bluuebunny/crossref_metadata_2025 huggingface dataset:
Badass Mom Art: Motherhood Untold in My Kind of Crazy
Authors: Peterson Lorinda Jean
Published: February 2025

Graphic memoir and feminist mothering theory are at the heart of my research-creation paper “Badass Mom Art: Motherhood Untold in My Kind of Crazy”, which brings feminist mothering theory into conversation with traumatic mothering stories. The research-creation comprises a series of sequential graphic stories from my 2023 memoir My Kind of Crazy and a drawing series, Mothering Myths: (Re)imaginings and (Re)visions. These narratives re-imagine trauma’s impact on my maternal generations and illustrate the feminist shift from the 20th century patriarchal institution of motherhood that creates mothers as powerless and oppressed to 21st century matricentric mothering that empowers mothers through agency, autonomy, authenticity, and authority. Through comic’s conventions of frames, gutters, and the ability to manipulate time, the stories—my grandmother’s, my mother’s, and mine—detail specific traumatic experiences that impact our abilities to mother; they also reveal my perspective on events according to my perceptions and beliefs as an adult creating our stories. These are real stories of mothers unfolding in images and words. The article foregrounds Western patriarchal mothering myths of the ideal mother and the generations of feminist activists and scholars, including Adrienne Rich and Andrea O’Reilly, who have worked to change how society perceives mothers. Feminist poet Adrienne Rich’s seminal text Of Woman Born (1986) differentiates between the idea of motherhood and the concept of mothering; she encourages mothers to be mother outlaws by mothering outside patriarchy’s institution of motherhood’s rules and prescriptions. O’Reilly first questioned why maternity was not understood as a subject position nor theorized as other subject positions regarding the meeting of gendered oppression and resistance in her 2016 text Feminism: Theory, Activism, and Practice. Rich’s and O’Reilly’s proposed mother-centered practice permeates and is key to my art and critical work.
The Clinical Nurse Specialist as the Manager of the Family Medicine Clinic: A Hybrid Solution Between Four Major Commonwealth Realms
Authors: Karczewski Dawid , Stephens Jennifer M. L. , Karczewski Tomasz
Published: February 2025

Background/Objectives: There exist several interconnected issues that hinder the development of family medicine in Commonwealth realms such as the United Kingdom, Canada, New Zealand, and Australia. These issues affect both the medical and nursing professions. Family physicians, in most countries including the United Kingdom, are not considered “specialists” and are called “general practitioners” instead. The term GP is an outdated and potentially demeaning term relegated to the early 20th century when they did not receive any more than a few rotations as staff grades before being allowed to run their own community clinic. Registered nurses often cover a minor and subaltern role when working as practice nurses in the UK. They are often replaced by cost-effective, licensed practical nurses in most other English-speaking countries. Nurse practitioners in the UK, though being de facto entirely equal to family physicians in countries like Canada, Australia, New Zealand, and most US states, do not hold a special registration status. Their training is not defined in specific legislation, and they do not function as alternatives to general practitioners in the sense that patient may register with them alone which is often the case in Canada or the USA. Family medicine is, therefore, generally left lacking leadership with members of the medical and nursing professions often struggling for “power” in a way that undermines the foundation of family medicine which is to serve the health needs of a large population ranging from children to seniors. Methods: The purpose of this paper is to describe a solution to management in a Family Medicine Clinic in Calgary, Alberta, Canada. Results: In this model, the physician-nurse team developed a highly trained role of Clinical Nurse Specialist which serves as an overall clinic manager. Conclusions: The implementation of the Clinical Nurse Specialist-led model in family medicine has improved clinic efficiency, patient access, and provider satisfaction. This approach demonstrates a viable framework for enhancing primary care management across Commonwealth realms.
Assessment of the Educational Needs of Spanish Nurses in the Care and Management of Patients with Diabetes
Authors: Fontán-Vinagre Guadalupe , Ruíz-Núñez Carlos , Domínguez-Fernández Silvia , Ayuso-Murillo Diego , Herrera-Peco Ivan
Published: February 2025

Introduction: The rising prevalence of chronic diseases such as diabetes poses significant challenges to healthcare systems globally, requiring specialized care and management. Nurses play an essential role in educating and caring for patients, but current continuing education programs often fail to meet the practical needs of clinical settings. Methods: This study used a qualitative descriptive–interpretative approach, conducting semi-structured interviews with 24 nurses working in primary care and hospital settings across Spain. The interviews focused on their experiences, perceptions, and educational needs in diabetes care. A thematic analysis was performed to identify key trends and insights. Results: Nurses emphasized the importance of ongoing education in building professional confidence and improving patient care outcomes. However, they reported significant barriers, including limited time, high costs, and a lack of practical focus in existing training programs. Participants favored hybrid learning models, which combine the flexibility of online training with the hands-on experience of in-person sessions. Nurses in rural areas highlighted the value of virtual training to overcome geographic constraints, while those in urban environments preferred hybrid approaches. Additionally, nurses called for accessible and concise resources, such as digital libraries and clinical simulations, to support decision making in real time. Conclusions: To be effective, diabetes- and ostomy-focused continuing education must align with nurses’ clinical realities and individual needs. Combining digital tools with practical in-person learning can enhance accessibility and foster the practical application of skills. These findings provide actionable insights for designing education programs that advance both patient care and nurses’ professional development.
The Relationship Between Social Anxiety and Depression Among Rural High School Adolescents: The Mediating Role of Social Comparison and Social Support
Authors: Cao Yang , Wang Jia , Huang Ziqin , Qin Yiming , Gao Siyu , Zhang Huiping , Yuan Meng , Tang Xinfeng
Published: February 2025

