bluuebunny/crossref_metadata_2025_split huggingface dataset:
The challenge of long-term stroke outcome prediction and how statistical correlates do not imply predictive value
Authors: Sperber Christoph , Gallucci Laura , Arnold Marcel , Umarova Roza M 
Published: January 2025

Abstract
Personalized prediction of stroke outcome using lesion imaging markers is still too imprecise to make a breakthrough in clinical practice. We performed a combined prediction and brain mapping study on topographic and connectomic lesion imaging data to evaluate (i) the relationship between lesion-deficit associations and their predictive value and (ii) the influence of time since stroke. In patients with first-ever ischaemic stroke, we first applied high-dimensional machine learning models on lesion topographies or structural disconnection data to model stroke severity (National Institutes of Health Stroke Scale 24 h/3 months) and functional outcome (modified Rankin Scale 3 months) in cross-validation. Second, we mapped the topographic and connectomic lesion impact on both clinical measures. We retrospectively included 685 patients [age 67.4 ± 15.1, National Institutes of Health Stroke Scale 24 h median(IQR) = 3(1; 6), modified Rankin Scale 3 months = 1(0; 2), National Institutes of Health Stroke Scale 3 months = 0(0; 2)]. Predictions for acute stroke severity (National Institutes of Health Stroke Scale 24 h) were better with topographic lesion imaging (R² = 0.41) than with disconnection data (R² = 0.29, P = 0.0015), whereas predictions at 3 months (National Institutes of Health Stroke Scale/modified Rankin Scale) were generally close to chance level. In the analysis of lesion-deficit associations, the correlates of more severe acute stroke (National Institutes of Health Stroke Scale 24 h &gt; 4) and poor functional outcome (modified Rankin Scale 3 months ≥ 2) were left-lateralized. The lesion location impact of both variables corresponded in right-hemisphere stroke with peaks in primary motor regions, but it markedly differed in left-hemisphere stroke. Topographic and disconnection lesion features predict acute stroke severity better than the 3-months outcome. This suggests a likely higher impact of lesion-independent factors in the longer term and highlights challenges in the prediction of global functional outcome. Prediction and brain mapping diverge, and the existence of statistically significant associations—as here for 3-months outcomes—does not imply predictive value. Routine neurological scores better capture left- than right-hemispheric lesions, further complicating the challenge of outcome prediction.
Characterization of different clinical presentation of Merkel cell carcinomas and their potential prognostic implications
Authors: Lai Michela , Piana Simonetta , Brancaccio Gabriella , Briatico Giulia , Mirra Marica , Raucci Margherita , Ronchi Andrea , Zerbini Alessandro , Carone Chiara , Banzi Maria , Kaleci Shaniko , Argenziano Giuseppe , Longo Caterina 
Published: January 2025

Abstract

Background
Recent studies analyzed the impact of Merkel cell polyomavirus (MCPyV) on the prognosis of Merkel cell carcinoma (MCC) patients. No data on specific morphological clinical differences of MCPyV+ or MCPyV- are currently available neither on the possible prognostic implication of different clinical presentation of MCC.

Objectives
1) to describe clinicopathological characteristics of MCC patients and the prevalence of MCPyV infection in an Italian cohort of patients; 2) to define possible differences in clinicopathological and prognostic features among MCPyV+ and MCPyV- MCCs.

Methods
Retrospective, multicenter, cohort study conducted in two Italian tertiary referral centers. MCPyV presence was detected by immunohistochemistry (IHC) and PCR with two different primers amplifying VP1 (VP1-PCR) and LT viral region (LT-PCR). Clinicopathological features were compared between MCPyV+ and MCPyV- tumors and between red exophytic nodules and subcutaneous cyst-like MCCs.

Results
62 MCCs were included, presenting as red exophytic nodules (69.3%) or with a subcutaneous cyst-like appearance (19.3%); MCPyV was detected in 40.3% of cases by IHC, 56.4% by VP1-PCR and 79% by LT-PCR. No correlation was found between clinical morphology and viral status. Mortality rate was 40.8% for MCPyV- and 23.1% for MCPyV+ (p-value 0.239) and 69.8% for red nodules and 25% for cyst-like lesions (p-value 0.005). By multivariable analysis, age at diagnosis, ki67 and treatment with surgery/radiotherapy remained the only factors significantly affecting the OS.

