bluuebunny/crossref_metadata_2025 huggingface dataset:
Environmental Security and Local Livelihoods: Challenges and Opportunities in the West Philippine Sea
Authors: Contreras Antonio P. , Ancog Rico C.
Published: February 2025

The discourse on the West Philippine Sea is framed in the context of traditional security, and the territorial disputes between the Philippines and the People’s Republic of China, and other claimant countries in the region. However, the West Philippine Sea is not just a geographical region that is playing a role in geopolitics. It is also an economic resource providing livelihoods even to local communities. This article frames the discourse on the West Philippine Sea in the context of environmental security and adopts a political-ecological framework that is also cognizant of the role of non-state actors. It explores non-traditional diplomatic channels that would give privilege to the region as an important source of livelihoods for local communities. It also recognizes the fact that the sources of threats are not solely emanating from China, but also from large scale commercial fishing industry in the country.
Re-evaluating the identity of Passiflora hastifolia (Passifloraceae), resulting into a new species of Passiflora ser. Menispermifoliae (Passifloraceae) from North-Central Peru
Authors: KUETHE J.R.
Published: February 2025

In 2009, a plant species from Tarapoto, Peru, was introduced into cultivation and identified as Passiflora hastifolia. However, a subsequent expedition to Bolivia, which included a visit to the type location of P. hastifolia, prompted a re-evaluation of the source material. This investigation revealed that the Peruvian material was incorrectly identified, leading to the recognition of a new species which is here described as Passiflora asprantha. The study provides a detailed comparison between P. hastifolia from Bolivia and the previously misidentified specimens circulating in popular cultivation under that name. Key differences in morphology, such as the acute apices of the leaf for P. hastifolia versus the ovoid apices in the Peruvian accessions; and flower structure which is pink-purple in P. hastifolia but fully white in the new species, are highlighted. Additionally, this paper includes notes on the ecology and distribution of the newly instated Passiflora asprantha, noting its specific habitat preferences and geographical range. This discovery contributes to the understanding of biodiversity within the Passiflora genus and underscores the importance of accurate species identification in botanical research.
Spaghetti worms from the reef: two new species of Loimia (Polychaeta: Terebellidae) from Bora-Bora and Moorea (Society Islands, French Polynesia) and a range extension of L. tuberculata Nogueira, Hutchings & Carrerette, 2015
Authors: HUTCHINGS PAT , DAFFE GUILLEMINE , GLASBY CHRISTOPHER , LAVESQUE NICOLAS
Published: February 2025

Two new species of coral-reef inhabiting Loimia are described: L. poraporaensis sp. nov., from the lagoon at Bora-Bora, French Polynesia and Hawaii and L. aimehoensis sp. nov., from Moorea in French Polynesia. Loimia poraporaensis sp. nov. has large lateral lobes on segments 2 and 3, a smooth body and eye spots absent. Loimia aimehoensis sp. nov. has banded buccal tentacles, large lateral lobes on segments 2 and 3, with those on segment 3 extending dorsally and with a basal flange, a smooth body and eye spots absent. These species are morphologically and molecularly compared to other recently described species from Pacific coral reefs. This study also allowed us to expand the known distribution of Loimia tuberculata from the type locality at Lizard Island (northern Great Barrier Reef, Australia) Southern GBR, Western Australia, eastern Papua New Guinea and New Caledonia. We provide two maximum likelihood trees (COI and 16S genes) for all species of Loimia for which data are available, as well as an identification key and a table of the diagnostic characters for the species of Loimia of this Pacific region. We also discuss their habitat and association with living corals.
Plio-Pleistocene deep-sea crinoid (Echinodermata) diversity from the western Rodrigues Ridge, Indian Ocean, revealed by microfossil evidence
Authors: ROUX MICHEL , THUY BEN , GALE ANDY S.
Published: February 2025

The deep-sea crinoid fauna of the Indian Ocean is still only partially known and its relationships with the Atlantic and W Pacific faunas remain questionable. Isolated ossicles, more or less biocorroded, of six species belonging to five families of stalked crinoids and one of comatulids were found in a sediment of late Pliocene to early Pleistocene age collected at a depth of 1460 m on the western Rodrigues Ridge. The material described contains three species of stalked crinoids including two new species of Rhizocrinidae. Paraconocrinus, a common genus in the Eocene, was previously unknown beyond the early Miocene. Cherbonniericrinus and Porphyrocrinus have representatives in the present-day oceans, the former only in the NE Atlantic, the latter in the Atlantic and Indo-western Pacific. The ossicles of Porphyrocrinus have been attributed to the extant species P. polyarthra known from the southwestern Indian Ocean, and have allowed us to improve the species diagnosis. P. polyarthra presents close affinities with two Atlantic species. The apparently high diversity of this Plio-Pleistocene fauna is due to a mixture of ossicles from autochthonous mesobathyal species and allochthonous epibathyal ones that lived at shallower depths.
A preliminary phylogenetic study of the cricket subfamily Phaloriinae (Orthoptera: Phalangopsidae: Phaloriinae)
Authors: ZHU YI-NING , HU TIAN-HAO , HE ZHU-QING
Published: February 2025

