bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rubisco packaging and stoichiometric composition of the native β-carboxysome in Synechococcus elongatus PCC7942
Authors: Sun Yaqi , Sheng Yuewen , Ni Tao , Ge Xingwu , Sarsby Joscelyn , Brownridge Philip J , Li Kang , Hardenbrook Nathan , Dykes Gregory F , Rockliffe Nichola , Eyers Claire E , Zhang Peijun , Liu Lu-Ning 
Published: December 2024

Abstract
Carboxysomes are anabolic bacterial microcompartments that play an essential role in CO2 fixation in cyanobacteria. This self-assembling proteinaceous organelle uses a polyhedral shell constructed by hundreds of shell protein paralogs to encapsulate the key CO2-fixing enzymes Rubisco and carbonic anhydrase. Deciphering the precise arrangement and structural organization of Rubisco enzymes within carboxysomes is crucial for understanding carboxysome formation and overall functionality. Here, we employed cryoelectron tomography and subtomogram averaging to delineate the 3D packaging of Rubiscos within β-carboxysomes in the freshwater cyanobacterium Synechococcus elongatus PCC7942 grown under low light. Our results revealed that Rubiscos are arranged in multiple concentric layers parallel to the shell within the β-carboxysome lumen. We also detected Rubisco binding with the scaffolding protein CcmM in β-carboxysomes, which is instrumental for Rubisco encapsulation and β-carboxysome assembly. Using Quantification conCATamer-based quantitative MS, we determined the absolute stoichiometric composition of the entire β-carboxysome. This study provides insights into the assembly principles and structural variation of β-carboxysomes, which will aid in the rational design and repurposing of carboxysome nanostructures for diverse bioengineering applications.
Burnout among medical residents: key drivers and practical mitigating strategies
Authors: Ng Isaac K S , Tham Sarah Z L , Chong Kar Mun , Goh Wilson G W , Thong Christopher , Teo Kevin Soon Hwee 
Published: December 2024

Abstract
Burnout is a prevalent phenomenon in medicine, affecting &gt;50% of physicians and up to 60% of medical residents. This has negative consequences for both doctors’ mental health and job satisfaction as well as patient care quality. While numerous studies have explored the causes, psychological effects, and workplace solutions, we aim to practicalize the issue from the perspectives of residents by discussing three key drivers of burnout and offering actionable, multipronged strategies that may be able to tackle these root causes effectively. From review of relevant literature and personal reflections/experiences, we identified three key factors that contribute to resident burnout, namely, (i) inherent physician attributes, (ii) mismatched expectations of the medical profession, and (iii) stressful nature of clinical work and residency training for junior physicians. We offer practical strategies that can be implemented by various stakeholders in a concerted manner to target these three areas, namely, to inculcate and foster accurate perception of the medical profession at the outset, develop psychological strength/resilience among medical residents, and make practical improvements to working and training environments.
Incorporating computer vision on smart phone photographs into screening for inflammatory arthritis: results from an Indian patient cohort
Authors: Phatak Sanat , Saptarshi Ruchil , Sharma Vanshaj , Shah Rohan , Zanwar Abhishek , Hegde Pratiksha , Chakraborty Somashree , Goel Pranay 
Published: December 2024

Abstract

Objectives
Convolutional neural networks (CNNs) are increasingly used to classify medical images, but few studies utilize smartphone photographs. The objective of this study was to assess CNNs for differentiating patients from controls and detecting joint inflammation.

Methods
We included consecutive patients with early inflammatory arthritis and healthy controls, all examined by a rheumatologist (15% by two). Standardized hand photographs of the hands were taken, anonymized and cropped around joints. Pre-trained CNN models were fine-tuned on our dataset (80% training; 20% test set). We used an Inception-ResNet-v2 backbone CNN modified for two class outputs (patient vs control) on uncropped photos. Separate Inception-ResNet-v2 CNNs were trained on cropped photos of middle finger proximal interphalangeal (MFPIP), index finger proximal interphalangeal (IFPIP) and wrist. We report accuracy, sensitivity, specificity and area under the receiver operating characteristic curve (AUC).

