bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reliability assessment of CT enhancement rate and extracellular volume in liver fibrosis prediction
Authors: Salahshour Faeze , Abkhoo Aminreza , Sadeghia Sina , Safaei Masoomeh 
Published: February 2025

Abstract

Background
Reliable, non-invasive evaluation of liver fibrosis is essential for early disease management. Computed tomography (CT)-based extracellular volume (ECV) fraction and portal venous phase enhancement rate (VP-ER) have shown potential in quantifying mild-to-moderate fibrosis. This study investigates the diagnostic performance of ECV and VP-ER in differentiating non-significant (F0–F1) from significant (F2–F3) fibrosis in biopsy-confirmed patients.

Methods
Ninety-three patients (20–72 years, 56.9% male) undergoing liver biopsy and multiphasic CT scans were retrospectively enrolled. Patients with METAVIR F4 cirrhosis or incomplete imaging/pathological data were excluded. Hematocrit levels were obtained on the day of CT. ECV was calculated from differences in liver and aortic attenuation between delayed and enhanced phases, adjusted for hematocrit. VP-ER was derived as the ratio of liver attenuation in venous to portal venous phases multiplied by 100. Spearman’s correlation, receiver operating characteristic (ROC) curves, and DeLong tests evaluated their performance. Multiple logistic regression assessed independent contributions of ECV and VP-ER to fibrosis status.

Results
Fifty-three patients had no significant fibrosis (F0–F1) and 40 had significant fibrosis (F2–F3). ECV demonstrated a moderate correlation with fibrosis grade (r = 0.531, p < 0.0001), while VP-ER showed a weaker yet statistically significant correlation (r = 0.363, p = 0.0003). ROC analyses yielded an area under the curve (AUC) of 0.698 for ECV (cut-off = 38%) and 0.763 for VP-ER (cut-off = 71%), with no significant difference between AUCs (p = 0.358). VP-ER accurately classified 70 patients, while ECV correctly predicted 65. Logistic regression revealed significant associations for both VP-ER (OR = 1.08; p = 0.007) and ECV (OR = 1.025; p = 0.0132), achieving 72.04% classification accuracy and an overall AUC of 0.756 (95% CI: 0.688–0.863).

Conclusion
ECV fraction and VP-ER demonstrated reliable, complementary capabilities for distinguishing non-significant fibrosis from significant fibrosis. Their combined use in routine multiphasic CT protocols may reduce dependence on invasive biopsy while offering robust sensitivity and specificity for early fibrosis assessment. Further studies including cirrhotic populations and larger cohorts are recommended.
Association between hydrocarbon exposure and risk of stroke: a systematic literature review
Authors: Shabil Muhammed , Gaidhane Abhay M. , Vadia Nasir , Menon Soumya V. , Chennakesavulu Kattela , Panigrahi Rajashree , Bushi Ganesh , Jena Diptismita , Rani Anju , Sah Sanjit , Singh Mahendra , Satapathy Prakasini , Goh Khang Wen , Razaqi Nosaibah 
Published: February 2025

Abstract

Background
Hydrocarbon exposure, including polycyclic aromatic hydrocarbons (PAHs) and volatile organic compounds (VOCs), is increasingly linked to vascular dysfunction and stroke, a leading cause of morbidity and mortality globally. Common in occupational and environmental contexts, hydrocarbons induce oxidative stress, systemic inflammation, and endothelial dysfunction, disrupting vascular health. This systematic review examines the association between hydrocarbon exposure and stroke, emphasizing specific metabolites and their cerebrovascular effects.

Methods
A comprehensive search across PubMed, Embase, and Web of Science was conducted through December 10 2024, identifying observational studies exploring hydrocarbon exposure and stroke risk. Studies meeting predefined inclusion criteria, excluding those with major methodological flaws, were synthesized narratively. Variations in hydrocarbon types, population demographics, and stroke outcomes were considered.

Results
Six studies, including five cross-sectional and one retrospective cohort, with sample sizes ranging from 5,537 to 283,666 participants, demonstrated significant associations between hydrocarbon exposure and stroke risk. Key findings revealed strong associations for metabolites like 1-hydroxynaphthalene (OR: 1.89; 95% CI: 1.62–2.20) and 2-hydroxyfluorene (OR: 1.94; 95% CI: 1.66–2.26). However, variability in findings was noted, attributed to differences in study design, exposure levels, and populations studied.

