bluuebunny/crossref_metadata_2025 huggingface dataset:
Taxonomic review of the genus Peltogyne Vogel (Leguminosae, Detarioideae)
Authors: KOCHANOVSKI FABIO J. , NOGUEIRA LUAN H.P. , ROSA MARCUS P.G. , MANSANO VIDAL F. , SARTORI ÂNGELA L.B.
Published: February 2025

We present the taxonomic revision of the genus Peltogyne with an identification key, descriptions, illustrations, and taxonomic comments for each species. Specimens from 22 herbaria, including scanned images, were evaluated, and collections and field observations were carried out. The species can be distinguished by the type of indumentum and shape of the leaflets and the indumentum of the ovary. Peltogyne has 25 species, including the recently described P. barbata. Lectotypifications were performed for P. altissima, P. confertiflora, and P. densiflora. Peltogyne prancei and P. crenulata were synonymized with Peltogyne heterophylla and Peltogyne pauciflora, respectively, and P. densiflora is being raised to the species rank. Peltogyne occurs from Mexico to Southeast Brazil. The species are widely distributed, mainly in the Atlantic Forest, Amazon Forest, and Caatinga. The following species have a restricted distribution: P. barbata is restricted to the Amazon region; P. discolor to the Atlantic Forest; P. gracilipes to Maracá Island and surroundings, Roraima; and P. maranhensis to the Caatinga. Updated geographic distribution data were essential for a better circumscription of the species and made it possible to understand their areas of occurrence.
Independent Living Skills and College and Career Readiness
Authors: Taconet Ashley V. , Rifenbark Graham G. , Lombardi Allison R. , Mazzotti Valerie L. , Morningstar Mary E.
Published: February 2025

The purpose of this study was to examine responses from high school students with ( n = 356) and without ( n = 1,599) an individualized education program (IEP) on 11 independent living skills (ILS) items taken from a broader college and career readiness assessment. Results indicated significant differences in ILS proficiency based on IEP status. Specifically, students with IEPs self-rated lower across all items. Students with and without IEPs self-rated the most similarly on community participation and differed the most on technology use. There were also notable differences based on school demographics. Limitations, implications for practice and policy, and research are discussed with regard to critical ILS that should be prioritized for all students, including those who receive special education transition services.
The Pennsylvania English Final Rise-Fall: Intonation, Pragmatics, and Regional Variation
Authors: Blanchette Frances , De La Rosa Yacomelo Johan Alberto , Eads Amanda , Lai Li-Fang , Harman Amanda , Hunt Leah
Published: February 2025

In contrast to the common final rising pattern of Mainstream English yes/no questions, these questions may be produced with a final rising then falling intonation in parts of Central and Western Pennsylvania (PA). Researchers have suggested that this pattern is pragmatically conditioned, used either when a particular response is expected, or when the speaker wishes to communicate the answer is not-at-issue. While previous work on this regional final rise-fall pattern has been limited to observations of spontaneous speech, this paper presents the results of a pair of production and perception experiments aimed at obtaining a more detailed characterization of its acoustic correlates and testing hypotheses regarding its pragmatic conditioning. The results replicate and extend previous findings, illustrating highly variable fluctuations in fundamental frequency across yes/no question tokens that share a final rise-fall pattern, and a tendency toward using this pattern to imply that the speaker already has some idea of what the answer to the question will be. Comparison of the perceptions of speakers from Central PA with speakers from outside the Midland Dialect region suggests that pragmatic knowledge of this intonational variant may be region-specific. The results are discussed in the context of recent work in which intonation is shown to be a marker of social group or region, providing an example where regional intonational variation appears to be shaped at least in part by pragmatic meaning.
Effects of Incorporating a Large Language Model-Based Adaptive Mechanism Into Contextual Games on Students’ Academic Performance, Flow Experience, Cognitive Load and Behavioral Patterns
Authors: Wang Minkai , Zhang Di , Zhu Jingdong , Gu Hanjie
Published: February 2025

Scientific knowledge is often abstract and challenging, making it difficult for students to apply these concepts effectively. Digital game-based learning (DGBL) offers an engaging and immersive approach, but the fixed resources and predetermined learning paths in most games limit its ability to adapt to individual learners’ needs. Large language models, as advanced conversational agents, are capable of personalized interaction by adapting to users' language styles, interests, and preferences. This study explores a large language model-based adaptive contextual game (LLM-ACG) approach aimed at transforming scientific education into engaging, interactive, and supportive learning environments. Additionally, this research examines the impacts of the LLM-ACG approach on academic performance, flow experiences, cognitive load, and behavioral patterns among students. A quasi-experimental design was employed to compare the differences in academic achievements and flow experiences between the LLM-ACG approach and the conventional contextual game (C-CG) approach among fifth-grade students. Furthermore, an in-depth analysis of student behavioral patterns during gameplay was conducted through lagged sequence analysis. The findings indicate that the LLM-ACG approach demonstrates a clear advantage over C-CG in terms of enhancing students' academic achievements and flow experiences. It effectively reduces cognitive load and significantly promotes positive learning behaviors and sustained motivation among students.
Microsaccades during video head impulse test in normal subjects
Authors: Xu Mingwei , Zhang Qin , Yao Yuan , Wu Qiong , Yang Jun , Jin Yulian , Zhang Qing
Published: February 2025

Objective

This study aimed to quantitatively analyze the characteristics of saccades in normal subjects during video head impulse test (vHIT), to establish a reference for clinical practice.

