bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and recurrence rates of spontaneous pneumothorax in patients with diffuse cystic lung diseases in China
Authors: Wang Rui , Chen Xianmeng , Xu Shicheng , Jiang Xianliang , Liu Jinli , Liu Xuehan , Ryu Jay H. , Hu Xiaowen 
Published: February 2025

Abstract

Objectives
To investigate the prevalence and recurrence rates of spontaneous pneumothorax (SP) in patients with diffuse cystic lung diseases (DCLDs).

Methods
We retrospectively identified and analyzed medical records of patients with DCLDs encountered at the First Affiliated Hospital of University of Science and Technology of China from Jan 1, 2017 to December 31, 2023.

Results
A total of 289 patients were identified with DCLDs; 212 females and 77 males, with a median age of 48 years (range, 18–81 years). Among them, 89 (31%) patients had experienced SP; 59% among 115 patients with Birt-Hogg-Dubé (BHD), 34% of 41 patients with lymphangioleiomyomatosis (LAM, all women), 36% of 11 patients with pulmonary Langerhans cell histiocytosis (PLCH), none of 57 patients with Sjögren’s syndrome-associated diffuse cystic lung disease (SS-DCLD), and 5% of 65 patients with no identifiable underlying disease (χ² = 90.585, P < 0.001). The overall recurrence rate of SP was higher with observation or chest tube placement strategy compared to surgical intervention, 59% vs. 11% (P < 0.001, 95% CI [0.1, -0.4]), respectively. The recurrence rate after surgical management was significantly lower compared to conservative management in patients with BHD (10% vs. 69%, P < 0.001, 95% CI [0.1, 0.3]) and LAM (20% vs. 57%, P = 0.322, 95% CI [0.1, 2.1]). Among patients with BHD, LAM, and PLCH, those who had pneumothorax as the initial presentation were diagnosed of their underlying disease at a significantly younger age (42.2 ± 13.0 years) compared to those without pneumothorax (48.1 ± 11.8 years) (P = 0.032, 95% CI [-8.24, -0.36]). Notably, eight of LAM patients who were treated with sirolimus after the initial SP did not experience recurrence of SP.

Conclusion
The risk of SP secondary to DCLDs was highest in patients with BHD, followed by those with PLCH and LAM. It was extremely low in SS-DCLD. Pneumothorax as the initial presentation often facilitated diagnosis of the underlying disease. Surgical treatment was associated with a lower recurrence rate of SP compared to nonsurgical management. In addition, sirolimus therapy may reduce the risk of pneumothorax recurrence in patients with LAM.
Fabrication of zein nanofibrous scaffold containing Scrophularia striata extract for biomedical application
Authors: Salahshour Yasin , Rastegarzadeh Saadat , Motamedi Hossein , Hoveizi Elham 
Published: February 2025

Abstract
Skin wounds have the potential to rapidly become infected, with bacteria having the ability to quickly penetrate to the skin’s deeper layers. Then they enter the lymph nodes and spread throughout the body; therefore, all wounds should be cleaned and have a permanent cover. Modern wound dressings with effective antibacterial and therapeutic properties are required to create a sterile environment for the acceleration of healing. The aim of this work was to prepare zein electrospun nanofibers containing Scrophularia striata extract for wound healing promotion. Electrospun nanofibers made of zein, a natural polymer, have attracted a lot of attention due to their biocompatibility and biodegradability. The prepared nanofibers were characterized by scanning electron microscopy (SEM), energy dispersive X‑ray analysis (EDX), water contact angle test, and Fourier transform infrared spectroscopy (FT-IR). The parameters affected by the electrospinning process were investigated and optimized. The results revealed that the zein nanofibers (25% w/v, zein) containing Scrophularia striata extract (6.7% w/v) had a smooth and bead-free morphology with improved surface hydrophilicity. The measurement of water contact angle confirmed that nanofibers containing extract showed higher wettability (64.9°) compared to fibers without extract (119.8), so the proposed mat adequately moisturizes the wound environment. The antimicrobial studies show that Scrophularia striata extract incorporated nanofibers has the ability to inhibit the growth of both gram-negative and gram-positive bacteria. The biophenols release profile indicated that nanofibrous mat can release more effective substances to promote wound healing. The biocompatibility and biodegradability of nanofibrous scaffold containing Scrophularia striata extract tested in in vivo and in vitro conditions show a significantly higher survival rate of fibroblast cells. In addition, macroscopic and histological observations confirmed that the implanted nanofibers containing the extract did not exhibit any signs of inflammation or redness after a month when inserted beneath the skin of mice surrounded by vessels containing epidermis.

