bluuebunny/crossref_metadata_2025_split huggingface dataset:
How feasible is nutrition intervention research in eating disorders? Lessons learnt from a pilot parallel randomised controlled trial of tyrosine supplementation in adolescents with anorexia nervosa
Authors: Hart Melissa , Sibbritt David , Wilcken Bridget , Williams Lauren T. , Levick Wayne , Nunn Kenneth P. 
Published: November 2024

Abstract
Objective
Eating disorders are complex illnesses with high morbidity and mortality. Yet, there is promising evidence to support the effects of nutrition on the brain and behaviour. One proposed example is the use of tyrosine as an adjunct treatment in anorexia nervosa (AN). However, recruitment and retention in eating disorder clinical trials has posed difficulties for researchers. The aim of this study was to pilot test a parallel randomised controlled trial (RCT) of tyrosine supplementation to explore the feasibility of recruitment and retention, intervention adherence and data collection methods from the perspective of participants and researchers.

Method
Feasibility was assessed using numbers participating, questionnaire completion in patients and parent/carers completing and declining participation, a researcher implementation record and clinical measures. Subjects included adolescents aged 12–17 years with AN. The study was conducted over a 12-week period, with the intervention group receiving 5 mg of L-tyrosine supplement and the control group receiving a placebo.

Results
Recruitment targets were not met and recruitment to a full RCT based on the current study protocol and recruitment sites did not prove feasible. Of the 39 approached for RCT participation, seven were recruited to the RCT (18% response rate) despite extending recruitment periods, with 100% retained and analysed. Patients or parents/carers identified barriers to study participation including burden, the need to consume tyrosine as tablets, and the use of blood, urine and psychological testing. Blood tyrosine rose markedly for subjects in the intervention group. No side effects were reported or measured.

Conclusions
This study offers a unique exploration of the feasibility of a tyrosine trial in anorexia nervosa and is of relevance to assist the success of future nutrition trials. Exploring the suitability of future study designs for nutrition intervention research is warranted.
Discrimination of older peers is associated with workplace age discrimination: moderation by occupational health literacy
Authors: Asiamah Nestor , Sarpong Emelia , Baidoo Usman Yaw , Eku Eric , Aidoo Isaac , Doamekpor Etornam , Khan Hafiz T.A. , Danquah Emelia , Yarfi Cosmos , Baffoe Rita Sarkodie , Manu Christiana Afriyie 
Published: November 2024

Abstract
Background
Workplace Age Discrimination Experienced (WADE) can be disorientating and detrimental to well-being. Hence, older employees would like to avoid it, but those who experience it may discriminate against their older peers. WADE may be associated with Age Discrimination of Peers (ADP), and this relationship can be moderated by Occupational Health Literacy (OHL).

Aim
This study aimed to assess the association of WADE with ADP and to ascertain whether this relationship is moderated by OHL.

Methods
A cross-sectional design based on a research-reporting checklist was adopted. Measures against confounding and common methods bias were utlised to avoid or minimise bias. The participants were 1025 middle-aged and older employees (average age = 58 years) who were permanent residents of Accra, Ghana. Hierarchical Linear Regression (HLR) analysis was utilised to analyse the data. Curve estimation was among the methods used to assess assumptions governing HLR analysis.

Results
WADE and OHL were positively associated with ADP, but OHL was negatively associated with WADE in the ultimate models incorporating the covariates. WADE was more positively associated with ADP at moderate and higher OHL, which signified positive moderation of the WADE-ADP relationship by OHL.

Conclusion
Older employees who experience higher age discrimination at work are more likely to discriminate against peers. OHL can be associated with lower WADE but higher ADP. Qualitative studies are needed to understand why OHL may be related to higher ADP.
Some studies on Abelmoschus esculentus (Indian Okra) fiber characteristics
Authors: Kolte Prafull Prabhakar , Shivankar Vijay Sitaram 
Published: November 2024