We sequence two mitochondrial genes (COI and cytb) and two nuclear (18S and 28S) genes of 13 Phaloriinae individuals from China and Thailand. By constructing a phylogenetic tree, we found that the genus Trellius Gorochov, 1988 was not monophyletic. Thus, two subgenera Vescelotrellius and Protrellius, previously under Trellius, are upgraded as genus status.
Linkage between Southeast and South Asian summer monsoons: Relative roles of the Pacific-Japan pattern and the El Niño-Southern Oscillation
Authors: Lu Mengmeng , Ren Hong-Li
Published: February 2025

The various regional summer monsoons over Asia have been known to be highly interactive, but their interrelationships are still under debate. The current study investigates the linkage between the South Asian summer monsoon (SASM) and the Southeast Asian summer monsoon (SEASM) and the involved physical mechanisms. A robust positive correlation is found between the first Empirical Orthogonal Function (EOF) modes of SASM and SEASM precipitations. However, asymmetric features emerge between the mutually-enhanced (ME) and mutually-weakened (MW) SEASM-SASM cases.

Apparent Pacific-Japan (PJ) pattern occurs in the ME SEASM-SASM cases under a relatively weak sea surface temperature (SST) background, causing a southwest-northeast precipitation dipole with a positive center over the northern Bay of Bengal and a negative center over the eastern Arabian Sea and southern India induced by westerly anomalies with anticyclonic curvature associated with the anomalous heating over the tropical western North Pacific and cooling over the Maritime Continent. While in the MW SEASM-SASM cases, the El Niño-Southern Oscillation related SST anomalies (i.e. a transition from the equatorial eastern Pacific warming in winter to cooling in summer) are substantial, which cause simultaneous weakening of the first modes of SEASM and SASM through anomalous western North Pacific anticyclone induced by the Pacific SST anomalies and the capacitor effects of other tropical oceans. In addition, intensified diabatic heating over the Maritime Continent driven by the anomalous zonal circulation related to the eastern Pacific cooling can enhance the precipitation over the eastern Arabian Sea and southern India via the westward-propagating Rossby wave.
Risk Factors Associated With Food Selectivity in Infants and Toddlers
Authors: Goffredo Martina , Santoro Nicola , Goffredo Paolo
Published: February 2025

Families of patients aged 3 to 6, evaluated between January and March 2023, were invited to respond to a questionnaire to investigate attitudes toward food in the first years of life. Based on the presence of food selectivity, 2 study groups were compared: 39 selective (42%) and 54 non-selective children (58%). Selective children tended to be less exposed to game activities with food ( P < .01), did not show curiosity toward new flavors ( P < .01), and presented a diet lacking a group of macronutrients ( P < .01). Moreover, selective eaters were more likely to use pacifier and baby bottle ( P = .02), to demand something different from what was presented on the dish ( P = .04), to be distracted by screens during meals ( P = .04). Also, selective children considered mealtime stressful ( P < .01) and were forced to eat ( P = .03). Finally, selectivity is a frequent reason of discussion between parents on their children nutrition ( P = .02).
Co-Design in Practice: Bringing STS to Post-Brexit Agricultural Policy
Authors: Tsouvalis Judith , Burns Charlotte , Fajardo-Escoffié José , Rose David Christian , Hartley Sue , Little Ruth
Published: February 2025

Following the Brexit referendum, the United Kingdom's Department for Food, Environment and Rural Affairs (Defra) began to "co-design" a new agri-environment policy for England with stakeholders: the environmental land management (ELM) scheme. ELM is the cornerstone of the most far-reaching agricultural policy reforms undertaken in the UK since the Second World War. This article provides the first empirically grounded assessment of the ELM co-design process. It uses a framework developed by science and technology studies (STS) scholars to help remake participation along constructivist lines to show where, how and why the co-design process was constrained by sociotechnical systems and constitutional relations between citizens, science and the state. Our analysis shows that while STS-informed interventions can help make government-orchestrated participation more experimental, reflexive, anticipatory and responsible, remaking it along constructivist lines requires a new constitutional moment in which major changes are made to the arrangement of epistemic and political authority. With the popularity of co-design rising with governments across the world, our article is relevant to a broad international readership wanting to know more about how co-design fares in the context of large-scale systemic transformations.
Mechanical behaviour of dual-phase SS301 under cryogenic conditions
Authors: T Antony Prabhu , Suryawanshi Rutujeet , DP Sudhakar , Kubendran Amos PG
Published: February 2025

The present work is the first comprehensive investigation of the cryogenic behaviour of dual-phase SS301 stainless steel over an extensive temperature range, including 20 K, 30 K, 40 K, 77 K, 120 K, 150 K, 170 K, and 300 K. The range of temperature involved in this study renders critical insights on the temperature sensitivity of the mechanical properties of SS301, such as yield strength, and ultimate tensile strength. This work notably unravels that the ductility and toughness of dual-phase SS301 remain largely unchanged between cryogenic and room temperatures owing to the similar level strain-induced transformation of martensite, and the resulting comparable phase-fractions. Furthermore, in addition to the two-stage serrations which are generally observed in discontinuous plastic-deformation, the present investigation reveals that the yield at 40 K accommodates four-stage serrations. However, interestingly, the four-stage of the serrations at 40 K progressively transition into two-stages as the deformation proceeds. Ultimately, the current work elucidates the mechanical behavior of dual-phase SS301 at cryogenic temperatures, in contrast to the more commonly analyzed austenitic stainless steels.
Nonlinear optimal control of variable speed wind turbines using optimal homotopy asymptotic method
Authors: Shalbafian Arefe , Ganjefar Soheil
Published: February 2025

