bluuebunny/crossref_metadata_2025_split huggingface dataset:
Carbon-based nanomaterials: interactions with cells, brain therapies, and neural sensing
Authors: Gárate-Vélez Lorena , Quintana Mildred 
Published: February 2025

Abstract
Carbon nanomaterials (CNMs) are characterized by their extensive surface area and extraordinary electronic, thermal, and chemical properties, offering an innovative potential for biomedical applications. The physicochemical properties of CNMs can be fine-tuned through chemical functionalization to design the bio-nano interface, allowing for controlled biocompatibility or specific bioactivity. This versatility offers a transformative approach to addressing the inherent limitations of conventional brain therapies, which frequently demonstrate low efficacy and significant adverse effects. This review delves into recent advances in understanding the intricate interactions between carbon nanostructures and cellular systems, highlighting their activity in brain therapy and neuronal sensing. We provide a comprehensive analysis of key nanostructures, including few-layer graphene (FLG), graphene oxide (GO), graphene quantum dots (GQD), single- and multi-walled carbon nanotubes (SWCNT and MWCNT), carbon nanohorns (CNH), carbon nanodiamonds (CNDs), and fullerenes (C60). Their unique atomic configurations and surface modifications are examined, revealing the underlying mechanisms that drive their biomedical applications. This review highlights how a deep understanding of the interactions between CNMs and cells can catalyze innovative neurotherapeutic solutions. By leveraging their unique properties, CNMs address critical challenges such as crossing the blood–brain barrier, improving therapeutic accuracy, and minimizing side effects. These advances have the potential to significantly improve the treatment outcomes of brain disorders, paving the way for a new era of targeted and effective neurological interventions.
Global, regional, and national trends in chronic kidney disease burden (1990–2021): a systematic analysis of the global burden of disease in 2021
Authors: Chen Jiaxi , Deng Miao , Zheng Rubin , Chen Yanjin , Pang Wenyi , Zhang Ziyang , Tan Zhouke , Bai Zhixun 
Published: February 2025

Abstract

Background
Chronic kidney disease (CKD) is a global health challenge with diverse etiologies. However, research on the incidence trends of CKD attributable to specific causes remains limited, and the incidence and mortality rates vary across regions. This study aims to identify the patterns and temporal trends of CKD incidence, providing valuable information for the development of targeted prevention strategies and interventions.

Methods
CKD data from the 2021 Global Burden of Disease Study (1990–2021) were analyzed by sex, region, country, cause, and Socio-demographic Index (SDI). Disease burden was assessed using age-standardized incidence (ASIR), mortality rates (ASMR), and estimated annual percentage changes (EAPC). Decomposition analysis evaluated population aging, growth, and epidemiological impacts. The autoregressive integrated moving average (ARIMA) model was used to predict the burden of CKD from 2021 to 2031, and the age-period-cohort (APC) model was employed to assess the effects of age, time, and cohort. Health inequality was analyzed using Slope Index of Inequality (SII) and Concentration Index (CI).

Results
In 2021, Saudi Arabia had the highest ASIR, while Mauritius had the highest mortality. China and India contributed the most cases and deaths. ARIMA forecasts CKD cases will rise to 22.21 million and deaths to 1.81 million by 2031. Epidemiological changes drove incidence growth in medium SDI regions and mortality in high SDI regions. EAPC correlated with ASIR and ASMR. APC analysis showed incidence peaked between 70–80 years, with earlier cohorts facing higher risks. Unknown causes, type 2 diabetes, and hypertension were the leading CKD etiologies. From 1990–2021, health inequality in CKD incidence and mortality worsened, especially in high SDI regions, where the mortality CI shifted from 0.05 to − 0.09.

