bluuebunny/crossref_metadata_2025_split huggingface dataset:
Osilodrostat treatment for adrenal and ectopic Cushing syndrome: Integration of clinical studies with case presentations
Authors: Fleseriu Maria , Auchus Richard J , Bancos Irina , Biller Beverly M K 
Published: February 2025

Abstract
Although most cases of endogenous Cushing syndrome are caused by a pituitary adenoma (Cushing disease), approximately one-third of patients present with ectopic or adrenal causes. Surgery is the first-line treatment for most patients with Cushing syndrome; however, medical therapy is an important management option for those who are not eligible for, refuse, or do not respond to surgery. Clinical experience demonstrating that osilodrostat, an oral 11ꞵ-hydroxylase inhibitor, is effective and well tolerated comes predominantly from Phase III trials in patients with Cushing disease. Nonetheless, reports of its use in patients with ectopic or adrenal Cushing syndrome are increasing. These data highlight the importance of selecting the most appropriate starting dose and titration frequency while monitoring for adverse events, including those related to hypocortisolism and prolongation of the QT interval, to optimize treatment outcomes. Here, we use illustrative case studies to discuss practical considerations for the management of patients with ectopic or adrenal Cushing syndrome and review published data on the use of osilodrostat in these patients. The case studies show that, to achieve the goal of reducing cortisol levels in all etiologies of Cushing syndrome, management should be individualized according to each patient’s disease severity, comorbidities, performance status, and response to treatment. This approach to osilodrostat treatment maximizes the benefits of effective cortisol control, leads to improvements in comorbid conditions, and may ameliorate quality of life for patients across all types and severities of Cushing syndrome.
Lysyl Oxidases are Necessary for Myometrial Contractility and On-Time Parturition in Mice
Authors: Ouellette Alexis , Do Christina , Cohn-Guthrie Sydney , Lam Ying-Wai , Mahendroo Mala , Nallasamy Shanmugasundaram 
Published: February 2025

Abstract
The extracellular matrix (ECM) plays a pivotal role in the maintenance of tissue mechanical homeostasis. Collagens and elastic fibers are the most predominant fibrous ECM proteins providing tissue mechanical function through covalent cross-linking which is mediated by the lysyl oxidase family of enzymes. In this study, the function of lysyl oxidases in maintaining the integrity of the extracellular matrix in the myometrium and its impact on parturition-timing was investigated. Gene and protein expression analyses demonstrate that a sub-set of the lysyl oxidase family of enzymes are highly induced in pregnant myometrium. Inhibition of the activity of the lysyl oxidase family of enzymes through β-aminopropionitrile (BAPN) delays parturition in mice, in part, due to myometrial dysfunction. In BAPN treated mice, the expression of genes encoding contraction associated proteins such as connexin 43, oxytocin receptor and prostaglandin synthase 2 is significantly reduced in the myometrium compared to the untreated control mice. Proteomic analysis revealed that the composition of the ECM is altered in response to BAPN treatment which demonstrates that the inhibition of the activity of lysyl oxidases disrupted the integrity of the myometrial ECM. Our findings demonstrate that the lysyl oxidases-mediated ECM function is necessary for the myometrium to transition from a quiescent to a contractile phenotype at term for on-time parturition.
Effective Treatment Strategies for Adults with Type 2 Diabetes
Authors: Czerska Magdalena Agata , Wójcik Zofia Martyna , Kamińska-Omasta Katarzyna , Omasta Bartosz , Krupa Olga , Pietrukaniec Paulina Dorota , Romańczuk Kuba Borys , Furtak Kinga , Stolarczyk Szymon Przemysław , Rybak Daria 
Published: February 2025

Introduction
Type 2 diabetes is a chronic metabolic disorder marked by insulin resistance and insufficient insulin production. It affects millions globally, with 537 million adults diagnosed in 2021, a prevalence that has doubled from 7% in 1990 to 14% in 2022. This rise imposes a significant burden on individuals, healthcare systems, and economies.
Aim of the Study
This study aims to provide an overview of therapeutic management for type 2 diabetes, focusing on pharmacological treatments and their integration with lifestyle changes, such as diet and exercise, to improve outcomes and reduce complications.
Materials and Methods
The study reviews literature and clinical guidelines on managing type 2 diabetes, emphasizing pharmacological treatments like insulin, oral hypoglycemic agents, and newer therapies. It also examines the role of diet and physical activity in controlling blood glucose and preventing complications. Data sources include peer-reviewed articles and health organization publications from the past ten years, targeting adults aged 18 and older.
Summary
Type 2 diabetes remains a global health challenge with rising prevalence. Effective management requires a combined approach of pharmacological therapies and lifestyle modifications, underscoring the importance of early intervention to reduce complications and improve outcomes.
Differences between healthcare practitioners' and patients' perceptions of IBD and its causative factors
Authors: Duff Alexa , Dawson Patrick , Pavilidis Polychronic , Mawdsley Joel 
Published: February 2025

