bluuebunny/crossref_metadata_2025_split huggingface dataset:
Urinary congophilia as a predictive biomarker of lupus nephritis in pregnant and non-pregnant women with systemic lupus erythematosus
Authors: Younis Dalia , Shemies Rasha , Zakaria Mahmoud M , Omar Sameha A , Mosbah Alaa , El-kannishy Ghada , Sabry Alaa , Elnagar Sherouk 
Published: January 2025

Background Endoplasmic reticulum stress with protein misfolding has been introduced as a key pathogenetic mechanism in lupus nephritis (LN). Pregnancy is thought to exaggerate proteostasis, which leads to the accumulation of potentially pathogenic misfolded proteins in the urine, serum, and placenta particularly in women with preeclampsia. The detection of misfolded proteins is made using Congo red stain, which is referred to as congophilia. This study aimed to assess the predictive value of urinary congophilia as a marker of LN activity in pregnant and non-pregnant LN women. Methods Urine samples from non-pregnant LN women ( n = 45), pregnant LN women ( n = 12), as well as pregnant healthy controls ( n = 38) were collected. Urinary congophilia was assessed by Congo Red Dot Blot assay. The disease activity was defined according to SLE Disease Activity Index (SLEDAI) score, and SLE Disease Activity Index-Renal Domain (SLEDAI-R) score. Renal biopsy was done for 33 non-pregnant LN women as it was clinically indicated, and modified NIH activity index (AI) was assessed according to the classification of LN by the International Society of Nephrology/Renal Pathology Society (ISN/RPS). Results Congo red retention (CRR) values were significantly higher for pregnant active LN patients, in comparison with pregnant inactive LN patients ( p = .014), as well as pregnant healthy controls ( p = .009). Additionally, CRR values were significantly higher for non-pregnant active LN patients, in comparison with non-pregnant inactive LN patients ( p = .016), as well as pregnant healthy controls ( p ≤ .001). There were significant positive correlations between CRR on one hand, and anti-ds-DNA (r = 0.791, p ≤ .001), serum creatinine (r = 0.620, p ≤ .001), SLEDAI score (r = 0.623, p ≤ .001), as well as SLEDAI-R score (r = 0.473, p = .005) on the other hand. A highly significant negative correlation was detected between CRR, and serum albumin (r = −0.454, p = .001). CRR at a cut point ≥21.85 had 83% sensitivity, and 58% specificity to capture high LN activity status (NIH-AI >10) versus lower LN activity status. Conclusion Urinary congophilia may add a diagnostic value in patients with LN and can be a reliable marker of disease activity. CRR is related to disease activity rather than pregnancy.
Cardiovascular changes in Persian cats with polycystic kidney disease: a study of cardiac troponin I, echocardiography and blood pressure
Authors: Saberi Niloufar , Khaksar Ehsan , Molazem Mohammad , Mashhady Rafiee Seeyamak 
Published: January 2025

Objectives Cardiovascular complications are well known in humans with autosomal dominant polycystic kidney disease (PKD), but limited data exist for cats. This study aimed to assess echocardiographic changes, cardiac troponin I (cTnI) levels and systolic blood pressure (SBP) in Persian cats with PKD to detect early cardiac abnormalities. Methods In total, 52 Persian and mixed-Persian cats were enrolled, with 26 cats in the control group and 26 diagnosed with PKD via ultrasound due to the unavailability of genetic testing. Although genetic testing is the gold standard for definitive diagnosis, this study utilised high-sensitivity ultrasound as an alternative diagnostic tool. This method aligns with existing literature supporting its effectiveness in detecting PKD, particularly in regions where genetic testing is not accessible. Echocardiographic examinations employed M-mode and two-dimensional echocardiography to measure the diastolic thickness of the interventricular septum and the left ventricular free wall. Doppler ultrasonography was used to measure SBP and cTnI serum levels were determined using a Monobind-ELISA kit. Results Median SBP and cTnI levels in PKD cats were 155 mmHg and 85.80 ng/l, respectively, which was significantly higher than the control group ( P ⩽0.001). Interventricular septum in systole, as well as diastolic thickness of the interventricular septum and the left ventricular free wall, was significantly elevated in PKD cats compared with controls ( P ⩽0.001). No significant differences were observed in other echocardiographic parameters. Conclusions and relevance Asymptomatic PKD-affected Persian cats exhibited elevated SBP and cardiac structural changes; however, the clinical significance of these findings remains uncertain due to a lack of long-term follow-up. While early cardiac changes may be present, further research is necessary to establish their clinical relevance and guide appropriate management strategies. Monitoring PKD cats is advised, but a direct clinical impact is not confirmed at this stage.
Long-term outcomes of scleral fixated black diaphragm intraocular lens in eyes with combined aphakia and aniridia
Authors: Hirawat Raj shri , Krishnappa Nagesha C , Sundarmoorthy Sathishkumar , Raviselvan Munispriyan , Ratra Dhanashree 
Published: January 2025

