bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pediatric Idiopathic Chylous Leak: A 15-Year Single-Center Experience
Authors: O’Guinn MaKayla L. , Keane Olivia A. , Adams Sarah N. , Knowlin Laquanda T. , Delfosse Erin , Miller Joseph , Kreimer Sara , Lee Shimwoo , Anselmo Dean M. 
Published: February 2025

Objective:
Idiopathic chylous leak (ICL) is defined by the accumulation of chyle in the pleural or peritoneal space, for which there is no underlying etiology. Given the low incidence and heterogeneity of presentation, evaluation, and management guidelines lack consensus. The purpose of this study is to provide insights regarding the clinical manifestations and propose a multidisciplinary treatment approach in ICL.

Methods:
A single-center retrospective chart review was conducted on patients with a diagnosis of idiopathic chylous ascites and/or chylothorax from January 1, 2008 to December 31, 2023. Data pertaining to the evaluation and treatments was abstracted.

Results:
A total of 18 patients with ICL were identified. Median age at diagnosis was 1 month (interquartile range [IQR]: 0–6.0) with 3 patients diagnosed prenatally. Clinical presentation was chylothorax for 78% and chylous ascites for 22% of patients. Most patients were initially managed conservatively with nil per os (NPO) and total parental nutrition (83%). Octreotide was utilized in 72% of patients. Sirolimus was used in 22% of patients. Seven patients required surgical management due to failure of medical management. All surgical patients underwent a magnetic resonance lymphangiogram before intervention. Nonoperative patients had fewer total NPO days (14.0, IQR: 0.0–45.0) relative to patients who required surgery (44, IQR: 20.0–48.0). However, median NPO days postoperatively were 12 days (IQR: 1.0–34.0).

Conclusion:
We describe our 15-year experience on the evaluation and management of ICL. We advocate a multidisciplinary management approach to promptly optimize both conservative measures and medical treatment. The use of dedicated lymphatic imaging and surgical intervention should be considered for intractable cases of ICL refractory to medical treatment.

Level of Evidence:
Level III.
Overview of mucosal immunity and respiratory infections in children: a focus on Africa
Authors: Mwape Richard K. , Barday Mish-Al , van der Zalm Marieke M. , Verhagen Lilly M. 
Published: February 2025

Purpose of review
Given the substantial burden of respiratory tract infections (RTIs) on global paediatric health, enhancing our understanding of mucosal immunity can help us advance mucosal biomarkers for diagnosis, prognosis and possible interventions in order to improve health outcomes. This review highlights the critical role of mucosal immunity in paediatric RTIs and recent advances in mucosal interventions, which offer promising strategies to improve outcomes.

Recent findings
The significant burden of paediatric RTIs and growing interest in mucosal immunity advanced our understanding of the role of the respiratory mucosal immune system in protective immunity against RTIs. Studies show that sub-Saharan Africa is disproportionately affected by paediatric RTIs with poverty-associated factors such as human immunodeficiency virus (HIV) and malnutrition as risk factors. Emerging evidence highlights the important role of the respiratory microbiome and mucosal innate and adaptive immune responses in protective immunity against RTIs.

Summary
The growing interest in mucosal immunity in RTIs has not only advanced our understanding of the overall immune responses in RTIs but also created opportunities to improve RTI care through translation of knowledge from these studies into diagnostics, therapeutics, and vaccines.
Genetic and epigenetic correlation between diabetic retinopathy and polycystic ovarian syndrome: in-silico analyses-experimental research
Authors: Mirzaei Samira , Sheikh Soleimany Darany Zahra , Arjmand Neda , Farhadi Bahar , Garrosi Lida , Najafi Amin 
Published: February 2025

Introduction:
Metabolic disorders, such as diabetes, can give rise to complications like diabetic retinopathy and polycystic ovarian syndrome, which have emerged as a primary concern among healthcare systems. This study aims to explore the genetic and epigenetic associations between diabetic retinopathy and polycystic ovarian syndrome.

Methods:
Gene expression data were retrieved from the Gene Expression Omnibus database. Common genes were identified using Venn diagrams, while the Enrichment Analysis Resource database pinpointed shared signaling pathways. Additionally, shared microRNAs and circular RNAs were identified using the MiRmap and Circaintractome databases to investigate potential epigenetic links between the two conditions.