This paper presents a new nonlinear optimal controller for wind energy conversion systems. This study utilizes a new strategy to solve the Hamilton–Jacobi–Bellman (HJB) equation and design a nonlinear optimal controller for wind turbines. The optimal homotopy asymptotic method (OHAM) is applied to derive the solution of the HJB equation corresponding to variable-speed wind turbines. The OHAM controller ensures proper tracking and achieves maximum wind power extraction while preventing excessive loads on the drive train. The proposed control strategy can provide fast convergence and rapid transient responses with high precision and small control input. The OHAM strategy requires a few iterations and can adjust the convergence domain and the convergence rate. The proposed OHAM controller is compared and evaluated with some existing control strategies. The obtained results indicate that OHAM achieves a suitable compromise between maximizing aerodynamic power capture and minimizing low-speed shaft oscillation.
Unveiling the clinical spectrum: Exploring the role of anti-β2glycoprotein-1 antibodies (anti-β2GPI) in antiphospholipid syndrome suspects
Authors: Effendi Muhammad Umer Naeem , Majid Hafsa , Moiz Bushra , Jafri Lena , Zehra Nawazish , Khan Aysha Habib
Published: February 2025

Objectives:

The objectives of this study were to determine the prevalence of anti-β2glycoprotein-1 antibodies (anti-β2GPI) in Pakistani patients clinically suspected to have antiphospholipid syndrome (APS) and assess their association with clinical manifestations.

Introduction:

The antiphospholipid syndrome (APS) is a complex disorder characterized by recurrent thrombotic and obstetric complications.

Methods:

An analytical cross-sectional study was conducted at Aga Khan University Hospital from January to June 2022, after obtaining ethical approval (ERC ID: 2021-6404-19580). A total of 133 patients aged 18–60 years, clinically suspected of having APS based on the updated international consensus (Sydney) classification criteria, were recruited. Anti-β2GPI antibodies were tested using the same blood samples provided for aCL testing, with verbal consent. Demographic, clinical, and biochemical data were collected via a structured questionnaire, while information on lupus anticoagulant testing was retrospectively obtained from prior records.

Results:

The study included 120 females (90.2%) and 13 males (9.8%) with a mean age of 31.3 ± 8.8 years. Predominant clinical manifestations included unexplained miscarriages at >10 weeks of gestation ( n = 77/120 female, 64.2%), while deep venous thrombosis (DVT) was a common non-obstetric clinical feature ( n = 18/133, 13.5%). The median level of anti-β2GPI was 2.12 U/ml (1.34–7.04) and 7.5% ( n = 10) were positive. Of the 10 positive patients, 2 displayed positive anti-β2GPI while concurrently testing negative for other aPL antibodies. A significant association was identified between the presence of anti-β2GPI and the occurrence of DVT and other venous thromboembolic events (VTE).

Conclusion:

This study highlights the prevalence and diagnostic utility of anti-β2GPI in Pakistani patients suspected of APS, identifying cases missed by other aPL tests and showing significant associations with thrombotic manifestations like DVT and VTE. However, the cross-sectional design, lack of confirmatory testing, and absence of locally derived cut-offs limit causal inferences.
Advancement of post-market surveillance of medical devices leveraging artificial intelligence: ECG devices case study
Authors: Hundur Madžida , Spahić Lemana , Bećirović Faruk , Gurbeta Pokvić Lejla , Badnjević Almir
Published: February 2025

Background

After 25 years of implementing the Medical Devices Directive (MDD), in 2017, the new Medical Devices Regulation (MDR) came into force, establishing stricter requirements for post-market surveillance of the safety and performance of medical devices (MD). For electrocardiogram (ECG) devices, which are crucial for monitoring cardiac activities, these requirements are essential to ensure the reliability and accuracy of diagnosing cardiac conditions and timely treatment.

Objective

This study aims to enhance post-market surveillance of ECG devices by leveraging Machine Learning (ML) algorithms to predict the operational status of these devices. Specifically, the research focuses on classifying the success or failure of ECG device operations based on performance and safety parameters. The ultimate goal is to improve the management strategies of ECG devices in healthcare institutions, ensuring optimal functionality and increasing the reliability of diagnostic procedures.

Method

During the inspection process of ECG devices conducted by an accredited laboratory in accordance with ISO 17020 standard in numerous healthcare institutions in Bosnia and Herzegovina, a total of 5577 samples were collected. Various machine learning algorithms, including Decision Tree (DT), Logistic Regression (LR), Random Forest (RF), Gaussian Naive Bayes (NB), and Support Vector Machine (SVM), were employed for result comparison and selection of the most accurate algorithm.

