bluuebunny/crossref_metadata_2025 huggingface dataset:
Research Practices to Foster Accessibility for, and the Inclusivity of, Older Adults With Vision Loss: Examples From a Critical Participatory Study
Authors: McGrath Colleen , Mohler Elizabeth , McFarland Jami , Hand Carri , Laliberte Rudman Debbie , Fitzgeorge Barb , Stone Melanie
Published: February 2025

Introduction: It is important that the embodied experience of visual impairment is understood in research, and critical participatory action research (CPAR) is one such research methodology that encourages the direct participation of individuals with disabilities in the design, development, and dissemination of research. Methods: This reflexive paper unpacked how our research collective carried out accessible and inclusive CPAR with older adults with vision loss. Using meeting notes, group discussions, and reflection as the primary data collection methods, the research collective set out to answer the following question(s): (1) How has the research collective worked to enact an inclusive and accessible CPAR study that supports the full participation of older adults with vision loss? And (2) What has the research collective learned through reflecting on the process regarding challenges and strategies for working towards an inclusive and accessible CPAR? Results: Methodological decisions made by the research collective to ensure an accessible and inclusive CPAR with older adults with vision loss were broken down into four key stages in the CPAR process including: (1) study planning stage; (2) data collection stage; (3) data analysis stage; and (4) knowledge mobilization (KMb) stage. Discussion: Our discussion highlights what has been learned, with respect to building inclusive research practices. Such key learnings are centered around the idea that there is no one-size-fits-all approach to building inclusive research practices, but rather a dedication to offering choice, autonomy, and control, in combination with flexibility, are paramount to building inclusive CPAR. Lastly, this paper unpacked those long-standing traditions, such as obstructive ethics processes and funding restrictions, that need to be addressed to support inclusive CPAR moving forward.
Assessing the impact of substitution rule changes in European football leagues
Authors: Zhang Haiyu , Mathes Justus , Caparrós Marc Garnica , Memmert Daniel
Published: February 2025

Four years after the COVID-19 pandemic, a major change in professional European football was increasing allowed substitutions from three to five players per game. This study explores the effects of this regulatory change on four major European leagues (Ligue 1, La Liga, Serie A, and the Premier League) from the 2015–2016 to the 2022–2023 seasons. Descriptive statistics and a Linear Mixed Model were used to study the impact of the rule change on temporal distribution and number of players substituted. To investigate the change in the immediate impact of substitutions, we created a quantifiable variable and compared pre- and post-rule change results. Additionally, a Difference-in-Difference model examined the new rule's effect on final match outcomes. The results show that clubs are tactically adjusting, with an increased use of halftime substitutions and more flexible second half strategies. Additionally, the variability in the immediate impact of substitution on the scoreline and the decrease in final score difference emphasize the crucial role of substitution in tactics. This study provides a comprehensive understanding of how rule adjustments in football can influence game dynamics and team strategies, offering valuable insights into the tactical adaptations prompted by regulatory changes.
Effect of pre-hospital hypertonic saline on neutrophil to lymphocyte ratio in traumatic brain injury: A retrospective analysis
Authors: Watson Adam JR , Riordan Ryan , Hannah Julian , Nicholson Roberts Tim , Plumb James
Published: February 2025

Hypertonic saline (HTS) may have anti-inflammatory properties. We aimed to investigate the effect of pre-hospital HTS on neutrophil to lymphocyte ratio (NLR), a simple marker of systematic inflammation, in patients with severe traumatic brain injury (TBIs). We included 110 adults with blunt TBIs requiring pre-hospital anaesthesia (median age 57.1 years, 67% male). On hospital admission, median NLR was lower in patients who received pre-hospital HTS (7.9 vs 11.9, p = 0.021), and in multivariable analysis, HTS use remained associated with NLR ( p = 0.048). We believe our findings highlight the neuroinflammatory properties of HTS as an area for future research.
Anti-aging Effects and Main Chemical Constituents of Spiraea salicifolia Stem Extracts
Authors: Park Gwee Kyo , Song Jin Yeong , Yoo Hye-Young , Kwon Minseo , Kim You Ah , Park Sung-Ha , Lee Ki Yong , Park Byoung Jun
Published: February 2025