Purpose To evaluate long-term anatomical and functional outcomes in eyes undergoing scleral fixation of aniridic black diaphragm intraocular lens (BDIOL). Methods Total 38 eyes that underwent scleral fixation of BDIOL for secondary aniridia following ocular trauma with aphakia with absent posterior capsule or primary congenital aniridia with subluxated lens were retrospectively analyzed. Final visual acuity, early and late complications were examined. Correlation analysis was done. Results The mean follow-up was 28 months (range 6 to 66 months). The mean preoperative visual acuity of 1.82 ± 0.90 logMAR improved to 0.69 ± 0.61 ( p = 0.00). The mean spherical equivalent refractive error of 7.88 ± 4.85 diopters improved to −0.69 ± 1.52( p = 0.00). Complications were seen in 9 eyes (23.6%). Early complications were raised intraocular pressure (IOP) in 2 eyes and one eye with suture site infection which were managed conservatively. Late complications were corneal decompensation 3eyes (7.8%), retinal detachment, hypotonic maculopathy and refractive surprise in 1 eye each (2.6%). None reported IOL tilt or dislocation. The patients noticed a significant reduction in glare disability and photophobia. No significant association was found between pre-operative factors such as prior surgical procedures, history of trauma and length of follow-up with surgical outcomes. Conclusions Scleral fixation of BDIOL is an effective option in eyes with aniridia and aphakia without capsular support that have undergone multiple previous surgeries. Despite severe damage, the BDIOL helps reconstruct the anterior segment and give a good quality of vision with minimal complications rate.
Visual deprivation and axial myopia: Considerations on long-term ocular development
Authors: Rinaldi Michele , Esposito Veneruso Paolo , Tranfa Fausto , Fioretto Gaetano , Troisi Salvatore , Passaro Maria Laura , Matarazzo Francesco , Costagliola Ciro 
Published: January 2025

Introduction Severe visual deprivation during infancy can lead to long-term changes in ocular development, including significant differences in axial length (AL) between eyes. This case report presents three adult patients with monocular infantile visual deprivation who developed substantial AL interocular differences. The aim is to explore the impact of early visual deprivation on AL and its potential implications for myopia progression. Case Report Three male patients, aged 19, 42, and 50, were evaluated at the Ophthalmology Department of the University Hospital of Naples “Federico II.” Each patient had a history of severe visual deprivation in one eye during infancy. The first patient experienced a dense corneal fibrovascular membrane from a chemical burn at age 1. The second suffered total corneal stromal scarring from a chemical burn at age 2. The third developed dense leukoma following infective keratitis at 0.3 years. Ophthalmological evaluations included refractive assessment, biomicroscopy, fundus examination (where feasible), electroretinogram (ERG), and A-Scan ultrasound. Affected eyes exhibited severe visual impairment (light perception in two patients, and 1.6 logMAR in the third), while the fundus could not be fully explored, and echographic assessment was used to exclude major chorioretinal changes. ERG findings were within normal limits, despite presumed early developmental impact on the retina due to lack of form vision. However, AL measurements revealed a 5.8–6.3 mm increase in the affected eyes compared to the healthy ones. Conclusion Infantile severe visual deprivation can lead to significant interocular AL differences in adulthood. These findings underscore the importance of investigating the underlying mechanisms to better understand and manage myopia progression in similar cases.
Longitudinal investigation of neuroimaging changes related to memory decline in multiple sclerosis: Testing a mechanistic model
Authors: Simani Leila , Tozlu Ceren , Lee Seonjoo , Dworkin Jordan , Ratzan Alexander S. , Buyukturkoglu Korhan , Onomichi Kaho , Mata Jennie , Riley Claire S. , Leavitt Victoria M. 
Published: January 2025

