bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of a transient lack of dietary mineral phosphorus on renal gene expression and plasma metabolites in two high-yielding laying hen strains
Authors: Qasir Hiba , Reyer Henry , Oster Michael , Ponsuksili Siriluck , Trakooljul Nares , Sommerfeld Vera , Rodehutscord Markus , Wimmers Klaus 
Published: February 2025

Abstract

Background
There is an emerging body of evidence that current poultry feed is formulated in excess for phosphorus (P), which results in unnecessarily high P excretions. Sustainable concepts for agricultural P flows should trigger animal-intrinsic mechanisms for efficient P utilization. In the current study, Lohmann Brown (LB) and Lohmann Selected Leghorn (LSL) laying hens were fed either a high P diet (P+) with 1 g/kg mineral P supplement or a low P diet (P-) with 0 g/kg mineral P supplement for a period of 4 weeks prior to sampling. Before and after onset of laying, i.e., at 19 and 24 weeks of life, kidney and plasma samples were collected to investigate the endogenous P utilization in response to restricted dietary P, laying hen strain, and sexual maturation.

Results
Plasma analyses of minerals and metabolites confirmed the response to a low P diet, which was characterized by a significant reduction in plasma P levels at week 19 in both strains. The plasma calcium (Ca) levels were tightly regulated throughout the entire experimental period. Notably, there was a numerical trend of increased plasma calcitriol levels in P- fed birds of both strains compared to the P + group, which might have mediated a substantial role regarding the adaptive responses to low P supply. At week 19, RNA sequencing of kidney identified 1,114 and 556 differentially expressed genes (DEGs) unique to the LB and LSL strains, respectively. The number of DEGs declined with increasing maturity of the hens culminating in 90 and 146 DEGs for LB and LSL strains at week 24. Analyses revealed an enrichment of pathways related to energy metabolism and cell cycle, particularly at week 19 in both strains. The diet-specific expression of target genes involved in P homeostasis highlighted transcripts related to active (SLC34A1, SLC20A2) and passive mineral transport (CLDN14, CLDN16), Ca utilization (STC1, CALB1), and acid-base balance (CA2, SLC4A1).

Conclusions
Results suggest that both laying hen strains adapted to the lack of mineral P supplements and achieved a physiological Ca: P-ratio in body compartments through endogenous regulation as evidenced via the endocrine profile.
How can we enhance ‘real-time’ patient involvement in medical education? A qualitative study of patients and students
Authors: Alao Adedoyin , Burford Bryan , Alberti Hugh , Vance Gillian 
Published: February 2025

Abstract

Background
Patient contact is integral to undergraduate medical training. While political strategies emphasise the ‘patient’s voice’ in medical education, the literature on how to enhance the active involvement of real-time patients is sparse. Increased demands for real-time patient interactions in primary care poses a challenge for educators to provide adequate opportunities for students to learn. Evidence on how students may benefit from patients’ active involvement may inform the design and construction of teaching/learning encounters to optimise the educational value while maintaining positive patient experiences. This study aimed to identify how the involvement of real-time patients in medical education might be enhanced. It examined two research questions: •How does enhanced patient involvement support student learning in different areas of practice? • What can be done to enhance patients’ active involvement in medical students’ training to support those learning benefits?

Methods
We conducted focus groups with patients, workshops and interviews with medical students and analysed the data using codebook thematic analysis.

Results
Patient contact helped students develop their knowledge, clinical and interpersonal skills, professional values, confidence and sense of identity. Students learn by practising the role of a doctor, observing clinicians and reflecting on their experiences. Real-time patients provided experience of diversity, real-life stories and contextual variations that promoted learning. Patients would like to perform active roles, such as shaping encounters and providing explanations, feedback and emotional support to students. While such active involvement may provide learning opportunities for students, many patients were unable to perform active roles during their previous interactions with students. Patients’ active involvement may be facilitated by ensuring adequate introductions, good relationships and an explicit invitation.

Conclusion
The resulting model may form the basis for future research and interventions that encourage and support patients to actively participate in teaching consultations. [293 words]
Impact of a POCUS-first versus CT-first approach on emergency department length of stay and time to surgical consultation in patients with acute cholecystitis: a retrospective study
Authors: Huang Chien-Tai , Wang Liang-Wei , Lin Shao-Yung , Chen Tai-Yuan , Ho Yi-Ju , Wang Pei-Hsiu , Liu Kao-Lang , Wu Yao-Ming , Wang Hsiu-Po , Lien Wan-Ching 
Published: February 2025

Abstract

Objective
This study aims to evaluate the impact of point-of-care ultrasound (PoCUS) and computed tomography (CT) on emergency department (ED) length of stay (LOS) and time to surgical consultation in patients with mild acute cholecystitis (AC).