Objective: To investigate the anti-aging effects and the main chemical constituents of Spiraea salicifolia stem extracts. Methods: The anti-aging effects were investigated by evaluating the antioxidant, anti-wrinkle, and anti-inflammatory properties. The 2,2′-azino-bis-3-ethylbenzthiazoline-6-sulphonic acid (ABTS) and 1,1-diphenyl-2-picrylhydrazyl (DPPH) assays were used to determine the antioxidant effects. The anti-wrinkle effects were evaluated by measuring the mRNA expression of matrix metalloproteinase (MMP)-1 and MMP-12 in human skin fibroblasts. The anti-inflammatory effects were investigated by measuring the decrease in nitric oxide (NO) production, the mRNA expression of Interleukin-6 (IL-6) and the protein expression of NO synthase (iNOS) in lipopolysaccharide-induced RAW 264.7 cells. Reconstructed human epidermis and cornea-like epithelium were used to evaluate the local toxicity of the extracts. The major compounds were isolated using chromatographic separations and purification methods. The structures were identified by interpreting the measured spectroscopic data (NMR and MS) and comparing them with published values. Results: S. salicifolia stem extracts showed concentration-dependent radical-scavenging effects on DPPH and ABTS. Furthermore, they exhibited anti-wrinkle effects as they downregulated the expression of collagenase MMP-1 and elastase MMP-12 by 43% ( p < 0.001) and 34% ( p < 0.05), respectively, at 100 μg/mL. Moreover, they showed inhibitory effects on NO, IL-6 and iNOS of 46% ( p < 0.0001), 42% ( p < 0.0001) and 72% ( p < 0.0001), respectively, at 100 μg/mL. The extracts were considered non-irritant to the skin and eyes (UN GHS no category). Five known compounds, luteolin 5- O- β-D-glucopyranoside (1), trans-resveratrol 3- O- β-D-glucopyranoside (2), hyperoside (3), apigenin 5- O- β-D-glucopyranoside (4), and prunioside A (5), were identified as the major chemical compounds. This is the first report of the isolation of compounds 1, 2, 4, and 5 from this species; notably, this is the second report of the isolation of 5 from nature. Conclusion: S. salicifolia stem extracts are an important source of natural antioxidant, anti-wrinkle, and anti-inflammatory ingredients that can be safely used in anti-aging cosmetic applications.
The role of lifestyle, physical activity and dietary practices in predicting overweight and obesity among university students in Morocco
Authors: Benchehida Hiba , El Aameri Mohammed , Razzak Sara , Taibi Mariame , Bengueddour Rachid , Taib Bouchra , Taboz Youness
Published: February 2025

Background

The dietary quality of young adults often worsens during the transition to adulthood. University students, especially considering documented gender differences in eating habits, are prime targets for promoting healthy lifestyles to prevent noncommunicable diseases.

Objective

This study investigates the prevalence of overweight among students and analyzes disparities in physical activity, dietary practices, and the use of complementary medicine across genders, while also exploring factors influencing overweight.

Methods

A cross-sectional survey of 502 students aged 23 ± 3.67 from Ibn Tofail University was conducted in the spring of 2023. Students completed a self-reported questionnaire addressing various lifestyle habits. Data were analyzed using the Statistical Package for Social Sciences (SPSS v23) to assess weight status, lifestyle habits, and gender differences.