Results

All algorithms demonstrated good performance, but the Random Forest (RF) algorithm stood out, achieving 100% accuracy in predicting the success/unsuccess status of the device. While the results of this research are specific to the collected data from EKG devices, the developed algorithms can be applied to other similar datasets, offering opportunities for broader use in the medical environment.

Conclusion

Implementing machine learning algorithms for automated systems in healthcare institutions can significantly enhance the quality of patient diagnosis and treatment. Additionally, these systems can optimize costs associated with managing medical devices. Improved post-market surveillance using ML can address challenges related to ensuring device reliability and safety.
Moral sensitivity and attitudes towards patient safety among critical care nurses
Authors: Afshari Ali , Torabi Mohammad , Dehghani Mahsa , Farhadi Mona
Published: February 2025

Introduction

Patient safety is essential for healthcare quality and a global concern. The rapid advancement of medical technology presents ethical challenges for critical care nurses, who navigate complex decision-making processes. Given their close relationships with patients, nurses are uniquely positioned to address patient safety issues. Thus, enhancing nurses’ moral sensitivity and ethical values is increasingly important.

Objective

This study aims to explore the relationship between moral sensitivity and attitude towards patient safety in critical care nurses.

Methods

This cross-sectional, descriptive-correlational study was conducted from June to September 2022 in three hospitals affiliated with Hamadan University of Medical Sciences in Iran. Participants were nurses in intensive care units (ICUs), selected via convenience sampling. A total of 382 nurses completed questionnaires assessing demographic information, moral sensitivity, and patient safety attitudes. Data analysis was performed using descriptive statistics, t-tests, ANOVA, Pearson’s correlation, and multiple regression in SPSS 26. Ethical considerations: This research received ethical approval from the Ethics Committee of Hamadan University of Medical Sciences. Participants provided informed consent regarding the study’s objectives, and their confidentiality was strictly upheld throughout the research.

Results

The nurses’ average age and work experience were 38.6 years and 12.4 years, respectively. Mean scores for moral sensitivity and patient safety attitude were 81.65 ± 2.69 and 51.47 ± 2.21, indicating high levels and a significant positive correlation. Factors such as increasing age, work experience, fewer working hours, and completion of ethics training were linked to more positive attitudes towards patient safety ( p < .05). Regression analysis showed that 42.8% of the variability in attitudes towards patient safety could be explained by moral sensitivity and demographic characteristics.

Conclusion

This study highlights the relationship between moral sensitivity and patient safety attitudes among critical care nurses, emphasizing the importance of education, experience, and training in shaping ethical values. Enhancing moral sensitivity is vital for reducing risky behaviors and improving patient safety outcomes in critical care settings.
Rethinking EU-China Higher Education Cooperation in a Dynamic Global Environment
Authors: Cai Yuzhuo , Pinna Cristina , van der Wende Marijk
Published: February 2025

In an era of global challenges and shifting geopolitical landscapes, higher education cooperation between the European Union (EU) and China plays a crucial role in fostering mutual understanding and addressing shared concerns related to innovation, sustainability, and global governance. This editorial introduces a special issue examining the evolving dynamics of EU-China collaboration in a changed global environment that is leading to disrupted goals, governance paradoxes, and politicisation of academic exchanges amid global disruptions. It argues that rethinking EU-China cooperation requires addressing these tensions while leveraging opportunities for mutual benefit through strategic and adaptive engagement. The special issue features diverse contributions, such as bibliometric, institutional, and comparative analyses, offering fresh insights into this complex partnership. This editorial synthesises these findings, highlighting the importance of resilience and innovation in rethinking collaboration frameworks. It underscores how the articles propose pathways for sustainable, ethical, and secure academic partnerships, advancing the global discourse on higher education cooperation.
Acute outbreak of polioencephalomalacia in adult beef cows on pasture associated with feeding broiler litter
Authors: Charnas Savannah R. , Walsh Timothy , Tharp Brandi , Fritz Scott A.
Published: February 2025

Polioencephalomalacia (PEM) is a neurologic disorder of ruminants that can affect cattle as a result of high levels of sulfur in the diet. Sulfur can be ingested by an animal through feed or water, and the mineral status of the animal can affect how much sulfur is ultimately absorbed. Broiler (poultry) litter is sometimes used in cattle diets as an economical protein source, although it runs the risk of supplying too much sulfur to the bovine diet. Here we report a case in which 15 cows had neurologic signs before death. Initial testing ruled out other causes of acute death, and histologic findings confirmed a diagnosis of PEM. The sulfur concentration was ~0.70% of the total mixed ration (TMR), which is above the maximum tolerable dietary concentration of sulfur. The broiler litter contributed nearly all of the sulfur to this ration and was the cause of the PEM experienced in this herd. When feeding by- and co-products as part of a TMR, it is important for producers to analyze the feed to mitigate risk and ensure good health.
Randomized Controlled Trial of Expanded Coming Out Group on Reducing Self-Stigma of Schizophrenia People
Authors: Ng Petrus Yat-Nam , Chiu Renee , Young Kim-Wan Daniel , Chen Qi-Rong Joseph , Corrigan Patrick
Published: February 2025

