bluuebunny/crossref_metadata_2025_split huggingface dataset:
Study of vascular endothelial dysfunction in children with beta-thalassemia major before and after quercetin therapy
Authors: Al Zahraa Sherai Fatma , Mabrouk Maaly , Badraia Ibrahim , Hagag Adel , Elaskary Eman 
Published: February 2025

Abstract

Background
Beta-thalassemia stands as an autosomal recessive disorder that occurs as a result of a defect in the beta-globin chain synthesis of hemoglobin. Oxidative stress has a crucial role in the β-thalassemia pathophysiology. It occurs due to erythroid expansion along with ineffective erythropoiesis. The free hemoglobin oxidation generates reactive oxygen species (ROS), free heme, and iron, thus inducing membrane oxidative damage as well as vascular endothelial dysfunction. Quercetin has a crucial impact on enhancing endothelial dysfunction in thalassemia major. This work aimed to investigate endothelial dysfunction among children diagnosed as beta-thalassemia major by assessing serum level of some endothelial markers (thrombomodulin as well as human ROS) and assessing the quercetin’s therapeutic value in improving endothelial dysfunction by measuring the previous markers 12 weeks following therapy. This randomized placebo-controlled study involved 72 children developing transfusion-dependent β-thalassemia major. Their age range fell between 8 and 18 years. They were categorized into two equal groups: group I: received 12 weeks of quercetin therapy and group II: served as control group and received 12 weeks of placebo.

Results
Serum ferritin, C-reactive protein, and lactate dehydrogenase levels showed significantly lower values among patients after 12 weeks of quercetin therapy compared with controls. Pre-transfusion hemoglobin was significantly higher in patients after 12 weeks of quercetin therapy in comparison to controls. Frequency of transfusion was significantly less in patients after 12 weeks of quercetin therapy in comparison to controls. Serum levels of ROS and thrombomodulin showed significantly lower values among cases after 12 weeks of quercetin therapy in comparison to controls (p < 0.001). ROS and thrombomodulin respectively carried the sensitivity of 83.33% and 77.78% and specificity of 80.56% and 83.33% in predicting the outcome with cutoff value ≤ 1073 and 232.

Conclusions
Twelve weeks of 500-mg quercetin therapy had a potent role in decreasing iron overload and improving frequency of transfusion, oxidative stress ,and endothelial dysfunction in children with β-thalassemia major.
Self-Perceived Barriers to Pediatric Cancer Care in Sub-Saharan Africa: A Cross-Sectional Multinational Study
Authors: Stoeter Ole , Mezger Nikolaus C.S. , Koenig Tamara , Chokunonga Eric , Tessema Girum , Damise Adugna Fekadu , Makouanzi Alda Stevy , Majaliwa Esther , Ivanga Mahine , Kamate Bakarou , Gnahatin Franck , Nambooze Sarah , Ekanem Ima-Obong A. , Bernig Toralf , Liu Biying , Gupta Sumit , Kantelhardt Eva Johanna 
Published: February 2025

PURPOSE
The number of patients with childhood cancer (CC) in sub-Saharan Africa is expected to rise over the coming years. According to the WHO Initiative for Childhood Cancer, access to care is crucial and must be guided by the needs of patients and their families. Our study explored barriers to CC treatment from a patient's perspective to guide the health care providers.

METHODS
From February to September 2021, we conducted a multinational cross-sectional study with a sample from nine population-based cancer registries in nine sub-Saharan countries. Inclusion criteria comprised a cancer diagnosis according to the International Classification of Childhood Cancer, age 0-19 years, and year of diagnosis 2017-2019. A questionnaire was administered asking families about self-perceived barriers accessing surgery, radiotherapy, and chemotherapy. To assess associated factors, we conducted a multivariable regression analysis presenting the results as odds ratios (ORs).

RESULTS
A total of 224 patients with CC was included. The fear of treatment effects and the perceived (poor) health of the child were named most frequently as barriers for all treatment modalities (78.9% and 75.5%, respectively). For chemotherapy, respondents who indicated themselves as rich had lower odds of perceiving the (poor) health of the child as a barrier (OR, 0.06 [95% CI, 0.01 to 0.36]). For radiotherapy, long waiting time and (limited) availability in the country were more commonly barriers (OR, 7.53 [95% CI, 3.38 to 16.78]; OR, 11.11 [95% CI, 2.04 to 60.46], respectively) than for chemotherapy.

