bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vessel wall enhancement and high-sensitivity CRP as prognostic markers in intracranial atherosclerotic stroke: A prospective cohort study
Authors: Na Seunghee , Kim Taewon , Koo Jaseong , Hong Yun Jeong , Kim Seong-Hoon 
Published: February 2025

Introduction: Eccentric vessel wall enhancement (EVWE) and high-sensitivity C-reactive protein (hs-CRP) are inflammatory biomarkers associated with atherosclerotic disease. We investigated their prognostic value in patients with acute ischemic stroke receiving guideline-adherent medical treatment. Patients and methods: In this prospective observational cohort study, patients with acute ischemic stroke attributed to intracranial arterial disease (ICAD) underwent vessel wall MRI and hs-CRP testing. The study included intracranial cases of both large artery atherosclerosis (LAA) and small vessel occlusion (SVO). The primary outcome was subsequent ischemic stroke during the follow-up period. The median follow-up duration was 21 months. Kaplan-Meier survival and Cox regression analysis was used to determine the associations between EVWE, hs-CRP levels, and subsequent ischemic stroke. Results: Among 191 patients, 81 (42.4%) had EVWE. EVWE positivity showed a trend toward a lower risk of subsequent ischemic stroke compared to EVWE negativity (HR 0.32, 95% CI 0.12–0.87; p = 0.061). Hs-CRP levels were not associated with recurrent stroke risk. The combination of EVWE positivity and low hs-CRP levels (<1.25 mg/l) was associated with a favorable outcome, while EVWE negativity and high hs-CRP levels (⩾1.25 mg/l) were associated with an unfavorable outcome (HR 0.143, 95% CI 0.04–0.50; p = 0.031). Discussion: In this observational study of patients with intracranial atherosclerotic stroke receiving optimal medical therapy, EVWE positivity appeared to be associated with a trend toward lower risk of recurrent stroke, though this relationship requires further validation. Conclusion: The combination of EVWE and hs-CRP status might potentially offer prognostic information, with preliminary data suggesting that EVWE positivity and low hs-CRP levels could be associated with more favorable outcomes in patients receiving guideline-adherent medical treatment. These preliminary findings suggest a possible role for combining imaging and serum inflammatory biomarkers in risk stratification, though larger prospective studies are needed to confirm these associations.
The Cost of Providing Mechanical Thrombectomy for Patients in Private Hospitals Across India: A Macro-costing Study
Authors: Sundar Kaushik , Panwar Ajay , Pramanick Gobinda , Kuruttukulam Gigy , Ichaporia Nasli R. , Bhirud Lomesh , Pawar Sanjay K. , Ilahi Fazal E , V. Vishnu Vardhan 
Published: February 2025

Purpose The benefits of using mechanical thrombectomy (MT) to treat large vessel occlusion stroke in terms of clinical efficacy and cost-effectiveness have been widely recognised. However, the cost of delivering MT to treat large vessel occlusion stroke in private tertiary care centres in India is unclear. This study aimed to determine the cost of MT and analyse cost-influencing factors. Methods A retrospective cost analysis of stroke patients who underwent MT with or without intravenous thrombolysis (IVT) was conducted at multiple centres (January–December 2022). The macro-costing method was used to examine the discharge bills and identify cost-influencing factors. The study gathered data on patients treated according to normal clinical procedures at four skilled and frequently performing thrombectomy centres. Results The study was conducted on 115 stroke patients who underwent MT with or without IVT. Results showed an average total cost of ₹555,399 (95% confidence interval: 246,306–864,492) per patient. Key cost drivers were length of hospital stay (9.7 ± 7.0 days, p < .01), modified Rankin Scale (mRS) score at discharge (3.6 ± 1.6, p < .01) and use of decompressive surgery (10.7/115, p < .03). Lower costs were seen in patients with mRS scores 1, 2 or 6 on day 3 after MT (57/115, 50.4%, p < .01). Neither MT type nor concomitant use of IVT had a significant cost impact. Conclusion In conclusion, the mRS score is a critical factor in determining the cost of acute stroke therapy with MT in India. Efforts must be made to identify patients with poor mRS as early as 3 days after MT and devise a strategy to reduce their stay in the ICU and in the hospital, which would, in turn, help reduce their hospitalisation costs. It is crucial to gather accurate and comprehensive data on micro-costing to inform policies and allocate resources effectively.
Exploring the role and mechanisms of MAGEA4 in tumorigenesis, regulation, and immunotherapy
Authors: Zhu Weijian , Yi Qiang , Chen Zheng , Wang Jiaqi , Zhong Kui , Ouyang Xinting , Yang Kuan , Jiang Bowei , Zhong Jianing , Zhong Jinghua 
Published: February 2025