Methods

A cohort of 20 healthy individuals (40 ears) was recruited and compared with a matched group of 20 patients (20 ears) suffering from vestibular neuritis (VN), utilizing vHIT to evaluate the functionality of all three semicircular canals (SCCs). This study analyzed the quantitative characteristics of saccades observed in healthy individuals and patients with VN.

Results

Significant differences were observed between both groups in terms of lateral saccade frequency, latency, peak velocity, and duration for both the first and second saccades (all p < 0.05, with age as a covariate). Similarly, significant differences were found in vertical SCCs between groups for the frequency, latency, peak velocity, and duration of the first saccade (all p < 0.05, with age as a covariate). However, no significant differences were found in Perez-Rey (PR) scores either in lateral ( p = 0.259) or vertical ( p = 0.102) SCCs. Within the healthy group, significant differences were observed in the frequency, peak velocity, and duration of the first saccade in lateral and vertical SCCs (all p < 0.05). However, the latency ( p = 0.827) and PR scores ( p = 0.552) exhibited no significant variation.

Conclusions

Microsaccades characterized by prolonged latency and reduced amplitude can occur in healthy individuals during vHIT and are distinct from the saccades seen in patients with VN due to vestibular impairment. This highlights the need to carefully identify and interpret relevant saccades during clinical assessments.
Acute unilateral vestibulopathy and corticosteroid treatment - A randomized placebo-controlled double-blind trial
Authors: Sjögren Julia , Fransson Per-Anders , Magnusson Måns , Karlberg Mikael , Tjernström Fredrik
Published: February 2025

Background

The efficacy of corticosteroids for treating acute vestibular neuritis, or acute unilateral vestibulopathy (AUVP), remains controversial.

Objective

This study aimed to evaluate whether corticosteroids improve vestibular function and reduce symptoms in both acute and chronic phases of AUVP.

Methods

This randomized, placebo-controlled, double-blind trial included patients with AUVP (ages 18–80) from emergency departments at three sites in southern Sweden. Patients were randomly assigned to one of three groups: placebo, 3-day or 10-day corticosteroid treatment. The steroid groups received intravenous betamethasone followed by oral steroids, while the placebo group received intravenous saline followed by oral placebo. The primary outcome was canal paresis (%) after 12 months, measured via caloric testing. Secondary outcomes included vHIT gain, Diary Vertigo score, Dizziness Handicap Inventory, and Hospital Anxiety and Depression Scale. Analyses were conducted on an intention-to-treat basis. The trial was registered with the EU Clinical Trials Register (EudraCT Number: 2014-005484-32) and ClinicalTrials.gov (NCT00802529).

Results

From December 2015 to March 2021, 350 patients were screened, and 69 were included: 23 in the 10-day corticosteroid group, 22 in the 3-day corticosteroid group, and 24 in the placebo group. All groups showed significant improvement in caloric function over time ( p = .002), with no significant differences between groups at any time point ( p = .629). Change in caloric asymmetry from baseline to 12 months did not differ between the treatment groups and the placebo group: mean difference −8.34 (95% CI –25.93 to 9.26; p = .347) in the 10-day steroid group and −6.61 (−24.67 to 11.45; p = .467) in the 3-day steroid group, compared with placebo. Secondary outcomes showed no significant differences between groups. Corticosteroid treatments were well tolerated with no safety concerns.

Conclusions

Corticosteroid treatment does not significantly improve caloric recovery, vHIT gain recovery, or subjective well-being in patients with AUVP.
Detection of bovine respiratory disease complex–related pathogens in nasopharynx-associated lymphoid tissue
Authors: Hegazy Asmaa A. , Nakai Mutsumi , Fuke Naoyuki , Hussein Amaal E. , Kondo Hiroaki , Hirai Takuya
Published: February 2025

Bovine respiratory disease complex (BRDC) is a multi-etiologic disease that significantly impacts the cattle industry. Nasopharynx-associated lymphoid tissue (NALT) is the nasal mucosal immune system that protects against various pathogens; however, reports on its pathology are limited. We compared the pathologic impact of BRDC-related viruses on the NALT and lungs of 10 pneumonic and 3 negative control Japanese black (JB) calves. Three bovine viral diarrhea virus (BVDV) persistently infected Holstein calves were examined as positive control; all 3 calves had BVDV in situ hybridization (ISH)-positive signals in NALT follicular macrophages and lymphocytes, suggesting viral replication in these cells. NALT and lungs of pneumonic JB calves had weak-positive BVDV results in PCR and negative results in ISH, indicating late-stage transient BVDV infection. The finding of BVDV in unvaccinated pneumonic JB calves confirmed the involvement of a BVDV field strain. PCR detection of bovine coronavirus (BCoV) and bovine respiratory syncytial virus (BRSV) in NALT along with ISH BCoV-positive signals in NALT epithelial cells confirms infection by those viruses. Pneumonic JB calves had nasopharyngitis and pneumonia, with the same bacteria present in nasopharyngeal swabs and lungs, indicating that, in these animals, the bacteria proliferating in the nasopharynx probably migrated to the lungs via inhalation. BVDV transient infection in the NALT may induce local immunosuppression; BCoV and BRSV infections are thought to damage epithelial cells, facilitating bacterial infection of the NALT and lungs. Our results confirm that bovine NALT is a location for viral replication and may be associated with BRDC development in cattle.
Incidence of optic neuritis among Afro-descendant, a cohort study
Authors: Bobelna Benoit , Lobjois Quentin , Croitoru Stefana , Jalkh Edmond , Ventura Eric , Merle Harold
Published: February 2025

Background:

Optic neuritis (ON) is a multifactorial condition with a strong association with ethnicity.