Results

Results show that 21.10% of students are overweight, while 72.90% are not. A significant association was found between gender and physical activity levels (p <0.0001), as well as gender differences in meal frequency (p <0.01), snacking behaviors (p <0.01), and sleep duration (p <0.0001). Notably, during stressful periods, males and females differed in their consumption of high-fat, high-sodium snacks such as crisps (p <0.01). Additionally, the internet and social media were significantly associated with BMI variations (p <0.01). Logistic regression analysis revealed that participants who reported that the internet influenced their eating habits had 1.68 times higher odds of being overweight compared to those unaffected by the internet (p =0.02).

Conclusion

These findings underscore the influence of online content on dietary behaviors and highlight the importance of strategies to improve students’ nutritional profiles, potentially reducing health risks associated with unhealthy lifestyles in the Moroccan population.
Safety and efficacy of luspatercept in treating anemia associated with myelodysplastic syndrome with ring sideroblasts in Asian patients who require red blood cell transfusions: a phase II bridging study
Authors: Chang Chunkang , Suzuki Takahiro , Liang Yang , Tong Hongyan , Usuki Kensuke , Liu Qifa , Wu Yu , Fujisaki Tomoaki , Han Bing , Huang Ruibin , Morita Yasuyoshi , Miao Miao , Nakashima Yasuhiro , Tian Yu (Olivia) , Pu Jie , Aggarwal Dimple , Pozharskaya Veronika , Shi Wenhui , Xiao Zhijian , Mitani Kinuko
Published: February 2025

Background:

Patients with lower-risk myelodysplastic syndromes (MDS) may experience anemia and a high transfusion burden, alongside a risk of progression to acute myeloid leukemia. Luspatercept, a recombinant fusion protein that acts as an erythroid maturation agent, was FDA/EMA-approved in 2020 based on the phase III MEDALIST trial. There remains an unmet need for anemia treatment in Asian patients for whom red blood cell (RBC) transfusion is a standard of care, and in whom rates/severity of anemia and serum erythropoietin levels are often higher versus Western patients.

Objectives:

The objective of this study was to assess the efficacy, safety, and tolerability of luspatercept in Asian patients with anemia due to transfusion-dependent lower-risk MDS with ring sideroblasts.

Design:

This was a phase II, single-arm, interventional bridging study (NCT04477850).

Methods:

Patients from China and Japan with very low-, low-, or intermediate-risk MDS with ring sideroblasts who were RBC transfusion-dependent received subcutaneous luspatercept starting at 1.0 mg/kg every 3 weeks. The primary endpoint was RBC transfusion independence (TI) ⩾8 weeks (weeks 1–24).

Results:

There was a statistically significant, clinically meaningful improvement of anemia in Asian patients; 60% ( n = 18, p < 0.0001) achieved RBC-TI for ⩾8 weeks and 43% ( n = 13) for ⩾12 weeks (weeks 1–24). Safety was consistent with the known profile of luspatercept in MDS.

Conclusion:

These results support luspatercept as a well-tolerated, efficacious alternative to transfusions for Asian patients with lower-risk MDS, who tend to have more severe anemia. Trial registration: clinicaltrials.gov, NCT04477850.
Transient unilateral brachial plexus block following landmark-guided superficial cervical plexus block: A case report
Authors: Besozzi Isabel , Goldmann Andrea , Button Daniel , Senn Stefanie , Madjdpour Caveh
Published: February 2025

We report a case of a 61-year-old male patient with impaired function of the contralateral brachial plexus after right parathyroidectomy. The symptoms appeared directly after emerging from general anaesthesia and disappeared completely within 24 h after surgery. The follow-up check after 6 weeks was unremarkable. The patient suffered from asthma, osteoporotic degenerative changes of the spine and a chronic impingement of the left shoulder. He showed no signs of pain or limitations while reclining his neck during pre-operative airway assessment. Before surgery, a bilateral superficial cervical plexus block was performed by the surgeon using the landmark technique. We discuss the positioning of the neck and cervical spine in preparation for surgery and pre-operative superficial cervical plexus block as possible causes for the impaired function of the brachial plexus observed in this patient. We conclude that the latter was the most likely cause in this patient and recommend considering ultrasound guidance for the performance of superficial cervical plexus block.
Predictors of Success Following Valve-Sparing Repair of Tetralogy of Fallot
Authors: Miller Paighton C. , Chomat Michael R. , Wan Fei , Miller Jacob R. , Nath Dilip , Eghtesady Pirooz
Published: February 2025