Abstract
MAGEA4 is a member of the Melanoma-Associated Antigen (MAGE) family, characterized by high expression in various tumor tissues but low expression in normal tissues, with the exception of testis and placenta. Its expression is associated with poor prognosis in cancer. This review summarizes the mechanisms of action, regulatory functions, and immunotherapeutic applications of MAGEA4 in cancer.MAGEA4 promotes tumor initiation and progression through multiple pathways, including ubiquitination and degradation of the tumor suppressor P53, regulation of cell cycle and apoptosis, modulation of DNA damage repair, and enhancement of cancer cell survival. By forming a complex with TRIM28, MAGEA4 accelerates tumor development via P53 degradation. Factors such as TWIST1 and BORIS can upregulate MAGEA4 expression. MAGEA4 interacts with proteins including Miz-1, p53, and RAD18, participating in gene transcription regulation and DNA damage repair. By stabilizing RAD18, MAGEA4 facilitates the recruitment of Y-family DNA polymerases, enabling cells to continue replication under DNA damage conditions and thus supporting cancer cell survival. MAGEA4-based TCR-T cell therapy and cancer vaccines show clinical potential. This article comprehensively reviews the structure and function of MAGEA4, as well as recent research progress in solid tumors, providing a theoretical foundation for the clinical translation of MAGEA4 and its application in immunotherapy.
The impact of remuneration, extrinsic and intrinsic incentives on interprofessional primary care teams: results from a rapid scoping review
Authors: Aggarwal Monica , Hutchison Brian , Kokorelias Kristina M. , Bilgic Selin , Glazier Richard H. 
Published: February 2025

Abstract

Background
High-performing primary care relies on effective interprofessional teams and provider payment arrangements. This study aims to examine the impact of provider remuneration mechanisms and intrinsic and extrinsic incentives in team-based primary care.

Methods
This rapid scoping review assessed various provider payment models and incentives in team-based primary care. Statistical tests were not applicable in this review.

Results
Fee-for-service models hindered team collaboration, while salaried and quality-based compensation models enhanced collaboration. Extrinsic incentives, such as pay-for-performance programs for physicians, showed mixed impacts on outcomes. Strong organizational cultures and leadership, resources, team meetings, training, clear protocols, and professional development opportunities facilitated teamwork. Intrinsic incentives like autonomy, mastery, and social purpose improved team performance and satisfaction.

Conclusions
This study underscores the importance of a holistic approach to designing interprofessional primary care teams. It highlights the need for implementing non-fee-for-service provider payment models and team-based pay-for-performance incentives. Investments in teams should include health human resources and leadership, training, guidelines, and professional development opportunities. Implementing a performance measurement framework for teams and regular public reporting can foster mastery. Continuous research and evaluation are crucial to optimizing teamwork and healthcare delivery in primary care settings.
Effects of a nutrition education intervention on nutrition knowledge and attitude among overweight and obese primary schoolchildren: a cluster randomized controlled trial
Authors: Selamat Rusidah , Aziz Nur Azlina Abdul , Raib Junidah , Zulkafly Norlida , Mohamad WNurul Ashikin W. , Ismail Ainan Nasrina , Jalaludin Muhammad Yazid , Zain Fuziah Md. , Ishak Zahari , Yahya Abqariyah , Mokhtar Abdul Halim 
Published: February 2025

Abstract

Background
School-based obesity interventions are a promising strategy for combating childhood obesity. In this study, we examined the efficacy of the “My Body is Fit and Fabulous at School” (MyBFF@school) program with a nutrition education intervention (NEI) for improving nutrition knowledge and attitude among overweight and obese primary schoolchildren.

