bluuebunny/crossref_metadata_2025 huggingface dataset:
A novel decomposer-exploiter interaction framework of plant residue microbial decomposition
Authors: Miao Youzhi , Wang Wei , Xu Huanhuan , Xia Yanwei , Gong Qingxin , Xu Zhihui , Zhang Nan , Xun Weibing , Shen Qirong , Zhang Ruifu
Published: February 2025

Background

Plant residue microbial decomposition, subject to significant environmental regulation, represents a crucial ecological process shaping and cycling the largest terrestrial soil organic carbon pool. However, the fundamental understanding of the functional dynamics and interactions between the principal participants, fungi and bacteria, in natural habitats remains limited.

Results

In this study, the evolution of fungal and bacterial communities and their functional interactions were elucidated during the degradation of complexity-gradient plant residues. The results reveal that with increasing residue complexity, fungi exhibit heightened adaptability, while bacterial richness declines sharply. The differential functional evolution of fungi and bacteria is driven by residue complexity but follows distinct trajectories. Fundamentally, fungi evolve towards promoting plant residue degradation and so consistently act as the dominant decomposers. Conversely, bacteria predominantly increase expression of genes of glycosidases to exploit fungal degradation products, thereby consistently acting as exploiters. The presence of fungi enables and endures bacterial exploitation.

Conclusions

This study introduces a novel framework of fungal decomposers and bacterial exploiters during plant residue microbial decomposition, advancing our comprehensive understanding of microbial processes governing the organic carbon cycling.
Sex and hand differences in haptic processing: implications for mental rotation ability
Authors: Aguilar Ramirez Daniela E. , R. Gonzalez Claudia L.
Published: February 2025

It has been proposed that the sensorimotor system provides a foundation for the development of cognitive abilities and their hemispheric specialization. In this study, we investigated the potential relationship between haptic processing and mental rotation ability, both of which are typically lateralized to the right hemisphere. Previous research has also indicated that males tend to outperform females in both functions. The current study investigates how the sensorimotor-haptic system relates to mental rotation ability, specifically to examine the influence of hand performance (as a proxy for hemispheric specialization) and biological sex on this relationship. Seventy-five participants (n = 41 females) completed a haptic task, and the well-known mental rotation test (MRT) developed by Shepard and Metzler (Science 171:701–3, 1971). Results confirmed a positive correlation between performance on the haptic and MRT tasks. Further, males outperformed females in both tasks. However, when sex and hand performance were considered, males were better in the haptic task, but only when using their left-hand. Moreover, left-hand haptic performance was the sole predictor of MRT performance. These findings suggest that sex differences in haptic processing may contribute to the observed sex differences in mental rotation ability, supporting the view that sensorimotor processes shape cognitive function and its hemispheric lateralization.
Metabolomics, network pharmacology, and microbiome analyses uncover the mechanisms of the Chinese herbal formula for the improvement of meat quality in spent hens
Authors: Li Zhihua , Azad Md. Abul Kalam , Meng Chengwen , Kong Xiangfeng , Gui Jue , Lin Wenchao , Cui Yadong , Lan Wei , He Qinghua
Published: February 2025

Background

Meat originating from the spent hen is an important source of poultry meat production; however, multiple factors cause the decline in the meat quality of spent hens. Chinese herbs have been widely used as medicine for a long time to prevent diseases and as nutrient supplements to improve the product quality. This experiment explored the effects of adding 1.0% Chinese herbal formula (CHF, including 0.30% Leonurus japonicus Houtt., 0.20% Salvia miltiorrhiza Bge., 0.25% Ligustrum lucidum Ait., and 0.25% Taraxacum mongolicum Hand.-Mazz.) for 120 d to the spent hens’ diet through metabolomics, network pharmacology, and microbiome strategies.

Results

The results indicated that CHF supplementation improved the meat quality by reducing drip loss (P < 0.05), b* value (P = 0.058), and shear force (P = 0.099) and increasing cooked meat percentage (P = 0.054) and dry matter (P < 0.05) of breast muscle. The addition of CHF improved the nutritional value of breast muscle by increasing (P < 0.05) the content of C18:2n-6, n-6/n-3 polyunsaturated fatty acids (PUFA), total PUFA, PUFA-to-saturated fatty acids (SFA) ratio, and hypocholesterolemic-to-hypercholesterolemic ratio, and tending to increase serine content (P = 0.069). The targeted metabolomics analysis revealed that the biosynthesis of SFA, linoleic acid metabolism, fatty acid degradation, fatty acid elongation, and fatty acid biosynthesis pathways were enriched by CHF supplementation. Furthermore, the network pharmacology analysis indicated that CHF was closely associated with oxidative stress and lipid metabolism. The CHF supplementation increased the glutathione peroxidase level (P < 0.05) and upregulated gene expression related to the Nrf2 pathway (including HO-1, P < 0.05; Nrf2, P = 0.098; CAT, P = 0.060; GPX1, P = 0.063; and SOD2, P = 0.052) and lipid metabolism (including PPARγ, P < 0.05; SREBP1, P = 0.059; and CPT1A, P = 0.058). Additionally, CHF supplementation increased Firmicutes and decreased Bacteroidetes, Spirochaetes, and Synergistetes abundances (P < 0.05), which may contribute to better meat quality.