Background: Illness perceptions influence the experience that patients with inflammatory bowel disease (IBD) have, as well as their engagement with their disease management, quality of life and adherence to medication. Differences have been found in the perceptions that healthcare professionals (HCPs) and patients have about IBD. Aims: To explore the illness perceptions and causes of IBD held by patients and HCPs, and to compare the differences between the two groups. Methods: Patients attending a specialist IBD psychology clinic were asked to complete a nine-item questionnaire about their illness perceptions and the perceived causes of their disease. A questionnaire about illness perceptions and causes was circulated among HCPs from two NHS IBD centres. Findings: There were significant differences between the perceptions of HCPs and patients about the impact and options available regarding the causes and treatment of IBD. There were similarities and differences in perceptions of causality. Conclusions: Good communication between patients and HCPs is necessary to bridge the gap between perceptions regarding IBD and ensure good engagement with healthcare teams and treatment.
Exploring outcomes of percutaneous endoscopic gastrostomy tubes following strokes, when the decision for insertion was made in a patient's best interest
Authors: Gibson Elizabeth , Murandu Moses 
Published: February 2025

Background: Percutaneous endoscopic gastrostomy (PEG) tube insertion decisions can be complex in incapacitated stroke patients, resulting in poor patient survival rates following the procedure. Aim: The aim of this study was to calculate the average length of survival of stroke patients with a PEG when a best interest decision (BID) was made, compared with when the patient consented (CS). Method: All PEGs inserted between 2020–2022 in an NHS Foundation Trust which serves 45 000 people in the West Midlands were identified through a review of electronic records. Collated data were analysed using SPSS software. Findings: Some 36 PEG procedures were performed in the study period, 16 CS and 20 BID (equalling 55.56% incapacitated stroke patients). CS patients had a mean survival of 271.3 days (P=0.001, standard deviation (SD) 138) and BID patients 245.8 days (P=0.001, SD 141.3), giving a 25.6-day difference. An effect size Cohen's d analysis with Hedges' correction for BID with lower correction was 0.98 (CI 95%), and for CS it was 1.04 (CI 95%). When using the upper interval data it was 2.33 BID (CI 95%) and for CS it was 2.66 (CI 95%). Conclusions: BID PEG tube insertions in incapacitated stroke patents demonstrated shorter survival times than in stroke patients able to consent to their PEG procedure.
Risk and outcomes of healthcare-associated infections in three hospitals in Bobo Dioulasso, Burkina Faso, 2022: A longitudinal study
Authors: Hema Arsène , Somé Satouro Arsène , Kaboré Odilon , Sanou Soufiane , Poda Armel , Meda Ziemlé Clément , Ouedraogo Abdoul Salam , Savadogo Léon 
Published: February 2025

Background
Healthcare-associated infections (HAIs) are one of the most common adverse events in healthcare and represent a major public health problem. The present study was conducted to analyze the incidence, risk factors, and outcomes of HAIs through active surveillance in three hospitals in the city of Bobo Dioulasso, Burkina Faso.

Methods
A prospective, longitudinal, multicenter study was conducted from May 1 to November 30, 2022, in two district hospitals (Do and Dafra) and the Sourô Sanou Teaching Hospital (CHUSS), Burkina Faso. Consenting patients hospitalized for reasons other than infection, cancer, immunosuppression in the postoperative care ward of Do or of Dafra district hospitals, intensive care unit (ICU)/CHUSS, neonatal ward/CHUSS, and gynecology and obstetrics postoperative care ward/CHUSS during a 2-month inclusion period in district hospitals and 4 months for CHUSS wards. For this study, we used the operational definitions of the French Technical Committee for Nosocomial Infections and Healthcare-associated Infections, with slight modifications. Logistic regression was used to analyze risk factors of HAIs.