Purpose: This study evaluates the efficacy of the expanded coming out proud (ECOP) group intervention in mitigating self-stigma among individuals with schizophrenia in Hong Kong. Methods: Eighty participants in recovery from mental illness were recruited and randomly assigned to the treatment and control group using a single-blind, multi-center randomized controlled trial. The treatment group underwent a 12-session ECOP intervention alongside their treatment as usual (TAU), while the control group received only TAU. Data were collected at pre-treatment, post-treatment, and at a 3-month follow-up. Results: The treatment group experienced significant reductions in self-stigma and notable improvements in self-empowerment and community empowerment, with medium to large effect sizes. These benefits persisted at the 3-month follow-up. Discussion: The findings suggest that the ECOP intervention is an effective method for reducing self-stigma and depression and enhancing empowerment among individuals with schizophrenia in Hong Kong. The study recommends further research and practice to focus on reducing self-stigma.
Identification and explanation of disinformation in wiki data streams
Authors: Arriba-Pérez Francisco de , García-Méndez Silvia , Leal Fátima , Malheiro Benedita , Burguillo Juan C
Published: February 2025

Social media platforms, increasingly used as news sources for varied data analytics, have transformed how information is generated and disseminated. However, the unverified nature of this content raises concerns about trustworthiness and accuracy, potentially negatively impacting readers’ critical judgment due to disinformation. This work aims to contribute to the automatic data quality validation field, addressing the rapid growth of online content on wiki pages. Our scalable solution includes stream-based data processing with feature engineering, feature analysis and selection, stream-based classification, and real-time explanation of prediction outcomes. The explainability dashboard is designed for the general public, who may need more specialized knowledge to interpret the model’s prediction. Experimental results on two datasets attain approximately 90% values across all evaluation metrics, demonstrating robust and competitive performance compared to works in the literature. In summary, the system assists editors by reducing their effort and time in detecting disinformation.
Genetically Distinct Acute Megakaryoblastic Leukemia following Low Hypodiploid B-Lymphoblastic Leukemia linked by TP53 Mutation
Authors: Harris Jaryse C. , Schubert Jeffrey , Lockhart Brian , Olson Rachel , Paessler Michele E. , Margolskee Elizabeth , Pillai Vinodh , Wu Jinhua , Golenberg Netta , Chen Jiani , Denenberg Elizabeth H. , Luke Tammy , Luo Minjie , Zhong Yiming , Li Marilyn M. , Wertheim Gerald B.
Published: February 2025

We report a case of acute myeloid leukemia with megakaryoblastic differentiation (AMKL) that developed after an initial B-lymphoblastic leukemia (B-ALL) with low hypodiploidy. Although the AMKL was initially thought either to be a phenotypic change from the original B-ALL or to have arisen as a result of treatment (acute myeloid leukemia, post cytotoxic therapy, AML-pCT [WHO]; AML, therapy related [ICC]), genetic evaluation of both the AMKL and the B-ALL suggest that neither of these considerations was correct. Rather, the AMKL did not harbor the most common genetic hallmark of AML-pCT–rearrangement of KMT2– and was genetically distinct from the B-ALL. Both the B-ALL and the AMKL, however, showed an identical TP53 mutation by next generation sequencing (NGS), while germline testing was negative for this mutant allele. Hence, either the patient had a tissue restricted constitutional TP53 mutation or had a somatic mutation in a multipotent hematopoietic precursor. This case highlights the necessity for close monitoring of patients with TP53-mutant tumors, as they may develop multiple lesions despite negative germline testing.
Use of mobile fitness app to improve pelvic floor muscle training in puerperal women with gestational diabetes mellitus: A randomized controlled trial
Authors: He Xiaocheng , Xie Yaping , Xie Baoyuan , Zhao Meijing , Zhang Honghui , Zhao Xiaoshan , Zhao Huifen
Published: February 2025

Background: Gestational diabetes mellitus (GDM) is one of the risk factors for postpartum urinary incontinence. Pelvic floor muscle training (PFMT) improves pelvic floor dysfunction in puerperal women, but patient compliance is low. Mobile Health (mHealth) is a promising solution. Objective: To investigate PFMT compliance and effects on pelvic floor muscles in GDM puerperal women guided by the mobile fitness app Keep. Methods: This randomized controlled trial included puerperal women with GDM ( n = 72) who were delivered at a tertiary general hospital, selected from November 2021 to April 2022 using convenience sampling, and randomly divided into control ( n = 36) and experimental ( n = 36) groups. The control group performed PFMT based on routine postpartum PFMT training instruction. The experimental group performed PFMT based on Keep. Both groups had a 4-week intervention period. The PFMT compliance, International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), Pelvic Muscle Self-efficacy Scale, and the Knowledge, Attitude, Belief, and Practice (KAP) scores of PFMT in puerperal women in the groups were compared pre- and post-intervention. Pelvic floor surface electromyographic biofeedback was used to compare the post-intervention pelvic floor muscle strength between the two groups. Results: Compared with the control group, the test group had higher post-intervention maternal PFMT compliance, pelvic floor muscle strength, pelvic floor muscle self-efficacy, and KAP scores ( p < 0.05); incontinence scores were lower ( p < 0.05). Pelvic floor muscles in both groups recovered better post-intervention ( p < 0.05). Conclusion: The Keep app can improve PFMT adherence, urinary incontinence, KAP scores, self-efficacy, and pelvic floor muscle strength in GDM puerperal women and promote pelvic floor rehabilitation after delivery.
Mechanical and UV stability of HDPE composites reinforced with carbon black and zinc oxide for solar floater applications
Authors: Khan Mohammed Wasim , Sahai Rai Sujit Nath , Pawar Kajal Bablya , More Pavan M
Published: February 2025

