bluuebunny/crossref_metadata_2025_split huggingface dataset:
Decoding mpox: a systematic review and meta-analysis of the transmission and severity parameters of the 2022–2023 global outbreak
Authors: Diaz Brochero Candida , Nocua-Báez Laura Cristina , Cortes Jorge Alberto , Charniga Kelly , Buitrago-Lopez Adriana , Cucunubá Zulma M 
Published: January 2025

IntroductionThe 2022–2023 mpox outbreak has been the largest in history. We aim to synthesise the key epidemiological parameters related to the dynamics, transmission, and severity of mpox (incubation period, serial interval, generation time, infectious period, basic (R0) and effective (R(t)) reproductive number, and case fatality rate (CFR)).MethodsSystematic review of observational studies in MEDLINE, EMBASE and other sources up to September 2023 (PROSPERO: CRD42023404503). Quality assessment using the Joanna Briggs Institute Critical Appraisal for case series, cross-sectional and cohort studies, and a designed quality assessment questionnaire for mathematical models. Meta-analysis was performed using a random effects model.ResultsFor transmissibility parameters, we estimated a pooled incubation period of 7.60 (95% CI 7.14 to 8.10) days and a pooled serial interval of 8.30 (95% CI 6.74 to 10.23) days. One study reported a generation time of 12.5 days (95% CI 7.5 to 17.3). Three studies reported presymptomatic transmission in 27–50% of paired cases investigated. R(t) varied between 1.16 and 3.74 and R0 varied between 0.006 and 7.84. The epidemic peaked between August and September 2022 in Europe and the Americas whereas transmission has continued in African countries. For severity parameters, we estimated a pooled CFR by continent: 0.19% (95% CI 0.09% to 0.37%) for the Americas and 0.33% (95% CI 0.15% to 0.7%) for Europe. For Africa, we found that the CFRs of countries associated with group I were higher (range 17–64%) than those associated with group IIb (range 0–6%).ConclusionPooled mpox serial interval was slightly larger than pooled incubation period, suggesting transmission occurs mostly postsymptom onset, although presymptomatic transmission can occur in an important proportion of cases. CFR estimates varied by geographical region and were higher in Africa, in countries linked with clade I. Our results contribute to a better understanding of mpox dynamics, and the development of mathematical models to assess the impact of current and future interventions.
Spinal cord demyelination predicts neurological deterioration in patients with mild degenerative cervical myelopathy
Authors: Al-Shawwa Abdul , Craig Michael , Ost Kalum , Anderson David , Casha Steve , Jacobs W Bradley , Evaniew Nathan , Tripathy Saswati , Bouchard Jacques , Lewkonia Peter , Nicholls Fred , Soroceanu Alex , Swamy Ganesh , Thomas Kenneth C , duPlessis Stephan , Yang Michael MH , Cohen-Adad Julien , Dea Nicholas , Wilson Jefferson R , Cadotte David W 
Published: January 2025

BackgroundDegenerative cervical myelopathy (DCM) is the most common form of atraumatic spinal cord injury globally. Clinical guidelines regarding surgery for patients with mild DCM and minimal symptoms remain uncertain. This study aims to identify imaging and clinical predictors of neurological deterioration in mild DCM and explore pathophysiological correlates to guide clinical decision-making.MethodsPatients with mild DCM underwent advanced MRI scans that included T2-weighted, diffusion tensor imaging and magnetisation transfer (MT) sequences, along with clinical outcome measures at baseline and 6-month intervals after enrolment. Quantitative MRI (qMRI) metrics were derived above and below maximally compressed cervical levels (MCCLs). Various machine learning (ML) models were trained to predict 6 month neurological deterioration, followed by global and local model interpretation to assess feature importance.ResultsA total of 49 patients were followed for a maximum of 2 years, contributing 110 6-month data entries. Neurological deterioration occurred in 38% of cases. The best-performing ML model, combining clinical and qMRI metrics, achieved a balanced accuracy of 83%, and an area under curve-receiver operating characteristic of 0.87. Key predictors included MT ratio (demyelination) above the MCCL in the dorsal and ventral funiculi and moderate tingling in the arm, shoulder or hand. qMRI metrics significantly improved predictive performance compared to models using only clinical (bal. acc=68.1%) or imaging data (bal. acc=57.4%).ConclusionsReduced myelin content in the dorsal and ventral funiculi above the site of compression, combined with sensory deficits in the hands and gait/balance disturbances, predicts 6-month neurological deterioration in mild DCM and may warrant early surgical intervention.
Mutational profile dynamics in follicular lymphoma and large cell transformation
Authors: Hesius Eva A M , Stevens Wendy B C , Stewart James P , Kroeze Leonie I , Spek Ellen van der , Issa Djamila , Nooijen Peet , Luijks Jeroen , Gonzalez David , Groenen Patricia J T A , Blijlevens Nicole M A , Spriel Annemiek B van , Brand Michiel van den 
Published: January 2025

