bluuebunny/crossref_metadata_2025 huggingface dataset:
Economic speed planning for commercial vehicles: A PMP based approach
Authors: Li Xingkun , Wang Guohui , Tian Guangyu , Li Liang , Lu Ziwang
Published: February 2025

This paper presents a methodology based on Pontryagin’s Maximum Principle (PMP) for formulating a control law to optimize the vehicle’s economic speed, allowing for rapid determination of the optimal cruising speed. The research focuses on two main aspects: modeling and the development of the economic speed control law. In the modeling phase, a nonlinear engine fuel consumption model is employed for a more accurate depiction of engine fuel consumption characteristics. Additionally, road functions are reconstructed through algorithms which better describe the actual operating conditions of the vehicles. The control law is derived by establishing the Hamiltonian equation, integrating the vehicle’s longitudinal dynamics equation, and ensuring practical conditions for economic speed control. Leveraging the derived variation in vehicle speed and formulated control law, the economic speed sequence is promptly ascertained, meeting real-time requirements for vehicle cruising and reducing computational complexity. Experiments conducted using a FAW J7 truck indicate that the speed sequence obtained aligns with the trend derived through Dynamic Programing (DP). With comparable average speeds, the PMP-derived economic speed exhibits a 6.71% lower fuel consumption than the Cruise Control System (CCS). The control law-derived economic speed detailed in this paper effectively enhances fuel economy during vehicle cruising. This study presents a valuable method for achieving economic driving in commercial vehicles.
Plunger motor fault analysis method based on improved wavelet packet threshold denoising and feature signal extraction
Authors: Hui Huang , Guo Yi , Xu Chen , Su Junshou , Huang Qiufang , Yuzheng Li
Published: February 2025

Aiming at the characteristics of dense noise sources, cross noise frequency, and non-linearity and non-stationarity of the acoustic signal inside the plunger motor, an improved wavelet packet threshold denoising combined with ensemble empirical modal analysis and Hilbert transform is proposed as the feature signal extraction method. By collecting vibration signals of both fault free and faulty motors under normal operation, constructing a wavelet packet secondary decomposition structure and thresholding to analyze and denoise the collected signals, and then using an improved signal processing method to obtain the true characteristic signal frequency of the plunger motorThe novelty of this study lies in the integration of advanced signal processing techniques to enhance fault detection accuracy by effectively handling noise and extracting characteristic frequencies in complex operational environments. Experimental validation shows that the proposed method effectively enhances the feature extraction of plunger motors, providing a reliable basis for fault diagnosis.
A cost guaranteed fractional PID control strategy for fractional uncertain time-varying delay systems on finite-time boundedness analysis
Authors: Jin Yitong , Li Ping , Huang Qian , Liu Mingqing , Wang Chunxiu
Published: February 2025

In this paper, a cost-guaranteed fractional PID control strategy is proposed for fractional order uncertain systems (FOUSs) with time-varying delay regarding finite-time boundedness (FTB) analysis, where the fractional order lies within (0,1). Fractional order PID control is typically studied in the frequency domain, but for an uncertain system with time-varying delay, it is more convenient to conduct the study in the time domain. A novel Lyapunov–Krasovskii function is constructed. Based on this and a fractional order integral matrix inequality, several corresponding less conservative sufficient conditions are derived to guarantee the FTB of the system. By employing LQR and LMI approaches, the proposed conditions can be solved using some standard numerical packages. Through fine-tuning the conditions, the derived results can also be effectively applied to asymptotic stability analysis. Two numerical examples are presented, which further validate the introduced theoretical formulation and highlight its effectiveness through result comparisons.
Evaluation of Family-Centered Care by Parents and Nurses of Children With Congenital Microtia
Authors: He Kexin , Liu Na , Gou Jiayan , Feng Yao , Li Yang
Published: February 2025

Background

The family-centered care is widely applied in pediatric nursing; however, there has been no research reflecting its extent of practice in the auricular reconstruction process for families of children with congenital microtia in China.

Objective

This study aims to understand the perspectives of parents of children with congenital microtia and nurses at auricular reconstruction centers in Beijing, China, regarding family-centered care practices and specific areas that need improvement.

Methods

The study utilized the Measure of Processes of Care (MPOC-20) and the Measure of Processes of Care for Service Providers (MPOC-SP) to survey 100 parents and 22 nurses. Scores for each dimension and item with low score (1-4 points, representing for at least 25% respondents) were statistically analyzed, indicated deficiencies in care services. The scores of parents and nurses were compared with international data.

Results

In this study, the dimension scores of the MPOC-20 ranged from 5.34 ± 1.22 (Coordinated and Comprehensive Care) to 5.57 ± 1.22 (Providing Specific Information). The dimension scores of the MPOC-SP ranged from 5.91 ± 1.08 (Showing Interpersonal Sensitivity) to 6.25 ± 1.20 (Providing General Information). Both sets of scores were higher than most previous studies, particularly in Providing General Information.