Methods
A school-based cluster randomized controlled trial of the MyBFF@school obesity intervention program was conducted among overweight and obese schoolchildren aged 9–11. Out of 1,196 eligible government primary schools in central Peninsular Malaysia, 23 were randomly assigned into seven intervention schools (647 children) and 16 control schools (750 children). A standard nutrition education module was delivered for 24 weeks to the intervention group, whereas children in the control group followed only the currently existing school nutrition education program. The main outcome measures were nutrition knowledge and attitude scores. Changes of nutrition knowledge and attitude scores from follow up until end of 6 months was assessed using the mixed effect model taking into account the cluster effect.

Results
A total of 563 children in the intervention group and 482 in the control group completed the six-month program and were included in the analysis. The overall nutrition knowledge score was significantly higher in the intervention group (adjusted mean difference (AMD): 4.75%,

$$p=0.028$$

p
=
0.028

) after controlling for mean nutrition knowledge score at baseline, gender, location school group (intervention vs control) and ethnicity. There was also a significant improvement in the nutrition knowledge score with AMD among boys (6.02%), urban children (8.07%), and non-Malays (10.4%). In contrast, after controlling for mean nutrition attitude score at baseline, gender, location, school group (intervention vs control) and ethnicity, there was no significant difference in the nutrition attitude scores between the intervention and the control groups in the overall, gender, location and ethnicity.

Conclusions
The MyBFF@school program with an adjunct NEI improves the overall knowledge on nutrition but has no positive effect on the nutrition attitude of younger schoolchildren, necessitating additional improvements.

Trial registration
Clinical trial number: NCT04155255, November 7, 2019 (Retrospective registered). National Medical Research Register: NMRR-13–439-16563. Registered July 23, 2013. The intervention program was approved by the Medical Research and Ethics Committee (MREC), Ministry of Health Malaysia and Educational Planning and Research Division (EPRD), Ministry of Education Malaysia. It was funded by the Ministry of Health Malaysia.
Study on the potential diagnostic value of metabolomics changes in different biological fluids for aspiration pneumonia
Authors: Chen Lianghui , Chen Yazhen , Lin Fansen , Wang Jianbao , Gao Hongzhi , Liu Yuqi 
Published: February 2025

Abstract

Background
Aspiration pneumonia (AP) is a type of lung inflammation caused by the aspiration of food, oropharyngeal secretions, or gastric contents. This condition is particularly common in older adults and individuals with impaired swallowing or consciousness. While the diagnosis of AP relies on clinical history, swallowing assessments, and imaging, these methods have significant limitations, often leading to underdiagnosis or misdiagnosis. Reliable biomarkers for AP diagnosis are lacking, making early detection and treatment challenging.

Methods
Nineteen patients diagnosed with pneumonia were included in this study, divided into two groups: AP (n = 10) and non-AP (n = 9). Biological fluid samples, including bronchoalveolar lavage fluid (BALF), saliva, serum, sputum, and urine, were analyzed using non-targeted liquid chromatography with tandem mass spectrometry (LC-MS/MS). Differential metabolites were identified using fold change analysis, statistical significance, and receiver operating characteristic (ROC) curve analysis to evaluate their diagnostic potential. Spearman correlation was used to examine the relationship between selected metabolites and clinical parameters.

Results
Significant metabolic differences were found between AP and non-AP patients, with many different metabolites identified across biological fluids. Dehydroepiandrosterone sulfate (DHEAS), Androstenediol-3-sulfate (ADIOLS), and beta-muricholic acid were identified as key biomarkers through fold change analysis and ROC curve analysis, showing consistent increasing or decreasing trends in BALF, sputum, and serum samples. DHEAS was found to be negatively correlated with the Acute Physiology and Chronic Health Evaluation II (APACHE II) (r = − 0.619, p = 0.005) in BALF sample. The area under curve (AUC) values showed that these molecules could serve as effective biomarkers for AP.

