bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Manifestations and Challenges in Adolescent and Adult Females With Classic Congenital Adrenal Hyperplasia Due to 21-Hydroxylase Deficiency
Authors: Engberg Hedvig , Nordenström Anna , Hirschberg Angelica Lindén 
Published: January 2025

Abstract
Classic congenital adrenal hyperplasia due to 21-hydroxylase deficiency (CAH) is a rare genetic condition that results in cortisol deficiency and excess production of adrenal androgens. While the introduction of newborn screening for CAH has reduced morbidity and mortality, management of CAH remains challenging. Lifelong treatment with glucocorticoids is required to replace the endogenous cortisol deficiency and reduce excess adrenal androgens. Undertreatment or overtreatment with glucocorticoids can lead to multiple disease- and treatment-related comorbidities, including impaired growth and compromised final height, menstrual irregularities and reduced fertility in females, and long-term cardiometabolic complications. In addition to avoiding adrenal crisis and sudden death, treatment goals in adolescent females with CAH are to obtain normal growth and bone maturation and normal timing of puberty. Management of adolescents is particularly challenging due to changes in growth and sex hormone levels that can lead to inadequate suppression of adrenal androgens and increasing independence that can affect treatment adherence. During the transition to adult care, treatment goals focus on preventing symptoms of hyperandrogenism, preserving menstrual regularity and fertility, and providing education and support for issues related to sexuality, atypical genitalia, and/or complications from previous surgical treatment. In addition, patients must be monitored continuously to prevent long-term complications such as decreased bone mineral density, obesity, diabetes, and hypertension. In this review, we discuss the challenges faced by adolescent and adult females with CAH and provide guidance to health-care professionals to help patients to navigate these challenges.
Barriers to the Management of Classic Congenital Adrenal Hyperplasia Due to 21-Hydroxylase Deficiency
Authors: Eitel Kelsey B , Fechner Patricia Y 
Published: January 2025

Abstract
Classic congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency is a rare genetic condition that requires lifelong management from birth. Individuals with CAH and their families often face structural barriers to obtaining comprehensive care and treatment, including limited access to appropriate newborn screening, comprehensive care centers, and medications. Social and cultural barriers to care may include stigmatization, discrimination, and adverse medical experiences. At the individual and family level, comprehensive care may be affected by education, finances, health-care coverage, geographic location, and lack of social supports. These barriers are often further magnified for individuals living in underresourced countries. Inadequate access to comprehensive care and medications increases the risk of life-threatening adrenal crisis and disease-related comorbidities. This review article examines the current structural, sociocultural, and individual barriers that individuals with CAH and their families may face when managing their condition throughout their lifetime.
Interferon (IFN)-gamma (γ) inducible protein 10 (IP-10) in the diagnosis of latent and active tuberculosis in Bacille Calmette Guerin (BCG)-vaccinated pediatric population
Authors: Druszczynska Magdalena , Seweryn Michał , Wawrocki Sebastian , Pankowska Anna , Kulbachko Anastasiia , Jurczak Magdalena , Kowalewska-Pietrzak Magdalena 
Published: January 2025

Background
Accurate diagnosis of tuberculosis (TB) in children continues to be challenging, primarily due to the low bacterial load characteristic of the disease and the obstacles in collecting sputum samples. Furthermore, detecting cases of latent Mycobacterium tuberculosis (M.tb) infection (LTBI) that have a high risk of progressing to active TB disease remains a significant diagnostic hurdle.

Objective
The study explored the utility of interferon-gamma (IFN-γ) inducible protein 10 (IP-10) for diagnosing latent and active M.tb infections among children vaccinated with the Bacille Calmette-Guerin (BCG) vaccine. The research specifically assessed IP-10 levels in serum, urine, and QuantiFERON-TB Gold Plus (QFT) cultures stimulated with M.tb antigens to determine if IP-10 could be a useful diagnostic marker for pediatric tuberculosis, either alongside or as an alternative to IFN-γ.

Results
Both urine and QFT cultures stimulated with M.tb antigens showed significantly higher IP-10 levels in individuals with active TB or latent TB infection (LTBI) when compared to those uninfected by M.tb but with nonmycobacterial pneumonia (NMP) and healthy controls (HC). Similarly, IFN-γ levels in M.tb-stimulated QFT cultures were significantly higher in the TB and LTBI groups compared to the NMP and HC groups. Notably, the study found a significant difference in IFN-γ levels between the TB and LTBI groups in the QFT cultures, a distinction not observed for IP-10 concentrations. Serum levels of IP-10 and IFN-γ did not significantly vary across the study cohorts.

