bluuebunny/crossref_metadata_2025 huggingface dataset:
Ten years of the digital twin brain: Perspectives and challenges
Authors: Guo Shuqi , Zhang Ge , Zeng Xin , Xiong Yue , Xu Yuanhang , Cui Yan , Yao Dezhong , Guo Daqing
Published: February 2025

Over the past decade, the digital twin brain (DTB) has emerged as a transformative brain science paradigm, integrating multimodal data to construct dynamic models closely simulating biological brain function. This approach has advanced understanding of structure-function relationships, cognitive behaviors, and disease mechanisms, while supporting personalized therapies. Recent progress highlights DTB's potential in capturing functional heterogeneity, simulating information integration, and predicting individual cognitive and pathological variations. Looking forward, the development of a high-precision DTB is expected to drive breakthroughs in understanding brain mechanisms and enabling precision medicine. This perspective summarizes DTB modeling strategies, including multimodal data integration and optimization, while addressing challenges such as model granularity, and biological interpretability. Future efforts should focus on refining modeling techniques and integrating with brain cognition and disease. We believe these advancements will pave the way for breakthroughs in brain science and precision medicine, ushering in a new era of neuroscience and personalized healthcare.
Fetuin B Is Related to Cytokine/Chemokine and Insulin Signaling in Adipose Tissue and Plasma in Humans
Authors: Kemper Esther J , Goossens Gijs H , Blaak Ellen E , Adriaens Michiel E , Meex Ruth C R
Published: February 2025

Context

Fetuin B is a steatosis-responsive hepatokine that induces glucose intolerance in mice. Recently, we found that fetuin B in white adipose tissue was positively associated with peripheral insulin resistance in mice and a small study population, possibly through a fetuin B–induced inflammatory response in adipocytes.

Objective

This translational study aimed to investigate the link between plasma fetuin B and the adipose tissue transcriptome and plasma proteome in a large cohort of humans.

Methods

Continuous linear regression analysis in R was applied to investigate the link between plasma fetuin B and the adipose tissue transcriptome (n = 207) and plasma proteome (n = 558) in humans, after adjustment for sex, age, and study center (model 1); model 1 + BMI (model 2); and model 2 + insulin sensitivity (Matsuda index) (model 3).

Results

Plasma fetuin B was associated with more than 100 genes in white adipose tissue, belonging to pathways related to cytokine/chemokine signaling (models 1 and 2) and insulin signaling (all models), and with more than 146 plasma proteins involved in pathways related to metabolic processes and insulin signaling (all models).

Conclusion

Plasma fetuin B is related to adipose tissue genes and plasma proteins involved in metabolic processes and insulin signaling. Our findings provide evidence for the involvement of white adipose tissue in fetuin B-induced insulin resistance.
The Hypothalamic Arcuate Nucleus Dopaminergic Neurons: More Than Just Prolactin Secretion
Authors: Lim Luis Wei Cheng , Egnot Christopher Thomas , Papaioannou Panagiotis , Yip Siew Hoong
Published: February 2025

The hypothalamic arcuate nucleus dopaminergic (A12) neurons are well known for their central role in regulating prolactin secretion through a sophisticated negative feedback loop. In this canonical pathway, prolactin stimulates A12 neurons to release dopamine, which suppresses further prolactin release from lactotrophs in the anterior pituitary. However, a collective of recent and past evidence strongly implies that the A12 neurons are far more dynamic and multifaceted than previously appreciated. This minireview discusses the developmental trajectory of A12 neurons, from prenatal origins to postnatal maturation, highlighting their diversity and heterogeneity. Beyond their well-characterized role in prolactin regulation, the A12 neurons contribute to a broader array of hypothalamic functions, including autoregulation, metabolism, and growth. By shedding light on these underexplored roles, this review outlines the expansive significance of A12 neurons as more than mere gatekeepers of prolactin secretion, positioning them as versatile players in endocrine and metabolic homeostasis.
External Validation of the Simple Postoperative Acute Kidney Injury Risk Index in Patients Admitted to the Intensive Care Unit After Noncardiac Surgery
Authors: Li Nan , Wang Jinwei , Zhou Weijie , Li Shuangling , Yang Li
Published: February 2025

BACKGROUND:

The Simple Postoperative AKI Risk (SPARK) index is a novel model for predicting risk of postoperative acute kidney injury (PO-AKI) among patients after noncardiac surgery. However, the performance of the index has been inconsistent partly due to heterogeneity in case mix and effects of the involved clinical features. To clarify potential reasons for poor performance, we tested the SPARK index in a cohort of high-risk patients requiring intensive care unit (ICU) care after noncardiac surgery and examined whether model modification by refitting coefficients of clinical features could optimize model performance.

METHODS:

This was a single-center prospective cohort study. Preoperative variables of the SPARK index were extracted from electronic medical records. PO-AKI was defined by an increase in sCr ≥26.5 mmol/L within 48 hours or 150% compared with the preoperative baseline value within 7 days after surgery, whereas critical AKI was defined as AKI stage 2 or greater and/or any AKI connected to postoperative death or requiring renal replacement therapy during the hospital stay. Discrimination was evaluated by the area under the receiver operating characteristic curve (AUC), and calibration was evaluated by the Hosmer–Lemeshow χ2 test and calibration plot. Model modification was performed by rebuilding the model with the original variables of the SPARK index through proportional odds logistic regression among participants in the earlier study period and was validated in the later one.

