bluuebunny/crossref_metadata_2025 huggingface dataset:
Urinary congophilia as a predictive biomarker of lupus nephritis in pregnant and non-pregnant women with systemic lupus erythematosus
Authors: Younis Dalia , Shemies Rasha , Zakaria Mahmoud M , Omar Sameha A , Mosbah Alaa , El-kannishy Ghada , Sabry Alaa , Elnagar Sherouk
Published: January 2025

Background

Endoplasmic reticulum stress with protein misfolding has been introduced as a key pathogenetic mechanism in lupus nephritis (LN). Pregnancy is thought to exaggerate proteostasis, which leads to the accumulation of potentially pathogenic misfolded proteins in the urine, serum, and placenta particularly in women with preeclampsia. The detection of misfolded proteins is made using Congo red stain, which is referred to as congophilia. This study aimed to assess the predictive value of urinary congophilia as a marker of LN activity in pregnant and non-pregnant LN women.

Methods

Urine samples from non-pregnant LN women ( n = 45), pregnant LN women ( n = 12), as well as pregnant healthy controls ( n = 38) were collected. Urinary congophilia was assessed by Congo Red Dot Blot assay. The disease activity was defined according to SLE Disease Activity Index (SLEDAI) score, and SLE Disease Activity Index-Renal Domain (SLEDAI-R) score. Renal biopsy was done for 33 non-pregnant LN women as it was clinically indicated, and modified NIH activity index (AI) was assessed according to the classification of LN by the International Society of Nephrology/Renal Pathology Society (ISN/RPS).

Results

Congo red retention (CRR) values were significantly higher for pregnant active LN patients, in comparison with pregnant inactive LN patients ( p = .014), as well as pregnant healthy controls ( p = .009). Additionally, CRR values were significantly higher for non-pregnant active LN patients, in comparison with non-pregnant inactive LN patients ( p = .016), as well as pregnant healthy controls ( p ≤ .001). There were significant positive correlations between CRR on one hand, and anti-ds-DNA (r = 0.791, p ≤ .001), serum creatinine (r = 0.620, p ≤ .001), SLEDAI score (r = 0.623, p ≤ .001), as well as SLEDAI-R score (r = 0.473, p = .005) on the other hand. A highly significant negative correlation was detected between CRR, and serum albumin (r = −0.454, p = .001). CRR at a cut point ≥21.85 had 83% sensitivity, and 58% specificity to capture high LN activity status (NIH-AI >10) versus lower LN activity status.

Conclusion

Urinary congophilia may add a diagnostic value in patients with LN and can be a reliable marker of disease activity. CRR is related to disease activity rather than pregnancy.
Becoming a Public Survivor of Sexual Violence in Australia
Authors: O’Neill Tully , Loney-Howes Rachel , Oldfield Jessica
Published: January 2025

The past decade has seen significant policy and law reforms relating to gender-based violence in Australia. Notably, there has been an emphasis on rape law reforms and related policy changes driven by the advocacy of survivors of sexual assault and child sexual abuse. Coupled with these reforms has been the emergence of public survivors – individuals who establish prominence in public and political arenas by identifying as survivors of sexual violence. In this article, we examine the political, cultural and legal conditions that have created opportunities for public survivors to emerge in Australia. We argue that public survivors are co-constituted by these conditions, along with a broader politics of speaking out and a politics of listening that constructs a willing audience ready to consume and support survivor narratives and advocacy. These politics are vexed, however, in their reinforcement of long-standing archetypal attitudes and knowledge about sexual violence that feed into who can successfully obtain and maintain the status of a public survivor. In conclusion, we focus on the afterlives of public survivors once their initial advocacy goals have been fulfilled.
Green Dreams, Concrete Realities: Overcoming Climate Hurdles in American Mid-Sized Cities
Authors: Scheuch Eric
Published: January 2025

There exists a contradiction in the literature on city size and policy outcomes between those who expect a positive relationship between city size and policy outcomes and those who expect mid-sized cities to be best at providing services. I evaluate this contradiction in the context of climate policy through original fieldwork in four mid-sized cities. Additionally, existing studies of climate policy in mid-sized cities focus on internal best practices for climate policy, while the broader literature on urban climate politics emphasizes the intersectional nature of economic and political context. I evaluate how these previous findings, drawn from research in large or small communities, apply to mid-sized cities. I find that, for my cities, the relationship between size and policy is more nuanced than previous findings expect, while institutions, state capacity, and environmental coalitions all play a crucial role. Finally, I highlight the importance of overcoming the physical legacy of industrialization.
Evaluation of the antimicrobial effect of encapsulated cumin seed essential oil in chickpea protein–maltodextrin matrix and its potential to extend the shelf life of meatballs
Authors: Devecioglu Dilara , Atli Onur , Karaca Asli Can , Karbancioglu-Guler Funda
Published: January 2025