Objectives:

We conducted a retrospective cohort study in a Caribbean Island, Martinique, French West Indies to assess the incidence and characteristics of ON among an Afro-descendant (AD) population.

Methods:

We reviewed medical records of all patients presenting ON at the Fort de France University Hospital, Martinique between 2018 and 2022. We analysed clinical, paraclinical, and biological examinations at onset and during follow-up (6 months, 1, 2 and 3 years). ON was confirmed after a neuro-ophthalmological evaluation according to the latest criteria defined in the Lancet, 2022.

Results:

Overall, 44 patients with a condition suggestive of ON were evaluated, out of which 29 fulfilled the criteria for ON. The overall incidence was 1.61 (95% CI: 1.12–2.08) per 100,000 person-years. The final diagnosis was distributed as follows: neuromyelitis optica spectrum disorder (NMOSD) (10%), myelin oligodendrocyte glycoprotein (MOG) ON (20%), multiple sclerosis (35%), single isolated ON (24%), relapsing isolated ON (7%) and (4%) unclassified diagnosis.

Conclusion:

This is the first cohort study assessing the incidence of ON and its characteristics among AD. We found a high proportion of severe disease, such as NMOSD and MOG-associated disease.
Inhibitors of soluble epoxide hydrolase and cGAS/STING repair defects in amyloid-β clearance underlying vascular complications of Alzheimer's disease
Authors: Fiala Milan , Hammock Bruce D , Hwang Sung Hee , Whitelegge Julian , Paul Ketema , Kaczor-Urbanowicz Karolina Elżbieta , Urbanowicz Andrzej , Kesari Santosh
Published: February 2025

Background

Alzheimer's disease (AD) and its monoclonal antibody therapies are associated with brain vasculitis and amyloid-related imaging abnormalities. The naturally-formed epoxides (EpFAs) of polyunsaturated fatty acids (PUFAs), such as 11,12-epoxyeicosatetraenoic acid (EEQ), are anti-inflammatory and pro-resolution mediators, which are increased by dietary supplementation with ω-3 PUFAs. EpFAs are, however, enzymatically hydrolyzed by soluble epoxide hydrolase (sEH) in AD patients' macrophages in vivo and in vitro .

Objective

To repair amyloid-β 1-42 (Aβ) degradation by AD macrophages using the inhibitors of a) soluble epoxide hydrolase (sEHIs), termed TPPU and EC5026, together with EpFAs, or b) STING pathway termed H-151.

Methods

Immunobiology, immunochemistry, RNA sequencing, and confocal microscopy were used.

Results

In AD brain (examined postmortem), monocyte/macrophages upload Aβ in plaques and transfer it without degradation into brain microvessels, suffer apoptotis, and release Aβ, inducing vasculitis. The EpFAs of epoxyeicosatetraenoic acid (EEQ), along with the inhibitors TPPU and H-151, decrease inflammatory cytokines and regulate macrophage unfolded protein response to endoplasmic reticulum stress. Treatment of AD macrophages by TPPU with EEQ or by STING inhibitor H-151 increased uploading of Aβ after 2 hours and increased degradation of Aβ after 24 hours.

Conclusions

The sEHI inhibitor EC5026 and the STING inhibitor H-151 increased macrophage uptake and degradation of Aβ. EC5026 administration was safe in normal volunteers. EC5026 together with ω-3 PUFA supplementation are indicated for in a clinical trial in patients with mild cognitive impairment.
Characterizing the thermal protective performance of textiles under flame exposure
Authors: Chowdhury Ishmam Zahin , Mandal Sumit , Agnew Robert J , Tushar Shariful Islam , Petrova Adriana , DenHartog Emiel , Boorady Lynn M
Published: February 2025