Results:
Analysis of datasets Gene Series Accession 53 257 and 54 248 revealed eight shared genes. These genes are involved in signaling pathways related to glycine, serine, and threonine metabolism, tRNA biosynthesis, and DNA repair. Furthermore, the genes associated with miRNA (6 cases) and circular RNAs (12 cases) were identified. These molecular factors play key roles in critical biological processes such as insulin secretion, adiponectin regulation, and electron transport in the respiratory chain.

Conclusion:
This study highlights the genetic, epigenetic, and metabolic pathways shared between diabetic retinopathy and polycystic ovarian syndrome, demonstrating that disruptions in these pathways may exacerbate metabolic complications. Identifying common genetic and epigenetic factors provides potential avenues for the clinical management and treatment of these disorders.
Efficacy and outcomes of inclisiran in the management of homozygous and heterozygous familial hypercholesterolemia: a systematic review and meta-analysis
Authors: Khan Zaraq , Singh Ajeet , Haseeb Ur Rasool Muhammad , Qasim Nimra , Yafaa Naveed Chaudhary Muhammad , Syed Saif , Riaz Monazza , Rehman Wajih , Rehman Ihtiham , Islam Rabia , Islam Hamza , Muhammad Aqeel , Devi Raveena , WEI Calvin R. , Naaz Farheen , Akilimali Aymar 
Published: February 2025

Objective:
To find out the efficacy of Inclisiran sodium in heterozygous familial hypercholesterolemia (HeFH) and homozygous familial hypercholesterolemia (HoFH) patient groups.

Methods:
PubMed, Embase, and Clinicaltrials.gov databases were searched for the relevant studies. Atherosclerotic parameters considered included LDL-C, total cholesterol, PCSK9, apolipoprotein-B, and non-HDL-C. Primary outcomes were the percentage difference in atherosclerotic parameters at follow-up relative to baseline values. Our study examined these primary outcomes to determine whether there is a statistically significant difference between the HeFH and HoFH groups. The risk of bias was assessed by the Cochrane risk of bias tool.

Results:
Analysis of four ORION clinical trials unveiled the significant difference in pooled mean differences in LDL-C (HeFH: –48.62%, HoFH: –9.12%; P < 0.05) total cholesterol (HeFH: –30.31%, HoFH: –11.50%; P < 0.05), apolipoprotein-B (HeFH: –39.97%, HoFH: –14.68%, P < 0.05), and non-HDL-C (HeFH: –44.51%, HoFH: –12.22%; P <0.05) between HeFH and HoFH groups. However, the difference in the pooled mean difference in PCSK9 values (HeFH: –68.41%, HoFH: –56.25%; P = 0.2) between the HeFH and HoFH groups was statistically insignificant. Studies were of high quality.

Conclusion:
There was a significant difference in the reductions in atherosclerotic lipid parameters in heterozygous and homozygous populations after the administration of inclisiran except for the PCSK9 parameter. Further studies are needed to support this conclusion.
Proximal bowel obstruction caused by high-grade duodenal adenocarcinoma: A rare case
Authors: Ibrahim Rana , Yassine Mohammad , Dika Zakaria 
Published: February 2025

Introduction:
Duodenal adenocarcinoma is an exceptionally rare malignancy, constituting less than 0.5% of all gastrointestinal cancers. Its nonspecific symptoms often lead to delayed diagnosis and advanced disease at presentation.

Case presentation:
A 64-year-old female presented with epigastric pain, nausea, and biliary vomiting. Imaging revealed a proximal small bowel obstruction, and endoscopy identified a high-grade duodenal adenocarcinoma. The patient underwent a successful duodenojejunectomy, side-to-side anastomosis, and lymphadenectomy.

Discussion:
Post-operative recovery was uneventful, leading to discharge in stable condition. This case underscores the importance of considering duodenal adenocarcinoma in differential diagnoses for small bowel obstruction and highlights the effectiveness of surgical management.

Conclusion:
Duodenal adenocarcinoma, though rare, should be considered in patients with small bowel obstruction. Early diagnosis and prompt surgical intervention are crucial for favorable outcomes.
Exploring the therapeutic potential of bi-modal stimulation for tinnitus
Authors: Khan Ali Aamir , Nasim Hamid , Manhal Gaffar Alemam A. , Abbasher Hussien Mohamed Ahmed Khabab 
Published: February 2025

Background:
Tinnitus is the perception of sound without any external acoustic stimuli, affecting over 10% of the population, especially older adults. Current treatments focus on symptom management rather than a complete cure, often providing limited relief.

