bluuebunny/crossref_metadata_2025_split huggingface dataset:
Over a decade of successful treatment with tocilizumab in a maintenance hemodialysis patient for Castleman disease: a case report and literature review
Authors: Shima Aya , Shima Takahiro , Matsuo Chie , Suehiro Takaichi , Kamimura Tomohiko , Niiro Hiroaki , Hirakawa Makoto 
Published: February 2025

Abstract

Background
Castleman disease (CD) is a rare, non-neoplastic lymphoproliferative disorder with characteristic histopathological features in lymph nodes. The clinical presentation of CD is highly variable, which can complicate both diagnosis and treatment. Tocilizumab, an interleukin-6 receptor antibody, is approved for the treatment of CD, but there is limited data regarding its use, efficacy, and safety in patients undergoing maintenance hemodialysis.

Case presentation
We present the case of a 53-year-old woman with CD who has been successfully and safely treated with tocilizumab for over 10 years, while on maintenance hemodialysis. Initially, at the age of 48 years, the patient presented with anemia and renal impairment, leading to a diagnosis of CD after an inguinal lymph node biopsy. Treatment with prednisolone was initiated, but poor compliance led to discontinuation of follow-up. At the age of 53 years, she returned with severe renal dysfunction (serum creatinine 7.16 mg/dL) and profound anemia (hemoglobin 4.0 g/dL), necessitating initiation of hemodialysis and erythropoiesis-stimulating agents. Despite these interventions, her anemia persisted. Additional findings of residual lymphadenopathy, polyclonal hypergammaglobulinemia, and elevated C-reactive protein (CRP) levels indicated that her anemia was likely attributable to CD. As a result, tocilizumab therapy was initiated, leading to rapid improvement in both anemia and CRP levels. Although her renal function did not recover, and she remained dialysis-dependent, the patient has continued to receive tocilizumab for over a decade without major adverse events, and has achieved stable disease control.

Conclusions
This case highlights the successful long-term management of CD with tocilizumab in a patient on maintenance hemodialysis. It underscores the potential for tocilizumab to provide sustained disease control and symptom relief in CD, even in the setting of renal failure and hemodialysis. Further research is needed to evaluate the safety and efficacy of tocilizumab in this patient population.
Spatial transcriptomics in autoimmune rheumatic disease: potential clinical applications and perspectives
Authors: Miyamoto Atsuko Tsujii , Shimagami Hiroshi , Kumanogoh Atsushi , Nishide Masayuki 
Published: February 2025

Abstract
Spatial transcriptomics is a cutting-edge technology that analyzes gene expression at the cellular level within tissues while integrating spatial location information. This concept, which combines high-plex RNA sequencing with spatial data, emerged in the early 2010s. Spatial transcriptomics has rapidly expanded with the development of technologies such as in situ hybridization, in situ sequencing, in situ spatial barcoding, and microdissection-based methods. Each technique offers advanced mapping resolution and precise spatial assessments at the single-cell level. Over the past decade, the use of spatial transcriptomics on clinical samples has enabled researchers to identify gene expressions in specific diseased foci, significantly enhancing our understanding of cellular interactions and disease processes. In the field of rheumatology, the complex and elusive pathophysiology of diseases such as rheumatoid arthritis, systemic lupus erythematosus, and Sjögren’s syndrome remains a challenge for personalized treatment. Spatial transcriptomics provides insights into how different cell populations interact within disease foci, such as the synovial tissue, kidneys, and salivary glands. This review summarizes the development of spatial transcriptomics and current insights into the pathophysiology of autoimmune rheumatic diseases, focusing on immune cell distribution and cellular interactions within tissues. We also explore the potential of spatial transcriptomics from a clinical perspective and discuss the possibilities for translating this technology to the bedside.
Investigating the higher education institutions’ guidelines and policies regarding the use of generative AI in teaching, learning, research, and administration
Authors: An Yunjo , Yu Ji Hyun , James Shadarra 
Published: February 2025