Conclusions
This study estimated the temporal trends of CKD incidence and mortality globally, as well as at the national and regional levels, from 1990 to 2021. It was observed that countries with higher socio-demographic index (SDI) exhibited unfavorable trends, suggesting that these countries should develop more targeted and specific strategies to address the growing burden of CKD.
Genomic and Immune Landscape of Non–Small Cell Lung Cancer Brain Metastases
Authors: Liu Manlu , Jagodinsky Justin C. , Callahan S. Carson , Minne Rachel L. , Johnson D. Bryan , Tomlins Scott A. , Iyer Gopal , Baschnagel Andrew M. 
Published: February 2025

PURPOSE
Metastatic spread of non–small cell lung cancer (NSCLC) to the brain is a commonly occurring and challenging clinical problem, often resulting in patient mortality. Systemic therapies including immunotherapy have modest efficacy in treating brain metastases. Moreover, the local immune environment of brain metastases remains poorly described. This study aims to understand the genomic and immune landscape of NSCLC brain metastases.

METHODS

A total of 3,060 patients with NSCLC sequenced with the Strata Select assay on the Strata Oncology Platform were analyzed. Genomic alterations, tumor mutation burden (TMB),
PD-L1
expression, and immune gene expression were compared across different tissue sites and histologies and within brain metastases.

RESULTS

A significant increase in TMB was observed in the brain metastasis samples compared with nonbrain metastasis samples. Mutations in
TP53
,
KRAS
, and
CDKNA2A
were more prevalent within the brain metastasis cohort compared with other tissue locations. In addition,
PD-L1
expression was significantly decreased within brain metastasis samples compared with other sites. The overall immune landscape within the brain metastasis samples was largely reduced compared with primary lung samples. However, an immune-enriched brain metastasis cohort was identified with higher expressions of
PD-L1
and other immune-related genes.

CONCLUSION
The overall TMB is increased within brain metastases compared with primary lung and other metastasis sites and is associated with a markedly diminished overall immune landscape. The identification of an immune-enriched brain metastasis subgroup suggests potential heterogeneity within the brain metastasis patient cohort, which might have implications for the development of targeted therapies.
NTRK
Fusion–Positive Thyroid Carcinoma: From Diagnosis to Targeted Therapy
Authors: Marczyk Vicente R. , Fazeli Sasan , Dadu Ramona , Busaidy Naifa L. , Iyer Priyanka , Hu Mimi I. , Sherman Steven I. , Hamidi Sarah , Hosseini Sayed Mohsen , Williams Michelle D. , Ahmed Salmaan , Routbort Mark J. , Luthra Raja , Roy-Chowdhuri Sinchita , San Lucas Francis Anthony , Patel Keyur P. , Hong David S. , Zafereo Mark , Wang Jennifer R. , Maniakas Anastasios , Waguespack Steven G. , Cabanillas Maria E. 
Published: February 2025

PURPOSE

Neurotrophic tropomyosin receptor kinase (
NTRK
) fusions may act as an oncogenic driver in thyroid carcinomas. Given their low frequency, clinical, pathological, and molecular data on these patients and their responses to targeted therapies are limited.

METHODS
This is an observational retrospective study conducted at a single high-volume cancer center in the United States. Data were retrospectively collected from medical records.

RESULTS

We included 65 patients (37 adult, 28 pediatric) with an
NTRK
fusion–positive thyroid carcinoma (24
NTRK1
, 41
NTRK3
), of which 54 were papillary thyroid carcinomas (PTC), four poorly differentiated thyroid carcinomas (PDTC), and seven anaplastic thyroid carcinomas (ATC). In PTC, an extensive follicular growth pattern was seen in 22 (41%) patients. In adults,
NTRK3
fusions were 3 times more frequent (nine
NTRK1
, 28
NTRK3
), whereas in pediatric patients their frequencies were similar (15
NTRK1
, 13
NTRK3
;
P
= .021). In patients with PDTC/ATC treated with larotrectinib, we detected four emergent solvent front mutations (three
NTRK3
G623R, one
NTRK1
G595R) causing resistance to drug and disease progression. Three of them (two ATC, one PDTC) received second-line selitrectinib on a clinical trial. Partial responses were seen in all three patients, but both patients with ATC progressed within a year.