AbstractOkra fiber is the bast fiber, extracted from the stem of the Abelmoschus esculentus plant which belongs to the Malvaceae family. In the whole world, India is the largest producer of okra for the cultivation of “okra fruit”, which is one of the main vegetables in the Indian Diet. After collecting vegetables, a huge amount of okra plant stem is discarded on the field annually as agricultural waste. Okra stem is an abundant source of okra fiber which can be used for various textile applications. This study aims understand the basic morphological, thermal and structural characteristics of okra fibre and compare it with other bast fibres generally used for textile application to prove the suitability of okra fibre for textile application.
Appendiceal neurofibroma after resection of multiple gastrointestinal stromal tumors of the small intestine in a patient with neurofibromatosis type 1: a case report
Authors: Sakashita Katsuya , Manabe Shoichi , Shiomi Akio , Kagawa Hiroyasu , Yamaoka Yusuke , Kasai Shunsuke , Tanaka Yusuke , Oishi Takuma , Sugiura Teiichi 
Published: November 2024

Abstract
Background
Neurofibromatosis type 1 (NF1), also known as von Recklinghausen disease, is an autosomal dominant disorder that can affect multiple organs. Although gastrointestinal manifestations, such as neurofibromas and gastrointestinal stromal tumors (GISTs), can occur, appendiceal neurofibromas are extremely rare, with no documented cases of their occurrence following other gastrointestinal lesions. Herein, we report a case of an appendiceal neurofibroma following the resection of multiple small intestinal GISTs.

Case presentation
A 68-year-old man with NF1 presented with melena and was diagnosed with anemia due to bleeding from multiple small intestinal GISTs. Laparoscopic three partial resection of the small intestine was performed to control the bleeding. Histopathologic examination revealed the proliferation of spindle cells that are positive for c-kit and Discovered on GIST-1, confirming the diagnosis of GIST. Two years later, a follow-up computed tomography (CT) scan revealed a progressively enlarging mass in the appendix with suspected invasion into the small intestine. Positron emission tomography/CT showed fludeoxyglucose accumulation in the tumor. Therefore, considering the possibility of malignancy, laparoscopic ileocecal resection with lymph node dissection was performed. Postoperatively, melena was observed, but the anemia did not progress and improved with fasting and hemostatic therapy. The patient was eventually discharged on postoperative day 8. Histopathologic examination revealed spindle cell proliferation with positivity for S-100, confirming the diagnosis of neurofibroma.

Conclusions
Patients with NF1 can develop a variety of gastrointestinal lesions. Appendiceal neurofibroma can be difficult to diagnose preoperatively and differentiate from malignancy. Hence, surgical resection should be considered.
Metanephrine mirage: distinguishing the phaeocopies, a case report and literature review
Authors: Gong Joanna Y. , Gordon Debbie , Ye Sylvia , Fleming Bill , Tan Jason , Hulf Toby , Shamassi Maryam , Orme Lisa M. , Houli Nezor , Boehm Emma , Yates Christopher J. , Kevat Dev A. 
Published: November 2024

Abstract
Background
We present one of only seven reported cases of a catecholamine-secreting adrenal neuroblastoma in an adult. The case is used as a platform to discuss key biochemical, genomic and imaging considerations that are central to the successful, targeted management of catecholamine-secreting adrenal tumours.

Case presentation
A 63-year-old male was urgently reviewed at a tertiary hospital endocrinology outpatient clinic for a 12 cm right-sided adrenal incidentaloma. Plasma normetanephrine and 3-methoxytyramine levels were approximately 10 times the upper limit of normal at 9272 pmol/L (< 900) and 1023 pmol/L (< 110), respectively.
The adrenal mass appeared to be inseparable from the liver on imaging, and thus was suspected to be an invasive malignant phaeochromocytoma. FDG positron emission tomography (PET)/CT demonstrated moderate to intense metabolic activity within the right adrenal mass. [68 Ga]Ga-DOTATATE (Ga-TATE) PET-CT demonstrated patchy, heterogenous somatostatin receptor (SSTR) expression in the adrenal lesion, at most Krenning 3 (intensity above liver).
The patient underwent a right adrenalectomy and segment 6/7 liver resection. Histopathology revealed a 130 mm diameter neuroblastoma of the differentiating subtype with a low Mitosis-Karyorrhexis Index. There was lymphovascular invasion and tumour focally present at the resection margin, but no tumour in one periadrenal lymph node, and no tumour invasion in the adherent liver. Immunohistochemistry revealed ALK positivity (+ 3) and wild type ATRX.
At nine months following adrenalectomy, the plasma normetanephrine level has reduced to 991 pmol/L (< 900). Post-operative GaTate PET/CT shows no definite abnormal SSTR-expressing lesions in the surgical bed or elsewhere. The patient has completed adjuvant radiotherapy and is a candidate for ALK-targeted therapy if required for recurrence in the future.