AimsFollicular lymphoma (FL) is characterised by significant heterogeneity in both the clinical trajectories and the molecular profiles. This study aimed to investigate clonal dynamics in FL by analysing mutation profiles at various time points during the disease course including at histological transformation (HT), to gain insight into the mutational changes over time.MethodsWe retrospectively analysed 76 biopsies from 25 patients, including 13 cases with three or more FL biopsies and 12 cases with subsequent HT. Hybrid capture-based Next-Generation Sequencing (NGS) with the EuroClonality-NGS DNA capture (EuroClonality-NDC) assay was used to examine clonal rearrangements and mutations.ResultsA total of 204 (potentially) pathogenic mutations were identified. Only 40% of mutations remained stably present during a median follow-up period of 139 months (range 9–198).KMT2DandCREBBPwere the most frequently mutated genes at diagnosis, exhibiting relative stability in follow-up biopsies. Conversely,EZH2displayed a dynamic pattern of mutations gained and lost during the disease course. At HT, pathogenic mutations affectingB2M,MYCandTP53emerged. Changes in mutational burden were observed in both FL-sequential and diagnosis-transformation cohorts, with more pronounced changes in the latter.ConclusionsThis real-world study provides insights into the complex molecular pathogenesis of FL and HT. As targeted therapies emerge as treatment modalities, mutational profiles could influence treatment decisions in the future. Therefore, recognising the significant changes occurring in the mutational landscape of FL throughout the disease course is crucial.
Comparison of flow diverter alone versus flow diverter with coiling for large and giant intracranial aneurysms: systematic review and meta-analysis of observational studies
Authors: Abo Kasem Rahim , Hubbard Zachary , Cunningham Conor , Almorawed Hani , Isidor Julio , Samman Tahhan Imad , Sowlat Mohammad-Mahdi , Babool Sofia , Abodest Layal , Spiotta Alejandro M 
Published: January 2025

BackgroundLarge and giant intracranial aneurysms pose treatment challenges. The benefit–risk balance of flow diverters (FDs) alone versus FDs with coiling remains unclear. This study aimed to compare these two strategies.MethodsThis systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive search of PubMed, Embase, Scopus, Cochrane, and Web of Science was performed up to October 2024. Studies comparing FDs with or without adjunctive coiling in large/giant intracranial aneurysms were included. The primary outcome was complete aneurysm occlusion, defined by the Raymond–Roy Occlusion Classification. Additional outcomes included procedural and postprocedural complications. Data were analyzed using a random effects model.Results15 studies with 1130 patients were analyzed, with 557 in the FD alone group and 573 in the FD+coiling group. The meta-analysis revealed that FD+coiling significantly improved complete aneurysm occlusion rates (OR 1.59, 95% CI 1.06 to 2.40, P=0.03). While overall ischemic complications were significantly lower in the FD alone group, a sensitivity analysis showed no significant difference (OR 0.49, 95% CI 0.20 to 1.23, P=0.13). Subgroup analysis of fusiform aneurysms showed no significant difference in complete aneurysm occlusion rates (OR 1.10, 95% CI 0.50 to 2.40, P=0.82). Procedural and hemorrhagic complications did not differ significantly, and no publication bias was detected in the results.ConclusionsCombining FDs with coiling improved complete aneurysm occlusion rates in large and giant saccular intracranial aneurysms, although the impact on complications remains controversial. Further investigation into the benefit–risk ratio of this combined approach is warranted.
Cognitive changes in patients with relapse-free MS treated with high efficacy therapies: the predictive value of paramagnetic rim lesions
Authors: Boccia Vincenzo Daniele , Leveraro Elisa , Cipriano Emilio , Lapucci Caterina , Sirito Tommaso , Cellerino Maria , Rebella Giacomo , Nasone Lorenza , Boffa Giacomo , Inglese Matilde 
Published: January 2025

