bluuebunny/crossref_metadata_2025 huggingface dataset:
Method for estimating physical interaction forces using human–exoskeleton kinematic modelling and energy optimization
Authors: Lim Seungbum , Kim Woojin , Suh Jungwook
Published: February 2025

Exoskeleton robots mimic the structure of the human body and are physically connected to the wearer through attachment parts such as cuffs or straps. Nevertheless, misalignment between the human body and the robot can occur due to improper wearing of the exoskeleton, the elasticity of human skin, and the geometric complexity of human joint movements. Such misalignment increases unnecessary physical interaction forces, causing discomfort and pain to the wearer. Therefore, these interaction forces should be considered when designing exoskeleton robots to ensure wearability. In this study, we propose a method for estimating human-exoskeleton interaction forces through posture prediction. The human-robot connection is modeled as an elastic element, and posture is predicted using an energy optimization algorithm. The predicted posture is then used to calculate the interaction forces. Since this method considers only the physical characteristics of the exoskeleton robot and wearer, it enables objective evaluation of the robot without the need to manufacture actual prototypes. We performed quantitative experiments using prototypes of a sensor-equipped dummy and an exoskeleton to confirm the effectiveness of the modeling method. Consequently, the proposed method is expected to reduce the time and costs associated with developing exoskeleton robots and obviate the need for human subject testing.
Efficient source-independent Q-compensated least-squares reverse time migration with LNCC imaging condition
Authors: Liu Wei , Shi Ying , Wang Ning , Li Songling
Published: February 2025

Source-independent Q-compensated least squares reverse time migration based on the convolutional misfit function constitutes an amplitude-preserving methodology that effectively compensates for seismic attenuation and alleviates the constraints imposed by the source wavelet. Nevertheless, its conventional implementation, which constructs the gradient through the cross-correlation between background wavefield and adjoint wavefield propagating in opposite directions, incurs exorbitant storage and computational expenses. To ease the computational and storage pressures, we develop an efficient source-independent Q-compensated scheme by introducing a local Nyquist cross-correlation imaging condition to formulate gradient. Instead of employing entire wavefields for migration, the local Nyquist cross-correlation imaging condition, in combination with the Nyquist rate, adopts only the local wavefields around the excitation amplitude time. Consequently, the proposed scheme considerably diminishes the storage requirement as well as the additional time resulting from frequent input-output (I/O) operations, thereby enhancing computational efficiency. Numerical examples conducted on the 2D layered model, Marmousi model, field data, and the 3D overthrust model reveal that the proposed scheme is capable of attaining imaging accuracy comparable to that of the conventional scheme, while exhibiting superior storage and computing performance, and possesses higher feasibility in 3D applications.
Virtue Monism and Medical Practice: Practical Wisdom as Cross-Situational Ethical Expertise
Authors: De Caro Mario , Bina Federico , Bonicalzi Sofia , Brunetti Riccardo , Croce Michel , Kerusauskaite Skaistė , Navarini Claudia , Ricci Elena , Vaccarezza Maria Silvia
Published: February 2025

This article defends the centrality of practical wisdom in medical practice by building on a monistic view of moral virtue, termed the “Aretai model,” according to which possession of practical wisdom is necessary and sufficient for virtuousness, grounding both moral growth and effective moral behavior. From this perspective, we argue that practical wisdom should be conceived as a cross-situational ethical expertise consisting of four skills:moral perception, moral deliberation, emotion regulation, and moral motivation. Conceiving of practical wisdom as both overall virtuousness and ethical expertise makes it possible to deal adequately with the uniqueness of concrete ethically relevant situations. We contend that this becomes particularly evident in the context of medical practice, both in terms of decision-making and action-taking, especially in the most challenging or contentious clinical cases. We conclude the article by suggesting the potential implications of the Aretai model for continuing education in medical and healthcare professions.
Adverse effects of nanoparticles on humans
Authors: Morimoto Yasuo , Izumi Hiroto , Tomonaga Taisuke , Nishida Chinatsu , Higashi Hidenori
Published: February 2025

It was previously thought that the particles inhaled by humans and having adverse effects were micron-sized; particles with a particularly high content of crystalline silica were thought to have harmful effects. In recent years, manufactured materials have been further refined to nano-level particles, and it has been reported that these ultrafine particles have different adverse effects, making it necessary to perform occupational health management for chemicals that differ from micron-sized particles. Here we report the adverse effects of carbon nanotubes, welding fumes, and organic substances as examples of nanoparticles.
“They Do Not Have Physiognomies of Their Own”: Tracking Racialization of Maritime Professions in the Eighteenth-Century Portuguese Empire
Authors: Crutcher Megan , Belton Lloyd
Published: February 2025

During the second half of the long eighteenth century, various nations and empires began keeping records of sailors arriving and departing certain ports. In Portugal, all sailors were required to register at the Junta do Comércio (the board of trade), a measure enacted in the wake of a ban on the importation of enslaved people into the kingdom in 1761; an exemption was later made for enslaved sailors or crew members. This article draws on a data set of 344 sailors registered in logs of the Junta’s Lisbon office, dating from 1767, when the board was formed, to 1788, when it was absorbed into the royal court. Our analysis shows how the Junta’s logbooks became a contested space in which enslaved and free sailors of color attempted to define their own occupations, racial identities, and legal status in terms that frequently conflicted with the increasingly homogenized racialization of the state. We link the patterns of increased racialization of sailor records in Portugal to wider Atlantic developments in Brazil, France, Britain, and elsewhere to show how, during a period of immense political, economic, and social change in the long eighteenth century, racial categories were created, expanded, and disseminated across empires. The racialized vocabulary and mechanisms of anti-Blackness were developed, tested, and implemented via maritime networks during an age of capitalist and imperialist growth.
Integrating cold hardiness and deacclimation resistance demonstrates a conserved response to chilling accumulation in grapevines
Authors: Londo Jason P , Kovaleski Al P
Published: February 2025