Conclusion

Parents of children with congenital microtia and nurses generally rated family-centered care practices positively. However, improvements are needed in Coordinated and Comprehensive Care and Showing Interpersonal Sensitivity. Future efforts should aim to enhance the care system for microtia by standardizing care service content, increasing auditory and psychological interventions, and strengthening long-term follow-up care.
Physicochemical, microbiology, and sensory characteristics of kombucha prepared with Tommy mango peel flour
Authors: Azara Cíntia Ramos Pereira , Didier Peixe Carolina Lírio , Cardoso Carlos Eduardo de Faria , Azara Maria Eduarda Pereira , Elias Monique , Freitas-Silva Otniel , Teodoro Anderson Junger
Published: February 2025

Fermented foods are a good option due to the beneficial compounds generated in the fermentation process and the low pH that allows conservation without additives. The objective of the study was to produce and include Tommy mango peel flour in the production of kombucha and evaluate its effects on the physicochemical and sensory properties, antioxidant capacity, and microbiological profile. The kombucha was developed with green tea and the addition of Tommy mango peel flour (10% and 20%). The kombuchas were evaluated in the first fermentation (aerobic) and at the end of the second fermentation (anaerobic), the granulometry and colorimetry of the flour and the antioxidant profile were evaluated. Microbiome analysis was performed by 16S DNA extraction. For sensory analysis, an affective test was performed for global evaluation, flavor, texture, and oral perception. The results showed that the total phenolic content was 4.86 mg EAG/mL in F1, 8.79 mg EAG/mL in F2 with 10% mango peel flour, and 8.83 ± 0.54 mg EAG/mL in F2 with 20% mango peel flour, evidencing a significant increase in the second fermentation with the addition of the flour. In addition, the antioxidant activity was also higher in the second fermentation. The values obtained were F1 = 15.27 µmol TE/mL; F2 with 10% FCMT = 18.80 µmol TE/mL; and F2 with 20% FCMT = 26.76 µmol TE/mL. These findings indicate that the antioxidant capacity increases significantly during the second fermentation, directly correlating with the amount of mango peel flour added. The most abundant bacterial genera were Liquorilactobacillus nagelii (72%), Acetobacter (13%), and Komagataeibacter (12%) and for fungi (90%) Brettanomyces/Dekkera bruxellensis. The beverage obtained different levels of acceptance among consumers and non-consumers only in terms of flavor, proving to be a good alternative for the food industry for applying a mango byproduct to drinks.
A Socio-Ecological Approach to Promoting Physical Activity in a Low-Income Neighborhood: A Randomized Controlled Pilot Trial
Authors: Kaushal Navin , Alamilla Rafael A. , Keith NiCole R.
Published: February 2025

Physical activity (PA) helps prevent several diseases; however, individuals residing in low-income neighborhoods have lower PA participation rates due to social disparities, as outlined in the social-ecological model. The purpose of this pilot study was to apply the social-ecological framework to test the effectiveness of a six-month, community-based PA program in a low-income neighborhood. Participants (n = 45) lived in a low-income neighborhood near a community fitness center. Those randomized to the experimental arm (n = 23) received gym access and attended monthly on-site workshops (Months 1–3) designed to enhance PA determinants such as planning and habit formation. The remaining participants (n = 22) were assigned to a wait-listed control group. PA, body composition, and fitness data were collected using accelerometers, BODPOD, and on-site fitness assessments at baseline, Month 3, and Month 6. Compared to the control group, participants in the experimental arm engaged in more moderate-to-vigorous PA (d = .48, d = .74), total PA (d = .41, d = .99), and steps (d = .48, d = .92) at Months 3 and 6, respectively. The experimental group also showed improvements in fitness tests, including the 30-s chair test (d = .29, d = .23) and the 8-foot up-and-go test at Month 3 (d = −.23), though these gains were not sustained at Month 6. Overall, this pilot study supports the feasibility of promoting PA and improving fitness outcomes in a low-income neighborhood. Notes for improvement and future directions are provided such as tracking PA exclusively performed at the community center to better assess program impact.
Diagnosis and Management of Tuberous Sclerosis Complex in a Resource-Limited Setting—A Case Report of a 14-Year-Old Female Zambian Adolescent
Authors: Lienda Mwamba , Mwila Meek , Sichula Chilala , Kabengele Chishiba , Akombwa Moses , Zulu Christina , Banda Chihena Hansini , M’hango Hellen
Published: February 2025

Tuberous sclerosis complex (TSC) is a rare multisystemic neurocutaneous syndrome with a wide spectrum of clinical manifestations. We present a case of a 14-year-old adolescent female who presented with a history of facial angiofibromas since the age of 8 months. Physical examination was remarkable for multiple angiofibromas on the face, and other multiple cutaneous manifestations of TSC. MRI of the head, and abdomen revealed cortical tubers, multiple bilateral periventricular and subependymal nodular lesions, calcifications, and bilateral kidney enlargement with multiple bilateral renal angiomyolipomas of varying sizes in a background of bilateral polycystic kidneys, MRI of the chest was unremarkable. A diagnosis of TSC was made using the clinical diagnostic criteria which consist of major and minor features. A diagnosis using genetic studies could not be made due to a lack of resources. Management was multidisciplinary and regular monitoring every 6 months will be required to monitor disease progression and manage complications as they arise. This case illustrates the multidisciplinary approach needed to address the diverse clinical manifestations of TSC and the diagnostic challenges, treatment limitations, and psychological impact of TSC in low-resource settings like Zambia where access to advanced therapies is limited.
From Exceptionality to Mundanity: Exploring the Everyday Particularity of Porn Spectatorship
Authors: Thorneycroft Ryan , Hanckel Benjamin , Smith Erika K. , Nicholas Lucy
Published: February 2025