Conclusions

Our results suggest that CHF supplementation improved the quality and nutritional value of meat, which will provide a theoretical basis for the utilization of CHF as a feed additive in spent hens’ diets.

Graphical Abstract
Teaching, learning, and growing: the construction of a novice L2 writing teacher’s personal practical knowledge
Authors: Li Mingyu
Published: February 2025

Although research interest in second language (L2) teachers has grown, novice L2 teachers remain understudied, especially writing teachers. Existing research on L2 writing teachers has largely centred on cognitive development, often overlooking crucial personal and socio-contextual aspects. Utilising a narrative case study approach, this study addresses the gap by exploring the personal practical knowledge of a novice L2 writing teacher, offering a personal, socio-contextual perspective on teacher knowledge. The study utilises narrative interviews, reflective journal entries and teaching artefacts to construct a comprehensive portrayal of the teacher’s journey of professional development. Findings reveal that novice teachers’ self-image, a significant component of their personal practical knowledge, is profoundly influenced by their past experiences and continually guides their teaching. The study calls for a re-evaluation of training programmes to incorporate strategies that help novice teachers integrate their personal histories and contextual realities into their professional practice. Recommendations for future research include cross-cultural and cross-disciplinary longitudinal studies that incorporate multimodal narratives to more effectively track the evolution of novice teachers’ practical knowledge and its impact on teaching efficacy in the global educational landscape.
Giant and irregular pituitary neuroendocrine tumors surgery: comparison of simultaneous combined endoscopic endonasal and transcranial and purely endoscopic endonasal surgery at a single center
Authors: Fu Jun , Luo Wenwei , Zhang Chunlin , Wang Zhicheng , Fan Wenjian , Lin Yuanxiang , Kang Dezhi , Song Jianping , Jiang Changzhen , Yan Xiaorong
Published: February 2025

Background

Surgical management of giant and irregular pituitary neuroendocrine tumors (GIPitNETs) presents a significant challenge in neurosurgery. While endoscopic endonasal surgery (EES) is a widely used approach for PitNETs, GIPitNETs with extensive intracranial extension pose challenges for purely EES. We use simultaneous combined endoscopic endonasal and transcranial surgery (CECS) for the treatment of this type of tumor. Currently, there is limited research comparing CECS to EES for GIPitNETs. This study aims to compare the efficacy and short outcome of CECS and purely EES in the management of GIPitNETs to better understand the advantages and limitations of each surgical approach.

Methods

The data of GIPitNETs patients who underwent surgery between March 2018 and May 2023 at a single center were retrospectively reviewed. All included cases were divided into CECS and EES groups according to the treatment modality received. The baseline characteristics and tumor imaging features of patients were compared between the groups, as well as surgical results, perioperative complications, and last follow-up outcomes.

Results

A total of 50 patients met the inclusion criteria, with 27 undergoing CECS and 23 EES. CECS achieved a significantly higher GTR rate compared to EES (66.7% vs. 13.0%, p < 0.0001). CECS had longer operation times and hospital stays, but both approaches had similar rates of complications, including intracranial infection, CSF leakage, new pituitary dysfunction, postoperative diabetes insipidus, and vascular infarction. CECS reduces the risk of postoperative bleeding. Tumor recurrence and reoperation were significantly more common in the EES group.

Conclusions

CECS is a safe and effective surgical approach for GIPitNETs, leading to higher rates of GTR, comparable complication rates, and reduced risk of postoperative bleeding when compared to purely EES. EES was associated with more tumor recurrence. Further long-term follow-up data is needed to validate these findings.
Exploring MAP3K genes in gastric cancer: biomarkers, tumor microenvironment dynamics, and chemotherapy resistance
Authors: Wei Senhui , Li Ying , Zhou Jing , Xia Yongming
Published: February 2025

Background

Gastric cancer (GC) presents a significant global health burden, necessitating a deeper understanding of its molecular underpinnings for improved diagnostics and therapeutics.

Methods

In this study, we investigated the expression profiles and clinical implications of MAP3K genes in GC using in silico and in vitro experiments.

Results

Utilizing RT-qPCR analysis, we observed significant up-regulation of MAP3K1, MAP3K4, MAP3K5, MAP3K6, MAP3K7, MAP3K8, MAP3K9, and MAP3K10 in GC cell lines, while MAP3K2, MAP3K3, MAP3K11, MAP3K12, MAP3K13, MAP3K14, and MAP3K15 exhibited down-regulation. Prognostic evaluation revealed that elevated expression of MAP3K1, MAP3K4, MAP3K7, MAP3K8, MAP3K9, and MAP3K10 was associated with shorter overall survival (OS), emphasizing their clinical significance. Furthermore, the diagnostic potential was demonstrated through robust Receiver operating characteristics (ROC) curve analysis, indicating the strong discriminatory power of these genes in distinguishing GC patients. Proteomic analysis further confirmed the higher expression of MAP3K1, MAP3K4, MAP3K7, MAP3K8, MAP3K9, and MAP3K10 genes in GC. Methylation profiling further supported the idea that promoter hypomethylation of MAP3K1, MAP3K4, MAP3K7, MAP3K8, MAP3K9, and MAP3K10 genes was associated with their up-regulation. Single-cell functional analysis elucidated the involvement of MAP3K genes in shaping the tumor microenvironment. miRNA-mRNA network analysis revealed intricate regulatory mechanisms, with hsa-mir-200b-3p emerging as a key regulator. Finally, the MAP3K1 knockdown has shown significant impacts on the cellular behavior of the BGC823 cells.