Graphical Abstract
Ixekizumab as a successful treatment in pediatric generalized pustular psoriasis
Authors: Esposito Maria , Antonetti Paolo , Vagnozzi Emanuele , De Berardinis Andrea , Bertelli Roberta , Brancati Francesco , Fargnoli Maria Concetta 
Published: February 2025

Abstract

Background
Generalized Pustular Psoriasis (GPP) is an autoinflammatory, multisystemic disease, characterized by widespread eruption of neutrophilic pustules on erythematous base, accompanied by systemic symptoms such as fever, leukocytosis, arthralgia, and general malaise. Globally, the disease is rare, particularly in children. If not adequately diagnosed and treated, systemic inflammation and multiorgan involvement can be life-threatening. The pathogenesis of GPP mainly involves the innate immune system, with inflammatory processes and neutrophil activation driven primarily by IL-36, but also by IL-1, TNF-alpha, IL-17 A. In particular, IL-17 A acts as a potent inducer of neutrophil recruitment. We report the case of a 7-years-old girl with GPP successfully treated with Ixekizumab, an IL-17 A antagonist.

Case presentation
A 7-years-old girl with an history of plaque psoriasis came to our attention for the sudden appearance of erythematous patches surmounted by pustules on the trunk and lower limbs, following repeated episodes of purulent tonsillitis. We started therapy with cyclosporine at a dosage of 3,5 mg/kg/day, with no clinical benefit and progression of manifestations to a sub-erythrodermic state after 2 weeks. Blood tests showed neutrophilic leukocytosis, and the patient experienced hyperpyrexia and malaise. Since ixekizumab was recently approved for pediatric use in patients with moderate to severe plaque psoriasis, we started therapy with 80 mg Ixekizumab, combined with prednisone at a dosage of 12.5 mg/day, gradually tapered until discontinuation after 15 days. A second dose of Ixekizumab 40 mg was administered at week-4, according to the indication of ixekizumab in pediatric plaque psoriasis. At week-8 the patient achieved complete remission of skin manifestations and normalization of blood count. After achieving a stable remission, at week 36 we decided to increase the administration interval to 6 weeks. The patient is still on therapy with ixekizumab 40 mg every 6 weeks, maintaining complete remission during a 52-week follow-up, without safety concerns.

Conclusions
This report supports the use of ixekizumab as a safe and effective option, both in the short and long-term, in the treatment of GPP, even at pediatric age. Larger studies are needed to confirm this positive, real-life experience.
Clinical features of intracardiac thrombotic complication in patients with severe Mycoplasma pneumoniae pneumonia
Authors: Li Xiao , Zhai Bo , Tang Yu , Zhang Lei , Wang Jing , Xu Chunna , Dong Lili , Wang Yanqiong , Su Yanyan , Dong Zhen , Yang Haiming , Shen Yuelin 
Published: February 2025

Abstract

Background
Intracardiac thrombus (ICT) is the rarest yet most severe complication of severe Mycoplasma pneumoniae pneumonia (SMPP) in children. This study aims to elucidate the clinical characteristics of patients with SMPP-related ICT.

Methods
We retrospectively enrolled 68 children with SMPP (18 cases of ICT, 50 cases of non-ICT) who were admitted from January 2014 to January 2024. We compared their demographic data, clinical symptoms, laboratory tests, imaging findings, treatment strategies, and prognoses. Additionally, we summarized data from 33 confirmed SMPP-related ICT cases reported in 12 references.