Conclusions
This study identifies DHEAS, ADIOLS and beta-muricholic acid as promising biomarkers for AP, with the potential to improve early diagnosis and treatment. These findings underscore the clinical value of metabolomics in developing diagnostic tools for AP, facilitating better clinical management and patient outcomes. Further research is required to validate these biomarkers in larger cohorts and explore their mechanistic roles in AP pathophysiology.
Validating the self-competence in death work scale for end-of-life care volunteers
Authors: Lin Zhuyun , Lou Vivian Weiqun , Chan Wallace Chi Ho 
Published: February 2025

Abstract
There is an increasing demand for end-of-life care (EoLC) volunteers in Hong Kong’s aging population. However, there is no validated measure that assesses volunteers’ self-competence in coping with death. This is essential to optimize their services, and ensure their psychological well-being. This study aimed to validate the existing Self-Competence in Death Work Scale (SC-DWS) for EoLC volunteers. This scale has been tested previously on health professionals providing end-of-life care, and was adapted for this study with words that fitted the volunteer context.
A self-administered survey collected demographic information, personal experiences, the 16-item SC-DWS, 15-item Templer Death Anxiety Scale, and the 8-item Spiritual Wellbeing Scale to examine the internal consistency, concurrent validity, and discriminative validity of this scale among EoLC volunteers. The study sample consisted of all applicants who registered for the EoLC volunteer training programme between 2019 and 2021. Applicants first underwent a systematic screening and selection procedure. They completed an online registration form which included risk assessment, followed by structured individual interviews focusing on applicants’ motivation and mental preparedness for their role. The content validity of the SC-DWS was determined using data from the 341 volunteers who were screened prior to training. Construct validity was tested using Exploratory Factor Analysis (EFA), which suggested that two-factors (subscales) offered the best combination of variables (Emotional and Existential Subscales). The new subscales and the component items differed slightly from those identified in health professional samples. Concurrent validity was demonstrated by strong correlations between the SC-DWS, and the Death Anxiety, and Spiritual Wellbeing scales. Discriminant validity was supported by strong relationships between the new subscales and participants’ personal experiences. The SC-DWS was shown not only to be reliable and valid for EoLC volunteers, but it also highlighted the unique emotional challenges they faced.
Challenges and opportunities in pediatric surgery training in Germany: a view from the trenches
Authors: Drossard Sabine , Schuffert Louisa 
Published: February 2025

Abstract

Introduction
Pediatric surgery training in Germany faces significant challenges related to structural issues and resource limitations, including variability in training sites and a lack of standardized oversight. This study aims to assess the current state of pediatric surgery training including its structure, quality, and resident satisfaction and identify areas for improvement.

Materials and methods
We conducted an online survey between May 2022 and November 2023 using single-choice, multiple-choice and open-ended questions. Additionally, information was gathered via analysis of available statistics and through direct contact with the State Chambers of Physicians.

Results
75 pediatric surgery residents and 15 young specialists participated in the survey. 12 of 17 state medical chambers responded to our inquiry, but only 4 maintain detailed statistics. Training often extends beyond the planned six years, mainly (75%) due to insufficient surgical exposure. Residents reported a predominant role of attendings in surgical training and other residents in clinical training. They desired more involvement from chiefs in their education. A significant proportion (58.9%) noted a lack of dedicated scientific education. Nearly half (44.4%) of the respondents had changed training sites, primarily due to clinical rotations (26,7%) and dissatisfaction with training conditions (30,0%).