Conclusion

This comprehensive assessment provides valuable insights into the role of MAP3K genes in GC, offering avenues for further research and therapeutic exploration.
Identification of prognostic biomarker of non-small cell lung cancer based on mitochondrial permeability transition-driven necrosis-related genes and determination of anti-tumor effect of ARL14
Authors: Ma Zhifei , Chen Wen , Zhang Aiping , Shen Xiaokang , Zheng Lin
Published: February 2025

Background

Mitochondrial permeability transition (MPT)-driven necrosis (MPTDN) is a non-apoptotic mode of cell death triggered by oxidative stress and cytosolic Ca2+ overload. Recent evidence suggests that activation of MPTND can effectively induce cancer cell death and may represent a novel therapeutic strategy for cancer. Yet, the role of MPTDN-related genes in non-small cell lung cancer (NSCLC) remains unrevealed. This study aimed to identify MPTDN-related biomarkers for predicting prognosis and guiding treatment in NSCLC.

Methods

Gene expression profiles and clinical information of NSCLC were collected from public databases, and MPTDN-related genes were obtained from published article. Differential expressed MPTDN-related genes in NSCLC and control were screened, and molecular clusters were obtained. Based on the differentially expressed genes (DGEs) between clusters, univariate Cox and LASSO regression analyses were performed to screen biomarkers, followed by nomogram construction. Correlations between these biomarkers and immune cell infiltration, immune checkpoints, and chemotherapeutic agents were observed. Expression levels of MPTDN-related biomarkers were detected using RT-qPCR in NSCLC tissues and cells. Moreover, the biological function of ARL14 in NSLCL was verified in vitro.

Results

Thirty-five differential MPTDN-related genes were identified, and two molecular clusters were obtained. Three biomarkers with prognostic values were finally screened, including ARL14, ZDHHC11B, and HLF. Among them, ARL14 was significantly upregulated in tumor samples, while ZDHHC11B and HLF were downregulated. Nomogram containing three genes exhibited predictive accuracy in 1, 3, and 5-year survival rates. Three gene were strongly associated with most immune cells, immune checkpoints, and drugs sensitivity. RT-qPCR confirmed that expression levels of three genes in tissues or cells were consistent with the results of bioinformatics analysis. Finally, ARL14 knockdown inhibited the malignant phenotype of NSCLC cells.

Conclusion

We first performed the comprehensive analysis of MPTDN in NSCLC and screened three NSCLC-related biomarkers as promising biomarkers. ARL14 might be a new potential target for therapy of NSCLC.
Models for predicting risk of endometrial cancer: a systematic review
Authors: Forder Bea Harris , Ardasheva Anastasia , Atha Karyna , Nentwich Hannah , Abhari Roxanna , Kartsonaki Christiana
Published: February 2025

Background

Endometrial cancer (EC) is the most prevalent gynaecological cancer in the UK with a rising incidence. Various models exist to predict the risk of developing EC, for different settings and prediction timeframes. This systematic review aims to provide a summary of models and assess their characteristics and performance.

Methods

A systematic search of the MEDLINE and Embase (OVID) databases was used to identify risk prediction models related to EC and studies validating these models. Papers relating to predicting the risk of a future diagnosis of EC were selected for inclusion. Study characteristics, variables included in the model, methods used, and model performance, were extracted. The Prediction model Risk-of-Bias Assessment Tool was used to assess model quality.

Results

Twenty studies describing 19 models were included. Ten were designed for the general population and nine for high-risk populations. Three models were developed for premenopausal women and two for postmenopausal women. Logistic regression was the most used development method. Three models, all in the general population, had a low risk of bias and all models had high applicability. Most models had moderate (area under the receiver operating characteristic curve (AUC) 0.60–0.80) or high predictive ability (AUC > 0.80) with AUCs ranging from 0.56 to 0.92. Calibration was assessed for five models. Two of these, the Hippisley-Cox and Coupland QCancer models, had high predictive ability and were well calibrated; these models also received a low risk of bias rating.

Conclusions

Several models of moderate-high predictive ability exist for predicting the risk of EC, but study quality varies, with most models at high risk of bias. External validation of well-performing models in large, diverse cohorts is needed to assess their utility.

Registration

The protocol for this review is available on PROSPERO (CRD42022303085).
Post-angiography spontaneous closure of cavernous sinus dural arteriovenous fistula: case report in Indonesia
Authors: Permana Affan , Samudra Stevanus , Santoso Fabianto , Wicaksono Adiguno
Published: February 2025

Intracranial cases of dural arteriovenous fistulas (dAVF) with spontaneous closure rarely occur. We reported a cavernous sinus dAVF (CS-DAVF) that closed spontaneously only after angiography. The patient complained of redness of left eye with reduced visual acuity, chemosis, retro-orbital pain, and ophthalmoplegia. The patient was compos mentis with anisocoria (right pupil with 3 mm diameter and left pupil with 5 mm diameter) and negative pupillary right reflex except the direct pupillary light reflex at the right eye. Diagnostic digital subtraction angiography (DSA) was performed two times without any intervention. The contrast could not fill the superior ophthalmic vein at the second DSA. At the therapeutic DSA a month later, the fistula between left and right meningohypophyseal trunk toward the cavernous sinus was no longer identified. We hypothesized that the phenomenon of spontaneous dAVF closure is similar by the mechanism according to publication by Al-Afif et al. as the patient had no history of trauma and only received diagnostic angiography procedure along with the contrast that used for the procedure.
Comparative safety and effectiveness of cryoballoon versus radiofrequency ablation for atrial fibrillation: a systematic review and meta-analysis
Authors: Furqan Muhammad , Raza Ifrah Inbisat , Younus Shaheera , Fatima Hareer , Azhar Hiba , Fatima Sania Kaneez , Ali Laiba , Khan Sara , Ellahi Aayat
Published: February 2025

