bluuebunny/crossref_metadata_2025 huggingface dataset:
Intramyometrial ectopic pregnancy masquerading as intramural leiomyoma: a diagnostic challenge
Authors: Rani Hephzibah , Malashree  , Kumar Ramesh , Shastri Dinesh
Published: February 2025

One of the extremely rare locations for an ectopic pregnancy is myometrium. Intramyometrial ectopic pregnancy is characterised by an unusual form of implantation wherein the gestational sac is situated deep in the myometrium, separated from the endometrial cavity and fallopian tubes. It accounts for <1% of all ectopic pregnancies. The preoperative diagnosis based on ultrasound findings may mimic a degenerated leiomyoma, thereby posing further diagnostic challenges. We report a case of a woman in her late 20s presenting with abnormal uterine bleeding diagnosed ultrasonographically as posterior wall fibroid. Histopathological evaluation of the myomectomy specimen revealed chorionic villi lined by trophoblastic cells, thereby confirming the diagnosis. This case report aims to increase the awareness about the possibility of this potentially life-threatening rare entity even with normal serum beta-human chorionic gonadotropin levels.
Coeliac disease masquerading as macroamylasaemia
Authors: Al-Rufayi Bashayer , Alsabban Abdulmalik M , Zagnoon Abbas A
Published: February 2025

Macroamylasaemia (MA) is a biochemical disorder characterised by elevated serum amylase activity, resulting from the circulation of a macromolecular complex of amylase bound to a serum component, often an immunoglobulin. The increased molecular weight of this complex prevents the normal renal excretion of the enzyme. A few cases of adult patients with coeliac disease (CD) and MA have been reported, in which the biochemical disorder resolved after treatment with a gluten-free diet. However, in other cases, this resolution did not occur. Here, we report a case of CD masquerading as recurrent pancreatitis due to the presence of MA.
Toxic epidermal necrolysis caused by vemurafenib in a metastatic malignant melanoma
Authors: Flor Duarte , Pedroso Mariana , Coutinho Inês , Gonçalo Margarida
Published: February 2025

Combination targeted therapy with vemurafenib and cobimetinib has proved effective for metastatic melanoma. However, severe cutaneous adverse reactions have been reported, most frequently not only drug rash with eosinophilia and systemic syndrome but also rare Stevens-Johnson syndrome and toxic epidermal necrolysis (TEN) cases. We report a case of life-threatening episode of TEN following metastatic melanoma targeted therapy with vemurafenib and cobimetinib, with a long but successful patient recovery.
Targeting malaria in high-risk populations in low endemic regions in northern Namibia: a quasi-experimental controlled trial to reduce malaria in seasonal agricultural workers and cattle herders
Authors: Smith Jennifer L , Ntuku Henry , Rerolle Francois , Burke Ashley Morgan , Mwema Tabeth , Turcios Keirstinne , Uusiku Petrina , Haikali Justine Kulla , Lifasi Michael , Smith-Gueye Cara , Vajda Elodie , Jacobson Jerry O , Greenhouse Bryan , Gosling Roly , Bennett Adam , Mumbengegwi Davis R
Published: February 2025

Background

Agricultural worksites are rarely targeted by malaria control programmes, yet may play a role in maintaining local transmission due to workers’ high mobility, low intervention coverage and occupational exposures.

Methods

A quasi-experimental controlled intervention study was carried out in farming and cattle herding populations in northern Namibia to evaluate the impact of a targeted malaria intervention package. Eight health facility catchment areas in Zambezi and Ohangwena Regions were randomised to an intervention arm and eligible individuals within worksites in intervention areas received targeted drug administration with artemether-lumefantrine, mop-up indoor residual spraying and long-lasting insecticidal nets, combined with distribution of topical repellent in Zambezi Region. Impact on malaria outcomes and intervention coverage was evaluated over a single transmission season using pre-intervention and post-intervention cross-sectional surveys in a random subset of worksites and community incidence from passively detected cases. Entomological collections and residual efficacy assays on canvas and tarpaulin were conducted.

Results

Delivery of a single intervention round was associated with a reduction in the prevalence of malaria (OR 0.24, 95% CI 0.1 to 0.5; risk difference (RD) −6.0%, 95% CI −9.4 to –2.8). Coverage of at least one intervention increased (RD 51.6%, 95% CI 44.4 to 58.2) among the target population in intervention compared with control areas. This effect was largely driven by results in Zambezi Region, which also observed a decline in community incidence (−1.29 cases/1000 person-weeks, 95% CI −2.2 to –0.3). Residual efficacy of pirimiphos-methyl (Actellic) on tarpaulin and canvas was high at 24hours but declined to 44.6% at 4 months.

Conclusion

The study shows that targeted delivery of malaria interventions to cattle herders and agricultural workers at worksites has potential to impact local transmission. Findings highlight the need for further research on the role of key populations inPlasmodium falciparumtransmission in Namibia.