Results
In our cohort, the ICT group exhibited higher incidences of tachypnea, chest pain, inflammation, and elevated D-dimer levels. They also presented more severe radiological findings and had longer hospital stays compared to the non-ICT group. The chordae tendineae-attached was the most common type (61.1%). Pathological examinations revealed ICT sizes ranging from 480 to 31,500 mm³. A favorable prognosis was observed in 94.4% of ICT patients. Clinical features did not significantly differ between various ICT types. In the overall cohort (51 cases), the right ventricle was the predominant location (68.6%). Notably, 66.7% of patients had concurrent extracardiac thrombosis, with pulmonary thrombosis being the most common subtype (41.2%).

Conclusions
The clinical characteristics of SMPP-related ICT are non-specific, often coexisting with severe pulmonary lesions and significantly elevated inflammatory markers. All ICT types were chordae tendineae or wall-attached, rather than mobile. These findings suggest that an inflammation storm induced by SMPP may play a significant role in the pathogenesis of in situ thrombosis within the heart and major blood vessels.
Early diagnosis of hereditary angioedema in children: genetic testing should be prioritized
Authors: Bocquet A. , Pagnier A. , Boccon-Gibod I. , Defendi F. , Dumestre-Perard C. , Hardy G. , Bouillet Laurence 
Published: February 2025

Abstract

Background
When a member of a family has been diagnosed with hereditary angioedema (HAE) before a child is born, the question of early diagnosis arises. Indeed, the first attacks may occur at birth. Early diagnosis is complicated by biological issues. Due to the immaturity of the complement system, C1 Inhibitor (C1 INH) and C4 levels can be low at birth, generally in the range of 60 to 100% of adult reference values. Like most complement proteins, their levels generally normalize after one year of life. However, this is not always the case, and we report two counter-examples here.

Case presentation
A woman with well-documented HAE due to type II C1 INH deficiency gave birth to two children 4 years apart. Functional C1 INH assays performed at 8 and 7 months of age returned normal C1 INH inhibitory activity. However, a genetic exploration revealed the presence of the mother’s pathogenic gene variant in both children. Subsequent monitoring of C1 INH activity at 3 and 4 years of age confirmed a pathological reduction in C1 INH inhibitory activity.

Conclusion
For the early detection of HAE in children, these cases lead us to recommend genetic testing for the index parent’s pathological variant rather than reliance on results of C1 INH assays.
Stability and Hopf bifurcation of a predator-prey model with Smith growth rate and Monod–Haldane functional response
Authors: Feng Xiaozhou , Li Kunyu , Liu Mengyan , Wang Lin , Wang Tonghui 
Published: February 2025

Abstract
This paper focuses on the qualitative analysis of the diffusive Monod–Haldane predator-prey model with Smith growth rate under Neumann boundary condition. First, the stability of the solution of corresponding ODE system is studied, and then the Hopf divergence direction and the stability of periodic solutions are given. Then considering the non-uniform distribution of populations in nature, by standard linear operator theory and center manifold theorem, the Turing instability and the Hopf bifurcation of the PDE system with diffusion effects is analyzed. Finally, the theoretical calculation results are verified by numerical simulations. It can be observed that the variation of Smith growth rate and diffusion coefficient within a certain range can increase the complexity of the model.
Low-cost extraction of multifaceted biological compounds from citrus waste using enzymes from Aspergillus Niger LBM 134
Authors: Díaz Gabriela Verónica , Coniglio Romina Olga , Ortellado Laura Ester , Zapata Pedro Darío , Martínez María Alejandra , Fonseca María Isabel 
Published: February 2025

Abstract
Agricultural industries search for biotechnological alternatives for waste management as they mean a significant concern and environmental challenge. More importantly, within a circular economy concept, such secondary substrates can be used to produce value-added compounds. This work is aimed at obtaining bioactive compounds from citrus waste by using a homemade enzymatic cocktail from Aspergillus niger LBM 134. The fungal enzymes were produced using raw sugarcane bagasse as substrate, which increased the ecological sustainability and the cost-effectiveness of the bioprocess. As the most relevant enzyme of this cocktail, a β-glucosidase showed to optimally act at 50 °C, retaining up to 70% of residual activity after 72 h. By means of an optimized enzyme-assisted extraction, the crude enzymatic cocktail produced was efficiently employed to extract the phenolics hesperetin, quinic, p-coumaric, and gallic acid, and the bioactive amino acid tryptophan from citrus waste. These assays yielded approximately 112% and 30% of phenolic compounds over alkaline conventional and commercial enzyme extraction methods, respectively.