CONCLUSION

NTRK1
/
3
fusions are seen in PTC, PDTC, and ATC, and a follicular growth pattern was observed in a high proportion of cases. In patients treated with larotrectinib,
NTRK
solvent front mutations are the main resistance mechanism, frequently occurring in PDTC/ATC. Responses to single-agent TRK inhibitor are short-lived in patients with ATC; thus, these drugs should be used with caution in this population.
Effective use of Item Analysis to improve the Reliability and Validity of Undergraduate Medical Examinations: Evaluating the same exam over many years: A different approach
Authors: Zubairi Nadeem Alam , AlAhmadi Turki Saad , Ibrahim Mohamed Hesham , Hegazi Moustafa Abdelaal , Gadi Fahad Ussif 
Published: February 2025

Objective: MCQ exams are part of end-module assessments in undergraduate medical institutions. Item Analysis (IA) is the best tool to check their reliability and validity. It provides the Reliability Coefficient KR20, Difficulty Index (DI), Discrimination Index (DISC), and Distractor Efficiency (DE). Almost all research papers on IA are based on single exam analysis. We examined the IA of multiple exams of the same module, taken in four years. We aimed to explore the required consistency over the years and the effectiveness of IA-based post-exam measures.
Methodology: Item Analysis of eight final MCQ exams of the Pediatric module from 2020-21 to 2023-24, at the Faculty of Medicine in Rabigh, King Abdulaziz University, Saudi Arabia, were included in the study.
Results: All exams had KR20 of 90 and above indicating excellent reliability. Difficulty levels were consistent except for a single year. Discriminative ability was maintained over the years. Only 28 out of 800 MCQs had a negative DISC. All exams maintained good DE. Only 15 MCQs over four years had zero DE. The practice of reviewing all Non-Functional Distractors yielded a gradual improvement in exam quality
Conclusion: Besides the IA of individual exams, it is also recommended that IA of the same exam be evaluated over 4-5 years to see consistency and trends towards improvement. It helps in improving the reliability and validity by addressing deficiencies and deviations from the recommended standards
doi: https://doi.org/10.12669/pjms.41.3.10693
How to cite this: Zubairi NA, AlAhmadi TS, Ibrahim MH, Hegazi MA, Gadi FU. Effective use of Item Analysis to improve the Reliability and Validity of Undergraduate Medical Examinations: Evaluating the same exam over many years: A different approach. Pak J Med Sci. 2025;41(3):810-815. doi: https://doi.org/10.12669/pjms.41.3.10693
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.
Exploring Faculty and Academic Advisors’ Experiences Supporting College Students with Mental Health Challenges: A Qualitative Study Using Interpretative Phenomenological Analysis
Authors: Johns Shantalea 
Published: February 2025

Abstract:
This interpretive phenomenological study explores faculty and academic advisors’ experiences in supporting students with mental health challenges. Guided by the Theory of Planned Behavior, which suggests that personal beliefs, prior experiences, and familiarity with symptoms influence behavior, the study examines participant narratives to identify key factors that shape their approaches to supporting students. Findings indicate that personal beliefs about mental health, prior experiences with individuals facing mental health challenges, and campus-based mental health training opportunities all significantly enhance mental health support mechanisms for students outside traditional counseling settings. The ability of faculty and academic advisors to recognize signs of mental health challenges is critical for promoting overall campus well-being.
Sources, Obstacles, and Opportunities for Primary-role Advisor Professional Development: Perspectives from NACADA Leaders
Authors: McGill Craig M. 
Published: February 2025

Abstract:
This qualitative study explores the perceptions of NACADA leaders regarding institutional and structural sources, obstacles, and opportunities related to learning and professional development (PD) for primary-role academic advisors. Through semi-structured interviews with 17 NACADA leaders, the study identifies three key themes: the critical role of professional associations in supporting learning and growth, substantial financial and structural barriers to PD, and the essential need for institutional recognition and support. The findings highlight the complexities academic advisors face in enhancing their skills and professional standing, emphasizes the importance of professional communities, and identifies the challenges posed by current institutional frameworks. Implications for fostering a supportive environment for advisor learning and PD are discussed, along with recommendations for future research.
“No More Separation between Zion and Her Children”: Palestine as a Sacred Geography and the Roots of the Gaza Genocide
Authors: Yaghi Adam A. H. 
Published: February 2025