Objective: This study aimed to explore the impact of social anxiety on depression among high school students and examine the parallel mediating roles of social comparison and social support. Methods: A total of 806 rural high school students were surveyed using the Short Mood and Feelings Questionnaire, the Social Phobia Inventory, the Chinese version of the Social Comparison Orientation Scale, and the Multidimensional Scale of Perceived Social Support. Results: Social anxiety and social comparison were significantly and positively correlated with depression, while social support exhibited a significant negative correlation with depression. The direct effect of social anxiety on depression was also found to be significant. Moreover, social comparison and social support both played significant parallel mediating roles in the relationship between social anxiety and depression. Conclusions: Social anxiety has a direct positive predictive effect on depression, and this effect can be indirectly mediated through the parallel roles of social comparison and social support.
A Novel Strategy for Understanding What Patients Value Most in Informed Consent Before Surgery
Authors: Gabay Gillie , Gere Attila , Zemel Glenn , Moskowitz Howard
Published: February 2025

Background/Objectives: To map and analyze patient expectations regarding communication in IC and identify communication that both heightens anxiety in the IC process and reduces anxiety in the IC process before surgery. Methods: Ethics approval was granted. A power analysis indicated a required sample of 90 patients. A conjoint-based experimental design was performed, post-discharge, overcoming typical biases of surveys. Results: The sample comprised 104 patients who underwent surgery in the last year. Three verbal communication messages were perceived as significantly decreasing pre-operative anxiety for the total sample. Mathematical clustering yielded three distinct mindsets. Post hoc ANOVA indices indicated that the mindsets were significantly different. Patients belonging to each mindset differed from patients belonging to other mindsets in their expectations from the dialogue with surgeons to mitigate their anxiety. Mindset 1 (70% of the sample) comprised patients who expected information that was tailored to their specific situation. To feel safer, they needed to know that nothing unexpected would happen. Mindset 2 (13%) comprised patients who expected providers to talk with them about benefits and risks at the clinic, not at the hospital, and have a dialogue with them. Mindset 3 (17%) comprised patients who perceived a lack of information regarding the purpose of signing the informed consent and lack of sufficient time to thoroughly read the form or signing the form minutes before the procedure as elements that would heighten their anxiety. Conclusions: Three verbal communication messages in the IC dialogue were thought to decrease pre-operative anxiety for all patients, as follows. “I want to make sure you read and understand the consent form entirely” “Everything is provided in clear and simple terms”. The surgeon says, “Let’s go over the entire form”.
SYNTAXIN OF PLANTS132 Regulates Root Meristem Activity and Stem Cell Niche Maintenance via RGF-PLT Pathways
Authors: Wang Mingjing , He Fumeng , Zhang Wei , Du Chong , Wang Linlin , Sui Jia , Li Fenglan
Published: February 2025

Root growth and development are contingent upon continuous cell division and differentiation in root tips. In this study, we found that the knockdown of the syntaxin gene SYNTAXIN OF PLANTS132 (SYP132) in Arabidopsis thaliana resulted in a significant reduction in root meristem activity and disruption of root stem cell niche (SCN) identity. The SYP132 knockdown mutant exhibits a compromised SCN characterized by an increased number of quiescent center (QC) cells, abnormal columella stem cells (CSCs), reduced meristem size, and subsequent inhibition of root growth. In syp132, vesicle transport of PIN proteins is disrupted, leading to altered auxin distribution and decreased expression of the auxin-response transcription factors PLETHORA 1 (PLT1) and PLETHORA 2 (PLT2). Furthermore, the transcription level of the precursor of root meristem growth factor 1 (RGF1) is also modified in syp132. The reduction in PLT2 transcription and protein levels along with defects in the root SCN are partially rescued by the application of synthesized RGF1. This finding suggests that both the auxin-PLT and RGF-PLT pathways are interconnected through SYP132-mediated vesicle transport. Collectively, our findings indicate that SYP132 regulates the PLT pathway to maintain the root stem cell niche (SCN) in an RGF1-dependent manner.
The Role of Beta-Defensin 2 in Preventing Preterm Birth with Chorioamnionitis: Insights into Inflammatory Responses and Epithelial Barrier Protection
Authors: Yun Sangho , Kang Shin-Hae , Ryu Jiwon , Kim Kyoungseon , Lee Keun-Young , Lee Jae Jun , Hong Ji Young , Son Ga-Hyun
Published: February 2025