Abstract
This study examined the guidelines issued by the top 50 U.S. universities regarding the use of Generative AI (GenAI) in academic and administrative activities. Employing a mixed methods approach, the research combined topic modeling, sentiment analysis, and qualitative thematic analysis to provide a comprehensive understanding of institutional responses to GenAI. Topic modeling identified four core topics: Integration of GenAI in Learning and Assessment, GenAI in Visual and Multimodal Media, Security and Ethical Considerations in GenAI, and GenAI in Academic Integrity. These themes were further explored through sentiment analysis, which revealed highly positive attitudes towards GenAI across all institution types, with significant differences between faculty and student-targeted guidelines. Qualitative thematic analysis corroborated these findings and provided deeper insights, revealing that 94% of universities had faculty guidelines emphasizing the importance of establishing and communicating course-specific GenAI policies. This analysis also highlighted recurring themes such as academic integrity and privacy concerns, which aligned with the security and ethical considerations identified in the topic modeling. The study highlights the rapid evolution of GenAI guidelines in higher education and the need for flexible, stakeholder-specific policies that address both the opportunities and challenges presented by this technology.
The evaluation of clinical outcomes assessments and digital health technologies in clinical trials for obesity
Authors: Goetz Iris A. , Sutter Carolyn , Abraham Traci , Kanu Chisom , Boye Kristina S. , Symonds Tara 
Published: February 2025

Abstract

Background
Clinical trials for obesity have traditionally focused on weight loss and resolution of comorbidities as primary outcomes. However, secondary outcomes, such as the impact of weight reduction on patient experience, like health-related quality of life (HRQoL), have increasingly been recognized as important. Therefore, a review was conducted to determine the Clinical Outcome Assessments (COAs) and Digital Health Technologies (DHTs) used in clinical trials for obesity to assess the patient experience.

Methods
Two clinical trial databases (United States & European Union) were reviewed to identify Phase 2–4 clinical trials for obesity (2018–2023). A targeted literature review was also conducted using the OVID database to identify clinical trial for obesity publications which included COAs/DHTs (2010–2023).

Result
Trials from the databases (n = 53) and publications (n = 42) were included in data extraction (N = 73). This resulted in identification of 108 COAs, the majority being patient-reported outcome (PRO) measures (n = 83), but also 24 performance outcomes (PerfO) measures, and 1 composite PRO-clinician-reported outcomes (ClinRO) measure, as well as 2 DHTs. The most frequently identified PRO measures were the Short Form 36 and the Impact of Weight on Quality of Life Lite Clinical Trials. Twenty-four PerfO measures were also identified, with the 6-minute walk test being most common. These measures were most often used to construct secondary endpoints, with physical function (PF) being the most frequently specified domain. PRO measures assessing eating-related thoughts/behaviours, physical activity, and disordered eating were also frequently included, although individual measures varied widely across trials.

Conclusion
Review of COAs and DHTs in registered clinical trials and publications for obesity found that PRO measures were the most common type of COA used to develop endpoints with current use of DHTs limited. Specifically, the physical function domain of multidimensional patient-reported outcome measures assessing health-related quality of life were often used to construct secondary endpoints. Further work is warranted to assess how the COAs and DHT data collected in clinical trials are viewed by regulators and payers.
Optimizing Wastewater Treatment Using Endophytic Fungi Isolated from Acacia saligna L. Bark
Authors: Serag Mamdouh S. , Mohesien Marwa T. , Hasballah Amany F. 
Published: February 2025