Conclusion
This review highlights a complex relationship between hydrocarbon exposure and stroke risk, with some studies indicating significant associations and others reporting inconsistencies. Standardized, large-scale research is essential to clarify this relationship, identify high-risk populations, and guide public health strategies to mitigate exposure and prevent stroke.

Clinical trial number
Not applicable.
“We just have to work with what we’ve got”: a qualitative analysis of contextual challenges in facilities and resources for pupil physical activity in English primary schools
Authors: House Danielle , Walker Robert , Emm-Collison Lydia , Kent-Saisch Simona , Salway Ruth , Porter Alice , de Vocht Frank , Jago Russell 
Published: February 2025

Abstract

Background
State primary schools present an opportunity to support children’s physical activity equitably, however, many school-based physical activity interventions have been unsuccessful. Many interventions have focused on school built environments to increase or measure the physical infrastructure a school has. Yet literature suggests that broader social and institutional factors, such as school policies and staffing, are equally crucial for supporting pupil’s physical activity. The aim of this study is to qualitatively explore and assess primary school staff perspectives on the role of school facilities and resources in supporting pupil physical activity and the factors that impact their use.

Methods
We conducted 33 semi-structured interviews with state primary school staff in the Bristol area, Southwest England, between November 2023 and January 2024. Staff roles included headteacher/principal (n = 5), deputy headteacher/principal (n = 6), class teacher (n = 7), teaching assistant (n = 2), Physical Education (PE) subject lead (n = 8), dedicated PE teachers (n = 4), and Parent Teacher Association chair (n = 1). Staff were recruited from 19 purposively-sampled schools with a range of school sizes, locations, and sociodemographic characteristics. Reflexive thematic analysis was used.

Results
Five themes were generated related to how school facilities and resources impact pupil physical activity: 1) Facilities and resources create potential for pupil physical activity, 2) A social context supportive of physical activity is needed to maximise this potential, 3) Logistical challenges undermine the potential of facilities and resources, 4) The potential of facilities and resources change throughout the school year, and 5) Facilities and resources are not always fit for purpose.

Conclusion
The presence of facilities or resources alone does not determine pupil physical activity at primary school. Factors such as the social context of the school, logistical and timetabling challenges, seasonality, and how fit for purpose facilities are for that school, are important factors in school staff and pupils’ use and management of these facilities, and whether their potential is maximised or undermined. Future research and policy must broaden the focus from the presence of facilities and resources for physical activity, to include a focus on how these are maintained and engaged with in a school’s specific context.
If not us, then who? Ethnographic insights into nurses’ role in redesigning a rural health service to meet changing demands
Authors: Krone-Hjertstrøm Helle , Norbye Bente , Abelsen Birgit , Obstfelder Aud Uhlen 
Published: February 2025

Abstract

Background
The increasing prevalence of chronic diseases and an ageing population challenge healthcare delivery, particularly in rural areas. Redesigning health services to meet these changing demands is crucial, esially in rural healthcare where service providers face capacity and expertise limitations. This paper explores how the rural context influences nurses' roles in the clinic and the process of redesigning a rural emergency clinic in Northern Norway to include a Municipal Inpatient Acute Care Service (MipAC).

Methods
The study combines observations (250 h), several in situ interviews with healthcare personnel, and individual in-depth interviews with nurses (n = 8) at the emergency clinic in a rural area in northern Norway. To explore nurses’ role in the clinic and in the redesign process, we were inspired by the theory of social organisation of healthcare work.

Results
The study highlights three prominent aspects of the rural dimension that are crucial for understanding the nurses’ role in the redesign process. First, ‘Absent present PCPs’ highlights how nurses ensure continuity of care during the intermittent absence of primary care physicians (PCPs). Second, ‘Learning without doing’ shows how the nurses utilized their competence, past experiences, and understanding of local conditions to adapt standardised guidelines, develop new work processes, and establish a framework that compensates for the lack of practical experience, enabling the clinic to function effecively under potential challanging circumstances. Third, ‘The local nurse' emphasises how the nurses’ connection to the local community influences how they organize care; they are commited to local adaptation and ensuring that "their" residents have acess to what they consider high-quality services.

