bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rites of Passage in the Atlanta Forest
Authors: Tycko Sasha 
Published: January 2025

Abstract
Through a combination of photography and text, this essay considers the activist occupation of the Atlanta Forest and the conflict over the city's plan to build a police training center known as Cop City in light of classical anthropological thought on rites of passage and liminal phenomena. It draws from nearly two years of ethnographic fieldwork and photography exploring time, memory, and history in the occupied forest between 2021 and 2023. Photography is here used to present, rather than represent, the forest as a liminal phenomenon, where norms are suspended and distinctions between city and nature, past and present, and politics and ecology blur.
Cdkn1c orchestrates a molecular network that regulates euploidy of male mouse germline stem cells
Authors: Kanatsu-Shinohara Mito , Yamamoto Takuya , Liu Tianjiao , Nakayama Keiichi I. , Shinohara Takashi 
Published: January 2025

ABSTRACT
Karyotype instability in the germline leads to infertility. Unlike the female germline, the male germline continuously produces fertile sperm throughout life. Here, we present a molecular network responsible for maintaining karyotype stability in the male mouse germline. Loss of the cyclin-dependent kinase inhibitor Cdkn1c in undifferentiated spermatogonia induced degeneration of spermatogenesis prior to entry into the differentiating spermatogonia stage. In vitro analysis of mouse spermatogonial stem cells revealed that CDKN1C localized to spindle microtubules during metaphase, and that disrupted microtubule dynamics increased its phosphorylation. Cdkn1c deficiency activated the spindle assembly checkpoint and led to centrosome amplification, premature chromosome segregation, and loss of AURKB, and ultimately TRP53-dependent apoptosis. Trp53-deficient spermatogonial stem cells exhibited karyotype defects, but proliferated normally despite reduced CDKN1C and AURKB expression. In contrast, Aurkb depletion upregulated TRP53 and CDKN1C, suggesting a negative feedback loop to maintain euploidy. Thus, Cdkn1c regulates the male germline karyotype.
Patient-derived xenograft models of gastrointestinal stromal tumors provide a ready-to-use platform for translational research
Authors: Sutter Luna De , De Cock Lore , Wang Chao-Chi , Gorgels Daniël , Wyns Karo , Verbeeck Kimberly , Vanleeuw Ulla , Douchy Thomas , Hompes Daphne , Jaekers Joris , Van Raemdonck Dirk , Vanden Bempt Isabelle , Debiec-Rychter Maria , Sciot Raf , Wozniak Agnieszka , Schöffski Patrick 
Published: January 2025

ABSTRACT
Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal malignancy of the gastrointestinal tract. Most GISTs harbor mutations in oncogenes, such as KIT, and are treated with tyrosine kinase inhibitors (TKIs), such as imatinib. Most tumors develop secondary mutations, inducing drug resistance against the available TKIs, requiring novel therapies. We established a GIST patient-derived xenograft (PDX) platform of GIST that can be used for preclinical drug testing. Tumor tissue from consenting GIST patients was transplanted subcutaneously to NMRI nu/nu mice. Once tumor growth was observed, the tumor was re-transplanted to a next generation of mice. Tumors were characterized histopathologically and molecularly at every re-transplantation and compared with the original patient tumor. We transplanted 112 tumor samples from 99 GIST patients, resulting in 12 established and well-characterized GIST models with different mutations and TKI sensitivity. Three models harbor secondary KIT mutations. One model is characterized by a primary, imatinib-resistant PDGFRA exon 18 p.D842V mutation. Our established platform of well-characterized GIST PDX models, covering the most relevant driver mutations, serves as an excellent tool for preclinical drug testing and tumor biology studies.
Correlation of shear wave elastography with liver biopsy in children with Chronic Liver disease
Authors: Imtiaz Mehwish , Khaqan Muhammad Umer , Mazhar Maryam , Seerat Iqtadar 
Published: January 2025

