bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of parametric modeling of tip winglets on the stable operating margin of the Stage 37 compressor
Authors: Zhong Jingjun , Wang Yuan , Wu Wanyang 
Published: February 2025

Abstract
In this study, a novel tip winglet structure was proposed and applied to NASA Stage 37, aiming to regulate leakage flow at the rotor tip while reducing additional weight caused by installing tip winglets. A parametric design approach was employed, providing general design guidelines for the parametric modeling of tip winglets. Tip winglet configurations were determined by adjusting the extension coefficient of the pressure surface and the contraction of the suction surface. By fixing the pressure surface extension coefficient and suction surface contraction amount, the effects of these parameters on the performance of the compressor were analyzed. The results indicated that the pressure-side tip winglet effectively weakened tip leakage vortex strength, reduced interference between shock wave and tip leakage vortex, lowered leakage flow rate, and increased the axial momentum of the leakage flow, thus expanding the main flow range. As the extension coefficient of the pressure-side tip winglet increased, the low-energy fluid blockage caused by tip leakage vortex fragmentation was gradually alleviated. Additionally, the tip winglet's regulation of the upstream rotor flow field reduced stator suction surface separation, thereby enhancing compressor efficiency. A moderate contraction of the tip winglet's suction surface improved the stabilizing effect of the tip winglet, whereas excessive contraction exacerbated suction surface separation. The pressure-side tip winglet configuration, with an extension coefficient of 6 and a suction surface contraction of 30%, increased the compressor's stable operating margin by 26.32% at the design speed.
IgG4-related disease causing dacryoadenitis, bronchial stenosis and lobar collapse
Authors: Chan Jessica , Biddle Kathryn , Green Anna , Batista Craig , D’Cruz David 
Published: February 2025

Immunoglobulin G4-related disease (IgG4-RD) is a rare systemic fibroinflammatory disease that can affect almost any organ in the body. The most common sites of IgG4-RD include the salivary glands, orbits and lacrimal glands, pancreas, biliary tree, retroperitoneum and thyroid. Immunoglobulin G4-related lung disease (IgG4-RLD) can occur in isolation or as a component of multisystem disease. Its manifestations are heterogeneous and include lung cavitation, interstitial changes, pleural effusions and lung lesions.We describe a patient with Ig4-RLD manifesting as bronchial stenosis and left upper lobe collapse.
‘Involve those who are managing these outbreaks’: stakeholders’ perspectives on the barriers and facilitators to the implementation of clinical management guidelines for high-consequence infectious diseases in Uganda—a thematic network analysis
Authors: Kabajaasi Olive , Schilling Stefan , Akugizibwe Mathias , Horby Peter W , Hart Peter , Sigfrid Louise , Jacob Shevin T 
Published: February 2025

IntroductionPrior research highlighting the complexity of clinical management guidelines’ (CMGs) implementation during high consequence infectious disease (HCID) outbreaks has suggested that limited access to treatments and equipment and substantial issues regarding availability, inclusivity, quality and applicability hinders the implementation of CMGs in low- and middle-income countries (LMICs). This in-depth case study of Uganda—coincidentally occurring during the 2022 Sudan virus disease outbreak—aimed to explore contextual and supplementary factors which hinder or facilitate CMG development and implementation.MethodsBetween August and December 2022, 43 interviews were conducted with medical personnel, consultant physicians, case managers and Uganda Ministry of Health officials. Interviews were analysed using a thematic network analysis approach to visualise thematic codes in qualitative data and highlight inherent relationships between codes.ResultsSix thematic topics emerged as the main barriers to the implementation of CMGs during HCID outbreaks in Uganda: (1) deficient content and slow updates of CMGs; (2) scarce resources and healthcare disparities; (3) slow dissemination and limited access to guidelines; (4) improvisation of patient care (5) lack of training for healthcare workers (HCWs); and (6) limited pandemic preparedness and response infrastructure. Codes most strongly linked to facilitators and suggestions included: (1) HCW training in CMG implementation; (2) adequate resourcing; (3) involvement of personnel with prior HCID response experience in CMG development and (4) improvements in access to CMGs.ConclusionsBy illustrating linkages to resource constraints, healthcare disparities, and limited surveillance and referral infrastructure, our study displays how insufficient training, patchy dissemination and slow updating exacerbate many of the underlying difficulties for CMG implementation in LMIC contexts. Findings offer valuable insights for LMICs to improve HCID outbreak responses and inform implementation of CMGs in future HCID outbreaks, where evidence is often initially limited. Recommendations to enhance CMG implementation are provided.
Investigating a structured diagnostic approach for chronic breathlessness in primary care: a mixed-methods feasibility cluster randomised controlled trial
Authors: Doe Gillian , Clanchy Jill , Wathall Simon , Barber Shaun , Edwards Sarah A , Evans Helen , Jackson Darren , Armstrong Natalie , Steiner Michael C , Evans Rachael A 
Published: February 2025