This study aimed to evaluate the antimicrobial effectiveness of cumin seed essential oil (CEO) after encapsulation in chickpea protein–maltodextrin matrix by spray drying and to provide insight into potential use as a natural ingredient in meat-based products. The surface morphology results of encapsulated CEO showed the dispersion in the wall material matrix, and the observed specific common peaks in the FT-IR spectra of encapsulated and non-encapsulated CEO proved the successful encapsulation. The antibacterial activity of non-encapsulated CEO against Escherichia coli BC1402, Pseudomonas aeruginosa ATCC 27853, Salmonella Typhimurium ATCC 0402, Staphylococcus aureus ATCC 25923 were first evaluated by disc diffusion assay. P. aeruginosa ATCC 27853 and S. Typhimurium ATCC 0402 were more sensitive with the inhibition zones ranging from 11.20 to 12.66 mm. The lowest minimum inhibitory concentration was noted for non-encapsulated CEO against P. aeruginosa ATCC 27853 (0.5 mg/mL) and the highest minimum bactericidal concentration (16 mg/mL) was found for encapsulated CEO against S. aureus ATCC 25923. In addition to notable microbial inhibition activity, in situ antibacterial activity of CEO for meatballs was remarkable along nitrite. The microbial load of meatballs without any additives increased with storage time (4.08–10.50 log CFU/g). At the end of the storage (14 days, 4 °C), the antibacterial activity of encapsulated and non-encapsulated CEO was statistically different ( p < 0.05) from nitrite in terms of total aerobic mesophilic (6.35–6.54 log CFU/g) and total coliform (2.63–3.09 log CFU/g). In conclusion, the encapsulated CEO was identified as a potential natural alternative for synthetic preservatives for meat-based products. The findings of this study can pave the way for future studies in this area.
Cardiovascular changes in Persian cats with polycystic kidney disease: a study of cardiac troponin I, echocardiography and blood pressure
Authors: Saberi Niloufar , Khaksar Ehsan , Molazem Mohammad , Mashhady Rafiee Seeyamak
Published: January 2025

Objectives

Cardiovascular complications are well known in humans with autosomal dominant polycystic kidney disease (PKD), but limited data exist for cats. This study aimed to assess echocardiographic changes, cardiac troponin I (cTnI) levels and systolic blood pressure (SBP) in Persian cats with PKD to detect early cardiac abnormalities.

Methods

In total, 52 Persian and mixed-Persian cats were enrolled, with 26 cats in the control group and 26 diagnosed with PKD via ultrasound due to the unavailability of genetic testing. Although genetic testing is the gold standard for definitive diagnosis, this study utilised high-sensitivity ultrasound as an alternative diagnostic tool. This method aligns with existing literature supporting its effectiveness in detecting PKD, particularly in regions where genetic testing is not accessible. Echocardiographic examinations employed M-mode and two-dimensional echocardiography to measure the diastolic thickness of the interventricular septum and the left ventricular free wall. Doppler ultrasonography was used to measure SBP and cTnI serum levels were determined using a Monobind-ELISA kit.

Results

Median SBP and cTnI levels in PKD cats were 155 mmHg and 85.80 ng/l, respectively, which was significantly higher than the control group ( P ⩽0.001). Interventricular septum in systole, as well as diastolic thickness of the interventricular septum and the left ventricular free wall, was significantly elevated in PKD cats compared with controls ( P ⩽0.001). No significant differences were observed in other echocardiographic parameters.

Conclusions and relevance

Asymptomatic PKD-affected Persian cats exhibited elevated SBP and cardiac structural changes; however, the clinical significance of these findings remains uncertain due to a lack of long-term follow-up. While early cardiac changes may be present, further research is necessary to establish their clinical relevance and guide appropriate management strategies. Monitoring PKD cats is advised, but a direct clinical impact is not confirmed at this stage.
Long-term outcomes of scleral fixated black diaphragm intraocular lens in eyes with combined aphakia and aniridia
Authors: Hirawat Raj shri , Krishnappa Nagesha C , Sundarmoorthy Sathishkumar , Raviselvan Munispriyan , Ratra Dhanashree
Published: January 2025

Purpose

To evaluate long-term anatomical and functional outcomes in eyes undergoing scleral fixation of aniridic black diaphragm intraocular lens (BDIOL).

Methods

Total 38 eyes that underwent scleral fixation of BDIOL for secondary aniridia following ocular trauma with aphakia with absent posterior capsule or primary congenital aniridia with subluxated lens were retrospectively analyzed. Final visual acuity, early and late complications were examined. Correlation analysis was done.

Results

The mean follow-up was 28 months (range 6 to 66 months). The mean preoperative visual acuity of 1.82 ± 0.90 logMAR improved to 0.69 ± 0.61 ( p = 0.00). The mean spherical equivalent refractive error of 7.88 ± 4.85 diopters improved to −0.69 ± 1.52( p = 0.00). Complications were seen in 9 eyes (23.6%). Early complications were raised intraocular pressure (IOP) in 2 eyes and one eye with suture site infection which were managed conservatively. Late complications were corneal decompensation 3eyes (7.8%), retinal detachment, hypotonic maculopathy and refractive surprise in 1 eye each (2.6%). None reported IOL tilt or dislocation. The patients noticed a significant reduction in glare disability and photophobia. No significant association was found between pre-operative factors such as prior surgical procedures, history of trauma and length of follow-up with surgical outcomes.