Conclusions
This study highlights the potential impact of clinical morphology of MCCs on prognosis. Subcutaneous cyst-like morphology may provide a survival benefit to the patients, regardless the presence of MCPyV.
The symbolic dimensions of waterfront regeneration projects: inter-referencing, legitimating strategies and circulating practices in three Latin American megaprojects
Authors: Jajamovich Guillermo , Silvestre Gabriel , Duque Franco Isabel 
Published: January 2025

Abstract
This paper provides a comparative analysis of three symbolic dimensions of waterfront regeneration projects in Latin American cities: the inter-referencing practices alluded to in relation to projects from elsewhere, legitimating strategies that are discursively and materially constructed to present these projects as socially distributive, and subsequent approaches to leverage lessons from these experiences and re-circulate practices to other places. Following recent literature on urban megaprojects, policy mobility and inter-referencing we postulate that urban megaprojects production and legitimation involves material and symbolic, as well as territorial and relational processes, including the mobilisation of symbols, representations and images that generate consensus and mitigate criticism and resistance.
Kidney replacement therapies in the older person: challenges to decide the best option
Authors: Selwood Jessica , Dani Melanie , Corbett Richard , Brown Edwina A 
Published: January 2025

ABSTRACT
A multitude of challenges exist when supporting older adults in deciding on the optimal kidney replacement therapy (KRT), including frailty, comorbidity, cognitive impairment, dialysis modality, as well as local availability of services. The combination of these factors can determine treatment outcomes and quality of life (QoL), and as such the care of older people should be tailored to take these into account. Frailty in older people with chronic kidney disease (CKD) leads to higher rates of hospitalization, increased mortality, and a diminished QoL, while cognitive impairment, present in up to 50% of people with CKD, exacerbates these challenges and affects decision making.
Dialysis, particularly haemodialysis, can accelerate physical and cognitive decline in frail older adults. Conversely, peritoneal dialysis (PD) presents a home-based alternative that may better support QoL, particularly for people wanting to prioritize treatment flexibility and independence. Assisted PD programmes have emerged as a valuable option for older people who cannot manage home-based care independently, improving access to KRT.
Ultimately shared decision making should be employed when discussing KRT, incorporating patient goals, prognostic awareness, and QoL measures. There is also the emerging role of the geriatrician and the need for an integrated Comprehensive Geriatric Assessment. These elements support older adults to make informed choices that align with the individuals’ values and health needs.
In designing future health services to meet the needs of increasing numbers of older people, there needs to be increased access to assisted PD as well as multidisciplinary working to ensure patient-focused care surrounding KRT in older adults.
Dragonfly larvae rearing: experimental insights and best practices
Authors: Bílková Eva , Kornová Veronika , Ožana Stanislav , Pyszko Petr , Schindlerová Hana , Chytilová Radana , Dolný Aleš 
Published: January 2025

Abstract
Understanding and optimizing rearing conditions for dragonfly larvae is crucial for ecological research and conservation efforts, yet optimal rearing conditions and general rearing practices are lacking. In this study, we investigated the effect of temperature, amount of oxygen in water, presence of (artificial) plants, and age of eggs on hatchability, survival, and development of dragonfly larvae using the model species Sympetrum striolatum. We conducted three independent experiments and assessed variability between egg clutches of individual females, as well as the occurrence of cannibalism among larvae. Our results showed that egg hatchability varied significantly between individual females and was negatively affected by egg aging and the presence of artificial plants. Larval survival was negatively affected by water temperatures above 24°C, the presence of artificial plants, and egg aging, and positively affected by high feeding frequency, in certain instars. Notably, cannibalism was observed among later instar larvae, especially under higher density conditions. Based on these findings, we provide practical recommendations for optimizing dragonfly larvae rearing protocols, emphasizing the importance of maintaining optimal temperature, appropriate feeding regimes, and managing larval density to reduce cannibalism. This study offers experimental, evidence-based guidelines for dragonfly larvae rearing, contributing to improved research methodologies and conservation efforts.
Sinus arrest and syncope in a young patient with Epstein–Barr virus infection: a case report
Authors: Sarto Gianmarco , Simeone Beatrice , Bernardi Marco , Frati Giacomo , Sciarretta Sebastiano 
Published: January 2025

Abstract

Background
Emerging evidence suggests a potential link between Epstein–Barr virus (EBV) infection and cardiovascular diseases. However, the impact of EBV infection on the development of arrhythmias and conduction abnormalities remains to be fully clarified.