To survive the harsh conditions of winter, woody perennial species such as grapevine have adapted to use environmental cues to trigger physiological changes to induce dormancy, acquire cold hardiness, and measure the length of winter to properly time spring budbreak. Human induced climate change disrupts these cues by prolonging warm temperatures in fall, reducing the depth and consistency of midwinter, and triggering early budbreak through false spring events. We evaluated variation in dormant bud cold hardiness and chilling hour requirements of 31 different grapevine varieties over 3 years. Differential thermal analysis was used to track changes in cold hardiness and deacclimation resistance was assessed throughout the season to track dormancy progression. Results demonstrate wide variation in maximum deacclimation rate (1.03 – 2.87 °C/day) among varieties under forcing conditions. Significant correlations were noted between wild species distributions or cultivar provenance with cold hardiness and deacclimation rates, demonstrating the likely climate-adaptive nature of these traits. When integrated with variation in cold hardiness, these rates revealed a relationship between winter cold hardiness, changes in deacclimation rate and budbreak phenology. Standardizing rates among varieties as deacclimation potential demonstrated a conserved response to chilling exposure among varieties that alters our interpretation of the concept of high and low chill varieties and chilling requirement in grapevine.
Detection and antimicrobial resistance profiles of Salmonella enterica recovered from house fly intestinal tracts and environments of selected broiler farms in Texas
Authors: Zwally Kirsten M , Holda Elizabeth , Perez Isaac , Kaufman Phillip E , Lyons Brandon , Athrey Giridhar , Taylor T Matthew
Published: February 2025

The entry of drug-resistant Salmonella enterica into the food supply is a challenge to public health and food safety. One emerging concern is the role of synanthropic insects for moving microbial pathogens throughout poultry production systems, where insects commonly thrive. We investigated the presence and phenotypic antimicrobial susceptibility of S. enterica from insect and environmental samples from broiler farms. Insects were collected throughout the broiler house and adjacent compost barn. Environmental samples (poultry feed, drinking water, fresh litter, and feces) were collected simultaneously (n = 80). Insect gastrointestinal tracts were dissected and pooled (n = 57). Recovered Salmonella isolates were serotyped and subjected to antimicrobial susceptibility testing against 14 medically important antimicrobials. Overall, six isolates were recovered from 137 total samples (4.4%): 3.5% (2/57) from adult house flies (Musca domestica), 15% (3/20) from poultry feed, and 4.8% (1/21) from litter. Salmonella Montevideo (16.7%; 1/6), Typhimurium (33.3%; 2/6), and Kentucky (50%, 3/6) were identified. All but one Salmonella isolate (83.3%; 5/6) demonstrated resistance to at least one antimicrobial. Further research should investigate movement patterns between broiler operations and food processing facilities to establish efficient biosecurity measures to prevent any instances of foodborne pathogen transmission into human food systems.
Direct N-body simulations of NGC 6397 and its tidal tails
Authors: Arnold Anthony D , Baumgardt Holger
Published: February 2025

We have performed a series of direct N-body simulations that study the evolution of the Galactic globular cluster NGC 6397 under the combined influence of two-body relaxation, stellar evolution, and the Milky Way’s tidal field. Our simulations follow the evolution of the cluster over the last several Gyr up to its present-day position in the Milky Way in order to allow us to derive present-day cluster parameters and the distribution of its extra-tidal stars. We have also determined a new density profile of NGC 6397 by selecting stars from Gaia Data Release 3 (DR3) using Gaia DR3 proper motions, parallaxes, and photometry to discriminate cluster members from non-members. This allows us to derive the surface density profile of NGC 6397 and the location of its tidal tails up to $10^{\circ }$ of the cluster centre, well beyond the tidal radius of NGC 6397. Our results show that the current state of NGC 6397 in terms of surface density, velocity dispersion profile, and stellar mass function can be matched by a cluster model evolving from a standard initial mass function and does not require an additional central cluster of dark remnants. We also find good agreement in the location and absolute number of the extra-tidal stars between our simulations and the observations, making it unlikely that NGC 6397 is surrounded by a dark matter halo.
The Dark Energy Survey Supernova Program: an updated measurement of the Hubble constant using the inverse distance ladder
Authors: Camilleri R , Davis T M , Hinton S R , Armstrong P , Brout D , Galbany L , Glazebrook K , Lee J , Lidman C , Möller A , Nichol R C , Sako M , Scolnic D , Shah P , Smith M , Sullivan M , Sánchez B O , Vincenzi M , Wiseman P , Allam S , Abbott T M C , Aguena M , Andrade-Oliveira F , Asorey J , Avila S , Bacon D , Bechtol K , Bocquet S , Brooks D , Buckley-Geer E , Burke D L , Rosell A Carnero , Carollo D , Carretero J , Castander F J , Conselice C , da Costa L N , Pereira M E S , Desai S , Diehl H T , Everett S , Ferrero I , Flaugher B , Frieman J , García-Bellido J , Gaztanaga E , Giannini G , Gruendl R A , Herner K , Hollowood D L , Honscheid K , Huterer D , James D J , Kent S , Kuehn K , Lahav O , Lee S , Lewis G F , Lima M , Marshall J L , Mena-Fernández J , Miquel R , Myles J , Ogando R L C , Palmese A , Pieres A , Plazas Malagón A A , Romer A K , Roodman A , Samuroff S , Sanchez E , Sanchez Cid D , Schubnell M , Sevilla-Noarbe I , Suchyta E , Suntzeff N , Swanson M E C , Tarle G , Tucker B E , Walker A R , Weaverdyck N ,   DES Collaboration
Published: February 2025