BackgroundHigh-efficacy disease-modifying therapies (HETs) have substantially improved multiple sclerosis (MS) management, yet ongoing cognitive decline remains a concern. This study aims to assess Symbol Digit Modalities Test (SDMT) changes in patients with stable relapsing-remitting MS (RRMS) treated with HETs and to evaluate the role of baseline MRI biomarkers as predictors of SDMT changes.MethodsConsecutive patients with RRMS treated with HETs underwent clinical, SDMT and MRI assessment at baseline with SDMT and clinical re-evaluation after 24 months. Patients presenting relapses or MRI activity (new T2 and/or gadolinium-enhancing lesions) during follow-up were excluded. Cognitive changes were defined using the 90% CI regression-based reliable change index methodology accounting for sex, age, education and baseline score. Baseline MRI examination included three-dimensional-sagittal Fluid Attenuated Inversion Recovery (FLAIR), T1-Magnetization Prepared - RApid Gradient Echo (T1-MPRAGE) and quantitative susceptibility mapping (QSM) for paramagnetic rim lesions (PRLs) and QSM-isointense lesions (ISO) assessment. Univariate and multivariable regression analyses were performed to predict SDMT changes.Results90 patients (mean age: 40.3 years, median Expanded Disability Status Scale: 2.0) were included. PRLs were present in 46 (51.1%) patients. After 24 months, 13 (14.4%) patients showed SDMT decline and 8 (8.9%) showed improvement. At multivariable analyses, PRLs were associated with higher risk of SDMT decline (β: 2.70, p: 0.02, OR: 14.82) while higher ISO lesion volumes were weakly associated with SDMT improvement (β: 0.07, p: 0.01, OR: 1.07).ConclusionsSDMT decline and improvement are detectable in patients with RRMS without clinical or MRI activity over 2 years. PRLs seem to predict SDMT decline in MS, underscoring the critical role of compartmentalised chronic inflammation in disease progression.
Trends to shorter diagnostic delay in spondyloarthritis patients during the last decades and association with clinical presentation: data from ASAS-COMOSPA study
Authors: Perez-Alamino Rodolfo , Maldonado-Ficco Hernan , Moltó Anna , Waimann Christian , Maldonado-Cocco José , Dougados Maxime , Landewé Robert , van der Heijde Désirée , Van den Bosch Filip 
Published: January 2025

BackgroundDiagnostic delay is one of the greatest challenges in spondyloarthritis (SpA). Better disease knowledge and more accessibility to new image technology could have a positive impact on time to diagnosis.ObjectivesThe objectives are (1) to evaluate trends in time to diagnosis in SpA patients during the last decades and (2) to determine the association between clinical presentation and diagnostic delay.MethodsCross-sectional, retrospective international study, including 3984 patients with SpA diagnosis.Statistical analysisDelay in diagnosis was calculated and patients were stratified according to decade of disease onset and initial clinical presentation. Multivariate logistic model, using an early diagnosis (≤2 years) as dependent variable was used. P value<0.05 was considered statistically significant. A possible interaction between decade of disease onset and initial clinical presentation was performed.ResultsThe overall median delay from disease onset to SpA diagnosis was 2.9 (p25−75=0.3–9.8) years. Diagnostic delay showed a progressive decrease during the last decades, patients with disease onset after 2010 showed a shorter delay in diagnosis than those with disease onset during 2000–2010 (m2.00 vs 0.41 years, p<0.01). Age at disease onset (OR 1.02), axial symptom (OR 16.25), peripheral arthritis (OR 6.81), decade at disease onset (OR 3.80) and extra-musculoskeletal manifestation (OR 2.89) were associated with an early diagnosis, while female gender (OR 0.66) was inversely associated.ConclusionsThe proportion of patients with early SpA diagnosis improve from 15% before 1980 to 88% when first symptoms occurred after 2010. Type and number of initial clinical presentation were independent predictors of time to diagnosis.
Sociocultural Attitudes Toward Appearance and Attitudes Toward Eating in Adolescents With Type 1 Diabetes: The Importance of Perfectionism
Authors: Ruiz-Aranda Desireé , Luque Ana , Russo Francesca , Fenollar-Cortés Javier 
Published: January 2025