Trial registration number

NCT04094727.
Effective coverage for reproductive, maternal, neonatal and newborn health: an analysis of geographical and socioeconomic inequalities in 39 low- and middle-income countries
Authors: Marthias Tiara , Anindya Kanya , Saputri Nurmala Selly , Putri Likke Prawidya , Atun Rifat , Lee John Tayu
Published: February 2025

Background

Inadequate access to quality maternal and child health services leads to poor health outcomes for millions of women, particularly in low- and middle-income countries (LMICs). This study aims to explore the effective coverage of reproductive, maternal, neonatal and newborn health (RMNCH) services and examines socioeconomic and rural and urban disparities in 39 LMICs.

Methods

Using Demographic and Health Surveys (DHS) data, the research assesses RMNCH service quality by applying an effective coverage framework, which measures service contact, crude coverage, quality-adjusted coverage and user adherence-adjusted coverage. We applied weighted analyses to investigate the rural–urban differences in service coverage based on countries’ Human Development Index (HDI) levels as well as crude coverage and socioeconomic levels.

Findings

Urban areas generally exhibit better effective coverage across all RMNCH services compared with rural areas, with significant disparities in antenatal, childbirth and postnatal care. For instance, 85% (95% CI=85–86%) of urban women received skilled birth attendance compared with 64% (95% CI=64–65%) in rural areas. High-HDI countries show smaller rural–urban gaps in service coverage than low-HDI countries. Socioeconomic inequalities are more pronounced in rural areas, particularly in services that require higher quality and adherence to standards. Socioeconomic disparities are significant in LMICs with lower HDI and are more evident in harder-to-achieve quality indicators, such as user adherence to recommended practices or treatment. For example, in medium-HDI countries, the relative inequality index (RII) for antenatal care user adherence coverage is 3.6 (95% CI=3.4–3.8) in rural areas compared with 1.9 (95% CI=1.8–2.1) in urban areas.

Interpretation

The research underscores the need for targeted interventions and policies to address these disparities. The evidence supports the need for a shift from focusing solely on access to care to improve the quality of care to address rural–urban and socioeconomic inequalities in RMNCH outcomes.
A behavioural science framework for tackling upstream challenges in health systems
Authors: Smith Jana , Zimmerman Emily , Gachiengo Nyabero Wambui , Nanda Priya , Fasawe Olufunke , Roder-DeWan Sanam
Published: February 2025

Insights from behavioural science can inform a wide range of solutions including policy reforms, infrastructure changes, process reengineering, communications, devices and others. Its application in global health has, however, often focused on narrowly defined issues with linear theories of change that are relatively straightforward to study. Using behavioural science to examine ‘upstream’ actors in complex health systems holds promise as a complementary and underused approach to improving health systems. Behavioural scientists have missed opportunities to tackle systemic issues and the field of health systems strengthening rarely accounts for human behaviour at the macrolevel of health systems. We present a framework, developed by experts from a range of disciplinary backgrounds in global health and behavioural science that guides (1) the distillation of a health system challenge into concrete, addressable behaviours (specific actors and accompanying actions) and (2) the investigation of contextual factors that influence each behaviour.
Acceptance and commitment therapy for mild traumatic brain injury (ACTion-mTBI): a quasiexperimental feasibility study
Authors: Faulkner Josh , Prouty Devin , Devlin Lucy , Appleton Damien , Roche Maree , Below Karen , Moffat John , Snell Deborah , Williams Matt N , Barker-Collo Suzanne , Theadom Alice
Published: February 2025

Objectives

This study aimed to determine the feasibility of recruiting, implementing and delivering an acceptance and commitment therapy (ACT) intervention for mild traumatic brain injury (mTBI) (ACTion-mTBI) within a multidisciplinary outpatient mTBI rehabilitation services. The study also aimed to conduct a preliminary investigation of group differences between ACTion-mTBI and an equivalent cognitive behavioural therapy (CBT) intervention on various outcome measures and psychological treatment targets.

Design

A two-arm quasiexperimental feasibility study.

Setting

Five mTBI rehabilitation clinics throughout New Zealand.

Intervention

Psychologists working in mTBI rehabilitation clinics throughout New Zealand were trained to deliver ACTion-mTBI or CBT. Eligible participants were assigned to either of these interventions based on the psychologist available at the clinic they were referred to. ACTion-mTBI is a five sessions intervention that incorporates all six components of the ACT model. The CBT intervention is an equivalent intervention and incorporating all four components of the CBT model. Both interventions are adapted for an mTBI context.

Primary outcome measures

The primary outcomes were related to the feasibility of ACTion-mTBI. This included recruitment, retention and treatment adherence of participants, study procedure and fidelity of treatment delivery.

Secondary outcome measures

To explore group differences between ACTion-mTBI and CBT on functional disability, postconcussion symptoms, mental health, valued living and psychological flexibility.

Results

The intervention proved feasible to implement with community-based mTBI rehabilitation services. Attrition rates were comparable between the two psychological interventions and fidelity to the treatments was high. At post-treatment, when covarying pretreatment scores, ACTion-mTBI had a significantly greater improvement in functional disability than CBT (moderate effect). ACTion-mTBI also had a significantly greater reduction in postconcussion symptoms, anxiety and stress. Promisingly, significant improvements in psychological flexibility was also found post-treatment. There were no group differences on depressive symptoms and valued living.

Conclusion

We conclude that a full clinical trial of ACTion-mTBI for individuals with mTBI is feasible and warranted.