We measure the current expansion rate of the Universe, Hubble’s constant $H_0$, by calibrating the absolute magnitudes of supernovae to distances measured by baryon acoustic oscillations (BAO). This ‘inverse distance ladder’ technique provides an alternative to calibrating supernovae using nearby absolute distance measurements, replacing the calibration with a high-redshift anchor. We use the recent release of 1829 supernovae from the Dark Energy Survey spanning $0.01\lt z\lt 1.13$ anchored to the recent baryon acoustic oscillation measurements from Dark Energy Spectroscopic Instrument (DESI) spanning $0.30 \lt z_{\mathrm{eff}}\lt 2.33$. To trace cosmology to $z=0$, we use the third-, fourth-, and fifth-order cosmographic models, which, by design, are agnostic about the energy content and expansion history of the universe. With the inclusion of the higher redshift DESI-BAO data, the third-order model is a poor fit to both data sets, with the fourth-order model being preferred by the Akaike Information Criterion. Using the fourth-order cosmographic model, we find $H_0=67.19^{+0.66}_{-0.64}\mathrm{~km} \mathrm{~s}^{-1} \mathrm{~Mpc}^{-1}$, in agreement with the value found by Planck without the need to assume Flat-$\Lambda$CDM. However, the best-fitting expansion history differs from that of Planck, providing continued motivation to investigate these tensions.
Discs around young free-floating planetary-mass objects: ultradeep Spitzer imaging of IC348
Authors: Seo Holly Hanbee , Scholz Aleks
Published: February 2025

Protoplanetary discs have been found around free-floating objects with masses comparable to those of giant planets. The frequency and properties of these discs around planetary-mass objects are still debated. Here, we present ultradeep mid-infrared images for the young cluster IC348, obtained through stacking of time-series images from Spitzer. We measure fluxes at 3.6 and 4.5 $\mu$m for known free-floating planetary-mass objects (FFPMOs, spectral type M9 or later) in this cluster. By comparing the observed infrared spectral energy distributions with photospheric templates, we identify six planetary-mass objects with discs, plus three, which may or may not have a disc. This corresponds to a disc fraction of $46\pm ^{13}_{12}$ per cent. The disc fraction among planetary-mass objects is comparable to more massive brown dwarfs. We show the disc fraction among FFPMOs as a function of age, demonstrating that these objects retain discs for several million years, similar to low-mass stars and brown dwarfs.
A comprehensive study of the gas-phase formation network of HC5N: theory, experiments, observations and models
Authors: Giani Lisa , Bianchi Eleonora , Fournier Martin , Ely Sidaty Cheikh Sid , Ceccarelli Cecilia , Rosi Marzio , Guillemin Jean-Claude , Sims Ian R , Balucani Nadia
Published: February 2025

Cyanopolyynes are among the largest and most commonly observed interstellar Complex Organic Molecules in star-forming regions. They are believed to form primarily in the gas-phase, but their formation routes are not well understood. We present a comprehensive study of the gas-phase formation network of cyanobutadiyne, HC5N, based on new theoretical calculations, kinetics experiments, astronomical observations, and astrochemical modeling. We performed new quantum mechanics calculations for six neutral-neutral reactions in order to derive reliable rate coefficients and product branching fractions. We also present new CRESU data on the rate coefficients of three of these reactions (C3N + C2H2, C2H + HC3N, CN + C4H2) obtained at temperatures as low as 24 K. In practice, six out of nine reactions currently used in astrochemical models have been updated in our reviewed network. We also report the tentative detection of the 13C isotopologues of HC5N in the L1544 prestellar core. We derived a lower limit of 12C/13C > 75 for the HC5N isotopologues, which does not allow to bring new constraints to the HC5N chemistry. Finally, we verified the impact of the revised reactions by running the GRETOBAPE astrochemical model. We found good agreement between the HC5N predicted and observed abundances in cold (∼10 K) objects, demonstrating that HC5N is mainly formed by neutral-neutral reactions in these environments. In warm molecular shocks, instead, the predicted abundances are a factor of ten lower with respect to observed ones. In this environment possessing an higher gas ionization fraction, we speculate that the contribution of ion-neutral reactions could be significant.
NEATH IV: an early onset of complex organic chemistry in molecular clouds
Authors: Priestley F D , Clark P C , Ragan S E , Scibelli S , Cusack M T , Glover S C O , Fehér O , Prole L R , Klessen R S
Published: February 2025