Results
Of the 664 patients enrolled, 166 experienced an HAI, with a cumulative incidence rate of 25% (95%CI: 21.7%–28.3%) or an incidence density rate of 36.7 per 1000 patient-days (95% CI: 31.7–42.9). Surgical site infections (SSI) (44%), followed by neonatal infections (42%) were the most common HAIs. Enterobacterales represented 60% of the bacteria identified in HAIs, and 38.9% of them were extended spectrum β-lactamase (ESBL) producers. Factors associated with HAIs were admission in the neonatal ward (aOR = 6.6; 95%CI:1.1–40.2), ICU (aOR = 3.3; 95%CI:1.3–8.5), previous hospital stay longer than two days (aOR = 2.0; 95%CI:1.2–3.3), or male sex (aOR = 1.8; 95%CI:1.1–3.0). In addition, HAIs were associated with longer follow-up, hospitalization, and mortality (18.1%; 95% 95%CI:12.1–24.4). Deaths were only recorded in the ICU and neonatal ward, with case fatality rates of 45.4% (95% 95%CI: 27.5–63.4) and 21.4% (95% 95%CI: 11.6–31.3), respectively, p = 0.019.

Conclusions
The incidence of HAIs was relatively high in the three hospitals in Bobo Dioulasso, Burkina Faso. It is essential to implement rigorous protocols for patient management, to reduce the incidence of HAIs and the spread of resistant pathogens in general and Enterobacterales in particular.
Geriatrics as a specialty: Insights from Mexican medical students’ decision-making process
Authors: Gómez-Moreno Carolina , Vives-Varela Tania , Gulias-Herrero Alfonso , Ávila-Funes José Alberto , Pérez-Méndez Ayari , Sánchez-Mendiola Melchor , Gutiérrez-Cirlos Carlos 
Published: February 2025

Main objective
To identify the elements associated with the decision to select or reject geriatrics as a medical specialty in Mexico.

Methods
Qualitative, with the focus group technique to obtain data. Two groups included students who rejected geriatrics, regardless of the specialty they chose, and two groups included students who chose geriatrics, interviews via Zoom were conducted. Data was analyzed qualitatively based on grounded theory.

Results
Thirty-four students were included in the final sample (52% women), mainly from the Central region of the country (44%). Students were mainly in their last year of medical school (97%). Previous experiences with older patients and older close relatives, both positive and negative, were important in choosing the specialty of geriatrics for most students. In contrast, personality, and interpretation of the experiences as good or bad was the main differentiator between groups. For those who did not choose geriatrics, the main factor was the lack of knowledge regarding contents, aims, and professional opportunities for geriatricians. Previous experiences with geriatric care influenced positively towards choosing geriatrics as a medical specialty. High-quality, structured exposure to geriatrics should be encouraged among medical students in order to increase knowledge and eventually interest in the specialty.
Evaluating elexacaftor/tezacaftor/ivacaftor (ETI; Trikafta™) for treatment of patients with non-cystic fibrosis bronchiectasis (NCFBE): A clinical study protocol
Authors: Swenson Colin E. , Hunt William R. , Manfredi Candela , Beltran Diana J. , Hong Jeong S. , Davis Brian R. , Suzuki Shingo , Barillá Cristina , Rab Andras , Chico Cynthia , Dangerfield Joy , Streby Ashleigh , Barton Erin , Cox Elizabeth M. , Stecenko Arlene A. , Westbrook Adrianna , Kapolka Rebecca , Sorscher Eric J. 
Published: February 2025

Background
Non-cystic fibrosis bronchiectasis (NCFBE) is a disease that exhibits dilatation of airways, airflow obstruction, persistent cough, excessive sputum production, and refractory respiratory infections. NCFBE exhibits clinical and pathological manifestations similar to key features of cystic fibrosis (CF) lung disease. In CF, pathogenesis results from dysfunction of the cystic fibrosis transmembrane conductance regulator (CFTR), and diagnosis is made by demonstrating elevated sweat chloride concentrations (typically ≥60 mEq/L), two CFTR mutations known to be causal, multi-organ tissue injury, or combination(s) of these findings.

Objective
Based on a considerable body of evidence, we believe many patients with NCFBE have disease likely to benefit from drugs such as elexacaftor/tezacaftor/ivacaftor (ETI) that activate CFTR-dependent ion transport. ETI is currently prescribed solely for treatment of CF and has not been adequately tested or proposed for patients with NCFBE, many of whom exhibit decreased CFTR function. Accordingly, we are conducting a clinical trial of ETI in subjects carrying a diagnosis of NCFBE.