Pornography scholarship is often dominated by discourses surrounding its alleged risks to viewers. Approaching sex and porn through the lens of ‘play’ rather than ‘drama’, this article concentrates on the everyday particularity of porn viewing, where media-related practices/technologies afford possibilities between porn users and digital objects. Drawing upon focus groups/interviews with 17 young adult porn viewers (18–25 years) based in western Sydney, this research illustrates the routinised and experimental, immersive and affective, experiences pornography provides. Far from the ‘sexually corrupt’ discourses that dominate, the participants identified playful affordances—boredom, distraction, curiosity, fun, exploration/experimentation, relaxation, stress relief and pleasure—informing their everyday affective engagements with pornography. There is greater need to listen to young adults’ everyday experiences with pornography and to examine the multiplicity of porn use. Moving from ‘texts and effects’ to ‘experiences’, and from ‘drama’ to ‘play’, identifies more nuanced and capacious elements to porn spectatorship unfettered by dominant moral panics.
A qualitative evaluation of the reflective fostering programme – examining foster and kinship carers’ experiences, practical application, and perceived impact
Authors: Katangwe-Chigamba Thando , Murdoch Jamie , Irvine Karen , Redfern Sheila , Midgley Nick
Published: February 2025

Background

Mentalization is the ability to think about and interpret behaviours of both self and others in terms of thoughts and feelings. Caregiver’s capacity to mentalize can enhance the quality of parent-child relationships. The UK Reflective Fostering Programme (RFP) has been developed to enhance foster and kinship carers’ self-regulation and self-mentalizing.

Aim

To understand carers’ experiences, practical application, and perceived impact of the RFP.

Methods

A qualitative evaluation of the RFP using in depth interviews with twenty-four carers. Interviews were audio-recorded, transcribed verbatim and analysed thematically.

Results

Three key themes were identified: (1) ‘ Me time’ – carer’s reflections on the programme and what makes it work, highlights sharing of challenging experiences as important for practising mentalizing. (2) ‘ Stopping and thinking in the moment’ - carer’s understanding of programme concepts explores carer's conceptualizations of mentalization, revealing some male carers described challenges regarding sharing personal experiences in a group and the practical application of mentalization. (3) Practical application and perceived impact of the programme suggests successful enactment of learning from the programme, resulting in enhanced capacity to cope with stress, prevention of outbursts and better communication with children in their care.

Conclusions

Our findings suggest the programme can successfully facilitate carer’s use of self-mentalizing, leading to greater self-regulation and capacity to support children in their care. Future research should explore experiences of male and kinship carers to inform tailoring.
Structural vibration control of the curved bridge based on the combined effects of TLMD and LMD
Authors: Xia Qi , Chen Ze , Yang Lin , Hou Jie , Zhang Jin-bei , Wang Zheng-xing , Wu Wang-lin , Ye Zhi-wei , Tan Hai-shan
Published: February 2025

The abnormal vibration of the bridges, particularly those with curved bridges, poses a significant threat to structural safety due to the complex dynamics of vehicle-bridge coupling. This coupling emerges from the generation of centripetal and eccentric forces as moving loads traverse the bridge, leading to intricate interactions that induce unusual vibrations within the structure. The Nanping Curved Bridge (NPCB) in Shenzhen City secrves as a case study, where vertical vibration acceleration can reach up to 1200 mm/s2. The primary research involves: (1) Conducting measurements and analyses of the structural dynamic characteristics both before and after the installation of dampers. (2) Analyzing field test data to reveal that the excitation effects on bridge structures vary depending on the type of vehicle (trucks, cars) and environmental factors. Specific frequency bands for vibration reduction were identified by incorporating finite element analysis results. (3) Innovatively, a combined control strategy of Tuned Liquid-Mass Dampers (TLMDs) and Lever Mass Dampers (LMDs) is proposed to address the challenge of controlling NPCB due to its wide frequency domain distribution. (4) After the installation of the dampers, the corresponding vibration tests were conducted. The analysis results indicated that TLMD and LMD combined operation could reduce bridge vibration by 37.7% and double the damping ratio.
Time to BeReal! Exploring users’ well-being in relation to BeReal use duration
Authors: Kaňková Jaroslava , Stevic Anja , Binder Alice , Matthes Jörg
Published: February 2025