Complex organic molecules (COMs) are widely detected in protostellar and protoplanetary systems, where they are thought to have been inherited in large part from earlier evolutionary phases. The chemistry of COMs in these earlier phases, namely starless and prestellar cores, remains poorly understood, as models often struggle to reproduce the observed gas-phase abundances of these species. We simulate the formation of a molecular cloud, and the cores within it, out of the diffuse interstellar medium, and follow the chemical evolution of the cloud material starting from purely atomic initial conditions. We find that the formation of both gas- and ice-phase COMs precedes the formation of cores as distinct objects, beginning at gas densities of a few $10^3 \, {\rm cm}^{-3}$. Much of this COM-enriched material remains at these relatively modest densities for several $\, {\rm Myr}$, which may provide a reservoir for accretion onto planet-forming discs in later evolutionary stages. We suggest that models of core and disc chemistry should not ignore the complex dynamical evolution which precedes these structures, even when studying supposedly late-forming molecules such as CH$_3$OH and CH$_3$CN.
Massive black holes or stars first: the key is the residual cosmic electron fraction
Authors: Latif Muhammad A , Khochfar Sadegh
Published: February 2025

Recent JWST observations have unveiled that the first supermassive black holes (SMBHs) were in place at z$\ge$ 10, a few hundred Myrs after the Big Bang. These discoveries are providing strong constraints on the seeding of BHs and the nature of the first objects in the Universe. Here, we study the impact of the freeze-out electron fractions ($f_e$) at the end of the epoch of cosmic recombination on the formation of the first structures in the Universe. At $f_e$ below the current fiducial cosmic values of $\rm \sim 10^{-4}$, the baryonic collapse is delayed due to the lack of molecular hydrogen cooling until the host halo masses are increased by 1 to 2 orders of magnitude compared to the standard case and reach the atomic cooling limit. This results in an enhanced enclosed gas mass by more than an order of magnitude and higher inflow rates of up to $0.1~{\mathrm{M}_{\odot } }\, {\rm yr^{ -1}}$. Such conditions are conducive to the formation of massive seed BHs with $\sim 10^{4}$ M$_{\odot }$. Our results reveal a new pathway for the formation of massive BH seeds which may naturally arise from freeze-out conditions in the early Universe.
Convergent Evolution of Cysteine-Rich Keratins in Horny Teeth of Jawless Vertebrates and in Cornified Skin Appendages of Amniotes
Authors: Sachslehner Attila Placido , Eckhart Leopold
Published: February 2025

Cornified skin appendages, such as claws and hair, of amniotes consist of keratins with high numbers of cysteine residues, which serve as sites of protein cross-linking through disulfide bonds. Here, we show by proteomic analysis that cysteine-rich keratins are also components of the horny teeth of the sea lamprey (Petromyzon marinus), a jawless vertebrate. The cysteine-rich keratins of the lamprey are conserved in hagfish, which diverged from lampreys around 460 million years ago. Phylogenetic analysis confirmed the orthology of the cysteine-rich keratins of lampreys and hagfish (cyclostomes) and showed that cysteine-rich keratins of amniotes belong to different clades of keratins. We conclude that keratins with elevated cysteine content evolved not only in amniotes but also, and much earlier, in jawless vertebrates. The convergent evolution of a high abundance of cysteine residues is in line with a critical role of intermolecular disulfide bonds in hard epithelial structures of vertebrates.
The role of prokinetics in managing gastrointestinal involvement in SSc: a systematic literature review
Authors: Ezquerra-Durán Alberto , Alcala-Gonzalez Luis G , Guillen-del-Castillo Alfredo , Simeón-Aznar Carmen P , Barba Elizabeth , Malagelada Carolina , Hughes Michael , McMahan Zsuzsanna H
Published: February 2025

Objectives

Gastrointestinal involvement (GI) in SSc is frequent and heterogeneous, manifesting with different degrees of dysmotility. This systematic literature review aimed to summarize evidence on prokinetics for treating SSc-related GI dysmotility.

Methods

Studies investigating the effects of prokinetic agents on GI function and/or GI symptoms in patients with SSc were systematically identified on PubMed and Embase. A qualitative data synthesis was conducted, given the (anticipated) wide heterogeneity in study designs, interventions and outcomes.

Results

Twenty-one studies evaluating the effects of prokinetics in patients with SSc were included. Thirteen studies focused on GI motility using objective tests, eight assessed clinical responses, and six evaluated both. Cisapride (n = 5 studies), metoclopramide (n = 7 studies), octreotide (n = 4 studies) and prucalopride (n = 1 study) were among the most studied prokinetics, with varying effects on different GI anatomical regions. While metoclopramide consistently improved overall GI motility, other prokinetics provided selective benefits; cisapride improved gastric emptying and colonic motility, but not oesophageal motility, and octreotide improved small bowel motility but delayed gastric emptying. Regarding symptomatic improvement, only prucalopride was evaluated using a validated patient questionnaire, showing improvement in both upper and lower GI symptoms.