Methods
Adult patients with CT-confirmed grade I AC were retrospectively enrolled and divided into the PoCUS-first group and the CT-first group. The primary outcome was the relationship between the door-to-ultrasound (US)/CT time and ED-LOS. The secondary outcome was the relationship between the door-to-US/CT time and time to surgical consultation.

Results
A total of 1627 patients were included with 264 in the PoCUS first group. In the PoCUS group, door-to-US time was positively associated with ED-LOS (β = 0.27, p < 0.001) and time to surgical consultation (β = 0.36, p < 0.001). Similarly, door-to-CT time was also positively associated with ED-LOS (β = 0.21, p < 0.001) and time to surgical consultation (β = 0.75, p < 0.001) in the CT group. Conducting PoCUS within 60 min was associated with a reduced ED-LOS and time to surgical consultation, resulting in a saving of 22.4 h and 266 min, respectively. In the CT group, performing CT within 120 min was associated with a reduced ED-LOS and time to surgical consultation, resulting in a decrease of 12 h and 188 min, respectively. The ED-LOS and time to surgical consultation were similar between patients receiving PoCUS within 60 min in PoCUS group and those receiving CT within 120 min in the CT group.

Conclusions
Performing PoCUS within 60 min or CT within 120 min was associated with shorter ED-LOS and earlier surgical consultation, enhancing the ED efficiency in patients with mild AC.

Trial registration
: NCT04149041 at ClinicalTrial.gov.
Industry return predictability using health policy uncertainty
Authors: Pham Thach , Bannigidadmath Deepa , Powell Robert 
Published: February 2025

Abstract
This paper examines how a change in health policy uncertainty affects US industry returns using monthly data from January 1985 to September 2020. We employ in-sample and out-of-sample analyses, and we find evidence that 25 out of 49 considered industries are predictable during the health crisis periods, including severe acute respiratory syndrome and the ongoing coronavirus pandemic. The out-of-sample tests corroborate the evidence for the in-sample predictability. Furthermore, using a mean–variance utility function-based trading strategy, we observe that investors can use this simple tool for their trading strategies and make profits from 2.99 to 11.44% per annum. Our findings are robust after accounting for different business cycles, macroeconomic factor effects, the fluctuation in economic policy uncertainty, and different pandemic phases. These results complement the existing literature on industry return predictability and have potential implications for asset pricing and risk management.
Incorporating Structured and Unstructured Data Sources to Identify and Characterize Hereditary Cancer Testing Among Veterans With Metastatic Castration-Resistant Prostate Cancer
Authors: Candelieri-Surette Danielle , Hung Anna , Agiri Fatai Y. , Hu Mengke , Hanchrow Elizabeth E. , Lee Kyung Min , Chang Nai-Chung N. , Yin Ming , Shevach Jeffrey W. , Li Weiyan , Nelson Tyler J. , Gao Anthony , Pridgen Kathryn M. , Schoen Martin W. , DuVall Scott L. , Wong Yu-Ning , Lynch Julie A. , Alba Patrick R. 
Published: February 2025

PURPOSE
This study introduces an integrated approach using structured and unstructured data from an electronic health record to identify and characterize patient utilization of hereditary cancer genetic testing among patients with metastatic castration-resistant prostate cancer (mCRPC). Secondary objectives were to describe factors associated with the receipt of testing.

METHODS
This retrospective cohort study included a cohort of Veterans diagnosed with mCRPC from January 2016 to December 2021. Receipt of genetic testing was identified using structured and unstructured data. Time to testing, age at testing, and testing rate were analyzed. Sociodemographic and clinical factors associated with receipt of hereditary cancer genetic testing were identified including race, marital status, rurality, Charlson comorbidity index (CCI), and genetic counseling.