BackgroundThere is a need to reduce delays to diagnosis for chronic breathlessness to improve patient outcomes.ObjectiveTo conduct a mixed-methods feasibility study of a larger cluster randomised controlled trial (cRCT) investigating a structured symptom-based diagnostic approach versus usual care for chronic breathlessness in primary care.Methods10 general practitioner practices were cluster randomised to a structured diagnostic approach for chronic breathlessness including early parallel investigations (intervention) or usual care. Adults over 40 years old at participating practices were eligible if presenting with chronic breathlessness without an existing explanatory diagnosis. The primary feasibility outcomes were participant recruitment and retention rate at 1 year. Secondary outcomes included number of investigations at 3 months, and investigations, diagnoses and patient-reported outcome measures (PROMs) at 1 year. Semistructured interviews were completed with patients and clinicians, and analysed using thematic analysis.ResultsRecruitment rate was 32% (48/150): 65% female, mean (SD) age 66 (11) years, body mass index 31.2 kg/m2(6.5), median (IQR) Medical Research Council dyspnoea 2 (2–3). Retention rate was 85% (41/48). At 3 months, the intervention group had a median (IQR) of 8 (7–9) investigations compared with 5 (3–6) investigations with usual care. 11/25 (44%) patients in the intervention group had coded diagnosis for breathlessness at 12 months compared with 6/23 (26%) with usual care. Potential improvements in symptom burden and quality of life were observed in the intervention group above usual care.ConclusionsA cRCT investigating a symptom-based diagnostic approach for chronic breathlessness is feasible in primary care showing potential for timely investigations and diagnoses, with PROMs potentially indicating patient-level benefit. A further refined fully powered cRCT with health economic analysis is needed.
Identification and functional characterisation of a novel DNASE1L3 variant (c.572A>G, p.Asn191Ser) in three Emirati families with systemic lupus erythematosus and hypocomplementaemic urticarial vasculitis
Authors: Aljaberi Najla , Bharathan Anjali , Gopal Remya Prajesh , Mohammed Ekhlass , Al Shibli Fatema , Tabouni Mohammed , Alhmoudi Sara , Kizhakkedath Praseetha , Baydoun Ibrahim , Allam Mushal , Mustafa Noor , Aljasmi Fatma , Al Dhaheri Afra , Alblooshi Hiba 
Published: February 2025

ObjectivesTo evaluate the functional impact of a novelDNASE1L3variant (c.572A>G, p.Asn191Ser) in three families with SLE and hypocomplementaemic urticarial vasculitis (HUV) from the United Arab Emirates.MethodsWhole-exome sequencing was performed on affected patients and findings were confirmed using Sanger sequencing in family members. DNASE1L3 protein expression, secretion and enzymatic activity were assessed in HEK293 cell lines. Plasma smear assay for neutrophil extracellular traps (NETs) was evaluated in patients, family members and healthy control.ResultsA total of seven patients diagnosed with both SLE and HUV were identified from three unrelated families. All affected individuals were found to carry a homozygous c.572A>G, p.Asn191Ser (191S) variant inDNASE1L3. The variant 191S was shown to impact the secretion and activity of DNASE1L3. Patients homozygous for 191S variant had significantly higher burden (p=0.0409) of NET structure in comparison to heterozygous and healthy control.ConclusionsWe functionally evaluated the effect of a novelDNASE1L3(c.572A>G, p.Asn191Ser) in familial SLE with a consistent pattern of HUV across seven patients. This variant resulted in impaired secretion and enzymatic activity of DNASE1L3 along with increased NETosis in patients with homozygous genotype.
Tumor Suppressors Condition Differential Responses to the Selective CDK2 Inhibitor BLU-222
Authors: Dommer Adam P. , Kumarasamy Vishnu , Wang Jianxin , O'Connor Thomas N. , Roti Michelle , Mahan Sidney , McLean Karen , Knudsen Erik S. , Witkiewicz Agnieszka K. 
Published: February 2025