The mobile app BeReal, launched in 2020, has gained popularity for its emphasis on authenticity, spontaneity, and real-time daily interactions with close ties, earning it the label of “anti-Instagram.” However, empirical evidence on its relationship with well-being is currently lacking. This study uses a quasi-experimental two-wave design to examine the relationship between BeReal use duration and well-being indicators. Results suggest that long-term BeReal use is linked to higher friendship satisfaction, positively influencing life satisfaction. In addition, long-term use is associated with reduced fear of missing out and connection overload compared to short-term use, suggesting BeReal may enhance well-being possibly by facilitating daily interactions with close ties, limiting usage time, and providing a more authentic representation of everyday life compared to other social media platforms.
Crossing consumption fields: Acculturation and status consumption of Chinese student sojourners attending U.S. universities
Authors: Huang Jing
Published: February 2025

By linking sojourners’ consumer cultures to shifts in their social status, as operationalized by Bourdieu’s (1984) theories of capital and field, this study examines the phenomenon of status consumption among Chinese college students during their sojourns in the U.S. The findings illustrate how participants’ consumer patterns are shaped by sociocultural resources connected to the experience of status tension during acculturation, where some participants feel they lack local social and cultural capital in the receiving society. In this context, consumption driven by status loss emerges as a central aspect of their studying abroadexperiences. Through redefining the boundaries of consumption fields, students navigate their social positions with consumption behaviors aimed at reworking the status hierarchy. While participants sought out Western goods as a form of cosmopolitan capital before studying abroad, they turned to Chinese products when faced with status incongruence abroad, engaging in a form of diaspora nationalism and adopting distinct consumer habits to maintain their status.
Optimization of science and technology project management system based on hybrid semantic similarity evaluation framework
Authors: Zhang Ying , Zhang Chao , Hu Fan
Published: February 2025

With the increasing complexity of scientific and technological project management, traditional project management systems are faced with the challenges of massive data processing and semantic understanding. The study first discusses the computer-implemented technology of semantic similarity evaluation, analyzes the application of word embedding and deep learning algorithms, and emphasizes the importance of these technologies in natural language processing (NLP). A novel hybrid semantic similarity evaluation framework has been developed and implemented, incorporating an optimized algorithm-based semantic feature extraction module alongside multi-source data fusion and processing techniques modeled on semantic relationships. The framework’s primary objective is to enable precise analysis of multilingual project data by deeply exploring contextual information. Experimental validation highlights the framework’s performance and effectiveness, with particular emphasis on its accuracy in semantic similarity calculations, data processing efficiency, and responsiveness in large-scale environments. During testing, the framework achieved a semantic similarity calculation accuracy of 67.37%, based on a test set comprising 73 samples. An analysis of 74,723 project records revealed that the system’s average response time for multi-source data fusion was 2.3 seconds. Under complex semantic analysis conditions, the framework processed data at a rate of 348.15 items per second. Multiple test results further demonstrated that the error margin in semantic evaluation remained within 2.51 percentage points. These findings confirm that the system optimization successfully meets the anticipated goals in terms of both accuracy and efficiency.
Comparison of Wear Compliance Across Three Accelerometer Protocols in Adolescents
Authors: Grimes Amanda , Todd Reagan , Sours Olivia , Valleroy Ella , Akagi-Bustin Zakry , Hillard Natasha , Lightner Joseph S.
Published: February 2025

Introduction. While physical inactivity remains a pervasive public health problem, issues surrounding measuring physical activity plague researchers. Accelerometers are the gold-standard tool to assess physical activity and consumer-grade devices are increasingly used in research. However, accelerometer wear compliance varies by population and is influenced by factors, such as social acceptability, among others. Non-compliance threatens data validity and limits the usefulness regarding health promotion. Therefore, the purpose of this study is to compare the effects of three consumer-grade accelerometer protocols on wear compliance among adolescents. Methods. Study participants were provided a Garmin VivoFit4 accelerometer watch; participant wear compliance, steps, and physical activity were measured during the study period. Three methods of data collection were used to assess physical activity: (1) continuous wear, self-sync ( n = 59); (2) continuous wear, researcher-sync ( n = 160); and (3) intermittent wear, researcher-sync ( n = 62). A one-way analysis of variance was conducted to assess between-group differences. Results. Mean valid days were significantly higher at baseline ( F = 27.52, p < .001) and endpoint ( F = 9.98, p < .001) for the intermittent wear, researcher-synced condition than for both the continuous wear conditions, and significantly higher at midpoint ( F = 4.05, p < .05) for the continuous wear, research-synced condition. Conclusion. Study findings suggest that an intermittent wear, researcher-synced protocol significantly improves wear compliance and meets recommendations needed for reliable estimates of physical activity compared with continuous wear protocols as measured by mean valid days. Implementing protocols to increase wear compliance will improve data for interventional studies and health promotion capabilities of consumer-grade accelerometers.
Relevant fabric parameters to be considered for optimizing combined drying and support properties of sports bras
Authors: Jerkovic Ivona , Ebrahimi Sahar , Baumann Joyce , Stämpfli Rolf , Camenzind Martin , Annaheim Simon , Rossi René M
Published: February 2025