RESULTS
Among 9,703 Veterans with mCRPC who did not decline testing, 16% received genetic testing, with nearly half of the tests occurring in 2020-2021. Factors positively associated with genetic testing included receipt of genetic counseling (adjusted odds ratio [aOR], 11.07 [95% CI, 3.66 to 33.51]), enrollment in clinical trial (aOR, 7.42 [95% CI, 5.59 to 9.84]), and treatment at a Prostate Cancer Foundation-Veterans Affairs Center of Excellence (aOR, 1.43 [95% CI, 1.04 to 1.95]). Negative associations included older age (aOR, 0.95 [95% CI, 0.93 to 0.97]) and severe CCI score (aOR, 0.82 [95% CI, 0.71 to 0.94]). Trends revealed that time to testing decreased per diagnosis year while median age at testing increased per year.

CONCLUSION
Although testing rates are still suboptimal, they have increased steadily since 2016. Educating Veterans about the benefits of genetic testing may further improve testing rates.
Evaluation of quality and bone microarchitecture alterations in osteopetrosis patients: assessed by HR-pQCT
Authors: Zhou Ruotong , Pang Qianqian , Qi Xuan , Wu Yushuo , Chi Yue , Cui Lijia , Jiajue Ruizhi , Li Xiang , Li Mei , Jiang Yan , Wang Ou , Xing Xiaoping , Zhang Li , Xia Weibo 
Published: February 2025

Abstract

Context
Osteopetrosis (OPT) is a rare skeletal disease characterized by high bone mass that has two major inheritance patterns: autosomal dominant osteopetrosis (ADO) and autosomal recessive osteopetrosis (ARO). However, comprehensive descriptions of bone microarchitecture in OPT patients are limited.

Objectives
The aim of this study was to comprehensively investigate the bone microarchitecture of OPT patients, explore age-related bone alterations and describe the skeletal heterogeneity among different genotypes.

Methods
Nine OPT patients, including 7 ADO patients with CLCN7 mutations, 1 ARO patient with CAII mutation, and 1 ARO patient with TCIRG1 mutation, were retrospectively enrolled in this study. Clinical and biochemical examinations were performed. Bone microstructure was investigated by high-resolution peripheral quantitative computed tomography (HR-pQCT).

Results
Compared with age- and sex-matched healthy controls, OPT patients had greater total volumetric bone mineral density. In addition, trabecular bone was denser, with greater trabecular volumetric bone mineral density, increased trabecular number, and decreased trabecular separation. However, the cortical bone in OPT patients was weaker, characterized by increased cortical thickness and porosity. OPT patients exhibited characteristic patterns, including bone islets and uneven dense structures, on the representative reconstruction HR-pQCT images. Skeletal heterogeneity across different genotypes was observed, with looser cortical bone in one OPT patient with CAII mutation and thicker cortical bone in one OPT patient with TCIRG1 mutation.

Conclusions
Compared with healthy controls, OPT patients presented with denser trabecular bone, thicker but looser cortical bone, unique bone patterns and skeletal heterogeneity. These results provide new insights into bone alterations in OPT patients.
Reviewing the current treatment approaches for bullous pemphigoid – analysis of literature
Authors: Nowak Julia , Najdek Agnieszka , Oleksy Daria , Komada Dawid , Kaczmarska Urszula , Woźniak Aleksandra , Cioch Michał Jakub , Mycyk Marcin , Hermanowicz Kamil , Doman Katarzyna 
Published: February 2025

Bullous pemphigoid (BP) is an autoimmune blistering disorder primarily affecting the elderly, particularly older men, and is characterized by type 2 inflammation. The disease is defined by autoantibodies targeting BP180 (BPAG2) and BP230 (BPAG1) within the basement membrane zone. Advanced age is a significant risk factor for BP, with additional associations identified, including certain medications—such as dipeptidyl peptidase-4 inhibitors and aldosterone antagonists—and neurological disorders like Parkinson’s disease. The global annual cumulative incidence of BP is estimated at 8.2 cases per 1,000,000 individuals, with Europe reporting higher incidence rates than other regions. BP significantly impacts patients’ quality of life due to painful, pruritic skin lesions and is associated with a higher prevalence of psychiatric comorbidities, such as schizophrenia. BP increases the risk of complications, including pulmonary embolism and pneumonia, and is linked to high mortality. These findings highlight the need for early diagnosis and comprehensive management to improve patient outcomes.
Eagle Syndrome - the issue of an elongated styloid process. A literature review
Authors: Brzoza Martyna , Dubniański Bartosz , Stawińska-Dudek Julia , Józefowicz Wiktoria , Machaj Damian 
Published: February 2025