Abstract
CDK2 inhibitors have recently been developed and entered clinical trials. Combination approaches can help broaden the use of therapeutic agents and establish more effective treatments. Here, we evaluated the selective CDK2 inhibitor BLU-222 for mechanisms of response in the context of ovarian and breast cancer models. Sensors of cellular CDK activity indicated that sensitivity to either CDK4/6 or CDK2 inhibition was related to the differential dependence on a single CDK for G1/S transition. Unlike CDK4/6 inhibitors, BLU-222 was able to robustly inhibit proliferation through cell cycle inhibition in both G1 and G2 phases. However, it remained possible for cells to re-enter the cell cycle upon drug withdrawal. The anti-proliferative strength and impact on G1/S versus G2/M accumulation was mediated by the RB tumor suppressor. To broaden the sensitivity to CDK2 inhibition, combinatorial drug screens were performed that identified both synergistic (e.g., CDK4/6 inhibitors) and antagonistic (e.g., WEE1 inhibitors) relationships. Models that were exceptionally sensitive to CDK2 inhibition displayed coordinate expression of cyclin E1 and P16INK4A, an endogenous CDK4/6 inhibitor. Functional studies demonstrated that P16INK4A and CDK4/6 activity were key mediators of sensitivity to BLU-222. Clinical gene and protein expression analysis revealed a positive correlation between cyclin E1 and P16INK4A and identified that ~25% of ovarian cancers exhibited coordinate expression of cyclin E, P16INK4A, and RB, indicative of strong sensitivity to CDK2 inhibition. Together, this work advances a precision strategy for the use of CDK2 inhibitors in the context of ovarian and breast cancers.
Comparison between arm port and chest port: A systematic review and meta-analysis
Authors: Wei Jianjian , Yin Wen , Yan Hongxia , Zhang Yue , Wang Chunmeng , He Fang 
Published: February 2025

Objective: This meta-analysis aimed to compare the efficacy and safety of arm ports (APs) and chest ports (CPs) in clinical practice. Methods: Randomized controlled trials (RCTs), controlled clinical trials, and retrospective studies were searched in both English and Chinese databases, encompassing PubMed, Embase, Cochrane Library, Web of Science, CNKI, WanFang Database, and SinoMed up to November 27, 2023. Data analysis was performed using Stata 15.0. Results: Seventeen studies, including two RCTs, three cohort studies, and twelve case-control studies, were finally included, involving a total of 4168 participants, with 2151 participants in the CP group and 2017 in the AP group. The meta-analysis showed that there was no significant difference between CP and AP in the incidence rates of infections [OR = 0.98, 95% CI (0.68, 1.41)], catheter occlusion[OR = 0.95, 95% CI (0.55, 1.64)], thrombosis [OR = 0.85, 95% CI (0.60, 1.21)], exudation [OR = 1.32, 95% CI (0.52, 3.36)], fibrin sheath [OR = 1.68, 95% CI (0.46, 6.19)], catheter malposition [OR = 0.62, 95% CI (0.30, 1.29)], fracture[OR = 1.84, 95% CI (0.49, 6.96)], pneumothorax [OR = 5.73, 95% CI (0.94, 35.11)], and malfunction [OR = 1.87, 95% CI (0.65, 5.42)]. Conclusion: This study reveals no significant differences in the incidence of infections, catheter occlusion, thrombosis, exudation, fibrin sheath, catheter malposition, fracture, pneumothorax, and malfunction between the two implanted venous access ports. Thus, it can be concluded that AP is as safe as CP.
Association between physical activity and physical health in German children and adolescents - results from the MoMo Longitudinal Study
Authors: Kolb Simon , Burchartz Alexander , Klos Leon , Jekauc Darko , Niessner Claudia , Woll Alexander 
Published: February 2025

Abstract

Background
Adequate physical activity is essential to maintain and improve physical health, including in adolescents and young adults. A significant part of physical activity is sports activity. However, few longitudinal studies cover the transition from adolescence to early adulthood. Therefore, the aim is to assess how the maintenance or a change in sports activity during this transition relates to physical fitness, BMI, and recurrent pain.