Background & Objectives: Liver biopsy remains the gold standard for assessment of liver fibrosis; however, it is limited practically because of issues of sampling errors and invasiveness. This opens the way for other important non-invasive processes of diagnosis including the role and utilisation of Shear Wave Elastography in coming years for liver diseases. This post-hoc study will firstly aim to establish the correlation existing between the currently preferred gold standard liver biopsy and 2D-Shear Wave elastography’s diagnostic accuracy in paediatric patients presenting with suspected or confirmed liver disease.
Methods: This retrospective study was conducted in Pakistan Kidney and Liver Institute and Research Center in Lahore, Pakistan from August 2017 to January 2024. In this analysis, 37 Paediatric patients with various liver diseases who underwent liver biopsy for autoimmune hepatitis, Budd-Chiari syndrome, Wilson disease and other liver-related pathologies were included.
Results: Thirty-seven patients with a mean age of 10 years (ranging from 4–14 years) were enrolled. According to this study, sixteen out of thirty seven (43%) cases of chronic liver disease were caused by autoimmune hepatitis. Patients’ average liver stiffness as determined by SWE was 12.14 ± 0.75 kPa. According to elastography, the average liver stiffness in individuals with F0–F1 fibrosis was 6 ± 0.01 kPa, 7.67 ± 0.29 in stage F2, 8.62 ± 0.20 in stage F3, and 14.05 ± 3.69 kPa in stage F4. We discovered that the mean level of hepatic stiffness varied significantly depending on the degree of fibrosis (p = 0.0001).
Conclusion: SWE gauges the liver tissue’s stiffness, which rises with fibrosis severity. Research has demonstrated that SWE, which is frequently equivalent to liver biopsy, has a high degree of accuracy in identifying and staging hepatic fibrosis.
doi: https://doi.org/10.12669/pjms.41.2.9886
How to cite this: Imtiaz M, Khaqan MU, Mazhar M, Seerat I. Correlation of shear wave elastography with liver biopsy in children with Chronic Liver disease. Pak J Med Sci. 2025;41(2):585-589. doi: https://doi.org/10.12669/pjms.41.2.9886
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
3.5 µm watt-level all-fiber Er3+-doped laser based on high-damage-resistant multi-color dielectric fiber mirrors
Authors: Zhou Xin , Wang Ning , Song Luming , Huang Lu , Su Jue , Bu Yikun , Luo Zhengqian 
Published: January 2025

We report ∼3.5 µm watt-level continuous-wave (CW) and gain-switched all-fiber Er3+: ZBLAN lasers using multi-color dielectric fiber mirrors (DFMs). A section of 1 mol.% Er3+: ZBLAN double-clad fiber with the 976/1976 nm dual-wavelength pumping provides ∼3.5 µm optical gain, and two home-made mid-IR DFMs as the input/output cavity mirrors are used to construct ∼3.5 µm all-fiber resonant cavity by self-made FC/PC fiber connectors. The key is to optimize the film structures of the DFMs and the standing-wave field in the film stacks for 0.98/1.98/2.8/3.5 µm multi-color anti- or high-reflection operation and high damage density of >2.5 MW/cm2 (CW) and >74 J/cm2 (pulse) at 3.5 µm which is crucial for mid-IR high-power laser generation. We perform the three following experiments: (1) stable 3.5 µm CW laser operation generates a maximum output power of 1.11 W and the power fluctuation is less than 1.23%; (2) 3.5 µm gain-switching operation with the tunable repetition rate of 10-20 kHz achieves the maximum pulse energy of 32.7 µJ and pulse duration of 1.21 µs; (3) comparison study on the 1976 nm core-pumping or clad-pumping scheme (976 nm clad-pumping always) shows that the 976/1976 nm clad-pumping scheme readily generates 2.8/3.5 µm dual-wavelength lasing with a lower conversion efficiency. This work may offer an alternative solution for low-cost, high-performance, all-fiber mid-IR CW and pulsed laser beyond 3 µm.
Low regulatory T-cells frequency is associated with graft rejection after small bowel transplantation: Clinical and experimental evidence
Authors: Papa-Gobbi Rodrigo , Stringa Pablo , Gentilini Maria Virginia , Ivanoff Ivana , Machuca Mariana , Arreola Nidia Monserrat , Serradilla Javier , Estefanía-Fernández Karla , Talayero Paloma , Velayos María , Sánchez—Zapardiel Elena , Gondolesi Gabriel , Andrés-Moreno Ane , Rumbo Martin , Hernández-Oliveros Francisco 
Published: January 2025

Background
Intestinal transplantation (ITx) represents the only curative option for patients with irreversible intestinal failure. Nevertheless, its rejection rate surpasses that of other solid organ transplants due to the heightened immunological load of the gut. Regulatory T-cells (Tregs) are key players in the induction and maintenance of peripheral tolerance, suggesting their potential involvement in modulating host vs. graft responses after ITx. Thus, we investigated the association of Tregs with allograft outcomes in pediatric patients and in an experimental model of small bowel transplantation.