Annually, thousands of firefighters suffer injuries, with burn injuries making up 7%–8% of these cases. Despite wearing protective clothing, burn injuries still occur, which underscores its limitations. The effectiveness of protective clothing is heavily influenced by the unpredictable and variable conditions firefighters face during hazardous incidents. This study compared the effects of heat flux, air gaps, and fabric attributes on TPP in multilayer systems. Results revealed a negative correlation between heat flux and TPP, with higher flux intensities increasing energy transfer through conduction and radiation, diminishing protection. Flame exposure highlighted differences in heat transfer mechanisms, with conduction and radiation dominating at high flux, whereas at low heat flux, convection, even though minimal, significantly impacts TPP. Air gaps improved TPP up to 6-mm, providing maximum insulation. However, performance plateaued or declined at 12-mm due to the transition of a stagnant air gap into a convective medium. Under prolonged, low-flux exposure, the protective benefits of 6-mm gaps diminished, revealing possible interactions between air gap size and exposure conditions. This challenges the established thresholds for air gap effectiveness for different exposure conditions. Fabric attributes further influenced TPP, with air permeability showing a positive correlation in multilayer systems due to entrapped air-enhancing insulation, which contrasts traditional findings for single-layer fabrics. Additionally, fabric weight demonstrated dual effects, improving TPP in short, high-flux exposures but reducing it under low-flux, prolonged conditions due to stored heat and thermal diffusivity. These findings underscore the interplay between the study parameters, offering critical insights into the evaluation and design of thermal protective clothing.
The High Costs of Veterans Affairs Privatization
Authors: Lopoo Evie
Published: February 2025

M. Evangeline "Evie" Lopoo on the threat of austerity at the VA.
Design of power information communication equipment status monitoring system based on IOT technology
Authors: Xie Weidong , Li Mingyang , Zhang Mingdong , Mao Yuanyuan
Published: February 2025

Power information communication equipment plays a crucial role in the power system, but there are still challenges in equipment status monitoring and fault prediction. This article aimed to design a power information communication equipment status monitoring system based on Internet of Things (IoT) technology to achieve real-time monitoring, fault prediction, and remote management of equipment status. The article analyzed the reliability of ring, single-star, and double-star topology structures, as well as the changes in bandwidth (Mb/s) and latency (ms) with access points. Finally, the article compared the time cost test results of traditional method 1 with traditional method 2 and the optimization design method of communication information monitoring systems based on IoT technology. In the reliability analysis of ring, single-star, and double-star topologies, ring topology has obvious advantages in distributed processing and is suitable for access layer networking. Based on the calculated bandwidth (Mb/s) and the calculated latency (ms), the variation is as follows. The total bandwidth is calculated to be 26 and 16.5, respectively, while the average latency was 12 and 276, respectively. With the continuous increase in data volume, the time cost of communication information monitoring gradually rises across different methods. However, implementing the optimization design method proposed in this article for the communication information monitoring system based on IoT results in higher reliability, more accurate and reliable output results, and better real-time information monitoring.
Controlled growth of citrate-stabilized gold nanoparticles using a semi-continuous seed-mediated route
Authors: Bilal Muhammad , Bandyopadhyay Sulalit
Published: February 2025

Gold nanoparticles (Au NPs) hold unique optical and electronic properties due to their surface plasmon resonance. The size, shape, and surface chemistry of Au NPs are key parameters for altering their optical properties to fine-tune Au NPs for specific applications. We report a size-controlled synthesis of citrate-stabilized Au NPs via the Turkevich method, followed by their growth through a semi-continuous seed-mediated approach. Au NPs of up to 53 nm were synthesized by controlled addition of chloroauric acid (HAuCl₄) to pre-prepared citrate stabilized Au NP seeds. Our approach leverages the residual sodium citrate from the Turkevich reaction to reduce HAuCl₄ during seed-mediated growth of Au NPs. Notably, we observed that a boiling temperature, as opposed to 70 °C, provided better control over nanoparticle size and morphology. Our method addresses several challenges associated with seed-mediated growth by yielding relatively spherical, monodisperse, citrate-stabilized, water-dispersible Au NPs in a single growth step, without sacrificing yield. Furthermore, a kinetics study revealed a continuous increase in particle diameter over the reaction period, hinting at the continuous and uniform growth of Au NPs.
Impact of glucose and propionic acid on even and odd chain fatty acid profiles of oleaginous yeasts
Authors: Bonzanini Veronica , Haddad Momeni Majid , Olofsson Kim , Olsson Lisbeth , Geijer Cecilia
Published: February 2025

Background

Odd chain fatty acids (OCFAs) are gaining attention for their valuable medical and nutritional applications. Microbial fermentation offers a sustainable and environmentally friendly alternative for OCFA production compared to traditional extraction or chemical synthesis methods. To achieve an economically feasible OCFA production process, it is essential to identify and develop microbial cell factories capable of producing OCFAs with high titers and yields.

Results

We selected 19 yeast species, including both oleaginous yeasts and representatives from the Ascomycota and Basidiomycota phyla, based on their known or potential ability to produce OCFAs. These species were screened under various growth conditions to evaluate their OCFA production potential. In glucose-based, nitrogen-limited media, the strains produced fatty acids to varying extents, with OCFAs comprising 0.5–5% of the total fatty acids. When using the OCFAs precursor propionic acid as the sole carbon source, only eight strains exhibited growth, with tolerance to propionic acid concentrations between 5 and 29 g/L. The strains also displayed varying efficiencies in converting propionic acid into fatty acids, yielding between 0.16 and 1.22 g/L of fatty acids, with OCFAs constituting 37–89% of total fatty acids. Among the top performing strains, Cutaneotrichosporon oleaginosus produced the highest OCFA titers and yields (0.94 g/L, 0.07 g/g), Yarrowia lipolytica demonstrated superior growth rates even at elevated propionic acid concentrations, and Rhodotorula toruloides achieved the highest proportion of OCFAs relative to total fatty acids (89%).

