bluuebunny/crossref_metadata_2025 huggingface dataset:
Slowly digestible starch impairs growth performance of broiler chickens offered low-protein diet supplemental higher amino acid densities by inhibiting the utilization of intestinal amino acid
Authors: Luo Caiwei , Yu Yao , Meng Gang , Yuan Jianmin
Published: January 2025

Background

The synchronized absorption of amino acids (AAs) and glucose in the gut is crucial for effective AA utilization and protein synthesis in the body. The study investigated how the starch digestion rate and AA levels impact intestinal AA digestion, transport and metabolism, breast muscle protein metabolism, and growth in grower broilers. A total of 720 21-day-old healthy male Arbor Acres Plus broilers were randomly assigned to 12 treatments, each with 6 replicates of 10 birds. The treatments comprised 3 different starch [corn: control, cassava: rapidly digestible starch (RDS), and pea: slowly digestible starch (SDS)] with 4 different AA levels [based on standardized ileal digestible lysine (SID Lys), 0.92%, 1.02% (as the standard), 1.12% and 1.22%].

Results

An interaction between dietary starch sources and SID Lys levels significantly affected breast muscle yield (P = 0.033). RDS and SDS diets, or SID Lys levels of 0.92%, 1.02%, or 1.22%, significantly decreased the breast muscle yield of broilers in contrast to the corn starch diet with 1.12% SID Lys (P = 0.033). The SID Lys levels of 1.12% and 1.22% markedly improved body weight (BW), body weight gain (BWG) from 22 to 42 days of age, and mRNA expression of y
+
LAT1 and mTOR while reducing feed intake (FI) and feed/gain ratio (F/G) compared to the 0.92% SID Lys level (P < 0.05). The SDS diet significantly decreased BW and BWG of broilers from 22 to 42 days of age, distal ileal starch digestibility, jejunal amylase and chymotrypsin activities, and mRNA expression of GLUT2 and y
+
LAT1 compared to the corn starch diet (P < 0.05). The RDS diet suppressed the breast muscle mass by down-regulating expression of mTOR, S6K1, and eIF4E and up-regulating expression of MuRF, CathepsinB, Atrogin-1, and M-calpain compared to the corn starch diet (P < 0.05). Targeted metabolomics analysis revealed that the SDS diet significantly increased acetyl-CoA and α-ketoglutaric acid levels in the tricarboxylic acid (TCA) cycle (P < 0.05) but decreased the ileal digestibility of Lys, Tyr, Leu, Asp, Ser, Gly, Pro, Arg, Ile, and Val compared to the corn starch group (P < 0.05).

Conclusion

The SDS diet impaired broiler growth by reducing intestinal starch digestibility, which inhibited intestinal AA and glucose absorption and utilization, increased AA oxidation for energy supply, and lowered the efficiency of protein synthesis. Although the RDS diet resulted in growth performance similar to the corn starch diet, it reduced breast muscle mass by inhibiting protein synthesis and promoting degradation.

Graphical Abstract
Innovative approach for modelling gravity-induced signal path variations of VLBI radio telescopes
Authors: Lösler Michael , Eschelbach Cornelia , Greiwe Ansgar , Zhou Boye , McCallum Lucia
Published: January 2025

Gravitationally induced deformation of the receiving unit of radio telescopes used for Very Long Baseline Interferometry (VLBI) distorts the observations and biases the deduced products. As this deformation acts systematically and is individual for each radio telescope, the International VLBI Service for Geodesy and Astrometry (IVS) calls for gravitational deformation investigations to be able to correct VLBI data on the observation level. The most commonly used approach for modelling signal path variations was developed in 1988 during investigations at the 26-m VLBI radio telescope in Fairbanks (Alaska). This approach considers only homologous deformation of the receiving unit and takes into account three main deformation patterns affecting the signal path. For this reason, the measuring and modelling effort can be greatly simplified because the original spatial problem is reduced to a two-dimensional problem. However, more recent investigations refute the assumption of homogeneous deformation, because the receiver unit can be affected by arbitrary deformation patterns. Hence, identification and modelling as well as considering all deformation patterns that can be parameterised in a corresponding correction function require specific and more complex analysis approaches. In this contribution an innovative approach for modelling signal path variations is presented, based on Zernike polynomials. In contrast to the conventional approach, the proposed approach models the entire receiving unit spatially, and is not restricted to a homologous deformation pattern. This new approach has been successfully exercised on the 26-m radio telescope at the Mount Pleasant Radio Observatory Hobart (Tasmania, Australia). Despite the large dimensions of this radio telescope, the detected deformation is unexpectedly small, and leads to signal path variations of less than 2 mm.

Graphical Abstract
An efficient decoupled 3-D axial anisotropic resistivity inversion for magnetotelluric data with OpenMP parallelization
Authors: Thongyoy Wisart , Siripunvaraporn Weerachai , Amatayakul Puwis , Rung-Arunwan Tawat , Baba Kiyoshi
Published: January 2025