Trial registration number

ACTRN1262100059482.
Therapy response prediction of focal cortex stimulation based on clinical parameters: a multicentre, non-interventional study protocol
Authors: Kalousios Sotirios , Hesser Jürgen , Dümpelmann Matthias , Baumgartner Christoph , Hamer Hajo M , Hirsch Martin , Imbach Lukas , Kaufmann Elisabeth , Kegele Josua , Knake Susanne , Leonhardt Georg , Mayer Thomas , Mertens Ann , Pataraia Ekaterina , von Podewils Felix , Quesada Carlos M , Steinhoff Bernhard J , Surges Rainer , Voges Berthold R , Wagner Jan , Weber Yvonne G , Wehner Tim , Winter Yaroslav , Schulze-Bonhage Andreas
Published: February 2025

Introduction

A novel focal cortex stimulation (FCS) device has recently received approval in Europe for patients with focal drug-resistant epilepsy (DRE). After 6 months of stimulation, 17 of 32 patients achieved ≥50% reduction in seizure frequency compared with their prestimulation baseline (responders). Currently, there is no established method for predicting FCS treatment response prior to implantation.

Methods and analysis

This is an ongoing combined retrospective-prospective non-interventional multicentre study. Clinical data of up to 100 patients treated with FCS are collected across 20 collaborating epilepsy centres in four European countries. The key outcome parameters, seizure frequency and severity, are measured along with metrics on cognition, mood and quality of life, both pre-electrode and postelectrode implantation. The data are complemented by demographics, medical history and information on antiseizure medication and FCS treatment parameters during the stimulation period. In addition to clinical data, MRI and electroencephalography registrations are used to gain insights into spatial and electrophysiological aspects of FCS. Multivariate statistical and machine learning analyses are employed to identify key predictive biomarkers associated with patient outcomes (responders vs non-responders). The primary goal is to improve counselling for DRE patients by identifying promising candidates for FCS treatment.

Ethics and dissemination

This study has received approval from the ethics committee of the University of Freiburg, Germany (23–1540 S1; 23–1183_1-S1-retro). The same approval is applicable for all participating centres in Germany as part of a multicentre study. Ghent University Hospital, Belgium, has received approval for participation in the retrospective arm from their local ethics committee(ONZ-2024-0168). The final approvals for the participating Swiss and Austrian sites are still pending. The results will be made available to the public through peer-reviewed journals and conference presentations.
Association between calcium and vitamin D supplementation and increased risk of kidney stone formation in patients with osteoporosis in Southwest China: a cross-sectional study
Authors: Shi Lingfeng , Bao Yinyin , Deng Xiang , Xu Xiaoli , Hu Jiongyu
Published: February 2025

Objectives

This cross-sectional study aims to evaluate the association between calcium and vitamin D supplementation for osteoporosis treatment and the development of kidney stones while investigating the impact of urinary calcium excretion on kidney stone risk among patients receiving this supplementation treatment.

Design

The study involved collecting data from 204 Chinese Han patients aged 50–89 with osteoporosis in the southwest region of China. These patients had been on daily doses of 600 mg of calcium carbonate and 0.5 µg alfacalcidol for at least 1 year. The study employed univariate analysis and multivariable logistic regression to identify risk factors for kidney stones, with independent t-tests used to compare differences between groups.

Setting

Data were collected from patients in the southwest region of China, covering the period from July 2019 to December 2023.

Participants

The study included 204 patients with osteoporosis, all of whom had been receiving the specified calcium and vitamin D supplements for the duration of the study.

Results

The study found that a history of recurrent kidney stones was an independent risk factor for the development of kidney stones. Patients with kidney stones who had a history of recurrent stones exhibited significantly higher levels of 24-hour urinary calcium excretion (1.00±0.62 vs 0.57±0.54, p=0.026) compared with those without such a history.

Conclusions

The results suggest that a history of recurrent kidney stones independently increases the risk of kidney stones in patients undergoing calcium and vitamin D supplementation for osteoporosis, likely due to increased urinary calcium excretion.
Gender, race and ethnicity biases experienced by hospital physicians: an umbrella review to explore emerging biases in the evidence base
Authors: Kendrick Abby , Krishnan Nithya , Baharani Jyoti , Tuttle Janet , Szczepura Ala
Published: February 2025

Objectives

To examine the authorship and content of systematic reviews (SRs) of biases experienced by medical professionals through a gender lens.

Design

Review of SRs.

Data sources

We searched PubMed, Embase, PsycINFO and CINAHL from inception. Searches were conducted in May 2022 and updated in October 2023.

Eligibility criteria

Reviews of studies reporting biases experienced by hospital physicians at any stage of their careers and in any country. Reviews were included if they used systematic methods to search the literature and synthesise the data. Non-English language publications were excluded.

Data extraction and synthesis

The main theme of each eligible review was identified through qualitative thematic analysis. We used NamSor to determine the first/last authors’ gender and computed the proportion of female authors for each review theme.