Conclusion
The nurses’, experience, dedication, and orientation towards the local community were crucial for the redesign process. The nurses ensured the continuiety in the clinic, despite the PCP's sporadic presence, adapted the standardized guidelines to a rural context and were crucial in organising patient care in the rural area. The study shows that the nurses organizing work, which often remains invisible, is essential in the redesign process. The study indicates that the scope of practice for nurses is more extensive in rural areas and should receive greater attention. in both research, practice and health policy
Ultra-processed food consumption in the central division of Fiji
Authors: Palu Aliyah , Santos Joseph Alvin , Coyle Daisy , Shahid Maria , Crowther Juliette , Waqa Gade , Bell Colin , Webster Jacqui , McKenzie Briar 
Published: February 2025

Abstract

Background
Processed packaged foods are readily available in Fiji; however, the extent to which ultra-processed foods (UPFs) currently contribute to energy and nutrient intake is unknown. This study aimed to assess the contribution of UPFs to total energy intake and nutrients of concern (sodium, sugar, fat) in a representative sample of adults in the central division of Fiji, identify the main food category sources of UPFs and assess variation by sociodemographic characteristics.

Methods
A random sample of 700 adults was selected from two statistical enumeration areas (one semi-urban, one rural). Participant characteristics were collected, and a three-pass 24-h diet recall was undertaken. Foods consumed were coded based on the level of processing, in alignment with the NOVA categorisation system.

Results
The contribution of UPFs to total energy, fat, sugar, and sodium intake and dietary sources of UPFs (based on the per cent daily energy contribution of UPFs from food groups) were estimated and assessed by sex, age group, ethnicity and location. A total of 534 adults participated (76% response rate, 50% female). UPFs contributed 21.5% (95% CI, 21.4% to 26.6%) of total energy intake, 22.8% (95% CI 20.5% to 25.1%) of total sodium intake, 24.0% (95% CI, 21.4% to 26.6%) of sugar intake and 18.6% (95% CI 16.5% to 20.7%) of total fat intake. Key food group contributors to UPF intake were bread and bakery products 42.9% (38.3% to 47.6%), non-alcoholic beverages 26.8% (22.4% to 31.1%), convenience foods 8.6% (6.3% to 10.8%), and meat, poultry, and meat alternatives 6.9% (4.8% to 8.9%). The contribution of UPFs to sodium, sugar and fat intake was similar for men and women; however, differences were observed by age group, ethnicity and region (semi-urban compared to rural).

Conclusions
This study identified that UPFs appear to be a large contributor to energy, sodium, fat and sugar intake in adults in the Central division of Fiji. A reduction of UPF consumption in Fiji may lead to a reduction of harmful nutrients such as sodium, fat, and sugar, crucial to reducing the diet-related burden of disease.
Assessment of the prevalence of respiratory pathogens and the level of immunity to respiratory viruses in soldiers and civilian military employees in Poland
Authors: Nakonieczna Aleksandra , Kwiatek Magdalena , Abramowicz Karolina , Zawadzka Magdalena , Bany Izabela , Głowacka Patrycja , Skuza Katarzyna , Lepionka Tomasz , Szymański Paweł 
Published: February 2025

Abstract

Background
This study provides a detailed analysis of respiratory tract infections (RTIs) and immunity levels against influenza and SARS-CoV-2 among soldiers and military personnel in Poland. Owing to their unique service environments, this occupational group is at high risk. During deployments, they often face adverse physical conditions, close living quarters, and exposure to both local and endemic pathogens. It particularly increases their susceptibility to RTIs, which remain a leading cause of illness worldwide.

Methods
The study cohort included 379 participants aged between 19 and 60 years. We used polymerase chain reaction (PCR) techniques to detect 34 common respiratory pathogens and analyzed blood serum samples to assess the degree of immunity against the influenza A, B, and SARS-CoV-2 viruses. In 78.10% of the participants, at least one respiratory pathogen was detected.