We have developed two novel axial anisotropic inversion codes for magnetotelluric (MT) data: a full axial inversion and a decoupled axial inversion. Both codes are based on the data space Gauss–Newton inversion method used in the WSINV3DMT code, enhanced with OpenMP parallelization and Intel MKL PARDISO direct solver for improved computational efficiency. The full axial inversion searches for three axial anisotropic resistivity elements

$${\rho }_{xx}$$

ρ

xx

,

$${\rho }_{yy}$$

ρ

yy

, and

$${\rho }_{zz}$$

ρ

zz

. Based on our prior influence studies, we identified contrasting influence patterns:

$${\rho }_{xx}$$

ρ

xx

has a strong influence on Z

xy
and Z

yy
, whereas

$${\rho }_{yy}$$

ρ

yy

has a strong influence on Z

yx
and Z

xx
, while

$${\rho }_{zz}$$

ρ

zz

has negligible impact on all responses. We, therefore, proposed a decoupled axial inversion. This novel technique splits the full axial inversion into two independent modes:

$${\rho }_{xx}$$

ρ

xx

- and

$${\rho }_{yy}$$

ρ

yy

-modes. The

$${\rho }_{xx}$$

ρ

xx

-mode requires just the Z

xy
and Z

yy
responses to recover

$${\rho }_{xx}$$

ρ

xx

, while the

$${\rho }_{yy}$$

ρ

yy

-mode requires the other two responses. By splitting the inversion, each mode requires half the data parameters and reduces model parameters to one-third compared to the full axial inversion. The substantial parameter reduction is the key factor leading to significantly faster processing times and lower memory requirements. Both codes were validated with the synthetic model. Utilizing OpenMP and direct solvers, the full axial inversion processed 256 MT stations in 65 min per iteration or a total of 195 min for three iterations to converge. The decoupled inversion achieved significantly faster processing, requiring just 32 min per iteration or a total of 96 min to finish the inversion. In addition, the decoupled inversion requires just a fraction of the memory used in the full axial inversion. This makes it practical to operate even on the standard personal computers of current technology. We further applied the decoupled inversion to real MT data acquired in the Northwestern Pacific Ocean. The resulting 3-D inverted

$${\rho }_{xx}$$

ρ

xx

and

$${\rho }_{yy}$$

ρ

yy

models support the existence of the anisotropy occurring at 60–120 km depth beneath the ocean floor, in agreement with previous studies.

Graphical abstract
First-principles study of the matrix alloying effect of X (X = Cr, Mo, W, V, Ti, Si) on the bonding characteristics and mechanical properties of the NbC/Fe interface
Authors: Yu Yutong , Zhong Lisheng , Han Enci , Shi Ke , Hu Kaiyuan , Zhang Chengwen , Xu Yunhua , Peng Jianhong , Hu Xu
Published: January 2025

Matrix alloying is currently the most commonly used means to improve the interfacial bonding strength. To explore the influence of different alloying elements on the interfacial bonding characteristics and mechanical properties of NbC/Fe, this study investigates the influence of the alloying element X (X = Cr, Mo, W, V, Ti, Si) on the properties of the NbC/Fe surface by using first principles and analyzes the segregation behavior, work of adhesion, electronic structure, and tensile strength of the interface before and after doping with the aforementioned alloying elements. The results demonstrate that the segregation energies of Cr, V, and Ti are less than 0, indicating that these alloy elements tend to segregate at the interface. Other alloying elements have positive segregation energies and are solids dissolved in the Fe matrix. When Si is doped at the interface, the adhesion work of the interface is reduced, and the binding property of the interface is destroyed. The charge density difference and population analyses demonstrated that the charge transfer between Cr, V, Ti, Mo, and W was localized, and there was a charge depletion region, presenting covalent characteristics. After doping, the Si atom demonstrated a charge state of loss, and the charge transfer had no clear direction, indicating the characteristics of an ionic bond. According to the theoretical tensile strength analysis, the addition of Mo, W, Si, and Cu will destroy the critical tensile strain at the interface. The tensile strength and strain of the interface significantly improved after the matrix alloying of Fe by Cr, V and Ti, the microstructure evolved during the tensile deformation, and a new phase was formed. A correlation between the atomic calculations and mechanical properties can be determined using first principles, as well as a reference for practical engineering applications.
Factors associated with assertiveness among Japanese community pharmacists: a cross-sectional study
Authors: Ishii Mitsuaki , Ozone Sachiko , Masumoto Shoichi , Maeno Tetsuhiro
Published: January 2025

Background

Community pharmacists play a crucial role in promoting medication safety within the community healthcare team. Effective communication by community pharmacists with other health professionals is essential to facilitate the sharing of patient healthcare information. In the context of information sharing between physicians and community pharmacists, assertive self-expression (defined as ‘a style of openly expressing one's needs and feelings while respecting others’) is beneficial. The aim of this study is to identify factors associated with assertive self-expression among community pharmacists.

Methods

A cross-sectional study was conducted by surveying 3,446 Japanese community pharmacists working at pharmacies across 10 prefectures. Participants were invited to complete a survey form by email and assessed for assertive self-expression using the Interprofessional Assertiveness Scale. Characteristics of participants and pharmacies were compared using univariate analysis. A generalized linear model was used to explore the factors associated with assertive self-expression.

Results

A total of 961 responses by community pharmacists were included in the analysis. Univariate analysis identified significant differences in assertive self-expression scores based on age, employment status, education, years of working experience as a pharmacist, pharmacist home visit service, and participation in joint regional workshops or conferences. After adjustment, participation in joint regional workshops or conferences was significantly associated with assertive self-expression (odds ratio, 1.037; 95% confidence interval, 1.005–1.070; p = 0.023).