Conclusion

Prokinetic drugs may improve GI motility and symptoms in patients with SSc. There is an unmet need for future well-designed studies to refine patient stratification and optimize treatment outcomes.
Long-term effects of institutional slavery on Black representation in entrepreneurship: a study of US communities
Authors: Qiao Kunyuan
Published: February 2025

I argue that the historical prevalence of slavery in different US communities has led to discernible patterns of hate crimes and hate groups. Such legacies of institutional slavery have persisted and, in turn, affected present-day Black representation in entrepreneurship. Drawing on a sample of US counties, I find supportive evidence for my hypotheses and use a spatial discontinuity design for additional evidence. I also explore several possible mechanisms, including vandalism, access to finance, role-modeling effects, and Black displacement, and provide a more comprehensive assessment of slavery by including historical data of the Northeastern states. My study contributes to the institutional legacy literature by characterizing one way through which legacies evolve such that institutions that have been abolished long ago create lasting impacts. I also contribute to understanding the lasting effects of chattel slavery by unpacking the hate-related legacies and extend the literature to understand Black representation in entrepreneurship.
Liminal Punishment and the Specter of Jail
Authors: Eife Erin
Published: February 2025

Poverty governance literature details how systems of control loom over marginalized populations as a form of social management. In this paper, I contribute a theory of liminal punishment to explain one form of poverty governance that uses tools of control enacted on individuals or groups who are documented within a system of punishment but have not yet faced adjudication. Through liminal punishment, the state prepares individuals for adjudication by conditioning people into the treatment they should expect when becoming formally enmeshed in the punishment system. Using 58 interviews with people charged with felonies in Chicago’s Cook County, I first show how individuals charged with (and not yet convicted of) a felony face informal punishment via release conditions, financial instability, and interactions with state actors. Then, I illustrate how the constant threat of re-incarceration from state actors creates a specter of jail, or a psychological tool that coerces individuals into performances of deservingness. Finally, I demonstrate how people respond to this specter of jail through severe self-governance, often going beyond the formal regulations required by the state. This work contributes to theories of poverty governance and liminality, as well as empirical work on pretrial release and surveillance.
Precision Medical Education: Institutional Strategies for Successful Implementation
Authors: Burk-Rafel Jesse , Triola Marc M.
Published: February 2025

Precision medical education (PME) represents a transformative approach in medical education, systematizing individualized and efficient learner competency development for enhanced patient care. While implementing PME has been described conceptually using the P4 medical education framework (proactive, personalized, participatory, predictive), many programs and institutions face implementation questions on navigating data integration complexities, resource constraints, cultural risk aversion to innovation, and more.

To address such challenges, the authors of this Commentary propose 5 concrete, concurrent strategies for institutions and training programs to implement PME successfully. Of these strategies, 4 are aligned with the P4 framework. Strategy 1: Curate educational data, adhering to 8 foundational data principles (relevant, trusted, consistent, timely, accessible, connected, interactive, actionable), and integrate it into an education data warehouse to create a comprehensive learner profile. Strategy 2: Build institutional analytic capabilities, including leveraging existing resources and tools, such as artificial intelligence, to turn data into actionable insights. Strategy 3: Establish transparent, accountable governance structures with broad stakeholder engagement, emphasizing principled co-production of PME by learners, faculty, and educational leaders. Strategy 4: Continuously collect and evaluate outcomes tied to PME interventions, building validity evidence through predictive linkages. Strategy 5: Lead change to drive PME forward. This strategy cuts across all 4 other strategies to promote the effective adoption of systems and processes that drive PME into institutional culture.

When successfully operationalized, PME enables precise, evidence-informed decision-making about and by learners, while benefiting faculty, coaches, and educational leaders. Through these strategies, programs and institutions can overcome implementation pitfalls and harness the full potential of PME to improve educational and patient care outcomes.
Accelerated 3-Year MD Programs in the United States: Key Features, Innovations, Growth, Outcomes, and Lessons Learned
Authors: Cangiarella Joan , Gonzalez-Flores Alicia , Fancher Tonya L. , Santen Sally A. , Coe Catherine L.
Published: February 2025

Accelerated 3-year MD (3YMD) programs have experienced rapid growth in the United States since 2010. In 2015, 8 institutions with 3YMD programs formed the Consortium of Accelerated Medical Pathway Programs (CAMPP). As of 2024, CAMPP has 32 member schools with 3YMD programs, and there have been nearly 1,000 graduates from 3YMD programs who have entered residency, many through directed pathways at the same institution where they attended medical school. Compared to traditional 4-year graduates, 3YMD graduates are equally prepared, have less educational debt, and are frequently filling physician workforce shortage and working in underserved communities. This commentary provides an update on the current state of 32 3YMD programs in the United States, highlighting the key features, innovations, growth, outcomes, and lessons learned in the development and implementation of these programs at CAMPP member institutions.
Reimagining the Medical School Accreditation Process in a Rapidly Changing Health Care Environment
Authors: Prober Charles G. , Porwal Aarti A. , Woolliscroft James O. , Kolars Joseph C.
Published: February 2025

Health care is changing rapidly due to advances in biomedical science and technology, as well as an expanding body of medical knowledge. This transformation necessitates a reevaluation of medical education models. The medical school accreditation process, administered through the Liaison Committee on Medical Education (LCME) for MD-granting schools in the United States and Canada, plays a crucial role in maintaining educational standards. However, current LCME accreditation standards sometimes conflict with innovative educational practices, potentially hindering necessary progress. This Commentary considers how the accreditation process could better support medical education as it advances and adapts to the evolving needs of the health care environment. The authors propose strategies to enhance the accreditation process and better serve medical schools: align accreditation with competency-based education, share best practices identified during the accreditation process, encourage innovation, address financial burdens associated with preparing for accreditation, support institutional missions, embrace advances in science and technology, and facilitate rapid curriculum changes. Balancing compliance with innovation would help schools optimize the educational journey for future physicians and advance the shared goals of improved medical education and patient care.
Weakly nonlinear dynamics of magnetosonic wave at a critical angle excited by a moving charged object in collisional plasmas
Authors: Mistri Arindam , Biswas Akash , Ghosh Samiran
Published: February 2025