Conclusions

Our findings highlight the diverse capacities of the selected yeast species for OCFA production, identifying several promising strains for further optimization as microbial cell factories in sustainable OCFA production processes.

Graphical Abstract
Unveiling the impact: understanding long-term care workers’ experiences and their perceptions of resident challenges amidst the COVID-19 pandemic
Authors: Halperin Donna M. , Whitfield Krista , Bettinger Julie A. , Orhierhor Marian , Salter Katherine L. , Selig Bailey M. , Mack Anna , Condran Brian R. , Davis Alexa , Salyzyn Camryn , Parsons Janet A. , Kervin Melissa , Halperin Scott A.
Published: February 2025

Background

During the COVID-19 pandemic, long-term care (LTC) facilities in Canada were confronted with many rapidly changing public health safety guidelines. Based on the guidelines, LTC facilities had to implement a series of virus containment and mitigation measures, presenting significant challenges for both workers and residents. This research aims to provide insights that could be used to guide improvements in the experiences of LTC workers, and of residents, in future pandemic crises.

Methods

A qualitative multi-case study was used to explore the pandemic experiences of a demographically diverse group of LTC workers in Canada, focusing on how public health safety guidelines impacted them, and their perceptions of challenges faced by residents. Fourteen workers were engaged from facilities in Nova Scotia and British Columbia, which are regions distinct geographically and with differences in safety guidelines and implementation. Semi-structured interviews were conducted between April to October 2021. Using thematic analysis, we identified patterns within and across the interview transcripts.

Results

The thematic analysis provided an understanding of the experiences and perspectives of LTC workers. There were four key themes: (1) Tangling with Uncertainty, that describes the effects of ambiguous messaging and shifting COVID-19 safety guidance on workers; (2) Finding Voice, that highlights how workers coped with feelings of helplessness during the healthcare crisis; (3) Ripple Effects, of pandemic pressures on workers beyond resident care, that included strengthening of inter-colleague support as well as financial challenges, and; (4) Loss of Home, where workers perceived that protection of residents led to a loss of the residents’ home environment, personal freedom, and autonomy.

Conclusions

The findings suggest that LTC workers’ experiences during future pandemics may be improved by their inclusion in the development of public health safety guidelines, facilitating inter-colleague support systems, and ensuring worker financial stability. A balance should be found between preventing infection in LTC facilities and retaining the principles of holistic and resident-centered care for workers’ and residents’ mental health benefits.
Association between triglyceride glucose-body mass index and gestational diabetes mellitus: a prospective cohort study
Authors: Liang Xiaomin , Lai Kai , Li Xiaohong , Ren Di , Gui Shuiqing , Li Ying , Xing Zemao
Published: February 2025

Background

Limited research has examined the potential association between triglyceride glucose-body mass index (TyG-BMI) and gestational diabetes mellitus (GDM). The objective of this investigation was to analyze this linkage and evaluate TyG-BMI’s capability to predict GDM.

Methods

This research employed secondary data derived from a prospective cohort in South Korea, which included 588 pregnant women with singleton gestations, collected between November 2014 and July 2016. To investigate the connection between TyG-BMI and GDM, logistic regression and sensitivity analyses were performed. Furthermore, an analysis of receiver operating characteristics (ROC) was conducted to assess the prognostic accuracy of TyG-BMI in relation to GDM.

Results

The cohort exhibited a mean age of 32.07 ± 3.80 years, with 36 individuals (6.12%) manifesting GDM during the interval of 24 to 28 weeks of gestation. Following the adjustment for possible confounding variables, an increased TyG-BMI was associated with an elevated risk of GDM, as indicated by an odds ratio (OR) of 1.02 (95% CI: 1.01–1.04). Additionally, the area under the curve (AUC) for TyG-BMI’s predictive performance was recorded at 0.7979 (0.7143–0.8814), with an optimal threshold established at 211.03, which resulted in a specificity of 86.23% and a sensitivity of 66.67%.

Conclusions

In this South Korean cohort, increased TyG-BMI during early pregnancy (10–14 weeks) was significantly associated with the onset of GDM (during pregnancy 24–28 weeks). TyG-BMI could be integrated into clinical practice as a complementary preliminary screening tool for detecting women who are at increased risk of GDM.
Using student-staff partnership to teach early years medical students about quality improvement: an evaluation
Authors: Goldwater Breheny Cate , O’Connell Eve , Edwards Lisa-Jayne , Ryan Noreen
Published: February 2025

Background

Quality Improvement (QI) skills are recognized as a key outcome for medical students but are still rarely taught at the undergraduate level. Whilst there is evidence that preclinical students enjoy learning about QI, there is limited practical work exploring the best way to teach QI to this cohort. There are gaps in the literature around the evaluation of student-staff partnership approaches in the context of teaching QI, especially in line with the sustainable QI (susQI) framework. Our study evaluates a worksheet-based interactive session developed through student-staff partnership. The session was delivered to year one medical students in January 2024 at Imperial College School of Medicine (ICSM).

Methods

An inductive approach to thematic analysis was used to review worksheet content submitted by students during the teaching session. This method was employed to determine the session’s effectiveness and ascertain common themes of interest and application. 16 groups comprising 69 total students submitted worksheets for analysis.