Conclusions

This study showed that assertive self-expression among community pharmacists was associated with participation in joint regional workshops and conferences. Further research is needed to examine whether enhancing assertive self-expression facilitates pharmacists' interprofessional communication skills and improves medication safety.
Efficacy and safety of avacopan in antineutrophil cytoplasmic autoantibody-associated vasculitis: a retrospective cohort study in Japan
Authors: Tagami Genri , Yamaguchi Makoto , Sugiyama Hirokazu , Kinashi Hiroshi , Imai Kentaro , Kamiya Keisuke , Katsuno Takayuki , Imaizumi Takahiro , Banno Shogo , Ito Yasuhiko , Ishimoto Takuji
Published: January 2025

Background

Avacopan, an oral C5a receptor antagonist, demonstrated efficacy as an alternative to glucocorticoid therapy in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) in the phase 3 ADVOCATE trial. However, limited real-world data exist on the outcomes and experiences associated with avacopan use for AAV in Japan.

Methods

We performed a single-centre retrospective analysis and evaluated 21 patients with newly diagnosed or relapsed AAV who received avacopan. The co-primary outcomes were clinical remission at 6 and 12 months.

Results

Among the 21 patients, 20 (95.2%) achieved clinical remission at 6 months, and 19 (90.4%) sustained remission at 12 months. The median time from initiation of immunosuppressive therapy to the start of avacopan was 12 days (interquartile range, 5–26). Adverse events were reported in 10 patients (47.6%), with elevated liver enzyme levels observed in eight patients (38.1%) as the most frequent complication. Avacopan was discontinued in nine patients (42.9%). Despite early discontinuation, these patients achieved comparable rates of clinical remission at 6 months, sustained remission at 12 months, and experienced a reduction in glucocorticoid doses relative to those who continued avacopan.

Conclusions

A high incidence of adverse events, particularly liver enzyme elevation, and frequent early discontinuations of avacopan were observed. Nevertheless, favourable clinical outcomes and reduced glucocorticoid doses were achieved regardless of avacopan discontinuation. Further studies are warranted to validate the optimal use of avacopan in clinical practice.
Oral cannabidiol did not impair learning and memory in healthy adults
Authors: Gebregzi Hanna H. , Zeiger Joanna S. , Smith Jeffrey P. , Stuyt Libby , Cullen Luann , Carsella Jim , Rogers Daniel C. , Lafebre Jordan , Knalfec Jennah , Vargas Alfredo , Diawara Moussa M.
Published: January 2025

Background

The effect of oral Cannabidiol (CBD) on interference during learning and memory (L&M) in healthy human volunteers has not been studied.

Method

A two-arm crossover, randomized, double-blind, placebo-controlled trial was conducted at Colorado State University Pueblo (CSU Pueblo) to evaluate the effects of 246 mg oral CBD on L&M in healthy adults. Among 57 healthy volunteers enrolled, 35 were included in the analyses. For assessment of L&M, Montreal Cognitive Assessment (MOCA) was used to evaluate verbal baseline cognitive function; RAVLT-R tests (List A and List B recalls, Proactive and Retroactive Interference ratios, and Forgetting Speed ratio) were used to evaluate verbal declarative memory; and total prose recall was used to evaluate verbal logical memory. Linear Mixed Models with Bonferroni Corrections were used to compare L&M results between primary outcomes (CBD vs. placebo) and secondary demographic outcomes, with a two-tailed statistical significance of P < 0.05.

Results

CBD administration did not affect any of the dependent variables measured compared to the placebo group. There were no effects of THC, history of CBD use, or sex on CBD’s modulation of L&M. However, a highly significant interaction effect between treatment groups (CBD vs. placebo) and age of subjects was observed for the PI ratio (P = 0.008; n = 35).

Conclusions

The results of this study suggest that administration of oral CBD alone does not significantly impair L&M in healthy adults. However, age might influence CBD related modulation of proactive interference during human L&M. Future research involving a larger group of older adults is needed to confirm this potential effect.

Trial registration

The study was approved by the CSU Pueblo IRB, conducted in accordance with the Declaration of Helsinki, and registered with ClinicalTrials.gov (NCT06074172).
Fire, land use, and the long-term dynamics of a pitch pine woodland in coastal Maine, USA
Authors: Barton Andrew M. , Nurse Andrea M. , Lalemand Laura , Fowke Thomas , Grenier Daniel
Published: January 2025

Background

Pitch pine is a globally rare tree species that occurs on xeric sites in the largely mesic landscape of eastern North America. Supporting a rich assemblage of rare species, pitch pine communities are undergoing succession to more mesophytic species in the absence of natural and anthropogenic disturbance. We examined the multi-millennial dynamics of pitch pine in relation to fire and land use across a local moisture gradient in southern coastal Maine, USA.

Results

Fossil pollen revealed that pitch pine has inhabited the study area for at least 9000 years. A positive correlation of pitch pine pollen with macroscopic charcoal (> 250 μm) demonstrated the historical importance of fire for this species. Euro-American settlement profoundly altered the forest. The sediment record revealed a pulse of fire, settlement-associated weeds, and pitch pine establishment as intensive land use commenced, followed by a recent decline as forests regenerated after pasture abandonment and fire suppression. Tree age structures and current regeneration patterns revealed ongoing succession of pitch pine to more mesophytic species, such as red oak and red maple, except on the most xeric sites, where the species appears to be self-perpetuating.