The transport properties of weakly nonlinear magnetosonic waves at a critical angle excited by a steadily moving charged obstacle are studied in the presence of effective electron-ion collisions. The weakly nonlinear dynamics of the wave is found to be described by a novel dissipative–dispersive nonlinear partial differential equation: a forced-fifth order Korteweg–de Vries Burgers’ equation. The computational results of this novel equation are noteworthy, and predict the generation of wake fields, precursor soliton, pinned soliton and multi-harmonic structures. The results are discussed in the context of astrophysical plasmas in the Low Earth Orbit region.
Safe focused ultrasound-mediated blood-brain barrier opening is driven primarily by transient reorganization of tight junctions
Authors: Noel Rebecca Lynn , Kugelman Tara , Karakatsani Maria Eleni , Shahriar Sanjid , Willner Moshe J. , Choi Claire Sunha , Nimi Yusuke , Ji Robin , Agalliu Dritan , Konofagou Elisa E.
Published: February 2025

Focused ultrasound (FUS) with microbubbles opens the blood-brain barrier (BBB) to allow targeted drug delivery into the brain. The mechanisms by which endothelial cells (ECs) respond to either low acoustic pressures known to open the BBB transiently, or high acoustic pressures that cause brain damage, remain incompletely characterized. Here, we use a mouse strain where tight junctions between ECs are labelled with eGFP and apply FUS at low (450 kPa) and high (750 kPa) acoustic pressures, after which mice are sacrificed at 1 or 72 hours. We find that the EC response leading to FUS-mediated BBB opening at low pressures is localized primarily in arterioles and capillaries, and characterized by a transient loss and reorganization of tight junctions. BBB opening still occurs at low safe pressures in mice lacking caveolae, suggesting that it is driven primarily by transient dismantlement and reorganization of tight junctions. In contrast, BBB opening at high pressures is associated with obliteration of EC tight junctions that remain unrepaired even after 72 hours, allowing continuous fibrinogen passage and persistent microglial activation. Single-cell RNA-sequencing of arteriole, capillary and venule ECs from FUS mice reveals that the transcriptomic responses of ECs exposed to high pressure are dominated by genes belonging to the stress response and cell junction disassembly at both 1 and 72 hours, while lower pressures induce primarily genes responsible for intracellular repair responses in ECs. Our findings suggest that at low pressures transient reorganization of tight junctions and repair responses mediate safe BBB opening for therapeutic delivery.

Significance Statement

Focused ultrasound with microbubbles is used as a noninvasive method to safely open the BBB at low acoustic pressures for therapeutic delivery into the CNS, but the mechanisms mediating this process remain unclear. Kugelman et al., demonstrate that FUS-mediated BBB opening at low pressures occurs primarily in arterioles and capillaries due to transient reorganization of tight junctions. BBB opening still occurs at low safe pressures in mice lacking caveolae, suggesting a transcellular route-independent mechanism. At high unsafe pressures, cell junctions are obliterated and remain unrepaired even after 72 hours, allowing fibrinogen passage and persistent microglial activation. Single-cell RNA-sequencing supports cell biological findings that safe, FUS-mediated BBB opening may be driven by transient reorganization and repair of EC tight junctions.
The Dialogic Health Systems Research Framework (DHSRF): A tool for facilitating self-criticality, researcher interactions and knowledge management in Health Systems Research & Policy Studies
Authors: Priya Ritu , Das Sayan , Kuriakose Liz M. , Shukla Madhurima , Sarkar Amitabha , Dumka Neha , Hannah Erin , Basheer Nisha , Kotwal Atul
Published: February 2025

Health Systems Research (HSR) has witnessed significant progress in theory, methodology and practice over the last two decades. The complexity of health systems has allowed for diverse lenses for HSR. However, given the absence of dialogue between the different streams of HSR, the diversity of this field, perhaps its greatest strength, is turning out to be quite the challenge. Without a common language that enables researcher interaction and critical examination of the field, diversity can easily turn into a din. To overcome this confusion evidence-based policy making requires tools that can assess the diverse evidence generated for designing systems coherent with the desired values and principles.

Hence, we need a common research framework for HSR, to understand, describe and explain the systems’ structure and functioning, including observed and projected processes of change, across streams. It should be able to make sense of the formulation of HSR, allowing diverse research paradigms their appropriate place in HSR, and make them talk to each other rather than against each other.