RESULTS:

A total of 973 patients were enrolled, among whom 79 (8.1%) PO-AKI cases and 14 (1.4%) critical AKI cases occurred. Our study participants demonstrated a higher SPARK risk score than the SPARK discovery cohort (eg, 8.02% vs 1.20% allocated in the highest risk group), and the incidence of both outcomes increased through the classes of the score (incidence proportion of PO-AKI increased from 2.56% in the lowest risk group to 25.64% in the highest risk group). The AUCs for PO-AKI and critical AKI were 0.703 (95% confidence interval [CI], 0.641–0.765) and 0.699 (95% CI, 0.550–0.848), respectively. The sensitivity, specificity, negative predictive value and positive predictive value were 68.35%, 57.49%, 95.36%, and 12.44%, respectively, when using 10% of predicted probability of PO-AKI as threshold. Calibration plots suggested acceptable consistency between the predicted and actual risk. After model modification, external validation demonstrated a significantly improved AUC for PO-AKI.

CONCLUSIONS:

The SPARK index showed fair discrimination and calibration among patients admitted to the ICU after noncardiac surgery. Modification of the model improved the performance of the model in terms of predicting PO-AKI.
A Randomized Controlled Trial of Sublingual Sufentanil in Early Management of Pain in Trauma
Authors: Guyette Francis X. , Chaudhary Prasanna , Vincent Laura E. , Love Emily T. , Brubaker DonavanP. , Neal Matthew D. , Brown Joshua B. , Rixe Jeffrey , Barton David J. , Yates Adam , Wisniewski Stephen R. , Sperry Jason L.
Published: February 2025

BACKGROUND:

Pain management is essential in trauma. Sufentanil is a potent sublingual opioid analgesic with no active metabolites and rapid onset relative to oral medications. We hypothesize that compared to standard care, Sufentanil reduces the verbally administered numerical pain scale (VNRS) at 30 minutes.

METHODS:

We performed a prospective multicenter, open-label, randomized trial utilizing level-1 trauma centers from within the Linking Investigator in Trauma and Emergency Services (LITES) network. Participants were randomly assigned in a 1:1 ratio to either sublingual sufentanil or standard care. We enrolled 150 patients from July 2022 to January 2024. The study was approved by the human subjects research protection offices of the University of Pittsburgh and the Department of Defense. Subjects were eligible if they had a trauma evaluation, were 18 to 70, had a VNRS (0–100) score ≥50, and remained in the ED for at least 30 minutes. We excluded patients who were prisoners, pregnant, allergic to opioids, required airway management, body mass index (BMI) >40, significant respiratory depression, suspected gastrointestinal obstruction, or other contraindication to analgesics. The primary outcome was the VNRS for clinical pain measurement (0–100) at 30 minutes after treatment. Secondary outcomes included adverse events (hypoxia, hypotension, need for airway management) and the incidence of nausea/vomiting/headache/dizziness requiring treatment. We hypothesize that sublingual sufentanil as compared to emergency department standard care, will reduce the VNRS at 30 minutes.

RESULTS:

The study population had a mean age of 48 years (standard deviation [SD] 15) and was 32% female. The mechanism of injury was mostly blunt (96%). The VNRS at 30 minutes was 67 (SD 25) for the entire cohort, 66 (SD 23) in the sufentanil group, and 68 (SD 27) in the standard care group (P = .37). The Health care Professional Global Assessment (HPGA) at 30 minutes showed decreased pain scores in the standard care group compared to sufentanil, with standard care having more patients scored as good or excellent (P = .009). There was no difference in the incidence of nausea, vomiting, headache, dizziness, hypoxia, hypotension, or need for an advanced airway.

CONCLUSIONS:

In this cohort of trauma patients with moderate to severe pain, the VNRS at 30 minutes after administration of analgesics did not differ between sublingual sufentanil and standard care. Adverse events did not differ between the groups suggesting the sublingual sufentanil in this population.
Caste Inequality in Occupational Exposure to Heat Waves in India
Authors: Shah Arpit , Thapliyal Sneha , Sugathan Anish , Mishra Vimal , Malghan Deepak
Published: February 2025

India is a leading global hot spot for extreme heat waves induced by climate change. The social demography of India is centered on its caste hierarchy rooted in endogamous occupational groups. We investigate the association between caste and climate inequality by studying occupational exposure during the 2019 and 2022 heat waves. We combine high spatiotemporal resolution heat stress information from satellite imagery with a large nationally and regionally representative labor force survey with rich socioeconomic and demographic information (n > 100,000 individuals). The slope of the heat stress dose–workhours curve corresponding to the marginalized caste groups is between 25% and 150% steeper than that for dominant caste groups for UTCI (Universal Thermal Climate Index) thresholds between 26°C and 35°C. Our models control for other economic-demographic confounders, including age, gender, education, and economic status, besides political-geographic controls and fixed effects. Our robust evidence for the association between caste identity and exposure to heat stress shows why adaptation and mitigation plans in India must account for the hierarchical social order characterized by the “division of laborers” along caste lines rather than the mere division of labor. Methodologically, our analysis demonstrates the utility of pairing satellite imagery and detailed demographic data.
DIS3L, cytoplasmic exosome catalytic subunit, is essential for development but not cell viability in mice.
Authors: Brouze Michał , Szpila Marcin , Czerwińska Areta Magdalena , Antczak Wiktor , Mroczek Seweryn , Kuliński Tomasz , Hojka-Osińska Anna Maria , Cysewski Dominik , Gewartowska Olga , Adamska Dorota , Gruchota Jakub , Borsuk Ewa , Dziembowski Andrzej
Published: February 2025

