bluuebunny/crossref_metadata_2025 huggingface dataset:
Towards personalized immersive virtual reality neurorehabilitation: a human-centered design
Authors: Cucinella Salvatore Luca , de Winter Joost C. F. , Grauwmeijer Erik , Evers Marc , Marchal-Crespo Laura
Published: January 2025

Background

Head-mounted displays can be used to offer personalized immersive virtual reality (IVR) training for patients who have suffered an Acquired Brain Injury (ABI) by tailoring the complexity of visual and auditory stimuli to the patient’s cognitive capabilities. However, it is still an open question how these virtual environments should be designed.

Methods

We used a human-centered design approach to help define the characteristics of suitable virtual training environments for ABI patients. We conducted (i) observations, (ii) interviews with eleven neurorehabilitation experts, and (iii) an online questionnaire with 24 neurorehabilitation experts to examine how therapists modify current training environments to promote patients’ recovery in conventional sensorimotor neurorehabilitation settings. Finally, (iv) we involved eight neurorehabilitation experts in a participatory design workshop to co-create examples of IVR training environments.

Results

Five phases of the recovery process (Screening, Planning, Training, Reflecting, and Discharging) and six key themes describing the characteristics of suitable (physical) training environments (Specific, Meaningful, Versatile, Educational, Safe, and Supportive) were identified. The experts agreed that modulating the number of elements (e.g., objects, people) or distractions (e.g., background noise) in the physical training environment enables therapists to provide their patients with suitable conditions to execute functional tasks. Additionally, the experts highlighted the importance of developing IVR training environments that are meaningful and realistic.

Conclusions

Through consultations with neurorehabilitation experts, we gained insights into how therapists adjust physical training environments to promote the execution of functional sensorimotor tasks in patients with diverse cognitive capabilities. Their recommendations on how to modulate and make IVR environments meaningful may contribute to increased motivation and skill transfer. Future studies on IVR-based neurorehabilitation should involve patients themselves.
The GLP-1R agonist semaglutide reshapes pancreatic cancer associated fibroblasts reducing collagen proline hydroxylation and favoring T lymphocyte infiltration
Authors: Cencioni Chiara , Malatesta Silvia , Vigiano Benedetti Virginia , Licursi Valerio , Perfetto Livia , Conte Federica , Ranieri Danilo , Bartolazzi Armando , Kunkl Martina , Tuosto Loretta , Larghi Alberto , Piro Geny , Agostini Antonio , Tortora Giampaolo , Corbo Vincenzo , Carbone Carmine , Spallotta Francesco
Published: January 2025

Background

Metabolic syndrome represents a pancreatic ductal adenocarcinoma (PDAC) risk factor. Metabolic alterations favor PDAC onset, which occurs early upon dysmetabolism. Pancreatic neoplastic lesions evolve within a dense desmoplastic stroma, consisting in abundant extracellular matrix settled by cancer associated fibroblasts (CAFs). Hereby, dysmetabolism and PDAC association was analyzed focusing on CAF functions.

Methods

PDAC development upon dysmetabolic conditions was investigated in: 1) high fat diet fed wild type immunocompetent syngeneic mice by orthotopic transplantation of pancreatic intraepithelial neoplasia (PanIN) organoids; and 2) primary pancreatic CAFs isolated from chemotherapy naïve PDAC patients with/without an history of metabolic syndrome.

Results

The dysmetabolic-associated higher PDAC aggressiveness was paralleled by collagen fibril enrichment due to prolyl 4-hydroxylase subunit alpha 1 (P4HA1) increased function. Upon dysmetabolism, P4HA1 boosts collagen proline hydroxylation, intensifies collagen contraction strength, precluding PDAC infiltration. Noteworthy, semaglutide, an incretin agonist, prevents the higher dysmetabolism-dependent PDAC stromal deposition and allows T lymphocyte infiltration, reducing tumor development.

Conclusions

These results shed light on novel therapeutic options for PDAC patients with metabolic syndrome aimed at PDAC stroma reshape.
Psychological symptoms, quality of life and dyadic relations in family members of intensive care survivors: a multicentre, prospective longitudinal cohort study
Authors: Rai Sumeet , Needham Dale M. , Brown Rhonda , Neeman Teresa , Sundararajan Krishnaswamy , Rajamani Arvind , Panwar Rakshit , Nourse Mary , van Haren Frank M. P. , Mitchell Imogen ,   for the PRICE study investigators
Published: January 2025

Background

There is scarce literature evaluating long term psychological or Quality of Life (QoL) outcomes in family members of ICU survivors, who have not experienced invasive ventilation. The objective was to compare long-term psychological symptoms and QoL outcomes in family members of intubated versus non-intubated ICU survivors and to evaluate dyadic relationships between paired family members and survivors.

Methods

Prospective, multicentre cohort study among four medical-surgical ICUs in Australia. Adult family members of ICU survivors and family-survivor dyads had follow-up assessments (3 and 12 months after ICU discharge), using Impact of Event Scale-Revised; Depression, Anxiety Stress Scales-21; EQ-5D-5L. Dyadic relationships examined associations of psychological symptoms or QoL impairments.