The use of textile science and innovative approaches in the development and manufacturing of multifunctional fabrics for sports bras has continuously grown in the last decades, contributing to female well-being and health. The fabrics used for sports bras must be lightweight and have good heat and moisture management properties. A sports bra must provide appropriate stabilization, as the most important and original functionality, while providing optimal thermal comfort. In this work, we examined basic fabric properties influencing the key functionalities, stabilization, and drying. Besides properties such as mass, thickness, water vapor permeability, air permeability, and relative porosity, thermal comfort (water uptake and drying) and mechanical properties (stabilization and support) were investigated. Multiple-linear regression statistical analysis was conducted to identify the most relevant variables and fabric characteristics for stabilization and drying. In addition, a “five-point” benchmarking and ranking system was established for performance assessment of the investigated knitted fabrics. With the proposed approach, we were able to identify the most suitable fabric from a set of benchmarking materials. This fabric exhibited a quick drying time of 16 minutes, along with high air permeability (312 mm/s), excellent moisture management, and very good dynamic elastic recovery (89%) and support. We successfully identified key fabric properties that define fabric drying and stabilization performance by applying models based on Multiple-linear regression. This provides the basis for the informed selection of fabrics for the systematic development of sports bras.
Cultural Influences on Parental Advocacy for Inclusion: Experiences of South Asian Families With Children with Extensive Support Needs
Authors: Krishnan Sudha
Published: February 2025

This qualitative study examined the cultural factors in parental advocacy in South Asian parents of children with extensive support needs (ESN), concerning the educational placement decisions for their children. Data were collected using semi-structured interviews and analyzed using thematic coding. The findings revealed that the predominant preference for segregated educational settings among participants was shaped by various cultural influences: persistent social stigma surrounding disability, a culturally-rooted belief in the curability of the disability, the prioritization of safety over academic integration, perceived inadequacies within general education settings, institutional pressures from school or IEP recommendations, advocacy for intensive home-based instruction, and a sense of immigrant gratitude and appreciation for the school system in the host country.
Design and experiment of a multimodal aerial aquatic vehicle with morphing wing and tilting rotors
Authors: Xia Minghai , Wang Baocai , Luo Zirong
Published: February 2025

Aerial aquatic vehicles have wide prospects in scientific and industrial fields because of their cross-domain locomotion ability. To improve the operation capacity of aerial aquatic vehicles, a novel multimodal hybrid vehicle was proposed in this paper. The vehicle combined the advantages of fixed-wing aircraft and multirotor aircraft. Owing to the special morphing wing and tilting rotors mechanism, the vehicle was reconfigurable to adapt to a variety of missions, including long distance flight, vertical take-off and landing, and underwater locomotion. The structure of the hybrid vehicle was designed, and the operating method in different modes were discussed. Then the kinematic and dynamic models were analyzed in terms of fixed-wing flight, multirotor flight, and underwater operation modes, respectively. The attitude control and a control allocation algorithm were established for locomotion control. Finally, the experiments of air flight, morphing wing, and underwater motion were conducted. The results showed that the hybrid aerial aquatic vehicle performed good flight stability and could move freely underwater. The morphing wing could fold and expand itself for resistance reduction and long-distance flight, respectively. The multimodal locomotion experiments verified the feasibility of the novel aerial aquatic vehicle and the control strategy.
Risk factors and clinical characteristics of Clostridium difficile colonization and infection in patients with inflammatory bowel disease exposed to Vedolizumab: a multicenter retrospective study
Authors: Li Qing , Song Xiaomei , Su Peizhu , Lv Xiaoping , Liu Xinyu , Chen Xuemin , Tang Jian , Gao Xiang , Chao Kang
Published: February 2025

Background:

Vedolizumab (VDZ), a humanized monoclonal antibody that selectively inhibits the binding of the α4β7 integrin, has been approved for treating inflammatory bowel disease (IBD). Long-term safety studies of VDZ in clinical trials identified Clostridium difficile infection (CDI) as the major opportunistic infection.

Objectives:

We aimed to address the incidence and risk factors of C. difficile colonization (CDC) and CDI in a real-world setting among IBD patients treated with VDZ.

Design:

Retrospective multicenter study.

Methods:

We retrospectively included IBD patients who tested negative for C. difficile before initiating standard VDZ therapy at four tertiary hospitals from November 1, 2021, to November 31, 2023. The primary outcome was the occurrence of CDC after VDZ initiation, and the secondary outcome was the occurrence of CDI and severe CDI.

Results:

A total of 454 patients were included in the final analysis. The median follow-up time was 12.9 (8.2–16.3) months, and the study was followed for 2488.6 person-months. The CDC occurred in 28 patients (6.2%), including 23 (11.4%) patients with ulcerative colitis (UC; 18 asymptomatic carriers and 5 with symptomatic CDI) and 5 (2.0%) patients with Crohn’s disease (asymptomatic carriers). Multivariate analysis showed that age >40 years old and UC were independent risk factors for the occurrence of the CDC after VDZ initiation. The incidence of CDI was 1.1%, and all patients were able to continue VDZ therapy after receiving antibiotic treatment. No risk factors were found to be significantly associated with CDI. There were no cases of severe CDI or deaths within 30 days.