CONCLUSION
Despite known barriers such as the availability of therapy, our study additionally indicates the importance of the patients' and families' perceptions of the disease and its treatment. Further expanding measures of social support for affected families should be regarded as one of the main pillars to assure access to care.
Prognostic Modeling for Bone Sarcomas Based on a Large Prospective Cohort From a Tertiary Care Cancer Center in India
Authors: Bajpai Jyoti , Sarkar Laboni , Rath Sushmita , Pawar Akash , Chandrashekharan Arun , Panda Goutam , Jakar Dharmpal , Ghosh Jaya , Laskar Siddhartha , Rekhi Bharat , Khanna Nehal , Jose Jifmi , Ramdawar Mukta , Purandare Nilendu , Bhargava Prabhat , Chakrabarty Nivedita , Gala Kunal , Kembhavi Yogesh , Rangarajan Venkatesh , Banavali Shripad , Gupta Sudeep 
Published: February 2025

PURPOSE
Outcomes of adolescents and young adults (AYA) with bone sarcomas including osteosarcoma (OGS) and Ewing sarcoma (ES) are affected by various factors including inadvertent previous treatment and poor compliance. We aimed to develop a risk-scoring system derived and validated at a tertiary care cancer center in India.

METHODS
All AYA OGS and ES cases treated at our institute with OGS-12 and Ewing’s family of tumors-2001 (EFT-2001) protocols from 2011 to 2021 and 2013 to 2018, respectively, were prospectively analyzed. Weighted scores provided to each prognostic variable on the basis of approximate ratios of the beta coefficients of each factor in the multivariable model were summated to divide patients into three clinically discriminatory risk groups, validated by applying separately to derivation, validation, and whole cohorts.

RESULTS
Among 606 (81.0%) of 748 AYA with nonmetastatic OGS, significant factors included in the prognostic model were failure to complete protocol (hazard ratio [HR], 2.65), previous treatment (HR, 2.93), necrosis <90% (HR, 1.63), joint involvement (HR, 2.0), and serum alkaline phosphatase >median (204 U/L; HR, 1.63). Of 104 (39.5%) of 263 AYA with ES, significant factors were failure to complete protocol (HR, 2.84), previous treatment (HR, 6.37), necrosis <100% (HR, 8.73), and tumor size >8 cm (HR, 2.64). For 142 (38.8%) of 366 AYA with metastatic OGS, significant factors were failure to complete protocol (HR, 5.29), metastases not amenable to local treatment (HR, 1.96), necrosis <90% (HR, 1.96), and >10 metastases (HR, 2.44). For 38 (43.6%) of 82 AYA with metastatic extremity ES, significant factors were failure to complete protocol (HR, 3.88) and metastases not amenable to local treatment (HR, 10.6).

CONCLUSION
We developed simple, effective prognostic models for AYA with bone sarcomas with specific potential relevance for low- and middle-income countries.
The Morning After and the Mourning to Come
Authors: Rodriguez Matthew Elbert 
Published: February 2025

Abstract
This article reads Hervé Guibert’s 1989 novella Fou de Vincent in dialogue with his writings on photography to analyze the novella’s representation of homosexual intimacy in the context of the HIV/AIDS epidemic. The peculiar narrative form of the novella—diary entries organized in reverse chronological order (“à l’envers”)—leads the reader to see the past through the lens of the present. By infusing the past with a sense of imminent loss, the novella reinscribes moments of intimacy (signified by the diaristic fragments that make up the text) as moments of anticipatory mourning. The motif of inversion (reading and looking “à l’envers”), as this article shows, relates directly to earlier texts by Guibert in which he writes about photography as a corruptible medium, as an art of imperfect preservation against the passage of time, and as a site of entanglement between viewer, photographer, and referent. Guibert’s lover Vincent, as an object of Guibert’s photographic attention, comes to signify the vulnerability of youth in an era of untimely death. Guibert’s diaristic writing preserves, in turn, his attachment to a fragile form of life and testifies to the ambivalence of looking back at the past in a time of personal and collective catastrophe.
Free Mediterranean
Authors: Kosmatopoulos Nikolas 
Published: February 2025