Methods
Data of 947 adolescents aged 11 - 17 years (53 % girls) from the Momo baseline (2003 - 2006) that were followed up at MoMo Wave 1 (2009 - 2012) were used. Sports activity was categorized (> 240 min/wk sports activity vs.

$$\le$$

≤

240 min/wk) and change patterns over time were calculated (maintain active, maintain passive, increasing, decreasing). Separate ANOVAs were used to analyze the difference in cardiorespiratory fitness (CRF), push-ups, standing long jump, and BMI at wave 1 between the sports activity groups. A logistic regression was used to assess the difference in the occurrence of recurrent headaches at wave 1 between groups. All analyses were controlled for sex and age, and post-Hoc-Tests were conducted where applicable.

Results
The analysis revealed significant differences between the activity groups at the follow-up for CRF (F(3, 502) = 13.65, p < .001), push-ups (F(3, 599) = 10.45, p < .001), and standing long jump (F(3, 601) = 12.03, p < .001). There were no significant differences in BMI between the groups (F(3, 610) = 0.08, p = .970). The odds for the low active group were two times higher to report recurrent headaches at the second measure compared to the consistently active ones.

Conclusion
Participating in sports regularly from adolescence to early adulthood is associated with the strongest health benefits. Nevertheless, those who were less active initially but increased their sports activity had similar health outcomes, highlighting the importance of sports activity as part of a healthy lifestyle in young adulthood.
Protein phosphatase 1 regulatory subunit 15 A (PPP1R15A) promoted the progression of gastric cancer by activating cell autophagy under energy stress
Authors: Cui Yingnan , Cao Xueyuan , Zhang Yangyu , Fu Chenhao , Li Dongming , Sun Yuanlin , Zhang Yuzheng , Xu Tingshuang , Tsukamoto Tetsuya , Cao Donghui , Jiang Jing 
Published: February 2025

Abstract

Background
Glucose metabolism plays a critical role in tumor progression. When glucose intake is insufficient and the tumor’s growth rate exceeds its energy supply, tumor cells typically adapt and overcome the energy stress through compensatory mechanisms to maintain the survival of tumor cells, which may also be related to tumor recurrence or metastasis.

Methods
Different concentrations of glucose were selected as the basis for the energy stress model of gastric cancer. Then CCK-8 and flow cytometry were used to detect its effects on cell proliferation, apoptosis, and cell cycle. Differentially expressed genes (DEGs) were screened by RNA sequencing and the regulated pathways were identified by gene set enrichment analysis. The regulatory relationship between the gene PPP1R15A and its transcription factor JUN was proved by ChIP-qPCR and dual-luciferase reporter assay. The gain and loss of function assays were conducted to examine the effects of PPP1R15A under energy stress in vivo and in vitro. Potential regulatory mechanisms of PPP1R15A were further analyzed through a combination of online databases, RNA sequencing, and metabolite sequencing. The regulation of PPP1R15A on cell autophagy under energy stress was detected by western blot, transmission electron microscope, mRFP-GFP-LC3 adenovirus and laser scanning confocal microscopy.

Results
PPP1R15A and the transcription factor JUN were significantly upregulated by glucose deprivation (0 mM vs. 25 mM), JUN combined with the promoter of PPP1R15A and activated its expression. Both PPP1R15A and JUN were highly expressed in gastric cancer tissues and were independent risk factors for prognosis in the gastric cancer cohort. Overexpression of PPP1R15A promoted cell proliferation, inhibited apoptosis, and was involved in cell cycle arrest. Further RNA and metabolite sequencing suggested that PPP1R15A was associated with cell autophagy. In vitro experiments confirmed that both glucose deprivation and overexpression of PPP1R15A promoted the biosynthesis of autolysosome and autophagosome, and activated the cleavage of LC3 complex in gastric cancer cells. Moreover, PPP1R15A knockdown inhibited cell autophagy induced by glucose deprivation.

Conclusions
PPP1R15A sustained the survival of gastric cancer cells by regulating autophagy under energy stress to resist or adapt to harsh environments.
Intraoperative hemodynamic management in abdominal aortic surgery guided by the Hypotension Prediction Index: the Hemas multicentric observational study
Authors: Giustiniano Enrico , Nisi Fulvio , Ferrod Federica , Lionetti Giulia , Viscido Cristina , Reda Antonio , Piccioni Federico , Buono Gabriella , Cecconi Maurizio 
Published: February 2025

Abstract

Background
Intraoperative hypotension (IOH) during non-cardiac surgery is closely associated with postoperative complications. Hypotensive events are more likely during major open vascular surgery. We prospectively investigated whether our institutional algorithm of cardiocirculatory management, which included the Hypotension Prediction Index (HPI), a predictive model of hypotension of the Hemosphere™ platform (Edwards Lifescience, Irwin, CA, USA), was able to reduce the incidence and severity of intraoperative hypotension during open abdominal aortic aneurysm repair.