This study, therefore, presents the Dialogic Health Systems Research Framework (DHSRF), developed through an iterative and reflexive methodology involving a systematic narrative review and a national consultation. The DHSRF draws upon the comprehensive primary health care principles and a complexity lens to be context-sensitive, open to diverse perspectives, adaptable to different settings, value-critical and dialogic. It potentially contributes to knowledge management by a) allowing for a comprehensive review of HSR at the proposal and design stage to ensure a ‘good fit for purpose’, and b) assessing the strength of the outcomes of HSR in relation to the purpose and objective(s) of the research. By surfacing the inner workings of HSR, the framework can galvanise dialogue and debate in enriching the field and facilitating utilisation of its outcomes for policy, planning and implementation.
Multi-ancestral genome-wide association study of clinically defined nicotine dependence reveals strong genetic correlations with other substance use disorders and health-related traits
Authors: Johnson Emma C , Lai Dongbing , Miller Alex P , Hatoum Alexander S , Deak Joseph D , Balbona Jared V , Baranger David AA , Galimberti Marco , Sanichwankul Kittipong , Thorgeirsson Thorgeir , Colbert Sarah MC , Sanchez-Roige Sandra , Adhikari Keyrun , Docherty Anna , Degenhardt Louisa , Edwards Tobias , Fox Louis , Giannelis Alexandros , Jeffries Paul , Korhonen Tellervo , Morrison Claire , Nunez Yaira Z , Palviainen Teemu , Su Mei-Hsin , Romero Villela Pamela N , Wetherill Leah , Willoughby Emily A , Zellers Stephanie , Bierut Laura , Buchwald Jadwiga , Copeland William , Corley Robin , Friedman Naomi P. , Foroud Tatiana M , Gillespie Nathan A , Gizer Ian R , Heath Andrew C , Hickie Ian B , Kaprio Jaakko A , Keller Matthew C , Lee James L , Lind Penelope A , Madden Pamela A , Maes Hermine HM , Martin Nicholas G , McGue Matt , Medland Sarah E , Nelson Elliot C , Pearson John V , Porjesz Bernice , Stallings Michael , Vrieze Scott , Wilhelmsen Kirk C , Walters Raymond K , Polimanti Renato , Malison Robert T , Zhou Hang , Stefansson Kari , Potenza Marc N , Mutirangura Apiwat , Shotelersuk Vorasuk , Kalayasiri Rasmon , Edenberg Howard J , Gelernter Joel , Agrawal Arpana
Published: February 2025

Genetic research on nicotine dependence has utilized multiple assessments that are in weak agreement. We conducted a genome-wide association study of nicotine dependence defined using the Diagnostic and Statistical Manual of Mental Disorders (DSM-NicDep) in 61,861 individuals (47,884 of European ancestry, 10,231 of African ancestry, 3,746 of East Asian ancestry) and compared the results to other nicotine-related phenotypes. We replicated the well-known association at theCHRNA5locus (lead SNP: rs147144681, p =1.27E-11 in European ancestry; lead SNP = rs2036527, p = 6.49e-13 in cross-ancestry analysis). DSM-NicDep showed strong positive genetic correlations with cannabis use disorder, opioid use disorder, problematic alcohol use, lung cancer, material deprivation, and several psychiatric disorders, and negative correlations with respiratory function and educational attainment. A polygenic score of DSM-NicDep predicted DSM-5 tobacco use disorder and 6 of 11 individual diagnostic criteria, but none of the Fagerström Test for Nicotine Dependence (FTND) items, in the independent NESARC-III sample. In genomic structural equation models, DSM-NicDep loaded more strongly on a previously identified factor of general addiction liability than did a “problematic tobacco use” factor (a combination of cigarettes per day and nicotine dependence defined by the FTND). Finally, DSM-NicDep was strongly genetically correlated with a GWAS of tobacco use disorder as defined in electronic health records, suggesting that combining the wide availability of diagnostic EHR data with nuanced criterion-level analyses of DSM tobacco use disorder may produce new insights into the genetics of this disorder.
Mitochondrial respiratory activity and DNA damage in peripheral blood mononuclear cells in borderline personality disorder
Authors: Behnke Alexander , Rappel Manuela , Ramo-Fernández Laura , Mavioğlu R. Nehir , Weber Benjamin , Neuner Felix , Bisle Ellen , Mack Matthias , Radermacher Peter , Witt Stephanie H. , Schmahl Christian , Karabatsiakis Alexander , Kolassa Iris-Tatjana
Published: February 2025

Alterations in the central and peripheral energy metabolism are increasingly recognized as key pathophysiological processes in various psychiatric disorders. This case-control study investigates mitochondrial energy production and oxidative DNA damage in Borderline Personality Disorder (BPD). We compared mitochondrial respiration, density, and DNA damage in peripheral blood mononuclear cells between women with acute BPD, remitted BPD, and healthy controls (n= 32, 15, 29), matched for age and BMI. Acute BPD was characterized by reduced and less efficient mitochondrial ATP production compared to both remitted BPD and controls (e.g., coupling efficiency:rx= −0.36 and −0.35,padj’s < .037). Decreased mitochondrial activity was closely associated with greater DNA damage (e.g., coupling efficiency:rS= −0.57,p< .001), although DNA damage did not differ between diagnostic groups. Our findings suggest mitochondrial energy production processes as promising and sensitive biomarkers for acute disorder severity and clinical remission in BPD.
Ranking Pretrained Speech Embeddings in Parkinson’s Disease Detection: Does Wav2Vec 2.0 Outperform its 1.0 Version Across Speech Modes and Languages?
Authors: Klempir Ondrej , Skryjova Adela , Tichopad Ales , Krupicka Radim
Published: February 2025