Background: Memory decline is common in multiple sclerosis (MS), although pathophysiological mechanisms are not fully understood. Objective: The objective was to investigate the relationship of changes in structural and functional neuroimaging markers to memory decline over 3-year follow-up. Methods: Participants with MS underwent cognitive evaluation and structural, diffusion, and functional 3T magnetic resonance imaging (MRI) scans at baseline and 3-year follow-up. Changes in neuroimaging metrics from baseline to follow-up were compared between memory stable and memory decline groups. Our hypothesis that structural and functional connectivity changes mediate the association of atrophy to memory decline was tested. Results: A total of 249 MS patients completed baseline visit; 169 (67.8%) returned at 3-year follow-up. Based on ⩾10% decline, memory decline was observed in 44.4% ( n = 75). Those with memory decline showed marginally greater whole-brain volume loss over time compared with those with stable memory performance ( p = 0.08). In those with memory decline, changes in white matter tract integrity were related to regional cortical thinning ( p < 0.01). Exploratory mediation analysis revealed structural and functional connectivity to mediate the relationship of atrophy to verbal and visual memory decline. Conclusion: Further work is needed to characterize complex interrelationships of atrophy and structural/functional connectivity changes to memory decline in MS.
Post-acute sequela of COVID-19 infection in individuals with multiple sclerosis
Authors: Salter Amber , Lancia Samantha , Cutter Gary R , Fox Robert J , Marrie Ruth Ann 
Published: January 2025

Background: Many common symptoms in post-acute sequelae following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (PASC) overlap with those of multiple sclerosis (MS). We examined symptoms and performance of the PASC score, developed in the general population, in MS based on infection history. Methods: We surveyed North American Research Committee on Multiple Sclerosis (NARCOMS) registry participants regarding infections and categorized participants based on infection history. Symptoms experienced before, during, and after infection were used to identify persistent new symptoms. PASC was defined as a score ⩾ 12 based on the National Institutes of Health (NIH) study RECOVER. Results: Of 4787 participants surveyed, 2927 were included: 294 (10%) having recent COVID-19; 853 (29.1%) recent non-COVID-19 infection; 246 (8.4%) recent COVID-19 and non-COVID-19 infection; 1534 (52.4%) uninfected, defined as never having COVID-19 nor any infection within the past 6 months. Compared to those uninfected, infection groups reported at least a two-fold increase in fever, cough, loss of smell/taste, and shortness of breath. Based on persistent new symptoms, PASC was identified in only 1.5% of participants with COVID-19. Conclusion: Our study suggests lower than expected prevalence of PASC in MS and a complex association between infections and development of new persistent symptoms following infections. The similar proportions classified with PASC across infection groups shows that symptoms of PASC are common and complicate assessment of PASC in MS.
Limb salvage prediction in peripheral artery disease patients using angiographic computer vision
Authors: Rusinovich Yury , Liashko Vitalii , Rusinovich Volha , Shastak Alina , Bruder Leon , Omran Safwan , Greiner Andreas , Doss Markus , Branzan Daniela 
Published: January 2025