Results

Three themes were identified: Making QI personal: learners chose to focus on improving their university experience over clinical projects, which affected how they identified stakeholders and designed their QI interventions; Misinterpretation of technical language: learners used their everyday understanding of QI terminology in the worksheets, evidencing some misconceptions; Understanding QI as a process: learners reported understanding and engaging with QI as a process and set of skills. Overall, students demonstrated both their understanding and application of QI methodology through engagement with the worksheet-based tasks.

Conclusions

Student-staff partnership is a feasible tool to develop and deliver an engaging and effective teaching session on QI, in line with susQI principles, for students with limited clinical experience. Further evaluation and use of partnership approaches in developing QI teaching and curricula are welcome and will likely deliver positive outcomes for learners.
Do we have a lost generation of junior doctors: Effects of the COVID-19 pandemic on junior doctors’ resilience status, medical knowledge and medical skills
Authors: Kolb Nicola Katharina , Keil Stephanie , Huber Johanna
Published: February 2025

Background

At the onset of the COVID-19 pandemic, strict measures suspended face-to-face teaching at German universities, posing significant challenges for medical education. Practical, patient-centered training couldn’t be fully replaced by online formats, leading to skill deficits and increased stress among students. To date, no study has examined the impact of COVID-19 on the resilience and the competence of medical graduates so far. This study aims to address this knowledge gap by investigating the pandemic impact on resilience, medical competence, communication skills, and research competence of medical graduates.

Methods

The study employed data from the “Bavarian Graduate Study of Medicine” (MediBAS), a cross-sectional evaluation survey conducted in cooperation with Bavarian universities and the Bavarian Institute for higher education research and planning. It targeted medical, dental, and veterinary graduates. The data were collected in two waves (2018/19 and 2022/23), with 1.114 human medicine graduates participating. The questionnaire assessed among others resilience, medical expertise, communication skills, and research competence. Statistical analysis involved descriptive statistics, correlation analysis, and Mann-Whitney-U tests due to non-normal data distribution.

Results

The study analyzed self-assessed resilience, medical expertise, communication, and research skills of medical graduates from two waves. The findings demonstrated through descriptive statistics a decline in all competencies except research skills, which exhibited an increase. Correlation analysis revealed significant relationships between variables. Mann-Whitney-U tests revealed no significant differences between the waves in resilience (p =.079, r =.06), medical expertise (p =.117, r =.05), communication skills (p =.053, r =.07), or research competence (p =.106, r =.05).

Conclusion

The study examined the impact of COVID-19 on medical graduates’ resilience, medical expertise, communication skills, and research competence. While there was a slight decline in resilience, medical expertise, and communication skills between the waves, there was an improvement in research competence. None of these changes were statistically significant. The findings suggest that the pandemic may have contributed to these trends by limiting practical experiences. No major negative impacts were found, suggesting no “lost generation” of doctors. The long-term effects of the changes remain uncertain due to the cross-sectional design and require further research.
An analysis of telehealth in a post-pandemic rural, Midwestern community: increased comfort and a preference for primary care
Authors: Salmon Chase , Bell Kameron , Reyes Eric , Ireland Ellen , Danek Robin
Published: February 2025

Background

The COVID-19 pandemic accelerated the adoption of telemedicine, integrating it into mainstream healthcare, especially in underserved and rural areas. This study examines the implementation and perceptions of telehealth in a rural Midwestern community in the post-pandemic period. Rural populations often face unique healthcare challenges. Telehealth has the potential to mitigate these issues by improving healthcare accessibility and patient satisfaction, thus being a vital topic for research.

Methods

A survey was created and conducted from September to October 2023 to evaluate Internet access, telehealth usage, and perceptions among residents of a rural Midwestern county. The county received fiberoptic Internet in November 2021, offering a valuable glimpse at the impact of advanced internet. The survey, distributed both online and in person, garnered 253 valid responses. Statistical analyses, including chi-square tests, were performed using IBM SPSS to explore the relationships between survey responses.

Results

Among the 253 participants, the majority were female (81.4%) with a median age of 50 years. Internet access varied, with 22% of paper survey respondents lacking home Internet compared to 1.3% of online respondents. Telehealth usage for participants increased from 5% pre-pandemic to 42.1% during the pandemic, with 21.8% continuing to use telehealth post-pandemic. Primary care visits were the most common telehealth appointments. Key concerns included a preference for in-person care and perceived lower quality of telehealth services. Despite these concerns, 59.7% of respondents were willing to use telehealth, rising to 67.5% if recommended by a healthcare provider. Comfort with telehealth was significantly linked to perceptions of Internet speed and stability.