Results

Of 144 family members (75% female, 54% partners/spouses) recruited, 59% cared for previously intubated survivors. Overall, 83% (110/132) of eligible family members completed ≥ 1 follow-up. In family members of intubated vs non-intubated survivors, clinically significant psychological symptoms (PTSD/depression/anxiety) were reported by 48% vs 33% at 3-months (p = 0.15); and 39% vs 25% at 12-months (p = 0.23). Family self-rated their QoL with a mean score of 83 (SD 13) on a visual analogue scale (range 0–100), and > 30% reported problems in pain/discomfort or anxiety/depression domains at 12-months. Family members were more likely to have persistent psychological symptoms of PTSD [OR 4.9, 95% CI (1.47–16.1), p = 0.01] or depression [OR 14.6, 95% CI (2.9–72.6), p = 0.001]; or QoL domain problems with pain/discomfort [OR 6.5, 95% CI (1.14–36.8), p = 0.03] or anxiety/depression [OR 3.5, 95% CI (1.02–12.1), p = 0.04], when the paired survivor also reported the same symptoms.

Conclusions

Almost one-third of the family members of ICU survivors reported persistent psychological symptoms and QoL problems at 12-months. There was a noticeable dyad effect with family members more likely to have persistent symptoms of PTSD, depression, and problems in QoL domains when the paired ICU survivors experienced similar symptoms. The family members of non-intubated ICU survivors had an equal propensity to develop long-term psychological distress and should be included in long-term outcome studies. Future recovery intervention trials should be aimed at ICU family-survivor dyads.

Trial registration ACTRN12615000880549
From fossil fuels to alternative fuels: strategy development for a sustainable transport sector in Germany
Authors: Vorwerg Franz Christian , Ebadi Torkayesh Ali , Venghaus Sandra
Published: January 2025

Background

Many countries agreed to reduce CO2 emissions to limit global warming under the terms of the Paris Agreement. In Europe, this agreement is supported by the climate targets introduced under the European Green Deal and the Fit for 55 package. Although Germany has made substantial progress in reducing emissions across various sectors, the transport sector remains a notable exception, showing little improvement. It is therefore essential to reevaluate the transport sector to strengthen its contribution to achieving the emission reduction targets. The aim of this study is to identify and propose strategies for shifting from fossil fuel-based transport to a more sustainable mode centred on alternative fuels. To investigate the potential pathways, an integrated approach is developed using a SWOT (Strengths, Weaknesses, Opportunities, Threats) analysis and multi-criteria decision analysis (MCDA).

Results

A two-step survey was used to collect data from different stakeholders in order to derive the key factors for the implementation of alternative fuels and devise transition strategies. The findings show that reducing GHG emissions, resource competition, and the impacts of environmental regulations are the most important factors for evaluating the transition strategies. On the other hand, reducing the competitiveness of fossil fuels through increased prices, as well as technical and infrastructural support, are the most promising strategies.

Conclusions

The sustainable transition in the transport sector is fundamentally driven by the use of renewable fuel alternatives as sustainable energy carriers to replace fossil fuels. The use and deployment of renewable fuel alternatives will play the most significant role in the defossilization of the transport sector, on course to achieve a 55% reduction by 2030 and reaching climate-neutrality by 2050. However, identification of the proper transition strategies in the phase-out of fossil fuels and their replacement with renewable fuel alternatives necessitates a comprehensive evaluation framework. This work contributes to this by developing a holistic evaluation framework, enabling the incorporation of multiple stakeholders within the identification and evaluation of the transition strategies. While several strategies are identified, stakeholders agree that reducing the competitiveness of fossil fuels through increased prices and lower subsidies would be the best strategy.
Cascading effects of top predator changes in a seagrass bed under selective fishing
Authors: Chen Shixuan , He Qiang
Published: January 2025

Background

With the widespread promotion of selective fishing which may target top predatory fishes, the abundance and species composition of top predators could change, which may further impact species at lower trophic levels through a chain of cascading trophic interactions. However, the top-down effects of changes in predator communities driven by selective fishing remain poorly investigated.

Methods

Focusing on a seagrass ecosystem, we investigated how changes in two coexisting top predators (Lateolabrax japonicus and Acanthogobius ommaturus) under different selective fishing scenarios would affect species at lower trophic levels in a field manipulative experiment.

Results

We found that the trophic niches of A. ommaturus and L. japonicus overlapped greatly, although not completely. If loss of L. japonicus led to increases in A. ommaturus, the abundances of herbivorous benthos Barleeia bureri increased likely owing to A. ommaturus’s suppression of low-level predators, while epiphyte and seagrass biomass decreased significantly likely owing to A. ommaturus’s disturbance of seagrasses and sediments. If both predators were depleted, the biomasses of herbivorous benthos Cyclina sinensis and B. bureri increased significantly likely owing to the absence of top predators’ disturbance of sediments, while epiphyte and seagrass biomass did not change.