Anti-UV (ultra-violet) hybrid polymer composites were developed for application in floating solar power plants. Virgin high-density polyethylene (HDPE) was mixed with carbon black (CB) in weight percentages of 1.5, 2, and 2.5% with 1, 2, and 3% zinc oxide (ZnO) to prevent the floater from degrading due to UV light. A twin-screw extruder was used to prepare the composite, and four batches were formed. The test sample was prepared by an injection molding machine. After 672, 1413, and 3212 hours of accelerated weathering, the mechanical tests were conducted. After 1413 hours of weathering, pure HDPE loses its tensile strength, impact resistance, and elongation at break. The optimum performance was observed in batch B2, which contains 2% CB and 2% ZnO, with respect to the mechanical properties after UV exposure. The scanning electron microscope (SEM),energy-dispersive X-ray (EDX), Fourier transform infrared spectroscopy (FTIR), and X-ray diffraction (XRD) results also revealed that pure HDPE was more degraded compared to other composites. The strength of the polymer composite will decrease when ZnO and CB concentrations increase further. It was found that HDPE with 2% CB and 2% ZnO is an appropriate composite material for developing floaters used in floating solar power plants.
Early Tibial Vessel Recoil Following Treatment With the Bare Temporary Spur Stent System: Results From the DEEPER OUS Vessel Recoil Substudy
Authors: Zeller Thomas , Zhang Zhiyuan , Parise Helen , Mascho Carolyn , Holden Andrew , Schmidt Andrej , Thieme Marcus , Piorkowski Michael , Hertting Klaus , Wissgott Christian , Andrassy Martin , Noory Elias , Weinberg Ido , Kolluri Raghu
Published: February 2025

Purpose:

Vessel recoil is a common phenomenon occurring in the tibial vessels following balloon angioplasty. This study examined the occurrence and short-term impact of acute vessel recoil in a subset of patients treated with retrievable scaffold therapy (RST) via the Spur Peripheral Retrievable Scaffold System (Spur).

Methods:

Patients with tibial disease underwent angiography immediately following RST, and then 15 minutes post-treatment. Vessel recoil was defined as a ≥10% decrease in lumen diameter after 15 minutes. Recoil was further analyzed by late lumen loss method, subsegmental late lumen loss method, and smallest segment to same segment method. Patient and vessel characteristics were evaluated. Functional recoil (acute vessel spasm), defined as no significant change in minimal lumen diameter (MLD) at baseline compared with 15 minutes post-treatment, was also evaluated.

Results:

Of the 38 patients (40 lesions; 33 men [87%]; mean [SD] age 75.3 [8.2] years; 26 (68.4%) with diabetes mellitus); recoil was noted in 42.5% of vessels. Prior to treatment, 13 lesions (32.5%) were total occlusions, the mean lesion length was 64.7±30.4 mm, and 27.5% (11/40) were moderate or severely calcified. Mean treated lesion length was 97.8±39.6 mm. For lesions evaluable by duplex ultrasound, 86.7% of vessels (26/30) were patent at 6 months. There was no significant difference in patency between lesions with recoil and lesions without recoil (81.8% vs 89.5%); there was a trend toward patency in the non-recoil group. Two lesions had functional recoil (acute vessel spasm) and were patent at 6 months. There was no statistically significant correlation of recoil to comorbidities or lesion characteristics, including calcification, for which there was also no correlation to patency.

Conclusion:

Vessel recoil was noted in 42.5% of vessels treated with RST, whereas previous published rates with balloon angioplasty demonstrated vessel recoil up to 97%, suggesting that RST may impact vessel recoil. This exploratory study did not demonstrate a correlation between vessel recoil and patency at 6 months.

Clinical Impact

Retrievable scaffold therapy may replace scoring devices and cutting devices for vessel preparation before definite (drug) therapy. Retrievable scaffold therapy supplements already established vessel preparation strategies in order to follow the concept of leaving nothing behaind. A temporary retrievable scaffold for changing vessel compliance and potentially releasing antiproliferative drugs represents a new interventional concept.
Multidisciplinary Collaboration and Novel Technological Advances in Hadron Therapy
Authors: Dosanjh Manjit , Degiovanni Alberto , Necchi Maria Monica , Benedetto Elena
Published: February 2025