Objective: We aim to report predictors of success following valve-sparing repair (VSR) for Tetralogy of Fallot (TOF). Methods: We performed a single-institution retrospective review of 70 patients who underwent VSR for TOF from 2007 to 2021. Risk factors for moderate to severe pulmonary insufficiency (PI) and surgical or catheter intervention for right ventricular outflow tract (RVOT) obstruction were analyzed. Results: During a median follow-up time of 6 years (range 1 month to 17 years), 5/70 (7%) patients required surgical or catheter intervention for isolated RVOT obstruction, 8/70 (11%) had moderate or severe PI, and 3/70 (4%) had a combined outcome of RVOT obstruction and PI. Patients who required reintervention had smaller pulmonary valve (PV) z-score (−2.8 vs −1.7, P < .01), were more likely to have isolated infundibular patching (75% vs 31%, P = .02), and had smaller PV z-score at the end of the procedure (−1.4 vs −1.0, P = .03). Patients with significant PI were more likely to have intraoperative valvotomy via Hegar dilation (36% vs 13%, P = .04). The strongest independent predictors of RVOT obstruction and/or PI were preoperative cyanotic episodes (odds ratio 6.0, 95%CI: 1.6-22, P = .01) and valvotomy via Hegar dilation (odds ratio 4.6, 95%CI: 1.0-21, P = .04). Conclusions: Valve-sparing repair of TOF is less likely to be successful if reliant on isolated infundibular patching or not achieving at least a z-score of −1 at the PV at the completion of the procedure. Repairs using blind dilation destabilize the valve and lead to long-term valve incompetence.
Conduit Size, Branch Pulmonary Artery Size, and Reoperation in Patients With Truncus Arteriosus
Authors: Mastropietro Christopher W. , Rodenbarger Andrew , Herrmann Jeremy L.
Published: February 2025

Background

Optimal right ventricle-to-pulmonary artery (RV-PA) conduit size for patients with truncus arteriosus is controversial. We aimed to determine the relationship between branch PA size and the need for conduit reoperation following repair of truncus arteriosus.

Methods

We performed a single-center chart review of patients who underwent truncus arteriosus repair from January 2009 to December 2023. Branch PAs were measured in systole, at the narrowest point if focal stenosis was present. For branch PA diameter analyses, the smaller diameter PA was used. Univariate Cox proportional hazards regression analysis was performed to determine hazard ratios (HRs) with 95% confidence intervals (CIs) for echocardiographic measures and conduit reoperation.

Results

We included 33 patients. Median age at surgery was 23 days (range: 3--34). Thirty-two patients received a bovine jugular vein graft, one patient received an aortic homograft. Mean RV-PA conduit Z-score was 2.7 ± 0.5 and mean preoperative conduit-to-PA ratio 2.6 ± 0.6. Postoperative diameter of at least one branch PA was decreased in 31 patients (93.9%); mean change was −19% ± 17%. Mean postoperative conduit-to-PA ratio was 3.3 ± 0.9. Conduit reoperation occurred in 19 patients (58%); median time to reoperation was 1.6 years (range: 0.4-10.4). Conduit reoperation was not associated with conduit diameter or Z-score. Conduit reoperation was significantly associated with truncus type A2 or A3 PA anatomy (HR: 3.53; 95%CI: 1.14-10.94) and conduit-to-PA ratio ≥ 4 (HR: 4.94; 95%CI: 1.63-14.97).