Methods
Treg frequency in human samples was analyzed by Flow cytometry (CD4+CD25highCD127-, blood samples) and immunohistochemistry (FoxP3, graft samples). Experimental allogenic-heterotopic small bowel transplantation was performed in rats and animals divided into 3 groups: non-immunosuppressant treatment, rapamycin (2 mg/kg), and tacrolimus (0.6 mg/kg) treatment. Acute cellular rejection (ACR) was diagnosed based on clinical and histological findings, graft gene expression of pro- and anti-inflammatory mediators assessed by RT-qPCR, serum IL-6 and IL-10 levels by Luminex, and Treg frequency analyzed by flow cytometry (CD4+CD25highFoxP3+).

Results
Blood samples from patients undergoing ACR exhibited a significant reduction in the Treg number compared to those with normo-functional grafts. Similarly, a diminished number of FoxP3+ cells was observed in mucosa samples with ACR. In the experimental model, rapamycin-treated animals displayed clinical and histological findings resembling those not receiving immunosuppression treatment. Notably, ACR correlated with a high CD8/CD4 ratio, loss of T-cell chimerism, mRNA upregulation of pro-inflammatory genes and diminished graft Treg frequency. In contrast, tacrolimus treatment prevented ACR and facilitate blood and graft Treg expansion. Remarkably, recipients who achieved Treg expansion within the graft remained free of ACR even after discontinuation of the immunosuppressant treatment and this phenomenon was associated with increased levels of serum IL-10.

Conclusion
Our clinical and experimental findings underscore the association between Treg frequency and graft rejection after ITx, advocating for strategies that promote their expansion within the gut mucosa to enhance long-term outcomes.
Insulin therapy adherence and its associated factors among diabetic patients in a Ghanaian primary care hospital
Authors: Sefah Israel Abebrese , Mensah Michael , Hutton-Nyameaye Araba Ata , Sarkodie Emmanuel , Meyer Johanna C. , Godman Brian , Bangalee Varsha 
Published: January 2025

Background
Diabetes mellitus (DM) is a global health problem. Adherence to intensive insulin therapy is necessary to achieve better glycemic control in types 1 and 2 DM. This study aimed to evaluate the extent of adherence to insulin therapy, its predictors and to identify barriers to its adherence.

Method
This was a cross-sectional survey among adult (≥18 years) diabetic patients who are currently using insulin, either alone or in combination with an oral antidiabetic regimen, and seeking primary care at Kwame Nkrumah University of Science and Technology Hospital in Ghana. A total of one hundred and eight-six patients were conveniently sampled, and interviewed. Insulin adherence was determined using the Medication Adherence Reporting Scale-5. Descriptive statistics, a chi-square test of independence, and a multiple logistic regression analysis were performed using STATA version 14 (StataCorp, TX USA).

Results
The majority of the patients interviewed were over 60 years (40.32%); female (61.83%); married (68.82%); and had completed secondary education (48.39%). 67.20% of the patients were adherent to insulin therapy. Adherence level was associated with age (p = 0.020), marital status (p = 0.001), employment status (p = 0.012), type of DM (p<0.001), regular follow-up (p = 0.007) and comorbidities (p = 0.002) and was only predicted by the type of DM (aOR = 14.82 C.I 1.34–163.50, p-value = 0.028).

Conclusion
Adherence to insulin therapy among our study population was suboptimal, which is a concern considering the associated increased risk of complications. Adherence assessment and counselling by healthcare professionals to address barriers to poor adherence must be continually undertaken to achieve optimal glycemic control.

Impact of findings on practice statements

Continuous adherence assessment and counselling must be offered to all diabetes mellitus patients on insulin therapy as part of their ambulatory care to help improve outcomes.
Using the Medication Adherence Reporting Scale-5 to determine patient adherence levels is an easy-to-use and an inexpensive method; however, it should be used with caution due to the potential for misclassification.
Efforts must be made to provide appropriate strategies to deal with barriers to insulin adherence at ambulatory care clinics as part of the individualized comprehensive diabetic care to reduce diabetic complications.
The measurement reliability and equivalence of print versus online versions of the Youth Activity Profile
Authors: Bai Yang , Dixon Philip M. , Saint-Maurice Pedro F. , Hibbing Paul R. , McLoughlin Gabriella M. , da Silva Michael Pereira , Welk Gregory J. 
Published: January 2025

Purpose
The Youth Activity Profile (YAP) is a 7-day self-report designed to quantify physical activity and sedentary behaviors among youth. This study evaluated the reliability of the online version of the YAP and equivalence with the paper-based version.

