bluuebunny/crossref_metadata_2025_split huggingface dataset:
Contrast-enhanced photon-counting detector CT for discriminating local recurrence from postoperative changes after resection of pancreatic ductal adenocarcinoma
Authors: Alagic Zlatan , Duran Carlos Valls , Svensson-Marcial Anders , Koskinen Seppo K. 
Published: February 2025

Abstract

Background
We evaluated the diagnostic capability of photon-counting detector computed tomography (PCD-CT) spectral variables in late arterial phase (LAP) and portal venous phase (PVP) to discriminate between local tumor recurrence (LTR) and postoperative changes (POC) after pancreatic ductal adenocarcinoma (PDAC) resection.

Methods
Seventy-three consecutive PCD-CT scans in 73 patients with postoperative soft-tissue lesions (PSLs) were included, 42 with POC and 31 with LTR. Regions of interest were drawn in each PSL, and spectral variables were calculated: iodine concentration (IC), normalized IC (NIC), fat fraction, attenuation at 40, 70, and 90 keV, and slope of the spectral curve between 40–90 keV. Multivariable binary logistic regression models were constructed. Diagnostic performance was assessed for LAP and PVP using receiver operating characteristic analysis.

Results
In LAP, all variables except fat fraction showed significant differences between LTR and POC (p ≤ 0.025). In PVP, all variables except NIC and fat fraction demonstrated significant differences between LTR and POC (p ≤ 0.005). Logistic regression analysis included NIC and 70 keV in the LAP-based model and IC and 90 keV in the PVP-based model. Both models achieved a higher area under the curve (AUC) than individual spectral variables in each phase. The LAP-based model achieved an AUC of 0.919 with 94% sensitivity, 84% specificity, and 87% accuracy, while the PVP-based model reached 0.820, 71%, 88%, and 81%, respectively.

Conclusion
Spectral variables from PCD-CT help distinguish between LTR and POC in LAP and PVP post-PDAC resection. Multivariable logistic regression improves diagnostic performance, especially in LAP.

Relevance statement
Measuring normalized iodine concentration and attenuation at 70 keV in late arterial phase, or iodine concentration and attenuation at 90 keV in portal venous phase, and incorporating these values into a logistic regression model can help differentiate between local tumor recurrence and postoperative changes after pancreatic ductal adenocarcinoma resection.

Key Points

Distinguishing recurrence from postoperative changes on CT after pancreatic ductal adenocarcinoma resection is challenging.

PCD-CT spectral variable values differed significantly between local tumor recurrence (LTR) and postoperative changes (POC).

Logistic regression of spectral variables can help distinguish LTR from POC.

The late arterial phase-based model reached an AUC of 0.919 with 94% sensitivity and 84% specificity.

Graphical Abstract
Evaluation of cannabidiol-based products in Brazil: how can current regulations influence their labeling quality?
Authors: Gallassi Andrea Donatti , de Oliveira André Wagner Carvalho , Mendes Nathália Silva , Filev Renato , Nakano Eduardo Yoshio 
Published: February 2025

Abstract
There is concern about the quality of cannabis-based products used in Brazil, mainly cannabidiol (CBD). This study aimed to evaluate the quality of labeling on CBD products marketed in Brazil authorized by two regulations – N660/2022 on imported products and N327/2019 on products with temporary trade permits – and whether there were differences between them concerning four domains: prescription, good manufacturing practices (GMP), laboratory tests, and safety of use. Determined labeling quality was based on a score of 45 criteria divided per domain and weights from 1 to 3 (according to the relevance for users' and prescribers' safety) built by public information provided by product manufacturers/representatives on websites and e-mail consultations. The quality score was classified as very satisfactory, satisfactory, or not very satisfactory, represented in median and interquartile range. Between the N327 and N660 products, the quality scores were compared using the Mann–Whitney U-test. All tests considered two-tailed hypotheses and a significance level of 5%. After applying the inclusion criteria, from 148 products selected, 105 were evaluated. Most of the evaluated CBD products were classified as satisfactory (47), followed by not very satisfactory (39) and very satisfactory (19). The N327 products presented information that was more accessible than the N660 products. Similarly, there was a significant difference between the two groups concerning the domains of prescription and safety of use; products in the N327 showed better results than those in the N660. This study contributes to the urgent debate on the quality of labeling and the risks of CBD widely marketed in Brazil.
Impact of the COVID-19 pandemic on brain death detection in German hospitals: a state-wide analysis of health data
Authors: Schoene Daniela , Roessler Martin , Eder Katharina , Günther Albrecht , Pleul Konrad , Rahmel Axel , Barlinn Kristian 
Published: February 2025

Abstract

Background
The low rate of organ donation in Germany has been linked to a deficit in the detection of patients with brain death (BD) in hospitals. It is unclear how crisis-related health system disruptions, such as the COVID-19 pandemic, affect this detection deficit.