Antimicrobial peptides, such as beta-defensin 2 (BD2), are vital in controlling infections and immune responses. In this study, we investigated the expression and role of BD2 in the amniotic membrane and human amniotic epithelial cells (hAECs) from patients with preterm birth and chorioamnionitis, focusing on its regulation of inflammatory cytokines and its protective effect on the epithelial barrier. Our results show increased BD2 expression in chorioamnionitis, and Lipopolysaccharide (LPS)-induced inflammation increased BD2 release from hAECs in a dose- and time-dependent manner. BD2 treatment effectively modulated the inflammatory response by reducing pro-inflammatory cytokines (IL-6, IL-1β) and enhancing the release of the anti-inflammatory cytokine IL-10. Additionally, BD2 helps preserve epithelial barrier integrity by restoring E-cadherin expression and reducing Snail expression in inflamed hAECs. In an LPS-induced preterm birth mouse model, BD2 treatment delayed preterm delivery and reduced inflammatory cytokine levels. These results suggest that BD2 plays a protective role in preventing preterm birth by regulating inflammation and maintaining epithelial barrier function, highlighting its therapeutic potential for inflammation-related preterm birth.
Inhibition of LncRNA H19 Attenuates Testicular Torsion-Induced Apoptosis and Preserves Blood–Testis Barrier Integrity
Authors: Cheng Linxin , Yin Zhibao , Liu Han , Shi Sijing , Lv Limin , Wang Yixi , Zhou Meng , Li Meishuang , Guo Tianxu , Guo Xiyun , Yang Guang , Ma Junjun , Yu Jinbo , Zhang Yu , Duo Shuguang , Zhao Lihua , Li Rongfeng
Published: February 2025

Testicular torsion is a common emergency in adolescents, and can lead to severe ischemia reperfusion injury (IRI). LncRNA H19 has been shown to increase during ischemia, but its role in testicular IRI remains unknown. Focusing on this research gap, we utilized H19 biallelic mutant mice and Sertoli cell line (TM4) to construct in vivo and in vitro models of ischemia/reperfusion (I/R) and oxygen–glucose deprivation/reperfusion (OGD/R). Compared to WT I/R mice, H19−/− I/R mice showed milder tissue disorganization and cell loss, with a more intact blood–testis barrier (BTB). The cell viability decreased, ROS levels and apoptosis-related factors such as Bax/Bcl-2 increased in TM4 cells after OGD/R, whereas these changes were reversed when H19 was knocked down followed by OGD/R (si-H19+OGD/R). In contrast, over-expression of H19 in TM4 cells exacerbates OGD/R-induced cell apoptosis. Through in-depth analysis of KEGG-enriched pathways, the PI3K/AKT pathway was identified as a potential target of H19 modulation. Western blotting confirmed that, in OGD/R cells, elevated H19 levels were accompanied by the excessive AKT phosphorylation and the tight junction marker ZO-1 degradation; and in si-H19+OGD/R cells, the decreased AKT phosphorylation was recovered and the up-regulated ZO-1 expression was weakened simultaneously via using the AKT activator SC79. These results suggest that inhibiting H19 in OGD/R cells might preserve the integrity of the BTB by reversing the excessive phosphorylation of AKT. Moreover, H19 deficiency in si-H19+OGD/R cells alleviated the disturbances in glycolysis, fatty acid biosynthesis, and amino acid metabolism. Our study indicates that H19 might be a potential therapeutic target for clinic testicular I/R treatment.
Animal Model Screening for Hyperlipidemic ICR Mice
Authors: Chen Xingtong , Zhou Yunyue , Yang Jinbiao , Yang Ruihong , Xue Shuang , Wang Qiao , Niu Wenying
Published: February 2025

This study aimed to establish a hyperlipidemia model in ICR mice using a homemade high-fat diet. It further investigated hyperlipidemia-related indicators in control and model mice at various feeding durations to determine the optimal time frame for successful model establishment. Sixteen male ICR mice were introduced at intervals of 3 weeks, starting from weeks 0, 3, 6, 9, and 12. The control group was fed a standard diet, while the model group received a homemade high-fat diet to induce hyperlipidemia. Blood lipid related indices were detected at 15 weeks. The liver, scapular fat, abdominal fat, and epididymal fat were harvested to calculate the organ index. The contents of T-CHO, TG, and TBA in the liver were measured. HE staining was used to observe pathological changes in liver tissue and white adipose tissue, while Oil Red O staining was used to observe lipid droplets in liver tissue. The mRNA and protein expression of SREBP-2, insig1, HMGCR, LXRα, ABCA1, and CYP7A1 in the liver were detected by RT-qPCR and Western Blot. In the model group, blood lipid levels significantly increased by the 9th week, aligning with pathological changes indicative of hyperlipidemia. The mRNA and protein expression levels of SREBP-2, Insig-1, HMGCR, LXRα, ABCA1, and CYP7A1 were markedly elevated at 9 weeks and remained relatively stable thereafter. This study provides a reliable reference for determining the optimal establishment time of hyperlipidemia models and for in vivo hyperlipidemia animal experiments.
Reduced Respiratory Sinus Arrhythmia in Infants with the FMR1 Premutation
Authors: Chase Abigail , Hamrick Lisa , Arnold Holley , Smith Jenna , Hantman Rachel , Cortez Kaitlyn , Adayev Tatyana , Tortora Nicole D. , Dahlman Alison , Roberts Jane
Published: February 2025

The fragile X premutation (FXpm) is caused by a CGG repeat expansion on the FMR1 gene. In adults, FXpm is linked with autonomic nervous system (ANS) dysfunction and impairment is associated with CGG repeat length. Given scant infancy research, we examined ANS functioning, via respiratory sinus arrhythmia (RSA) and interbeat interval (IBI), in 82 FXpm and neurotypical infants and their associations with CGG repeats. FXpm infants exhibited lower RSA but no IBI differences. There were no associations between ANS functioning and CGG repeat length. These findings identify an ANS biomarker consistent with the emerging pediatric phenotype in FXpm.
Plasma miR-145-5p Levels and Risk of Future Cancer—Results from the HUNT Study
Authors: Antoun Christopher , Oto Julia , Morelli Vânia M. , Hveem Kristian , Brækkan Sigrid K. , Medina Pilar , Hansen John-Bjarne
Published: February 2025