The battle against cancer remains a top priority for society, with an urgent need to develop therapies capable of targeting challenging tumours while preserving patient's quality of life. Hadron Therapy (HT), which employs accelerated beams of protons, carbon ions, and other charged particles, represents a significant frontier in cancer treatment. This modality offers superior precision and efficacy compared to conventional methods, delivering therapeutic the dose directly to tumours while sparing healthy tissue. Even though 350,000 patients have already been treated worldwide with protons and 50,000 with carbon ions, HT is still a relatively young field and more research as well as novel, cost-effective and compact accelerator technologies are needed to make this treatment more readily available globally. Interestingly the very first patient was irradiated with protons in September 1954, the same month and year CERN was founded. Both of these endeavours are embedded in cutting edge technologies and multidisciplinary collaboration. HT is finally gaining ground and, even after 70 years, the particle therapy field continues innovating and improving for the benefits of patients globally. Developing technologies that are both affordable and easy to use is key and would allow access to more patients. Advances in accelerator-driven Boron Neutron Capture Therapy (BNCT), image-guided hadron beams delivery, clinical trials and immunotherapy, together with the recent interest and advances in FLASH therapy, which is currently an experimental treatment modality that involves ultrahigh-dose rate delivery, are just a few examples of innovation that may eventually help to provide access to a larger number of patients.
Update on the therapeutic role of metformin in the management of polycystic ovary syndrome: Effects on pathophysiologic process and fertility outcomes
Authors: Brand Kerstin MG , Gottwald-Hostalek Ulrike , Andag-Silva Aimee
Published: February 2025

Influential guidelines have supported the role of metformin in the management of polycystic ovary syndrome (PCOS) for a number of years. However, regulatory approvals for this therapeutic indication are still exceptional and exist only in a few countries, including for the originator, Glucophage®. PCOS is an insulin-resistant state, which drives hyperandrogenism and anovulatory infertility. The metabolic action of metformin involves amelioration of insulin resistance, which helps to resolve hormonal and metabolic disturbances and increases ovulation, pregnancy, and live birth rates relative to placebo. A combination of metformin with clomifene citrate (another widely used treatment for PCOS) is more effective than either alone and is a useful option in women with clomifene-resistant PCOS. Combining metformin with letrozole (1st-line agent for ovulation induction in women with PCOS and no other infertility risk factors) is not more effective than letrozole alone. Continuing metformin to the end of the 1st trimester at an effective dose (e.g. 1000–2000 mg/day) may help to reduce the rate of miscarriages. Metformin also has an adjunctive role in women with PCOS receiving assisted reproduction technology (ART) using the long gonadotrophin-releasing hormone agonist protocol, where it appears to increase the pregnancy rate and to reduce the risk of ovarian hyperstimulation syndrome. There is no role for metformin in women receiving short ART protocols. Where a successful pregnancy is achieved, metformin is generally safe for the mother and neonate. Further research is needed to define with greater precision the optimal dosage and times to initiate and discontinue metformin in women with PCOS who achieve pregnancy.
Narrow-based gait in people with Parkinson's disease: Its mechanisms explored
Authors: Jansen Jamie AF , Buurke Tom JW , van de Venis Lotte , Weerdesteyn Vivian , Keijsers Noël , Nonnekes Jorik
Published: February 2025

Background

People with Parkinson's disease (PD) typically exhibit a narrow-based gait. We previously found that walking with reduced trunk rotation and obliquity led to narrow-based gait in healthy adults; a decrease in trunk motion coincided with a decrease in mediolateral extrapolated center of mass (XCoM) excursion, requiring a smaller step width to maintain a constant mediolateral margin of stability (MoS).

Objective

To assess whether reduced trunk motion in PD is related to narrow-based gait, without affecting mediolateral MoS. To explore the underlying mechanisms of narrow-based gait, we examined the effects of increasing arm swing (aiming to increase trunk motion), and widening steps on gait in PD.

Methods

Fifteen people with PD and narrow-based gait and 17 age-matched controls walked on a treadmill for three minutes at a fixed gait speed during three conditions: baseline, increased arm swing and widened step width. Step width, trunk rotation and obliquity were calculated using marker data, and XCoM excursion and MoS using ground reaction forces.

Results

Trunk rotation, XCoM excursion, and step width were significantly smaller in PD compared to controls, while the MoS did not differ. Increased arm swing did not substantially increase trunk motions in PD, though people with PD were able to widen their step width.

Conclusions

We provide further evidence for a relation between trunk motion and step width. In PD, reduced trunk motion may contribute to narrow-based gait, without affecting mediolateral MoS; future work is needed to confirm a causal relationship between reduced trunk motion and narrow-based gait in PD.
From Healthcare to Employment: Tackling the Regulatory Challenges of In-Body Wearable Devices at Work in the European Union
Authors: Marassi Stefania , Földes Mária Éva
Published: February 2025

The use of in-body wearable devices is increasing in the healthcare sector, given their capacity to diagnose diseases and monitor health conditions. At the same time, some of these devices have entered the market and are being researched for use in workplace settings to enhance workers’ health and safety. However, neither specific EU legislation nor national law currently regulates the use of in-body wearables in employment, raising questions about the safeguarding of workers’ fundamental rights to privacy and data protection. Addressing the challenges posed by this regulatory gap, this article explores whether the European legislative framework employed in the healthcare sector for medical devices could be applied to the use of in-body wearables in employment settings. It also discusses the application of a key principle of the General Data Protection Regulation when in-body wearables are used in the workplace: lawfulness.
Geographies of philanthropy: The intricate, the critical, and the generative
Authors: Mc̲Guirk Pauline
Published: February 2025