Methods
Secondary data analysis of anonymized data from deceased patients with acute brain injury from Saxony, Saxony-Anhalt and Thuringia during the pre-pandemic and pandemic period (01/2019–12/2022). Pandemic phases were stratified according to the predominant SARS-CoV-2 variant. Logistic multilevel models were employed to assess outcomes including diagnosis of BD, deceased organ donations, missed cases with potential BD and organ donation-related interactions with the German Organ procurement organization. Models accounted for regional COVID-19 incidence and first-dose vaccination rates, as well as age, gender and types of brain injuries.

Results
A total of 11,100 deceased individuals from 136 hospitals were analyzed. An inverse association was observed between COVID-19 incidence and the determination of BD (adjusted odds ratio [aOR] 0.94, 95%CI [0.91; 0.97]; p < 0.001) as well as deceased organ donation (aOR 0.94, 95%CI [0.90; 0.98]; p = 0.001). When stratified by pandemic phases, this inverse association was evident for both BD determination (aOR 0.92, 95%CI [0.87; 0.99]; p = 0.02) and deceased organ donation (aOR 0.90, 95%CI [0.83; 0.97]; p = 0.01) during the initial wild-type phase. In the alpha phase, the association was observed only for BD determination (aOR 0.76, 95%CI [0.59; 0.98]; p = 0.03). No association was found in subsequent pandemic phases.

Conclusion
The initial impact on BD detection during the pandemic highlights the importance of the health system's adaptive capacity in times of crisis.
Mind the guideline gap: emergent CT in patients with epilepsy for trauma rule-out—A retrospective cohort study
Authors: Szabo Kristina , Obertacke Udo , Sandikci Vesile , Ghanayem Sarah , Alonso Angelika , Rink Johann S. , Marzina Annika , Platten Michael , Hoyer Carolin 
Published: February 2025

Abstract

Background
Patients with epileptic seizures represent a significant proportion of emergency department (ED) admissions and are often referred for cranial imaging due to suspected or observed trauma. Neurological guidelines provide limited advice on indications for imaging in this scenario, and traumatological clinical decision rules on the use of CT in mild traumatic brain injury explicitly exclude patients with seizures preceding the trauma. This gap in recommendations may contribute to overimaging for trauma rule-out after a seizure.

Methods
We analysed medical records of patients with known epilepsy admitted to our ED after a seizure between January 2022 and March 2024. Using clinical data including the findings from cranial CT and risk factors for traumatic brain injury, we re-assessed the need for CT imaging by application of the Canadian CT head rule (CCHR) or in the context of head trauma under anticoagulation.

Results
During the observational period, 683 patients with known epilepsy were referred to our hospital due to a seizure (mean age 48.8 years, 57.7% male). A head CT scan was obtained in 337 (49.3%) of all encounters. In only two patients, CT diagnosed an acute seizure-related traumatic lesion, one focal subarachnoid haemorrhage and one skull base fracture. Twenty-six cases (3.8%) with seizure-related trauma were reassessed as requiring a CT for trauma-related injury evaluation. Particularly in the absence of head impact or risk factors, a high degree of variability regarding CT ordering practice was observed.

Conclusions
Our results demonstrate frequent use and low diagnostic yield of CT in ED seizure patients with respect to trauma-related head injury. Circumstantial factors, clinical signs or symptoms and medical risk factors variedly impact on clinicians’ decision to perform imaging. The absence of clear recommendations regarding imaging for trauma apparently provokes frequent diagnostic rule-out even in patients with low risk for traumatic brain injury. We suggest an approach to identify patients not requiring a head CT by considering the CCHR, presence of anticoagulation and appreciating the postictal state as a feature specific to patients with seizures.
Adoptive transfer of natural killer cells in therapeutic treatment of COVID-19 patients
Authors: Alamri Abdulaziz 
Published: February 2025

Abstract

Background
Natural killer (NK) cells are crucial constituents of innate immunity, playing a vital role in the early defense against viral infections and cancer. Their antiviral capabilities stem from direct cytotoxic activity against infected cells and immunoregulatory functions that modulate adaptive immune responses. In the context of Coronavirus disease (COVID-19), NK cells contribute to controlling viral replication and limiting excessive inflammatory responses.

Aims
This review highlights the mechanisms underlying NK cell-mediated antiviral activity, focusing on their interactions with severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2). We discuss potential sources of NK cells for adoptive transfer therapy, critical factors influencing their therapeutic efficacy, and considerations for clinical translation in COVID-19 treatment.

Methods
Various NK cell sources for adoptive therapy are discussed, including peripheral blood, cord blood, and genetically engineered NK cells. Key factors influencing the therapeutic efficacy and safety of NK cell-based therapies are analyzed, including cytokine modulation, NK cell subset selection, and delivery methods.