Results

56 articles were included in the review. These covered 12 themes related to gender, race and ethnicity bias experienced by physicians at any stage of their careers. The overall proportion of female authors was 70% for first authors and 51% for last authors. However, the gender of authors by theme varied widely. Female authors dominated reviews of research on discrimination and motherhood, while male authors dominated reviews on burnout, mental health and earnings. Only six reviews were identified that included race and ethnicity; 9 out of the 12 first and last authors were female.

Conclusions

Understanding the potential for a gendered evidence base on biases experienced by hospital physicians is important. Our findings highlight apparent differences in the issues being prioritised internationally by male and female authors, and a lack of evidence on interventions to tackle biases. Going forward, a more collaborative and comprehensive framework is required to develop an evidence base that is fit for purpose. By providing a point of reference, the present study can help this future development.

PROSPERO registration number

CRD42021259409; Pre-results.
Investigating the general effects of different types of toluene exposure on the health of workers: an integrative review of the literature
Authors: El-Hagrasy Ahmed Mohsen Abbas , Karrout Ramadan Hani , Mcguinness Alexa Lulu , Albutain Tarek Ziyad Assaf Mousa , Khalifa Dana , Khalil Fatema Mohamed Hasan Ali , Tawash Eman , Alaradi Maryam
Published: February 2025

Objectives

This integrative review aims to evaluate the available empirical and theoretical literature on the effects caused by different types of occupational toluene exposure on the health of workers. We aim to guide future research, legislation, and guidelines with evidence-based recommendations on toluene exposure.

Design

An integrative review of the literature.

Data sources

A systematic search strategy was undertaken across five electronic databases; PubMed, Scopus, Medline, CINAHL and ScienceDirect. Furthermore, grey literature was incorporated through hand-searching databases, Google Scholar, open-access engines and Google Advanced Search tool, among other tools.

Eligibility criteria

Studies investigating the effects of occupational toluene exposure between 2010 and July 2023 were included. Inclusion criteria included full-text English articles, workers aged 18–65, and studies with co-exposures to benzene, toluene, ethylbenzene and xylene or volatile organic compound if direct findings to toluene were reported. Notable exclusion criteria were non-human studies, pregnant women, paediatric and geriatric populations, and studies addressing toluene abuse and not occupational exposure.

Data extraction and synthesis

27 studies met the eligibility criteria and were appraised using the Mixed Methods Appraisal Tool. Data were systematically extracted, guiding the synthesis of various themes, namely acute exposure effects, chronic exposure effects, short-term effects, long-term effects, low-dose effects, high-dose effects and reversible versus irreversible effects.

Results

The review demonstrated that occupational toluene exposure impacts health differently depending on the nature and context of the exposure. Effects can arise in both acute and chronic scenarios, with outcomes that vary by duration, dose and whether the effects are reversible or irreversible.

Conclusions

The results demonstrate that toluene exposure can cause a wide range of effects based on the type of occupational toluene exposure. These findings can be used to update current guidelines on the recommended threshold limit for toluene exposure. Furthermore, strategies such as implementing mandatory personal protective equipment, improving ventilation and educating workers on the risks of toluene exposure can be put in place to mitigate the risks.
Longitudinal evaluation of neointimal formation using optical coherence tomography for an intracranial aneurysm with flow diverter placement in vivo: preliminary experience
Authors: Matsuda Yoshikazu , Aiura Ryo , Hirose Eisuke , Mizutani Tohru
Published: February 2025

Placement of a flow diverter (FD) has been a mainstream treatment for intracranial aneurysms. Neointimal formation in the aneurysmal neck and stent struts is important for promoting aneurysm healing and reducing ischemic complications. Although several animal studies have reported the longitudinal evaluation of neointimal formation post-FD placement using optical coherence tomography (OCT), no human studies have been published. We describe the first case of a patient with follow-up longitudinal angiography and OCT examination at 1 and 3 months post-FD placement for an internal carotid artery aneurysm. At 1 month, the OCT images showed complete neointimal formation on stent struts of the parent artery and partial neointimal formation on the neck. The aneurysm was occluded on angiography at 3 months and all stent struts were covered with neointima on OCT images. An OCT examination may provide insights regarding the mechanism underlying the healing process of aneurysms treated by an FD.
Driving under the influence of opioids in 2024: a narrative review of science and pandemic policy updates
Authors: Kirsch Colin , Wintergalen Patrick , Cohen Steven P , Mirzadeh Zaman , Farber S Harrison , Wilhelmi Brian G
Published: February 2025

Background/Importance

Driving under the influence of drugs (DUID) refers to operating a vehicle after consuming drugs or medications other than alcohol that impair the ability to drive safely. There is no consensus on legal limits for drug intoxication while driving in the USA. Balancing the benefits of prescription medications, such as opioids, with traffic safety remains an ongoing public health challenge.

Objective

This article examines DUID policy and provides recommendations for policy improvement and unification grounded in scientific evidence on opioid-related impairment and driving risks.

Evidence review

A literature review of epidemiologic data, psychomotor effects, and public policy related to opioid use and driving was conducted. A total of 38 epidemiological studies, 21 studies on psychomotor effects, and pertinent laws and policies were reviewed.