Conclusions
Neuroblastomas may be misdiagnosed as phaeochromocytomas given the ability to secrete catecholamines and similarities in radiological appearance. Differentiating neuroblastomas from phaeochromocytomas and paragangliomas (PPGL) is critical, but clinically difficult. Genomics are central for management; diagnosing ALK-positive neuroblastoma triggers consideration of ALK-targeted therapy, which is not relevant for PPGL. A critical eye is required for the accurate diagnosis and management of malignant adrenal incidentalomas.
How patient-reported outcomes and experience measures (PROMs and PREMs) are implemented in healthcare professional and patient organizations? An environmental scan
Authors: Lowry Véronique , Tremblay-Vaillancourt Vanessa , Beaupré Priscilla , Poirier Marie-Dominique , Perron Marie-Ève , Bernier Jessica , Morin Anaëlle , Cormier Caroline , Haggerty Jeannie , Ahmed Sara , Brodeur Magaly , David Geneviève , Lambert Sylvie , Laberge Maude , Zidarov Diana , Visca Regina , Poder Thomas G. , Zomahoun Hervé Tchala Vignon , Sasseville Maxime , Poitras Marie-Eve 
Published: November 2024

Abstract
Background
Patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) are becoming essential parts of a learning health system, and using these measures is a promising approach for value-based healthcare. However, evidence regarding healthcare professional and patient organizations’ knowledge, use and perception of PROMs and PREMs is lacking.

Objectives
The objectives of the study were to: 1- Describe the current knowledge and use of PROMs and PREMs by healthcare professional and patient organizations, 2- Describe the determinants of PROMs and PREMs implementation according to healthcare professional and patient organizations.

Methods
We conducted an environmental scan using semi-structured interviews with representatives from healthcare professional and patient organizations. Interviews were recorded and live coded based on the Franklin framework. We used inductive and deductive thematic analysis to extract information about the main themes addressed during the interview (awareness of PROMs and PREMs, examples of implementation and use of PROMs and PREMs, tools used, vision for future implementation, barriers and facilitators to implementation and the best way to collect PROMs and PREMs data).

Results
63% of healthcare professional organizations (n = 19) and 41% of patient organizations (n = 9) that were contacted agreed to have a representative interviewed. The representatives from both the healthcare professional and patient organizations acknowledged the importance of assessing patients’ experience and outcomes. However, they considered the implementation of PROMs and PREMs tools to be scarce within their organizations, in clinical practice and in the education system. Patient organizations were worried that overuse of PROMs and PREMs could lead to depersonalization of practice. Barriers to implementing PROMs and PREMs included lack of awareness of tools, resistance to change and lack of motivation to complete or explain the questionnaire. Barriers also included factors such as lack of financial, technological and human resources and issues with integration of data and inconsistency of digital platforms.

Conclusions
This environmental scan revealed a lack of awareness of tools by healthcare professional and patient organizations’ representatives and limited implementation. Adequate training, technological integration, and demonstration of PROMs and PREMs benefits to foster broader adoption in clinical and organizational settings is dearly needed. Addressing these challenges is essential for enhancing value-based care.
Aggressive driving behavior: road rage incidents in Athens from the clinical forensic point of view
Authors: Kouzos Dimitrios , Katsos Konstantinos , Anastopoulou Ioanna , Kolentinis Christoforos , Goutas Nikolaos D. , Vlachodimitropoulos Dimitrios G. , Moraitis Konstantinos , Spiliopoulou Chara A. , Sakelliadis Emmanouil I. 
Published: November 2024

Abstract
Background
Aggressive driving behavior may lead to interpersonal violence. The Athens Metropolitan area has over four million inhabitants. Public transportation has improved over the last decades, mainly due to the work performed before the 2004 Olympic Games but is still lacking in the coverage of the Attica region with fixed track transportation. Thus, traffic in Athens is usually heavy during the day, a fact that combined with limited parking spaces available, acts as fuel to aggressive driving behaviors.
For this retrospective study, data from forensic clinical examinations performed at our department by the authors were reviewed. More specifically, cases examined from January 1st, 2012, to September 30rd, 2021, all concerning allegations for road rage were included, totally 177 cases. The data obtained was analyzed by utilizing SPSS Statistics.