Abstract
How does Palestine solidarity alter thinking from the sea? How does the anticolonial insurgency in Palestine connect to and enhance international solidarity movements and other struggles against neocolonial formations at sea? Can we think of a solidarity-induced insurgency in saltwater, and can this insurgency take us beyond a focus on dry land, its material resources, and its cosmological meanings? Drawing on years of active involvement in and research on sea-centered movements of solidarity in the Mediterranean, including efforts to challenge the embargo in Gaza and to support border-crossing refugees, this essay argues that contemporary solidarity practices that crisscross the Mediterranean Sea relate directly to the politics of radical social change and, more generally, the question of anticolonialism today.
Asymmetric Power, Asymmetric Knowledge, and Solidarity
Authors: Rodríguez Patricia Cipollitti 
Published: February 2025

Abstract
Emancipatory social movement solidarities are prefigurative associations. While pursuing broad-based social transformations, solidaristic agents attempt to model—in an incomplete and provisional way—the social relations they wish to bring into existence. Existing structures of domination, deep-set and overlapping as they are, pose an abiding challenge to the prefiguration of just relations, however. This article considers the challenge of prefiguration by developing a diachronic, goal-oriented, and epistemic account of solidarity. The author argues that solidarity is a collaborative process whereby agents prefigure relationships of nondomination while working together to reach shared understandings about the political task at hand. The author examines two epistemologies that have not been traditionally connected to philosophical discussions of solidarity, philosophical hermeneutics and creolization, to elaborate the account. While both frameworks enable an understanding of solidarity as a properly transformative relation, creolization illuminates the possibilities and difficulties of collaborating under conditions of domination.
C2-P2 Bypass: Technical Assessment of Petrous Carotid Artery to Posterior Cerebral Artery Interpositional Bypass Through the Combined Transcochlear-Subtemporal Approach as a Part of Microsurgical Treatment for Dolichoectatic Vertebrobasilar Artery Aneurysms
Authors: Tayebi Meybodi Ali , Castillo Andrea L. , Gomez-Castro Gerardo , Lang Michael J. , Preul Mark C. , Lawton Michael T. 
Published: February 2025

BACKGROUND AND OBJECTIVES:
Managing dolichoectatic vertebrobasilar artery aneurysms requires a multifaceted approach. Revascularization of the posterior circulation with a high-flow bypass is part of the flow reversal paradigm. Performing a robust high-flow bypass and addressing the aneurysm through the same approach smooths the operative intervention. This study assessed the anatomic feasibility of accessing the basilar trunk and aneurysm simultaneously to revascularize the posterior circulation using a petrous internal carotid artery (pICA)-posterior cerebral artery (PCA) interpositional bypass through a complete petrosectomy.

METHODS:
Six embalmed cadaveric heads (12 sides) underwent a combined extended transcochlear-subtemporal approach to expose the pICA and P2 PCA. A pICA (side-to-end) graft (end-to-side) PCA bypass was attempted. The lengths of the vessels relevant to the bypass and the graft length were measured.

RESULTS:
The bypass was successfully completed in all specimens. The mean exposed lengths of the pICA and PCA were 21.3 and 20.0 mm, respectively. The mean length of the perforator-free zone on PCA was 11.2 mm. The mean length of the interposition graft was 36.6 mm.

CONCLUSION:
The transcochlear approach can be used to expose the pICA as a donor for a high-flow bypass to the PCA as part of the treatment paradigm for dolichoectatic vertebrobasilar artery aneurysms. Careful patient selection and extensive knowledge of skull base anatomy are mandatory for this strategy.
Psychiatric Symptoms in Acute Intermittent Porphyria - Case Report and Course of Treatment Using Placebo
Authors: Kosiba Waldemar , Prystacka-Szar Dominika , Siemko Jakub , Kupczak Wojciech 
Published: February 2025