Background Peripheral artery disease (PAD) outcomes often rely on the expertise of individual vascular units, introducing potential subjectivity into disease staging. This retrospective, multicenter cohort study aimed to demonstrate the ability of artificial intelligence (AI) to provide disease staging based on inter-institutional expertise by predicting limb outcomes in post-interventional pedal angiograms of PAD patients, specifically in comparison to the inframalleolar modifier in the Global Limb Anatomic Staging System (IM GLASS). Methods We used computer vision (CV) based on the MobileNetV2 model, implemented via TensorFlow.js library, for transfer learning and feature extraction from 518 pedal angiograms of PAD patients with known 3-month limb outcomes: 218 salvaged limbs, 140 minor amputations, and 160 major amputations. Results After 43 epochs of training with a learning rate of 0.001 and a batch size of 16, the model achieved a validation accuracy of 95% and a test accuracy of 93% in differentiating salvaged limbs from amputations. In manual testing with 45 angiograms excluded from the training, validation, and test processes, the AI predicted mean limb salvage probabilities of 96% for actual salvaged limbs, 27% for minor amputations, and 17% for major amputations ( p-value < .001). The correlation coefficient between the CV model-predicted outcome and the actual outcome for these 45 angiograms was 0.7, nearly five times higher than that between the IM GLASS pattern and the actual outcome (0.14). Conclusion Computer vision can analyze angiograms and predict disease outcomes, demonstrating a significant correlation between predicted and actual limb salvage rates, outperforming IM GLASS segmentation by a vascular specialist. It has the potential to provide immediate and precise treatment results during vascular interventions, tailored to (inter)institutional expertise, and enhance individualized decision-making.
Does a distal radial fracture lead to osteoarthritis? Re-examining the evidence for early treatment
Authors: Warwick David , Smythe Laura , Fetouh Sherif 
Published: January 2025

There are many good reasons to improve the anatomy of a distal radius fracture, such as early return to function and avoidance of sigmoid notch incongruity or ulnocarpal impaction. It is often feared by patients, and portrayed by some authors of scientific articles and medicolegal reports, that a fracture of the distal radius has a propensity to cause symptomatic osteoarthritis. This article examines some of the current evidence and shares the authors’ experience. Critical questions are asked to direct our observations and guide future research questions. We propose that both clinical experience and a literature analysis do not support the commonly held assumption that untreated distal radial fractures lead to symptomatic osteoarthritis. Level of evidence: V
Randomized clinical trial: the effects of mirtazapine in functional dyspepsia patients
Authors: Cao Lina , Li Gaozhong , Cao Jingmei , Li Fuxin , Han Wei 
Published: January 2025

Background: Functional dyspepsia (FD) is one of the most common gastrointestinal disorders worldwide. Currently, anti-gastric drugs, gastric acid inhibitors, prokinetic drugs, and mucosal protective drugs are widely used in FD patients, however, only a small proportion of patients benefit from these drugs. Studies reported mirtazapine may improve symptoms of FD patients but the efficacy and safety of mirtazapine in the treatment of FD is unclear. Objectives: To investigate the efficacy and safety of mirtazapine in FD patients. Design: We performed a prospective, single-randomized, two-group parallel clinical trial involving 120 FD patients with poor traditional drug treatment outcomes to evaluate the efficacy and safety of mirtazapine. Methods: Qualified patients identified through the screening assessments were randomly divided into two groups: mirtazapine group ( n = 60) treated with mirtazapine 15 mg qn on top of traditional drugs, and control group ( n = 60) who continued to be treated with traditional drugs. Subjects were evaluated for meal-related symptoms and severity, quality of life, gastrointestinal-specific anxiety, and body weight before and after the 8-week intervention. Adverse reactions were also recorded. Results: At the end of 8-week treatment, dyspeptic symptoms in the mirtazapine group were significantly relieved compared with the baseline (7.95 ± 1.86 vs 11.17 ± 2.14, p < 0.001). Assessment of the impact of dyspepsia on patients’ quality of life from the short form-Nepean Dyspepsia Index showed that patients generally feel better in mirtazapine group than control group (24.52 ± 2.87 vs 28.64 ± 4.32, p < 0.001). Mirtazapine group also showed significant weight gain and decreased visceral sensitivity index score. Conclusion: Compared with control group, 8-week administration of mirtazapine significantly improved the overall severity of symptoms of dyspepsia (such as individual symptoms of postprandial fullness, early satiation, nausea, and vomiting), gastrointestinal-specific anxiety, quality of life, and increased weight in FD patients. This study provided clues to clinicians that mirtazapine may be a good choice for the treatment of FD patients. Trial registration: This study was registered in the Chinese clinical trial registry ( https://www.chictr.org.cn/index.html , protocol No. ChiCTR2100048304).
Formal Mentorship in Surgical Training: A Long-Term Prospective Interventional Study
Authors: Mohajeri Sepideh , Seikaly Hadi , Alrajhi Yaser , Wright Erin D. , El-Hakim Hamdy , Zhang Han 
Published: January 2025