Conclusions
IP-10 might be a viable alternative biomarker to IFN-γ for identifying M.tb infection in BCG-vaccinated children, although it cannot distinguish between latent and active TB cases. This highlights the potential of IP-10 in improving TB diagnosis among children, addressing the challenges posed by the paucibacillary nature of pediatric TB, but also underscores the need for further research to refine diagnostic approaches for distinguishing between latent and active TB infections.
Antenatal depression among pregnant women in Ethiopia: An umbrella review
Authors: Abebe Mesfin , Asgedom Yordanos Sisay , Gebrekidan Amanuel Yosef , Tebeje Tsion Mulat 
Published: January 2025

Introduction
Antenatal depression, ranging from mild to severe, is influenced by hormonal changes during pregnancy and childbearing years, making it a significant public health issue. Antenatal depression, with its far-reaching effects on mothers, infants, and children, continues to be a significant public health issue in developing countries such as Ethiopia. Research on antenatal depression in Ethiopia has produced varied results. Although previous systematic reviews and meta-analyses studies have addressed this topic, a comprehensive summary of existing reviews has not been available. Therefore, this umbrella review aims to consolidate the findings on antenatal depression and associated factors among pregnant women in Ethiopia.

Methods
This review included five systematic reviews and meta-analyses from various databases, including PubMed, PsycINFO, Research4life, CINHALE and Science Direct. Only reviews published between January 1, 2010, and July 30, 2024, were considered. The search, conducted from August 5 to 15, 2024, used CoCoPop questions and included only English-language reviews. Study quality was assessed with the AMSTAR tool, and data extraction and analysis were performed using Microsoft Excel 2016 and STATA 14.0. The I2 and Cochran’s Q tests were used to assess heterogeneity. Pooled effect sizes were calculated based on the pooled prevalence of antenatal depression and odds ratios for associated factors, with a 95% confidence interval indicating statistical significance.

Results
This umbrella review encompassed 50 primary studies from five systematic reviews and meta-analyses, involving a total of 25,233 pregnant women. The pooled prevalence of antenatal depression in Ethiopia was found to be 24.60% (95% CI: 22.46–26.73). Significant associations were identified between antenatal depression and several factors: unplanned pregnancy (POR = 2.29; 95% CI: 1.75, 2.82), poor social support (POR = 2.10; 95% CI: 1.37, 2.84), history of abortion (POR = 2.49; 95% CI: 1.64, 3.34), history of depression (POR = 3.57; 95% CI: 2.43, 4.71), and history of obstetric complications (POR = 2.94; 95% CI: 1.61, 4.28).

Conclusions
The significant prevalence of antenatal depression (24.60%) among pregnant women in Ethiopia is closely linked to factors such as unplanned pregnancy, poor social support, history of abortion, previous depression, and obstetric complications. To tackle this issue, it is recommended to enhance social support networks, increase access to family planning services to minimize unplanned pregnancies, conduct regular mental health screenings, and incorporate mental health services into antenatal care.
Close to the border—Resilience in healthcare in a European border region: Findings of a needs analysis
Authors: Loeffler Leonie A. K. , Lambert Sophie Isabelle , Bouché Lea , Klasen Martin , Sopka Saša , Vogt Lina ,   COMPAS Consortium
Published: January 2025

Objectives
Promoting resilience, the ability to withstand and overcome challenging situations, is crucial for maintaining the performance of healthcare systems. Unique challenges faced by healthcare facilities in border regions render them particularly vulnerable during crises, emphasizing the need to promote resilience in these areas. The current study evaluated the state and needs of resilience in healthcare professionals in a representative European border region.

Methods
All hospitals and emergency medical care services in the Euregio Meuse-Rhine (Germany, Belgium, the Netherlands) were approached to participate via an online-survey. Behavioral data on psychological distress (Patient Health Questionnaire-4), work-related stressors, individual resilience (Brief Resilience Scale, Resilience at Work scale), and organizational resilience (Benchmark Resilience Tool-short) were collected.

Results
2233 participants initiated the survey with 500 responses included in the analysis. 46% of the participants indicated clinically significant psychological distress. Most challenging stressors were staff availability, available time, and workload. On average, individual resilience was in the normal range, yet 15.6% showed below average resilience. At the organizational level, healthcare institutions can particularly enhance resilience in the domains of Internal resources, Situation Awareness, and Unity of purpose. Compared to their neighbor countries, German healthcare professionals indicated higher levels of depressive symptoms, were more burdened by work-related stressors, and reported lower levels of organizational resilience.