Among numerous enzymes involved in RNA decay, processive exoribonucleases are the most prominent group responsible for the degradation of the entire RNA molecules. The role of mammalian cytoplasmic 3’-5’ exonuclease DIS3L at the organismal level remained unknown. Herein, we established knock-in and knock-out mouse models to study DIS3L functions in mice. DIS3L in mice is indeed a subunit of the cytoplasmic exosome complex, the disruption of which leads to severe embryo degeneration and death in mice soon after implantation. These changes could not be prevented by supplementing extraembryonic tissue with functional DIS3L through the construction of chimeric embryos. Preimplantation Dis3l-/- embryos were unaffected in their morphology and ability to produce functional embryonic stem cells, showing that DIS3L is not essential for cell viability. There were also no major changes at the transcriptome level for both embryonic stem cells and blastocysts, as revealed by RNA sequencing experiments. Notably, however, Dis3l knock-out led to inhibition of the global protein synthesis. These results point to the essential role of DIS3L in mRNA metabolism, which is crucial for proper protein synthesis during embryo development.
Η σχέση των Αρχετύπων, της Μαθηματικής Αστρονομίας και της Φυσικής Φιλοσοφίας στην Ύστερη Αναγέννηση
Authors: Αθανασάκης Ανδρέας
Published: February 2025

Η διατριβή αναφέρεται στις επιστημολογικές καταβολές της κοπερνίκειας επανάστασης. Ειδικότερα εστιάζω στη σχέση συγκεκριμένων αστρονομικών αρχών (αρχή της αποχής, σχέση απόστασης-περιόδου, τριγωνομετρική παράλλαξη, κ.ά.) με αρχετυπικές αρχές της φυσικής φιλοσοφίας (η τελειότητα της κυκλικής κίνησης, η αρχή της σταθερής γωνιακής ταχύτητας, αρχή της πληρότητας, κ.ά.), με στόχο την αποσαφήνιση της πρόσληψής τους από την κλασική αρχαιότητα έως την ύστερη Αναγέννηση. Μέσω της μελέτης των κοσμολογικών, φυσικών και μαθηματικών συνεπειών του ανωτέρου ερευνητικού πεδίου εξετάζω, μεταξύ άλλων, τη διαμόρφωση και τη φιλοσοφική θεμελίωση του κοπερνίκειου συστήματος. Σε τελευταίο στάδιο, μέσω του έργου του Johannes Kepler, αναδεικνύω τρόπους γνωσιολογικού ελέγχου αντικρουόμενων φυσικών θεωριών, οι οποίες κρίνονται ως εμπειρικώς επαρκείς, μολονότι στερούνται φυσικής τεκμηρίωσης.
Nonlinear propagation of ultrasound in microbubble populations
Authors: Ματαλλιωτάκης Αγησίλαος
Published: February 2025

Αυτή η διατριβή περιγράφει την ανάπτυξη μιας αριθμητικής μεθόδου ικανής να μοντελοποιήσει τη μη γραμμική διάδοση των κυμάτων υπερήχων μέσω ενός πληθυσμού σκεδαστών, λαμβάνοντας υπόψη διάφορα φυσικά φαινόμενα. Βασίζεται στην υπάρχουσα μέθοδο Iterative Nonlinear Contrast Soucre (INCS). Βασισμένη σε ένα επαναληπτικό σχήμα Neumann, η αρχική μέθοδος INCS λύνει την εξίσωση Westervelt σε έναν τετραδιάστατο χωροχρονικό τομέα ενημερώνοντας επαναληπτικά την ακουστική πίεση με ολοένα και πιο ακριβείς διορθώσεις πεδίου. Η τρέχουσα επέκταση του INCS εξυπηρετεί τη διασπορά από μεγάλους πληθυσμούς παραγόντων αντίθεσης μονοδιασποράς όπως μικροφυσαλίδες (MBs), αντιμετωπίζοντας το καθένα ως ανεξάρτητο σκεδαστή σημείων. Η σκέδαση αυτών των παραγόντων προκύπτει με την επίλυση της εξίσωσης που διέπει την ταλάντωση κάθε MB. Φυσικά, κάθε επανάληψη του INCS προσθέτει μια επιπλέον σειρά πολλαπλής σκέδασης μεταξύ των MB. Η μέθοδος είναι επεκτάθηκε περαιτέρω για να ληφθούν υπόψη οι παγκόσμιες μεσαίες και τοπικές μη γραμμικότητες, ζωτικής σημασίας σε σενάρια απεικόνισης που περιλαμβάνουν MB. Στη συνέχεια, το INCS χρησιμοποιείται για να επιδείξει την επίδραση διαφορετικών σχημάτων μετώπου κύματος στη δημιουργία τεχνουργημάτων μη γραμμικής απεικόνισης κάτω από την ανάρτηση MB, ανακατασκευάζοντας εικόνες B-mode και βελτιωμένης αντίθεσης. Επιπρόσθετα, η αποτελεσματικότητα των παραγόντων σκιαγραφικής μονοδιασποράς αποδεικνύεται σε σύγκριση με έναν πληθυσμό διασκορπιστών πολυδιασποράς. Τέλος, ο πρωταρχικός στόχος αυτής της διατριβής είναι η επέκταση της μεθόδου INCS με την ενσωμάτωση σημειακών εκπομπών που προσομοιώνουν πηγές πρωτονίων. Αυτές οι εξελίξεις σε συνδυασμό υπόσχονται εφαρμογές στον διαγνωστικό υπερηχογράφημα με ενισχυμένη αντίθεση (CEUS) και στον θεραπευτικό υπέρηχο. Ο μακροπρόθεσμος στόχος είναι να επινοηθούν εξατομικευμένα σχέδια θεραπείας του καρκίνου χρησιμοποιώντας σκιαγραφικά για μη συμβατικές προσεγγίσεις όπως η θεραπεία με πρωτόνια.
Application of digital twin for industrial process control: A case study of gauge-looper-tension optimized control in strip hot rolling
Authors: Sun Jie , Chen Shang , Ding Cheng-yan , Peng Wen , Zhang Dian-hua
Published: February 2025