Conclusions

Scleral fixation of BDIOL is an effective option in eyes with aniridia and aphakia without capsular support that have undergone multiple previous surgeries. Despite severe damage, the BDIOL helps reconstruct the anterior segment and give a good quality of vision with minimal complications rate.
Visual deprivation and axial myopia: Considerations on long-term ocular development
Authors: Rinaldi Michele , Esposito Veneruso Paolo , Tranfa Fausto , Fioretto Gaetano , Troisi Salvatore , Passaro Maria Laura , Matarazzo Francesco , Costagliola Ciro
Published: January 2025

Introduction

Severe visual deprivation during infancy can lead to long-term changes in ocular development, including significant differences in axial length (AL) between eyes. This case report presents three adult patients with monocular infantile visual deprivation who developed substantial AL interocular differences. The aim is to explore the impact of early visual deprivation on AL and its potential implications for myopia progression.

Case Report

Three male patients, aged 19, 42, and 50, were evaluated at the Ophthalmology Department of the University Hospital of Naples “Federico II.” Each patient had a history of severe visual deprivation in one eye during infancy. The first patient experienced a dense corneal fibrovascular membrane from a chemical burn at age 1. The second suffered total corneal stromal scarring from a chemical burn at age 2. The third developed dense leukoma following infective keratitis at 0.3 years. Ophthalmological evaluations included refractive assessment, biomicroscopy, fundus examination (where feasible), electroretinogram (ERG), and A-Scan ultrasound. Affected eyes exhibited severe visual impairment (light perception in two patients, and 1.6 logMAR in the third), while the fundus could not be fully explored, and echographic assessment was used to exclude major chorioretinal changes. ERG findings were within normal limits, despite presumed early developmental impact on the retina due to lack of form vision. However, AL measurements revealed a 5.8–6.3 mm increase in the affected eyes compared to the healthy ones.

Conclusion

Infantile severe visual deprivation can lead to significant interocular AL differences in adulthood. These findings underscore the importance of investigating the underlying mechanisms to better understand and manage myopia progression in similar cases.
Longitudinal investigation of neuroimaging changes related to memory decline in multiple sclerosis: Testing a mechanistic model
Authors: Simani Leila , Tozlu Ceren , Lee Seonjoo , Dworkin Jordan , Ratzan Alexander S. , Buyukturkoglu Korhan , Onomichi Kaho , Mata Jennie , Riley Claire S. , Leavitt Victoria M.
Published: January 2025

Background:

Memory decline is common in multiple sclerosis (MS), although pathophysiological mechanisms are not fully understood.

Objective:

The objective was to investigate the relationship of changes in structural and functional neuroimaging markers to memory decline over 3-year follow-up.

Methods:

Participants with MS underwent cognitive evaluation and structural, diffusion, and functional 3T magnetic resonance imaging (MRI) scans at baseline and 3-year follow-up. Changes in neuroimaging metrics from baseline to follow-up were compared between memory stable and memory decline groups. Our hypothesis that structural and functional connectivity changes mediate the association of atrophy to memory decline was tested.

Results:

A total of 249 MS patients completed baseline visit; 169 (67.8%) returned at 3-year follow-up. Based on ⩾10% decline, memory decline was observed in 44.4% ( n = 75). Those with memory decline showed marginally greater whole-brain volume loss over time compared with those with stable memory performance ( p = 0.08). In those with memory decline, changes in white matter tract integrity were related to regional cortical thinning ( p < 0.01). Exploratory mediation analysis revealed structural and functional connectivity to mediate the relationship of atrophy to verbal and visual memory decline.

Conclusion:

Further work is needed to characterize complex interrelationships of atrophy and structural/functional connectivity changes to memory decline in MS.
Post-acute sequela of COVID-19 infection in individuals with multiple sclerosis
Authors: Salter Amber , Lancia Samantha , Cutter Gary R , Fox Robert J , Marrie Ruth Ann
Published: January 2025

Background:

Many common symptoms in post-acute sequelae following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (PASC) overlap with those of multiple sclerosis (MS). We examined symptoms and performance of the PASC score, developed in the general population, in MS based on infection history.

Methods:

We surveyed North American Research Committee on Multiple Sclerosis (NARCOMS) registry participants regarding infections and categorized participants based on infection history. Symptoms experienced before, during, and after infection were used to identify persistent new symptoms. PASC was defined as a score ⩾ 12 based on the National Institutes of Health (NIH) study RECOVER.

Results:

Of 4787 participants surveyed, 2927 were included: 294 (10%) having recent COVID-19; 853 (29.1%) recent non-COVID-19 infection; 246 (8.4%) recent COVID-19 and non-COVID-19 infection; 1534 (52.4%) uninfected, defined as never having COVID-19 nor any infection within the past 6 months. Compared to those uninfected, infection groups reported at least a two-fold increase in fever, cough, loss of smell/taste, and shortness of breath. Based on persistent new symptoms, PASC was identified in only 1.5% of participants with COVID-19.