Methods
Participants will exhibit one disease-causing CFTR mutation and/or sweat chloride measurements of 30–59 mEq/L. Cutaneous punch biopsy or blood samples will be obtained for iPS cell differentiation into airway epithelial monolayers–which will then be tested for response to ETI. Each patient will be given CFTR modulator treatment for approximately four weeks, with monitoring of clinical endpoints that include FEV1 (forced expiratory volume in one second), sweat chloride, quality of life questionnaire, and weight. The study will evaluate response of patients with NCFBE to ETI, and test usefulness of iPSC-derived airway epithelial monolayers as a novel in vitro technology for predicting clinical benefit.

Trial registration
This trial is registered at clinicaltrials.gov (Identifier: NCT05743946. Date: 02/23/2023).
NOTCH1 promotes the elevation of GM-CSF and IL-6 through the EZH2/STAT3 pathway to facilitate the fibrotic state of the myocardium in DLBCL
Authors: Zhang Huimin , Dong Wen , Zhang Lihong , Ma Bing , Wang Jianying , Shen Yang , Zhao Dan , Yin Wanyi , Li Yuexian , Liu Qingchi 
Published: February 2025

Objective
Investigate the role of the Neurogenic locus notch homolog protein 1 (NOTCH1) signaling pathway in Diffuse large B-cell lymphoma (DLBCL)-related heart pathogenesis.

Methods
Utilize R (version 4.2.1) to retrieve DLBCL and myocardial infarction datasets from the GEO database, normalize data with limma, perform differential analysis and GO analysis with GOplot, and visualize findings with ggplot2. Various assays were conducted including stable cell line construction, myocardial infarction modeling, imaging, Western Blot, ELISA, staining, and functional assays.

Results
Significant gene expression and pathway disparities were found between DLBCL and myocardial infarction samples. NOTCH1, The molecules named Recosomal-binding protein 70 (RBP-J), zeste 2 polycomb repressive complex 2 subunit (EZH2), trimethylated histone H3 at lysine 27 (H3K27me3), Signal Transducer And Activator Of Transcription 3 (STAT3) and Jumonji domain containing-3 (JMJD3) matters a lot in DLBCL. NOTCH1 inhibition decreased DLBCL cell proliferation and activity, reduced inflammatory factors, and improved myocardial fibrosis and infarction severity. NOTCH1 inhibits Granulocyte-macrophage colony-stimulating factor (GM-CSF) and Interleukin-6 (IL-6) expressions depending on STAT3 and EZH2. Co-culturing with DLBCL cells increased fibroblast proliferation, invasion, and fibrosis.

Conclusion
NOTCH1 signaling influences DLBCL development and myocardial infarction severity through the EZH2/STAT3 pathway, leading to increased heart fibrosis.
Anxiety among pregnant women in Addis Ababa, Ethiopia
Authors: Melesse Hanna , Shifraw Tigest , Berhane Yemane 
Published: February 2025

Background
Anxiety is one of the most prevalent mental health problems during pregnancy which result in various maternal and newborn complications affecting the health and well-being of the mother and the baby. In countries like Ethiopia, anxiety among pregnant women was not well explored, limiting the development of informed interventions. Thus, this research aims to assess the magnitude of anxiety and associated factors among pregnant women visiting ANC at public health centers in Addis Ababa, Ethiopia.

Method
We conducted an institutional-based cross-sectional study. Pregnant women who visited antenatal care (ANC) from April 1–14, 2021, were recruited from seven public health centers in Addis Ababa, Ethiopia. Data were collected using a structured questionnaire by trained data collectors. Poisson regression with a robust error variance estimate was used to calculate the prevalence ratio to identify the associated factors; the results were presented with an adjusted prevalence ratio (APR) and a 95% CI.

Result
A total of 323 pregnant women were recruited from the ANC clinics of public health centers in Addis Ababa. The overall prevalence of anxiety disorder was 12.70%, 95% CI (9.00%–16.10%). The prevalence risk of anxiety was higher among women who reported unplanned pregnancy compared to those who had planned pregnancy (APR 1.99, CI 1.04–3.81), and being single was associated with a higher prevalence risk than being married (APR 2.29, CI 1.14–4.59).