Conclusion
Understanding the mechanisms underlying NK cell-mediated antiviral activity and the factors that influence the success of adoptive NK cell therapy can inform the design of more effective immunotherapies for COVID-19 patients. Strategies for improving NK cell function, such as genetic modification and optimizing therapy protocols, are highlighted to enhance therapeutic outcomes.

Graphical Abstract
NK cells neutralize SARS-CoV-2 by releasing cytotoxic granules, inhibiting replication, and modulating inflammation. They originate from peripheral blood, cord blood, and genetic engineering. Therapeutic strategies include adoptive transfer, cytokine modulation, and optimized delivery. Inflammation is controlled, reducing excessive immune responses.
Fire-resistance design and experimental research for the stay cables of super-long span cable-stayed bridge
Authors: Shen Kongjian , Jiang Zhenxiong , Zhao Jun , Zhou Zhubing , Wu Qiong , Qiang Qiang , Wang Hongchao 
Published: February 2025

Abstract
The cables are crucial to the service life of cable supported bridges. Fire accidents involving bridge cables may cause severe damage, impacting the structural integrity and performance of bridges, and therefore requires thorough attention and research. This research mainly focuses on the key technologies for the fire resistance of stay cables, including the structural system design of fire-resistant stay cables, selection of fireproof materials, and experimental verification of fire-resistant performance and qualification of the proposed system. The results show that the multiple wrapped composite structures with fire resistance are suitable for the fire-resistant design of stay cables in the Changtai Yangtze River Bridge. The fire-resistant structure of the stay cables is designed as one layer of flame barrier layer using 316L matte stainless steel, one layer of fire retardant layer using modified ceramic fiber cloth and two layers of insulation layer using aluminum foil glass fiber cloth. Moreover, the fire-resistant performance of the structural system is experimentally validated to meet the design requirements that the fire-resistant time of the stay cables should not be less than 60 min, and the temperature of the internal steel wire should not exceed 300 °C. Meanwhile, tensile testing under high temperature demonstrates that the designed stay cable can resist the applied load for 60 min under a high temperature of 300 °C at the surface of cable without slip or failure of anchorage components. The development of fireproof stay cable products, as applied in the Changtai Yangtze River Bridge project, provides a valuable reference for fire resistance design of bridge cables and contributes significant economic and social benefits.
Study on the mineral processing technology of copper-nickel sulfide ore
Authors: Gao Xichao 
Published: February 2025

Abstract
This paper briefly introduces the research status of mineral processing and mineral processing agents and summarizes the mineral processing technical difficulties of copper-nickel sulfide ore into five points: the difficulties in dissociation of copper-nickel mineral monomer, magnesium-containing silicate minerals have a great influence on flotation, the separation process of copper and nickel easily leads to the mixing of nickel and copper, effects of certain ions on flotation, and the recovery of associated precious metal elements. The key technical problems for beneficiation of copper-nickel sulfide ore are discussed and pointed out that the embedding particle size, embedding relationship, and gangue mineral type determine the formulation of the mineral processing process. Based on process mineralogy research, developing a scientific and reasonable comprehensive mineral processing process is the key to doing a good job of copper-nickel processing technology indexes, comprehensive recovery of various valuable metals, and improved economic benefits.
Pounding along expansion joints in steel moment resisting frames
Authors: Osman Ashraf , Salem Abu baker 
Published: February 2025

Abstract
In steel framed structures having large footprints or variable heights, expansion/ settlement joints are usually introduced by structural designers to minimize the straining actions developed within buildings structural elements. These joints separate the buildings into parts which are self-standing. During severe earthquake events, these parts vibrate differently causing pounding which result in damage to buildings structural elements. To overcome such problem, design codes suggested widening these expansion joints to avoid collision between building parts. However, such wide joints pose as challenge to architects since they affect buildings architectural appearance and internal use. This study examines the impact of minimizing the width of the expansion joints on the level of damage experienced by steel framed buildings during earthquakes. For such purpose, hypothetical porotype building having expansion joint between its parts were developed. The main lateral load resisting system for this building was characterized as limited ductile steel moment resisting frame according to Egyptian seismic code which is corresponding to Intermediate moment resisting frames in International codes. The parts of the building were having different number of floors and spans, so they can vibrate differently during earthquake. The building was subjected to seven different time histories with different a/v ratio (ground acceleration to ground velocity ratios). Non-linear inelastic analyses were performed to this building utilizing different expansion joint widths. The recurrence of pounding between buildings' parts in terms of locations and magnitude of pounding forces was identified for each analysis case and evaluated. In addition, the variation in beams & columns straining actions and the spread of plastic hinges within them was recorded and examined. From the obtained results it was concluded that the effect of pounding can be mitigated in this case if expansion joint width set equal to 0.5 the square root of the sum of the squares of the building parts inelastic displacements at collided floors provided the concept of strong column-weak beam is applied to the building.
Perioperative assessment and management of frailty in elderly patients: a national survey of Italian anesthesiologists
Authors: Greco Massimiliano , Luca Ersilia , Chiumiento Fernando , Behr Astrid U. , Bettelli Gabriella , Bignami Elena , Antonelli Massimo , Cecconi Maurizio , Aceto Paola 
Published: February 2025

Abstract

Background
The prevalence of frailty is increasing as the global population continues to age. Frailty is associated with poor perioperative outcomes including increased morbidity and mortality. The purpose of this study is to examine current practices and perspectives of anesthesiogists in Italy on the provision of care for elderly surgical patients with frailty.