MicroRNA-145-5p (miR-145) has been reported to regulate multiple oncogenes and is considered a tumor suppressor. However, it remains unknown whether the level of plasma miR-145 can serve as a risk biomarker for future cancer. Using a population-based cohort (n = 1740) derived from the Trøndelag Health Study (HUNT), we investigated whether plasma miR-145 levels were associated with (1) first life-time cancer, (2) cancer stage at diagnosis, and (3) 2-year all-cause mortality after cancer diagnosis. Cox regression analysis was used to estimate hazard ratios (HR) and 95% confidence intervals (CI). Our findings showed that individuals in the highest quartile of plasma miR-145 levels had a 44% increased risk of developing cancer compared to those in the lowest quartile, independent of age, sex, body mass index, or smoking status (HR 1.44, 95% CI 1.03–2.00 p < 0.05). However, no association was observed between quartiles of miR-145 levels and the risk of being diagnosed with a metastatic cancer, or the risk of 2-year mortality after cancer diagnosis. Our findings suggest that high plasma miR-145 levels are associated with increased cancer risk without affecting the severity of the cancer at diagnosis or affecting the short-term prognosis.
Analysis of the Frequency of the A1 and A2 Alleles in the Beta-Casein Gene and the A, B and E Alleles in the Kappa-Casein Gene in Local Cattle Breeds: Polish Red and Polish White-Backed
Authors: Sawicka-Zugaj Wioletta , Chabuz Witold , Barłowska Joanna , Mucha Sebastian , Kasprzak-Filipek Karolina , Nowosielska Agnieszka
Published: February 2025

In view of the threat to local breeds resulting from intensive animal production, many studies are conducted in search of arguments confirming their importance in food production. In the case of milk production, not only is its quantity important, but its quality is as well, including its chemical composition. Particular focus has recently been placed on the casein proteins beta-casein (CSN2) and kappa-casein (CSN3), due to their potential impact on human health or on the suitability of milk for cheese production. The present study analysed the polymorphism of these proteins in 1777 cows belonging to two local cattle breeds, Polish Red and Polish White-Backed, using Illumina Infinium XT SNP technology on a EuroGenomics MD chip. The results indicate that the Polish White-Backed breed is predisposed to produce ‘A2 milk’, as the frequency of the CSN2 A2 allele in the population was 61.2%. The Polish Red breed was characterised by a higher frequency of the CNS3 B allele (35%), which according to extensive scientific literature is associated with better coagulation properties, and increased whey expulsion. The highest yield of milk and its constituents, confirmed at p ≤ 0.01, was obtained for Polish White-Backed cows with the A2A2 genotype in CSN2 and cows with the AA genotype in CSN3. In the Polish Red breed, no statistically significant differences were obtained between means for milk production traits.
An Expected Value-Based Symmetric–Asymmetric Polygonal Fuzzy Z-MCDM Framework for Sustainable–Smart Supplier Evaluation
Authors: Hashemi-Tabatabaei Mohammad , Amiri Maghsoud , Keshavarz-Ghorabaee Mehdi
Published: February 2025

Background: Nowadays, traditional supply chain management (SCM) processes are undergoing a profound transformation enabled by advanced technologies derived from Industry 4.0. The rapid adoption of these technologies has led to the emergence of smart SCM, which integrates modern technologies in sourcing, production, distribution, and sales. Supplier evaluation and selection (SES) in smart SCM is a strategic decision impacting the entire supply chain. Organizations must also incorporate sustainability principles into their strategic decisions alongside smart production and efficiency. Methods: The main objective of this study is to develop a multi-criteria decision-making (MCDM) approach under uncertainty to address sustainable–smart supplier evaluation and selection problems. The approach integrates polygonal fuzzy numbers (POFNs), Z-numbers, expected interval (EI), and expected value (EV) to develop methods such as the logarithmic methodology of additive weights (LMAW) and the weighted aggregated sum product assessment (WASPAS), which are used to prioritize criteria and rank suppliers. Furthermore, novel approaches are introduced for calculating membership functions, a-cut formulations, and the crispification process in POFNs. Results: A real case study in the home appliance industry revealed that cost reduction through smart technologies, green and smart logistics and manufacturing, and smart working environments are the most critical evaluation criteria. Suppliers three and four, excelling in these areas, were identified as top suppliers. Conclusions: The proposed approaches effectively addressed hybrid uncertainty in SES problems within smart SCM. Finally, sensitivity and comparative analysis confirmed their robustness and reliability.
Gender Differences for His Bundle Pacing Long-Term Performance in the Elderly Population
Authors: Pestrea Catalin , Cicala Ecaterina , Lovin Dragos , Gheorghe Adrian , Ortan Florin , Manea Rosana
Published: February 2025