Objective: Adolescents managing type 1 diabetes (T1D) are at increased risk of experiencing eating disorders (EDs). Identifying risk factors is essential to develop preventive strategies. This study examines the potential mediation value of self‐esteem and the perfectionism associated with EDs in the relationship between sociocultural attitudes toward appearance and eating attitudes related to EDs in a sample of adolescents with T1D.Methods: Forty‐six adolescents aged 12–17 years diagnosed with T1D participated in the current study. Sociocultural attitudes toward appearance, perfectionism associated with EDs, and self‐esteem were measured. Multiple and simple mediator analyses using the bootstrapping method with bias‐corrected confidence estimates were conducted.Results: Our results show that perfectionism associated with eating problems is not only related to sociocultural attitudes toward appearance and eating attitudes, but rather the relationship between these last two variables would be fully mediated by perfectionism.Conclusions: A high degree of perfectionism could be a risk variable when developing potential eating problems in T1D adolescents. Perfectionism and its self‐management would be a prominent factor that may help to design interventions developed for adolescents with diabetes who show behaviors that potentially conflict with eating. The clinical implications are discussed.
Contextual Neutralisation of Voicing in Maltese Obstruents
Authors: Avram Andrei A. 
Published: January 2025

This chapter explores the historical evolution of contextual voicing neutralization in Maltese obstruents, focusing on regressive voicing assimilation and word-final devoicing. By comparing Modern Maltese with its Arabic ancestor, evidence shows sporadic instances of spontaneous voicing and devoicing in earlier stages, transitioning to systematic phonological rules by the late 18th century. An analysis of texts, lexicons, and notarial records from the 15th to 18th centuries reveals that while early Maltese exhibited voiced obstruents and mixed clusters, regressive assimilation and word-final devoicing gradually became pervasive. Both rules, first attested in the 16th century, spread via lexical diffusion, affecting Semitic roots and Romance loanwords alike.
The study underscores the typological shift from unrestricted obstruent voicing contrasts in Arabic to the Maltese system characterized by regressive assimilation and word-final devoicing. This development challenges claims of direct inheritance from Sicilian Arabic, suggesting instead a Maltese-specific innovation. Despite some exceptions, such as non-integrated borrowings, these phonological rules persist synchronically in Modern Maltese.
The findings contribute to understanding the diachronic phonology of Maltese, highlighting its divergence from other Arabic varieties and its typological realignment. The study also emphasizes the importance of historical linguistic evidence in reconstructing phonological change and its implications for the interaction of Semitic and Romance components in Maltese.
Examining Heart Failure Informal Care Partners Using Person and System Levels and Domains: A Meta-Synthesis
Authors: Buck Harleah G. , Durante Angela , Howland Chelsea , Aldossary Heba , Bidwell Julie T. , Irani Elliane , Liebzeit Daniel , Massouh Angela , Abshire Saylor Martha , Stawnychy Michael A. , Graven Lucinda J. 
Published: January 2025

Background: Within the last decade, system and policy-level changes have driven substantial shifts in heart failure (HF) care from hospital to home, requiring greater support from informal care partners. What has not been examined is the state of the care partner science by person and system-level domains using qualitative studies to understand impact across multiple person and system levels. Objectives: (1) Identify by person and system levels and domain what is known about informal care partners and (2) Identify gaps in the caregiving science and suggest ways to move forward. Methods: This secondary analysis of a large HF systematic review is guided by the National Institute on Minority Health and Health Disparities and MIRACLE frameworks and uses meta-synthesis techniques with critical realist approaches to synthesize and interpret the themes across papers. Results: Using data from 46 papers and 1695 care partners, we identified patterns occurring across 6 domains (biological, behavioral, affective, physical/built environment, sociocultural environment, and healthcare system) and on 4 levels (individual, interpersonal, community, and societal). Existing research predominantly addressed affective and behavioral domains, followed by health system and sociocultural domains. Few studies focused on biological and physical/built environment domains, leaving large gaps in what is known about caregiving at the cellular (biological) and societal (community and societal) levels. Conclusions: HF caregiving continues to be studied at a very rudimentary level. This synthesis also reveals critical gaps in what is known about caregiving within the physical/built environment domain and at the community and societal levels.
Hepatic conditioning results in better lung endothelial cell preservation under hypoxic environment in vitro
Authors: Noda Kentaro , Atale Neha , Austin Taylor , Geller David A , Gerlach Jorg , Sanchez Pablo G. 
Published: January 2025