Objective:
To evaluate the efficacy and safety of bimodal neuromodulation therapy for tinnitus, compared to traditional treatment methods.

Results:
Bimodal neuromodulation, which combines sound and tongue stimulation, has shown significant improvement in tinnitus symptoms. FDA-approved studies report sustained symptom reduction in over 77% of patients for up to 12 months. The most common side effect is an increase in tinnitus symptoms, similar to sound-only treatments.

Conclusion:
This therapy presents a high benefit-to-risk ratio with minimal side effects, offering better clinical outcomes and patient satisfaction compared to existing treatments. Adjustments in treatment parameters can further enhance its effectiveness over time. Bimodal neuromodulation shows promise as a more effective treatment for tinnitus. Future clinical trials should replicate these positive findings, evaluate long-term effects, and compare their effectiveness to other treatment options to improve accessibility and clinical outcomes for tinnitus patients.
ChatSchema: development and validation of a pipeline for extracting structured nursing information with large multimodal models
Authors: Wang Fei , Zheng Yuewen , Wu Jingyi , Li Qing , Li Pengfei , Zhang Luxia 
Published: February 2025

Abstract

Objective:
Timely access to essential patient information is critical for informed, data-driven decision-making in clinical nursing to enhance care efficiency and quality. Despite advancements in electronic health records, many medical reports remain in paper form, posing challenges for data analysis and application. This study aimed to develop ChatSchema, a pipeline based on Large Multimodal Models (LMMs) for extracting structured information from paper-based medical reports, and evaluated its effectiveness in a pilot setting.

Method:
ChatSchema was a two-stage approach to extract and structure data from paper-based medical reports. The classification stage leveraged Optical Character Recognition (OCR) of the pictured medical reports, pre-correction, desensitization, and prompt engineering to categorize report types. In the extraction stage, OCR-converted text was transformed into a structured format using a predefined schema, with LMMs applied for standardizing fields and converting data types. A dataset of 100 annotated medical reports was collected from Peking University First Hospital, and the effectiveness of ChatSchema was evaluated in terms of precision, recall, F1-score, and overall accuracy. To validate ChatSchema’s effectiveness, we compared it against a baseline method that provided only schema and task instructions. For sensitivity analysis, two basic LMMs, GPT-4o and Gemini 1.5 Pro, were utilized and compared in the development of ChatSchema.

Results:
A ground-truth dataset comprising 2,945 test item-result pairs was extracted from 100 annotated medical reports. ChatSchema was capable of correctly extracting and structuring data from paper-based medical reports, showing remarkable accuracy across various data types, unit standardization, field mapping, and basic LMMs. Overall, ChatSchema achieved a high F1-score of 95.8%, an accuracy of 97.2%, a precision of 95.8%, and a recall of 95.8%. ChatSchema surpassed the baseline model by 12.9% in accuracy and by 12.3% in F1-score using the GPT-4o model.

Conclusion:
Our findings demonstrate that ChatSchema is highly effective for extracting and structuring data from paper-based medical reports. By providing accurate, structured information extraction, ChatSchema has the potential to enhance patient care and support clinical decision-making, showing significant promise for broader application in nursing and healthcare settings.
A Systems Perspective of How Community-Engaged Public Health Addresses Social Determinants of Health: A Case Study of a Population-Based COVID-19 Testing Program
Authors: Frerichs Leah , Akiwumi Ann-Marie , Kaz Lia , Kim Doyoung , Florick Laura , Lucas Valerie , Layer Marcus , Farrar Brandy , Dave Gaurav , Hassmiller Lich Kristen 
Published: February 2025

Context:
Despite the recognition that social determinants of health (SDOH) are key to improving the health of all communities, the causality and specific mechanisms through which SDOH impacts health behaviors and outcomes are often ambiguous.

Objective:
The aim of this study was to use systems thinking to document pathways through which SDOH affected health-seeking behaviors and identify how community engagement strategies intervened to address SDOH barriers.