Speech and language technologies are effective tools for identifying the distinct speech changes associated with Parkinson’s disease (PD), enabling earlier and more accurate diagnosis. Recent advancements in self-supervised speech pretraining, particularly with Wav2Vec models, have demonstrated superior performance over traditional feature extraction methods. While Wav2Vec 2.0 has been successfully utilized for PD detection, a rigorous quantitative comparison with Wav2Vec 1.0 is needed to comprehensively evaluate its advantages, limitations, and applicability across different speech modes in PD. This study presents a systematic comparison of Wav2Vec 1.0 and Wav2Vec 2.0 embeddings across three multilingual datasets using various classification approaches in classifying normal (healthy controls; HC) and PD speech. Additionally, both Wav2Vec versions were benchmarked against traditional baseline features across diverse linguistic contexts, including spontaneous speech, non-spontaneous speech, and isolated vowels. A multicriteria TOPSIS approach was employed to rank feature extraction methods, revealing that the Wav2Vec 2.0 consistently excelled across all speech modes, with its first transformer layer demonstrating the best performance for contextual tasks (read text and monologue) and its feature extractor performing best in vowel-based classification. In contrast, the Wav2Vec 1.0, while generally outperformed by the Wav2Vec 2.0, still provided a faster alternative with competitive performance in contextual tasks, highlighting its potential for specific applications, such as federated learning. This comparative analysis furthermore underscores the strengths of each Wav2Vec architecture and informs their optimal use in PD detection.
Southern European Prospective Investigation Into Childhood Cancer and Nutrition (EPICkids): Study Design and Protocol
Authors: Perganti Foteini , Huybrechts Inge , Balduzzi Adriana Cristina , Barr Ronald , Biondi Andrea , Bladé Aina Llenas , Bravo Evangelina Muñoz , Damasco Erika , Katsagoni Christina N. , Kattamis Antonis , Lassaletta Alvaro , Lera Marta Llopis , Llort Anna , Blanco Lopez Jessica , Martinez Antonio Perez , Massimino Maura , La Madrid Andrés Morales , Moreno Lucas , Alonso Ana Muñoz , Nicolas Genevieve , Preziati Giorgia , Rizzari Sofia , Della Valle Serena , Marquez Vega Catalina , Walters Michelle , Kozlakidis Zisis , Ladas Elena J.
Published: February 2025

The survival rates for children with cancer have increased appreciably over the last few decades; however, childhood cancer survivors continue to suffer from long-lasting sequelae. Studies have demonstrated that the presence of malnutrition, over- and under-nutrition, at diagnosis or the duration of malnutrition during treatment is associated with increased toxicity, infection, and inferior survival. Dietary habits, along with behavioral and socioeconomic status, are known factors that lead to obesity or undernutrition and can affect the prognosis and quality of life of children with cancer. Unfortunately, the underlying mechanisms responsible for these observations are largely unknown. To address this gap in science, we established the EPICkidscohort study, an initiative of the International Initiative for Pediatrics and Nutrition at Columbia University Irving Medical Center and the International Agency for Research on Cancer of the World Health Organization. Over a 5-year period, children and adolescents with acute lymphoblastic leukemia and brain tumors receiving treatment in Spain, Italy, or Greece will be recruited. Clinical data and biospecimens (blood and stool) will be collected at designated timepoints in therapy. At the same time, several surveys will be administered to collect data on sociodemographics, physical activity, quality of life, food insecurity, and dietary habits. The primary aim of EPICkidsis to develop a large informative nutrition biobank and database to investigate the etiologic pathways that connect nutritional status and lifestyle factors with clinical outcomes in children and adolescents with cancer. Secondary aims are to create evidence-based guidelines for European children with cancer in this understudied region and to ultimately improve the quality of life of those children and adolescents.

TheClinicalTrials.govID for EPICkidsstudy isNCT05375617.
Diarrheal disease attributed toShigellaspp. and EnteroinvasiveEscherichia coliamong children at households in rural Haïti: A case-control study
Authors: Sriguha Ishae , Kuyt Saradiya R , Cajusma Youseline , Cato Emilee , Brinkley Lindsey , Sayeed Md Abu , Maples Stace , Madsen Beau De Rochars Valery , Maurelli Anthony T , Baril Chantale , Leung Daniel , Klarman Molly , Nelson Eric Jorge
Published: February 2025

Infections fromShigellaspp. and EnteroinvasiveEscherichia coli(EIEC) are considered leading causes of symptomatic diarrheal disease, globally. However, there is a paucity of case-control studies from Caribbean nations to guide regional public health priorities and interventions. A case-control study was conducted within a larger cross-sectional healthcare study in Haïti. Participant households were identified using a geospatially randomized method; families with children under 5 years were consented and enrolled. Rectal swabs from child participants were tested forShigellaspp./EIEC by qPCR using theipaHtarget. Two case-definitions were used: 'diarrheal symptom' (DS) cases were defined as those reporting diarrheal symptoms ≤7 days ago; 'acute diarrhea' (AD) cases were defined as those reporting diarrheal symptoms ≤7 days ago with ≥3 loose stools in the past 24 hours and onset <7 days ago. Of 868 households screened, 568 were enrolled with 794 participating children; samples from 732 children were analyzed. Rates ofShigellaspp./EIEC. detection among DS cases and controls were 11.4% (22/193) and 6.1% (33/539), respectively. Rates of detection among AD cases and controls were 18.6% (8/43) and 6.8% (47/689), respectively. The adjusted odds of having DS increased by 84% (aOR=1.84; 95%CI 1.02 to 3.27) and having AD increased by 183% (aOR=2.83; 95%CI 1.14 to 6.36) whenShigellaspp./EIEC was detected. The attributable fractions for DS and AD were 5.62% (95%CI 0.44% to 10.9%) and 12.6% (95%CI 0% to 25.3%), respectively. Rates of bloody diarrhea (dysentery) were minimal (<1%, 6/732). Within this case-control study in Haïti,Shigellaspp./EIEC detection was common and attributed to symptomatic disease. These results align with prior global health studies.Shigellaspp./EIEC represent an important public health target for intervention once the security situation in Haïti stabilizes.