Background

Over the past fifty years, the incidence of atrial fibrillation (AF) has tripled. Traditionally, the main treatment for this condition has been pulmonary vein isolation (PVI) performed using radiofrequency catheter ablation (RFCA). However, another technique known as cryoballoon ablation (CBA) has been developed as another option for managing this heart rhythm disorder. This study evaluated the efficacy and safety of CBA and RFCA for the treatment of AF.

Methods

This study compared the safety and effectiveness of CBA and RFCA for the treatment of AF using a thorough review of randomized controlled trials up until June 1, 2023.

Results

The results revealed that CBA and RFCA had similar effectiveness and safety profiles in achieving freedom from AF (RR: 1.00; 95% CI: 0.93 to 1.07, p = 0.99) and paroxysmal atrial fibrillation (PAF) (RR: 0.99; 95% CI: 0.89 to 1.10, p = 0.79). CBA was faster (MD =  − 23.99; 95% CI: − 32.98 to − 15.00; p < 0.00001) with a higher risk of phrenic nerve palsy (RR = 6.88; 95% CI: 3.26 to 14.50, p < 0.00001). Acute PVI rate (RR = 1.0; 95% CI: 0.99 to 1.01, p = 0.95), overall complications (RR = 1.37; 95% CI: 0.93 to 2.01, p = 0.11), pericardial effusion (RR = 0.59; 95% CI: 0.25 to 1.41, p = 0.24), and fluoroscopy time (MD = 1.63; 95% CI: − 2.06 5.32; p = 0.39) did not significantly differ between the two procedures.

Conclusions

CBA and RFCA offer similar outcomes for patients with AF and PAF, with CBA being quicker but carrying a slightly higher risk of phrenic nerve palsy.
Clinical and angiographic profile of left main coronary artery disease in patients with chronic coronary syndrome: a retrospective study
Authors: Algamal Abdulsalam Mahmoud , Salem Mahmoud Abdelbadie , Bedier Ahmed Ibrahim , Hussein Mohammed Salah A. , Abdelrahim Mona Malek , Elhusseiny Shady Hussein
Published: February 2025

Background

Obstructive left main disease (LMD) is a challenging entity of coronary artery disease with variable patterns among different studies. We aimed to evaluate the prevalence, demographic, clinical, and angiographic profiles of LMD. We conducted a single-center retrospective study over a period of 10 years to screen all patients who underwent elective cardiac catheterization for chronic coronary syndrome. Of the 19,336 screened cases, 944 obstructive LMD patients were included as the patients' group. Age and sex-matched control groups included patients with normal coronary angiography and non-LMD.

Results

Obstructive LMD had a prevalence of 4.9%, a mean age of around 60 years, and a male to female ratio of approximately 3:1. About 9.8% of LMD patients were < 50 years. Compared to males, females with LMD had significantly older age and increasing prevalence with age from 9.7% in patients < 50 years to 27.4% in patients > 70 years. LMD versus non-LMD patients had a significantly higher prevalence of diabetes mellitus, dyslipidemia, and number of stenotic coronary segments and arteries, and nonsignificant differences regarding smoking, hypertension, previous myocardial infarction, and ejection fraction. Ostial LMD had a prevalence of 2%, a mean age of around 58 years and 21% were females. In LMD patients, the most affected sites were the ostial/proximal left anterior descending artery and distal left main bifurcation. Bypass grafting surgery was the standard angiographic decision in LMD in 75.8% of cases, which was significantly higher than non-LMD. LMD patients revascularized surgically versus percutaneous treatment had significantly lower ejection fraction, significantly higher multivessel disease, and no significant differences regarding age, sex, hypertension, and diabetes mellitus.

Conclusion

Obstructive LMD is a relatively common angiographic finding, with a higher prevalence among males around 60 years. In LMD, bypass grafting was the main revascularization strategy. We recommend integrating clinical characteristics, and noninvasive investigations as a predictive model of LMD.
Efficacy and safety of repetitive transcranial magnetic stimulation in the treatment of male smokers with tobacco use disorder: a randomized controlled trial
Authors: Mousa Salma W. , Badawy Adel A. , Attia Gehan F. , Ghareeb Wesam A.
Published: February 2025

Background

Tobacco use disorder (TUD) is a long-term condition marked by compulsive smoking, intense cravings, and withdrawal effects. Repetitive transcranial magnetic stimulation (r-TMS), which targets the left dorsolateral prefrontal cortex (DLPFC), has been identified as a promising therapeutic approach. However, research on the use of r-TMS for treating TUD in Egypt remains scarce. This study aimed to assess the effectiveness of active r-TMS in reducing smoking behavior, withdrawal symptoms, cravings, and nicotine dependence, in comparison to sham treatment, while also examining its tolerability as a treatment option for TUD.