Conclusions

The results support a conceptual model of varying pitch population dynamics across a xeric to mesic gradient. They also reveal current mesophication and contraction of pitch pine woodland, a pattern found across the species’ range. If maintenance of large areas of pitch pine woodlands in the study area is an important management goal, then active management to reduce competing vegetation should be considered. If other goals, such as carbon sequestration or restoration of pre-colonial conditions, when pitch pine was apparently less abundant are paramount instead, then allowing natural succession to more mesic forest would make sense.
β-Glucosidase VmGlu1 is required for toxin production and pathogenicity of Valsa mali
Authors: Cui Xinyue , Zhang Dewan , Gao Liyong , Liu Na , Lian Sen , Ren Weichao , Li Baohua , Wang Caixia
Published: January 2025

Flavonoids, serving as crucial secondary metabolites, are widely distributed in plants and play a key role in inhibiting microbial growth, protecting plants from pathogen invasion, and conserving energy. Our previous study revealed that the β-glucosidase VmGlu2 effectively catalyzes the degradation of phloridzin, a typical flavonoid in apples, and regulates the pathogenic process of Valsa mali. However, VmGlu2 exhibits a lower efficiency in degrading rutin, another characteristic flavonoid in apples. In this study, we found that the expression level of the β-glucosidase gene VmGlu1 was induced by 9.42-fold following rutin treatment, and VmGlu1 possessed the capability to degrade both rutin and phloridzin, but under the same conditions, VmGlu1 showed a distinct preference for rutin degradation, with an initial degradation rate 8.66 times higher than that of VmGlu2. Targeted deletion of VmGlu1 resulted in a 99.32% reduction in pycnidia production, a nearly 33% decrease in toxin production, and a significant decrease in pathogenicity on apple twigs and leaves. Furthermore, we verified that VmGlu1 and VmGlu2 exhibit functional redundancy in pycnidia production, toxin-related β-glucosidase activity, and pathogenicity by generating double-deletion mutants. The results of this study provide valuable insights into the roles of VmGlus in the interaction of V. mali and apple during the infection process.
Natural products targeting ubiquitination to combat kidney fibrosis
Authors: Li Lianhua , Huang Xinhui , Chen Yao , Liu Jibin , Qiao Yuhang , Fan Wenyu , Zhang Peiqing , Yan Xiaoming , Chen Ming
Published: January 2025

Background

Kidney fibrosis is a crucial component that contributes to end-stage renal disease and is the inevitable last pathological process in many progressive chronic kidney diseases (CKD). Ubiquitination, one of the most refined and widespread reversible post-translational modifications, plays a significant role in the development of renal fibrosis through its regulation and deubiquitination processes.

Main body of the abstract

Recent studies have shown that ubiquitination and deubiquitination represent promising intervention targets against renal fibrosis, with numerous natural products intervening in renal fibrosis by regulating the processes of ubiquitination and signal pathways such as transforming growth factor-β1/Smads (TGF-β1/Smads), Wnt/β-catenin, Janus kinase/signal transducer and activator of transcription/suppressor of cytokine signaling (JAK/STAT/SCOS), and nuclear factor erythroid-derived 2-like 2 (Nrf2), and then link.

Conclusion

Herein, we summarize the processes of ubiquitination and deubiquitination and introduce the interactions between ubiquitination and natural products. This is conducive to the development of new candidate drugs that intervene in renal fibrosis through the regulation of ubiquitination, representing a promising strategy to combat renal fibrosis with natural products.

Graphical abstract
Therapeutic potential of the neutralizing monoclonal antibody 45G3 against encephalomyocarditis virus
Authors: Zhang Yanfang , Wang Zhiying , Fang Yaohui , Zhu Qiong , Fu Jie , Hu Sijing , Jin Jiayin , Zhou Min , Liu Xijia , Zhang Danna , Huang Shouwei , Deng Yali , Xie Lingling , Shen Shu , Ye Jing , Deng Fei , Cao Shengbo
Published: January 2025

Encephalomyocarditis virus (EMCV), a potential zoonotic pathogen, poses significant socioeconomic and public health challenges across various host species. Although EMCV rarely triggers severe clinical symptoms in humans, its widespread prevalence and unique biological characteristics underscore the need for continuous surveillance and the development of effective therapeutics and prophylactics. In this study, we evaluated the neutralizing effects of a monoclonal antibody derived from the spleens of mice immunized with EMCV virus-like particles (VLPs), both in vitro and in vivo. Using recombinant DNA technology, we engineered a baculovirus system to express EMCVs P12A and 3C, facilitating the production of VLPs in Sf9 cells. These VLPs serve as antigens to immunize mice, leading to the isolation of the monoclonal antibody 45G3. This antibody exhibited high specificity for EMCV conformational epitopes, excluding linear epitopes, and demonstrated potent in vitro neutralizing activity, with an IC50 of 0.01873 μg/mL. Immunoelectron microscopy (IEM) revealed a strong direct interaction between the 45G3 antibody and EMCV particles. Virus adsorption inhibition assays demonstrated that 45G3 effectively blocked viral attachment, thereby preventing further infection of host cells. These findings further support the notion of a robust interaction between the virus and the antibody. Moreover, in vivo assessments revealed that 45G3 significantly reduced viral loads in treated mice and improved survival outcomes following EMCV exposure. Additionally, posttreatment analysis revealed reduced tissue damage and a markedly decreased inflammatory response in the brain, indicating that the 45G3 antibody effectively blocked viral infection, thereby mitigating tissue damage and enhancing survival. These findings position 45G3 as a promising candidate for EMCV management and provide a strong foundation for the future development of antiviral drugs targeting this widespread virus.
Extension for Community Healthcare Outcomes-Palliative Care in Africa and Quality of Life, Symptoms, Patient Experience, and Caregiver Distress Among Patients With Cancer
Authors: Yennurajalingam Sriram , Soyannwo Olaitan , Weru John , VND Addo Opare-Lokko Edwina Beryl , Burger Henriette , Nafulah Esther , Aikomo Oladayo , Adenipekun Adeniyi , Botchway Irene , Ocansey Mary , Deodhar Jayita , Dai Jianliang , Andersen Clark R. , Arthur Joseph Anthony , Rozman de Moraes Aline , Stanton Penny A. , Bruera Eduardo , Reddy Suresh
Published: January 2025