Background and aims: His bundle pacing (HBP) is considered the most physiological form of cardiac pacing. Although feasibility studies have included older patients, specific data for HBP in this population are scarce. This study aimed to evaluate gender differences in HBP long-term performance in elderly patients with atrioventricular (AV) block. Methods: This retrospective study included 73 patients aged over 65 years with successful HBP and at least 2 years of follow-up. The patients' baseline and follow-up clinical and procedural characteristics were recorded. Results: The mean age of the cohort was 72.8 ± 6.3 years, with 43 males and 30 females. The paced QRS complex was significantly narrower than the baseline value for both genders. Females had a narrower-paced QRS complex without differences in detection, type of His bundle capture, impedance, or fluoroscopy time. The pacing threshold increased progressively, reaching statistical significance compared to the baseline values at the two-year follow-up. The pacing threshold increased by more than 1 V over the follow-up period in twenty-four patients (32.9%) and by more than 2 V in six patients (8.2%), with no significant difference between genders. The pacing threshold increase occurred within the first year for most patients, without gender differences. Multivariate Cox regression analysis demonstrated that the paced QRS duration, left ventricular ejection fraction, and ischemic cardiomyopathy were significantly associated with the pacing threshold increase over time. Conclusion: In elderly patients with AV block, HBP remains a feasible pacing method, without significant gender differences, over a long-term follow-up period. Pacing threshold increases are expected in up to one-third of the patients, requiring regular follow-ups to adjust the programmed parameters and optimize battery longevity.
Predictors of Treatment Adherence in Kidney Transplant Patients: A Systematic Review of the Literature
Authors: Melilli Edoardo , Díaz María Isabel , Gomis-Pastor Mar , González Esther , Gutierrez-Dalmau Alex , Nuño Enriqueta Isabel , Pérez Ana María , Plasencia Inmaculada , Sangrador Ana , Lázaro Esther , Montero Nuria , Soria Cristina
Published: February 2025

Background: Kidney transplantation (KTx) is a safe procedure that improves the life expectancy and quality of life of patients requiring it. However, despite the known benefits for patients who receive a kidney transplant, non-adherence to immunosuppressive medication is an unsolved problem, reflected mainly by graft rejection. Objective: The aim of this study is to systematically review the existing literature on adherence factors to medication after renal transplantation. Methods: A systematic literature review of studies published since 2010 was conducted in three databases. Records for the search were limited to publications from 2010 to 2024, available in full-text. The search was carried out in July 2024. In total, 2632 abstracts were downloaded from the different databases. Inclusion criteria were papers of any type (quantitative or qualitative) whose objective was the identification of predictors of adherence for patients who were prescribed immunosuppressive medication after kidney transplantation. Results: The predictors of adherence to treatment found in the systematic review were grouped into the following categories of the World Health Organization classification: socio-economic factors, factors related to the treatment/therapy, patient-related factors, disease-related factors, and health care system factors. Most of the studies were excluded, and in the end, 30 were included in the final analysis. According to these studies, a set of strong predictors was identified, but discrepancies among the variables of gender in young patients, pre-emptive transplantation, and the time of the transplantation were detected. Conclusions: In this study, we identified specific predictors and directions for the association of those predictors with adherence to immunosuppressive medication for patients after KTx. Further research should consider conducting reviews for different patient sub-groups on medication adherence and the development and validation of a screening instrument for adherence/non-adherence factors that clinicians could use as a detection tool for subjects at risk of low adherence.
Cone Beam Computed Tomography Evaluation and Proposal of a Functional Radiographic Classification of the Coronoid Process—A Cross-Sectional Study
Authors: Nagpal Archna , Tadinada Aditya
Published: February 2025

Background: The objective of this study is to investigate the cone beam computed tomography (CBCT) features of the coronoid process in patients without limitations in mouth opening and to develop a functional classification of the coronoid process, considering its relationship with the zygomatic bone. Methods: This cross-sectional retrospective study analyzed the CBCT features of 408 coronoid processes. Volume rendered and axial images were evaluated to assess the shape, surface configuration, length of the coronoid process, the coronoid/condyle ratio, the distance of the coronoid process from the posteromedial surface of the zygoma, and its vertical level. The coronoid process was considered hyperplastic when the coronoid/condyle ratio was >1. Results: The maximum coronoid processes had a triangular shape (221). The mean length of the coronoid process was 13.85 mm. The mean coronoid/condyle ratio was 0.84. A total of 85 coronoid processes were hyperplastic. The mean distance from the coronoid process to the posteromedial surface of the zygoma was 15.99 mm, ranging from 5.8–27.9 mm. The mean vertical level of the coronoid process in the study sample was 9.6 mm. A novel functional radiographic classification was developed. The coronoid processes were classified as Type I, II, III (a,b,c), and IV (a,b,c). Type IIIa was the most common (45.83%), followed by Type II (29.68%), Type I (16.17%), Type IIIc (4.41%), Type IIIb (3.18%), Type IVa (0.49%), and Type IV b (0.24%). Conclusions: The vertical extension of the coronoid process beyond the lower border of the zygomatic bone/arch and its distance from the posterior surface of the body of the zygoma could play a significant role in impacting the mandibular movements.
Denosumab in the Management of Glucocorticoid-Induced Osteoporosis: Long-Term Efficacy and Secondary Fracture Outcomes
Authors: Liao Sian-Siang , Deng Ya-Lian , Hsu Chiann-Yi , Lee Hsu-Tung , Li Chi-Ruei , Yang Chi-Chan
Published: February 2025