Conclusions

Our study showed that loss of one top predator could lead to rapid changes in species at lower trophic levels in seagrass beds, depending on changes in, and the trophic or non-trophic effects (including biological disturbances) of, its competitors. Therefore, in fisheries resource management, the ecological impacts of selectively fishing a target predator must be managed considering changes in, and the trophic or non-trophic effects of, its competitors where present.
Engagement in a web-based intervention for individuals who committed sexual offenses against children: observational study
Authors: Schröder Sonja , Tozdan Safiye , Briken Peer , Müller Jürgen L. , Fromberger Peter
Published: January 2025

Web-based interventions have been shown to be effective for various health and mental health problems. However, the effectiveness of interventions is often limited by the fact that individuals do not start or complete them. Using data from an intermediate analysis of the randomized placebo-controlled clinical trial to evaluate the effectiveness of @myTabu, the current study investigated engagement with a web-based intervention for 113 individuals convicted of child sexual abuse and/or for child sexual exploitation material. @myTabu is a human-supported, web-based intervention for individuals who have been convicted for sexual abuse of children or the use of child sexual exploitation material with the goal of reducing the risk factors for recidivism and actual recidivism. The results of the present study indicate that (a) 81% of the participants logged into the web-based intervention within 8 weeks after login credentials were sent; (b) there was a trend toward lower treatment readiness and lower belief in their own technical prerequisites in individuals who did not login; (c) 15% of the participants completed all requested sessions within the first 5 weeks of participation, and the average participant logged in on 6 different days and completed two sessions; (d) the number of login days and completed sessions could be predicted by treatment readiness. We discuss these findings and their implications for the development and implementation of further web-based interventions in the forensic context. Trial registration: German Clinical Trial Register (DRKS00021256). Prospectively registered 24.04.2020.
Three-dimensional quantitative temporomandibular joint changes in skeletal class I malocclusion treated with extraction and non-extraction protocols: a comparative study of fixed orthodontic appliances and clear aligners
Authors: Al-Somairi Majedh Abdo Ali , Zheng Bowen , Yang Xaiofeng , Zhang Yongxin , Alhammadi Maged S. , xu Hao , Alhashimi Najah , Almaqrami Bushra Sufyan , Al –Worafi Naseem Ali , Alyafrusee Enas Senan , Al-Tayar Barakat , Liu Yi
Published: January 2025

Objective

This study aimed to evaluate the positional and morphological changes in the temporomandibular joint (TMJ) in adult patients with skeletal Class I malocclusion treated with fixed orthodontic appliances (FAs) and clear aligners (CAs), both with and without premolar extractions.

Methods

This retrospective study involved 120 adult patients divided into non-extraction and extraction groups, each further subdivided equally into those treated with FAs and CAs. Cone beam computed tomography (CBCT) was used to assess the TMJ measurements before (T0) and after treatment (T1). Statistical analyses were conducted to compare the mean changes in intra- and inter-groups. A significance level of p ≤ 0.05 was considered.

Results

In the non-extraction group, specifically in FAs, significant increases were observed in TMJ parameters; anteroposterior condylar position (APCP) and mediolateral condylar inclination (MCI). Conversely, significant decreases were noted in vertical condylar position (VCP) and vertical condylar inclination (VCI). In the extraction group, significant increases were noted in APCP and anterior joint space (AJS), while posterior joint space (PJS) and anteroposterior condylar joint position (APCJP) decreased. For inter-group comparisons, the extraction group showed significant increases in APCP in FAs compared to CAs, and a significant decrease in APCJP in FAs compared to CAs.

Conclusion

FAs significantly impact condylar positions and joint spaces, especially in extraction cases. Monitoring TMJ parameters during orthodontic treatment is crucial to ensure positive outcomes and prevent TMJ disorders (TMDs). These findings may guide the selection of orthodontic appliances based on individual malocclusion characteristics.
Like objects or like subjects? Effects of student–robot interaction (SRI) and mathematical ability on students learning outcomes
Authors: Ojetunde Segun Michael , Ramnarain Umesh
Published: January 2025

Learning interaction patterns is key to the explanation of learning outcomes. Different studies have reported the relationship between classroom process variables and learning outcomes in a traditional classroom setting. However, the advent of robotics and its attendant student–robot interaction moderated by students’ mathematical ability is yet to be widely discussed empirically. This constitutes the major reason why the study investigated the effects of student–robot interaction and mathematical ability on students' learning outcomes, particularly among Nigerian high school students where the robotics curriculum is at the early stage of implementation. The study was anchored on engagement theory. A mixed-methods explanatory sequential Quant-dominant approach was adopted. A total of 327 high school students who have been exposed to robotic lessons from the year 2021 including robotics subject teachers and learning managers were sampled for the study. Data collected was analyzed using descriptive and inferential statistics alongside thematic analysis for qualitative data. It was found that mathematical ability could not moderate the relationship between student–robot interaction and learning outcomes (behavioural: β = − 0.001, t = 0.028, p > 0.05, Affective: β = 0.105, t = 0.316, p > 0.05, cognitive engagements: β = − 0.08, t = 0.316, p > 0.05). Affective engagements have a significant influence on critical thinking (β = .126, t = 3.19, p < 0.05) while both affective (β = 0.28, t = 5.63, p < 0.05) and cognitive (β = .17, t = 4.65, p < 0.05) engagements could predict students’ problem-solving. The conclusion was made that learning robotics is a potential instrument to develop students who can think critically to solve some long-standing problems in society. Furthermore, the process requires a lot of affective and cognitive engagement of the students, and in this regard, both parents and teachers have a role to play in offering support to students.
On the Effect of the Patient Table on Attenuation in Myocardial Perfusion Imaging SPECT
Authors: Huxohl Tamino , Patel Gopesh , Burchert Wolfgang
Published: January 2025

Background

The topic of the effect of the patient table on attenuation in myocardial perfusion imaging (MPI) SPECT is gaining new relevance due to deep learning methods. Existing studies on this effect are old, rare and only consider phantom measurements, not patient studies. This study investigates the effect of the patient table on attenuation based on the difference between reconstructions of phantom scans and polar maps of patient studies.