Findings

Epidemiological data reveal an increasing prevalence of opioid-positive drivers and an association between opioid use and elevated risk of motor vehicle collisions. Psychomotor studies show mixed results, with some indicating impairment in opioid users and others suggesting minimal effects on driving ability. State laws regarding DUID remain heterogeneous, with trends toward expanded testing powers, lower impairment thresholds, and limitations on prescription-based defenses. The lack of standardized opioid testing limits and inconsistent policy approaches across states hinder effective management of opioid-related impaired driving.

Conclusions

A balanced public health approach can reduce opioid-involved crashes through education, prevention, enhanced enforcement tools, and rehabilitation. In drafting future DUID laws, policymakers must analyze evolving opioid research when balancing the pain relief of opioids with public roadway safety.
Association of hyponatremia with outcomes after geriatric trauma: a systematic review and meta-analysis
Authors: Naaseh Ariana , Tohmasi Steven , Stoll Carrie , Luo Chongliang , Yaeger Lauren H , Hoofnagle Mark H , Colditz Graham A , Spruce Marguerite W
Published: February 2025

Background

Trauma is a major cause of mortality in the elderly population. Hyponatremia is the most common electrolyte imbalance in geriatric patients and has been demonstrated to be a risk factor for altered cognition, low bone density, falls, and death. We systematically and critically reviewed the literature to ascertain the association between hyponatremia and geriatric trauma outcomes.

Methods

We searched seven databases for articles published from inception to October 2023. Studies included reported on geriatric trauma, hyponatremia, and clinical outcomes. Two investigators independently reviewed 6535 abstracts, 235 full-text articles, and critically appraised each study. Study details, patient characteristics, and outcomes were independently extracted by two reviewers. Data quality assessment was performed using the Grading of Recommendations Assessment, Development, and Evaluation approach. Publication bias was assessed using funnel plot-based methods. A meta-analysis of risk ratios (RR) was performed using the random effects method.

Results

Four retrospective cohort studies involving 11 894 geriatric patients were included. Among these, 492 (21.4%) were classified as trauma patients due to a fall and 1806 (78.6%) were classified as a trauma patient due to the presence of a fracture. In total, 2298 (19.3%) patients were classified as hyponatremic (125–135 mmol/L) while 9596 (80.7%) were classified as normonatremic. The pooled RR for in-hospital mortality for hyponatremic patients was 2.23 (95% CI 1.51 to 3.74) with high heterogeneity across the studies (I2=82.17%).

Conclusions

Geriatric trauma patients presenting with hyponatremia appear to have an increased risk of in-hospital mortality. Given this association, national trauma registries should consider collecting serum sodium values for geriatric patients and providers should work to address hyponatremia as a possible contribution to falls. Given the paucity of published literature on this topic, there is a need for prospective studies evaluating the association between hyponatremia and geriatric trauma outcomes.

Level of evidence

Level III, systematic review with meta-analysis
Habitat dependent life history
Authors: Morris Douglas W.
Published: February 2025

Life-history research, commonly treated as the study of age and stage-dependent vital rates, often invokes a role for habitat but seldom in the context of theories of density- and frequency-dependent habitat selection. Merging life history research with habitat-selection theory is crucial because habitat and habitat selection modify the partial interactive effects of genetics, traits, demography, and environment on adaptive evolution. The density and frequency dependence of habitat selection feeds back onto life histories whenever the relationship between fitness and density varies among habitats and individuals occupy the habitat yielding highest fitness. Comparisons of life history and habitat selection in rodents, fishes, and fisheries support the habitat-dependent perspective but also reveal manifold processes in need of further theoretical and empirical study.
FAMILY-DRIVEN INNOVATION: A MULTILEVEL INVESTIGATION OF CONTINGENCY FACTORS FOR INNOVATION STRATEGY
Authors: GAMBLE JORDAN ROBERT , CLINTON ERIC , O’GORMAN COLM
Published: February 2025

This paper explores the drivers of innovation in family firms. Using contingency theory as our theoretical lens, we investigate how contingency factors (“where”, “how”, and “what”) relate to the development of innovation strategies, and how family firm idiosyncrasies affect the development of these innovation strategies. Using four multi-generational family firm case studies, the data collection consisted of 21 interviews and 1,496 items of archival data. We identify five specific elements of family firm innovation strategies (vision and culture alignment, generational approaches, change strategy, future orientation, and shared decision-making). We show how innovation strategy in family firms is contingent on three factors: “Where”: willingness to innovate; “How”: structures and processes needed to innovate; and “What”: capabilities and resources needed to innovate, and that these are influenced by idiosyncratic characteristics of family firms (familiness, founder influence, and succession).
Predicting Diabetes with Federated Learning: A Digital Twin and Medical Fog-based IoT Framework
Authors: Mishra Kaushik , Ghugar Umashankar , Rajareddy Goluguri , Sahoo Kshirasagar , Bhoi Sourav , Bhuyan Monowar , Gandomi Amir
Published: February 2025