Conclusion:

Our study suggests lower than expected prevalence of PASC in MS and a complex association between infections and development of new persistent symptoms following infections. The similar proportions classified with PASC across infection groups shows that symptoms of PASC are common and complicate assessment of PASC in MS.
Investigation of mechanical properties and residual stress in the combined simple shear extrusion-forward extrusion (CSSE-FE) process of 1050 aluminum alloy
Authors: Izi Ali , Honarpisheh Mohammad , Ahmadi Farshid
Published: January 2025

The combined simple shear extrusion-forward extrusion technique was recently known as a new severe plastic deformation technique for processing bulk materials. The unique design of the die channel in this process has led to the production of samples with a regular cross-section. This study investigated the effect of the combined simple shear extrusion-forward extrusion process on the mechanical properties, micro-hardness, and residual stress of 1050 aluminum alloy samples. The residual stress was studied numerically and experimentally using the contour method. The finite element software was used to analyze process parameters numerically. After the combined simple shear extrusion-forward extrusion process, yield stress, tensile strength, and average micro-hardness values were increased by 316.28%, 147.09%, and 88.82%, respectively. Among the mechanical properties, the combined simple shear extrusion-forward extrusion technique significantly affects yield stress. In this study, after measuring the residual stress numerically and experimentally using the contour method, there was a good correlation between their results. Also, the numerical results showed that with the increase of the friction coefficient from 0 to 0.04, the compressive residual stress value is reduced by about 71.92%.
Rice stubble reinforced polymeric composites: Improvement in hygrothermal durability through fibre pre-treatment
Authors: Somal Supreet Singh , Bhowmick Hiralal , Jain Deepak
Published: January 2025

Currently, there is a lack of comprehensive scientific knowledge on the response of hygrothermal ageing of rice stubble-based composites, which limits their potential applications. In this work, the effect of alkali and water pre-treatment on the hygrothermal ageing, mechanical strength, contact angle, and morphology of the rice stubble fibre-reinforced polymer composites is presented. The rice stubble-reinforced polymer composites are fabricated using two different weight fractions (50% and 60%) of stubble inside the polymer matrix resin. Accelerated environmental ageing is performed inside the temperature-controlled water bath and moisture-controlled humidity chambers for 7 and 14 days. The results of environmentally aged specimens are compared with untreated virgin specimens. The tensile strength of stubble polymer composites is improved by ∼177% (65%), using water (alkali) pre-treatment. There is a notable improvement in the flexural modulus as well. The mass gain analysis is conducted in temperature-controlled submerged environments. The water pre-treatment reduced the mass gain by ∼20% and the contact angle by ∼18%, in comparison to the untreated composites. Although both pre-treatments resulted in a significant improvement in the hygro-mechanical properties and wettability characteristics of the composites, the water pre-treatment appears to be more promising in comparison to the alkali-treatment. The findings have significant implications for spurring the development of rice straw-based polymer composites through proposed pre-treatments. The usage of stubble waste composites for low to medium load-bearing applications, such as furniture, partition boards, and packaging materials can help curb the stubble burning practice and save the environment.
Experimental investigation on N2O emission characteristics of ammonia-diesel dual-fuel engines
Authors: Liu Yi , Cai Kaiyuan , Qi Yunliang , Chen Qingchu , Chen Hu , Wang Zhi
Published: January 2025

Blending ammonia in combustion is an effective approach to reducing carbon emission for diesel engines, but the combustion of ammonia may result in the generation of elevated concentrations of nitrous oxide (N2O), potentially contributing to a new source of greenhouse gas emissions. This study investigates the impact of engine load, diesel double injection strategy, and the ammonia energy ratio (AER) on N2O emission in ammonia-diesel dual-fuel combustion mode. The results show that N2O emission is increased with blending ammonia compared to pure diesel combustion, while as the load increases, the higher in-cylinder combustion temperature leads to a decrease in N2O emission. In the ammonia-diesel dual-fuel combustion mode, diesel double injection strategy is conducive to the reduction in N2O emission compared to single injection strategy. As the pre-injection timing is delayed, N2O emission first decreases and then increases, reaching a minimum near −40 °CA ATDC. The postponed main-injection timing leads to the decreased in-cylinder combustion temperature, deteriorating N2O emission. In the engine with a compression ratio (CR) of 18, when AER is in the range of 20% to 65%, the volume fraction of N2O emission remains around 20 × 10−6. However, under the condition of AER = 80%, low chemical reactivity of ammonia causes the substantially increased N2O emission. By increasing CR to 21 and adopting optimal injection strategy, combustion in activated thermal atmosphere is achieved, resulting in a substantial reduction in the N2O original emission concentration. Ultra-low N2O emission (exhaust N2O volume fraction less than 10 × 10−6) is achieved at AER = 80%.
Hydrodynamic performance of a hybrid floating breakwater-wave energy conversion system
Authors: Patil Shivakumar B , Karmakar Debabrata
Published: January 2025