Results
We analysed 800 hands from 200 controls (mean age 37.8 years) and 200 patients (mean age 49 years). Two rheumatologists showed 0.89 concordance. The wrist was commonly involved (173/400) followed by the MFPIP (134) and IFPIP (128). The screening CNN achieved 99% accuracy and specificity and 98% sensitivity in predicting a patient compared with controls. Joint-specific CNN accuracy, sensitivity, specificity and AUC were as follows: wrist (75%, 92%, 72% and 0.86, respectively), IFPIP (73%, 89%, 72% and 0.88, respectively) and MFPIP (71%, 91%, 70% and 0.87, respectively).

Conclusion
Computer vision distinguishes patients and controls using smartphone photographs, showing promise as a screening tool. Future research will focus on validating findings in diverse populations and other joints and integrating this technology into clinical workflows.
Implementing an artificial intelligence system into a diabetic eye screening programme in Tanzania
Authors: Cleland Charles R , Makupa William U , Shilio Bernadetha R , Rwiza Justus , Macleod David , Bascaran Covadonga , Burton Matthew J 
Published: December 2024

Abstract
Tanzania has the highest age-adjusted prevalence of diabetes in sub-Saharan Africa. Diabetic retinopathy, a common complication, is a significant cause of vision loss; but with effective screening and treatment this often can be prevented. However, with very few specialist eye care staff in Tanzania this is a major challenge. Artificial intelligence (AI) systems, which automate clinical decision making and therefore task-shift away from specialist staff, could contribute to improved diabetic retinopathy screening services in low-resource settings. This article describes our experiences of selecting, procuring and implementing an AI system into a regional diabetic eye screening programme in northern Tanzania.
A hidden finch from the Galapagos Islands: a genetically and morphologically distinctive woodpecker finch from San Cristobal Island
Authors: Lawson Lucinda P , Nemeth Erwin , Dvorak Michael , Cunninghame Francesca , Fessl Birgit , Mueller Jakob C , Mosquera Denis , Wendelin Beate , Petren Kenneth 
Published: December 2024

Abstract
The Galapagos finches represent a rapid radiation of birds across the remote oceanic archipelago that vary morphologically, behaviourally, and genetically. The level of diversity and rapid rate of speciation have created taxonomic difficulties in resolving phylogenetic relationships. While much of the phylogeny has recently been clarified with modern genomic methods, some of the diversity has been overlooked by under-sampling across islands within presumed species. The woodpecker finch, Camarhynchus pallidus Sclater and Salvin, 1870, represents one such lineage, as all three recognized subspecies have never been fully phylogenetically assessed in regard to their species’ status and relationship with their close sister-species, the mangrove finch (C. heliobates; Snodgrass and Heller 1901). Using genetic and genomic tools, along with morphological analyses, we show that the San Cristobal woodpecker finch (C. p. striatipecta; Swarth 1931) is genetically distinct and paraphyletic with the mangrove finch, compared to all other woodpecker finch subspecies. Given these results we propose that the San Cristobal woodpecker finch be prioritized for further research, as our results hint that it should be given full species’ status as Camarhynchus striatipecta Swarth, 1931.
Effects of Botulinum Toxin Type A Treatment on Clinical and Biophysical Parameters in Patients With Erythematotelangiectatic Rosacea: A Prospective, Randomized, Controlled, Double-Blind Study
Authors: Dağtaş Buğra Burç , Erdem Ozan , Güneç Tuğba İlter , Avcı Elif Bal , Manav Vildan , Koku Aksu Ayşe Esra 
Published: December 2024

BACKGROUND
Erythematotelangiectatic rosacea (ETR) lacks a gold-standard treatment. Recent studies show that intradermal Botulinum Toxin-A (BoNT-A) is effective for erythema, though objective data are limited.

OBJECTIVE
This study aims to evaluate the efficacy and tolerability of intradermal BoNT-A in patients with ETR.