In today's world, maintaining good health has become increasingly paramount. The global prevalence of diabetes has surged due to the stress of modern life and unhealthy dietary habits. Detecting diabetes at an early stage has become imperative. Leveraging advancements in Cloud and Fog computing, we can create an Internet-enabled Medical Fog framework that incorporates Machine Learning (ML) techniques to predict and diagnose diabetes at its inception. This early prediction and diagnosis would enable remote medical assistance for individuals living far from immediate medical facilities. The Internet of Medical Things allows patient data to be gathered via sensors, analyzed using ML techniques, and stored in the Cloud, providing direct access for healthcare professionals. Therefore, the current study introduces a Digital Twin (DT)-enabled Internet of Medical Fog framework, supported by Federated Learning (FL) and the SaJAYA-ANFIS ML approach for diabetes prediction. FL ensures patient data privacy is upheld while fostering a seamless, intelligent healthcare ecosystem that bridges the gap between patients and doctors through DT. Data collection begins at the Internet of Things (IoT) layer through sensors, followed by processing at the Fog layer, comprising diverse computing nodes with specific pre-processing tools and the SaJAYA-ANFIS model for diabetes prediction. Predicted outcomes are then stored in the Cloud for analysis by medical professionals. The proposed framework addresses privacy concerns through Federated Learning (FL). The proposed method has been validated with a UCI diabetes dataset and compared with state-of-the-art FL-supported ML and DT-supported ML techniques for various performance metrics (Accuracy, Precision, Specificity, Recall and Fβ-measure). The results demonstrate that our method outperforms other baselines, achieving 93.5% accuracy and 92% Fβ-measure, respectively.

Fog computing, Cloud computing, Healthcare
Imaging of the Acute and Chronic Cardiovascular Complications of Radiation Therapy
Authors: Wilson James , Jun Hua Chong , Aziminia Nikoo , Manisty Charlotte
Published: February 2025

Chest radiotherapy (XRT) plays a crucial role in the treatment of a multitude of cancers including breast, lung, esophageal, and lymphoma. Although XRT enhances cancer survival rates, it may also expose healthy bystander tissues to radiation, potentially leading to severe complications. Initially considered relatively resistant to radiation damage, the heart has been shown over the past 4 decades to be susceptible to radiation-induced cardiovascular toxicity and despite advances in XRT which can minimize radiation exposure to heart tissue, no cardiac radiation dose is entirely safe. The clinical spectrum of radiation-induced cardiovascular toxicity is broad, encompassing coronary artery disease, myocardial dysfunction, valvular abnormalities, and pericardial disorders. Radiation-induced cardiovascular toxicity may manifest acutely or many years after XRT, with each condition more likely to present at certain time points post-XRT. Cardiac imaging is a crucial tool in both the screening and diagnosis of radiation-induced cardiovascular toxicity with an understanding of its pathophysiology, incidence, and progression required to implement a comprehensive, multimodality imaging approach to detect and manage these complications effectively.
A review and analysis of names and designations published in Kalanchoe (Crassulaceae subfam. Cotyledonoideae) (when, where, by whom, and from where did the material originate) between 1801 and 1908, when the final part of Raymond-Hamet’s two-part monograph was published
Authors: SMITH GIDEON F.
Published: February 2025

Although the validly published and legitimate genus name Kalanchoe (Crassulaceae subfam. Cotyledonoideae) dates from 1763, the first species names and combinations in the genus were only published in the early 1800s. Adanson, the author of the genus name, did not himself validly publish any species names therein. Between 1801 and January 1908, when the second part of Hamet’s two-part monograph of Kalanchoe appeared in print, a total of 154 new names, new combinations, and designations were published in the genus, mostly at the rank of species. [Hamet later changed his name to Raymond-Hamet, i.e., by hyphenating his first name and surname.] These 154 names and designations were essentially the ones that Hamet considered in his monograph published in November 1907 and January 1908. Note though that by 1907, when the monograph was submitted for publication, names for six genus-rank taxa had already been published for species today included in Kalanchoe. These synonyms are: (1) Vereia (1798); (2) Bryophyllum (1805) [the basionym of K. subg. Bryophyllum (1919)]; (3) Physocalycium (1820); (4) Baumgartenia (1821); (5) Meristostylus (1861); and (6) Kitchingia (1881) [the basionym of K. subg. Kitchingia (2018)]. A seventh genus name, (7) Geaya (1908), was only published in 1908, the year in which the second (and final) part of Hamet’s monograph appeared in print. Names published in the first six genera were therefore also taken into account in the monograph. Of the 141 names—the other 13 were designations—validly published in Kalanchoe up to the publication of Hamet’s monograph in 1907 and 1908, 71 are today treated as accepted species: virtually exactly 50%. The 13 designations, i.e., not validly published ‘names’, published by 1908 do not feature in priority considerations. Overall, Hamet’s approach to the taxonomy of Kalanchoe was rather conservative and he recognised only 52 species and one nothospecies, with a further 10 species treated as “Species non satis notæ”. Taxonomic and nomenclatural complications that arose from Hamet’s monographic interpretation of the taxonomy of Kalanchoe are highlighted and discussed.
The phylogenomic position and barcoding resources of Ficus conglobata with additional notes to its distribution ranges
Authors: LIAO SHUAI , MIAO BAI-GE , GAO JIN-XIA , GAO JIE , YANG DA-RONG , XIONG YONG-MEI , SENSARMA SREYOSHEE , PENG YAN-QIONG , ZHANG ZHEN
Published: February 2025