Results
Most victims and perpetrators were drivers of their vehicles. In most cases (85.3%), perpetrators acted alone. 80.2% of victims reported that the incident was triggered by a minor conflict. Perpetrators used mostly just their hands and feet, or even their head as a blunt force instrument to inflict injuries (72.3%). Hammers, crowbars, and brass knuckles were used in 12.4% of cases, while in 9.6% the vehicle was used to overrun the victim. In 2.8% of cases, perpetrators attempted to strangulate the victims, while in 1.7% they used a sharp force instrument. In 9.6% of cases, victims did not sustain any visible external injury. 18.1% of victims sustained just a single injury, while in 72.3% multiple injuries were observed. 69.5% victims sustained merely external injuries, while in 20.2% at least one internal organ injury was sustained. The predominant injury site was by far the head-neck region. In more than one third of the road rage incidents, the injuries could be characterized as grievous.

Conclusions
Most people involved were male motorists. Females are rarely victims of road traffic violence, and even more rarely act as perpetrators. Commonest injury site was the head-neck region, with second commonest the upper extremities.
Cochlear implantation of a child with Townes-Brocks Syndrome in Tanzania: a case report
Authors: Jaffer Ali F. , Mehanna Ahmed , Patel Nina , Jaffer Fayaz , Hassuji Rashida 
Published: November 2024

Abstract
Background
Townes-Brocks Syndrome (TBS), an autosomal dominant disorder, is known to cause hearing loss amongst other expressions including anomalies that affect the external ear, hands, feet, anus, and kidneys.

Case presentation
This report describes a case of a four-year-old male of Iranian origin with TBS diagnosed with bilateral profound sensorineural hearing loss who underwent unilateral cochlear implantation in Tanzania. Along with sensorineural hearing loss, the child has dysplastic external ears, ulnar deviation of the thumbs, and overlapping toes. Radiological evaluation revealed cochlear hypoplasia with an enlarged vestibular aqueduct. This is the first known published case of TBS with a cochlear implant in East Africa and details the child’s history, audiological findings, surgical procedure, and post-surgical outcomes. The patient has shown a remarkable increase in Infant–Toddler Meaningful Auditory Integration Scale (IT-MAIS) scores and aided sound-field thresholds at 3 months and 6 months post-switch on.

Conclusion
This case advocates for encouraging intervention via cochlear implantation and increased awareness of such syndromes. It also adds to the literature on TBS, and its relation to sensorineural hearing loss and inner ear malformations.
The Jo-1 mystery
Authors: Krishna Kavita , Bellary Vaibhav S , Kadimisetty Nikhila B 
Published: November 2024

AbstractA 51-year-old male patient presented with fever, myalgia, and bilateral thigh pain, followed by proximal weakness of limbs. Laboratory features were suggestive of inflammatory polymyositis (PM). He initially responded to steroids, but subsequently, the patient’s clinical condition deteriorated. In the initial investigations, there was no evidence of any malignancy. Over the next 2 months, he had a catastrophic downhill course—progressive pancytopenia, acute abdominal pain, and features of mesenteric panniculitis and he eventually was diagnosed with acute myeloid leukemia (AML).This case underscores the high index of suspicion for underlying malignancy while managing cases of refractory PM and emphasizes the importance of comprehensive diagnostic evaluation and interdisciplinary collaboration in managing patients with complex autoimmune and hematological conditions. Jo-1 antibody, also known as anti-histidyl-tRNA synthetase antibody, is a specific type of autoantibody associated with a group of autoimmune diseases collectively known as idiopathic inflammatory myopathies (IIMs), particularly polymyositis (PM) and dermatomyositis (DM). Here, we present a case report highlighting the rare clinical association between Jo-1-positive PM and hematological malignancy. The presence of Jo-1 antibodies in this context may suggest potential immune dysregulation or paraneoplastic phenomena linking PM and AML. Accurate diagnosis and timely intervention are crucial for managing patients with complex autoimmune and hematological conditions, especially when they present with atypical clinical features and show poor response to treatment.
Transcription factor PbrERF114 is involved in the regulation of ethylene synthesis during pear fruit ripening
Authors: Wang Guoming , Guo Zhihua , Wang Tengjiao , Wang Xueping , Qi Kaijie , Xuan Jiping , Gu Chao , Zhang Shaoling 
Published: November 2024