METHODS
In this randomized, double-blind, split-face study, 30 patients were enrolled. One side of the face received 15 units of BoNT-A, reconstituted in 10 mL of saline, while the control side received saline injections. Assessments were made at baseline and 1-month posttreatment. Clinician's Erythema Assessment (CEA) scale and Patient Self-Assessment (PSA) scores were recorded. Erythema and Melanin Index measurements using a Mexameter. Background erythema was assessed through dermatoscopy, while vascular structure and density were evaluated using Investigative Global Assessment (IGA) scores through videocapillaroscopy.

RESULTS
The BoNT-A-treated side demonstrated significant reductions in CEA scores, Erythema Index, and dermatoscopic background erythema, while no significant changes were observed on the saline control side. IGA scores indicated a significant response to treatment on the BoNT-A side. Patient Self-Assessment scores improved on both sides. No serious adverse events requiring hospitalization were reported.

CONCLUSION
Intradermal BoNT-A effectively reduces erythema and vascular density in patients with ETR and is well-tolerated.
Greenhouse gas emissions due to inhalation anaesthetics in the Netherlands, usage data and a survey of preferences among Dutch anaesthesiologists
Authors: Friedericy Herman J. , Venema Pascale A.H.T. , Lockyer Jessica F. , Kweekel Dinemarie M. , van der Eijk Anne C. , Jansen Frank Willem , Sarton Elise Y. 
Published: December 2024

BACKGROUND
Anaesthetic gases are an important source of greenhouse gas emissions from operating theatres and can attribute significantly to the carbon footprint of a nation's healthcare system.

OBJECTIVE
To estimate the magnitude of the climate impact of inhaled anaesthetics in the Netherlands. Furthermore, the goal was to assess the preferences of Dutch anaesthesiologists for anaesthesia techniques, and to explore opportunities for reducing greenhouse gas emissions due to anaesthesia practice.

DESIGN
A 2019 bottom-up purchase analysis of inhalation anaesthetics used in all of the Dutch hospitals was executed and an online survey was conducted among Dutch anaesthesiologists regarding their preferences for anaesthetic agents.

RESULTS
Purchasing quantities of volatile anaesthetic agents were obtained from 61 of the 69 hospital organisations in the Netherlands (response rate 88.4%). A total of 12.2 kilotons CO2 equivalent (0.07% of the Dutch healthcare system) was emitted due to inhalation anaesthetics in the Netherlands in 2019. The volume of the in 2019 purchased inhalation volatile anaesthetics was 9.178 l of sevoflurane (93.4%), 404 l of desflurane (4.1%) and 245 l of isoflurane (2.5%). The survey in which 182 anaesthesiologists participated demonstrated that propofol was the first drug of choice of 70% of respondents, desflurane was available in 16% of Dutch hospitals and 83% of anaesthesiologists answered never using desflurane. Nitrous oxide was not used by 63% of respondents, the remaining 27% reported using nitrous oxide only in less than 5% of their cases.

CONCLUSION
The relatively low emission of greenhouse gases due to inhalation anaesthetics in Dutch healthcare compared to other countries can be explained by the limited use of nitrous oxide and desflurane by Dutch anaesthesiologists and their strong preference for intravenously administered propofol as an anaesthetic.
Mortality after concurrent treatment with gabapentin and opioids in older adults with spine diagnoses
Authors: Gold Laura S. , Heagerty Patrick J. , Hansen Ryan N. , Friedly Janna L. , Johnston Sandra K. , Deyo Richard A. , Curatolo Michele , Turner Judith A. , Rundell Sean D. , Wysham Katherine , Jarvik Jeffrey G. , Suri Pradeep 
Published: December 2024