Graphical Abstract
Assessment attendance and treatment engagement with talking and internet-enabled therapies of people with and without a long-term physical health condition: analysis of Talking Therapies service data
Authors: Jenkinson Emma , Hackett Ruth A. , Moss-Morris Rona , Wong Grace , Wheatley Jon , Cirkovic Mirko , Hudson Joanna 
Published: February 2025

Background
Research indicates that treatment outcomes are poorer for people with long-term physical health conditions (LTCs) in Talking Therapies services (formerly known as Improving Access to Psychological Therapies). However, the impact of having an LTC on attendance at assessment and treatment appointments within Talking Therapies remains unclear. Internet-enabled therapies may be one way to overcome barriers to treatment engagement in Talking Therapies. However, their effect on engagement and the influence of LTC status on receipt of internet-enabled therapies is unknown.

Aims
To explore the association between LTC status and assessment attendance, treatment engagement and internet-enabled therapy receipt within Talking Therapies services, and whether receipt of internet-enabled treatment bolsters engagement.

Method
We used anonymous patient-level data from two inner London Talking Therapies services during January to December 2022 (n = 17 095 referrals). Binary logistic regression models were constructed to compare differences between LTC and non-LTC groups on (a) assessment attendance, (b) engagement and (c) internet-enabled therapy receipt. In our regression models, we controlled for key clinical and demographic covariates.

Results
There were no differences between patients with or without an LTC in assessment attendance or treatment engagement, after controlling for covariates. Across the whole sample, receiving internet-enabled treatment increased engagement. People with an LTC were less likely to receive an internet-enabled treatment.

Conclusions
Having an LTC does not negatively affect assessment attendance and engagement with talking therapies. However, receiving an internet-enabled treatment bolstered engagement in our regression models. People with an LTC were less likely to receive internet-enabled treatment.
Anti-obesity pharmacotherapy for patients with genetic obesity due to defects in the leptin-melanocortin pathway
Authors: Welling Mila S , van Rossum Elisabeth F C , van den Akker Erica L T 
Published: February 2025

Abstract
Lifestyle interventions are the cornerstone of obesity treatment. However, insufficient long-term effects are observed in patients with genetic obesity disorders, as their hyperphagia remains untreated. Hence, patients with genetic obesity often require additional pharmacotherapy to effectively manage and treat their hyperphagia and obesity. Recent advancements in anti-obesity pharmacotherapy have expanded the range of available anti-obesity medications (AOM). This includes the targeted AOM setmelanotide, approved for specific genetic obesity disorders, as well as non-targeted AOMs such as naltrexone-bupropion and glucagon-like peptide-1 analogues. Targeted AOMs have demonstrated significant weight loss, reduced obesity-related comorbidities, and improved hyperphagia and quality of life in patients with genetic obesity. Small observational studies have shown that similar benefits from non-targeted AOMs or off-label pharmacotherapies can be achieved in patients with specific genetic obesity disorders, compared to common multifactorial obesity. In the future, novel and innovative pharmacotherapeutical options, including combination therapies and possibly gene therapy, will emerge, offering promising effects on body weight, hyperphagia, and, most importantly, quality of life for patients with a variety of genetic obesity disorders.
Risk factors for valgus subsidence in uncemented medial unicompartimental knee arthroplasty
Authors: Gallant Alexander , Vandekerckhove Pieter-Jan , Beckers Lucas , De Smet Arne , Depuydt Cedric , Victor Jan , Hardeman François 
Published: February 2025