The study presents the hydrodynamic performance and wave energy conversion of a hybrid floating breakwater under the framework of small amplitude linear wave theory. The hybrid floating breakwater is composed of a partially liquid-filled rectangular-box type tank with built-in buoys connected to a Power Take-Off (PTO) (linear inductance generator) and is excited under regular wave conditions for (a) constrained roll motion, and (b) constrained surge, heave, and roll motion. The Boundary Element Method (BEM) is employed with the assumption of modest sloshing in the tank of the hybrid floating breakwater to estimate the hydrodynamic efficiency of the hybrid floating breakwater. Further, the experimental investigation on the Wave Energy Converter (WEC) capabilities and the hydrodynamic coefficients (wave reflection and transmission coefficients) are estimated for the excitation frequencies corresponding to nondimensional wavenumber. The present study reveals that the hybrid concept improves wave attenuation performance by 20%–35% compared to conventional floating breakwaters by increasing wave attenuation, damping and stabilizing the wave transmission coefficient [Formula: see text] within [Formula: see text]. The experimental investigation shows that hybrid floating breakwater attaints its floating stability for the depth 15 – 25% of partially filled fluid for which the proposed design as floating breakwater as well as WEC system is achieved for a wide range of excitation frequencies. Furthermore, the hybrid floating breakwater functions as a barrier which is noted to be capable of significantly attenuating incoming progressive waves below the predetermined threshold values of wave attenuation characteristics, in addition to converting wave energy.
Limb salvage prediction in peripheral artery disease patients using angiographic computer vision
Authors: Rusinovich Yury , Liashko Vitalii , Rusinovich Volha , Shastak Alina , Bruder Leon , Omran Safwan , Greiner Andreas , Doss Markus , Branzan Daniela
Published: January 2025

Background

Peripheral artery disease (PAD) outcomes often rely on the expertise of individual vascular units, introducing potential subjectivity into disease staging. This retrospective, multicenter cohort study aimed to demonstrate the ability of artificial intelligence (AI) to provide disease staging based on inter-institutional expertise by predicting limb outcomes in post-interventional pedal angiograms of PAD patients, specifically in comparison to the inframalleolar modifier in the Global Limb Anatomic Staging System (IM GLASS).

Methods

We used computer vision (CV) based on the MobileNetV2 model, implemented via TensorFlow.js library, for transfer learning and feature extraction from 518 pedal angiograms of PAD patients with known 3-month limb outcomes: 218 salvaged limbs, 140 minor amputations, and 160 major amputations.

Results

After 43 epochs of training with a learning rate of 0.001 and a batch size of 16, the model achieved a validation accuracy of 95% and a test accuracy of 93% in differentiating salvaged limbs from amputations. In manual testing with 45 angiograms excluded from the training, validation, and test processes, the AI predicted mean limb salvage probabilities of 96% for actual salvaged limbs, 27% for minor amputations, and 17% for major amputations ( p-value < .001). The correlation coefficient between the CV model-predicted outcome and the actual outcome for these 45 angiograms was 0.7, nearly five times higher than that between the IM GLASS pattern and the actual outcome (0.14).

Conclusion

Computer vision can analyze angiograms and predict disease outcomes, demonstrating a significant correlation between predicted and actual limb salvage rates, outperforming IM GLASS segmentation by a vascular specialist. It has the potential to provide immediate and precise treatment results during vascular interventions, tailored to (inter)institutional expertise, and enhance individualized decision-making.
School principals’ networking preferences for instructional and administrative advice-seeking relations: Insights from inferential social network analysis
Authors: Banoğlu Köksal , Karataş İbrahim Hakan , Gümüş Sedat
Published: January 2025

Investigating the social, structural, cognitive and individual enablers of principals’ cross-district professional relations is a challenging yet essential research endeavour. To that end, this study explores principals’ networking preferences for instructional and administrative advice-seeking relations through inferential social network analysis. Data were collected from 62 school principals serving in a large urban district of Istanbul, Türkiye. The study provides significant insights into district-wide advice-seeking relations among the participating school principals. Results highlight the importance of factors such as age, gender, long-serving experience within the same district, school location, school level, joint union membership and mutual friendship ties in shaping principals’ advice-seeking behaviours. Male principals are perceived as more resourceful, older principals are more active in seeking advice and those with less teaching experience tend to seek more instructional advice. Mutual friendships and localised principalship experience encourage principals to engage in both instructional and administrative advice relations. These findings indicate the need for tailored mentorship programmes for novice and moderately experienced older principals, as well as those with less teaching experience. Formalising these programmes ensures consistent support from senior principals in the district, leveraging their experience to help newcomers navigate instructional leadership and promote a holistic approach to school management.
Does a distal radial fracture lead to osteoarthritis? Re-examining the evidence for early treatment
Authors: Warwick David , Smythe Laura , Fetouh Sherif
Published: January 2025

There are many good reasons to improve the anatomy of a distal radius fracture, such as early return to function and avoidance of sigmoid notch incongruity or ulnocarpal impaction. It is often feared by patients, and portrayed by some authors of scientific articles and medicolegal reports, that a fracture of the distal radius has a propensity to cause symptomatic osteoarthritis. This article examines some of the current evidence and shares the authors’ experience. Critical questions are asked to direct our observations and guide future research questions. We propose that both clinical experience and a literature analysis do not support the commonly held assumption that untreated distal radial fractures lead to symptomatic osteoarthritis.