Introduction and purpose:
Since orofacial pain poses a common ailment nowadays, it is important to identify properly its source and implement all the necessary measures that are required to mitigate its consequences. Among a wide range of various medical conditions, Eagle Syndrome should be considered during differential diagnosis. The aim of this article is to have a thorough insight into the matter of this particular condition and expand knowledge based on scientific investigations discussed in literature.
The state of knowledge:
Eagle Syndrome is a condition which manifests either by an elongated styloid process or ossification of the stylohyoid ligaments which interfere with adjacent anatomical structures resulting in many different, often nonspecific, symptoms such as, for example, limited ability of jaw opening, increased salivary flow, foreign body sensation in pharynx as well as tinnitus. However, in majority of cases it is asymptomatic condition and may be detected incidentally during clinical examination. In order to ensure accurate diagnosis, thorough medical history and anamnesis are required as well as clinical and radiographic examination. Treatment methods that involve either conservative or surgical approach are selected depending on the severity of symptoms as well as patient’s general condition.
Conclusions:
Eagle Syndrome is a rare clinical condition that requires detailed and precise diagnostics as well as cooperation between healthcare professionals of various specialties in order to undertake proper measures regarding condition’s management. Therefore, knowledge in this field needs to be expanded and due to the complexity and nature of the Eagle Syndrome further studies are necessary to explore the matter more broadly.
Assessment of Subclinical Atherosclerosis in Patients with Psoriasis Using Echocardiographic Coronary Flow Reserve Parameters: A Systematic Review and Meta-Analysis
Authors: Jain Hritvik , Tariq Muhammad Daoud , Khan Abdul Moiz , Ahsan Areeba , Zulfiqar Eeshal , Shahnoor Syeda , Jain Jyoti , Ahmed Raheel , Odat Ramez M. , Wali Agha , Khan Rozi 
Published: February 2025

Aims/Background Psoriasis is a chronic inflammatory condition associated with an elevated risk of cardiovascular diseases including coronary artery disease (CAD). This study assessed coronary microvascular dysfunction (CMD) in psoriasis patients using echocardiographic coronary flow parameters, controlling for traditional cardiovascular risk factors and atherosclerosis, to fill gaps identified in previous research. Methods A comprehensive literature search was performed using multiple electronic databases for studies on echocardiographic coronary flow parameters in patients with psoriasis. The outcomes of interest included the coronary flow velocity reserve (CFVR), hyperemic diastolic peak flow velocity (DPFV), and baseline DPFV. Data were extracted and analyzed using RevMan 5.4 (Nordic Cochrane Center, Copenhagen, Denmark), with pooled standard mean differences (SMDs) and 95% confidence intervals (CIs) were calculated. Statistical significance was set at p < 0.05. Results Four studies involving 557 patients were included in this analysis. Pooled analysis revealed a significant reduction in CFVR in patients with psoriasis compared to controls (SMD: –0.71; 95% CI: –0.97, –0.45; p < 0.00001). Hyperemic DPFV was significantly reduced (SMD: –0.71; 95% CI: –1.30, –0.12; p = 0.02), whereas baseline DPFV showed no signficant difference (SMD: 0.20; 95% CI: –0.92, 1.32; p = 0.73). Conclusion Psoriasis was associated with reduced CFVR and hyperemic DPFV, suggesting early CMD. CFVR could aid in early CMD detection in psoriasis patients, informing cardiovascular risk management and potential anti-inflammatory treatment benefits. Systematic Review Registration PROSPERO: CRD42024574085 .
Interruption versus continuation of adalimumab during hidradenitis surgery: secondary wound healing and postoperative complications
Authors: Esme Pelin , Botsali Aysenur , Caliskan Ercan 
Published: February 2025