AimsValgus subsidence of uncemented tibial components following medial unicompartmental knee arthroplasty (UKA) poses a challenge in the early postoperative phase, necessitating a comprehensive understanding of its prevalence, risk factors, and impact on patient outcomes.MethodsThis prospective multicentre study analyzed 97 knees from 90 patients undergoing UKA across four participating hospitals. A standardized surgical technique was employed uniformly by all participating surgeons. Postoperative evaluations were conducted preoperatively, and one day, four weeks, three months, and one year postoperative, encompassing weightbearing radiographs, bone mineral density assessments, and clinical outcome reports using the Forgotten Joint Score and Oxford Knee Score. Statistical analyses, including non-parametric correlation analysis using the Kendall correlation coefficient and Mann-Whitney U test, were performed to explore associations between subsidence and various patient-related or radiological parameters.ResultsA total of eight patients showed more than 2° valgus subsidence (8.2%), higher than previously reported rates. There were significant correlations between subsidence and higher preoperative varus alignment of the tibia, larger adaptation of the preoperative varus to a postoperative neutral or valgus alignment, mediolateral undersizing of the tibial component, excessive lateral load of tibial component by more lateral position of femoral component relative to tibial component, a lower T-score, and female sex. Our study found no significant difference in pain scores between subsidence and non-subsidence groups at various postoperative milestones.ConclusionThese findings corroborate earlier suggested risk factors based on biomechanical models. Further research might provide the opportunity to identify high-risk groups preoperatively and adapt treatment strategies for these patients.Cite this article: Bone Jt Open 2025;6(2):178–185.
Correlation between baseline anion gap and early acute kidney injury in patients with acute pancreatitis in the intensive care unit: A single-center retrospective cohort study
Authors: Zhang Yaqing , Ma Haiping , Wang Rui , Li Li , Kong Qingwei , Hao Cuiping , Zhang Ying , Li Jinfeng 
Published: February 2025

Objective
Acute pancreatitis (AP) is an acute inflammatory disease that can lead to multiple system dysfunction, including acute kidney injury (AKI). AKI occurs in 10%-42% of AP patients, and studies have shown that early (48 hours) acute pancreatitis associated acute kidney injury (AP-AKI) can increases the risk of death in acute pancreatitis. Anion gap (AG) is a common index in clinical evaluation of acid-base imbalance and an important index in critically ill patients. The aim of this study was to investigate the relationship between baseline anion gap values and early acute kidney injury in patients with acute pancreatitis in intensive care unit.

Methods
Our data were derived from inpatients admitted to Beth Israel Deaconess Medical Center (BIDMC) in the United States between 2008 and 2019. A total of 4,017 adult patients with acute pancreatitis admitted to the ICU were enrolled in the study, and 475 were enrolled according to the exclusion and inclusion criteria. Only the baseline value and one day after arrival to the intensive care unit (ICU) were considered for all laboratory test values. According to previous literature and clinical significance, AG was divided into two groups: low value (< 16mmol/L) group and high value (≥16mmol/L) group, and logistics univariate and multifactor regression analysis was applied to verify the relationship between anion gap and AKI risk.

Results
Only 157 of the 475 AP cases had an AG level below 16 mmol/L, whereas 318 patients had an AG level over 16 mmol/L. Within 48 hours, 89 and 240 cases (56.7% and 75.5%) and the low- and high-AG groups had AKI. In AP cases, an elevated AG was related to an increased risk of AKI [odds ratio (OR) = 1.06, 95% confidence interval (CI): 1.03–1.1], and is a nonlinear relationship. When controlling for other factors, this correlation was still significant. Compared to the lower group, high-AG (≥16mmol/L) values can increase the risk of early acute kidney injury in patients with acute pancreatitis (OR = 2.35, CI: 1.57–3.53).

Conclusion
Anion gap (AG) is an independent risk factor for early acute kidney injury in patients with acute pancreatitis, and has a nonlinear relationship with 48-hour AKI. Higher AG(≥16mmol/L) values can significantly increase the risk of AP-AKI.