Conclusion
Findings highlight that healthcare institutions not only need to promote the resilience of the individual employee particularly in border regions, healthcare institutions, must also act to be better prepared for potential threats and crises while considering each country’s unique needs.
DIVERSIDADE NA UNIVERSIDADE
Authors: Abreu de Queiroz Mírian , Oliveira Guimarães Marina , Alves Perdigão Denis 
Published: January 2025

A pesquisa teve por objetivo investigar a percepção e vivência de discentes transgênero no ambiente acadêmico da Universidade Federal de Juiz de Fora (UFJF). Realizamos uma pesquisa de abordagem qualitativa, com coleta de dados por meio de entrevistas semiestruturadas. Para a análise do corpus se utilizou a análise semântica de discurso. A pesquisa contou com a colaboração de discentes vinculados à Universidade Federal de Juiz de Fora. A pesquisa evidenciou que, embora a UFJF se apresente como espaço de inclusão e mobilidade social, ainda reflete as desigualdades e o conservadorismo da sociedade contemporânea. Concluiu-se pela necessidade de ações afirmativas concretas e sustentáveis que assegurem a plena inclusão e respeito às pessoas trans na universidade, criando um ambiente acadêmico verdadeiramente acolhedor e inclusivo.
INTEGRANDO A EPISTEMOLOGIA FEMINISTA DE SANDRA HARDING À IDENTIDADE CIENTÍFICA
Authors: Gedoz Laís , Monteiro Nascimento Matheus 
Published: January 2025

A literatura nacional sobre gênero no Ensino de Física e de Ciências apresenta uma escassez de estudos teóricos sobre a noção de identidade científica. Para diminuir essa lacuna, este trabalho teve como objetivo realizar um estudo teórico que articula a abordagem de Sandra Harding sobre epistemologia feminista, os estudos sobre identidade de Dorothy Holland, o modelo de identidade científica na Física de Zahra Hazari e a análise de discurso de James Paul Gee. Na construção da articulação teórica, foi desenvolvida uma análise da consistência entre as abordagens, a articulação entre os principais conceitos de cada obra e realizado um diálogo com a literatura. Através da integração dessas abordagens, identificou-se que o campo da Física é constituído por uma cultura predominantemente masculina, que favorece o sucesso dos homens. Essa cultura pode impactar negativamente no desenvolvimento da identidade científica das mulheres e de grupos minoritários, influenciando sua persistência em cursos de Física.
A INVISIBILIDADE DA MÃE CIENTISTA
Authors: Marta Moraes Castro Michele , Fernandes Tereza 
Published: January 2025

Este artigo surge no contexto de um grupo de estudos livres, que investiga os feminismos plurais mediados por tecnologias digitais em rede, na universidade, na escola e com mulheres ciberfeministas. O objetivo é compreender a relação entre gênero, maternidade, ciência e tecnologias e refletir sobre as conquistas das mães pesquisadoras, como a inclusão da licença-maternidade no currículo Lattes, no contexto do projeto Parent in Science, para apoiar mães na ciência e na conquista dos seus direitos enquanto pesquisadoras. A metodologia se baseia na abordagem de pesquisa-formação na cibercultura, em que a docência não se separa da pesquisa, e considera os espaços de formação em sua multirreferencialidade. Os resultados destacam a necessidade de superar políticas públicas isoladas, enfatizando a urgência de transformar a estrutura androcêntrica em uma perspectiva feminista plural, para integrar maternidade e ciência como formas de existência social da mulher.
Mathematical modelling of MHD hybrid nanofluid flow in a convergent and divergent channel under variable thermal conductivity effect
Authors: Alharbi Abdulaziz H. 
Published: January 2025

Abstract
The aim of this research is to analyse the combined effect of variable thermal conductivity and nonlinear thermal radiation on magnetohydrodynamic (MHD) hybrid nanofluid flow in convergent-divergent channels. The effects of two nanoparticles (i.e.

ZrO

2

{\text{ZrO}}_{\text{2}}

and

SiO

2

{\text{SiO}}_{\text{2}}

) in base fluid (i.e.

H

2

O

{\text{H}}_{\text{2}}\text{O}

) are considered in this work. The partial differential equations modelling the problem are reduced to ordinary differential equations following the application of the similarity transformations. The system has been solved analytically with the differential transform method and numerically with the Runge–Kutta–Fehlberg 4th–5th order method with the assistance of the shooting technique. Comprehensive analysis and discussion have been conducted regarding the impact of multiple governing parameters on the dimensionless velocity and temperature distributions. These parameters include variable thermal conductivity, nonlinear thermal radiation, Hartman number, and hybrid nanoparticle volume fraction. Finally, this method will provide some insights into the usefulness of MHD hybrid nanofluid flow in convergent-divergent channels, and the results produced by the analytical data have also been strengthened and verified by the use of numerical data as well as data from the literature.
Quantitative immunohistochemistry analysis of breast Ki67 based on artificial intelligence
Authors: Wang Wenhui , Gong Yitang , Chen Bingxian , Guo Hualei , Wang Qiang , Li Jing , Jin Cheng , Gui Kun , Chen Hao 
Published: January 2025