Abstract
Endophytic fungi’s application in biological wastewater treatment is a cost, clean, and eco-friendly. This study aimed to assess the efficiency of three Aspergillus species in the mycoremediation of industrial (I) and agricultural (A) wastewater. These species were Aspergillus flavipes, Aspergillus niger, and Aspergillus flavus isolated from the bark of a medicinal plant (A0cacia saligna). Aspergillus species were subculture on potato dextrose broth at 28 °C for 7 days on a rotatory shaker at 180 rpm until fungal pellets were formed. Before and after treatment with fungi, all wastewater samples were examined for pH, TDS, salinity, EC, COD, BOD, TP, TN, and turbidity. According to the results, Aspergillus flavipes has a good removal efficiency of total phosphorus, removing 78% of it from sample (I) after 25 days, and turbidity removing 91% after 20 days in (A) sample. Aspergillus niger has a high chemical oxygen demand removal efficiency of 99% and 99.8% in (I and A) samples after the 15th and 10th day, respectively, in addition to total nitrogen removal efficiency of 99% in (A) sample after the 25th day; and turbidity removal efficiency of 99.7% in the same sample. Also, Aspergillus flavus recorded high removal of biological oxygen demand by 76% and 66% in (I and A) samples after the 10th day of each, respectively; total nitrogen by 69% after the 10th day in (I) sample; total phosphorus by 23% after 10th day in (A) sample; electrical conductivity by 10.7% after 10th day in (I) sample; and total dissolved salts by 1.3% after 5th day in (I) sample. The results explained that Aspergillus niger and Aspergillus flavus were the most efficient in the removal of chemical oxygen demand and biological oxygen demand which represented indicators of pollution in wastewater. The obtained results will be useful for optimal management of agricultural and industrial wastewater.
Quercetin inhibits steroid-induced hypergluconeogenesis in Saccharomyces cerevisiae
Authors: Doss Victor Arokia , Subramaniam Gowtham , Manoharan Keerthana 
Published: February 2025

Abstract

Background
Steroid-induced hypergluconeogenesis is a significant contributor to hyperglycemia, often complicating the therapeutic use of steroids. This study investigates the potential of quercetin, a naturally occurring flavonoid, to mitigate steroid-induced hypergluconeogenesis in Saccharomyces cerevisiae. The levels of glucose, total proteins, free amino acids, pyruvate, lactate and antioxidants were assessed in the quercetin-treated yeast cells induced with betamethasone at different time intervals. The glucose uptake potential of yeast cells treated with quercetin was also studied and also the effect of steroids and quercetin on cell viability was analyzed.

Results
Our results show that quercetin effectively reduces gluconeogenesis by normalizing the levels of metabolites involved in the process and alleviates the hyperglycemic effects associated with steroid exposure. Quercetin-treated yeast cells also demonstrated a better uptake of glucose. Additionally, quercetin was found to improve the overall cell viability highlighting its role in modulating glucose metabolism.

Conclusion
These outcomes suggest that quercetin can serve as a promising adjunct therapy for managing steroid-induced metabolic disturbances, providing a natural and effective approach to counteracting steroid-induced hyperglycemia.
Overall Survival and Economic Impact of Triple-Negative Breast Cancer in Brazilian Public Health Care: A Real-World Study
Authors: Mattar André , Antonini Marcelo , Amorim Andressa Gonçalves , Teixeira Marina Diógenes , de Resende Cristiano Augusto Andrade , Cavalcante Francisco Pimentel , Zerwes Felipe , Arakelian Renata , Millen Eduardo de Camargo , Brenelli Fabricio Palermo , Frasson Antonio Luiz , Leite Renata Montarroyos , Gebrim Luiz Henrique 
Published: February 2025

PURPOSE
Triple-negative breast cancer (TNBC) presents notable treatment difficulties, especially in the public health care systems of low- and middle-income countries where access to advanced therapies is restricted. This study investigates TNBC's clinical, epidemiologic, and economic effects on survival within Brazil's public health care system.

METHODS
We conducted a retrospective cohort study of patients with TNBC treated between 2010 and 2019. Overall survival (OS) rates by stage were analyzed across various patient groups, including those receiving neoadjuvant or adjuvant treatment, patients with or without complete pathologic response, Black and non-Black patients, and those treated with or without carboplatin-based therapy. Cox proportional hazards models were applied to estimate hazard ratios (HRs) with 95% CIs, and annual treatment costs were calculated per stage.