Methods

Jaszczak phantom scans are acquired according to quality control and MPI procedures. An algorithm is developed to automatically remove the patient table from the CT for attenuation correction. The scans are then reconstructed with attenuation correction either with or without the patient table in the CT. The reconstructions are compared qualitatively and on the basis of their percentage difference. In addition, a small retrospective cohort of 15 patients is examined by comparing the resulting polar maps. Polar maps are compared qualitatively and based on the segment perfusion scores.

Results

The phantom reconstructions look qualitatively similar in both the quality control and MPI procedures. The percentage difference is highest in the lower part of the phantom, but it always remains below 17.5%. Polar maps from patient studies also look qualitatively similar. Furthermore, the segment scores are not significantly different (p=0.83).

Conclusions

The effect of the patient table on attenuation in MPI SPECT is negligible.
Assessing the impact of sewage and wastewater on antimicrobial resistance in nearshore Antarctic biofilms and sediments
Authors: Clark Melody S , Gregson Benjamin H , Greco Carla , Nair Harisree Paramel , Clark Marlon , Evans Claire , Hughes Kevin A. , Hwengwere Kudzai , Leung Marcus , Peck Lloyd S , Walker Caray A. , Chow William
Published: January 2025

Background

Despite being recognised as a global problem, our understanding of human-mediated antimicrobial resistance (AMR) spread to remote regions of the world is limited. Antarctica, often referred to as “the last great wilderness”, is experiencing increasing levels of human visitation through tourism and expansion of national scientific operations. Therefore, it is critical to assess the impact that these itinerant visitors have on the natural environment. This includes monitoring human-mediated AMR, particularly around population concentrations such as visitor sites and Antarctic research stations. This study takes a sequencing discovery-led approach to investigate levels and extent of AMR around the Rothera Research Station (operated by the UK) on the Antarctic Peninsula.

Results

Amplicon sequencing of biofilms and sediments from the vicinity of Rothera Research Station revealed highly variable and diverse microbial communities. Analysis of AMR genes generated from long-reads Nanopore MinION sequencing showed similar site variability in both drug class and resistance mechanism. Thus, no site sampled was more or less diverse than the other, either in the biofilm or sediment samples. Levels of enteric bacteria in biofilm and sediment samples were low at all sites, even in biofilm samples taken from the station sewage treatment plant (STP). It would appear that incorporation of released enteric bacteria in wastewater into more established biofilms or associations with sediment was poor. This was likely due to the inactivation and vulnerability of these bacteria to the extreme environmental conditions in Antarctica.

Conclusions

Our results suggest minimal effect of a strong feeder source (i.e. sewage effluent) on biofilm and sediment microbial community composition, with each site developing its unique niche community. The factors producing these niche communities need elucidation, alongside studies evaluating Antarctic microbial physiologies. Our data from cultivated bacteria show that they are highly resilient to different environmental conditions and are likely to thrive in a warmer world. Our data show that AMR in the Antarctic marine environment is far more complex than previously thought. Thus, more work is required to understand the true extent of the Antarctic microbiota biodiversity, their associated resistomes and the impact that human activities have on the Antarctic environment.
The paradox of resource-richness: unraveling the effects on financial markets in natural resource abundant economies
Authors: Imran Muhammad , Khan Muhammad Kamran , Wahab Salman , Ahmed Bilal , Jijian Zhang
Published: January 2025

In the contemporary global landscape, understanding the nexus between financial inclusion and natural resource abundance is crucial, especially for resource-rich nations. This study uses diagnostic tests and method of moments quantile regression to examines this interplay across Australia, Brazil, Canada, China, India, Russia, and the United States. We find that achieving financial inclusion is significantly challenging for countries that heavily rely on natural resources. Diversified income sources and equitable wealth distribution are essential to mitigate these challenges. Additionally, we identify a positive correlation between economic development and financial inclusion, highlighting the mutually reinforcing relationship between growth and inclusivity. Our research also reveals a notable link between adopting renewable energy and improving financial inclusion, suggesting that environmental responsibility and financial accessibility are intertwined. Foreign direct investment has nuanced impacts on financial inclusion, adding depth to our understanding. Overall, stable income from natural resources and diversified economic development emerge as key promoters of financial inclusion. These insights advocate for regionally specific policies and lay a solid foundation for future research and informed policymaking that address financial inclusion challenges and advance sustainable development.

Graphical abstract
Therapeutic potential of 4-hexylresorcinol in reducing sarcopenia in diabetic masseter muscle
Authors: Gaida Dhouha , Park Young-Wook , Kang Yei-Jin , Kim Seong-Gon
Published: January 2025

Background

This study aimed to evaluate the effects of 4-hexylresorcinol (4HR), a synthetic compound with antioxidant and stress-modulating properties, on diabetic sarcopenia in the masseter muscle.