Objectives: Osteoporosis is a common complication in patients undergoing long-term corticosteroid therapy, particularly those with rheumatological and immunological conditions. Denosumab has shown potential in enhancing bone density and reducing fracture risk in such patients. This study evaluates the effectiveness of denosumab in osteoporosis management among corticosteroid-treated individuals. Methods: Between 2013 and 2022, 390 osteoporosis patients who received denosumab (60 mg subcutaneously every 6 months) for ≤18 months were enrolled. Patients were categorized based on corticosteroid use, and age-matching was applied to ensure comparability. Bone mineral density (BMD) and trabecular bone score (TBS) at the lumbar spine and femoral neck were assessed, and secondary fractures during the follow-up period were recorded. Results: Over the 18-month follow-up, both groups showed improvements in lumbar spine T-scores. The corticosteroid group increased from −2.1 ± 1.2 to −2.0 ± 1.3 (p < 0.001), while the non-corticosteroid group improved from −2.6 ± 1.2 to −2.4 ± 1.2 (p = 0.003). However, logistic regression analysis revealed that corticosteroid use remained a significant risk factor for secondary fractures (odds ratio: 1.69; 95% confidence interval: 1.11–2.56, p = 0.014), despite denosumab treatment. Conclusions: This retrospective study observed stabilization and a modest increase in BMD and TBS among corticosteroid users. Although differences in secondary fractures persisted between groups, denosumab shows potential for managing corticosteroid-induced osteoporosis. The study’s focus on Taiwanese patients limits its generalizability, and future research should include diverse populations to enhance applicability.
Comment on Watson et al. Alliance for Sleep Clinical Practice Guideline on Switching or Deprescribing Hypnotic Medications for Insomnia. J. Clin. Med. 2023, 12, 2493
Authors: Moline Margaret , Cheng Jocelyn Y. , Yardley Jane , Pinner Kate
Published: February 2025

Health authorities and medical communities in many countries are discouraging the use of benzodiazepines and non-benzodiazepine hypnotics for patients with insomnia [...]
Prescribing Patterns for the Treatment of Bipolar Disorder in Pregnancy: A Retrospective Cohort Study
Authors: Kernizan Nalinoë J. , Yancey Abigail M. , Forinash Alicia B. , Chavan Niraj R. , Mathews Katherine J.
Published: February 2025

Background: Untreated bipolar disorder during pregnancy is associated with poor prenatal care, decreased fetal growth, and an increased risk for postnatal complications, including postpartum psychosis. Although mood stabilizers are first-line therapy, many patients and providers discontinue them in early pregnancy. Antidepressants as monotherapy can increase the risk of mania and rapid cycling, especially in patients with bipolar I, and are not recommended. Objective: This study aims to describe prescribing patterns for the pharmacologic management of bipolar disorder in pregnancy. Methods: This retrospective cohort study included pregnant patients, ≥14 years old, with a documented diagnosis of bipolar disorder and ≥two clinic visits after 1 January 2014, who delivered by 31 October 2017, within our health system. Eligible patients were identified by the ICD-9 and ICD-10 codes for bipolar disorder and their medication profiles. The primary outcome was to describe bipolar disorder treatment regimens at first visit, during pregnancy, and at delivery. Descriptive statistics were used. Results: Of the 214 pregnancies analyzed, 134 (62.6%) used psychiatric medications during pregnancy, with 79/134 (59%) being mood stabilizers. During the initial visit, 61/214 (28.5%) pregnancies were on psychiatric medications, including 30 (49.2%) on mood stabilizers and 16 (26.2%) on antidepressants alone. At delivery, 98/214 (45.8%) pregnancies were on psychiatric medications, with 48/98 (49%) on mood stabilizers and 35/98 (35.7%) on antidepressants without mood stabilizers. Other therapies included benzodiazepines, buspirone, and amphetamines, as monotherapy or combination. Conclusions: Despite having documented bipolar disorder, only 30/214 (14%), 79/214 (36.9%), and 48/214 (22.4%) pregnancies were treated with mood stabilizers at the first visit, during pregnancy, and at delivery, respectively. Unfortunately, justification for discontinuation was not documented. The most commonly prescribed mood stabilizer was lurasidone, followed by lamotrigine. Antidepressant monotherapy persisted throughout pregnancy, demonstrating inappropriate disease management.
Factors Influencing the Mortality of Patients with Subarachnoid Haemorrhage in the Intensive Care Unit: A Retrospective Cohort Study
Authors: Cetinkaya Onur , Arslan Ulku , Temel Hakan , Kavakli Ali Sait , Cakin Hakan , Cengiz Melike , Yilmaz Murat , Barcin Nur Ebru , Ikiz Fatih
Published: February 2025

Background: Spontaneous subarachnoid haemorrhage (SAH) represents a significant cerebrovascular disease with considerable morbidity and mortality. The aim of this study was to determine the demographic/clinical characteristics of spontaneous SAH patients admitted in the intensive care unit (ICU) and factors affecting the mortality. Methods: This study was designed as a retrospective cohort study that included patients with a diagnosis of spontaneous SAH hospitalized in the ICU. The clinical and radiological parameters were compared between mortality and survival cohorts. Univariate logistic regression analyses were performed for the effect profiles of the parameters on mortality. Results: ICU mortality was 41% in patients with spontaneous SAH. A number of factors have been identified as being independently associated with mortality in the studied cohort. These factors are hospital admission with loss of consciousness (Glasgow Coma Scale score <8), a high Clinical Comorbidity Index score, stage >2 according to the Hunt and Hess grading system and complication status (meningitis and sepsis/septic shock). Conclusions: Spontaneous SAH is a condition associated with a high mortality in severe cases. Patients exhibiting these risk factors require meticulous monitoring in the ICU.
Arthroscopic Deltoid Ligament Repair as a Potential Alternative Treatment for Ankle Deltoid Ligament Injury
Authors: Kim Sung Hwan , Lee Sang Heon , Cha Joo Young , Choi Seung Won , Lee Young Koo
Published: February 2025