During the hot rolling process, the performance of most control systems gradually degrades due to equipment aging and changing process conditions. However, existing gauge-looper-tension control method remain restricted by a lack of intelligent parameter maintenance strategies. To address this challenge and enhance the smart manufacturing capabilities of strip hot rolling, based on the digital twin method, this paper proposes a data-driven optimized control method for the gauge-looper-tension system of strip hot rolling. First, a hot rolling process model is constructed based on a digital twin method to serve as an evaluation and optimization platform. Subsequently, relevant data are collected to calculate the Hurst index for identifying the performance of the controller during the rolling process. Additionally, for controllers with poor Hurst index values, the crayfish optimization algorithm is employed for adjusting controller parameters to maximize the Hurst index. Experimental results demonstrate that the evaluation method effectively recognized the control state of gauge-looper-tension system and the optimization method successfully enhances the performance of the control system. Therefore, based on the digital twin platform, the proposed method can effectively maintain performance-degraded control systems.
Assessing the role of vascular risk factors in dementia: Mendelian randomization meta-analysis and comparison with observational estimates
Authors: Lee Liam , Walker Rosie , Whiteley William
Published: February 2025

Background Although observational studies demonstrate that higher levels of vascular risk factors are associated with an increased risk of dementia, these associations might be explained by confounding or other biases. Mendelian randomization (MR) uses genetic instruments to test causal relationships in observational data. We sought to determine if genetically predicted modifiable risk factors (type 2 diabetes mellitus, low density lipoprotein cholesterol, high density lipoprotein cholesterol, total cholesterol, triglycerides, systolic blood pressure, diastolic blood pressure, body mass index, and circulating glucose) are associated with dementia by meta-analysing published MR studies. Secondary objectives were to identify heterogeneity in effect estimates across primary MR studies and to compare meta-analysis results with observational studies. Methods MR studies were identified by systematic search of Web of Science, OVID and Scopus. We selected primary MR studies investigating the modifiable risk factors of interest. Only one study from each cohort per risk factor was included. A quality assessment tool was developed to primarily assess the three assumptions of MR for each MR study. Data were extracted on study characteristics, exposure and outcome, effect estimates per unit increase, and measures of variation. Effect estimates were pooled to generate an overall estimate, I2 and Cochrane Q values using fixed-effect model. Results We screened 5211 studies and included 12 primary MR studies after applying inclusion and exclusion criteria. Higher genetically predicted body mass index was associated with a higher odds of dementia (OR 1.03 [1.01, 1.05] per 5 kg/m2 increase, one study, p=0.00285). Fewer hypothesized vascular risk factors were supported by estimates from MR studies than estimates from meta-analyses of observational studies. Conclusion Genetically predicted body mass index was associated with an increase in risk of dementia.
Therapeutic potential of Nigella sativa extract against inflammatory markers interleukin-1ß (IL-1ß) and tumor necrosis factor-α (TNF-α) in rat models with high fat diet
Authors: Ridwan Muhammad , Nurkhalis Nurkhalis , Husna Fauzul , Ali Yafi Dhanang , Izzuddin Abdurrohman
Published: February 2025

Abstract Background Nigella sativa L., known as black cumin, is thought to possess anti-inflammatory properties that may help alleviate related conditions. This study examined the effects of black cumin extract on levels of Interleukin-1β (IL-1β) and Tumor Necrosis Factor-α (TNF-α), both inflammatory markers. Methods The experimental design included a control group used solely for post-testing. Five groups of Wistar rats were studied: a negative control group (N), a dyslipidemia group as a positive control (P), a dyslipidemia group given black cumin (P1), a dyslipidemia group treated with atorvastatin (P2), and a dyslipidemia group receiving both atorvastatin and black cumin (P3).IL-1β and TNF-α levels were measured using ELISA, and statistical analysis was conducted using ANOVA followed by the Duncan test. Results After treatment, the average IL-1β levels were 38.26 pg/mL (N), 102.16 pg/mL (P), 57.05 pg/mL (P1), 29.16 pg/mL (P2), and 54.06 pg/mL (P3). The Duncan test indicated no significant differences in IL-1β levels among groups N, P2, and P3 (p>0.05), while group P exhibited the highest IL-1β levels, significantly different from the others. For TNF-α, average levels post-treatment were 30.42 pg/mL (N), 22.02 pg/mL (P), 27.25 pg/mL (P1), 16.33 pg/mL (P2), and 13.29 pg/mL (P3). The Duncan test showed that group P3 had the lowest TNF-α levels, which were not significantly different from P2 (p>0.05) but significantly different from groups P, P1, and N (p<0.05). Conclusions In conclusion, black cumin extract effectively reduces IL-1β levels in high-fat diet rat models, while the combination of atorvastatin and black cumin extract yields the most significant reduction in TNF-α levels.
Solvolytic recycling of unsaturated polyester resin-based sheet moulding composites
Authors: van de Moosdijk John , van de Runstraat Annemieke , van Someren Richard , Roelands Mark
Published: February 2025