Level of evidence: V
Randomized clinical trial: the effects of mirtazapine in functional dyspepsia patients
Authors: Cao Lina , Li Gaozhong , Cao Jingmei , Li Fuxin , Han Wei
Published: January 2025

Background:

Functional dyspepsia (FD) is one of the most common gastrointestinal disorders worldwide. Currently, anti-gastric drugs, gastric acid inhibitors, prokinetic drugs, and mucosal protective drugs are widely used in FD patients, however, only a small proportion of patients benefit from these drugs. Studies reported mirtazapine may improve symptoms of FD patients but the efficacy and safety of mirtazapine in the treatment of FD is unclear.

Objectives:

To investigate the efficacy and safety of mirtazapine in FD patients.

Design:

We performed a prospective, single-randomized, two-group parallel clinical trial involving 120 FD patients with poor traditional drug treatment outcomes to evaluate the efficacy and safety of mirtazapine.

Methods:

Qualified patients identified through the screening assessments were randomly divided into two groups: mirtazapine group ( n = 60) treated with mirtazapine 15 mg qn on top of traditional drugs, and control group ( n = 60) who continued to be treated with traditional drugs. Subjects were evaluated for meal-related symptoms and severity, quality of life, gastrointestinal-specific anxiety, and body weight before and after the 8-week intervention. Adverse reactions were also recorded.

Results:

At the end of 8-week treatment, dyspeptic symptoms in the mirtazapine group were significantly relieved compared with the baseline (7.95 ± 1.86 vs 11.17 ± 2.14, p < 0.001). Assessment of the impact of dyspepsia on patients’ quality of life from the short form-Nepean Dyspepsia Index showed that patients generally feel better in mirtazapine group than control group (24.52 ± 2.87 vs 28.64 ± 4.32, p < 0.001). Mirtazapine group also showed significant weight gain and decreased visceral sensitivity index score.

Conclusion:

Compared with control group, 8-week administration of mirtazapine significantly improved the overall severity of symptoms of dyspepsia (such as individual symptoms of postprandial fullness, early satiation, nausea, and vomiting), gastrointestinal-specific anxiety, quality of life, and increased weight in FD patients. This study provided clues to clinicians that mirtazapine may be a good choice for the treatment of FD patients.

Trial registration:

This study was registered in the Chinese clinical trial registry ( https://www.chictr.org.cn/index.html , protocol No. ChiCTR2100048304).
Formal Mentorship in Surgical Training: A Long-Term Prospective Interventional Study
Authors: Mohajeri Sepideh , Seikaly Hadi , Alrajhi Yaser , Wright Erin D. , El-Hakim Hamdy , Zhang Han
Published: January 2025

Objective

Surgical training programs have a high prevalence of trainee stress and burnout. Formal mentorship programs (FMP) have been shown to alleviate these factors and improve quality of life (QOL) in short-term follow-up. This study aims to determine the long-term effects of an FMP on the well-being of a single-center cohort of surgical trainees.

Methods

A voluntary FMP was established at a surgical training program comprised 8 resident physicians. To quantitatively measure stress and burnout, the Perceived Stress Survey (PSS) and Maslach Burnout Inventory (MBI) were administered at baseline, 3, 6, 9, 12, 18, and 24 months. The World Health Quality of Life-Bref Questionnaire (WH-QOL) was administered at baseline, 12 and 24 months.

Results

Baseline levels of stress and burnout were high among all residents with an average PSS of 18.5 and MBI of 47.6, 50.6, and 16.5 for the emotional, depersonalization, and personal achievement domains respectively. After FMP implementation, PSS was reduced to 7.9 at 12 months ( P = .001). These scores were sustained at 24 months (6.8, P = 1). MBI scores improved in emotional exhaustion (14.9, P < .0001), depersonalization (20.1, P < .0001), and personal achievement (40.1, P < .0001) at 12 months. All these benefits were sustained at 24 months. Baseline overall WH-QOL scores reflected low QOL (71.9). These significantly improved at 12 months (37.5, P = .002) with further improvement by 24 months (17.2, P = .03).

Conclusion

Long-term follow-up of a previously successful academic surgical FMP showed lasting improvements in stress, burnout, and overall QOL, despite new life challenges.
Transcreating BMT4me: A protocol for adapting an mobile health medication adherence app for Spanish-speaking caregivers in pediatric hematopoietic stem cell transplant
Authors: Benhayoun Ashley , Wang Mark , Beauchemin Melissa , Sezgin Emre , Skeens Micah A.
Published: January 2025

Objective

Hematopoietic stem cell transplant is a life-saving procedure that treats patients with various conditions by transplanting hematopoietic stem cells from bone marrow. Mobile health apps could be useful in closing the digital divide and improving health equity among Spanish-speaking caregivers of children who undergo pediatric hematopoietic stem cell transplant. This study aims to transcreate the BMT4me adherence app originally designed for English-speaking caregivers for Spanish-speaking caregivers and evaluate the feasibility and usability.