Results

Forty male smokers (aged 18–60 years) who smoked a minimum of 10 cigarettes per day for a minimum of 12 months were randomized into two groups: the active r-TMS group (n = 20) and the sham group (n = 20). Active r-TMS treatment, delivered over 15 sessions (5 sessions weekly for 3 consecutive weeks), significantly reduced the number of cigarettes smoked daily (p = 0.001), nicotine dependence (p = 0.023), withdrawal symptoms (both self-reported and observer-rated) (p = 0.001), and craving (p = 0.007) compared to the sham treatment. Urinary cotinine levels, a biomarker of nicotine intake, were also significantly lower in the active r-TMS group during the follow-up period (p = 0.011). The treatment was generally well-tolerated, with only minor side effects, such as headaches (22.5%).

Conclusions

Active r-TMS targeting the left DLPFC effectively reduced nicotine dependence, withdrawal symptoms, and craving, demonstrating its potential as a promising treatment for TUD. These findings align with previous studies supporting the efficacy of r-TMS in addiction treatment. Further research is needed to optimize treatment protocols, explore combined therapies, and assess long-term outcomes to improve smoking cessation in diverse populations.
Prospective observational study of oral clonazepam to prevent high-dose busulfan-induced seizures in adult patients
Authors: Díaz-Carrasco María Sacramento , Sánchez-Salinas Andrés , Fernández-Ávila Juan José , Olmos-Jiménez Raquel , Español-Morales Ignacio , Espuny-Miró Alberto
Published: February 2025

Background

Busulfan at high doses has been associated with a risk of seizures. Phenytoin has been used traditionally as anti-seizure prophylaxis, and benzodiazepines and levetiracetam have been introduced more recently, providing data from retrospective series. The main purpose of this study was to evaluate the effectiveness of oral clonazepam as anti-seizure prophylaxis in adult patients receiving high doses of intravenous busulfan as part of the conditioning regimen for hematopoietic stem cell transplantation. The secondary objectives were to determine the feasibility of this regimen and to analyze the adverse events associated with the use of clonazepam.

Methods

This prospective, single-center study included 64 adult patients who received conditioning regimens with high doses of intravenous busulfan and anti-seizure prophylaxis with oral clonazepam, at a dose of 1 mg/8 h, from 12 h before starting treatment with busulfan until 48 h after ending administration.

Results

The effectiveness of the prophylaxis was 100%, with no episodes of seizures during busulfan treatment or in the 72 h afterwards. Treatment was feasible, and oral scheduled administration was completed in all patients. Adverse events that could be associated with clonazepam included the onset of somnolence, dizziness, and confusion, mostly mild.

Conclusion

The oral clonazepam regimen described in this study has been prospectively shown to be an effective, feasible anti-seizure prophylaxis option with manageable toxicity.
Adopting augmented reality into retailing mix strategy: Generation Z’s perspective in Egypt
Authors: Ibrahim Marwa Mahmoud , Nasr Rasha Ihab
Published: February 2025

Augmented reality (AR) is a great opportunity for the retail industry because it provides companies with new ways to communicate with customers, promote their products, and achieve more sales. The purpose of this research is to gain a better understanding of the benefits of including AR as part of retailers’ mix on customers’ behavioural intentions, considering the mediation effect of customer experience and the moderation effect of technology readiness. This research has been conducted among Generation Z in Egypt. Consequently, a conceptual model proposing specific connections between the research's variables has been developed and tested. The empirical part of this research relied on a single cross-sectional data collection design, with a sample of 400 respondents using a structured questionnaire. Structural equation modelling analysis was the main statistical tool for testing the hypotheses. The research findings validate the research conceptual framework, emphasizing that the inclusion of AR in the retail mix plays a crucial role in influencing customer behavioural intention. The overall findings suggest that AR enhances interaction and exerts a significant impact on consumer responses by enriching the perceived informativeness as well as fostering perceived playfulness, guaranteeing engagement, enjoyment, and a sense of fun. Also, the findings show that individuals' readiness and comfort with technology play a significant role in shaping their behavioural intentions when interacting with AR applications. From an academic perspective, this research highlights significant issues and formulates vital conclusions that address the gaps in considering AR as part of the retail mix. Furthermore, from a practical perspective, it provides a significant clue for online retailers who are operating in the Egyptian market for the importance of using AR on customer experience and indicates Generation Z's readiness to use the technology.
The impact of mobile health interventions on service users' health outcomes and the role of health professions: a systematic review of systematic reviews
Authors: Alkhuzaimi Fathiya , Rainey Deborah , Brown Wilson Christine , Bloomfield Jacqueline
Published: February 2025

Background

Mobile health (mHealth) tools have gained prominence in global healthcare in recent years, with demonstrated impacts on managing service users' health. While many systematic reviews have assessed the effectiveness of mHealth on health outcomes, the role of health professions in promoting mHealth adoption and leading to improved outcomes is less clear. This systematic review of systematic reviews (SR of SRs) critically appraises and synthesises evidence to examine both the impact of mHealth interventions on service users' outcomes and the role of health professions in facilitating their adoption.