AbstractThe plant hormone ethylene is indispensable to the ripening of climacteric fruits. Although extensive studies have been conducted on ethylene signaling, the ethylene response factor (ERF)-mediated transcriptional regulation of ethylene biosynthesis in pear fruits remains to be fully elucidated. We here constructed, sequenced, and analyzed transcriptome libraries in ethephon-treated and 1-MCP-treated Cuiguan pear fruits. In total, 721 fruit ripening-associated differentially expressed genes were identified. Among them, two key genes exhibited positive correlations: the 1-aminocyclopropane-1-carboxylic acid synthase (ACS)-encoding gene PbrACS3 and the ERF-encoding gene named PbrERF114. PbrERF114 overexpression increased ethylene production as well as the PbrACS3 expression level. Conversely, virus-induced gene silencing downregulated PbrERF114, thereby decreasing ethylene production and reducing PbrACS3 expression levels. Notably, PbrERF114 could directly interact with PbrACS3 and PbrERF24 promoters, thus inducing their expression. However, it did not result in an enhancement in luciferase activity, which is regulated by the PbrACS1b or PbrACO1 promoter. PbrERF24 could directly bind to PbrACO1 as well as PbrACS3 to promote ethylene synthesis. In conclusion, PbrERF114 can directly and indirectly mediate ethylene biosynthesis by transcriptionally regulating PbrACS3 and PbrERF24, respectively, thereby triggering a signaling cascade that induces the expression of both PbrACS3 and PbrACO1.
Let’s focus on the insula in addiction: A refined anatomical exploration of insula in severe alcohol and cocaine use disorders
Authors: Billaux Pauline , Segobin Shailendra , Maillard Angeline , Bloch Vanessa , Delmaire Christine , Cabé Nicolas , Laniepce Alice , Maurage Pierre , Poireau Margaux , Volle Emmanuelle , Vorspan Florence , Pitel Anne-Lise 
Published: November 2024

Abstract

Background
Theoretical and empirical contributions have identified insula as key in addiction. However, anatomical modifications of the insula in addictive states, and their variations across substance use disorders (SUDs), remain to be specifically explored. We therefore explored the specificities and commonalities of insula gray matter (GM) alterations in severe alcohol use disorder (sAUD) and severe cocaine use disorder (sCUD).

Methods
We explored insula GM volume through a refined parcellation in 12 subregions (six bilateral): anterior inferior cortex (AIC), anterior short gyrus, middle short gyrus, posterior short gyrus, anterior long gyrus (ALG), and posterior long gyrus (PLG). Using a linear mixed model analysis, we explored the insula volume profiles of 50 patients with sAUD, 61 patients with sCUD, and 36 healthy controls (HCs).

Results
In both sAUD and sCUD, we showed overall insular lower volume with a right-sided lateralization effect, and a major volume deficit in bilateral ALG. Moreover, differences emerged across groups, with higher left AIC and PLG volume deficits in sCUD compared to sAUD and HC.

Conclusions
We offered the first joint exploration of GM insular volumes in two SUD through refined parcellation, thus unveiling the similarities and dissimilarities in volume deficit profiles. Our results bring evidence complementing prior ones suggesting the core role of the right and posterior insula in craving and interoception, two crucial processes in addiction. Left AIC and PLG group differences also show that, while insula is a region of interest in SUD, sCUD and sAUD generate distinct insular profiles, which might parallel clinical differences across SUD.