Conclusions

While broadband and fiberoptic Internet are associated with better telehealth experiences, other types of Internet also facilitated telehealth usage in our study, indicating that factors beyond access influence patient comfort and willingness to use telehealth. Our findings also reveal significant interest in telehealth for primary care, suggesting rural patients prefer familiar providers for telehealth interactions. Despite increased telehealth interest and usage during the pandemic, a decline post-pandemic indicates potential barriers exist, such as limited availability of healthcare providers. Exploring and addressing these barriers remains crucial for sustaining telehealth adoption and improving healthcare access in rural communities.
Development and validation of prediction models for stroke and myocardial infarction in type 2 diabetes based on health insurance claims: does machine learning outperform traditional regression approaches?
Authors: Stephan Anna-Janina , Hanselmann Michael , Bajramovic Medina , Schosser Simon , Laxy Michael
Published: February 2025

Background

Digitalization and big health system data open new avenues for targeted prevention and treatment strategies. We aimed to develop and validate prediction models for stroke and myocardial infarction (MI) in patients with type 2 diabetes based on routinely collected high-dimensional health insurance claims and compared predictive performance of traditional regression with state-of-the-art machine learning including deep learning methods.

Methods

We used German health insurance claims from 2014 to 2019 with 287 potentially relevant literature-derived variables to predict 3-year risk of MI and stroke. Following a train-test split approach, we compared the performance of logistic methods with and without forward selection, LASSO-regularization, random forests (RF), gradient boosting (GB), multi-layer-perceptrons (MLP) and feature-tokenizer transformers (FTT). We assessed discrimination (Areas Under the Precision-Recall and Receiver-Operator Curves, AUPRC and AUROC) and calibration.

Results

Among n = 371,006 patients with type 2 diabetes (mean age: 67.2 years), 3.5% (n = 13,030) had MIs and 3.4% (n = 12,701) strokes. AUPRCs were 0.035 (MI) and 0.034 (stroke) for a null model, between 0.082 (MLP) and 0.092 (GB) for MI, and between 0.061 (MLP) and 0.073 (GB) for stoke. AUROCs were 0.5 for null models, between 0.70 (RF, MLP, FTT) and 0.71 (all other models) for MI, and between 0.66 (MLP) and 0.69 (GB) for stroke. All models were well calibrated.

Conclusions

Discrimination performance of claims-based models reached a ceiling at around 0.09 AUPRC and 0.7 AUROC. While for AUROC this performance was comparable to existing epidemiological models incorporating clinical information, comparison of other, potentially more relevant metrics, such as AUPRC, sensitivity and Positive Predictive Value was hampered by lack of reporting in the literature. The fact that machine learning including deep learning methods did not outperform more traditional approaches may suggest that feature richness and complexity were exploited before the choice of algorithm could become critical to maximize performance. Future research might focus on the impact of different feature derivation approaches on performance ceilings. In the absence of other more powerful screening alternatives, applying transparent regression-based models in routine claims, though certainly imperfect, remains a promising scalable low-cost approach for population-based cardiovascular risk prediction and stratification.

Graphical abstract
Preliminary insights into the effects of spinal manipulation therapy of different force magnitudes on blood biomarkers of oxidative stress and pro-resolution of inflammation mediators
Authors: Duarte Felipe C. K. , Funabashi Martha , Starmer David , Partata Wania A.
Published: February 2025

Background

Evidence has been reported that spinal manipulation therapy (SMT) leads to spine segmental hypoalgesia through neurophysiological and peripheral mechanisms related to regulating inflammatory biomarker function. However, these studies also showed substantial inter-individual variability in the biomarker responses. Such variability may be due to the incomplete understanding of the fundamental effects of force-based manipulations (e.g., patient-specific force-time characteristics) on a person’s physiology in health and disease. This study investigated the short-term effects of distinct SMT force-time characteristics on blood oxidative stress and pro-resolution of inflammation biomarkers.

Methods

Nineteen healthy adults between 18 and 45 years old were recruited between February and March 2020 before the COVID-19 pandemic and clustered into three groups: control (preload only), target total peak force of 400 N, and 800 N. A validated force-sensing table technology (FSTT®) determined the SMT force-time characteristics. Blood samples were collected at pre-intervention, immediately after SMT, and 20 min post-intervention. Parameters of the oxidant system (total oxidant status, lipid peroxidation and lipid hydroperoxide), the antioxidant system (total antioxidant capacity and bilirubin), and lipid-derived resolvin D1 were evaluated in plasma and erythrocytes through enzyme-linked immunosorbent assay and colorimetric assays.

Results

The COVID-19 global pandemic impacted recruitment, and our pre-established target sample size could not be reached. As a result, there was a small sample size, which decreased the robustness of the statistical analysis. Despite the limitations, we observed that 400 N seemed to decrease systemic total oxidant status and lipid peroxidation biomarkers. However, 800 N appeared to transitorily increase these pro-oxidant parameters with a further transitory reduction in plasma total antioxidant capacity and resolvin D1 mediator.

Conclusion

Despite the small sample size, which elevates the risk of type II error (false negatives), and the interruption of recruitment caused by the pandemic, our findings appeared to indicate that different single SMT force-time characteristics presented contrasting effects on the systemic redox signalling biomarkers and pro-resolution of inflammation mediators in healthy participants. The findings need to be confirmed by further research; however, they provide baseline information and guidance for future studies in a clinical population.
Multiple forms of discrimination and obsessive-compulsive disorder: a prospective cohort study
Authors: Nagata Jason M. , Talebloo Jonanne , Diep Thang , Shim Joan , Al-Shoaibi Abubakr A. A. , Ganson Kyle T. , Testa Alexander , He Jinbo , Lavender Jason M. , Baker Fiona C.
Published: February 2025

Background

Discrimination increases the risk for adverse mental health in minority populations, with studies showing elevated rates of obsessive-compulsive disorder (OCD) in Black adults facing racial discrimination. Yet, there is a lack of longitudinal research on the different forms of discrimination in relation to OCD risk in early adolescence. The objective of this study was to examine the prospective associations between multiple forms of discrimination and OCD in a national sample of U.S. early adolescents.