Results
Human rhinovirus (HRV) was the most common (8.71%), followed by SARS-CoV-2 (4.75%) and influenza A (H1N1) sw (2.90%). Staphylococcus aureus was the most prevalent bacterial pathogen (18.47%), with significant occurrences of Haemophilus influenzae (14.24%) and Klebsiella pneumoniae (9.76%). Additionally, 52.3% of those with coinfections had combinations of bacterial and viral pathogens, highlighting the complexity of diagnosing and managing these infections. We also assessed immunity levels, which focused on antibodies specific to influenza A/B and SARS-CoV-2 viruses. For all the results obtained, statistical analyses were performed. A weak positive correlation between age and levels of anti-influenza antibodies was observed, suggesting a slight increase in antibody levels with age. A total of 81.53% of the participants had received at least one dose of the SARS-CoV-2 vaccine. A significant correlation between the number of vaccine doses and higher anti-SARS-CoV-2 IgG antibodies was observed, indicating stronger immunity with more vaccinations.

Conclusions
This study underscores the importance of specialized health monitoring and preventive measures such as vaccinations to protect military personnel from RTIs and maintain their operational readiness. The detailed analysis of pathogen prevalence and immunity levels offers valuable insights into this occupational group's health risks and needs.

Clinical trial number: Not applicable.
Impaired microcirculation in the skin and subclinical atherosclerosis in individuals with dysglycaemia in a large population-based cohort
Authors: Cederqvist John , Rådholm Karin , Nystrom Fredrik H. , Engvall Jan , Bergstrand Sara , Fredriksson Ingemar , Strömberg Tomas , Östgren Carl Johan 
Published: February 2025

Abstract

Background and aim
Dysglycaemia is a known risk factor for cardiovascular disease and microcirculatory dysfunction is associated with an increased cardiovascular disease risk. The aim of this study was to investigate the prevalence of impaired microcirculation, coronary atherosclerosis, and arterial stiffness in individuals with normo- and dysglycaemia.

Methods
The study included 3,300 participants with microcirculatory measurements and information on glycaemic status, aged 50–65 years, from the Linköping site of the Swedish CArdio-Pulmonary bioImage Study (SCAPIS). Microvascular function was assessed in forearm skin using an arterial occlusion and release protocol determining peak blood oxygen saturation (OxyP). Data on pulse wave velocity (PWV) and the Coronary Artery Calcification Score (CACS) were collected. Participants were categorised into three glycaemic categories: normoglycaemia, prediabetes and diabetes.

Results
OxyP was lower in the prediabetes group − 1.2%-units, 95% CI (-1.8 to -0.6) and in study participants with diabetes − 2.4%-units, 95% CI (-3.1 to -1.6) compared to the normoglycaemic group 84.3%, 95% CI (83.6 to 84.9). PWV and CACS were higher in participants with dysglycaemia. Prevalent impaired function at three vascular levels (lowest quartile of OxyP + PWV ≥ 10 m/s and CACS ≥ 100) were observed in 0.8%, 2.3% and 7.6% in the glycaemic categories respectively. The difference between the normoglycaemic and the diabetes category and the difference between the pre-diabetes and the diabetes category was significant, p = < 0.05.

Conclusions
Patients with prediabetes and diabetes are more likely to have impaired microcirculation in the forearm skin and macrovascular disorders such as arterial stiffness and atherosclerosis in the coronary arteries compared to normoglycaemic individuals.

Graphical abstract
Genotypes and different clinical variants between children and adults in progressive familial intrahepatic cholestasis: a state-of-the-art review
Authors: Vitale Giovanni , Sciveres Marco , Mandato Claudia , d’Adamo Adamo Pio , Di Giorgio Angelo 
Published: February 2025

Abstract

Introduction
Progressive Familial intrahepatic cholestasis (PFIC) are rare disorders of bile acid (BAs) secretion and transport with a genetic background. PFIC are paediatric manifestations, but the same variants causing PFIC can also cause cholestasis with a later paediatric onset or adult-onset cholestatic disease (AOCD). Pruritus is a symptom of cholestasis that can be so devastating that it requires a liver transplant (LT) in children; some PFIC types have been described as at risk of liver cancer development. Commonly prescribed medications for PFIC symptoms can partially relieve pruritus without changing the natural history of the disease. Recently, a therapy reducing the intestinal resorption of BAs has been approved; it is effective on both pruritus and cholestasis in PFIC, potentially being a disease-modifying intervention.