Case summary
We present a case report of a healthy 38-year-old Caucasian male who underwent an occupational medicine visit, during which a resting electrocardiogram (ECG) showed numerous premature ventricular contractions. He was later prescribed a stress test. During the test, he experienced a sinus arrest of 6.5 seconds with true syncope during the recovery phase. EBV infection was the only concomitant pathological finding observed during subsequent diagnostic investigations. Initially, it was necessary to rule out all possible cardiac causes of the event, especially in such a young patient. Comprehensive cardiac evaluations, including ECG, echocardiography, cardiac computed tomography, cardiac magnetic resonance, and electrophysiological studies, were normal. After 2 months, both the resting ECG and stress test were completely normal. The final diagnosis for the patient was ‘reflex cardioinhibitory syncope’. Accordingly, a pacemaker (PMK) device was not implanted, as the patient was under 40 years old and had no history of recurrent syncope, in accordance with European Guidelines.

Discussion
Temporary conditions that may cause conduction abnormalities are a contraindication to PMK implantation. Therefore, it is crucial to always consider EBV infection in the differential diagnosis of cardiac conduction disorders. One hypothesis is that EBV may have specifically affected the sinoatrial node and a few right ventricular outflow tract cells without causing myocarditis signs.
Transcatheter aortic valve replacement for left ventricular assist device-related aortic regurgitation and prohibitive surgical risk: a case report
Authors: Barragán-Amado Andrés F , Manzur Barbur María , Holguín Diego , Obando Carlos , Rodríguez-González María J 
Published: January 2025

Abstract

Background
Aortic regurgitation (AR) is a prevalent complication following left ventricular assist device (LVAD) implantation, which elevates the risk of mortality. Prompt recognition and intervention are crucial to mitigate this risk.

Case summary
A 52-year-old male with severe left ventricular dysfunction secondary to Chagas cardiomyopathy and severe pulmonary hypertension underwent implantation of a HeartMate 3 device as a bridge to transplant candidacy. Post-implantation, he developed progressive AR and a decline in overall health, characterized by right ventricular dysfunction, worsening mitral regurgitation, and elevated pulmonary pressures. Given the very high surgical risk, transcatheter aortic valve replacement was successfully performed, yielding excellent outcomes, including normalization of right ventricular function, reduction in pulmonary pressures, and a decrease in mitral regurgitation.

Discussion
Aortic regurgitation is a progressive complication in patients with continuous flow-LVAD, limits effective blood flow, and can lead to severe outcomes like biventricular failure, high rates of hospitalization, and mortality. Managing AR is challenging, often requiring percutaneous interventions due to high surgical risks. Treatment choices depend on centre expertise and patient specifics.
Enhancing gamma-aminobutyric acid (GABA) synthesis from defatted rice bran extract by lactobacillus brevis VTCC-B397: technical parameters analysis
Authors: Lai Quoc Dat , Doan Ngoc Thuc Trinh , Nguyen Thi Hien 
Published: January 2025

Abstract
Gamma aminobutyric acid (GABA) is a biologically active compound that has attracted significant attention in recent years due to its beneficial effects on the nervous system and its role in brain synthesis processes. GABA is widely produced by fermentation method, and its microbial biosynthesis can be improved by adjusting operational parameters and supplementing nutrients during fermentation. However, the optimal fermentation conditions for GABA production vary depending on raw materials and microbial strain used. Rice bran is known as a low-cost and nutritious raw material, capable of producing greater GABA content than other substrates. This study aimed to enhance GABA production from rice bran slurry fermented by Lactobacillus brevis VTCC-B397 by adjusting fermentation conditions, including temperature (25–37 °C), pH (3.0–6.0), monosodium glutamate (MSG) concentration (0–1 M) and fermented time (0–72 hours). The effects of these factors on bacterial cell density and GABA content were assessed over the fermentation period. Furthermore, response surface methodology (RSM) was applied to optimize the medium and fermentation parameters, as well as to investigate the interactions between factors that influence the fermentation process. The biosynthesis pathway of GABA was considerably impacted by temperature, pH and MSG content. The optimal conditions for GABA production from defatted rice bran solution was found to be 0.56 M MSG, 34 °C and pH 5.12. Under optimized conditions, the highest GABA yield achieved was 7.69 g/L.
CD209d/e promotes inflammation and lung injury during influenza virus infection
Authors: Gopal Radha , Marinelli Michael A , Rago Flavia , Richwalls Lacee J , Constantinesco Nicholas J , Debnath Deepa , Kupul Saran , Garcia-Hernandez Maria de la Luz , Rangel-Moreno Javier , Kolls Jay K , Alcorn John F 
Published: January 2025