Methods

We examined prospective cohort data from Year 2 (2018–2020, ages 10–13) and Year 3 (2019–2021) of the Adolescent Brain Cognitive Development Study (N = 7,983). Multiple logistic regression models were used to analyze associations between Year 2 past 12-month experiences of discrimination (based on race and ethnicity, country of origin, sexual orientation, weight, and combined multi-discrimination) and Year 3 probable OCD (Child Behavior Checklist; based on dichotomized t-score indicating high risk), adjusting for theoretically relevant covariates including age, sex, sexual orientation, race and ethnicity, country of origin, household income, parent education, depression, body mass index category, study site, and Year 2 probable OCD.

Results

Adjusting for all covariates, multi-discrimination (OR = 1.67; 95% CI 1.23, 2.27), racial discrimination (OR = 2.77; 95% CI 1.32, 5.80), sexual orientation discrimination (OR = 2.51; 95% CI 1.11, 5.64), and weight discrimination (OR = 2.51; 95% CI 1.13, 5.59) at Year 2 were prospectively associated with developing probable OCD at Year 3. There were no significant findings for discrimination based on country of origin.

Conclusions

Early adolescents who have experienced several forms of discrimination have higher odds of developing probable OCD, suggesting the utility of screening for OCD in even younger adolescents who have encountered discrimination. Educators can play a role in guiding adolescents experiencing discrimination to appropriate resources for accessing mental healthcare.
Highlighting recent achievements to advance more effective cancer immunotherapy
Authors: Belmonte Beatrice , Spada Sheila , Allavena Paola , Benelli Matteo , Bronte Vincenzo , Casorati Giulia , D’Ambrosio Lorenzo , Ferrara Roberto , Mondino Anna , Nisticò Paola , Sommaggio Roberta , Tazzari Marcella , Tripodo Claudio , Sica Antonio , Ferrucci Pier Francesco
Published: February 2025

From 17 to 19th October 2024, the XXI Italian Network for Bio-Immunotherapy of Tumors Meeting (NIBIT) took place in Palermo, in the marvelous historical location of Teatro Politeama, under the auspices of the Italian Association of Medical Oncology (AIOM), Italian Association of Cancer Research (AIRC), Fondazione Pezcoller, Italian Alliance against Cancer (ACC), Italian Lymphoma Foundation (FIL), Grazia Focacci Foundation and Melagioco Foundation. The conference covered a spectrum of topics ranging from target discovery to therapeutic advances in immuno-oncology, bringing world-renowned experts to present groundbreaking innovations in basic, translational, and clinical cancer research. Six sessions focused on cellular therapies, digital pathology, vaccines, tertiary lymphoid structures, and microenvironment in order to get deep insights on how to personalize diagnosis and therapies in the clinical setting. Young investigators had the opportunity to meet and greet their mentors, promoting the synergy of the academic and industrial sectors within the national and international panorama, discussing the application of artificial intelligence on multi-specific antibodies, drug conjugates, and antibody fusion proteins that are advancing the efficacy of precision medicine and minimizing off-target effects.
Application of fatty acid-based eutectic mixture as a phase change material in microencapsulation of drugs: preparation, characterization and release behavior
Authors: Ghaffari Fariba , Shekaari Hemayat
Published: February 2025

Recently, microencapsulation has developed in various industries with its versatile applications. Its profound impact is particularly notable in the chemical, food, and pharmaceutical sectors. Among its research areas, the microencapsulation of drugs using phase change materials (PCMs) stands out as a groundbreaking advancement in drug delivery systems. This innovative approach involves encasing drugs within a PCM shell, significantly enhancing their stability and delivery regulation. The focus of our study is the microencapsulation of certain drugs with poor water solubility namely, cyclosporine, baclofen, and biotin within a bio-based PCM. It has identified PCMs with phase transition temperatures near human body temperature ( 310 K) as ideal candidates for this purpose. A eutectic mixture of stearic-lauric acid in a 1:3 mole ratio was selected for its optimal phase change properties to create microcapsules with core–shell morphology in spherical form. Our comprehensive characterization of the microcapsules, validated by FT-IR and SEM techniques, confirms their proper formation. All studied drugs microencapsulated with the PCM exhibited an excellent thermal stability at working temperature from thermal stability analysis based on TGA results. Furthermore, differential scanning calorimetry (DSC) tests conducted on the microencapsulated drugs obtained the melting point of all three microencapsulated drugs near the melting point of PCM. Also, the release behavior of drugs from drug delivery method was investigated in PBS (pH 7.4) and two temperatures (310.15 and 318.15) K. Drug release occurred sustainably, such that 50% and about 60% of the total of each drug was released from the microcapsules at mentioned temperatures respectively during 24 h.