Background New regulations on low emission vehicles has incentivized a push towards reducing the weight of vehicles. While the implementation of lightweight Sheet Moulding Compounds (SMC’s) in the automotive industry is taking shape, a recycling strategy that does not downgrade the fibers is not commercially applied yet. This paper investigates a broad scope of reaction conditions for the solvolysis of SMC’s based on unsaturated polyester resins (UPR). Methods The Hansen Solubily Parameter theory was used to model and select prospective solvents for the project. A method is disclosed for recovering the glass fibers from SMC’s, using base chemicals such as monoethoxyamine (MEA) and potassium hydroxide (KOH), and relatively mild conditions. Tensile testing is used to assess the effect of solvolysis on the fibers. Thermogravimetric analysis was used to determine residual material on the fibers. Results The best solvolysis results were obtained with MEA/KOH at 170 °C. As a result of the mild conditions used, the strength of the fibers is not affected. TGA analysis shows that the removal of fiber sizing depends on the nature of the used catalyst. It also showed that the use of acetophenone as solvent raised the decomposition temperature of the resin Conclusions An effective and mild method for the solvolysis of UPR based sheet moulding compounds was developed. The removal of the sizing of the fibers can be influenced by choosing an appropriate catalyst. It is postulated that acetophenone reacts with the resin and as a result makes it more thermally stable.
Bilateral superficial circumflex iliac artery perforator free flap reconstruction for a large elbow neurofibroma: a case report
Authors: Lee Seungjun , Eun Seokchan
Published: February 2025

Neurofibromas are benign neoplasms originating from neural tissues that rarely transform into malignancies. Approximately 25% to 45% of neurofibromas are located in the head and neck; the most common sites are the lateral cervical region and mouth. A 27-year-old female patient visited our hospital complaining of a painful brownish mass in the right elbow that had recently increased in size. She had no history of cancer and was otherwise in excellent health. This mass accounted for 80% of the total elbow circumference. Genetic mutation testing resulted in a diagnosis of neurofibromatosis type 1. A wide surgical excision was performed, and the area was repaired using a bilateral large superficial circumflex iliac artery perforator free flap. The flap survived well, with no partial necrosis. Histological findings showed a plexiform neurofibroma measuring 14×12×1.5 cm3. The patient’s postoperative course was uneventful; at an 18-month follow-up, she had good cosmetic and functional outcomes with no signs of relapse.
Character of the Neolithic ‘Imagery’ in the Upper Euphrates Valley and Konya Plain and Its Role in Discerning Changes in Religiosity
Authors: Stosik Weronika
Published: February 2025

In recent years, the study of rituals and manifestations of religious practices in prehistoric societies has taken on a new, multifaceted dimension. These studies have been inspired by a series of innovative research concepts emerging from the fields of history and sociology of religion, coupled with the application of modern methods from the realm of digital humanities. This article aims to analyze a range of objects, motifs, and decorative remnants, collectively referred to as imagery, which exhibit rich symbolism, facilitating their interpretation within ritual contexts. The main focus of the article involves a comparison of two crucial regions of the Neolithic of the Near East, the Upper Euphrates Valley and the Konya Plain, with an emphasis on the presence and characteristics of imagery. Furthermore, drawing from the same array of sources, the article endeavors to delineate the emergence and subsequent transformations of the Neolithic belief system from the 9th to the end of the 7th millennium BCE. The application of the “divergent modes of religiosity (DMR)” concept developed by Harvey Whitehouse for interpreting the above sources yields interesting observations regarding the trajectory of development of Neolithic lifeways, in particular, transformative forms of religiosity in these communities.
An In-depth Exploration of an Unexamined Reliquary in the Church of Mar Tadros-Blat, Syria
Authors: Khouli Dana
Published: February 2025

This article explores an unstudied, though not recent, discovery – a sarcophagus-shaped reliquary discovered in the village of Blat in Homs, Syria. The research aims to shed light on its cultural and historical importance. By conducting a detailed analysis of its carvings and symbolic iconography, the study seeks to unravel the religious motifs embedded in its design and interpretation, elucidating their connections with saints, pivotal figures intricately associated with sarcophagus reliquaries. Furthermore, the discussion investigates the incorporation of what is known as the circulation system, shedding light on regional religious practices and traditions. It also aims to determine whether the reliquary was openly displayed or kept hidden. The current condition of the reliquary emphasizes its continued reverence and preservation within the religious community.
Efecto y potencia de los psicodélicos a nivel psicofarmacológico, psicológico y neurobiológico
Authors: Castaño Guillermo , Iguarán Sebastián , Murillo Leandro , Espinosa Duque Daniel
Published: February 2025

Los psicodélicos son psicoactivos que alteran la percepción, el estado de ánimo y la cognición. Desde de los 50s se ha estudiado su relación molecular con el sistema serotoninérgico, lo que se ha evidenciado a través de la neuroimagen. El objetivo de esta revisión es realizar una evaluación de los efectos y la potencia de los psicodélicos en diferentes dimensiones (molecular, subjetiva, física y neurobiológica). Para ello, se llevó a cabo una revisión de artículos (PRISMA-ScR) publicados entre 1960 - 2022, buscando en PubMed, Medline, PsycINFO y EMBASE en inglés y español. En los resultados se da cuenta de los desafíos a los que se enfrenta la investigación interdisciplinar de la acción de estas sustancias en lo molecular (la psicofarmacología), lo estructural (la neurobiología) y en lo subjetivo (lo psicológico) y más que dar respuestas específicas, proporciona una visión panorámica del fenómeno estudiado: sus hallazgos históricos, los nuevos conocimientos mediados por la tecnología actual, la comparación sintética de los efectos subjetivos, una breve descripción de las hipótesis neurobiológicas  actuales e identifica los vacíos de conocimiento sobre el tema.
Fatores associados às mudanças percebidas na atividade física e comportamento sedentário na comunidade universitária brasileira durante a pandemia da covid-19
Authors: Silva Junior Marcos Cezar Pitombo da , Menezes Enaiane Cristina , Tenório Sand Araújo , Santos Sueyla Ferreira da Silva dos , Sousa Thiago Ferreira de , Lima Luiz Rodrigo Augustemak de
Published: February 2025