Introduction:
Acute intermittent porphyria is a disease inherited in an autosomal dominant manner, occurring with a frequency of 1:75,000 people. The main symptom of the disease is paroxysmal, colicky abdominal pain, which is accompanied by neuropsychiatric symptoms. For some patients, psychiatric symptoms are the only symptom of the disease. In this paper, the case of a 43-year-old patient struggling with recurrent colicky abdominal pain and depressive and anxiety disorders, which intensify during exacerbation periods, is presented, featuring an ambiguous diagnosis of porphyria in previous laboratory tests. In the treatment, glucose infusions, morphine, psychiatric and psychological therapy were used - saline solution was administered as a placebo.
Aim:
The aim of this paper is to highlight the difficulties in diagnosing psychiatric symptoms during an acute attack of porphyria, which significantly complicate its treatment, and to consider the possibility of using placebo as one of the elements in the diagnostic and therapeutic plan in order to optimize treatment and avoid complications by using smaller doses of narcotic drugs.
Review methods:
A thorough analysis of research studies available on PUBMED was conducted using the following keywords: acute intermittent porphyria; porphobilinogen; depression; anxiety disorders; psychiatry; placebo. The medical history of a 43-year-old female patient, suspected of having acute intermittent porphyria due to recurrent abdominal pain and psychiatric symptoms, was also analyzed.
Conclusion:
Our case illustrates how psychiatric symptoms can complicate the diagnosis of acute intermittent porphyria. Failing to recognize acute porphyria also carries the risk of life-threatening complications and may lead to unnecessary pharmacotherapy and stigmatization as a mental illness. This case demonstrates that placebo can be one of the components of a diagnostic and therapeutic plan of acute intermittent porphyria.
Hypersonic wake velocity measurements using acetone molecular tagging velocimetry
Authors: Andrade Angelina , Shoemake W. Lawton , Willamson Chad O. , Stegmeier Nicholas W. , Posladek Kevin R. , Strasser Nathan S. , Hall Christopher L. , Olshefski Kristopher T. , Nutter Nicole F. , Glasby Ryan S. , Combs Christopher S. 
Published: February 2025

Molecular tagging velocimetry, a minimally intrusive laser diagnostic, was used to find quantitative off-body velocity measurements in the wake of both strut-mounted and free-flight spheres in hypersonic flow. Acetone gas seeded in the flow was excited using the fourth harmonic of a pulse-burst Nd:YAG laser. The experimental tests were validated and compared to simulations using a continuous Galerkin flow solver and an adaptive mesh refinement process. Near the centerline in the wake of the sphere, velocities between −105 and 65 m/s were observed due to reverse flow in the viscous shear layer. Similarly, the simulated data showed negative velocity values in the shear layer region. Outside of the shear layer, average velocities of 730 m/s were observed in both the experimental and simulated results. The overall average uncertainty for the strut-mounted and free-flight cases was estimated to have an accuracy of ±4% (±35.5m/s or 4.9%). This non-intrusive technique provides a velocity map of the wake behind a sphere under hypersonic conditions.
A SuperLearner-based pipeline for the development of DNA methylation-derived predictors of phenotypic traits
Authors: Khodasevich Dennis , Holland Nina , van der Laan Lars , Cardenas Andres 
Published: February 2025

Background
DNA methylation (DNAm) provides a window to characterize the impacts of environmental exposures and the biological aging process. Epigenetic clocks are often trained on DNAm using penalized regression of CpG sites, but recent evidence suggests potential benefits of training epigenetic predictors on principal components.

Methodology/findings
We developed a pipeline to simultaneously train three epigenetic predictors; a traditional CpG Clock, a PCA Clock, and a SuperLearner PCA Clock (SL PCA). We gathered publicly available DNAm datasets to generate i) a novel childhood epigenetic clock, ii) a reconstructed Hannum adult blood clock, and iii) as a proof of concept, a predictor of polybrominated biphenyl exposure using the three developmental methodologies. We used correlation coefficients and median absolute error to assess fit between predicted and observed measures, as well as agreement between duplicates. The SL PCA clocks improved fit with observed phenotypes relative to the PCA clocks or CpG clocks across several datasets. We found evidence for higher agreement between duplicate samples run on alternate DNAm arrays when using SL PCA clocks relative to traditional methods. Analyses examining associations between relevant exposures and epigenetic age acceleration (EAA) produced more precise effect estimates when using predictions derived from SL PCA clocks.

Conclusions
We introduce a novel method for the development of DNAm-based predictors that combines the improved reliability conferred by training on principal components with advanced ensemble-based machine learning. Coupling SuperLearner with PCA in the predictor development process may be especially relevant for studies with longitudinal designs utilizing multiple array types, as well as for the development of predictors of more complex phenotypic traits.
Differential risk of cardiovascular complications in patients with type-2 diabetes mellitus in Ghana: A hospital-based cross-sectional study
Authors: Obirikorang Christian , Adu Evans Asamoah , Afum-Adjei Awuah Anthony , Darko Samuel Nkansah , Ghartey Frank Naku , Ametepe Samuel , Nyarko Eric N. Y. , Anto Enoch Odame , Owiredu William Kwame Boakye Ansah 
Published: February 2025

Aim
To characterize clinically relevant subgroups of patients with type-2 diabetes mellitus (T2DM) based on adiposity, insulin secretion, and resistance indices.