Abstract
Influenza virus infects millions each year, contributing greatly to human morbidity and mortality. Upon viral infection, pathogen-associated molecular patterns activate pattern recognition receptors on host cells, triggering an immune response. The CD209 protein family, homologs of DC-SIGN (dendritic cell–specific intercellular adhesion molecule 3–grabbing nonintegrin), is thought to modulate immune responses to viruses. The effects of the mouse functional DC-SIGN homolog CD209d/e on the lung immune responses during influenza viral infection are not known. Therefore, we generated mice that lack both CD209d and e isoforms to determine the role in influenza viral infection. We infected wild-type and CD209d/e gene–deficient (CD209d/e−/−) mice with influenza virus and measured the cellular response in bronchoalveolar lavage, the expression of proinflammatory cytokines, antiviral genes, toll-like receptors (TLRs) in the lung, and lung pathology. We found CD209d/e−/− mice had decreased viral burden, TLR3 and TLR9 expression, interferon response, macrophages in bronchoalveolar lavage, and parenchymal lung inflammation compared with control mice. We also found less influenza viral uptake in alveolar macrophages and bone marrow–derived macrophages isolated from CD209d/e−/− mice when compared with control mice. We further investigated the role CD209d/e by treating bone marrow–derived macrophages from control and CD209d/e−/− mice with TLR agonists. We found that lacking CD209d/e decreased the expression of TLR3, TLR9, RIG1, STAT1, and STAT2 compared with controls. Collectively these results show that CD209d/e plays an important role in viral sensing/uptake and inflammatory immune responses during influenza viral infection.
Beneficial effects on T cells by photodynamic therapy with talaporfin enhance cancer immunotherapy
Authors: Ezzaldeen Ehab M , Yaguchi Tomonori , Imagawa Ryotaro , Soltan Mohamed A , Hirata Akira , Murakami Kosaku , Tsukamoto Hirotake , Muto Manabu , Honjo Tasuku , Chamoto Kenji 
Published: January 2025

Abstract
Photodynamic therapy (PDT), a local cancer treatment using photosensitizers, has been reported to enhance antitumor immune responses by inducing immunogenic cell death. Although several studies have demonstrated the synergistic antitumor effects of PDT and immune checkpoint blockage (ICB), the detailed underlying mechanisms remain poorly understood. In this study, we investigated the immunological effects of PDT with talaporfin (Tal-PDT), a clinically approved photosensitizer, using bilateral tumor-bearing mouse models. Treatment with Tal-PDT on the tumor on one side of the mouse resulted in tumor growth inhibition on the untreated opposite side. This phenomenon, accompanied by tumor antigen-specific immune reactions, is indicative of an abscopal effect. When combined with anti PD-L1 antibody, synergistic antitumor effects were observed on both the laser-treated and untreated sides. Mechanistically, Tal-PDT enhanced the induction of XCR-1+ dendritic cells in the proximal draining lymph node likely through the induction of ferroptosis in tumor cells. This, in turn, led to the systemic generation of precursor-exhausted CD8+ T cells. Moreover, talaporfin was selectively incorporated into tumor cells rather than into tumor-infiltrating T cells in vivo, leading to targeted tumor killing while preserving T cells. These beneficial effects of Tal-PDT on antitumor immunity collectively enhance ICB cancer immunotherapy. Our study demonstrates the potential of combining Tal-PDT with ICB therapy for clinical applications.
Could the Artist Not Be Wrong? A Critical Notice of Sherri Irvin's Immaterial: The Rules of Contemporary Art (Oxford: Oxford University Press, 2022)
Authors: Costello Diarmuid 
Published: January 2025