PURPOSE

In this study, we aimed to evaluate the association between the Extension for Community Healthcare Outcomes-Palliative Care (ECHO-PC; ECHO Model–Based comprehensive educational and telementoring intervention) for health care professionals (HCPs) and change in patient-reported quality-of-life (QOL; Functional Assessment of Cancer Therapy-General [FACT-G]) among patients with advanced cancer. We also examined the association between ECHO-PC and changes in symptom distress (Edmonton Symptom Assessment Scale [ESAS]), patient experience and satisfaction, and caregiver distress scores.

METHODS

ECHO-PC Clinic sessions were conducted twice a month for 1 year by an interdisciplinary team of PC clinicians at the MD Anderson Cancer Center, with participation of experts in PC in sub-Saharan Africa, using standardized curriculum on the basis of PC needs in the region. Study participants included palliative HCPs from ECHO participating programs in Kenya, Nigeria, Ghana, and South Africa. HCPs, their patients, and caregivers were assessed at baseline, 3, 6, 9, and 12 months of the study for QOL (FACT-G), ESAS-Symptom Distress Score (prorated) (SDS), patient experience, satisfaction (FAMCARE-P-16-patient), and caregiver distress (FAMCARE-caregiver).

RESULTS

Two hundred seventy patients completed the assessments. Fifty-eight percent was female, the mean age was 56 years, and most common cancer type was breast cancer (24.3%). Multivariate generalized linear mixed model analysis found that ECHO-PC intervention was associated with significant improvement in QOL and symptom distress (FACT-G total score,
P
= .0433; FACT-G physical well-being,
P
< .013; FACT-G emotional well-being,
P
= .0232, and ESAS-SDS,
P
< .0001). No significant changes were found in patient experience, satisfaction, and caregiver distress scores.

CONCLUSION

Our preliminary study found that the ECHO-PC intervention was significantly associated with improvement in patient outcomes including QOL and symptom distress scores. Further studies are needed.
Development and Implementation of Oral Anticancer Agent Tools for a Thematic Quality Improvement Program: A Collaboration Between Hematology Oncology Pharmacist Association and ASCO Quality Training Program
Authors: Nachar Victoria , Adams Curry Marjorie , Kostoff Diana , Wood Angela , Farris Karen B. , Muluneh Benyam , Morris Amy , Keng Michael , Guerrier Vedner , Mackler Emily R.
Published: January 2025

PURPOSE

The Hematology Oncology Pharmacist Association Oral Chemotherapy Collaborative (HOPA OCC) developed practice-based tools to use in program development and improvement for the management of patients receiving oral anticancer agents (OAAs).

METHODS

These tools include a baseline OAA program assessment, clinical OAA adherence tool, and OAA dashboard. HOPA OCC distributed these tools to teams participating in the 6-month HOPA ASCO Quality Training Programs (QTPs). Barriers in the delivery of OAA services across practice sites were determined through the use of baseline assessments, and the following domains were evaluated: (1) side-effect monitoring, (2) adherence monitoring, (3) use of patient-reported outcomes, (4) social determinants of health, and (5) collaborative practice agreements for oncology pharmacists. The OAA adherence tool offers clinical patient adherence questions and guidance for supporting adherence in practice. Finally, the dashboard includes multiple metrics that may be helpful for practices to measure their program outcomes. HOPA OCC used the Consolidated Framework for Implementation Research to assess tool usefulness by the QTP participants.

RESULTS

Barriers to implementation include deficits in information technology, resources, and competing priorities.

CONCLUSION

Standardized OAA tools can inform and support quality improvement initiatives and improve the care of patients receiving OAAs.
The effect of serum cortisol level on the outcomes of Persistent Inflammation, Immunosuppression and Catabolism Syndrome patients in the intensive care unit
Authors: Eroğlu Onur , Özgültekin Asu , Ekinci Osman
Published: January 2025

Objective: This study sought to elucidate the potential association between serum cortisol level and clinical outcomes in patients diagnosed with Persistent Inflammation, Immunosuppression, and Catabolism Syndrome (PIICS).
Methods: This prospective observational study, initiated in January 2023 and concluded in July 2023 enrolled 42 patients diagnosed with PIICS admitted to the intensive care unit (ICU) at Training and Research Hospital. For the purpose of analysis, serum cortisol levels were categorized as low (<15 μg/dL) and high (>15 μdL). To facilitate data organization and subsequent analysis, measurements were categorized into three time intervals following ICU admission: T1 (days 14-21), T2 (days 21-28), and T3 (days >28). Statistical analysis was performed using IBM-SPSS 28. A significance level of p < 0.05 was set to determine statistically significant differences between groups.
Results: Cortisol measured at T3 were significantly lower (p < 0.05) compared to T2. In contrast, SOFA scores were significantly higher (p < 0.05). No statistically significant differences were observed between the low and high cortisol level groups at T1, T2 and T3 in terms of gender, APACHE-2 score, SOFA score, ICU length of stay (days), duration of mechanical ventilation (days), mortality rate, or mechanical ventilation requirement at discharge. Patients in the low cortisol group at T3 exhibited a significantly higher mean age compared to those in the high cortisol group (p < 0.05).
Conclusion: Cortisol levels in ICU patients may change over time. That cortisol levels tend to decrease as the length of stay increases, in older patients, and in PIICS patients with elevated SOFA scores.
doi: https://doi.org/10.12669/pjms.41.2.10256
How to cite this: Eroglu O, Ozgultekin A, Ekinci O. The effect of serum cortisol level on the outcomes of Persistent Inflammation, Immunosuppression and Catabolism Syndrome patients in the intensive care unit. Pak J Med Sci. 2025;41(2):542-547.  doi: https://doi.org/10.12669/pjms.41.2.10256
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Efficacy of the refined pediatric endoscope equipment management based on the quality control mode
Authors: Gong Shuokang , Wang Liya , Zhao Xiaobo , Zheng Lijuan , Xi Xiaohong , Dong Jiejing
Published: January 2025