Methods

Five electronic databases—EMBASE, CINAHL Plus, Medline, Web of Science, and the Cochrane Library—were searched for systematic reviews published between 1 January 2015 and 8 June 2024. Reviews focused on the impact of mHealth interventions on service users' outcomes and the role of health professions in promoting adoption were included. Screening, data extraction, and quality assessment were conducted by four independent reviewers.

Results

Fourteen systematic reviews, covering 393 primary studies, were included. mHealth interventions showed positive impacts on clinical outcomes, such as reductions in blood pressure, HbA1c, and cholesterol. Behavioural improvements were also reported, including better medication adherence and physical activity. Psychological benefits, such as reduced anxiety and enhanced patient satisfaction, were noted. The involvement of health professions significantly enhanced mHealth outcomes. However, challenges such as sustainability, accessibility, and usability remain.

Discussion

This SR of SRs provides critical insights into the effectiveness of mHealth interventions on health outcomes and highlights the important role of health professions in promoting their adoption. While the findings are promising, concerns about training, sustainability, accessibility, and user acceptance need to be addressed to improve the broader adoption of mHealth interventions. Further research is recommended to address these challenges and enhance the long-term success of mHealth tools in healthcare.

Trial registration

PROSPERO CRD 42023414435. DOI: https://doi.org/10.1186/s13643-024-02624-y
‘It takes a village’: patient lived experiences of residential treatment for an eating disorder
Authors: Rankin Rebekah , Conti Janet , Ramjan Lucie , Hay Phillipa
Published: February 2025

Background

Residential treatment facilities for eating disorders are becoming increasingly common and purport to provide recovery-orientated care in a less restrictive environment than traditional hospital settings. However, minimal attention has focused on individuals’ lived experiences of these residential services.

Aims

This study explores participants’ lived experiences of care at Australia’s first residential facility for the treatment of eating disorders.

Method

Qualitative data were collected as part of a clinical evaluation (June 2021 to August 2023). Fifteen women participated in semi-structured interviews about their experience of treatment following discharge. Data were analysed with inductive reflexive thematic analysis.

Results

Three main themes were generated from the data that included participants’ journeys to treatment, experiences of treatment and the transitions associated with and following discharge. Cutting across these main themes were participants’ encounters of barriers, setbacks and hope. Participant experiences of residential treatment were complex and multifaceted, marked by inherent ideological dilemmas that arose in balancing standardised treatment protocols with person-centred and recovery-oriented care. Participants also spoke of reclaiming a sense of self and identity beyond their eating disorder, emphasising the importance of relationships and consistent and collaborative care.

Conclusions

Participant accounts of residential treatment emphasised the importance of holistic, person-centred and recovery-oriented care. Despite the complexities of treatment experiences, participant narratives underscored how recovery may be more about the reclamation of a sense of identity outside of the eating disorder than merely symptom improvement. As such, adopting person-centred and recovery-oriented treatment approaches within residential treatment settings may maximise individual autonomy and promote holistic recovery pathways.
Associations between antidepressants and risk of suicidal behavior and violent crimes in personality disorder
Authors: Herttua Kimmo , Scola Giulio , Paljarvi Tapio , Fazel Seena
Published: February 2025

Background

Despite uncertain benefits, antidepressants are used in the management of personality disorders (PDs). We investigated the association between antidepressants and two adverse outcomes - suicidal behaviour and violent crimes - in individuals with PDs.

Methods

We used nationwide Danish healthcare registries to identify all individuals with a diagnosed PD aged 18–64 years from 2007 to 2016. Antidepressant use was identified using dispensed prescriptions. Individuals were followed up for healthcare presentations of suicidal behaviour and separately for police-recorded charges of violent crimes. We applied a within-individual design comparing rates of suicidal behaviour and violent crimes during time periods of antidepressant treatment with periods without treatment. Subgroup analyses were performed according to PD clusters, individual antidepressants, specific PDs, psychiatric comorbidities, and history of suicidal behaviour and violent crime.

Results

The cohort included 167,319 individuals with a diagnosed PD, 19,519 (12%) of whom were prescribed antidepressants and presented at least one outcome event during follow-up, making them eligible for within-individual analyses. Overall, we found an association with lower rates of suicidal behavior during periods of antidepressant treatment, compared with periods when individuals were not on antidepressants (incidence rate ratio 0.86, 95% CI 0.84–0.89). However, this association was modified by specific PDs, individual antidepressants, comorbidities, and past history. For violent crimes, we did not observe consistent associations in any direction.

Conclusions

Antidepressants were associated with lower rates of suicidal behaviour, but less clearly in violent crimes. Types of PDs, individual antidepressants, and comorbidities modified these associations.
Classification and Diagnosis of Epilepsy
Authors: Katyal Roohi
Published: February 2025

OBJECTIVE

This article provides readers with a foundational understanding of epilepsy, including epilepsy classification, and presents a strategic approach to the diagnosis of seizures and epilepsy.

LATEST DEVELOPMENTS

Epilepsy classification systems have evolved over the years, with improved categorization of seizure types and adoption of more widely accepted and comprehensible terminologies. The International League Against Epilepsy (ILAE) Classification of the Epilepsies (2017) introduces a three-tiered framework. The levels focus on the determination of seizure type, epilepsy type, and identification of epilepsy syndrome, when applicable. The 2017 ILAE classification emphasizes the evaluation of the underlying etiology of epilepsy and the identification of associated comorbidities at all stages of classification. Epilepsy syndromes often have age-dependent symptoms.