Methods

A controlled, parallel-arm study was conducted using 38 Sprague–Dawley rats divided into diabetic and non-diabetic groups. Diabetes was induced with streptozotocin (STZ), and the groups were further subdivided to receive weekly subcutaneous injections of either 4HR or saline. Muscle volume was assessed using micro-computed tomography (μCT), and glycogen storage and protein expression were analyzed using periodic acid-Schiff (PAS) staining and immunohistochemistry.

Results

μCT analysis revealed that diabetic rats exhibited significantly reduced masseter muscle volume compared to non-diabetic rats. However, 4HR treatment partially mitigated muscle volume loss in diabetic animals. Histological analysis showed higher PAS staining intensity in the diabetic group treated with 4HR compared to the untreated diabetic group, suggesting improved glycogen storage. Immunohistochemistry demonstrated that 4HR treatment significantly increased Glut4 and phosphorylated AMPKα (p-AMPKα) expression in diabetic muscle, indicating enhanced glucose uptake and metabolic activity.

Conclusions

4HR effectively alleviates diabetes-induced sarcopenia by preserving muscle volume, enhancing glycogen storage, and upregulating Glut4 and p-AMPKα expression. These findings suggest that 4HR holds potential as a therapeutic agent for combating muscle wasting in diabetes.
A digital platform for automated analysis of 1H NMR data: prototype framework of digital reference standard
Authors: Paudel Sunil Babu , Nam Joo-Won , Garcia Gonzalo R. Malca , Shapiro Ben , Laatikainen Pekka , Liu Yang
Published: January 2025

This study introduces an innovative approach to automatically analyzing 1H nuclear magnetic resonance (NMR) data, integrating a quantum mechanical spectral analysis (QMSA) to enhance efficiency over manual data analysis in NMR. This proposed digital platform features a standardized quantitative NMR (qNMR) procedure, digital Reference Spectra within a spectral library, and a visualized interactive interface for streamlined, automated NMR data analysis. This digital platform significantly reduces the need for manual intervention and shows promise in using spectral fitting to compare the calculated spectrum derived from a digital Reference Spectrum with an experimental spectrum. The digital platform excels in processing data of both single chemical and mixture, delivering accurate results, and positioning it as an essential tool for automatic 1H qNMR analyses. Case studies highlight the digital platform’s effectiveness, demonstrating its wide-ranging applicability. This shows that the proposed digital platform, based on a qNMR-based QMSA approach, offers reliable qualitative and quantitative analyses and paves the way for integrating digital reference standards into future compendial tests.

Graphical Abstract
Prevalence and pattern of skin disorders among children living in orphanages in Fayoum and Giza governorates, Egypt
Authors: Mohamed Noha Ezzat , Abdel-Wahed Wafaa Yousif , Gomaa Shimaa Mohammed , Hosny Mai Ashraf
Published: January 2025

Background

Childhood is a crucial period that shapes a person’s growth and development. For orphans, a lack of familial support affects their upbringing, making orphanages crucial for care. Children living in orphanage centers are vulnerable to several conditions, including dermatological disorders, due to factors such as malnutrition, overcrowding, and poor hygiene. The current study was carried to determine the prevalence and patterns of skin disorders among orphan children in Egypt, and to identify associated risk factors among orphans in Egypt.

Methods

A cross-sectional study was conducted among 415 children aged 1–18 years living in orphanage centers in Fayoum and Giza governorates, Egypt.

Results

Among the children, 77.1% had at least one skin disorder, with noninfectious conditions being more prevalent than infectious conditions (67.4 vs. 24.3%). The most common noninfectious conditions were dermatitis/eczema, pigmentary disorders, skin appendage disorders, and psycho-cutaneous issues. Fungal infections were the most common infectious condition. There was a significant relationship between hygiene and the type of skin disorder.

Conclusion

The prevalence of skin diseases in orphanages in Egypt is relatively high and is dominated by noninfectious skin diseases, and the prevalence of psycho-cutaneous disorders is high among these children. Comprehensive care strategies focusing on improving hygiene and emotional support and preventing abuse are essential for reducing the incidence of skin disorders and enhancing the overall health of orphaned children.
First-time use of electronic patient-reported outcome measures in a cluster randomized trial: a qualitative study
Authors: Skåre Terese Solvoll , Lundeby Tonje , Lund Jo Åsmund , Hjermstad Marianne Jensen , Midtbust May Helen
Published: January 2025

Background

Although there is clear evidence supporting the beneficial effects of regularly assessing patient-reported outcomes (PROs), the comprehensive integration of patient-reported outcome measures (PROMs) into routine cancer care remains limited. This study aimed to explore the facilitators and barriers encountered by principal investigators (PIs) (oncologists) and study nurses during the implementation of the Eir ePROM within a cluster randomized trial (c-RCT) in cancer outpatient clinics. Additionally, we sought to examine the influence of Eir on the working routines of the participants.

Methods

Individual semi-structured interviews and a focus group were conducted with nine oncologists and study nurses involved in the implementation of the ePROM tool Eir. Interviews elucidated their experiences of barriers and facilitators when implementing Eir through a cluster randomized trial. Data were analysed according to Framework Analysis, using both an inductive and deductive approach. The Consolidated Framework for Implementation Research (CFIR) was used in the deductive stages of analysis.