Abstract
This article maps out the Gaza genocidal rhetoric onto a genealogy of European-American imaginative re-makings of the geography of Palestine. This tradition, rooted in nineteenth-century visions of ethnically cleansing and repurposing the land according to colonial and theological worldviews, has systematically imagined freeing a barren Palestine from Palestinian barbarity, neglect, and spiritual corruption. This hegemonic tradition and its geographies of domination, however, have not gone unchallenged. Indeed, as a model – one rarely studied though, Ibrahim Fawal’s diasporic Palestinian novel On the Hills of God offers an alternate anti-colonial geography of resistance. To develop its claims, the article first uses a body of interdisciplinary scholarship to establish the genealogy and expose its genocidal spatial remapping of Palestinian geography. It, next, strategically resorts to On the Hills of God as an anti-colonial text that not only uncovers the Zionist destruction of a fairly harmonious multifaith local cultural geography in pre-1948 Palestine, but also captures traumatic memories of a nation currently besieged in its shrinking indigenous geography, exposes established hegemonic narratives, and charts a trajectory of resistance.
A single dose of inactivated influenza virus vaccine expressing COBRA hemagglutinin elicits broadly-reactive and long-lasting protection
Authors: Shi Hua , Zhang Xiaojian , Ross Ted M. 
Published: February 2025

Influenza virus infections present a pervasive global health concern resulting in millions of hospitalizations and thousands of fatalities annually. To address the influenza antigenic variation, the computationally optimized broadly reactive antigen (COBRA) methodology was used to design influenza hemagglutinin (HA) or neuraminidase (NA) for universal influenza vaccine candidates. In this study, whole inactivated virus (WIV) or split inactivated virus (SIV) vaccine formulations expressing either the H1 COBRA HA or H3 COBRA HA were formulated with or without an adjuvant and tested in ferrets with pre-existing anti-influenza immunity. A single dose of the COBRA-WIV vaccine elicited a robust and broadly reactive antibody response against H1N1 and H3N2 influenza viruses. In contrast, the COBRA-SIV elicited antibodies that recognized fewer viruses, but with R-DOATP, its specificity was expanded. Vaccinated ferrets were protected against morbidity and mortality following challenge with A/California/07/2009 at 14 weeks post-vaccination with reduced viral shedding post-infection compared to the naïve ferrets. However, the COBRA-IIVs did not block the viral transmission to naïve ferrets. The contact infection induced less severe disease and delayed viral shedding than direct infection. Overall, the COBRA HA WIV or the COBRA HA SIV plus R-DOTAP elicited broadly reactive antibodies with long-term protection against viral challenge and reduced viral transmission following a single dose of vaccine in ferrets pre-immune to historical H1N1 and H3N2 influenza viruses.
IMPORTANCE The goal of the next-generation influenza vaccine is to provide broadly reactive protection against various drifted influenza strains. With the previous studies evaluating the COBRA HA-based vaccines, the breadth of antibody activities was confirmed following two or three vaccinations. However, for the commercial influenza vaccine, only one shot is required. In this study, only one shot was administrated to the pre-immune ferrets and the COBRA-WIV efficiently elicited broadly reactive antibodies and long-lasting protection against the pdm09 strain. Moreover, this study showed that different infection methods can lead to different disease severity, which emphasizes the significance of the model selection. The infection was conducted 14 weeks post-vaccination to evaluate the long-term protection elicited by only one vaccination. This is the first longevity study describing the immune responses elicited by COBRA-IIVs in ferrets and provides promising results for the potential clinical utilization.
COVID-19 symptom severity and duration among outpatients, July 2021-May 2023: The PROTECT observational study
Authors: Vashi Bhavya , Pettrone Kristen , Wilson Claire S. , Chenoweth Josh G. , Brandsma Joost , Gregory Melissa K. , Genzor Pavol , Striegel Deborah A. , Rothman Richard E. , Hansoti Bhakti , Avornu Gideon D. , McBryde Breana , Zimmerman Lauren Reynolds , Woods Christopher W. , Petzold Elizabeth A. , Cowden Jessica , Nitayaphan Sorachai , Nasomsong Worapong , Clark Danielle V. 
Published: February 2025

Introduction
With the emergence of new SARS-CoV-2 variants has come significant variations in disease manifestation, severity, and duration in non-hospitalized infected patients. To characterize symptom patterns and risk factors associated with symptom severity and duration, COVID-19 and influenza-like illness (ILI) outpatients and their contacts were enrolled at two sites in the United States of America and one site in Thailand.