Objective: To explore the efficacy of refined management based on the quality control (QC) mode in maintaining pediatric endoscope equipment.
Methods: Eighty sets of pediatric endoscopes that were sent to the endoscopy room for cleaning, disinfection, and storage at Hebei Children’s Hospital from January 2022 to October 2023 were enrolled. Based on the maintenance method, endoscopes were divided into study group (refined management plus QC mode, n=40) and control group (conventional QC mode, n=40) using a random number table method. The rate of dirt presence, detection rate of pathogenic bacteria, adenosine triphosphate (ATP) positivity rate, cleanliness qualification rate, adverse event occurrence rate, endoscopy-related processing time, and endoscopic usage were analyzed.
Results: The presence rate of dirt, detection rate of pathogenic bacteria, and ATP positivity rate in the study group were significantly lower than in the control group. The cleaning qualification rate, safety storage rate, and disinfection record qualification rate were significantly higher than those of the control group (P<0.05). The incidence of adverse events in the study group was lower than in the control group (P<0.05). The study group had significantly shorter endoscopic recovery time, packaging review time, sterilization distribution time, and clinical acceptance confirmation time than the control group (P<0.05). Satisfaction with endoscope use was significantly higher in the study group than in the control group (P<0.05).
Conclusions: Refined management based on the QC mode can significantly improve the cleaning quality of pediatric endoscopes. This management mode can shorten processing time, reduce the occurrence of adverse events, and achieve high satisfaction with endoscope use.
doi: https://doi.org/10.12669/pjms.41.2.11368
How to cite this: Gong S, Wang L, Zhao X, Zheng L, Xi X, Dong J. Efficacy of the refined pediatric endoscope equipment management based on the quality control mode. Pak J Med Sci. 2025;41(2):449-454. doi: https://doi.org/10.12669/pjms.41.2.11368
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Η μορφή του Ηρακλή στην Αττική τραγωδία
Authors: Κωνσταντακοπούλου Μαρία
Published: January 2025

Η παρούσα διδακτορική διατριβή, πιστεύω ότι ξεχωρίζει για την πρωτοτυπία της θεματολογίας της. Η εμβάθυνση στη μορφή του Ηρακλή μέσα στην αττική τραγωδία απαιτούσε μια ολοκληρωμένη προσέγγιση για να φωτιστούν πλήρως όλες οι σχετικές πτυχές γύρω από αυτόν τον εμβληματικό χαρακτήρα. Θεωρώ ότι αυτή η διατριβή ξεχωρίζει για την πρωτοτυπία της, ιδιαίτερα στην επιλογή του θέματος. Η μορφή του Ηρακλή στην Αττική Τραγωδία είναι ένας εμβληματικός αλλά και πολύπλοκος χαρακτήρας και η μελέτη του απαιτεί μια ολοκληρωμένη προσέγγιση που απευθύνεται σε κάθε πτυχή —πολιτική, ηθική και κοινωνική. Αναλαμβάνοντας αυτήν την πρόκληση, ένιωσα μεγάλη ευθύνη να φωτίσω τα περίπλοκα στρώματα του χαρακτήρα του Ηρακλή και τη σημασία του μέσα στο ευρύτερο πλαίσιο της ελληνικής λογοτεχνίας και σκέψης. Σε αυτή τη διατριβή, είχα σκοπό να εξερευνήσω όχι μόνο τις θρυλικές πτυχές του Ηρακλή αλλά και να εξετάσω τα βαθιά αξονικά θέματα που προκαλεί η ιστορία του. Αυτά τα θέματα φτάνουν στην καρδιά των κοινωνικών αξιών, των ηθικών διλημμάτων και του πολιτικού πλαισίου του αρχαίου κόσμου, τα οποία ζωντανεύουν τόσο έντονα στις τραγωδίες εκείνης της εποχής. Εμβαθύνοντας σε αυτές τις διαστάσεις, επιδίωξα να ρίξω νέο φως στον Ηρακλή ως κάτι περισσότερο από έναν μυθολογικό ήρωα, αλλά ως σύμβολο μέσω του οποίου μπορούμε να έχουμε πρόσβαση σε ευρύτερες ανθρώπινες ανησυχίες που παραμένουν επίκαιρες σήμερα. Το ερευνητικό μου ταξίδι σημαδεύτηκε από την πρόκληση της ενασχόλησης με μια εκτενή βιβλιογραφία, πλούσια και ποικίλη σε προοπτική. Ήταν απαραίτητο να προσεγγίσουμε αυτές τις πηγές με επιστημονική αυστηρότητα και ευσυνειδησία, και έτσι κάθε παραπομπή επιλέχθηκε προσεκτικά και αναφέρθηκε σχολαστικά για να υποστηρίξω και να εμπλουτίσω τα επιχειρήματά μου. Τέλος, ελπίζω η παρούσα διδακτορική εργασία να χρησιμεύσει ως μια πρωτότυπη συμβολή στη φιλολογική έρευνα. Εφαρμόζοντας τα ερμηνευτικά εργαλεία της αφηγηματικής επιστήμης σε αυτήν την εμβληματική φιγούρα του Ηρακλή, στόχος μου ήταν να προσφέρω νέες γνώσεις για τον Ηρακλή ως σύνθετο χαρακτήρα και ως πολιτιστικό σύμβολο.
Artificial Intelligence and Finance: A bibliometric review on the Trends, Influences, and Research Directions
Authors: Roy Prasenjit , Ghose Biswajit , Singh Premendra Kumar , Tyagi Pankaj Kumar , Vasudevan Asokan
Published: January 2025