Conclusion
More than 1 in 10 women had anxiety during pregnancy. The prevalence of anxiety was about two-fold higher among single mothers and among mothers who had an unplanned pregnancy. The study suggests the importance of integrated mental health assessment and services in regular antenatal care, with an emphasis on identifying and caring for women at a disadvantage due to social and obstetric factors.
Retrospective and statistical analysis of hand and forearm injuries in the Silesian pediatric population – study of post-traumatic X-rays in 2022
Authors: Machnikowska-Sokołowska Magdalena , Ciekalski Marcin , Szymańska Iga , Mordarski Jakub , Gruszczyńska Katarzyna 
Published: February 2025

Background and objectives
Upper limb injuries are a common occurrence in the pediatric demographic, particularly wrist injuries, which constitute a noteworthy subset. Fractures involving the forearm, wrist, and phalanges are recurrent reasons prompting visits to emergency departments. This investigation endeavors to offer a comprehensive insight into hand and forearm fractures within the pediatric cohort, delineating data across various age groups, gender distributions, and fracture location.

Materials and methods
This study involved data from the reports of 834 post-traumatic wrist X-ray examinations conducted in 2022 at the Department of Diagnostic Imaging of the Upper Silesian Child Health Centre. The analysis included bone injuries, the age and gender of the child, the nature of the lesions, and anatomical location of the injury. The study group consisted of 327 girls and 511 boys, who were on average 11.4 ±  3.6 and 12.0 ±  3.8 years old, respectively.

Results
There were 273 single fractures and 66 multiple fractures in the study group. The highest number of fractures were recorded in the metacarpal bones (29,2%), among which the fifth meta-carpal bone was the most frequently injured (14,5%). The second most common fracture was in the forearm (28,9%). There were 55 phalangeal fractures in the study group (16,2%).

Conclusions
The risk of fractures is statistically highest among boys, peaking at 12 years of age. The metacarpal bones and the radius are most susceptible to fractures. The likelihood of fractures in the right and left hand is similar in females, whereas males are more likely to sustain injuries to the right hand.
Discurso, normatividade e paráfrase
Authors: Soares Zampiêr Letícia , Alves Wedencley 
Published: February 2025

O artigo tem como objetivo pensar o debate público e midiatizado sobre gênero e sexualidade na Psicanálise, a partir do mapeamento de quais formações discursivas se materializam nessa discussão. Para isso recorremos aos dispositivos teóricos da Análise de Discurso (percurso Pêcheux-Orlandi) em diálogo com estudos decoloniais e queer. O estudo toma como ponto de partida, que também serve como marco temporal, a intervenção de Paul Preciado, na Escola da Causa Freudiana, e os debates e embates que se seguiram. Foi possível perceber que a intervenção do filósofo espanhol desencadeou uma cena discursiva que denuncia o modo como o campo psicanalítico vem se mostrando na questão específica das discussões de gênero e sexualidade.
Deep multi-view feature fusion with data augmentation for improved diabetic retinopathy classification
Authors: Boualleg Yaakoub , Daouadi Kheir Eddine , Guehairia Oussama , Djeddi Chawki , Cheddad Abbas , Siddiqi Imran , Bouderah Brahim 
Published: February 2025

Abstract
Diabetic retinopathy (DR) is a leading cause of blindness worldwide, necessitating early detection to prevent severe visual impairment. Despite numerous proposed classification techniques, challenges persist due to the high parameter count of deep learning algorithms, imbalanced datasets, and limited performance. This study introduces a novel framework for DR classification that leverages multi-view deep features, multilinear whitened principal component analysis, tensor exponential discriminant analysis, synthetic minority oversampling technique, and deep random forest. We evaluated this architecture using the APTOS blindness dataset under a standard protocol. The results demonstrate that our architecture significantly improves classification accuracy, surpassing existing methods. Our contributions highlight a promising approach for enhancing DR classification performance.
Die Frage der Zurechnung. Ein Aspekt in der Kontroverse zwischen Kant und Reinhold über Willensfreiheit
Authors: Bondeli Martin 
Published: February 2025

Abstract
In his understanding of imputation, developed centrally in the Metaphysics of Morals, Kant favors the point of view of the (real and ideal) judge who applies the moral law to an acting person. Reinhold, on the other hand, when speaking of imputation, emphasizes the role of the autonomous and scrupulous acting person. This is a consequence of his view that free will is the faculty of a morally capable person to decide for or against the moral law. Considering the relevant insights of both positions, I argue that the notion of imputation should be understood in a multi-perspective manner and in the sense of a multi-place relation.