Results

Three overarching themes were identified from the data: (1) Willingness to invest; accepting that new eras come with a cost, (2) Management anchoring; changes start at the top, and (3) Creation of a cohesive framework; fostering collective comprehension. We found a notable disparity between oncologists and nurses in their willingness to invest time and effort in implementing the tool. While participants recognized the need to transform patient consultation methods to benefit from digital symptom management, opinions varied on whether the potential benefits justified the associated cost. Furthermore, the degree of management anchoring at various levels significantly impacted the implementation process. At the local level, it was seen as either a facilitator or a barrier, influencing the outcome of the implementation. Additionally, establishing a cohesive framework was crucial, as this fostered a collective understanding among those involved in the implementation.

Conclusions

Our study underscores the importance of considering the diverse perspectives of health care professionals and fostering interprofessional collaboration for the successful implementation of ePROMs in healthcare settings. Future research should explore strategies to bridge professional disparities and promote a shared understanding of the value provided by ePROMs.
Next generation bioelectronic medicine: making the case for non-invasive closed-loop autonomic neuromodulation
Authors: Lerman Imanuel , Bu Yifeng , Singh Rahul , Silverman Harold A. , Bhardwaj Anuj , Mann Alex J. , Widge Alik , Palin Joseph , Puleo Christopher , Lim Hubert
Published: January 2025

The field of bioelectronic medicine has advanced rapidly from rudimentary electrical therapies to cutting-edge closed-loop systems that integrate real-time physiological monitoring with adaptive neuromodulation. Early innovations, such as cardiac pacemakers and deep brain stimulation, paved the way for these sophisticated technologies. This review traces the historical and technological progression of bioelectronic medicine, culminating in the emerging potential of closed-loop devices for multiple disorders of the brain and body. We emphasize both invasive techniques, such as implantable devices for brain, spinal cord and autonomic regulation, while we introduce new prospects for non-invasive neuromodulation, including focused ultrasound and newly developed autonomic neurography enabling precise detection and titration of inflammatory immune responses. The case for closed-loop non-invasive autonomic neuromodulation (incorporating autonomic neurography and splenic focused ultrasound stimulation) is presented through its applications in conditions such as sepsis and chronic inflammation, illustrating its capacity to revolutionize personalized healthcare. Today, invasive or non-invasive closed-loop systems have yet to be developed that dynamically modulate autonomic nervous system function by responding to real-time physiological and molecular signals; it represents a transformative approach to therapeutic interventions and major opportunity by which the bioelectronic field may advance. Knowledge gaps remain and likely contribute to the lack of available closed loop autonomic neuromodulation systems, namely, (1) significant exogenous and endogenous noise that must be filtered out, (2) potential drift in the signal due to temporal change in disease severity and/or therapy induced neuroplasticity, and (3) confounding effects of exogenous therapies (e.g., concurrent medications that dysregulate autonomic nervous system functions). Leveraging continuous feedback and real-time adjustments may overcome many of these barriers, and these next generation systems have the potential to stand at the forefront of precision medicine, offering new avenues for individualized and adaptive treatment.
Injectable Estradiol Dosing Regimens in Transgender and Nonbinary Adults Listed as Male at Birth
Authors: Kanin Maralee , Slack Margaret , Patel Reema , Chen Kuan-Ting , Jackson Nicholas , Williams Kristen C , Grock Shira
Published: January 2025

Context

Many transgender and nonbinary (TGNB) individuals assigned male at birth (AMAB) seek hormone therapy to achieve physical and emotional changes. Standard therapy includes estradiol, with or without an anti-androgen. Our clinical observations suggest that currently recommended injectable estradiol dosing may lead to supratherapeutic estradiol levels.

Objective

We sought to evaluate whether lower-than-recommended doses of injectable estradiol were effective in achieving serum estradiol and testosterone goals.

Methods

We conducted a retrospective cohort study to evaluate injectable estradiol dosing in treatment-naïve AMAB individuals initiating hormone therapy. Data from a single provider at an academic center from January 2017 to March 2023 were analyzed. A total of 29 patients were eligible for inclusion. The primary variables of estradiol dosage, serum estradiol and testosterone levels were analyzed over 15 months.

Results

The average estradiol dose decreased from 4.3 to 3.7 mg weekly (p < 0.001) during the study period with a final on-treatment estradiol level of 248 pg/mL. All individuals achieved a testosterone <50 ng/dL during the study period. The average initial on-treatment testosterone level was not significantly different from average final on-treatment measurement of 24.0 mg/dL (p=0.95). Spironolactone use at study initiation was not associated with a lower initial on-treatment testosterone level, though it was associated with a lower estradiol level of 285 pg/dL compared to 427 pg/dL for those on estradiol monotherapy (p=0.017).

Conclusion

Lower doses of injectable estradiol can achieve therapeutic estradiol levels with excellent testosterone suppression. Spironolactone was not associated with additional testosterone suppression and may result in lower estradiol levels.
Comparing General Anesthesia–Based Regimens for Endovascular Treatment of Acute Ischemic Stroke: A Systematic Review and Network Meta-Analysis
Authors: Plitman Eric , Mohammed Ayman , Rajaleelan Wesley , Nakatani Rodrigo , Englesakis Marina , Shankar Jai , Venkatraghavan Lashmi , Chowdhury Tumul
Published: January 2025

BACKGROUND:

Total intravenous anesthesia (TIVA)-based and volatile-based general anesthesia have different effects on cerebral hemodynamics. The current work compares these 2 regimens in acute ischemic stroke patients undergoing endovascular therapy.