ESSENTIAL POINTS

A systematic approach to the classification of seizures and epilepsy is essential for the selection of appropriate diagnostic tests and treatment strategies. An accurate classification not only facilitates clinical assessment but has important implications in the determination of prognosis.
Surgical Treatments, Devices, and Nonmedical Management of Epilepsy
Authors: Friedman Daniel
Published: February 2025

OBJECTIVE

Many patients with epilepsy are unable to achieve optimal seizure control with medical therapy. This article focuses on surgical approaches, dietary therapies, and seizure detection devices.

LATEST DEVELOPMENTS

For more than a century, resective epilepsy surgery has been a treatment option for some patients with drug-resistant epilepsy. Other surgical options have emerged for patients for whom resection is not possible or is associated with unacceptable risks, including minimally invasive epilepsy surgery and neurostimulation therapies. Dietary therapies, such as the ketogenic diet, can also help improve seizure control, especially in children. For patients with ongoing nocturnal convulsive seizures, seizure detection devices can alert caregivers and potentially reduce the risk of sudden unexpected death in epilepsy (SUDEP).

ESSENTIAL POINTS

Patients with drug-resistant epilepsy should be referred to comprehensive epilepsy centers to determine if they qualify for nonpharmacologic treatment options to reduce the risk of seizures and premature death and improve quality of life.
Epilepsy Comorbidities
Authors: Keezer Mark R.
Published: February 2025

OBJECTIVE

This article reviews the comorbidities of epilepsy and identifies tools to incorporate comorbidity awareness into clinical practice.

LATEST DEVELOPMENTS

The comorbidities of epilepsy are broadly defined, including conditions that may cause but also be a consequence of epilepsy. These can be divided into somatic and psychiatric conditions. Many conditions occur twice as frequently in people with epilepsy compared with the general population. The comorbidities of epilepsy are a major determinant of quality of life and mortality in people with epilepsy. This article provides a concerted focus on the relationship between epilepsy and cognition, mental health disorders, and cardiovascular disease.

ESSENTIAL POINTS

There are practical means of adopting a comorbidity-aware approach to clinical care without overburdening already busy clinical practices. Screening instruments can be used to identify people with comorbid anxiety or depression. Fundamental safety precautions are relevant to all people with epilepsy. Appropriate consideration of the comorbidities of epilepsy, particularly when choosing an antiseizure medication, leads to improved patient care.
First Seizures, Acute Repetitive Seizures, and Status Epilepticus
Authors: Vossler David G.
Published: February 2025

OBJECTIVE

This article provides current evidence on how and when to treat unprovoked first seizures in children and adults, guides intervention with appropriate doses and types of modern and effective therapies for acute repetitive (cluster) seizures, and reviews evidence for the diagnosis and management of established, refractory and super-refractory status epilepticus.

LATEST DEVELOPMENTS

Artificial intelligence shows promise as a clinical assistant in decision making after a first seizure. For nonanoxic convulsive refractory status epilepticus third-phase treatment, equipoise exists regarding whether it is better to add a second IV nonsedating antiseizure medication given via loading dose (eg, brivaracetam, lacosamide, levetiracetam, fosphenytoin or valproic acid) or to start an anesthetizing continuous IV infusion antiseizure medication such as ketamine, midazolam, propofol or pentobarbital.

ESSENTIAL POINTS

After a first seizure, the risk of a second seizure is about 36% at 2 years and 46% after 5 years. The risk is doubled in the presence of EEG epileptiform discharges, a brain imaging abnormality, a nocturnal first seizure, or prior brain trauma. For acute repetitive seizures, providers should give a proper dose of benzodiazepines based on the patient’s weight and needs. First-phase treatment for convulsive established status epilepticus is the immediate administration of full doses of benzodiazepines. Second-phase treatment for convulsive established status epilepticus is a full loading dose of IV fosphenytoin, levetiracetam, valproic acid, or if necessary, phenobarbital.
Sexual and Reproductive Health in the Management of Epilepsy
Authors: Bensalem-Owen Meriem K.
Published: February 2025

OBJECTIVE

The management of epilepsy should be patient centered, and the treating team should carefully balance eliminating seizures while minimizing adverse effects associated with antiseizure medications. This article highlights important aspects of care related to sexual and reproductive health in people with epilepsy.

LATEST DEVELOPMENTS

Gender- and sex-based management in epilepsy can present unique challenges especially in people with epilepsy of childbearing potential. One of the most important considerations with the prescription of antiseizure medications to people of childbearing potential involves reproductive health. Folic acid supplementation is recommended to reduce the risk of congenital malformations, but there is no consensus on the optimal dose. The clinical management of pregnancy in the setting of epilepsy can be challenging. Significant knowledge gaps remain regarding the risks for most new antiseizure medications, neurostimulation therapy, and ketogenic diets during pregnancy. Ongoing multicenter pregnancy registries continue to inform practitioners on the medical treatment of people with epilepsy of childbearing potential. Data evaluating the effect of antiseizure medications on male patients with epilepsy, especially around conception, continue to be insufficient.