Areas covered
The clinical and genetic characteristics of different PFIC and AOCD are summarized to provide a common background for geneticists and paediatric and adult hepatologists in diagnosis and management.

Expert opinion
Collaboration between paediatric and adult hepatologists and geneticists will become crucial for cholestatic disease research and patient treatment. Therefore, adult hepatologists will need to learn more about FIC. This might enable the implementation of individualized surveillance in FIC patients and the evaluation of patient family histories.
Structural changes and cellulose ultrastructure mapped with electron microscopy and SAXS after enzymatic hydrolysis of mildly steam pretreated Norway spruce
Authors: Brollo Maria E. F. , Caputo Fabio , Naidjonoka Polina , Olsson Lisbeth , Olsson Eva 
Published: February 2025

Abstract

Background
The efficient use of softwood in biorefineries requires harsh pretreatment conditions to overcome biomass recalcitrance. While this allows the solubilization of hemicellulose, it also leads to the formation of compounds that act inhibitory against microorganisms during the fermentation step. To improve the efficacy of biomass utilization and identify optimal processing conditions, we evaluated the microstructural alterations occurring during pretreatment and enzymatic hydrolysis in Norway spruce. The biomass was steam pretreated at six different severities defined by two different temperatures (180 °C and 210 °C), with and without the addition of various acids (HAc, H3PO4, H2SO4, SO2). After pretreatment, the materials were enzymatically hydrolysed using a cellulolytic cocktail (Celluclast + Novozym188) supplemented with a hemicellulolytic cocktail (Ultraflo). Scanning electron microscopy and small angle X-ray scattering were utilized to evaluate the structural changes, of the differently steam pretreated materials, before and after the enzymatic hydrolysis.

Results
Scanning electron microscopy revealed increased surface roughness and pore enlargement in all the materials after enzymatic hydrolysis. The higher the severity of the pretreatment, the more the surface was rough since it was easier for the enzymes to access the binding site. As revealed by small angle X-ray scattering (SAXS), increasing the enzymatic hydrolysis of hemicellulose did not result in further collapse of cellulose. In line with the SAXS result, a qualitative evaluation of the cellulose surface using Congo red showed a larger exposed cellulose surface area after enzymatic hydrolysis.

Conclusions
The present study reports the microstructural changes caused by pretreatment and enzymatic hydrolysis of Norway spruce. By enzymatically increasing the hemicellulose hydrolysis, the exposed cellulose surface area increases meaning that the cellulose might be easier to access for the enzymes. Structural analysis of biomass after enzymatic hydrolysis can direct the choice of enzymes for improved saccharification efficiency.
Revealing complex mosquito behaviour: a review of current automated video tracking systems suitable for tracking mosquitoes in the field
Authors: Bredt Beatrice H. , Tripet Frédéric , Müller Pie 
Published: February 2025

Abstract
Mosquito-borne pathogens continue to cause tremendous suffering, morbidity and mortality. For many of these diseases, vector control remains the most effective approach. The development and deployment of effective and efficient mosquito control products and strategies require a profound understanding of mosquito behaviour. To study complex mosquito behaviour, automated video tracking of mosquito flight paths has proven to be a comprehensive approach, and several video tracking approaches have emerged in recent years, making the choice for a suitable system challenging. Here, we conducted a literature review by searching PubMed and Google Scholar, and we identified 66 publications focusing on mosquito video tracking, which made use of eight different systems. We then compared and scored those video tracking systems by assessing their performance in the laboratory as well as their potential suitability for tracking mosquito behaviour in a field setting. While all eight systems have produced valuable information on mosquito behaviour, for tracking mosquitoes in the field, ‘Braid’, ‘EthoVision XT’ and ‘Trackit3D’ appear to be the most suitable systems as they need small disk capacity and are well adaptable to different settings. However, the optimal choice will ultimately depend on the specifications required to answer a given research question, the financial resources available and user preferences.

Graphical Abstract