Method
A total of 2,490 participants from 17 schools in Iowa and Texas completed the YAP. Each classroom was randomly assigned to complete either the print or online version twice. A variance components model was used to assess the test-retest reliability and equivalence testing was also applied.

Results
Both paper and online versions had similar reliability for the PA estimates in school (ICCprint = 0.69–0.91; ICConline = 0.54–0.84), at home (ICCprint = 0.72–0.83; ICConline = 0.64–0.94), PA at weekend (ICCprint = 0.33–0.72; ICConline = 0.39–0.70), and SB (ICCprint = 0.69–0.90; ICConline = 0.66–0.80). The two versions were statistically equivalent for most YAP items except for recess.

Conclusion
The online YAP appears to be a reliable assessment of physical activity and sedentary behavior in youth populations.
Patient adherence, satisfaction and changes in anthropometric parameters with e-health versus in-person monitoring in metabolic bariatric surgery patients: A study protocol for a systematic review and non-inferiority meta-analysis of cohort studies
Authors: Goulart Maíra Ribas , Schmidt Karine Elisa Schwarzer , Waclawovsky Gustavo , Vian Izabele 
Published: January 2025

Background
Obesity is a risk factor for cardiovascular diseases and associated with reduced life expectancy metabolic bariatric surgery (MBS) is the treatment indicated when patients are unable to lose weight through lifestyle changes and medication alone. However, more evidence is necessary to show non-inferiority of e-health compared to in-person monitoring with regard to important parameters for the success of surgical treatment of obesity such as anthropometric changes.

Methods and analyses
This review study will include cohort studies involving individuals with obesity and e-health or in-person patient monitoring before and after MBS. This study protocol was registered in the PROSPERO (CRD42023491051). We will conduct searches in the following databases: PubMed, EMBASE (Elsevier), Cochrane (CENTRAL), Web of Science, SCOPUS and CINAHL (EBSCO) and LILACS-VHL. We will also search databases in the gray literature. The primary outcomes will be changes in body mass index (BMI), body weight (kg) and body fat percentage (BF%) and patient adherence and satisfaction. The risk of bias of individual eligible studies will be assessed using the Newcastle-Ottawa Scale and the overall quality will be assessed using the GRADE tool. Our analyses will involve comparisons of mean differences or standardized mean differences across the groups using random-effects models and 95% confidence intervals. Statistical analyses will be performed with RStudio for Windows (v1.3.959) using R package meta (v3.6.1).

Discussion and conclusion
Our study can offer evidence that shows the benefits of e-health patient monitoring of individuals undergoing MBS and supports scaling up this care modality to reduce waiting times and health care costs.
Systematic review on the compliance of WHO guidelines in the management of patients with advanced HIV disease in Africa: The case of cryptococcal antigen screening
Authors: Ally Zuhura Mbwana , Mbishi Jackline Vicent , Mbwana Mariam Salim , Bakari Hafidha Mhando , Salim Swalehe Mustafa , Rodoshi Zarin Nudar , Hundisa Muhidin Ibrahim , Sileshi Rebecca Mesfin , Ayalew Biruk Demisse , Musoke Rahma , Moshi Lynn , Fakhoury Yousef Elias , Ally Haji Mbwana , Ramadhani Habib Omari 
Published: January 2025

Background
The World Health Organization (WHO) recommended cryptococcal antigen (CrAg) screening for people presenting with advanced HIV disease (AHD) and for those with positive CrAg without evidence of meningitis to initiate preemptive antifungal medication. Data on the implementation of WHO recommendations regarding CrAg screening is limited. We estimated pooled prevalence of CrAg screening uptake, cryptococcal antigenemia, lumbar puncture, cryptococcal meningitis and initiation of preemptive antifungal medication from available eligible published studies conducted in Africa.