Objective Surgical training programs have a high prevalence of trainee stress and burnout. Formal mentorship programs (FMP) have been shown to alleviate these factors and improve quality of life (QOL) in short-term follow-up. This study aims to determine the long-term effects of an FMP on the well-being of a single-center cohort of surgical trainees. Methods A voluntary FMP was established at a surgical training program comprised 8 resident physicians. To quantitatively measure stress and burnout, the Perceived Stress Survey (PSS) and Maslach Burnout Inventory (MBI) were administered at baseline, 3, 6, 9, 12, 18, and 24 months. The World Health Quality of Life-Bref Questionnaire (WH-QOL) was administered at baseline, 12 and 24 months. Results Baseline levels of stress and burnout were high among all residents with an average PSS of 18.5 and MBI of 47.6, 50.6, and 16.5 for the emotional, depersonalization, and personal achievement domains respectively. After FMP implementation, PSS was reduced to 7.9 at 12 months ( P = .001). These scores were sustained at 24 months (6.8, P = 1). MBI scores improved in emotional exhaustion (14.9, P < .0001), depersonalization (20.1, P < .0001), and personal achievement (40.1, P < .0001) at 12 months. All these benefits were sustained at 24 months. Baseline overall WH-QOL scores reflected low QOL (71.9). These significantly improved at 12 months (37.5, P = .002) with further improvement by 24 months (17.2, P = .03). Conclusion Long-term follow-up of a previously successful academic surgical FMP showed lasting improvements in stress, burnout, and overall QOL, despite new life challenges.
Transcreating BMT4me: A protocol for adapting an mobile health medication adherence app for Spanish-speaking caregivers in pediatric hematopoietic stem cell transplant
Authors: Benhayoun Ashley , Wang Mark , Beauchemin Melissa , Sezgin Emre , Skeens Micah A. 
Published: January 2025

Objective Hematopoietic stem cell transplant is a life-saving procedure that treats patients with various conditions by transplanting hematopoietic stem cells from bone marrow. Mobile health apps could be useful in closing the digital divide and improving health equity among Spanish-speaking caregivers of children who undergo pediatric hematopoietic stem cell transplant. This study aims to transcreate the BMT4me adherence app originally designed for English-speaking caregivers for Spanish-speaking caregivers and evaluate the feasibility and usability. Methods This study consists of two phases. Phase 1 transcreates the existing BMT4me app for Spanish-speaking populations. App feedback is collected from three community advisory board focus groups ( n = 10; each meeting will include the same 10 community advisory board members). Groups consist of members connected to the local Spanish-speaking population and participating in the Community Engagement Program at The Ohio State University Center for Clinical and Translation Science. Phase 2 tests the feasibility and usability of the Spanish BMT4me app with child–caregiver dyads ( n = 30; 15 at site 1, n = 15 at site 2) whose primary language is Spanish. This phase is mixed methods and incorporates both a qualitative approach (caregiver interviews) and quantitative measures (system usability scale). It is expected that app users in phase 2 will report above average system usability scale scores (>68%). It is also expected that >75% of families approached in phase 2 will enroll and complete the surveys in our study. Conclusion This protocol paper details the transcreation process of the BMT4me app into a Spanish version. The findings of the study will demonstrate the level of acceptability of the Spanish BMT4me app with participants whose primary language is Spanish. As a digital health intervention for an underrepresented population that is increasingly online yet historically underserved, this app can overcome health barriers and disparities and improve overall health equity.