Background: Arthroscopic deltoid ligament (DL) repair is a recently introduced technique, with few studies currently comparing the outcomes of open and arthroscopic deltoid repairs. This study compares the clinical and radiologic outcomes of patients who underwent either open or arthroscopic DL repair. Methods: Forty-one patients underwent surgical repair for a ruptured DL by a single surgeon at the study site hospital between 2013 and 2022. Clinical outcomes were assessed using the Foot and Ankle Outcome Score (FAOS), the American Orthopedic Foot and Ankle Society (AOFAS) Ankle–Hindfoot Scale, and a visual analog scale (VAS). Radiologic outcomes were evaluated through anterior talar translation and talar tilt tests, with stress radiography conducted at 6 months and 1 year post-surgery. Results: No significant differences in sex ratio, age, or direction of injury were observed between the groups. Additionally, there were no significant differences in clinical and radiologic outcomes between the groups. However, both clinical and radiologic outcomes showed significant improvement after surgery compared to preoperative conditions in both groups. Conclusions: Considering the benefits of arthroscopic surgery, arthroscopic deltoid repair can be regarded as a suitable option for treating DL injuries.
Radioiodine Therapy of Graves’ Disease in Women with Childbearing Potential and the Pre-Conceptional Counseling About Antithyroid Drugs
Authors: Dietlein Markus , Schmidt Matthias , Drzezga Alexander , Kobe Carsten
Published: February 2025

Graves’ disease and hyperthyroidism in women with childbearing potential are a challenge in pre-conceptional counseling. The non-surgical alternatives are radioiodine therapy or antithyroid drugs. Here, we focus on the TSH receptor antibody (TRAb) level—without or after radioiodine therapy—and the probability of fetal or neonatal hyperthyroidism. This immunological effect should be weighed against the risk of congenital malformation taking propylthiouracil during pregnancy. For up to 2 years after radioiodine therapy for Graves’ disease, TRAb levels may remain above the pre-therapeutic level. The time of conception after radioiodine therapy and a high TRAb level are associated with the likelihood of neonatal hyperthyroidism: 8.8% probability if conception occurred 6–12 months after radioiodine therapy, with a 5.5% probability for 12–18 months, and 3.6% probability for 18–24 months. The TRAb value above 10 U/L in the third trimester is the main risk factor for neonatal hyperthyroidism. If a woman does not wish to postpone her family planning, the pre-conceptional counseling has to describe the risk of propylthiouracil, thiamazole, or of an uncontrolled hyperthyroidism. According to some national cohort studies (Danish, Swedish, Korean), the risk for fetal malformations (ear, urinary tract) under propylthiouracil is increased by 1.1–1.6%, in addition to the spontaneous risk for unexposed pregnant women. For thiamazole, the additional risk for fetal malformation was about 2–3%, depending on the dose of thiamazole. Propylthiouracil has posed a lower risk for congenital malformation than an uncontrolled hyperthyroidism. To minimize the risk for the newborn, women with Graves’ disease and hyperthyroidism should offer a definitive therapy strategy (e.g., radioiodine therapy) long before planning a pregnancy.
The Effects of Calcined Waste Oyster Shells on Physicochemical Changes in Coastal Sediments
Authors: Jeong Ilwon , Hibino Tadashi , Yoon Seokjin , Kim Kyunghoi
Published: February 2025

Approximately 300,000 tons of waste oyster shells (OS) are generated annually in the Republic of Korea. Comprehensive research is required on the effects of OS on coastal environments for direct application of OS. This study aimed to investigate the physicochemical property changes in coastal sediments caused by the application of calcined OS. OS were pyrolyzed at 300 °C, 600 °C, and 800 °C, and mixed with coastal sediment at 10% (P31, P61, P81), 20% (P32, P62, P82), and 30% (P33, P63, P83). The mixed sediments’ calcium content varied depending on the calcination temperature and mixing ratio of the OS, leading to accompanying physicochemical changes. OS in P31–P33 without residual organic matter could be used as a sand replacement. The calcium produced calcium silicate hydrate, densifying and increasing the sediment’s shear strength by 1.4 times (P63) and 2.8 times (P81) compared to the control. The release of hydroxide ions from calcined OS alleviated acidification in P61–P63. Although P81–P83 had a high pH, they exhibited the highest PO4-P fixation ability. OS calcined at different temperatures showed potential as a material for sand replacement, acidification mitigation, and strength improvement in coastal sediments. Therefore, the appropriate calcination temperature on OS can potentially improve the coastal sediment environment.
Simulation of 3D Summer Circulation in the Red Sea
Authors: Madah Fawaz , Alsaafani Mohammed
Published: February 2025