ESSENTIAL POINTS

The decision to prescribe an antiseizure medication depends on several considerations because of the potential for lifetime treatment with a daily medication. It is important to tailor management to the patient’s specific circumstances. Seizures and antiseizure medications can both affect sexual and reproductive health. Furthermore, hormone fluctuations may affect seizure frequency, treatment, and contraception. All these factors should be considered when treating people with epilepsy during their reproductive years. In addition, it is important to foster a multidisciplinary approach for the treatment of people with epilepsy.
A Multidisciplinary Approach to Nonepileptic Events
Authors: Patron Victor , Bermeo-Ovalle Adriana C.
Published: February 2025

OBJECTIVE

This article provides a guide for neurologists managing nonepileptic events (NEEs), a complex intersection of neurology and psychiatry. It covers risk factors, pathophysiology, current treatment approaches, and prognosis, with specific management strategies for challenging scenarios such as patients with intellectual disabilities and comorbid epilepsy.

LATEST DEVELOPMENTS

An emphasis on strong communication and coordinated care among health care specialists improves patient outcomes and reduces unnecessary medical consultations and procedures. This approach is now recognized as essential for addressing the complex presentation and comorbidities associated with NEEs.

ESSENTIAL POINTS

NEEs are prevalent and highly disabling, and multiple pathophysiologic mechanisms for these events have been proposed. Mortality is comparable with that of patients with treatment-refractory epilepsy, and prognosis is better for children than adults. Achievable treatment goals for adults include improved quality of life and reduced frequency and severity of events, even if complete remission of NEEs is not achieved. Enhanced communication and coordinated care through multidisciplinary care teams enable the efficient use of individual expertise at different treatment stages to address the presentation, risk factors, and comorbidities associated with NEEs, resulting in a better quality of life for patients.
Diversity and Underserved Patient Populations in Epilepsy
Authors: Clarke Dave F.
Published: February 2025

OBJECTIVE

Despite advancements in epilepsy management, disparities and lack of inclusion of many people with epilepsy are associated with increased morbidity and mortality. Compounding these problems is the paucity of diversity among health care providers, research participants, and researchers. This issue as well as potential solutions are explored in this article.

LATEST DEVELOPMENTS

Prompted by recent social justice incidents, patient advocacy groups, epilepsy societies, and governing bodies such as the National Institute of Neurological Disorders and Stroke, US Centers for Disease Control and Prevention, and the Intersectoral Global Action Plan on Epilepsy and Other Neurological Disorders have proposed initiatives to improve disparities in epilepsy care. Public health epilepsy research continues to expose deficiencies and disparities. Increased awareness of health care gaps and technologic advances should help foster improved epilepsy health equity and inclusivity.

ESSENTIAL POINTS

To deliver timely, effective care for people with epilepsy, we must be knowledgeable of sociodemographic obstacles to access. These include confounding factors such as historical determinants, unconscious bias, and lack of diversity. Improving awareness and promoting diversity in research participation can advance treatment for underserved populations and improve trust.
All Implantable Cardioverter Defibrillators Are Not Programmed Equal: A Case Report of Pseudomalfunction
Authors: Nelson Mark T. , Miller Anna Julia , Kalahasty Gautham
Published: February 2025

As the population ages, the need for anesthesiologists to manage complicated implantable cardioverter defibrillators (ICDs) has increased. We present a case of hemodynamically unstable ventricular tachycardia occurring during a transcatheter aortic valve replacement where magnet removal from the ICD did not result in the expected tachytherapies. When managing patients with an ICD, we emphasize preoperative placement of external defibrillator pads and prompt use of external shocks rather than relying on the ICD to manage hemodynamically unstable tachyarrhythmias.
The Sacral Multifidus Plane Block for Analgesia After Coccygectomy: Case Report
Authors: Marrone Francesco , Fusco Pierfrancesco , Paventi Saverio , Tomei Marco , Pullano Carmine
Published: February 2025

Coccygodynia results from traumatic, nontraumatic, or idiopathic causes. Chronic cases resistant to conservative treatments may necessitate surgery. This case report highlights the innovative use of sacral multifidus plane block (S-MPB) for multimodal pain management after a coccygectomy performed under spinal anesthesia. The patient, suffering from chronic coccygodynia due to exostosis, underwent surgical removal of the coccyx and associated fistula. S-MPB was chosen for its simplicity, efficacy, and safety, providing postoperative analgesia without complications. This approach suggests that S-MPB is a promising addition to the pain management arsenal for coccygectomy, warranting further investigation to optimize its application and outcomes.
Nonresident Parent Wealth Among Children
Authors: Hays Jake , Fomby Paula
Published: February 2025

Wealth matters for children's well-being. However, most research has considered only the wealth held in children's resident households, even though more than one quarter of U.S. children have a parent living elsewhere. We provide the first national estimates of nonresident parent wealth among children who ever lived with both parents in a shared household. We use the Panel Study of Income Dynamics (1984–2021)—whose survey design enables us to produce unbiased estimates with respect to factors that condition access to nonresident parents—to describe the characteristics of nonresident parent wealth, children's potential access to it, and its contribution to educational attainment. We find that nonresident parent wealth varies substantially and that the rank–rank correlation between nonresident and resident parent wealth is roughly .3. Nonresident parent wealth is positively predictive of more frequent parent–child contact, more consistent and higher value child support payments, and children's bachelor's degree attainment, suggesting that it is related to multiple domains of parenting and child well-being. The findings demonstrate that accounting for the spread of resources across households, but within a family system, is critical to understanding broader patterns of inequality in American family life.