Methods
COVID-19 infection was confirmed at enrollment with a positive antigen or PCR test. Baseline demographics and medical histories were collected from participants at enrollment and daily self-reported symptom questionnaires were obtained to assess symptom severity and duration. Risk factors associated with symptom severity and duration were determined by multivariate logistic regression and Cox proportional hazards model.

Results
Two hundred and forty one participants meeting the eligibility criteria were enrolled, including 174 confirmed COVID-19 cases (9% Delta and 90% Omicron), 33 ILI cases, and 34 healthy contacts. COVID-19 participants had a shorter median symptom duration of 9.0 (95% CI, 8.0–11.0) days than ILI participants. Infection with the Delta variant resulted in a longer symptom alleviation period compared to infection with the Omicron variant. The most commonly reported symptoms among COVID-19 participants were reported in the nasal and chest/respiratory domains of the FLU-PRO Plus. Participants infected with the Delta variant reported more symptoms overall, with significantly more symptoms affecting eyes and senses reported. 55% of SARS-CoV-2-positive participants reached a negative N1 Ct value by the day 14 study time point. No risk factors for moderate to severe symptoms were identified in this outpatient cohort. Male sex was associated with a shorter symptom duration.

Conclusion
Symptom manifestation varied among Delta and Omicron variants. Few risk factors were identified for increased symptom severity or duration.
HIV retesting prevalence among clients accessing anti-retroviral therapy and HIV testing services in Ghana
Authors: Adu-Gyamfi Raphael , Addo Stephen Ayisi , Baddoo Nyonuku Akosua , Kenu Ernest , Ashinyo Anthony , Owusu Kwadwo Koduah , Chihana Menard Laurent , Adams Alice Sallar , Magdalene Odikro , Bandoh Delia , Abdulai Marijanatu , Danso Kenneth , Senya Kafui , Johnson Cheryl 
Published: February 2025

Introduction
Ghana is working towards achieving the 95-95-95 targets for its HIV response. One challenge has been low linkage to care rates, possibly due to high rates of retesting among people living with HIV who are already aware of their status. This leads to an overestimation of the first 95 and a subsequent underestimation of the second 95. This study aimed to measure the prevalence of HIV retesting among PLHIV in Ghana who are already aware of their status and to explore their reasons for retesting.

Methods
This was a facility-based cross-sectional study conducted in the three ecological zones of Ghana. A total of 11,145 individuals from 30 ART centres and 90 HTS centres participated. The sample size for each zone was determined proportionally based on the number of people enrolled in ART. A profiling tool was used to assess testing behaviours among clients visiting HTS sites linked to ART clinics. Focus group discussions were also conducted with clients and health workers to gather their perceptions of reasons for retesting.

Results
Participants were predominantly female (74.3%; 8,285/11,145), with a median age (interquartile range) of 43.0 (35–52). The prevalence of retesting among ART clients was 32.9% [95% CI: 0.32–0.34] (3,670/11,145). Among those who retested, the majority did so twice (2,041; 55.6%). Of the clients who tested positive for HIV during the study period, 53.1% (43/835; 95% CI: 0.49–0.57) had a previous HIV diagnosis. Adjusting for retesting, the positivity rate at HTS sites decreased from 8.4% to 4.1%. Key reasons for retesting included the desire to confirm diagnosis, denial and doubt regarding test results, retesting required due to documentation issues, and religious beliefs.

Conclusion
The prevalence of retesting over the past six years was found to be high, resulting in an overestimation of HIV positivity rates and affecting linkage to care. Implementing interventions to accurately account for retesting instances may improve data accuracy and the country’s linkage to care rate, bringing Ghana closer to achieving the 95-95-95 targets.