METHODS:

We conducted a systematic literature search across MEDLINE, Embase, Cochrane, CINAHL, Web of Science, and Scopus. We identified English language studies including adult acute ischemic stroke patients managed with endovascular therapy under general anesthesia delineable into TIVA only and/or volatile only, and obtained categorical data for favorable functional outcomes using the modified Rankin scale (mRS ≤2), at 90 days after endovascular therapy. Odds ratios (OR) and standardized mean differences were calculated to inform a network meta-analysis approach, which permitted the inclusion of studies comparing a form of general anesthesia (ie, TIVA only or volatile only) to conscious sedation.

RESULTS:

The search rendered 6235 articles, of which 15 met inclusion criteria. Three studies directly investigated TIVA versus volatile, whereas 12 studies compared general anesthesia to conscious sedation. The total number of subjects was 3015 (conscious sedation: n = 1067; general anesthesia: n = 1948 [TIVA: n = 1212, volatile: n = 736]). No significant differences were identified between TIVA and volatile groups in 90-day neurological outcome (OR = 1.25, 95% confidence interval [CI], 0.81–1.91; P = .31), 90-day mortality (OR = 0.72, 95% CI, 0.42–1.24; P = .24), successful recanalization (OR = 1.33, 95% CI, 0.70–2.52; P = .39), or recanalization time (standardized mean difference = 0.03, 95% CI, –0.35 to 0.41; P = .88). Additionally, no significant differences were identified between the conscious sedation group and the TIVA group in 90-day neurological outcome (OR = 1.14, 95% CI, 0.84–1.53; P = .40), 90-day mortality (OR = 0.87, 95% CI, 0.62–1.23; P = .43), successful recanalization (OR = 0.76, 95% CI, 0.52–1.10; P = .15), or recanalization time (standardized mean difference = –0.18, 95% CI, –0.47 to 0.11; P = .23), and between the conscious sedation group and the volatile group in 90-day neurological outcome (OR = 1.42, 95% CI, 0.92–2.17; P = .11), 90-day mortality (OR = 0.63, 95% CI, 0.36–1.12; P = .11), successful recanalization (OR = 1.01, 95% CI, 0.52–1.94; P = .98), or recanalization time (standardized mean difference = –0.15, 95% CI, –0.52 to 0.23; P = .44).

CONCLUSIONS:

This network meta-analysis showed that the perioperative use of either general anesthesia-based regimen, or sedation, did not significantly impact various endovascular therapy-related outcomes. However, the current work was underpowered to detect differences in anesthetic agents, clinico-demographic characteristics, or procedural factors.
Anesthetic Management of a Patient With Arnold Chiari Malformation and Syringomyelia During Laparoscopic Surgery With Neurologic Monitoring: A Case Report
Authors: Soued Mickaël , Le Gouez Agnès , Mercier Frédéric J.
Published: January 2025

We describe a patient with severe Arnold Chiari Malformation and syringomyelia who underwent gynecological laparoscopy in an emergency context; no brain imaging was available. We here report the successful use of optic nerve sheath diameter (ONSD) and middle cerebral artery (MCA) velocity measurements as surrogate monitoring for cerebral blood flow and intracranial pressure, respectively. MCA velocity was low when assessed after peritoneal insufflation and ONSD increased to 6.3 mm after Trendelenburg positioning. This noninvasive Ultrasound and Doppler neurological monitoring helped adapt the anesthetic management and the patient recovered both normal ONSD and MCA velocity values.
A comparative study of the effects of topical dexamethasone 0.1% and loteprednol etabonate 0.5% on clinical ocular parameters in Iraqi patients following cataract surgery
Authors: Taha Leqaa Basil , Al-Atrakji Mohammed Qasim Yahya Malallah A. , Hussein zaid Rajab
Published: January 2025

Background Cataracts are an assortment of conditions causing the lens to become opaque and lose its typical transparency. Topical corticosteroids like loteprednol etabonate and dexamethasone are commonly administered to alleviate inflammation following cataract surgery. Aim of the study To compare the efficacy of loteprednol etabonate and dexamethasone in managing different clinical parameters following cataract removal, as well as their patient safety. Methods This trial was registered by local IRB at the College of Medicine/University of Baghdad on November 27, 2023, under document approval number UoB.Med.21. Patients undergoing cataract surgery were randomly assigned to two groups: group A received loteprednol etabonate 0.5% drop postoperatively for four weeks, while group B received dexamethasone 0.1% drop postoperatively for the same period. The levels of intraocular pressure (IOP), anterior chamber (AC) reaction, and scores for flare, conjunctival congestion, and pain were monitored at one and four weeks during follow-up visits. Results The visual outcomes were similar between the two groups, and both treatments were well tolerated with minor side effects. Both loteprednol etabonate and dexamethasone effectively reduced IOP, AC reaction, and grading for flare, conjunctival congestion, and pain in cataract patients. None of these clinical measures displayed any significant differences between the two drugs. Conclusion There is no significant difference between topical loteprednol etabonate 0.5% and topical dexamethasone 0.1% pertaining to clinical ocular parameters post-cataract surgery. The decision between these corticosteroids may depend on patient needs and preferences.
On homomorphism and Cartesian products of fuzzy PUP ideal on PUP algebra
Authors: Mechderso Alachew Amaneh , Alaba Birhanu Assaye , Munie Tilahun Mekonnen
Published: January 2025