Abstract
Given the negative impact of opioid use on population health, prescriptions for alternative pain-relieving medications, including gabapentin, have increased. We wanted to determine whether people who filled gabapentin and opioid prescriptions concurrently (“gabapentin + opioids”) had greater mortality than those who filled an active control medication (tricyclic antidepressants [TCAs] or duloxetine) and opioids concurrently (“TCAs/duloxetine + opioids”). In this population-based, propensity score-matched cohort study, we identified Medicare beneficiaries with spine-related diagnoses from 2017 to 2019. We compared people treated with gabapentin + opioids (n = 67,133) to people treated with TCAs/duloxetine + opioids (n = 67,133) who were matched on demographic and clinical factors. The primary outcome was mortality at any time, and a secondary outcome was occurrence of a major medical complication at any time. Among 134,266 participants (median age 73.4 years; 66.7% female), 2360 died before the end of follow-up. No difference in mortality was observed between groups (adjusted hazard ratio and 95% confidence interval for gabapentin + opioids 0.98 [0.90-1.06]; P = 0.63). However, people treated with gabapentin + opioids were at slightly increased risk of a major medical complication (1.02 [1.00-1.04]; P = 0.03) compared to those treated with TCAs/duloxetine + opioids. Results were similar in analyses (1) restricted to ≤30-day follow-up and (2) that required ≥2 fills of each prescription. When treating pain in older adults taking opioids, the addition of gabapentin did not increase mortality risk relative to addition of TCAs or duloxetine.
Signatures of chronic pain in multiple sclerosis: a machine learning approach to investigate trigeminal neuralgia
Authors: Latypov Timur H. , Wolfensohn Abigail , Yakubov Rose , Li Jerry , Srisaikaew Patcharaporn , Jörgens Daniel , Jones Ashley , Colak Errol , Mikulis David , Rudzicz Frank , Oh Jiwon , Hodaie Mojgan 
Published: December 2024

Abstract
Chronic pain is a pervasive, disabling, and understudied feature of multiple sclerosis (MS), a progressive demyelinating and neurodegenerative disease. Current focus on motor components of MS disability combined with difficulties assessing pain symptoms present a challenge for the evaluation and management of pain in MS, highlighting the need for novel methods of assessment of neural signatures of chronic pain in MS. We investigate chronic pain in MS using MS-related trigeminal neuralgia (MS-TN) as a model condition focusing on gray matter structures as predictors of chronic pain. T1 imaging data from people with MS (n = 75) and MS-TN (n = 77) using machine learning (ML) was analyzed to derive imaging predictors at the level of cortex and subcortical gray matter. The ML classifier compared imaging metrics of patients with MS and MS-TN and distinguished between these conditions with 93.4% individual average testing accuracy. Structures within default-mode, somatomotor, salience, and visual networks (including hippocampus, primary somatosensory cortex, occipital cortex, and thalamic subnuclei) were identified as significant imaging predictors of trigeminal neuralgia pain. Our results emphasize the multifaceted nature of chronic pain and demonstrate the utility of imaging and ML in assessing and understanding MS-TN with greater objectivity.
Baseline and early dynamic changes in inflammatory and nutritional status can predict survival in patients with advanced biliary tract carcinoma receiving immunotherapy: A retrospective cohort study
Authors: Shen Hao-Yang , Wang Fang , Zhang Jia-Guang , Tian Yi-Tong , Jin Ke , Zhang Xin-Yi , Ji Lian-Hua , Ding Yu-Ting , Qian Hao , Ma Ling , Chen Xiao-Feng , Xu Lu 
Published: December 2024

Abstract

Background
Inflammatory and nutritional indicators are established prognostic factors in patients with various types of solid tumors. However, it remains unclear whether differences in the baseline and early dynamic changes in these factors can predict the prognosis of immunotherapy in patients with advanced biliary tract carcinoma (aBTC).

Methods
Data were retrospectively collected from 74 consecutive patients who were diagnosed with aBTC and received immunotherapy. Peripheral blood cell counts and other laboratory tests were performed at baseline and after two cycles of immunotherapy. The skeletal muscle index was measured using computed tomography/magnetic resonance imaging scans. Analyses of the relationship between clinicopathological characteristics and survival outcomes were conducted using Kaplan-Meier curves and Cox regression models.

