11 knockdown.

Conclusions

Collectively, USP11 knockdown protects R6/1 mouse neurons from oxidative stress by alleviating mitochondrial dysfunction, thereby preventing the HD progression. This is achieved by inhibiting PTEN expression, which in turn activates the AKT pathway. This study suggests that USP11-PTEN-AKT signaling pathway may be a new attractive therapeutic target for HD.
Tracing the paths of modular evolution by quantifying rearrangement events of protein domains
Authors: Coban Abdulbaki , Bornberg-Bauer Erich , Kemena Carsten
Published: January 2025

Background

Protein evolution is central to molecular adaptation and largely characterized by modular rearrangements of domains, the evolutionary and structural building blocks of proteins. Genetic events underlying protein rearrangements are relatively rare compared to changes of amino-acids. Therefore, these events can be used to characterize and reconstruct major events of molecular adaptation by comparing large data sets of proteomes.

Results

Here we determine, at unprecedented completeness, the rates of fusion, fission, emergence and loss of domains in five eukaryotic clades (monocots, eudicots, fungi, insects, vertebrates). By characterizing rearrangements that were previously considered “ambiguous” or “complex” we raise the fraction of resolved rearrangement events from previously ca. 60% to around 92%. We exemplify our method by analyzing the evolutionary histories of protein rearrangements in (i) the extracellular matrix, (ii) innate immunity across Eukaryota, Metazoa, and Vertebrata, and (iii) Toll-Like-Receptors in the innate immune system of Eukaryota. In all three cases we can find hot-spots of rearrangement events in their phylogeny which (i) can be related with major events of adaptation and (ii) which follow the emergence of new domains which become integrated into existing arrangements.

Conclusion

Our results demonstrate that, akin to the change at the level of amino acids, domain rearrangements follow a clock-like dynamic which can be well quantified and supports the concept of evolutionary tinkering. While many novel domain emergence events are ancient, emerged domains are quickly incorporated into a great number of proteins. In parallel, the observed rates of emergence of new domains are becoming smaller over time.
Inverse association between obesity and suicidal death risk
Authors: Lee Joonyub , Lee Seung-Hwan , Kim Mee-Kyoung , Kwon Hyuk-Sang , Yun Jae-Seung , Yang Yeoree , Yoon Kun-Ho , Cho Jae-Hyoung , Pae Chi-Un , Han Kyungdo , Son Jang Won
Published: January 2025

Background

Suicide is a significant yet preventable public health issue. Body mass index (BMI) is a readily measurable indicator associated with various health outcomes. However, the relationship between BMI and suicidal death risk is complex and warrants further investigation, particularly within contemporary, non-Western contexts with consideration of potential confounders. The purpose of this study was to investigate the relationship between BMI and the risk of suicidal death.

Methods

This study was nationwide, retrospective, observational study based on Korean National Health Insurance Service database. We analyzed 4,045,081 participants who were aged > 19 years and underwent national health surveillance in 2009. The participants were categorized according to their BMI (underweight: < 18.5 kg/m², normal weight: 18.5–23 kg/m², overweight: 23–25 kg/m², class I obesity: 25–30 kg/m², and class II obesity: > 30 kg/m²). The primary outcome was the death events caused by suicide which was defined by International Classification of Disorders (ICD-10) codes (X60–X84) and death records documented by the Korea National Statistical Office. Multivariate Cox proportional hazard regression analysis was performed to estimate the risk of suicidal death with respect to BMI categories after adjusting for potential confounders (age, sex, income, diabetes, hypertension, dyslipidemia, smoking, drinking, exercise, self-abuse, waist circumference, schizophrenia, bipolar disorder, eating disorder, cancer, anxiety, and substance use disorder).

Results

Underweight individuals had an increased risk (hazard ratio [HR] 1.44, 95% confidence interval [CI] 1.31–1.57) while overweight (HR 0.79, 95% CI 0.76–0.83), class I (HR 0.76, 95% CI 0.71–0.80) and class II obesity (HR 0.71, 95% CI 0.63–0.81) were associated with decreased risks of suicidal deaths compared to those of the normal weight individuals (BMI 18.5–23). This trend was consistent regardless of the presence of major depressive disorder (MDD) or the type of living arrangements of the participants.

Conclusions

Suicidal death risk was inversely correlated with BMI categories, independent of MDD or living arrangements. Our data suggests the importance of physiological factors associated with body mass in understanding suicidal death risk. Furthermore, these data provide valuable insights to where the public health resources should be invested to reduce suicidal death rates.
Young people’s proposals for tackling everyday challenges in order to improve mental health: a qualitative comparison study based on different socioeconomic neighborhoods
Authors: Gard Helena , Ingvarsdotter Karin , Isma Gabriella Elisabeth , Enskär Karin , Mangrio Elisabeth
Published: January 2025

Background

Everyday challenges and stress negatively affect young people’s mental health. Socioeconomic status (SES) is associated with different stressors and different stress-coping mechanisms. Many interventions target youth mental health, but few consider socioeconomic differences in the planning, implementation, or evaluation. In a Swedish context socioeconomic status is related with migration experience. The aim of the study was to explore proposals for tackling everyday challenges among young people from different socioeconomic neighborhoods.