Objetivo: Este estudo teve como objetivo identificar a prevalência e fatores associados às mudanças percebidas na prática de atividade física (AF) e comportamento sedentário (CS) durante a pandemia da covid-19 na comunidade universitária. Métodos: Estudo observacional, multicêntrico, do tipo transversal, realizado com a comunidade acadêmica de Instituições de Ensino Superior do Brasil. Utilizou-se um questionário estruturado e validado. Foi aplicada regressão logística multinomial assumindo intervalo de confiança de 95%. Resultados: Participaram 4809 indivíduos (65,8% mulheres; 74% estudantes). Observou-se que 44,6% (n = 2.136) perceberam redução da AF, e 74,2% (n = 3.549) perceberam aumento do CS. Mulheres com 40 anos ou mais e homens em distanciamento apresentaram menores chances de serem ativos (31% e 43%, respectivamente). Apresentaram mais chances em serem ativos as mulheres com boa percepção de saúde (OR = 3,33; IC 95%: 2,22 - 4,99) ou regular (OR = 1,98; IC 95%: 1,30 - 3,04), e homens com boa percepção de saúde (OR = 2,38; IC 95%: 1,35 - 4,20). As chances de maior CS foram menores nas mulheres com boa percepção de saúde (58%), idade entre 30-39 anos (34%) ou 40 anos ou mais (50%), e nos homens com boa percepção de saúde (61%), idade entre 30-39 anos (42%) ou 40 anos ou mais (54%). Apresentaram mais chances de maior CS as mulheres que estavam em distanciamento (OR = 1,71; IC 95%: 1,25 - 2,34), por dois meses ou mais (OR = 1,43; IC 95%: 1,10 - 1,85), ou cômodo per capita de 1,20 (OR = 1,51; IC 95%: 1,13 - 2,01), e homens em distanciamento (OR = 1,61; IC 95%: 1,10 - 2,34), por dois meses ou mais (OR = 1,42; IC 95%: 1,02 - 1,96) e que residiam na região Nordeste (OR = 2,34; IC 95%: 1,20 - 4,57) e Sudeste (OR = 2,96; IC 95%: 1,47 - 5,96). Conclusão: A pandemia resultou em aumento percebido do CS e diminuição da AF, especialmente entre mulheres mais velhas, em distanciamento e menor cômodo per capita, assim como entre homens em distanciamento.
Factors associated with perceived changes in physical activity and sedentary behavior in the Brazilian university community during the COVID-19 pandemic
Authors: Silva Junior Marcos Cezar Pitombo da , Menezes Enaiane Cristina , Tenório Sand Araújo , Santos Sueyla Ferreira da Silva dos , Sousa Thiago Ferreira de , Lima Luiz Rodrigo Augustemak de
Published: February 2025

Objective: This study aimed to identify the prevalence and factors associated with perceived changes in physical activity (PA) and sedentary behavior (SB) during the COVID 19 pandemic within the university community. Methods: It is an observational, cross-sectional, multicenter study conducted with the academic community of higher education institutions in Brazil. A structured and validated questionnaire was utilized, and multinomial logistic regression was applied with a 95% confidence interval. Results: A total of 4,809 individuals participated (65.8% women and 74.0% students). It was observed that 44.6% (n= 2,136) perceived a reduction in PA, and 74.2% (n = 3,549) perceived an increase in SB. Women aged 40 and over and men in social isolation were less likely to be active (31.0% and 43.0%, respectively). Women with a good (OR = 3.33; 95% CI: 2.22 - 4.99) or fair health perception (OR = 1.98; 95% CI: 1.30 - 3.04) and men with a good health perception (OR = 2.38; 95% CI: 1.35 - 4.20) were more likely to be active. The likelihood of higher SB was lower among women with a good health perception (58.0%) or aged 30–39 (34.0%) or 40+ (50.0%), and among men with a good health perception (61.0%) or aged 30–39 (42.0%) or 40+ (54.0%). Increased SB likelihood was higher among women in isolation (OR = 1.71; 95% CI: 1.25 - 2.34), isolated for two or more months (OR = 1.43; 95% CI: 1.10 - 1.85), or with a room per capita ratio of 1.20 (OR = 1.51; 95% CI: 1.13 - 2.01); and among men in isolation (OR = 1.61; 95% CI: 1.10 - 2.34), isolated for two or more months (OR = 1.42; 95% CI: 1.02 - 1.96), and living in the Northeast (OR = 2.34; 95% CI: 1.20 - 4.57) or Southeast (OR = 2.96; 95% CI: 1.47 - 5.96) regions of Brazil. Conclusion: The pandemic led to a perceived increase in SB and a decrease in PA, especially among older women, those in isolation, and those with limited living space, as well as among men in isolation.
Scimitar syndrome: unveiling the complexities of a rare congenital cardiopulmonary anomaly
Authors: Mateen Nargis , Rezkalla Abraam , Orhun Nagihan
Published: February 2025

Scimitar syndrome is a rare congenital anomaly characterised by anomalous pulmonary venous drainage of the right lung into the inferior vena cava, often accompanied by right lung hypoplasia and dextroposition of the heart. Here, we present the case of a 24-year-old female with scimitar syndrome and a history of asthma who presented with acute exacerbation of asthma. A chest X-ray revealed opacification of the right hemithorax, and a CT angiography revealed congenital hypoplasia of the right lung and dextrocardia. This report provides a detailed description of scimitar syndrome to spread awareness of this rare diagnosis and highlights the unique and various constellations of anatomical abnormalities seen in scimitar syndrome that make diagnosis difficult.
Hemophagocytic lymphohistiocytosis secondary to dengue fever
Authors: Kashfi Simon , Kim Joon Yup , Shohet Naomi , Shakil Shams , Dastagir Manile
Published: February 2025

Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening hyperinflammatory syndrome often misdiagnosed due to its rarity and overlapping symptoms with sepsis or organ dysfunction. This case report describes a 52-year-old male who developed dengue-induced HLH after traveling to Barbados, presenting with multi-organ failure and laboratory abnormalities, including hyperferritinaemia and elevated IL-2R. Diagnosed via bone marrow biopsy, he was treated with corticosteroids and the IL-1R antagonist anakinra, leading to recovery. Dengue-associated HLH in adults is rare but rising due to increased global dengue incidence. Early recognition and tailored treatment are critical for improved outcomes.
Diagnosis of cardiac papillary fibroelastoma presenting with acute coronary syndrome and concomitant Salmonella bacteraemia, mimicking aortic endocarditis
Authors: De Masi De Luca Gabriele , Nicolardi Salvatore , Albanese Miriam , Colopi Marzia , Zezza Luigi , Guido Alessandro , Sciarra Luigi
Published: February 2025

Introduction: A case of fibroelastoma of the aortic valve in a patient with acute coronary syndrome has been reported. Cardiac papillary fibroelastomas (PFE) are rare cardiac tumours that are generally benign. In most cases they are incidental findings, their first clinical manifestation is often associated with embolic events. Case presentation: We present the case of a 63-year-old man who experienced coronary embolization without any indications of underlying coronary artery disease. Further investigation led to the identification of the cause of embolization. The concomitant presence of Salmonella bacteraemia, associated with symptoms of gastrointestinal inflammation and elevated inflammation indices, led to the hypothesis of valvular endocarditis. Therefore, a transoesophageal echocardiogram was performed, which confirmed the presence of a mobile, well-demarcated, echo-dense mass identified on the left coronary cusp. Despite the diagnostic uncertainty between fibroelastoma and endocarditic formation, the occurrence of the embolic event and the marked hypermobility we decided that prompt intervention was required. Surgical cleavage of the valve formation was performed, revealing macroscopic morphological characteristics consistent with, PFE which was confirmed by the histological finding. Conclusions: This case highlight the importance of a comprehensive diagnostic approach, including transoesophageal echocardiography, in patients with embolic events with no obvious evidence of an embolic causes.
Advanced clinical practitioners' untapped potential to become managers
Authors: Addison Elizabeth , Scott Vikki-Jo
Published: February 2025

Background:

Leadership and management is one of the four pillars of advanced practice, which implies that advanced clinical practitioners (ACPs) would be well positioned to take on these roles.

Aim:

This study aimed to explore whether ACPs' management responsibilities would support their transition into a clinical management role.

Method:

This mixed-method narrative literature review uses reflective thematic analysis and a deductive approach to generate themes based on the six critical tasks of a manager mapped to the four pillars of advanced clinical practice. The Mixed Methods Appraisal Tool was used to assess research quality.

Findings:

Eleven articles of varying quality were identified. Research suggests that, although ACPs can demonstrate they already have the skills to fulfil management roles, there is limited evidence that they take on these positions.

Conclusion:

ACPs have the clinical background and training to transition into management roles more easily than staff without these prerequisites. Nevertheless, there remains insufficient evidence that this is happening in practice. By promoting and encouraging this role transition, ACPs could use their breadth of skills to become future managers.
The role of the nurse leader in facilitating effective support and communication to raise concerns
Authors: Norman Kay , Lewis Alison , Carter Louise
Published: February 2025

This article examines several factors that can affect how raising of concerns can be supported. Nurse leaders play a vital role in this process to maintain patient safety and act accordingly within the Nursing and Midwifery Council Code. Considerations are provided to explore how the nurse leader can facilitate communication with all team members to influence organisational culture, where colleagues feel confident in voicing concerns. Professional responsibilities pertinent to this process are highlighted, including the nurse leader as an advocate and supporting constructive challenge.
The compassionate mind approach to supporting psychological wellbeing in people living with HIV
Authors: Croston Michelle , Summerside Jack , Kakaiya Mina , Irons Chris
Published: February 2025

There is a growing body of evidence exploring the health, psychological and social benefits of compassion-focused therapy (CFT) for managing complex issues such as shame, loneliness, stigma and disease adjustment. As a component of CFT, compassionate mind training (CMT) has been found to bring about significant reductions in psychological distress and improvements in levels of compassion, emotion regulation and wellbeing. There is also growing evidence for how these approaches can bring benefits across a variety of psychological and physical health difficulties, including HIV. This study explored how a CMT-informed wellbeing day followed by access to The Self-Compassion App supported people with HIV. Most study participants (97%) found taking part in the session helpful, reporting they felt they had increased their knowledge around compassion and understood the benefits of CMT after engaging in it. The compassionate mind approach and CFT can support and improve psychological wellbeing in people living with HIV.
Managing fever in children under 5
Authors: Duncan Debbie , Mullins Louise
Published: February 2025

Fever is common in children under the age of 5 and often the result of self-limiting viral infections. It is one of the main reasons parents or carers seek medical advice for this age group; therefore, it is important to provide them with clear guidance on the assessment and management of fever in infants and young children.
‘I just had to park up at the hospital and leave her’: A retrospective interview study of pregnancy, birth and parenting during the COVID-19 pandemic restrictions
Authors: Moss Becky , Henry Lucy , Davies Catherine , Rosario Chelo Del , Gonzalez-Gomez Nayeli , Hendry Alexandra , Hill Elisabeth , McGillion Michelle , Prior Emily , Reimers Stian , Shapiro Laura , Van Blankenstein Emily , Botting Nicola
Published: February 2025