Methods
A multi-center observational study was conducted at IRCCS-Humanitas Research Hospital (Milan) and AO Mauriziano Umberto I Hospital (Turin) between July 2022 and September 2023, enrolling patients undergoing elective open abdominal aortic aneurysm repair. A hemodynamic protocol based on the Acumen-HPI Hemosphere™ platform was employed, integrating advanced parameters (e.g., HPI, Ea-dyn, dP/dt) and tailored interventions to minimize intraoperative hypotension. The primary endpoint was cumulative intraoperative hypotension time < 10% of surgical time, with secondary endpoints including incidence of hypotensive events, time-weighted averages of MAP < 65 mmHg (TWA65) and < 50 mmHg (TWA50), and postoperative complications.

Results
We enrolled 53 patients submitted to open abdominal aortic repair. The primary endpoint (time in hypotension < 10%) was successfully reached: 5 [1–10] %. The targeted time-weighted average (< 0.40 mmHg) both for MAP < 65 mmHg (TWA65) and MAP < 50 mmHg (severe hypotension; TWA50) were reached: TWA65 = 0.26 [0.04–0.65] mmHg and TWA50 = 0.00 [0.00–0.01].

Conclusions
Our hemodynamic management algorithm based on the HPI and other parameters of the Hemosphere™ platform was able to limit the incidence and severity of intraoperative hypotension during open abdominal aortic repair.

Trial registration
NCT05478564.
General anaesthesia in special care dentistry: Part 3. case series
Authors: Yeo Xin Hui , Gillway Daniel , Kahatab Ahmed , Doshi Mili , Shehabi Zahra , Geddis-Regan Andrew 
Published: February 2025

General anaesthesia is frequently used to provide comprehensive dental care to the varied groups of patients treated in special care dentistry services, as discussed in Parts 1 and 2 of this case series. General anaesthesia provision also offers an opportunity for multidisciplinary team working to support holistic patient care, particularly if investigations are difficult, impossible or compromised owing to patient factors. Thorough patient assessment and consideration, as well as a collaborative approach between the different teams, are required for successful patient-centred care. Reasonable adjustments are often crucial for special care patients, requiring thoughtful planning and consideration from admission to safe discharge. This article presents five case examples of the use of general anaesthesia to provide dental care in complex circumstances. CPD/Clinical Relevance: Examples are presented of how the use of general anaesthesia in special care dentistry requires careful consideration and planning.
Examining the flavor descriptors of e-cigarettes, heated tobacco products, and nicotine pouches in the Philippines: Regulatory challenges and opportunities
Authors: Ackary Samantha J. , Cabrera Patrik James D.L. , Santiago Alen Josef A. , Amul Gianna Gayle H. 
Published: February 2025

In the Philippines, the regulation of e-cigarettes, heated tobacco products (HTPs), and nicotine pouches under Republic Act 11900 or the Vape Law is crucial as their use continues to rise. As e-cigarettes are rapidly gaining popularity due to their social appeal, perceived novelty, ever-changing flavors, and sensations that are attractive to consumers, HTPs and nicotine pouches are continuously developing as well. This study aims to characterize e-cigarette, HTP, and nicotine pouch flavor descriptors in the Philippines and to assess the regulatory implications of existing policies regulating these products. We adapted the Tobacco Pack Surveillance System (TPackSS) data collection protocol developed by the Institute for Global Tobacco Control and employed both inductive and deductive thematic analyses to categorize flavor descriptors from 278 e-cigarette, HTP, and nicotine pouch products. We identified 11 categories of flavor descriptors: colors (18.08%), fruits (15.07%), codes or acronym-like descriptors (13.70%), concept descriptors (12.05%), menthol (10.96%), beverages (9.86%), sweet (8.22%), miscellaneous (5.48%), pop culture (3.56%), tobacco (2.47%), and nuts (0.55%). We also examined the flavor imagery, marketing tactics, and promotional strategies on these products. To effectively regulate e-cigarettes, HTPs, and nicotine pouches, we recommend streamlining their governing policies. Establishing a complete flavor ban on appealing flavors, descriptors, and imagery is crucial to curbing use. Additionally, increasing taxation and implementing plain packaging can reduce the marketing appeal of these products, thereby enhancing prevention and control efforts.