Methods

Eight focus groups, with participants between 13 and 15 years old from eight schools, were conducted in the south of Sweden. The participants discussed proposals for tackling everyday challenges. Using comparative thematic analysis, the focus group transcripts were divided into two groups, based on the socioeconomic status of the school’s neighborhood, and analyzed comparatively. Most of the participants in low SES neighborhoods had foreign background and most of the participants in high SES neighborhoods were Swedish born.

Results

The analysis resulted in four shared themes between the two SES groups: society is responsible, school is responsible, parents are responsible, and I am responsible. The differences and similarities between the two groups are presented in sub-themes. Many of the proposals were similar between the two SES groups, but with different underlying issues and examples.

Conclusion

Both groups proposed that adults must listen more to young people in order to improve the everyday challenges young people face. However, the low SES group in general expressed both more frustration and more agency, compared to the high SES group. This could be important to consider when planning school-based mental health promotion in different socioeconomic neighborhoods.
Early childhood caries risk prediction using machine learning approaches in Bangladesh
Authors: Hasan Fardous , Tantawi Maha El , Haque Farzana , Foláyan Moréniké Oluwátóyìn , Virtanen Jorma I.
Published: January 2025

Background

In the last years, artificial intelligence (AI) has contributed to improving healthcare including dentistry. The objective of this study was to develop a machine learning (ML) model for early childhood caries (ECC) prediction by identifying crucial health behaviours within mother-child pairs.

Methods

For the analysis, we utilized a representative sample of 724 mothers with children under six years in Bangladesh. The study utilized both clinical and survey data. ECC was assessed using ICDAS II criteria in the clinical examinations. Recursive Feature Elimination (RFE) and Random Forest (RF) was applied to identify the optimal subsets of features. Random forest classifier (RFC), extreme gradient boosting (XGBoost), support vector machine (SVM), adaptive boosting (AdaBoost), and multi-layer perceptron (MLP) models were used to identify the best fitted model as the predictor of ECC. SHAP and MDG-MDA plots were visualized for model interpretability and identify significant predictors.

Results

The RFC model identified 10 features as the most relevant for ECC prediction obtained by RFE feature selection method. The features were: plaque score, age of child, mother’s education, number of siblings, age of mother, consumption of sweet, tooth cleaning tools, child’s tooth brushing frequency, helping child brushing, and use of F-toothpaste. The final ML model achieved an AUC-ROC score (0.77), accuracy (0.72), sensitivity (0.80) and F1 score (0.73) in the test set. Of the prediction model, dental plaque was the strongest predictor of ECC (MDG: 0.08, MDA: 0.10).

Conclusions

Our final ML model, integrating 10 key features, has the potential to predict ECC effectively in children under five years. Additional research is needed for validation and optimization across various groups.
Primary care utilisation in different patients’ profiles with cardiovascular risk factors
Authors: Malo Sara , Maldonado Lina , Rabanaque María José , Bengoa-Urrengoechea Irantzu , Castel-Feced Sara , Sánchez-Calavera María Antonia , Aguilar-Palacio Isabel
Published: January 2025

Background

This study aimed to identify profiles of patients with cardiovascular disease (CVD) risk factors, based on their sociodemographic and clinical characteristics, and to analyse how their complexity is related to their frequency of visits in Primary Care.

Methods

Observational longitudinal study conducted in the Spanish CArdiovascular Risk factors for HEalth Services research (CARhES) cohort. Individuals older than 15 with hypertension, type 2 diabetes mellitus (DM) and/or dyslipidaemia in 2017 were selected and followed until 2021. Cluster analyses were performed to identify patients’ profiles according to age, sex and morbidity burden. Characteristics and annual visits in Primary Care in the different profiles were described. Panel data models were applied to study the variability of the frequency of visits to both physicians and nurses in Primary Care in the profiles across different time points.

Results

In this population-based cohort of 446,998 individuals, different profiles were identified among those with hypertension, type 2 DM and/or dyslipidaemia. Profiles comprising the elderly showed the highest morbidity burden. Among the profiles of individuals under 80, those that included women had a higher burden than profiles with men. This higher complexity was associated with higher frequency of Primary Care visits, regardless of the patient’s socioeconomic level and depopulation level of his/her Basic Health Area.

Conclusions

Women and the elderly comprised the profiles with the highest morbidity burden and Primary Care attendance. Tailoring care and resources according to the complexity profile is essential to ensure that patients receive the best possible care based on their needs.