Conclusion
Pediatric surgery residents in Germany face inconsistent training quality and extended training periods, mainly due to insufficient surgical exposure. They report that some chiefs do not meet their obligations as trainers adequately. To address these issues, there is a need for enhanced oversight, standardized curricula, more surgical exposure and improved collaboration among training institutions.
Poor hypotheses and research waste in biology: learning from a theory crisis in psychology
Authors: Nakagawa Shinichi , Armitage David W. , Froese Tom , Yang Yefeng , Lagisz Malgorzata 
Published: February 2025

Abstract
While psychologists have extensively discussed the notion of a “theory crisis” arising from vague and incorrect hypotheses, there has been no debate about such a crisis in biology. However, biologists have long discussed communication failures between theoreticians and empiricists. We argue such failure is one aspect of a theory crisis because misapplied and misunderstood theories lead to poor hypotheses and research waste. We review its solutions and compare them with methodology-focused solutions proposed for replication crises. We conclude by discussing how promoting inclusion, diversity, equity, and accessibility (IDEA) in theoretical biology could contribute to ameliorating breakdowns in the theory-empirical cycle.
MAAT: a new nonparametric Bayesian framework for incorporating multiple functional annotations in transcriptome-wide association studies
Authors: Wang Han , Li Xiang , Li Teng , Li Zhe , Sham Pak Chung , Zhang Yan Dora 
Published: February 2025

Abstract
Transcriptome-wide association study (TWAS) has emerged as a powerful tool for translating the myriad variations identified by genome-wide association studies (GWAS) into regulated genes in the post-GWAS era. While integrating annotation information has been shown to enhance power, current annotation-assisted TWAS tools predominantly focus on epigenomic annotations. When including more annotations, the assumption of a positive correlation between annotation scores and SNPs’ effect sizes, as adopted by current methods, often falls short. Here, we propose MAAT expanding the horizons of existing TWAS studies, generating a new model incorporating multiple annotations into TWAS and a new metric indicating the most important annotation.
On the tracks of an uninvited guest, the Asian tiger mosquito, Aedes albopictus in Cyprus
Authors: Piccinno Riccardo , Fiorenza Giulia , Vasquez Marlen Ines , Bouyer Jeremy , Notarides Gregoris , Gomulski Ludvik Marcus , Meletiou Soteris , Akiner Mustafa , Michaelakis Antonios , Forneris Federico , Maga Giovanni , Gasperi Giuliano , Malacrida Anna Rodolfa 
Published: February 2025

Abstract

Background

Aedes albopictus, the Asian tiger mosquito, which is listed among the world's 100 most dangerous invasive species, is the main vector of chikungunya, dengue and Zika viruses. This mosquito species has rapidly dispersed and invaded much of the globe assisted by its life history traits and high propagule pressure driven by human activities. Aedes albopictus is currently widespread across mainland Europe and the Mediterranean region, including the islands. Cyprus remained free of Ae. albopictus until October 2022, when specimens were recorded for the first time in Limassol district, including the port area. Understanding the processes associated with the introduction, expansion and establishment of this vector in Cyprus is of primary importance to mitigate its dispersal on the island, and to implement control methods to prevent disease outbreaks. A genetic analysis of these invasive specimens collected in Limassol district and in areas from the Central Mediterranean was performed to obtain a genetic portrait of the demographic history of the invasive mosquitoes on Cyprus.

Methods
We applied highly polymorphic simple sequence repeat (SSR) markers to the Ae. albopictus mosquitoes collected in Cyprus and to specimens from Italy, France, Switzerland, the Balkans, Greece and Turkey to construct an SSR individual genotype dataset that would enable the invasion pattern of Ae. albopictus in Cyprus to be traced. Bayesian clustering analyses using STRUCTURE and BayesAss version 3 were employed to derive information on the degree of ancestry among Cypriot and Mediterranean mosquitoes and on recent mosquito movements both within Cyprus and between Cyprus and the Central Mediterranean areas.

Results
The Cypriot mosquitoes appear to be highly polymorphic with no signs of genetic drift due to recent founder effects. An ongoing mosquito dispersal within the Limassol district was detected, suggesting the presence of established, hidden adventive populations. These mosquitoes share a high degree of ancestry with those in the Balkans and parts of northern Italy that border the Adriatic Sea.

Conclusions
Considering the trade connections of Limassol port, Cyprus with the Balkans and the Adriatic Italian region, we hypothesise that these areas may be involved in the incursion of Ae. albopictus into Cyprus. As the Balkan and Italian mosquitoes display high competence for CHIKV, questions arise about possible arbovirus outbreaks in Cyprus and highlight the need to implement surveillance and control measures.

Graphical Abstract