Results
Seventy-four patients were enrolled in the study, with 42 (56.8%) being male. The median age at diagnosis for all participants was 61 years (range, 35–77 years). In the univariate analysis, six baseline indices were associated with survival, namely, lactate dehydrogenase (LDH), carbohydrate antigen 199, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio, Prognostic Nutritional Index, and Controlling Nutritional Status score. In the multivariable analysis, an elevated baseline NLR (HR: 3.363, 95% CI: 1.600–7.070, P = 0.001) and elevated baseline LDH (HR: 2.030, 95% CI: 1.122–3.670, P = 0.019) were independent risk factors for a shorter overall survival. Sarcopenia was not correlated with the overall survival (P > 0.05). A persistently high NLR, platelet-to-lymphocyte ratio, and Controlling Nutritional Status score and low Prognostic Nutritional Index indicated a worse prognosis.

Conclusions
Elevated baseline NLR and LDH values are independent negative prognostic factors in patients with aBTC receiving immunotherapy. Patients with persistently high inflammation and poor nutritional status experience a poorer prognosis.
Bibliometric analysis of global research on vitamins and cancer between 2003 and 2022
Authors: Wang Wen , Ye Xiangming , Wang Sisi 
Published: December 2024

Background:
Vitamins are essential nutrients that play an indispensable role in maintaining the vital functions of the human body. A growing number of studies have shown a link between vitamins and cancer. However, there is no systematic review and bibliometric analysis in this field. This study aims to summarize the hotspots and emerging research topics in this field of vitamins and cancer research.

Methods:
Articles on the topic of vitamins and cancer published between 2003 and 2022 were retrieved from the Web of Science core collection database (WOSCC) on May 1, 2023. Subsequently, we conducted VOSviewer and CiteSpace to examine the annual output distribution, countries/regions, institutions, journals, authors, co-cited references, and keywords.

Results:
A total of 3166 publications were extracted using a timespan of 2003 to 2022. The number of publications has grown rapidly over the past 20 years. Most publications were from the United States; Harvard University was the most active institutions; Giovannucci stood out among authors with the highest number of publications, citations and H-index; Cancer Epidem Biomar published the most papers in this field; the highest cited reference was published in Nat Rev Cancer, authored by Feldman in 2014. Breast cancer was the most common type of cancer, while vitamin D was a research hotspot in this field. Oxidative stress may be the primary anticancer mechanism of vitamins, while also involving epithelial-mesenchymal transition, apoptosis, polymorphism, and calcium metabolism. “nanoparticle” may be the new focus of attention in the next few years.

Conclusion:
This study presented an overview of the major research directions of vitamins and cancer by bibliometric methods over the past 2 decades. The results could reveal the research trends and the hotspots in the field and provide helpful information for clinical treatments of cancer.
Complex pancreaticobiliary maljunction diagnosed by endoscopic ultrasound: A case report
Authors: Xu Wen , Lv Yang , Zhu Ying , Zhang Yingchun , Gong Wei , Cui Xiaobing 
Published: December 2024

Rationale:
This case report aims to enhance understanding of pancreatobiliary maljunction (PBM) and promote more proactive treatment.

Patient concerns:
The patient, a 24-year-old Chinese female, was admitted to the hospital on April 7, 2020, due to “recurrent abdominal pain for over 2 years, with a recent episode accompanied by nausea and vomiting for 1 day.” She had a previous history of gallstones.

Diagnoses:
The initial diagnosis upon admission was biliary acute pancreatitis. During the emergency endoscopic retrograde cholangiopancreatography (ERCP) procedure, anatomical abnormalities were discovered. Intraoperative endoscopic ultrasonography led to a diagnosis of complex PBM (JSPBM, type D) + choledochal cyst (Todani, Ic) + incomplete pancreatic divisum + early chronic pancreatitis. These diagnoses were confirmed by postoperative magnetic resonance cholangiopancreatography.

Interventions:
After multiple conservative treatments such as ERCP with accessory pancreatic duct stent placement, the patient underwent surgical treatment in April 2021, which included “laparoscopic left hemihepatectomy + choledochal cyst excision + cholecystectomy + hepatic portal cholangioplasty.”

Outcomes:
The patient has not experienced any abdominal pain since the surgery and is currently under regular follow-up.

Lessons:
Endoscopic ultrasound is effective for the diagnoses of complex PBM and incomplete pancreatic divisum. ERCP with pancreatic duct stent placement and surgical procedure is reliable for relieving the patient’s symptoms.