Conclusion:

The incidence of CDC after VDZ treatment was 6.2% and the majority of patients identified as asymptomatic carriers and were able to continue VDZ treatment. Age (>40 years old) and UC were the risk factors for CDC.
Efficacy of goserelin in ovarian function suppression and preservation for pre- and perimenopausal breast cancer patients: a systematic review
Authors: Chen Nan , Audi Blotta Daniella , Kim Hee Jeong , Sayeed Salma , Cannon Joan , Osman Noran , Macrito Rosa , Lambertini Matteo
Published: February 2025

Background:

Over the past few decades, the gonadotropin-releasing hormone agonist goserelin has been evaluated in ovarian function suppression (OFS) with adjuvant endocrine therapy and ovarian function preservation (OFP) during chemotherapy.

Objective:

The goal of this systematic literature review was to assess the efficacy of goserelin in OFS and OFP in combination with endocrine therapies and chemotherapy, respectively, in pre- and perimenopausal women with early-stage breast cancer.

Design:

This study is a systematic review.

Data sources and methods:

The literature search was conducted using PubMed. Prospective clinical studies evaluating the efficacy of goserelin in OFS or OFP in pre- or perimenopausal breast cancer were identified by four reviewers working in teams of two.

Results:

Twenty-nine studies were included in this systematic review. The addition of goserelin as OFS to adjuvant endocrine therapy generally resulted in significant benefits in disease-free survival. Studies have shown better OFP results among women 40 years or younger compared with older patients. Chemotherapy in association with goserelin for OFP resulted in a higher recovery rate of menses within 6–24 months, a shorter time for menstrual recovery, and significantly higher pregnancy rates when compared with cytotoxic therapy without goserelin. Hormonal recovery with higher anti-Müllerian hormone and estradiol levels, and lower follicle-stimulating hormone and luteinizing hormone levels occurred more frequently among women who received goserelin during chemotherapy as compared with those receiving cytotoxic therapy alone. The benefits of goserelin in OFP were more substantial among women 40 years or younger than in older patients.

Conclusion:

The findings of this systematic review highlight the benefits of adding goserelin to endocrine therapies for OFS and chemotherapy for OFP in early-stage breast cancer. Additionally, scientific data supporting OFS (including goserelin) in combination with newer agents such as cyclin-dependent kinase 4 and 6 inhibitors and bone-modifying agents are emerging.
Comparison of the Effect of Teleconsultations, Hybrid Visits, and In-Person Visits on Glycemic and Metabolic Parameters Among Individuals With Type 2 Diabetes in India
Authors: Amutha Anandakumar , Reji Shyama , Hema Aarthi Ramamurthy , Keertan Rao Srinivas , Ganesan S. , Jebarani Saravanan , Praveen Gangadhara , Unnikrishnan Ranjit , Mohan Viswanathan , Anjana Ranjit Mohan
Published: February 2025

Aim:

We compared biochemical and clinical data of individuals with type 2 diabetes (T2D) who opted for only teleconsultation (ie, no in-person visit at all), hybrid visits (combining home blood tests and in-person consultation), and fully in-person visits (both tests and consultation in person) at a tertiary care diabetes center.

Methods:

In this observational cohort study, we retrieved demographic, anthropometric, and biochemical data of 8197 individuals with T2D who sought diabetes care between 2021 and 2023 (384 participants with only teleconsultations, 721 with hybrid visits, and 7092 with fully in-person visits) from the electronic medical records of a chain of tertiary diabetes care centers across India.

Results:

Individuals who opted for teleconsultation had a shorter duration of diabetes compared with those who opted for hybrid or fully in-person visits. Although participants who opted for a teleconsultation had better glycemic and lipid control at baseline, those who underwent hybrid and in-person visits showed greater improvements in fasting plasma glucose, glycated hemoglobin (A1c), and LDL cholesterol (LDL-C) during follow-up. Improvements in overall ABC target achievement (A1c, Blood pressure, and LDL-C) were greater in participants who had in-person visits compared with the other two groups.

Conclusion:

While teleconsultation is a useful complement to in-person visits, the latter results in better glycemic and lipid control, perhaps due to more effective engagement with the diabetes care team.
Universals, difference, and ghosts: A response to Joseph Blankholm's the secular paradox
Authors: Keel Terence
Published: February 2025

This essay provides a critical response to Joseph Blankholm’s new work The Secular Paradox. I praise the book for its ingenuity and then raise questions about how the experience of what he calls the “secular paradox” might vary by racial identity. I also explore the intolerance of western liberalism toward ghosts to explore how Blankholm’s account of the secular paradox might also offer insight into America’s unwillingness to grapple with its primitive past.
Efficacy of a physical rehabilitation program using virtual reality in patients with chronic tendinopathy: A randomized controlled trial protocol (VirTendon-Rehab)
Authors: Lucena-Anton David , Dominguez-Romero Juan G , Chacon-Barba Juan C , Santi-Cano María José , Luque-Moreno Carlos , Moral-Munoz Jose A
Published: February 2025

Objectives

To analyze the efficacy of a virtual reality (VR)-based rehabilitation program in people with chronic tendinopathy (CT) on pain, muscle activation pattern, range of motion, muscle strength, kinesiophobia, physical function, quality of life, and user satisfaction compared to a control group. In addition, the relationship between these variables and the clinical profile of this population will be analyzed.

Design

A 12-week, single-blind, low-risk, randomized controlled trial.