Background This bibliometric study examines the intersection of artificial intelligence (AI) and finance, providing a comprehensive analysis of its evolution, central themes, and avenues for further exploration. The study aims to uncover the theoretical foundations, methodological approaches, and practical implications of AI in financial contexts. Methods The research employs bibliometric techniques, using 607 Web of Science (WoS) indexed papers. The Theory-Context-Characteristics-Methodology (TCCM) framework guides the analysis, focusing on thematic mapping to explore key topics. Core areas such as risk management, market efficiency, and innovation are analyzed, alongside emerging themes like ethical AI, finance applications, and factors influencing AI-driven financial decision-making. Results The findings reveal critical gaps in interdisciplinary methods, ethical considerations, and methodological advancements necessary to develop robust and transparent AI systems. Thematic mapping highlights the increasing importance of ethical AI practices and the influence of AI on financial decision-making processes. Emerging research areas emphasize the need for innovative frameworks and solutions to address current challenges. Conclusions This study provides valuable insights for academics, industry practitioners, and policymakers to harness transformative potential of AI in finance. This research offers a foundation for future studies and practical applications by addressing key gaps and promoting interdisciplinary and ethical approaches in a rapidly evolving field.
ADvAnced PhysioTherapy in MuSculosKeletal Triage: Investigating prognostic factors, healthcare utilisation and clinical outcomes (ADAPT MSK) - a cohort study protocol.
Authors: Callan Fiona , Keating Louise , Casserley-Feeney Sarah , French Helen P.
Published: January 2025

Background Clinical specialist physiotherapist-led musculoskeletal triage clinics were introduced nationally in Ireland in 2011 to improve patient care and reduce waiting times for secondary care orthopaedics and rheumatology. Evidence has shown them to be effective in reducing waiting lists, however there are currently no data on longitudinal patient outcomes following attendance at these clinics. The primary aim of this prospective, cohort study is to identify predictors of clinical outcome (pain and function) at 12-months post MSK-triage appointment. Secondary aims are to describe the clinical course of patients attending MSK triage clinics and measure self-reported use of healthcare resources up to 12 months post-MSK-triage appointment. This is a prospective cohort study. Methods ADvAnced PhysioTherapy in MuSculosKeletal Triage (ADAPT MSK) will recruit a cohort of 252 adults through musculoskeletal triage clinics across five secondary care sites in Ireland. The STrengthening the Reporting of Observational studies in Epidemiology (STROBE) guidelines will be adhered to for future reporting. Adults (≥ 18 years old) attending physiotherapist-led musculoskeletal triage clinics with musculoskeletal pain, who do not require surgical or consultant-led medical care will be considered for participation in this study. Participant demographics, health literacy, healthcare utilisation, and self-report questionnaires on pain, function, musculoskeletal health status, musculoskeletal risk stratification, fear of movement, and psychological distress will be obtained at baseline, with follow-ups at three, six, and 12 months. The primary outcomes are pain intensity and function. Secondary outcomes include musculoskeletal risk stratification status, musculoskeletal health status, healthcare utilisation, and work status. Descriptive statistics will be used to profile the cohort of participants and predictors of outcome will be assessed using multivariable linear regression. Results Results will be disseminated via peer-reviewed journal publication and presentation at national and international conferences. Engagement with a public patient involvement (PPI) panel will explore dissemination strategies for public and service user engagement.
Bodies of evidence: The human remains from Flinders Petrie’s excavations in British Mandate Palestine
Authors: Sparks Rachael Thyrza , Maaranen Nina
Published: January 2025

Background In the 1920s and 1930s Flinders Petrie excavated several sites in British Mandate Palestine (Tell Jemmeh, Tell Fara and Tell el-ʿAjjul), encountering numerous burials dating from the Chalcolithic period down to the Ottoman period. The osteological finds were thought to have been discarded, until the authors identified a curated selection of skeletal human remains from these tombs at the Duckworth Laboratory in Cambridge in 2017/2018. Methods Rachael Sparks conducted archival research to explore how the human remains from Petrie’s excavations in the Southern Levant were recovered, recorded, curated and studied. This drew on original excavation records, contemporary publications, official and private correspondence, unpublished research notes, and the evidence of the human skeletal remains themselves. Following on this archival investigation, Nina Maaranen conducted skeletal analyses on individuals from Bronze Age contexts – recording crania and mandibles using various non-invasive, macroscopic techniques to estimate age, sex and ancestry. Results It was established that selected skulls were sent to Karl Pearson’s Biometric Laboratory at University College in London for craniometric study as part of wider programmes of research into ancient populations. After the war, changes in the organisation of the Eugenics Department at the University led to the transfer of Pearson’s collection of human skulls to the Duckworth Laboratory in Cambridge, where attempts to get the material published were unsuccessful. The current skeletal analysis of the assemblage revealed a preference for adult individuals, in line with the curation motivations of the original investigators. Earlier research on these remains was compared with our new data and contextualised within the theoretical and methodological development of bioanthropology and osteology. Conclusions Our investigation successfully identified the history of this assemblage, and revealed ethical issues surrounding the collection and subsequent use of some of these human remains, particularly where there may be familial links to modern Palestinian populations.
Visual Dactyloscopy: in Schemes and Illustrations
Authors: Tokareva Elena , Solodova Tat'yana , Lavrent'eva Natal'ya
Published: January 2025