RESULTS

Among 1,266 patients with TNBC, 710 met eligibility criteria. Kaplan-Meier analysis indicated stage II patients had a 47% lower mortality risk than stage III (HR, 0.53 [95% CI, 0.33 to 0.85];
P
= .009). Patients in the adjuvant treatment group had a reduced risk (HR, 0.48 [95% CI, 0.34 to 0.69]) compared with the neoadjuvant group. Achieving complete pathologic response (pCR) greatly improved OS (HR, 0.21 [95% CI, 0.11 to 0.43];
P
< .001). Black patients had better survival rates than non-Black (HR, 0.58 [95% CI, 0.40 to 0.86];
P
= .006). Carboplatin use did not significantly affect OS (HR, 0.96 [95% CI, 0.65 to 1.43];
P
= .857). The average monthly cost for systemic TNBC treatment increased with disease progression, from $101.87 in US dollars (USD) for stage I to $314.77 USD for stage IV second-line therapy.

CONCLUSION
This study provides insight into TNBC in Brazil's public health system, showing that OS decreases with disease progression but is higher among Black patients. pCR and adjuvant therapy improve survival, although costs increase significantly at advanced stages, highlighting the economic burden of late-stage TNBC management.
Engage: A Survivorship Program to Improve Childhood Cancer Survivors' Self-Efficacy and Quality of Life
Authors: Signorelli Christina , McLoone Jordana , Wakefield Claire , Donoghoe Mark , Alchin Joseph Elliot , Johnston Karen , Baldwin Rachael , Thornton-Benko Elysia , Webber Kate , Foreman Tali , Neville Kristen , Cohn Richard 
Published: February 2025

PURPOSE
We evaluated a survivorship program Engage, aimed at improving childhood cancer survivors' health-related self-efficacy and their health-related quality of life (HRQoL).

MATERIALS AND METHODS
Engage provides (1) a telehealth nurse-led health assessment, (2) a remote multidisciplinary case review, (3) personalized recommendations and care plan for survivors and their primary care physician (PCP), and (4) a telehealth nurse-led consultation to promote survivors' understanding of the recommendations. We recruited survivors >5 years postdiagnosis of any age who had not received cancer-related care in the past 24 months. We assessed survivors' outcomes pre-intervention and at 1-, 6-, 12-, and 24-month follow-ups.

RESULTS

Seventy-eight survivors participated: 62% male, median age = 30 years, and 14% lived regionally/rurally. Participating survivors' self-efficacy scores improved from baseline to 1 month and were maintained at 6-, 12-, and 24-month follow-ups (
P
< .001). Survivors' HRQoL remained similar from baseline to postintervention, as did the proportion of survivors reporting a regular PCP or engaging in health/risky behaviors (eg, exercise). Survivors' distress, anxiety, and anger significantly decreased pre- to 6 months postintervention. Survivors' satisfaction with care increased by 28% (
P
< .001) and was maintained across follow-up (
P
= .002). Information needs reduced from baseline to 1 month postintervention (
P
= .023) although they were similar at further follow-up.

CONCLUSION
Survivors' self-efficacy, satisfaction with care, and some psychosocial outcomes improved after participating in Engage. Further effort is needed to improve survivors' primary care engagement and health behaviors.
The Indian Question in Afrocentric Politics
Authors: Shankar Shobana 
Published: February 2025

Abstract
For African-Indian relationships, the idealism of Afro-Asian solidarity did not often match realities on the ground, which were volatile and rapidly changing from the 1940s. This essay explores how Idi Amin's expulsion of Asians was embedded in a racial calculus that had a history beyond Uganda in 1972, in the context of ongoing struggles for African independence, Pan-Africanism, the Cold War, and religious nationalism in the Middle East. The Indian question in Africa was a political and sociocultural one—emblematic of division and partition based on ethno-religious and cultural difference and hierarchy—and not simply an economic one for Africans. The Ugandan expulsion was complex and not a single event but one made in multiple registers, as wider continental African perspectives reveal.
Optimizing Mecca
Authors: Shah Omer 
Published: February 2025