Methods
We conducted a national survey. Data were collected via an online questionnaire distributed by the Italian Society of Anaesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI). Responses were collected over 24 weeks between October 2022 and March 2023.

Results
Seven-hundred thirteen anesthetists completed the survey. A total of 39.8% (277) of respondents were working in university hospitals. Frailty scoring was routinely performed in 51.8% of care settings. Only 26.3% of organizations surveyed had a dedicated pathway for perioperative management of frail elderly patients. The most common method for frailty assessment was the subjective assessment by the anesthesiologist (58.3%). More than half of the participants reported the use of ERAS items in most cases. Almost half of respondents reported the use of postoperative screening tools for delirium (45% of respondents).

Discussion
While these results point to the resistance to clinical implementation of frailty assessment, they also highlight the perceived need for careful management. This can help in identifying elderly patients who may require targeted perioperative management and in ensuring the preservation of cognitive and functional status.
Endocrine adverse reactions of tyrosine kinase inhibitors in combination with immune checkpoint inhibitors
Authors: Shao Wen , Yang Kaiwei , Lu Difei , Gao Ying , Zhang Junqing , Zhang Yang 
Published: February 2025

Abstract

Background
Tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs) were recognized to cause endocrine adverse reactions (EARs). However, combination therapy-associated EARs are still unclear.

Methods
This was a retrospective study based on FDA Adverse Event Reporting System. We identified 938,464 cases of all adverse events related to three types of treatments. A total of 22,275 cases were EARs and divided into TKIs (n=9,181), ICIs (n=11,363) and TKIs+ICIs group (n=1,731).

Results
The incidence of EARs was the highest in TKIs+ICIs followed by ICIs and TKIs group. TKIs+ICIs group had a higher risk of hypothyroidism than in ICIs group (OR 1.47, 95% CI [1.28-1.69]), while a lower risk compared to TKIs group (OR 0.68, 95% CI [0.58-0.79]). TKIs+ICIs group presented a higher risk of type 1 diabetes mellitus compared to TKIs group (OR 26.61, 95% CI [18.60-38.07]), but a lower risk compared to ICIs group (OR 0.63, 95% CI [0.47-0.84]). The risk of hypoglycaemia was approximately 2.77 times greater in TKIs+ICIs group than in ICIs group (OR 2.77, 95% CI [1.95-3.95]) and was also higher in TKIs group compared to ICIs group (OR 3.44, 95% CI [2.93-4.03]). Compared to ICIs group, TKIs+ICIs group did not display a higher risk of pituitary dysfunction and primary adrenal insufficiency. The mortality risk of TKIs+ICIs group was comparable to ICIs groups, but significantly lower than TKIs group.

Conclusions
EARs were more common in TKIs+ICIs therapy. The distribution of EARs in different glands varied among combination therapy and monotherapy. Combination therapy-associated EARs did not increase the risk of mortality.
Effect of 0.8mg/ml Losartan on Corneal Opacities
Authors: Fawad Aisha , Waqar Muzaffar  , Unnab Anjum  , Mahad Naseer Amer  
Published: February 2025

Losartan, commonly used as an angiotensin receptor II inhibitor for hypertension, has recently revealed additional therapeutic properties. Studies demonstrate its potential in treating liver fibrosis, mitigating heart disease secondary to radiation, reducing skin scar formation, and even reversing renal cortical fibrosis. In a specific case, a female patient suffering from persistent bilateral nummular keratitis and corneal opacities experienced significant improvement in her left eye after using 0.8mg/ml Losartan eye drops. Untreated right eye showed no change. Based on the positive outcome, patient was offered same treatment in her right eye as well with monthly follow-ups, which she happily accepted. The stark contrast between the treated and untreated eye highlights the promising role of Losartan in treating corneal opacities.
doi: https://doi.org/10.12669/pjms.41.3.11237
How to cite this: Fawad A, Muzaffar W, Anjum U, Amer MN. Effect of 0.8mg/ml Losartan on Corneal Opacities. Pak J Med Sci. 2025;41(3):926-928. doi: https://doi.org/10.12669/pjms.41.3.11237
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.