Methods

This study consists of two phases. Phase 1 transcreates the existing BMT4me app for Spanish-speaking populations. App feedback is collected from three community advisory board focus groups ( n = 10; each meeting will include the same 10 community advisory board members). Groups consist of members connected to the local Spanish-speaking population and participating in the Community Engagement Program at The Ohio State University Center for Clinical and Translation Science. Phase 2 tests the feasibility and usability of the Spanish BMT4me app with child–caregiver dyads ( n = 30; 15 at site 1, n = 15 at site 2) whose primary language is Spanish. This phase is mixed methods and incorporates both a qualitative approach (caregiver interviews) and quantitative measures (system usability scale). It is expected that app users in phase 2 will report above average system usability scale scores (>68%). It is also expected that >75% of families approached in phase 2 will enroll and complete the surveys in our study.

Conclusion

This protocol paper details the transcreation process of the BMT4me app into a Spanish version. The findings of the study will demonstrate the level of acceptability of the Spanish BMT4me app with participants whose primary language is Spanish. As a digital health intervention for an underrepresented population that is increasingly online yet historically underserved, this app can overcome health barriers and disparities and improve overall health equity.
Integrating telerehabilitation and serious gaming during home-based exercise intervention after stroke: A randomized controlled pilot trial of the DISKO-tool
Authors: Åkesson Elisabet , Bergqvist Maria , Eder Maja , Bäckström Nanna , Franzén Erika , Borg Jörgen , Palmcrantz Susanne
Published: January 2025

Background

To support recovery after stroke, rehabilitative actions and innovations are needed in resource-limited health care and geographically distant regions.

Objective

The first objective was to explore the feasibility of performing home-based training using the novel DISKO-tool including both telerehabilitation and serious gaming customized to target dynamic balance poststroke. The second objective was to assess the outcome using the Balance Evaluation Systems Test as the primary outcome.

Methods

This randomized controlled pilot trial, included ambulatory patients ≥18 years of age with physical impairments 3–6 months poststroke. During primary care rehabilitation, patients were randomized to conventional and 6 weeks of DISKO-tool training in the home ( n = 10) or conventional training only ( n = 11). Feasibility was assessed with process, resource, management, and scientific perspectives using questionnaires, logbooks, DISKO-tool data and clinical assessments.

Results

The study design was feasible including safety, resource capacity, a retention rate of 87%, high compliance to the protocol (mean 30 training days), and highly rated experience of the tool (median 10 of 10) despite some technical issues. The recruitment rate was low. The DISKO-group presented improved balance, especially in anticipatory postural adjustment compared to the conventional group ( p < 0.001; effect size 2.195; 95% CI 1.015–3.336).

Conclusions

Applying the DISKO-tool in home-based stroke rehabilitation was feasible and the piloted methodology suited for a larger RCT, as long as a wider inclusion time window poststroke is applied to enhance the recruitment rate. Rapid development and a limited lifespan of off-the-shelf hardware products warrant continuous technical development.
Digital assessment of muscle adaptation in obese patients with osteoarthritis: Insights from surface electromyography (sEMG)
Authors: Luo Xinran , Wang Qiaojie , Tan Hongyu , Zhao Wenbo , Yao Yifei , Lu Shengdi
Published: January 2025

Background

Obesity and severe knee osteoarthritis (KOA) lead to significant gait and muscle adaptations. However, the relationship between core muscle strength and the severity of KOA in obese patients remains unclear. This study aimed to determine the association between muscle strength adaptation and the severity of KOA in obese individuals.

Methods

We recruited 119 obese participants with unilateral KOA from January 2021 to December 2023, all classified with mild to moderate KOA grades. KOA severity was assessed using the Western Ontario and McMaster University Osteoarthritis Index (WOMAC), which categorized participants into two groups based on disease severity. Electromyographic data from the psoas, gluteus medius, vastus lateralis, vastus medialis, rectus femoris, medial gastrocnemius, lateral gastrocnemius, tibialis anterior, and biceps femoris muscles were collected during isometric and dynamic knee extension.

Results

Significant differences were observed in all selected muscles between the affected knee joint and the contralateral side during both dynamic and isometric knee extensions. The difference in electromyographic data—including mean absolute value (MAV), root mean square (RMS), and center frequency (CF)—was significantly different across groups categorized by KOA severity. Notably, the MAV values of the vastus medialis, lateral gastrocnemius, and biceps femoris, as well as the CF values of the medial and lateral gastrocnemius, showed no significant differences in some instances during both dynamic and isometric extensions.