Abstract
Breast cancer is a common malignant tumor of women. Ki67 is an important biomarker of cell proliferation. With the quantitative analysis, it is an important indicator of malignancy for breast cancer diagnosis. However, it is difficult to accurately and quantitatively evaluate the count of positive nucleus during the diagnosis process of pathologists, and the process is time-consuming and labor-intensive. In this work, we employed a quantitative analysis method of Ki67 in breast cancer based on deep learning approach. For the diagnosis of breast cancer, according to breast cancer diagnosis guideline, we first identified the tumor region of Ki67 pathological image, neglecting the non-tumor region in the image. Then, we detect the nucleus in the tumor region to determine the nucleus location information. After that, we classify the detected nucleuses as positive and negative according to the expression level of Ki67. According to the results of quantitative analysis, the proportion of positive cells is counted. Combining the above process, we design a breast Ki67 quantitative analysis pipeline. The Ki67 quantitative analysis system was assessed on the validation set. The Dice coefficient of the tumor region segmentation model was 0.848, the Average Precision index of the nucleus detection model was 0.817, and the accuracy of the nucleus classification model was 96.66%. Besides, in clinical independent sample experiment, the results show that the proposed breast Ki67 quantitative analysis system achieve excellent correlation with the diagnosis efficiency of doctors improved more than ten times and the overall consistency of diagnosis is intra-group correlation coefficient: 0.964. The research indicates that our quantitative analysis method of Ki67 in breast cancer has high clinical application value.
Research on thermal aging characteristics of silicone rubber composite materials for dry-type distribution transformers
Authors: Li Woyang , Zhou Lijun , Qian Yunyun , Lei Qian , Xia Yingyi , Wang Dongyang 
Published: January 2025

Abstract
To enhance the long-term operational stability of transformers, this study focuses on silicone rubber composite insulation materials for dry-type distribution transformers (D-DTs). Based on obtaining the optimal initial performance of silicone rubber composite materials through response surface model, the thermal aging characteristics and long-term stability of intrinsic silicone rubber and silicone rubber composites are compared using molecular simulations, thermogravimetric analysis, and accelerated thermal aging tests. The results indicate that the addition of a small amount of h-boron nitride (BN) and Al2O3 can improve the thermal stability of the composite materials, and the decline in elongation at break is the key factor determining the thermal lifetime of silicone rubber. The silicone rubber composite material doped with 21.42 phr h-BN, 1.58 phr carbon nanotubes, and 2.67 phr Al2O3, based on the optimal initial performance, is projected to have a lifetime of 3,128 h under accelerated thermal aging at 200°C and 27.40 years under stable operating conditions of D-DTs, making it suitable for widespread application.
Reduced neural responses to natural foreground versus background sounds in auditory cortex
Authors: Hamersky Gregory R. , Shaheen Luke A. , López Espejo Mateo , Wingert Jereme C. , David Stephen V. 
Published: January 2025

In everyday hearing, listeners face the challenge of understanding behaviorally relevant foreground stimuli (speech, vocalizations) in complex backgrounds (environmental, mechanical noise). Prior studies have shown that high-order areas of human auditory cortex (AC) pre-attentively form an enhanced representation of foreground stimuli in the presence of background noise. This enhancement requires identifying and grouping the features that comprise the background so they can be removed from the foreground representation. To study the cortical computations supporting this process, we recorded single unit activity in AC of male and female ferrets during the presentation of concurrent natural sounds from these two categories. In contrast to expectations from studies in high-order AC, single-unit responses to foreground sounds were strongly reduced relative to the paired background in primary and secondary AC. The degree of reduction could not be explained by a neuron’s preference for the foreground or background stimulus in isolation but could be partially explained by spectro-temporal statistics that distinguish foreground and background categories. Responses to synthesized sounds with statistics either matched or randomized relative to natural sounds showed progressively decreased reduction of foreground responses as natural sound statistics were removed. These results challenge the expectation that cortical foreground representations emerge directly from a mixed representation in the auditory periphery. Instead, they suggest the early AC maintains a robust representation of background noise. Strong background representations may produce a distributed code, facilitating selection of foreground signals from a relatively small subpopulation of AC neurons at later processing stages.Significance statementPerception of important sounds in a world cluttered with competing background noise requires the ability to segregate relevant and irrelevant sound sources. Most prior work investigating neural mechanisms of this background/foreground contrast has supported the theory that auditory cortex activity is largely invariant to background noise, consistent with evidence from behavioral studies. However, it remains unclear what information about background noise is represented at the single-unit level. Here, contrary to prevailing theories, we show a relative dominance of single-unit responses to natural background noise over responses to natural foreground sounds in ferret auditory cortex. A robust representation of background noise in early stages of auditory cortex may be necessary for grouping features into perceptual objects and selecting information from foreground signals for preferential representation in downstream brain areas.