Methods
PubMed, Cochrane Library and Embase were searched for articles published between January 2011 and December 2023. CrAg uptake was defined as percentage of eligible people (CD4 ≤ 200 cells/mm3 or WHO stage III/IV) who received cryptococcal antigen testing. Stratified analysis to compare uptake and cryptococcal antigenemia between studies that involved multiple vs single sites was performed. Using random effects models, we computed the pooled estimate of CrAg screening uptake, cryptococcal antigenemia, lumbar puncture, cryptococcal meningitis, preemptive antifungals treatment and 95% confidence intervals (CIs).

Results
Ten studies with 18,820 individuals with AHD were analyzed. Overall, the pooled estimate of CrAg screening uptake was 57.1% (95% CI: 41.4–72.7). CrAg screening uptake was significantly lower among studies that involved multiple sites compared to those that involved single site, (47.3% vs 73.3%; p<0.001). Overall, the pooled prevalence of cryptococcal antigenemia was 9.6% (95% CI:6.4–12.9). Cryptococcal antigenemia was significantly lower among studies that involved multiple sites compared to those that involved single site, (9.1% vs 10.4%; p<0.001). Among those who tested positive for CrAg, 84.6% (95% CI: 54.1–99.0) received preemptive antifungal treatment, though nearly 25% did not undergo lumbar puncture, highlighting gaps in diagnostic follow-up. Six studies evaluated CrAg positive patients with lumbar puncture and the overall prevalence of lumbar puncture was 74.9% (48.0–94.8). The overall prevalence of cryptococcal meningitis was 58.1% (46.6–69.6).

Conclusions
Not screening for CrAg among people with AHD and failure to initiate antifungal medications among eligible patients with cryptococcal antigenemia presents a significant missed opportunity. Emphasis on improving CrAg screening is critical given its proven cost-effective benefits.
Trends and ethnic disparity in endometrial cancer mortality in South Africa (1999–2018): A population-based Age-period-cohort and Join point regression analyses
Authors: Olorunfemi Gbenga , Libhaber Elena , Ezechi Oliver Chukwujekwu , Musenge Eustasius 
Published: January 2025

Background
Endometrial cancer is the sixth leading cause of cancer among females and about 97,000 global deaths of endometrial cancer. The changes in the trends of obesity, fertility rates and other risk factors in South Africa (SA) may impact the endometrial cancer trends. The aim of this study was to utilise the age period cohort and join point regression modelling to evaluate the national and ethnic trends in endometrial cancer mortality in South Africa over a 20year period (1999–2018).

Methods
Data from Statistics South Africa was obtained to calculate the annual number of deaths, and annual crude and age standardised mortality rates (ASMR) of endometrial cancer from 1999–2018. The overall and ethnic trends of endometrial cancer mortality was assessed using the Join point regression model, while Age-period-cohort (APC) regression modelling was conducted to estimate the effect of age, calendar period and birth cohort.

Results
During the period 1999–2018, 4,877 deaths were due to endometrial cancer which constituted about 3.6% of breast and gynecological cancer deaths (3.62%, 95% CI: 3.52%–3.72%) in South Africa. The ASMR of endometrial cancer doubled from 0.76 deaths per 100,000 women in 1999 to 1.5 deaths per 100,000 women in 2018, with an average annual rise of 3.6% per annum. (Average Annual Percentage change (AAPC): 3.6%, 95%CI:2.7–4.4, P-value < 0.001). In 2018, the overall mean age at death for endometrial cancer was was 67.40 ± 11.04 years and, the ASMR of endometrial cancer among Indian/Asians (1.69 per 100,000 women), Blacks (1.63 per 100,000 women) and Coloreds (1.39 per 100,000 women) was more than doubled the rates among Whites (0.66 deaths per 100,000 women). Indian/Asians had stable rates while other ethnic groups had increased rates. The Cohort mortality risk ratio (RR) of endometrial cancer increased with successive birth cohort from 1924 to 1963 (RR increased from 0.2 to 1.00), and subsequently declined among successive cohorts from 1963 to 1998 (1.00 to 0.09). There was strong age and cohort but not period effect among the South African women. Ethnic disparity showed that there was age effect among all the ethnic groups; Cohort effect among Blacks and Coloureds only, while Period effect occurred only among Blacks.

Conclusions
The mortality rates of endometrial cancer doubled over a twenty-year period in South Africa from 1999–2018. There was strong ethnic disparity, with age and cohort effect on endometrial cancer trends. Thus, targeted efforts geared towards prevention and prompt treatment of endometrial cancer among the high-risk groups should be pursued by stake holders.