Design:
We leveraged the case context of a large federal initiative (Rapid Acceleration of Diagnostics-Underserved Populations [RADx-UP]) designed to improve COVID-19 testing for underserved populations through community-engaged and participatory approaches. First, we used structured sessions with RADx-UP partners to create causal maps that documented relationships between factors relevant to SDOH, a health-seeking behavior (COVID-19 testing), and community engagement strategies. Second, we searched, reviewed, and tied evidence from RADx-UP peer-reviewed literature to contextualize the causal maps.

Results:
We identified 17 unique pathways that linked SDOH to COVID-19 testing. The map also highlighted 3 mechanisms through which the community engagement addressed SDOH: (1) improving access to testing, (2) addressing health and digital literacy, and (3) conducting social needs screening and assistance.

Conclusions:
Our findings highlighted the complexity of public health issues such as COVID-19 and how community engagement is critical to addressing SDOH and health equity. Importantly, dedicating resources to community engagement created positive reinforcing dynamics to improve the health of communities; however, as COVID-19 became better managed, funding also diminished and decreased the capacity for community-engaged efforts. Research in public health needs to focus on understanding and reshaping systems that better support community-engaged efforts.
Exploring the Impact of COVID-19 on a Child Maltreatment Prevention Network
Authors: Kohl Patricia L. , Harris Jenine K. , Shires Mary Katherine , Bacon Caren , Sulaima Sanaria , Jonson-Reid Melissa 
Published: February 2025

Objective:
Child maltreatment is a complex and preventable public health problem that cannot be effectively addressed by a single organization or sector. We examined a network of organizations working to prevent childhood maltreatment before and during COVID-19, including members of the Parents and Children Together–St. Louis Collaborative. The Collaborative is an initiative with the purpose of strengthening ties among service agencies and was new when the COVID-19 shutdowns began.

Design and Participants:
In September 2020, we surveyed 62 agencies working on childhood maltreatment prevention in the public health, health, or social service sectors. We asked about frequency of contact between organizations before (pre-COVID) and during COVID (in-COVID). We used descriptive and inferential network methods to examine network properties and changes.

Results:
There were 360 ties among organizations in the pre-COVID network (density = 0.19) and 321 ties among organizations (density = 0.17) during COVID. The median number of ties per organization decreased from pre- to in-COVID for most organizations and most notably for smaller and newer organizations and mental health care organizations. The only organization type that increased connections was substance abuse organizations. Pre- and in-COVID odds of connection were significantly higher for mental health care, substance abuse, health care, child welfare, and legal-advocacy organizations compared to multisector organizations. Odds of a connection between 2 organizations were significantly higher pre-COVID and in-COVID if one or both organizations were Collaborative members.

Conclusions:
Disruptions during COVID-19 coincided with fewer connections among organizations. Collaborative members had higher odds of connection before and during COVID-19, suggesting a potential strategy for building and maintaining a cross-sector service network. Understanding network structure and change in the early stages of COVID-19 provides an opportunity to work on building and sustaining inter-organizational connections essential in violence prevention and child well-being and other areas of public health.
Adaptive Capacity Within the Homecare Setting: The Importance and Value of a Shared Perception of Risk
Authors: Idsøe-Jakobsen Ingvild , Dombestein Heidi , Lawton Rebecca , Wiig Siri 
Published: February 2025

Objectives:
Patients receiving homecare are living their everyday lives in their own homes. Adapting care to individual needs, preferences, risks, and family situations is seen as essential. The overall aim of this study was to develop empirical knowledge of risk perception in homecare services. The research question that guided the study was: How is a shared perception of risk between health care professionals and leaders a part of providing high-quality care within a homecare setting?

Methods:
The research design was a multiple-embedded case study including 3 single cases. Participants were recruited from 3 Norwegian municipalities. Two focus group interviews were conducted in each municipality. In total, 19 informants participated, including 11 homecare department leaders and 8 health care professionals. The data were analyzed using thematic analysis according to Braun and Clarke’s 6-phase thematic analysis.

Findings:
Two higher-order themes were developed from the data: “Risk perception is a collective understanding” and “A flawed system requires adapting just to make it work.” The study showed that, in the homecare departments, leaders’ and health care professionals’ opinion, flexibility and professional discussions are key to enhancing the system’s adaptive capacity. High-quality care is always perceived as person-centered and adaptive. Overgeneralizations and the use of guidelines were perceived as demanding. The findings also showed that making sense of and managing risks within a homecare setting is complex.