Background: as we look to extend ex vivo lung perfusion times (EVLP) to improve preservation, the metabolic activity of the lungs will require support from other organ functions. Active functional liver support, including detoxification, synthesis, and regulation, can improve lung preservation during EVLP. This study aimed to demonstrate the effects of hepatic conditioning of the EVLP perfusate on lung endothelium, via the receptor of advanced glycation end-products (RAGE)-nuclear-factor-κB (NF-κB) signaling in vitro. Methods: we performed in vitro experiments using human lung microvascular endothelial cells (HLMVECs), human hepatocytes, and perfusate (Steen solution). Four experimental groups: 1) fresh Steen (negative controls, NC), 2) EVLP’ed Steen control, this solution collected after 12 h of EVLP of human lungs, 3) hepatocyte conditioned EVLP’ed Steen (Hep-cond.), and 4) a RAGE inhibitor added in EVLP’ed Steen (RAGE inhibitor). HLMVECs were incubated in each testing condition and exposed to hypoxia (1% O2/8% CO2) for 24 h. Media were collected to investigate NF-κB signaling and endothelial glycocalyx damage. Results: HLMVECs incubated under hypoxia in EVLP’ed Steen showed significantly upregulated NF-κB signal and endothelial damage denoted by increased glycosaminoglycans and matrix metalloproteinase-2 activity among the groups. The Hep-cond. solution significantly attenuated those findings, while the RAGE inhibitor attenuated the NF-κB signal but not endothelial glycocalyx damage. Conclusion: Our study demonstrates that hepatic function incorporated into EVLP can ameliorate pulmonary endothelial cells injury under hypoxic normothermic perfusion exposure. Our data supports the concept of incorporating other organ functions into an organ perfusion platform, to enhance lung graft preservation.
Comparative evaluation of left atrial size in healthy cats measured by two-dimensional echocardiography and cardiovascular MRI
Authors: Wei Lirou , Li Jing , Ren Honglin , Fu Shiyi , Liu Yiting , Wu Yuhong , Liu Bo 
Published: January 2025

Objectives This study aimed to assess left atrial (LA) size in healthy cats using cardiovascular MRI (cMRI) and to compare this with LA size assessed by two-dimensional echocardiography. The hypothesis was that cMRI would accurately determine LA size in domestic cats. Methods A prospective comparative study was performed. Six healthy cats were selected for the study. Standard two-dimensional echocardiography was performed with and without general anaesthesia. cMRI was conducted under general anaesthesia. A comprehensive analysis of LA mass and function measurements was performed to determine the consistency and correlation of LA size and function indicators between two-dimensional echocardiography and cMRI. Results Our study found that intraobserver variability for cMRI measurements was lower than that for two-dimensional echocardiography. Compared with cMRI, echocardiography under anaesthesia significantly overestimated maximal LA volume (LAVmax_2D, P <0.01) and significantly underestimated minimal LA volume (LAVmin_2D, P <0.01). The LAVmin measured by two-dimensional echocardiography exhibited the highest consistency (intraclass correlation coefficient = 0.857) and correlation ( R = 0.75, P <0.01) with LAVmin measured by cMRI. The linear regression equation was LAVmin_ cMRI = 0.891 × LAVmin_2D + 0.304. Conclusions and relevance cMRI represents a reproducible method for assessing LA mass in domestic cats. This study underscored the importance of echocardiography in veterinary cardiology, and the LAVmin measured by two-dimensional echocardiography may reflect the true LAVmin.