Background In this paper, we explore the Cartesian product of fuzzy PUP ideals and subalgebras within a PUP (pseudo-UP)algebra X. We investigate how fuzzy pseudo-UP ideals are affected under PUP homomorphisms, particularly focusing on the image and inverse image of the fuzzy sets K α and K v , which generalize classical fuzzy sets. These fuzzy sets aim to quantify the level of ambiguity in fuzzy situations. Methods We introduced the concept of the Cartesian product of fuzzy PUP ideals and subalgebras of PUP algebra and analyzed their properties. Specifically, we studied the behavior of fuzzy pseudo-UP ideals under PUP homomorphism, using the fuzzy sets K α and K v to model ambiguity. We also examined the strongest fuzzy PUP relation on a fuzzy PUP subalgebra and ideal of PUP algebra. Results We proved that the Cartesian product of fuzzy PUP ideals forms a fuzzy pseudo-UP ideal. This result was characterized through its level sets, providing a deeper understanding of the interaction between fuzzy PUP ideals and their algebraic structure. Additionally, the strongest fuzzy PUP relation on a fuzzy PUP subalgebra was defined, and several important properties were derived. Conclusions This work extends the concept of fuzzy PUP ideals in the context of PUP algebras and explores how fuzzy homomorphism influence their structure. Our results contribute to a better understanding of fuzzy relations in algebraic settings and open the door for further research into the properties and applications of fuzzy ideals in PUP algebras.
Automated post-run analysis of arrayed quantitative PCR amplification curves using machine learning
Authors: Brintz Ben J. , Operario Darwin J. , Brown David Garrett , Wu Shanrui , Wang Lan , Houpt Eric R. , Leung Daniel T. , Liu Jie , Platts-Mills James A.
Published: January 2025

Background The TaqMan Array Card (TAC) is an arrayed, high-throughput qPCR platform that can simultaneously detect multiple targets in a single reaction. However, the manual post-run analysis of TAC data is time consuming and subject to interpretation. We sought to automate the post-run analysis of TAC data using machine learning models. Methods We used 165,214 qPCR amplification curves from two studies to train and test two eXtreme Gradient Boosting (XGBoost) models. Previous manual analyses of the amplification curves by experts in qPCR analysis were used as the gold standard. First, a classification model predicted whether amplification occurred or not, and if so, a second model predicted the cycle threshold (Ct) value. We used 5-fold cross-validation to tune the models and assessed performance using accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and mean absolute error (MAE). For external validation, we used 1,472 reactions previously analyzed by 17 laboratory scientists as part of an external quality assessment for a multisite study. Results In internal validation, the classification model achieved an accuracy of 0.996, sensitivity of 0.997, specificity of 0.993, PPV of 0.998, and NPV of 0.991. The Ct prediction model achieved a MAE of 0.590. In external validation, the automated analysis achieved an accuracy of 0.997 and a MAE of 0.611, and the automated analysis was more accurate than manual analyses by 14 of the 17 laboratory scientists. Conclusions We automated the post-run analysis of highly-arrayed qPCR data using machine learning models with high accuracy in comparison to a manual gold standard. This approach has the potential to save time and improve reproducibility in laboratories using the TAC platform and other high-throughput qPCR approaches.
Project management
Authors: Averin Aleksandr , Astaf'eva Ol'ga , Bashmakov Daniil , Golembiovskaya Dar'ya , Golubev Sergey , Grigor'eva Valentina , Gruzina Yuliya , Zhidikov Vitaliy , Korneeva Irina , Ksenofontov Andrey , Luk'yanova Anna , Mokrova Lidiya , Polevoy Sergey , Titov Sergey , Trifonova Natal'ya , Cherepovskaya Natal'ya
Published: January 2025

The textbook examines various aspects of project management, shows the role of projects in the activities of a modern organization, describes the specifics of project implementation in various sectors of the economy and public administration, and reveals the role and actions of the project manager and team members at all stages of its implementation.
The textbook materials contain theoretical and practical provisions on the main issues of project management, control questions and tests for self-control.
Meets the requirements of the latest generation of federal state educational standards for higher education.
For students in the areas of "Management" and "Personnel Management" (all profiles of the bachelor's degree program). Useful and new materials, best practices and approaches will be found in the textbook by everyone who is more or less involved in project work.
Data analysis. Methods of probability theory and mathematical statistics in Python
Authors: Krivolapov Sergey
Published: January 2025

The textbook contains a description of probabilistic and statistical methods that form the theoretical basis of data analysis. It is characterized by intensive use of Python language tools. Detailed solutions are provided for all examples and tasks.
Meets the requirements of the latest generation of federal state educational standards for higher education.
For students, postgraduates, researchers and teachers.