Conclusions:
Bridging the gaps by conceptualizing and acting upon risks in the homecare setting constitutes a fundamental part of adaptive capacity at a system level. However, better alignment of system demands to local risks is needed for sustainable and safe services.
Utilising multi-modal data-driven network analysis to identify monotherapy and combinational therapy targets in SOX2-dependent squamous cell lung cancer
Authors: Hwang Woochang , Kottmann Daniel , Guo Wenrui , MacMahon Méabh , Correia Lucia , Harris Rebecca , McCaughan Frank , Han Namshik 
Published: February 2025

AbstractDrug discovery requires a deep understanding of disease mechanisms, making the integration and analysis of diverse, multi-modal data types essential. These data types, spanning omics types, disease- associated, and biological pathway information, often originate from disparate sources and must be combined to uncover critical insights. We have developed iPANDDA (in-silico Pipeline for Agnostic Network-based Drug Discovery Analysis), a computational pipeline that integrates multi-modal data through a network-based approach to predict candidate drug target proteins for specific diseases.We applied iPANDDA to lung squamous cell carcinoma (LUSC), a subtype of non-small cell lung cancer (NSCLC) that accounts for approximately 25% of all lung cancer cases globally. Despite advances in cancer therapeutics, targeted therapies specifically approved for LUSC remain lacking, exacerbated by the shortage of robust models for studying LUSC carcinogenesis and therapeutic responses. The SOX2 gene, amplified in about 50% of LUSC patients, plays a critical role in driving and maintaining the cancer phenotype. Using iPANDDA, we identified relevant therapeutic targets for SOX2-dependent LUSC.Selected candidate drug targets were validated in vitro using cell-based models. We conducted target inhibition studies in both SOX2-dependent and non-SOX2-dependent cell lines, evaluating the effects of inhibition and knockout through cell viability assays.Our findings confirmed key monotherapy and combination therapy targets for SOX2-focused models. Specifically, we validated the AKT and mTOR complexes as promising therapeutic targets for LUSC. Additionally, we identified potential pathways for developing novel combination therapies targeting SOX2-dependent LUSC. iPANDDA offers a robust approach to refining and focusing therapeutic strategies for diseases with unmet clinical needs.
SPECTRE-Plex: an automated, fast, high-resolution-enabled approach for multiplexed cyclic imaging and tissue spatial analysis
Authors: Anderson Michael D. , Plone Abigail , La Jeffrey , Wong Madison , Raghunathan Krishnan , Silvester Jocelyn A. , Thiagarajah Jay R. 
Published: February 2025

AbstractMapping the spatial organization of tissues is critical to understanding organ biology in health and disease. Developments in multiplexed antibody-based, fluorescence labelling methods have provided unique insights into tissue microenvironments. However, many current methods have a variety of limitations that reduce their practical utilization. To address this, we developed SPECTRE-Plex; an end-to-end solution based on a series of methods that significantly improve speed, automation, and resolution of cyclic multiplex immunofluorescence imaging.
Reconstructing Sordida subcomplex (Hemiptera, Reduviidae, Triatominae) phylogeny across species distribution range
Authors: Burgueño-Rodríguez Gabriela , Nattero Julieta , Ríos Néstor , Piccinali Romina Valeria , Carbajal-de-la-Fuente Ana L. , Panzera Francisco , Lopes Catarina Macedo , Lobbia Patricia A. , de Arias Antonieta Rojas , Cavallo María J. , Rodríguez Claudia S. , Lorite Pedro , Vega-Gómez María C. , Rolon Miriam , Pita Sebastián 
Published: February 2025

ABSTRACTThe conformation of the Sordida subcomplex has been a topic of prolonged debate, with diverse methodological approaches employed to discern its constituent species. Up to now,Triatoma sordida,T. garciabesiandT. rosaicomprise part of this subcomplex. Distinguishing and identifying these three species pose significant challenges due to their pronounced morphological similarity, overlapping distributions, and presence of natural hybrids. This study aims to uncover the genetic diversity and geographic spread of these three species by analyzing a mitochondrialcytochrome bgene fragment and complementing it with chromosomal studies across natural populations from an extensive geographical range, including Argentina, Bolivia, Brazil, and Paraguay. Phylogenetic analyses revealed genetic distances that suggest the presence of at least six putative species, rather than the three currently recognized. The present findings underscore the potency and significance of molecular analyses from natural populations for species identification and highlight the limitations of morphology in classifying Triatominae species.