The educational visual aid contains material for law enforcement personnel of African countries undergoing training
and internship at the faculty of retraining and advanced training under the programs «Advanced training for law enforcement
personnel of African countries on the topic “Dactyloscopy and Fingerprint Examination”», «Advanced training of law
enforcement personnel of African countries on the topic “Modern Expert Diagnostics and Identifi cation. Modern fi ngerprinting
and fi ngerprint registration”».
The book is illustrated with schemes and pictures that facilitate the perception of lecture material containing a presentation
of the scientifi c foundations of dactyloscopy and fi ngerprint examination, as well as private methods of expert research. The
publication is designed for teachers and law enforcement personnel of African countries undergoing advanced training at
universities of the Ministry of Internal Aff airs of Russia.
Translation — Lavrentyeva N.V. (Teacher of the highest category).
Locked-in Syndrome: Insights into Etiology, Diagnosis, Management, and Quality of Life
Authors: Zelik Urszula , Florczak Wojciech , Śnieżna Joanna , Dziewic Jakub , Dzwonnik Karol , Domino Wiktoria , Trestka Gabriela , Przygoda Maria , Włodyka Jagienka , Stępień Kamila , Adamczyk Sabina
Published: January 2025

Locked-in Syndrome (LIS) is a rare and severe neurological condition resulting from damage to the ventral pons, leading to complete paralysis of voluntary muscles while preserving consciousness and cognitive function. This review consolidates current knowledge on the etiology, diagnosis, management, and quality of life in LIS, emphasizing its complexity and the need for a multidisciplinary approach.The condition’s etiological spectrum includes vascular events, trauma, infections, and demyelinating disorders, necessitating a comprehensive diagnostic approach integrating advanced neuroimaging and electrophysiological tools.
Therapeutic strategies emphasize multidisciplinary care to address acute stabilization and long-term rehabilitation. Early interventions, such as thrombolysis and respiratory support, combined with advanced neurorehabilitation techniques, have shown promise in improving outcomes. Notably, patients with LIS often report a higher-than-expected quality of life, attributed to strong social support, emotional resilience, and access to assistive technologies, highlighting the resilience of patients in adapting to extreme physical limitations.
This review underscores the importance of individualized care that aligns with patient values and emphasizes the necessity of further research. Future studies should focus on refining diagnostic methods, advancing communication technologies, and exploring the psychological dynamics affecting both patients and caregivers. By fostering a collaborative, patient-centered approach, the quality of life and care for individuals with LIS can be significantly improved.
Physical activity to prevent older adult falls: an Aotearoa New Zealand approach
Authors: Vlietstra Lara , Bryant Katrina Pōtiki , Hale Leigh , Dando Margaret , Waters Debra
Published: January 2025

Physical activity and exercise decreases falls by improving gait, balance, and strength. All types of exercise, particularly balance and functional exercises reduce the rate of falls by approximately 24%, although walking practice alone does not reduce falls rate. New Zealand has developed three effective, empowering and sustainable falls-prevention exercise classes for older adults. The world-renowned, home-based Otago Exercise Programme, the peer-led community-based Steady As You Go© and Aligned to Go, and Taurite Tū indigenous exercise program. The majority of the exercises are conducted while standing and progress to where the participant stands with feet close together, on one leg, minimises hands assisting with balance, and practice controlled movements of the body’s centre of mass and body awareness. Peer-led classes such as Steady As You Go©, Aligned to Go and Taurite Tū have demonstrated their ability to attract participants to engage long term through strong social connections and culturally appropriate exercises that enable older adults to maintain their balance, strength and reduce their falls risk.
Environmental Management through Machine Learning-based Fish Species Classification for Sustainable Fisheries
Authors: N. Indhumathi  , S. Maheswaran  , I. Bhuvaneshwarri  , U. M. Ramya  , S. Kayalvili  , S. Aadithyan
Published: January 2025

Fish species classification is crucial for understanding and preserving marine biodiversity. Advanced technologies such as computer vision and machine learning facilitate the identification and classification of different fish species based on their unique physical characteristics. Automatic fish classification systems are essential for biodiversity assessment, fisheries management, and environmental monitoring. This process involves collecting the image data of fish, extracting relevant features, and training machine learning models. Preprocessing the image data using Gaussian and median filters removes noise and enhances image quality. Mathematical morphological operations are employed for segmentation. For feature extraction, Gray Level Co-occurrence Matrix (GLCM) and geometrical features are used. The GLCM extracts texture features, while geometrical features describe the shape and structure of the fish. Classifiers such as Support Vector Machines (SVM) and Convolutional Neural Networks (CNN) are then used to train the data, comparing it with the extracted features to achieve high accuracy in classification. This accurate classification is critical, especially considering the impact of environmental factors and fish species reduction on the balance of marine ecosystems. Changes in fish population can disrupt the ecological balance, highlighting the importance of effective monitoring and management systems to protect oceanic and sea environments.