Methods

Sixty patients diagnosed with CT will be enrolled and randomly assigned to two groups. The control group will receive a physical exercise program without VR support (45 min), whereas the experimental group will receive an additional 15-min intervention through a physical exercise program delivered by VR. Both groups will receive three sessions per week, and the outcomes will be collected at baseline, after 12 weeks, and at the 24-week follow-up. Stratified groups will be established according to tendinopathy location (shoulder rotator cuff, elbow, patella, and Achilles tendon). Statistical analyses using SPSS v.24 will include descriptive analysis, stratified analysis by tendinopathy location, normality checks, intragroup and intergroup differences, effect sizes, and variable relationships.

Discussion

The results of this project may have a significant impact on the knowledge of using VR in tendinopathy management, understanding how the outcomes are related, and characterizing the clinical profiles of the population diagnosed with CT. If these results are confirmed, VR would be clinically useful for the treatment of these conditions.

Trial registration number

NCT06056440.
Book review: Gerrard, B A., Carter, M. J., & Ribera, D. (Eds.). (2020). School-based family counseling: An interdisciplinary practitioner’s guide
Authors: Kaplan Toren Nurit , Brown Meegan
Published: February 2025

School-Based Family Counseling: An Interdisciplinary Practitioner’s guide is a valuable resource for practitioners, students, researchers and anyone working on the therapeutic interference between school and family. Based on the School-Based Family Counselling (SBFC) metamodel theory, the book offers practical and hands-on ways to implement SBFC in schools in a wide range of contexts.
Assessing the Acceptability of a Vaginal Self-Sampling Device in a Rural Parish of Cuenca, Ecuador
Authors: Delgado López Dayanara , Acosta Bedón Ana , Rivas-Párraga Roque , Heredia Micaela , Muñoz Carolina , Vega Crespo Bernardo , Vermandere Heleen , Hendrickx Marie , Gama Ana , Neira Vivian Alejandra
Published: February 2025

Introduction:

Cervical Cancer (CC) is a preventable and treatable disease if detected early, yet it remains a global health challenge. In Ecuador, CC is the second most common cancer; however, screening uptake remains suboptimal due to poor knowledge, low willingness, and limited access to healthcare. Traditionally, CC screening requires a healthcare professional, creating social and access barriers. Innovative techniques such as “self-sampling” (SS) for human papillomavirus (HPV) detection offer a promising alternative.

Objective:

This study evaluates the acceptability, attitudes, and user experience of a community-based SS program among a hard-to-reach population following a local educational session.

Methods:

A quasi-experimental study was conducted in a rural community in Cuenca, Ecuador. Educational sessions were organized, after which women were offered the option to perform SS for HPV detection. Three questionnaires were administered to assess population characteristics, risk factors, and experiences toward the process.

Results:

Of the 130 participants, 90% accepted SS, and 10% rejected SS. A significant number of women reported that SS was faster and less painful compared to traditional Papanicolaou tests ( P < .05).

Conclusions:

SS shows strong potential for increasing CC screening, especially in hard-to-reach areas, emphasizing the need to adapt screening programs to meet diverse community needs.
Psychological and Emotional Challenges Faced by Female HIV Counselors in Kashmir—A Phenomenological Study
Authors: Bashir Khalid , Haq Inaamul , Qurieshi Mariya Amin , Khan S. Muhammad Salim
Published: February 2025

Background

Human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) counselors play a crucial, albeit challenging, role in preventing and controlling HIV. People living with HIV (PLHIV) need emotional support in addition to clinical treatment. Counseling is more difficult for female counselors, considering the psychological and emotional aspects of HIV counseling.

Methodology

A qualitative study design was used to understand the complexity of the challenges faced by female HIV counselors. Interpretative phenomenological analysis (IPA) was employed as the research design. A small, homogeneous sample was purposively selected, comprising all 11 female HIV counselors in the Kashmir province and one female counselor in Leh (Ladakh). The IPA methodology was utilized, which emphasizes meaning-making and understanding the counselor's perspectives. The study was conducted from December 2022 to January 2023, with data collected through in-depth interviews at the counselors’ workplaces and via Zoom for the Leh participant. Data were analyzed thematically using the IPA approach, revealing the counselors’ real-life experiences, perceptions, and challenges.

Results

The analysis generated two superordinate themes with multiple overarching themes and sub-themes: Intrusive emotional and psychological experiences: Counselors experienced significant emotional strain, including emotional exhaustion, burnout, and stigma. Inadequate skills for effective counseling of people who inject drugs (PWID): Limited training hindered effective counseling for substance users and PWID, highlighting the need for specialized training.

Conclusion

Female HIV counselors in Kashmir face numerous psychological and emotional challenges, including emotional exhaustion, burnout, and stigma. Additionally, there is a lack of adequate training for counseling substance users. Addressing these issues through specialized training, stigma reduction initiatives, and mental health support is crucial for improving HIV counseling services and the overall HIV/AIDS response in the region.
Community Preceptors’ Views on the Training Needs of Medical Students and Factors Affecting Medical Education in the Community Setting: An Exploratory Study
Authors: Yasuda Megumi , Saiki Takuya , Kawakami Chihiro , Imafuku Rintaro
Published: February 2025

OBJECTIVES

To identify community preceptors’ views on the qualities and abilities required of physicians in community medicine, the education to acquire those qualities and abilities, and the factors affecting preceptors’ involvement in community-based teaching.