A high-resolution numerical model called Delft3D (5 km resolution) forced with realistic high-frequency atmospheric conditions was set up to describe the circulation pattern in the Red Sea basin. The validation of the model was performed considering several tide gauge data, the SST of AVHRR/Pathfinder, and the available literature. The model outcomes show that the general circulation pattern in the Red Sea is dominated by energetic anticyclonic eddies consistent with observations in terms of both size and magnitude. We conducted two scenarios of numerical experiments considering thermohaline and wind forcing to investigate the main driving mechanism of the circulation patterns. When simulated using full forcing (wind and thermohaline), the wind forcing experiment mostly reproduces the circulation patterns. On the other hand, thermohaline forcing generates weaker circulation patterns with cyclonic eddy dominance. The model effectively replicates the reversal of the three-layer exchange flow system at the Bab el Mandeb Strait, which is enhanced by both wind and thermohaline forcing. The simulation indicates that subsurface inflow deflects along the eastern coastline of the southern part of the Red Sea.
Research on a Fully Parameterized Geometric Modeling Method for an Air Cavity Planing Hull
Authors: Chen Junjie , Ou Yongpeng , Xiang Guo , Wang Wei , Wu Hao
Published: February 2025

An air-lubricated planing hull with integrated air channels presents a transformative approach for enhancing marine vessel performance by significantly reducing hydrodynamic resistance. Within the framework of air-layer drag reduction research, the precise definition and optimization of geometric design parameters are critical, as they directly influence the formation and stability of the air layer and the hydrodynamic characteristics of the hull. Applying a fully parameterized modeling approach to the air-lubricated planing hull is highly relevant and pivotal for advancing systematic, performance-driven hull design and optimization in modern naval architecture. This study proposes a fully parameterized modeling method specifically designed for such crafts. The method utilizes B-spline curves to represent the planar projections of the primary hull contours and the sectional lines of key hull surfaces. The hull surfaces are fitted using non-uniform rational B-Spline (NURBS) surfaces, and the design parameters are smoothed according to the principle of minimum strain energy, leading to fair and smooth hull surfaces. A dedicated program is developed based on this method. It facilitates the rapid generation of smooth hull forms for an air-lubricated planing hull solely from design parameters without depending on parent hull forms. This approach provides geometric hull samples for optimizing the hydrodynamic performance of the air-lubricated planing hull.
Prescribed-Time Formation Tracking Control for Underactuated USVs with Prescribed Performance
Authors: Sui Bowen , Zhang Jianqiang , Liu Zhong
Published: February 2025

Abstract: This article proposes a prescribed-time formation tracking control scheme for USVs with prescribed performance constraints to address the issue of multiple underactuated USV formation tracking control with external environmental disturbances and input saturation [...]
Insights into the Interaction Between Clostridioides difficile and the Gut Microbiome
Authors: Mougiou Dimitra , Gioula Georgia , Skoura Lemonia , Anastassopoulou Cleo , Kachrimanidou Melania
Published: February 2025

Clostridioides difficile (C. difficile) is a significant healthcare-associated pathogen that is predominantly caused by antibiotic-induced microbiota disturbance. Antibiotics decrease microbial diversity, resulting in C. difficile colonization and infection. Clostridium difficile infection (CDI) manifests through toxins A and B, causing diarrhea and colitis. Antibiotic usage, old age, and hospitalization are significant risk factors. A healthy gut microbiota, which is dominated by Firmicutes and Bacteroidetes, provides colonization resistance to C. difficile due to competition for nutrients, creating inhibitory substances and stimulating the immune response. Antibiotic-induced dysbiosis decreases resistance, allowing C. difficile spores to transform into vegetative forms. Patients with CDI have decreased gut microbiota diversity, with a decrease in beneficial bacteria, including Bacteroidetes, Prevotella, and Bifidobacterium, and a rise in harmful bacteria like Clostridioides and Lactobacillus. This disparity worsens the infection’s symptoms and complicates therapy. Fecal Microbiota Transplantation (FMT) has emerged as a potential therapy for recurrent CDI by restoring gut microbiota diversity and function. Comprehending the connection between gut microbiota and CDI pathogenesis is critical for establishing effective preventive and treatment plans. Maintaining a healthy gut microbiota through careful antibiotic use and therapeutic options such as FMT can help in the management and prevention of CDI.
Investigating the Relationship Between ESG Performance and Financial Performance During the COVID-19 Pandemic: Evidence from the Hotel Industry
Authors: Kaminskyi Andrii , Osetskyi Valerii , Almeida Nuno , Nehrey Maryna
Published: February 2025

The global economy was profoundly impacted by the emergence of the COVID-19 pandemic, with the hotel industry being among the sectors most severely affected. This study explores the relationship between environmental, social, and governance (ESG) performance and financial performance during the pandemic, focusing on 35 of the world’s largest hotel companies. A structured methodology was employed to assess short-term financial resilience using the shock depth (SD) and recovery rate (RR) indicators and long-term performance through the value-added weekly index (VAWI) and K-ratio. The findings of this study indicated that faster recovery was associated with greater capitalization. Furthermore, analysis of ESG scores indicated a median increase from 2019 to 2022, particularly in the figures of the environmental component. Despite these increases, pre-pandemic ESG scores demonstrated limited influence on short-term financial performance, though a correlation was observed between governance scores (as ESG score subscores) and long-term K-ratios. This finding suggests potential trade-offs between improving financial performance and maintaining governance standards in the sense of ESG scores. This study points to the intricate interplay between ESG and financial metrics during systemic crises, providing valuable insights for risk management and strategic planning in the hospitality business. The implications of these findings extend to the enhancement of resilience and the alignment of ESG strategies with financial sustainability.