Conclusion

This study indicates that obese individuals with KOA exhibit lower muscle intensity and higher fatigability in comparison to the contralateral side during both isometric and dynamic knee extensions. Furthermore, significant reductions in muscle intensity were observed in the psoas, gluteus medius, vastus lateralis, rectus femoris, medial gastrocnemius, and tibialis anterior muscles, correlating with the advanced severity of KOA.
Simulation Analysis of Big Data Discriminatory Pricing Behavior from the Perspective of Game Theory
Authors: Wang Nan , Chang Yu , Song Xiao Yu
Published: January 2025

With the increasing popularity of big data technology, some enterprises use the massive amount of consumer data collected for the analysis of consumers’ purchasing power and preferences to implement discriminatory pricing and increase profits, with consumer rights infringed upon. Therefore, it is of great significance to study how consumers respond to big data discriminatory pricing (BDDP) behavior by enterprises. This article categorizes consumers into new and old users. In the strategy sets of whether consumers choose to purchase and whether enterprises engage in discriminatory pricing, the costs and benefits of consumer rights protection and enterprise compensation are considered, respectively. A new “government-consumer-enterprise” tripartite game model is proposed, along with an analysis of different behavioral strategy combinations of the three parties. The impact of key parameters on each party is studied through simulation analysis to provide a reference for cracking down on BDDP behavior. The experimental results indicate that increasing government punishment and credibility can effectively suppress the BDDP behavior by enterprises; however, increasing the compensation limit for enterprises will only have a certain effect in the early stage; the higher the evaluation value of products or services by consumers, the less effectiveness it is in suppressing the BDDP behavior by enterprises.
Exploring the relationship between income inequality and crime in Toronto using frequentist and Bayesian models: Examining different crime types and spatial scales
Authors: Cai Renan , Tan Su-Yin
Published: January 2025

Income inequality, which refers to the uneven distribution of income in a population, has been linked to many societal problems, including crime. Although environmental criminology theories, such as rational choice theory, suggest a positive association between income inequality and crime, previous empirical studies have reported divergent results based on different crime types, statistical models, and spatial units of analysis. This study employs non-spatial and spatial regression models using frequentist and Bayesian modelling frameworks to explore the impacts of within-area and across-area income inequality on five types of major crimes in the City of Toronto at the census tract and dissemination area scales. The use of spatial regression models improves the model fit in both frequentist and Bayesian frameworks. The Bayesian shared component model, which accounts for the interactions between different types of crimes, further enhances model performance. Results obtained from the best-fitting frequentist and Bayesian models are inconsistent but do not conflict in terms of the relationship between crime and income inequality, where within-area income inequality generally increases major crime rates, while across-area income inequality has varying effects dependent on crime type and spatial scale. The discrepancies between spatial scales are a manifestation of the modifiable areal unit problem (MAUP).
Paired constraints: A paradigm for solving the creativity problem
Authors: Stokes Patricia D.
Published: January 2025

The creativity problem is the product of operant conditioning. Both experts and novices get stuck in more-or-less successful solutions. The problem has two parts: how do you start, and, how do you continue, to do something new? The paired constraint paradigm presented in this paper is a framework, a template, for solving the problem. The framework has three parts: a structure (the problem space), a strategy (the paired constraints), and a process (solution-by-substitution). The structure is based on Newell and Simon’s seminal work; the strategy, on Reitman’s demonstration that constraints can both limit and direct search in a problem space; the process, on Stokes’ development of the paradigm. Photography is the domain used to demonstrate its possibilities. The case studies focus on Cindy Sherman, an identity-changing artist whose medium is photography, and Orham Pamuk, a Nobel prize winning author whose photography focuses on his perennial subject, Istanbul.
TiO2–ZnO functionalized low-cost ceramic membranes from coal fly ash for the removal of tetracycline from water under visible light
Authors: Sawunyama Lawrence , Oyewo Opeyemi A. , Makgato Seshibe S. , Bopape Mokgadi F. , Onwudiwe Damian C.
Published: January 2025

Hybrid wastewater treatment systems offer viable solutions to enhance the removal of complicated contaminants from aqueous system. This innovation has opened new avenues for advanced wastewater treatment processes. Herein, a novel TiO2–ZnO functionalized coal fly ash-based ceramic membrane was fabricated by utilizing a combined pressing and sintering method. The intrinsic properties of the functionalized membranes were characterized and their chemical and physical properties such as chemical stability, mechanical stability, water absorption, and porosity were established. The shape, crystallinity, thermal characteristics, and functional groups present were also determined using SEM, XRD, TGA, and FTIR studies, respectively. The results showed that the ceramic membrane functionalized with 0.5 g of TiO2–ZnO and sintered at 850 °C exhibited the best thermal, and chemical stability, and possessed the required porosity for ultrafiltration applications. Photocatalytic degradation of tetracycline (TC) as a model pollutant was examined and the optimum efficiency of 77% was achieved within 100 min of visible irradiation using the functionalized membrane. Moreso, the functionalized membrane was found to be stable with 73% degradation efficiency after 5 consecutive cycles of reusability study, showing negligible loss of efficiency. The scale-up of photocatalytic ceramic membranes and their utilization in real industrial applications will confirm their robustness.

Graphical Abstract