Fuentenebro et al.'s (2024) intervention on geographies of philanthropy provides a welcome prompt for geographers to engage more extensively with philanthropy's undeniable socio-political significance. My commentary focuses on the authors’ proposition and disaggregation of ‘the philanthropic complex’. Useful as the proposition is, I argue we will be well advised to resist the urge to allow ‘the complex’ to sediment as a macro-concept. Geographical engagements with philanthropy will benefit from engaging with more fully relational thinking and an insistent focus on practice to understand how philanthropy's powers and capacities are assembled and, more generatively, to identify the potential to disassemble and even to redirect philanthropy's impacts.
Diverse Patient Experiences of Internet-Based Cognitive Behavioral Therapy with Guided Peer Support for Generalized Anxiety Disorders
Authors: Connors Jill Nault , Magalhaes Ernani , Prather Kevin , Khan Nida , Draucker Claire , Eliacin Johanne , Montgomery Chet , Hayden Julie , Millard Michael , Kroenke Kurt , Musey Paul
Published: February 2025

Opportunities exist to improve patient experience in the emergency department for low-risk (ie, non-cardiac) chest pain patients with anxiety and panic as the underlying cause of symptoms. Referral to internet-based cognitive behavioral therapy (iCBT) with guided support is a scalable, evidence-based option that is underused, particularly among non-white patients. In collaboration with a diverse group of patient and community partners, we co-developed and tested an existing iCBT course for generalized anxiety disorder with delivery of guided support by a peer recovery specialist with concordant lived experience. We analyzed patient partner feedback from debriefing sessions during the testing phase using conventional content analysis. Results revealed overall positive experiences with both iCBT lessons and peer support calls. Key points derived from qualitative findings include: (1) iCBT lesson content resonated reasonably well with the diverse group of patient partners, (2) the peer relationship was key to individualizing application of content to various lived experiences, and (3) the guided discussion should be participant-driven and based on content that resonates most with the participant. In conclusion, iCBT with guided peer support was acceptable to patient partners involved in co-development and testing who were representative of a diverse patient population.
Management of Chronic Generalized Pustular Psoriasis: A Review and Expert Opinion
Authors: Elewski Boni , Lebwohl Mark G.
Published: February 2025

Introduction: Generalized pustular psoriasis (GPP) is a rare, chronic inflammatory skin disease characterized by persistent symptoms and sudden flares of painful sterile pustules, sometimes accompanied by systemic inflammation. Patients with GPP experience chronic disease burden even when not experiencing flares. There is an unmet need for guidelines on continuous long-term management of this disease. Areas Covered: This review summarizes existing literature describing the chronic disease burden of GPP, the persistence of symptoms and effects on quality of life (QoL) when patients are not experiencing a flare, the recurring nature of GPP flares, and the high prevalence of chronic comorbidities. We also present an overview of results from the EFFISAYIL® 2 study, which was the first randomized, placebo-controlled clinical trial to systematically evaluate continuous management with subcutaneous spesolimab, a first-in-class anti-interleukin-36 receptor monoclonal antibody specifically designed to treat GPP. Expert Opinion: An unmet need in GPP is the establishment of guidelines for chronic disease management, including measures for treating GPP between flares, flare prevention, and long-term disease control. Treatment strategies should mitigate both the persistent disease burden and potentially life-threatening flare episodes. Intravenous spesolimab is currently the only FDA-approved medication to treat GPP flares, and subcutaneous spesolimab is the only FDA-approved medication to treat GPP when patients are not experiencing a flare. Guidelines should aim to advance the recognition of GPP as a chronic disease and emphasize prompt diagnosis and timely access to FDA-approved therapies according to the diagnostic criteria established by the International Psoriasis Council and the National Psoriasis Foundation.
Beyond the Hit: The Hidden Costs of Repetitive Head Trauma
Authors: Khan Sikandar , Talley Lora
Published: February 2025

Repetitive head trauma in sports, particularly concussions, has been strongly associated with neurocognitive impairments, including depression, chronic traumatic encephalopathy (CTE), and altered brain function. These injuries can have significant consequences on major cognitive processes, such as learning and memory. This review synthesizes research that examines the effects of sports-related head trauma, particularly in football, on cognitive functioning. Post-mortem analyses of players across all positions have revealed neuropathological evidence of CTE, including a distinct reduction in hippocampal volume. Notably, episodic memory, a component of declarative memory, is frequently compromised in individuals with CTE. Furthermore, deficits in working memory may contribute to decreased performance during play. Early detection of head trauma and implementation of preventive strategies are crucial for mitigating long-term consequences. While impact-reducing techniques have shown some efficacy in decreasing brain injury incidence, proper tackling techniques, such as “heads-up play,” also play a vital role in minimizing risk. Further research and increased awareness are needed to ensure athletes are fully informed of the potential cognitive risks associated with participation in high-impact sports.