Methods
A cross-sectional study was conducted at Eastern Regional Hospital in Ghana from July to October 2021 to investigate long-term patients with T2DM. To select participants, a systematic random sampling method was employed. Demographic data was collected using a structured questionnaire and fasting blood samples were taken to measure glycemic and lipid levels. Blood pressure and adiposity indices were measured during recruitment. The risk of cardiovascular disease (CVD) was defined using Framingham scores and standard low-density lipoprotein thresholds. To analyze the data, k-means clustering algorithms and regression analysis were used.

Results
The study identified three groups in female patients according to body mass index, relative fat mass, glycated hemoglobin, and triglyceride-glucose index. These groups included the obesity-related phenotype, the severe insulin resistance phenotype, and the normal weight phenotype with improved insulin resistance. Among male patients with T2DM, two groups were identified, including the obesity-related phenotype with severe insulin resistance and the normal weight phenotype with improved insulin sensitivity. The severe insulin resistance phenotype in female patients was associated with an increased risk of high CVD (OR = 5.34, 95%CI:2.11–13.55) and metabolic syndrome (OR = 7.07; 95%CI:3.24–15.42). Among male patients, the obesity-related phenotype with severe insulin resistance was associated with an increased intermediate (OR = 21.78, 95%CI:4.17–113.78) and a high-risk CVD (OR = 6.84, 95%CI:1.45–32.12).

Conclusions
The findings highlight significant cardiometabolic heterogeneity among T2DM patients. The subgroups of T2DM patients characterized by obesity and/or severe insulin resistance with or without poor glycemic control, have increased risk of CVD. This underscores the importance of considering differences in adiposity, insulin secretion, and sensitivity indices when making clinical decisions for patients with T2DM.
Cost drivers associated with autologous stem-cell transplant (ASCT) in patients with relapsed/refractory diffuse large B-cell lymphoma in a Japanese real-world setting: A structural equation model (SEM) analysis 2012–2022
Authors: Tsutsué Saaya , Makita Shinichi , Asou Hiroya , Wada Shingo , Lee Wen Shi , Ainiwaer Dilinuer , Idehara Koki , Aoyagi Sona-Sanae , Kim Seok-Won , Taylor Todd 
Published: February 2025

Diffuse large B-cell lymphoma (DLBCL) is the most prevalent non-Hodgkin lymphoma, with increasing incidence, in Japan. It is associated with substantial economic burden and relatively poor survival outcomes for relapsed/ refractory (r/r) DLBCL patients. Despite its association with economic burden and the relatively limited number of eligible patients in Japan as reported in previous real-world studies, Japanese clinical guidelines recommend stem-cell transplantation (SCT) for transplant-eligible r/r DLBCL patients. This is the first study to elucidate the total healthcare cost, associated cost drivers and healthcare resource use of SCT among patients with r/r DLBCL in a nationwide setting. The study design included a follow-up period of up to 24 months with subsequent lines of therapies using retrospective nationwide claims data from the Medical Data Vision Co., Ltd. Health Insurance Association from April 2012 to August 2022. Included patients had a confirmed diagnosis of DLBCL, received allogeneic SCT (allo-SCT) or autologous SCT (ASCT) after the first DLBCL diagnosis, and received high-dose chemotherapy during the 6-month look-back period. The results confirmed that no patients had allo-SCT, hence only ASCT was included in the analysis. Structural equation modeling was used to identify potential total healthcare cost drivers by evaluating direct, indirect, and total effects and provide a benchmark reference for future innovative therapies. A total of 108 patients (3.8%) among all DLBCL patients who received SCT met the eligibility criteria and were considered ASCT patients; majority of which were males (n = 63, 58.33%), with a mean [median] (SD) age of 52.04 [55] (9.88) years. A total of 15 patients (13.89%) received subsequent therapies. The most frequent subsequent therapy was GDP-based with or without rituximab (n = 8, 7.41%). The mean [median] (SD) number of follow-up hospitalizations on or after SCT-related hospitalizations was 1.66 [1] (1.36), with a mean [median] (SD) length of hospital stay being 36.88 [34] (12.95) days. The total mean [median] (SD) healthcare cost after adjustment incurred per patient per year during follow-up was $79,052.44 [$42,722.82] ($121,503.65). Number of hospitalizations and Charlson Comorbidity Index scores (+5) were the key drivers of total healthcare costs in patients with r/r DLBCL. Index years 2020–2022 and heart disease as a complication were other statistically significant factors that had positive effects as increase on total healthcare costs.