Ficus conglobata, a fig tree previously reported in the east Himalaya region, including northeast India, Bhutan, and Bangladesh, is additionally recorded here in Motuo County, Xizang Autonomous Region in China and Putao District, Kachin State in Myanmar. This less known species is distinguishable from its morphologically related taxa, such as F. heterostyla, F. hispida, and F. squamosa, by its fascicular and ramous breeding shoots bearing numerous figs. Phylogenomic investigation based on a large nuclear dataset and chloroplast genomes were implemented to verify its phylogenetic position. Furthermore, we annotated and provided its barcodes for future research, including a super-barcode (the complete chloroplast genome) and a nuclear barcode (internal transcribed spacer, ITS).
Morphological differences of crickets in different generations: A case study on the Sonotrella (s. str.) laosensis Liu, Zhang & Shi, 2016 (Orthoptera: Grylloidea: Oecanthidae)
Authors: MA YONG , LIU YUWEI , LIU HAOYU
Published: February 2025

While some cricket species can undergo two or more generations per year, limited research has been conducted on the stability of external morphological characteristics across different generations. This study provides a comparative morphological analysis of using materials collected from Sonotrella (s. str.) laosensis in Laos during both the rainy and dry seasons. For the first time, it reveals variations in the stability of phallus among different generations. These research findings will provide valuable evidence to support the establishment of new units within cricket taxonomy, particularly when discussing subspecies status.
Two new species of Domene Fauvel, 1873 (Coleoptera: Staphylinidae: Paederinae) from Portugal and faunistic notes
Authors: SERRANO ARTUR R.M. , AGUIAR CARLOS A.S.
Published: February 2025

Two new species of rove beetles belonging to the genus Domene Fauvel, 1873, subgenus Lathromene Koch, 1938 from Portugal are described: Domene (Lathromene) boavidae sp. nov. and Domene (Lathromene) pedroi sp. nov. These subterranean species are diagnosed and compared with closely related species from the Iberian endemic subgenus Lathromene. The external morphology and male genitalia are illustrated and information on the species` ecology is presented. A dichotomous key for identifying species of the Lathromene subgenus, based on male genitalia, is presented. New faunistic and ecological data on Domene (Lathromene) viriatoi Serrano & Boieiro, 2015 are also given.
Description and Genetic Barcode of Arria stanleyi sp. nov. (Mantodea: Haaniidae), a new moss-mimicking mantis species from Vietnam
Authors: CHAO MICHAEL
Published: February 2025

A new species of moss-mimicking mantis, Arria stanleyi sp. nov. is described based on female and male specimens collected in Tam Dao, Vietnam. The new species shows morphological characteristics vastly different from most other species in the genus Arria (Stal, 1877), with Arria muscoamicta (Unnahachote et al. 2021) having the most similar characteristics. Its discovery may outline a distant evolutionary branch compared to other species within the genus due to its geographic isolation and unique morphology. Genetic barcode is presented, and behavior and habitat are described.
Occurrence of Megamouth Shark, Megachasma pelagios (Lamniformes: Megachasmidae) in the Central Indian Ocean
Authors: RAHMAN RIYAS P. K. , ABHIJITH E. K. , KRISHNAPRASAD P. H. , SARLIN P. J. , SURESHKUMAR S.
Published: February 2025

The Megamouth Shark (Megachasma pelagios), considered rare, has been observed in increased records recently, surpassing 273. The present study provides insight into the limited Indian Ocean records by reporting a specimen collected in Sakthikulangara Harbour, Kollam, Kerala, India. It highlights the need for monitoring and improved research to better understand this species in the Indian Ocean.
Caregiver Strain in Children with Attention Deficit Hyperactivity Disorder: A Cross-Sectional Study
Authors: Chandrakar Alka , Karthik Selvaraj M , Sathianathan R  , Udayakumar N  , Natrajan S
Published: February 2025

Background:

Attention Deficit Hyperactivity Disorder (ADHD) is among the most prevalent psychiatric disorders observed in children, which causes significant caregiver burden in terms of psychological, emotional, physical, and financial status. The current study correlates the severity and subtypes of ADHD with caregiver strain in children with ADHD.

Methods:

A cross-sectional study in which 40 caregivers of children with ADHD were assessed using a semi-structured proforma, Caregiver Strain Questionnaire (CSQ), and Vanderbilt ADHD Diagnostic Parent Rating Scale (VADPRS).

Results:

The mean global score of caregiver strain in this study was suggestive of moderate caregiver burden. The combined subtype of ADHD was the most common (42.5%) and had the greatest mean score of severity in this study, but it caused the least caregiver burden ( P < .05). The inattentive subtype of ADHD was causing the greatest caregiver strain in all the domains of strain (objective, subjective externalized, and subjective internalized) [ P < .05]. Most of the children had co-morbid psychiatric conditions (67.5%), of which oppositional defiant disorder was the commonest (60%) and caused significant caregiver strain in all the domains ( P value even up to <.01 and <.001 for some domains).