Objective: The combination of adalimumab and surgical interventions plays a crucial role in managing severe hidradenitis suppurativa (HS). However, there is still limited scientific evidence regarding administering adalimumab during the perioperative period. This study aimed to evaluate whether adalimumab could adversely affect postoperative complications and the total time of wound closure (TTWC) in patients undergoing cutaneous surgery for HS. Method: In this single-centre cohort study, patients with HS were allocated to two groups. Group 1 (biological cohort) consisted of patients with HS who had continuously received adalimumab for at least three months before the procedure. Group 2 (non-biological cohort) patients underwent cutaneous surgery after only four weeks of anti-inflammatory medication. All patients were left to secondary wound healing. Results: A total of 30 surgical sites in 20 patients were included in the study (Group 1: 15 surgical sites/nine patients; Group 2: 15 surgical sites/11 patients). Disease severity and excised skin areas were significantly higher in Group 1 (p<0.001 and p=0.042, respectively) than in Group 2. While the median TTWC was longer in Group 1 than in Group 2 (p=0.004), multivariate regression analysis showed that TTWC was associated with the excised skin area (p=0.016) and Hurley stage (p=0.032), but was not affected by the use of adalimumab (p=0.076). Conclusion: In this study, the use of adalimumab around surgery was not associated with an increased risk of postoperative complications or a prolonged course of wound closure. The results in this patient cohort suggest that adalimumab should not be discontinued during the perioperative period of HS surgery.
Metastatic pancreatic cancer with activating BRAF V600E mutations: A case report
Authors: Li Fang , Shen Feng 
Published: February 2025

BACKGROUND
Pancreatic cancer (PC) is a highly malignant tumor that is resistant to chemotherapy, radiotherapy and immunotherapy. Combination chemotherapy regimens are the standard first-line regimens for metastatic disease, with a median survival < 12 months. Although recurrent genomic alterations such as the BRAF V600E mutation have been reported in PC, evidence supporting the clinical effectiveness of molecularly guided targeted therapies is limited.
CASE SUMMARY
We report a case of a 33-year-old male who was referred to our department with weight loss of 5 kg in 2 months, anorexia and abdominal pain. Imaging showed extensive lesions involving the pancreas, liver, bones, muscles and lymph nodes accompanied by elevated carbohydrate antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA). Biopsy yielded a diagnosis of PC. Treatment with gemcitabine and nab-paclitaxel was initiated, but the disease progressed in < 2 months even though the patient’s general condition improved. Molecular testing revealed the presence of BRAF mutation. Dabrafenib/trametinib combination therapy was introduced, and the patient was treated for 2 months with a decrease in CA19-9 and CEA levels, but he died after 2 months of treatment.
CONCLUSION
BRAF alterations are infrequent in PC. This case highlights the significance of molecular profiling in patients with PC, especially in patients with a high tumor burden.
Efficacy of catheter-based ultrasound renal denervation in the treatment of hypertension
Authors: Ou Yi-Chao , Peng Xin-Yuan , Yang Jing-Xi , Chen Bo-Yu , Chen Peng-Fei , Liu Mao 
Published: February 2025

BACKGROUND
Hypertension (HTN) is a prevalent chronic health condition that significantly increases the risk of cardiovascular diseases-associated mortalities. Despite the use of antihypertensive medications, numerous patients fail to achieve guideline-recommended blood pressure (BP) targets.
AIM
To evaluates the efficacy of catheter-based ultrasound renal denervation (uRDN) for the treatment of HTN.
METHODS
Relevant studies were identified through searches in PubMed, Embase, the Cochrane Library, Web of Science, and China National Knowledge Infrastructure, with a cut-off date at April 1, 2024. A random-effects model was employed in this study to mitigate potential biases. The risk of bias for included studies was assessed using the Cochrane Risk of Bias assessment tool. Statistical analyses were conducted using Review Manager version 5.3. This meta-analysis incorporated four studies encompassing a total of 627 patients. The reporting bias of this study was deemed acceptable.
RESULTS
Compared to the Sham group, the uRDN group demonstrated a significant reduction in daytime ambulatory systolic BP (SBP) [mean difference (MD) -3.87 mmHg, 95% confidence interval (CI): -7.02 to -0.73, P = 0.02], office SBP (MD -4.13 mmHg, 95%CI: -7.15 to -1.12, P = 0.007), and home SBP (MD -5.51 mmHg, 95%CI: -8.47 to -2.55, P < 0.001). However, there was no statistically significant reduction observed in either 24-hour or nighttime ambulatory SBP levels. Subgroup analysis shows that uRDN can significantly reduce the SBP in patients with non-resistant HTN (MD -6.19 mmHg, MD -6.00 mmHg, MD -7.72 mmHg, MD -5.02 mmHg, MD -3.61 mmHg).
CONCLUSION
The current evidence suggests that uRDN may effectively reduce home, office, and daytime SBP in patients with HTN, particularly in those with non-resistant HTN.