METHODS

We conducted semi-structured interviews with 13 male community preceptors in northern Japan who had at least 5 years of experience in community medicine and prior teaching experience with preclinical students. Participants were selected using purposive sampling to ensure diversity in clinical roles and institutional affiliations. A thematic analysis was conducted on verbatim transcripts to identify recurring themes.

RESULTS

Participants emphasized “communication skills,” “understanding the perspectives and backgrounds of patients and their families,” and “love for the community and its people” among the essential qualities and abilities for community physicians. They cited deepening relationships with and fostering an attachment to the community as necessary to cultivate these skills. The factors identified as facilitating community-based teaching included “positive emotions felt throughout the teaching experience,” “supporting hospitals and the wider community,” and “devotion to students.” Factors that hindered involvement included “perceived difficulty of teaching preclinical students” and “education-related issues at universities assigning students on placement,” such as the lack of opportunities for community-based teaching within the curriculum.

CONCLUSIONS

In line with the “social axis” in Worley's four Rs model, deep community involvement is essential to developing communication skills and patient-centered medicine. This study identified the qualities and abilities required for community physicians, as well as the educational activities needed to cultivate them from the early years of medical school. Strengthening collaboration between universities and community preceptors is vital to advancing community-engaged medical education (CEME). Cross-cultural studies could further explore how CEME operates in diverse contexts, contributing to socially accountable and community-responsive medical education.
Impact of a USMLE Step 2 Prediction Model on Medical Student Motivations
Authors: Shanks Anthony , Steckler Ben , Smith Sarah , Rusk Debra , Walvoord Emily , Dafoe Erin , Wallach Paul
Published: February 2025

PURPOSE

With the transition of USMLE Step 1 to Pass/Fail, Step 2 CK carries added weight in the residency selection process. Our goal was to develop a Step 2 predicted score to provide to students earlier in medical school to assist with career mentoring. We also sought to understand how the predicted scores affected student's plans.

METHOD

Traditional statistical models and machine learning algorithms to identify predictors of Step 2 CK performance were utilized. Predicted scores were provided to all students in the Class of 2024 at a large allopathic medical school. A cross-sectional survey was conducted to assess if the estimated score influenced career or study plans.

RESULTS

The independent variables that resulted in the most predictive model included CBSE score, Organ System course exam scores and Phase 2 (Third Year Clinical Clerkships) NBME percentile scores (Step2CK = 191.984 + 0.42 (CBSE score) + 0.294 (Organ Systems) + 0.409 (Average NBME). The standard error of the prediction model was 7.6 with better accuracy for predicted scores greater than 230 (SE 8.1) as compared to less than 230 (SE 12.8). Nineteen percent of respondents changed their study plan based on the predicted score result. Themes identified from the predicted score included reassurance for career planning and the creation of anxiety and stress.

CONCLUSION

A Step 2 Predicted Score, created from pre-existing metrics, was a good estimator of Step 2 CK performance. Given the timing of Step 2 CK, a predicted score would be a useful tool to counsel students during the specialty and residency selection process.
Association and Prognostic Implications of Peripheral Arterial Disease and Calcific Aortic Stenosis
Authors: Faure M. , Jouan J. , Lacroix P. , Blossier J.D. , Preux P.M. , Chastaingt L. , Boukhris M. , Cané M. , Lux G. , Aboyans V. , Magne J.
Published: February 2025

Background

Calcific aortic stenosis (AS) and peripheral artery disease (PAD) share common pathophysiological mechanisms and risk factors related to atherosclerosis. However, the prevalence of PAD and its association with mortality in patients with AS remains heterogeneous and require further investigations.

Objectives

The aims of this study were (a) to determine the prevalence of PAD in patients with severe AS and (b) to assess the impact of PAD on mortality in these patients.

Methods

From June 2000 to December 2019, patients who underwent surgical aortic valve replacement (SAVR) at the Limoges University Hospital were enrolled. Over a median observational period of 7.6 years [4.9–11.4], 1462 patients were studied. PAD was defined by mention of clinical diagnosis, significant stenosis on ultrasound, or history of lower-limb revascularization.

Results

Patients with PAD accounted for 8.9% ( n = 130). Long-term survival of patients with PAD was significantly worse than for patients without PAD (HRa = 1.62, 1.28-2.04, P < .0001). This association was even more marked among patients with concomitant coronary artery disease (CAD) (HRa = 1.92, 1.46-2.51, P < .0001). Of note, long-term survival was similar in patients with PAD with or without CAD, and patients with PAD alone (ie, without CAD) have similar survival than those with CAD alone (ie, without PAD).

Conclusions

Almost one out of 10 patients with severe AS presents PAD. This comorbidity was independently associated with traditional risk factors and markedly reduced survival, increased mortality. Similarly to patients with CAD, patients with AS and concomitant PAD should be considered at high risk of poor outcome.