Abstract
This article is a critical notice of Sherri Irvin’s Immaterial: Rules in Contemporary Art (2022). After introducing Irvin’s project, notably how she understands the role of “custom rules” for the display and conservation of, and participation in, works of contemporary art, I focus on two case studies that motivate her argument: Jan Dibbets’ work, All shadows that occurred to me (1969) and Sarah Sze’s Migrateurs (1997). According to Irvin, both works require the participation of museum conservators not merely for their preservation, but also realization. Granting the latter, I consider its implications. Prior to the involvement of conservators the works in question appear indeterminate in crucial respects. The conservators’ role is to seek enough clarity about various rules governing the work to afford future installations of the work without consulting the artist. But both case studies reveal considerable artistic whimsy when it comes to abiding by the rules supposedly underwriting these works’ identity, raising worries for their persistence over time. Given their constitutive role, I consider whether there is room, on Irvin’s account, for the conservators to be right and the artist wrong about the nature of the works in question.
Population pharmacokinetic analysis of teicoplanin in paediatric patients, including those receiving continuous kidney replacement therapy: a prospective cohort study
Authors: Butragueño-Laiseca Laura , García-Orueta Gastón , Riva Natalia , Trocóniz Iñaki F , Fernández Sarah N , Camacho Vicente Verónica , Padilla Belén , Slöcker María , Santiago María José 
Published: January 2025

Abstract

Objectives
Teicoplanin is a commonly used antibiotic in critically ill children. However, teicoplanin dosing is often inaccurate, especially in children undergoing continuous kidney replacement therapy (CKRT). This study aims to develop a population pharmacokinetic (PK) model to optimize teicoplanin dosing in critically ill children, including those on CKRT.

Methods
Data from 26 critically ill children (12 with CKRT) receiving the standard dosing regimen were analysed. In total, 172 teicoplanin concentration measurements from plasma, pre- and post-filter ports were modelled simultaneously using NONMEM 7.4. Simulations were conducted to assess the target attainment (Cmin = 10 mg/L and AUC24/MIC &gt; 800 h) of the current standard dosing regimen and of different alternative dosing regimens.

Results
A two-compartment model was selected. Weight significantly affected renal clearance and volume of distribution of the central compartment, while filter surface area affected haemofilter clearance. Only 16 patients (59%) achieved a Cmin of &gt;10 mg/L with the standard dosing regimen, and only 1 achieved the target AUC/MIC. Based on simulation results, 3 × 15 mg/kg q12h + 10 mg/kg q24h (CKRT) and 3 × 15 mg/kg q12h + 15 mg/kg q24h (no CKRT) could be better alternative regimens.

Conclusions
This population model is a good proof of concept to develop modelling approaches that could help in an individualized dosing approach that needs to be adopted in critically ill paediatric patients. The standard paediatric dosage for teicoplanin could be insufficient for optimal exposure, and higher doses may benefit both CKRT and non-CKRT patients.
P02 Exploring medical students’ knowledge, attitudes, and motivation towards antimicrobial resistance efforts in Eastern Uganda
Authors: Babuya Jonathan , Waruingi Daniel , Mungujakisa Douglas , Ahimbisibwe Osmas , Ruth Kako Victoria , Aporu Faith , Mugume Emmanuel , Nyamupachitu Julian , Kiyimba Kennedy 
Published: January 2025

Abstract

Objectives
To assess knowledge, attitudes, and key motivational drivers influencing medical students’ participation in antimicrobial resistance (AMR)-related extracurricular initiatives at Busitema University, Uganda.

Methods
A descriptive cross-sectional study was conducted among 193 undergraduate students. A semi-structured, pre-tested questionnaire was used to assess knowledge, attitudes, and motivations. Bloom cut-off method was used to evaluate knowledge, and χ2 and multivariate regression analyses were employed to identify engagement factors.

Results
Overall, 71.5% of students had sufficient knowledge of AMR. Ninety percent supported integrating AMR into curricula, and 87.5% favoured a One Health Approach to training. Peer influence, university support and mentorship were top motivators for AMR club engagement. Male students and those in higher academic years were more engaged. Sufficient AMR knowledge was strongly associated with extracurricular involvement.

Conclusions
Medical students demonstrated good knowledge and positive attitudes toward AMR, but deeper training is needed. Extracurricular activities play a pivotal role in motivating engagement. Embedding AMR and antimicrobial stewardship into curricula, along with peer mentorship, is critical for preparing future healthcare professionals to combat AMR.