Abstract
In the holy city of Mecca, crowds and numbers matter. A hadith or saying of the Prophet reports that when pilgrims number fewer than seven hundred thousand, angels will perform the rituals in their stead. One of the names of Mecca is umm al-zuhm or “Mother of Crowds.” Thinking about crowds in Mecca requires an alternate, Islamic genealogy of “the crowd.” But in contemporary Saudi Arabia, the crowd is becoming a resource in new ways. As part of the Vision 2030 national transformation plan, the Saudi government wants to intensify Mecca's crowds, increasing the annual number of pilgrims from eight million to thirty million. Under this plan, the holy city is to become a laboratory for new sciences and technologies of crowd management, logistics, and optimization. This article demonstrates how Mecca comes to be constitutive of these new crowd sciences. The author shows how a range of knowledges (both religious and more secular) compete and collaborate through the building of a massive hajj infrastructure (the Jamarāt Bridge) and its system of logistical optimization (tafwīj). While the author is generally interested in how Mecca comes to be useful for these new crowd sciences and technologies, he is particularly interested in how Islamic law is deployed as “optimization” and as a crowd management “solution.” These strategies of crowd efficiency and optimization not only transform the performance of ritual itself but also diminish the cosmopolitanism that undergirds the hajj and its knowledge worlds.
Why the superb physiological capacity of birds matters
Authors: Hawkes Lucy A. 
Published: February 2025

ABSTRACT
Among vertebrates, birds undertake the longest, fastest and highest migrations of any taxonomic group, largely due to their unique cardiorespiratory system, which permits for very large rates of gas exchange. Managing resultant elevated production of reactive oxygen species, and thus oxidative stress, has meant that birds can largely avoid pathologies relating to major medical challenges that now probably account for the majority of global healthcare spending. Hypoxia underlies most critical illnesses faced by humans, but the avian cardiorespiratory system can supply far more oxygen per unit of time than any mammal. Birds have high circulating glucose levels, but have adaptations to cope with the elevated production of oxidative stress brought about by hyperglycaemia. Birds also avoid the inflammatory responses brought about by obesity in humans when they seasonally gain huge fat stores. Lastly, birds live four times longer than similarly sized mammals, with seasonal endogenous muscle hypertrophy, and some birds even increase telomere length with age. A new frontier of ‘physiologging’ is emerging, making use of technologies for medical use, but that provide novel parameters for better understanding the biomechanics, energetics and ecology of a range of species. These physiologging tools are likely to provide insight into avian physiology, biomechanics and ecology including their ability to spread disease, as well as each of the medical challenges detailed in this Commentary. By virtue of their physiological capacity, the study of avian physiology is a critical area for future discovery and research using applied and interdisciplinary areas of biomechanics, ecology and physiology.
Positive consequences of group living among male bats during spermatogenesis
Authors: Komar Ewa , Szafrańska Paulina A. , Dechmann Dina K. N. , Keicher Lara , Koprowska Dominika , Shipley J. Ryan , Ruczyński Ireneusz 
Published: February 2025

1. Energy can be limiting, especially for small animals with high metabolisms, particularly if they rely on ephemeral resources. Some energy-saving strategies, such as torpor, can impair physiological processes. Alternatively, group living can reduce energetic costs through social thermoregulation. This may allow individuals to maintain a high metabolism as well as processes such as gamete production. Although group living is common, its energetic benefits for heterothermic individuals during the season of sperm production have yet to be investigated.
2. We remotely quantified the daily energy expenditures of individual parti-coloured bats (Vespertilio murinus) kept solitarily and in groups during the period of spermatogenesis, using high-resolution heart rate monitoring.
3. Data showed that the energetic benefits of group living are complex. In groups, individual daily energy expenditures were more than 50% lower. Group roosting reduced the cost of thermoregulation during normothermia and allowed for a decrease in the depth, but not the duration, of torpor.
4. Group living may enable bats to buffer unfavorable environmental conditions. Energy saved this way can then be invested into fitness-relevant processes potentially making this a driver of the evolution of male sociality.