Conclusion:

The severity of caregiver burden is influenced by the subtype of ADHD and the existence of co-morbid psychiatric conditions. Applying such findings in routine clinical practice can be more helpful for improving the overall well-being of the child and the caregiver.
Postural tachycardia in psychiatric inpatient eating disorders treatment
Authors: Seiler Natalie , Ziegeler Benjamin , Sacco Natalie , Teh Andrew W , Gwee Karen
Published: February 2025

Background: Postural tachycardia has been observed as a sign of malnutrition in eating disorders, including anorexia nervosa. However, there is limited information regarding other contributors to postural tachycardia in this population. Aim: This study aimed to determine the following among patients admitted to the Eating Disorders Unit (EDU) at a metropolitan tertiary hospital in Victoria, Australia: (a) the prevalence of postural tachycardia among eating disorder inpatients, and (b) the associated demographic and clinical features. Methods: Retrospective review of patient files was undertaken for inpatients aged 18–65 years with an eating disorder who resided within the Body Image & Eating Disorders Treatment & Recovery Service catchment area and were admitted to EDU between January 01, 2021 and October 30, 2023. Logistics regression was used for statistical analysis. Results: Among 177 admissions, 48 patients had postural tachycardia and this was at least partially attributed to malnutrition in 42 patients. Antipsychotics were significantly positively associated, and for every increase in one antipsychotic medication, there was an 89% increase in postural tachycardia diagnosis likelihood (B = 0.637) (Exp(‘B’)) = 1.890). Higher admission body mass index/weight, emergency medical reviews, ≥ 10 prior psychiatric admissions, and 1–3 prior medical admissions showed significant positive associations. Conclusions: Postural tachycardia is a multifactorial issue which contributes to medical instability and is associated with antipsychotic medications and a history of multiple medical and psychiatric admissions.
Pursuing the Promise of Transit Justice: Learning From Austin
Authors: Horak Martin
Published: February 2025

This commentary reflects on the broader significance of Austin's experience with Project Connect, as discussed in Karner and Shuster's article. It suggests that, absent major shifts in the structure of the American political economy and the character of local political institutions, the struggle for transportation justice will remain challenging. Yet the Austin case makes it clear that not all is lost. The prevalence of ballot initiatives means that local pro-transit coalitions must develop broadly appealing proposals. By building their organizational capacity and taking advantage of strategic opportunities to position themselves as valuable coalition partners, transit justice activists can from time to time achieve the influence needed to score significant victories, even in the face of long odds.
EXPRESS: Image Generative AI in Tourism: Trends, Impacts, and Future Research Directions
Authors: Yu Joanne , Meng Ting
Published: February 2025

The integration of image generative AI (GenAI) into tourism marketing represents a transformative shift in how destination images are created and perceived. This paper employs a comprehensive literature review and theoretical synthesis to explore the impact of image GenAI on marketing, focusing on its potential to transcend current strategies on marketing, communication, and tourist engagement. Theoretical backgrounds are classified into four major areas, followed by novel research directions, such as the examination of consumer perceptions, the effects of hyper-personalisation, the integration of virtual environment, the impact on sustainable practices, the effect of “programmed” destination images, and the intersection of linguistic and cognitive processes. By highlighting the need to understand and harness image GenAI, this research serves as a foundation for future works and offers practical insights for marketing professionals to leverage GenAI for enhanced tourism positioning and personalised experiences.
In silico study of selected alkaloids as dual inhibitors of β- and γ-secretases for Alzheimer's disease
Authors: Onifade Isreal Ayobami , Umar Haruna Isiyaku , Aborode Abdullahi Tunde , Awaji Aeshah A. , Jegede Ifeoluwapo Deborah , Adeleye Bunmi Helen , Fatoba Dorcas Oladayo , Bello Ridwan Opeyemi , Fakorede Sodiq , Idowu Nike
Published: February 2025

Background

Alzheimer's disease (AD) has become common as the number of aged people increases making it as a socioeconomic problem lately. To date, no success is recorded for disease-modifying therapies for AD but only drugs for symptomatic relief exist. Research has been centered on the role of amyloid-β on the pathogenesis of AD, which has led to the development of drugs that target Aβ (β- and γ-secretase inhibitors) to reduce the amount of Aβ formed. However, the existing β and γ-secretase inhibitors were associated with harmful side effects, low efficacy, and inability to cross the blood-brain barrier.

Objective

This study therefore used in silico approach to predict the inhibitory properties of alkaloids as potential drug targets against AD.

Methods

Thus, in this current study, 54 alkaloids from the PhytoHub server (phytohub.eu), and two approved drugs were docked against β-secretases. Additionally, galantamine and 5 alkaloids with the utmost binding potential with β-secretase were subjected to pharmacokinetics evaluation and docked against γ-secretase.

Results

From the result, 5 compounds displayed for both docking periods, with demissidine, solasodine, tomatidine, and solanidine having better BE than the control drugs. Based on the pharmacokinetics evaluation, 4 compounds possessed good pharmacokinetic evaluation and biological activities than galantamine.

Conclusions

This study suggests that demissidine, solasodine, tomatidine, and solanidine are promising dual inhibitors against β- and γ-secretase proteins in silico. However, there is an urgent need to carry out in vitro and in vivo experiments on these new leads to validate the findings of this study.