Lockdown restrictions during the COVID-19 pandemic had a negative impact on many aspects of people's lives. In the UK, evidence showed higher rates of stress and depression among parents during restrictions. Disruption to early years education affected preschoolers' language and cognitive development, and associations between parental health and child behaviour were apparent. The longer-term consequences on infants born during the pandemic restrictions, who are now approaching school age, are not yet known. This study focused on parents' retrospective reflections of the pandemic, and aimed to explore the longer-term effects of lockdown restrictions on children and families. The study followed a retrospective, qualitative interview design. Recruitment sampling ensured views were gathered from people of different genders, sexual orientations, birth/adoptive status and geographic areas. Seventeen participants were interviewed. Three overarching themes emerged: navigating antenatal and postnatal care alone; difficult decisions when caring for an infant and the long shadow on the family. Major issues which emerged included attending antenatal appointments – and in some cases giving birth – alone; limited postnatal care; disrupted parental leave; changes in employment and strained relationships. In the event of a future pandemic, restrictions should accommodate couples from the same household more pragmatically, and children's developmental checks should not be deprioritised. Finally, as part of post-pandemic provision, in-person antenatal and postnatal care and consistent early years provision remain vital services which must be acknowledged
Artificial intelligence and deepfakes: Keeping children safe in schools
Authors: Rose Elizabeth
Published: February 2025

Articifical intelligence is now being used to create images and deepfake videos of children and child abuse. Elizabeth Rose looks at the implications for safeguarding work in schools
Development of a Functional Ingredient Using Pomace from Selected Pineapple [Ananas comosus (L.) Merr.] Varieties in the Philippines
Authors:   Institute of Food Science and Technology, College of Agriculture and Food Science, University of the Philippines Los Baños, College, Laguna, Philippines, 4030, Panganiban Merly T. , Pagatpatan Camila Mari L. ,   Institute of Food Science and Technology, College of Agriculture and Food Science, University of the Philippines Los Baños, College, Laguna, Philippines, 4030, Tengco Jonina Marie J. ,   Institute of Food Science and Technology, College of Agriculture and Food Science, University of the Philippines Los Baños, College, Laguna, Philippines, 4030,   Science Education Institute, Department of Science and Technology, Taguig City, Philippines 1631, Reginio Florencio C. Jr. ,   Institute of Food Science and Technology, College of Agriculture and Food Science, University of the Philippines Los Baños, College, Laguna, Philippines, 4030
Published: February 2025

This study aimed to develop a functional ingredient using pomace from selected pineapple varieties in the Philippines. In a preliminary trial, cabinet- and freeze-drying methods were compared to determine the ideal drying technique for preparing pineapple pomace powder (PPP) as a functional ingredient. Pomace samples were collected from three pineapple varieties: Smooth Cayenne, MD2 and Queen. The collected pomace samples were dried, ground, sieved, and analyzed for bioactive compounds, including total phenolic content (TPC), total flavonoid content (TFC), ascorbic acid content (AAC), total dietary fiber (TDF), and antioxidant activity using DPPH, FRAP, and ABTS assays. The PPP with the highest concentration of bioactive compounds was selected for developing the functional ingredient. The physicochemical properties of the developed PPP were also evaluated. The findings revealed that freeze-drying resulted in a significantly higher drying rate and lower moisture content compared to cabinet-drying. Among the three pineapple varieties, the freeze-dried MD2 pomace exhibited the highest concentrations of bioactive compounds and antioxidant activity. The study concluded that freeze-drying the MD2 pineapple pomace was the most effective for developing a functional ingredient. The resulting freeze-dried PPP had a moisture content of 9.65%, water activity of 0.35, pH of 3.89, titratable acidity of 2.70% as citric acid, total soluble solids of 2.6°Brix, and a light-yellow color based on CIE Lab color space values (L* = 84.44, a* = 0.34, and b* = 27.29).
Editorial
Authors:   Department of Orthopaedics, Rainbow Children’s Hospital, Bangalore, Karnataka, India., Sampath Jayanth S.
Published: February 2025

At the outset, I must apologize on behalf of the Editorial Committee of IJPO for the recent loss of continuity in the release of journal issues. The National Medical Commission stopped recognising Index Copernicus towards publication credit for academic clinicians in medical colleges. Consequently, there was a steep reduction in the number of articles submitted to the journal from institutions based in India, one of our main sources of submissions. There was some delay from our reviewers in speedy completion of the review process.
To address these issues, the IJPO Editorial Team with the help of the Executive Council of Paediatric Society of India (POSI) have put in place several measures to improve the number of submissions and for the timely review of submissions. We will increase our presence on social media to expand our reach to young orthopaedic surgeons all over the world. We would like to invite our readers, particularly members of POSI and paediatric orthopaedic academic societies around the world, to join our panel of reviewers. This will provide members a direct insight into the review process and contribute to the dissemination of knowledge within the profession. This is a noble and worthwhile cause and we request your support.
We are also looking towards expanding our editorial board. The current team has been in place for over 6 years. It is time to introduce new talent and ideas, in the long-term interests of the journal.
This issue offers readers a comprehensive overview of the current thinking on the management of musculoskeletal infection in childhood. A series of five articles introduces readers to the basic pathophysiology of infections in the bone, progressing to acute osteomyelitis, mimics and sequelae of infection, and concluding with a review on tuberculosis. I am sure that this symposium will benefit orthopaedic postgraduates and practising surgeons.
We invite your suggestions and comments for any improvements to the journal. Kindly write to us editor@ijpo.com
Before I finish, it is my pleasure to acknowledge the contributions of Mr Saurabh Pullawar from Indian Orthopaedic Research Group who manages the page proofs, communications and the IJPO website single-handedly. The cover page artwork is by Dr Easwar T Ramani, POSI Webmaster and part-time artist. An explanatory note is available below this message.
Sincerely
Dr Jayanth S Sampath
Editor, International Journal of Paediatric Orthopaedics