Conclusion

In a single-center cohort of children who underwent repair of truncus arteriosus, RV-PA conduit diameter was not associated with increased conduit longevity. Rather, larger postoperative RV-PA conduit to branch PA diameter ratio was significantly associated with greater hazard for conduit reoperation.
Cartilaginous Endplate Damage May be a Root Pathology Underlying Modic Changes on Lumbar Spine MR Images
Authors: Feng Zhiyun , Ding Shuchen , Wu Honghao , Liu Miao , Hu Xiaojian , Chen Lunhao , Wu Kai , Battie´ Michele C. , Wang Yue
Published: February 2025

Study Design

Rabbit model study.

Objective

To examine whether cartilaginous endplate (CEP) destruction leads to endplate and vertebral marrow signal changes (Modic changes, MCs) on MR images.

Methods

Sixteen adult rabbits were used in the study and underwent an anterolateral procedure to expose the L2-6 intervertebral discs. The L4/5, L3/4 and L2/3 discs underwent annulotomy, annulotomy and CEP curettage, or annulotomy and chemonucleolysis, respectively, while the L5/6 disc served as a shame control. MR imaging was performed preoperatively and at 1, 3, and 6 months postoperatively to evaluate the presence or absence of MCs. After the last imaging, animals were sacrificed for histological study, focusing on endplate pathologies and their associations with MCs.

Results

Among the 64 endplates that underwent CEP curettage or were exposed to chemonucleolysis, there were 6 (9.4%), 19 (29.7%), and 32 (50%) endplates with MCs at 1, 3 and 6 months, respectively. No MCs developed in the sham controls. Both surgical curettage and chymopapain injection successfully induced CEP destruction. Endplates with full layer CEP defects were most likely to develop MCs (59.6% vs 11.4%, P < 0.001). Moreover, endplates with MCs had a greater histological degeneration score than those without (8.97 ± 1.92 vs 5.35 ± 2.28, P < 0.001) and higher expression levels of inflammatory factors (IL-1β, TNF-α, and IL-6, P < 0.05 for all) in the subchondral vertebral marrow.

Conclusions

CEP destruction, induced either by physical curettage or chemical lysis, can lead to long-lasting inflammation in the vertebral marrow and Modic-like signal changes on MR images. CEP destruction may be a root pathology underlying MCs.
Quality of Life, Self-Esteem, and Stress among First-Semester Student Nurses in Indonesia: A Cross-Sectional Study
Authors: Komariah Maria , Eriyani Theresia , Rahayuwati Laili , Agustina Hana Rizmadewi , Nurhakim Furkon , Somantri Irman , Qadous Shurouq Ghalib , Janmanee Aurawan , Gartika Nina
Published: February 2025

Introduction

College presents students with various new challenges, including changes in environment, learning methods, friendships, and other unfamiliar situations, potentially triggering mental health issues. Recent epidemiological data show that the prevalence of depression and stress among college students aged 18–24 years is 37.2% and 23.7%, respectively.

Objective

This study aimed to determine the circumstances and factors affecting the quality of life, self-esteem, and stress of first-year undergraduate nursing students in Indonesia.

Methods

In total, 300 nursing students were recruited to participate in a quantitative descriptive cross-sectional mental health survey to determine the quality of life, self-esteem, and stress levels of first-semester students across multiple nursing education centers. The instruments used in this study were the WHOQOL-BREF, Rosenberg Self-Esteem Scale (RSES), and Perceived Stress Scale (PSS). Multiple linear regression was conducted to identify significant relationships between the variables. Data were analyzed using univariate and bivariate analyses with Microsoft Excel and SPSS, presenting results as regression coefficients and 95% confidence intervals.

Results

The results of bivariate analysis in this study showed that health status, relevance of expectations, goals, and standards had a significant influence on quality of life ( p < .05). In addition, our study found that self-esteem had a significant relationship with quality of life in first-semester student nurses ( p = .010).

Conclusion

Based on the findings that first-semester nursing students experience moderate stress yet generally exhibit good self-esteem and quality of life, universities should prioritize assessments of students’ physical and psychological well-being during their adaptation period. It is recommended to implement counseling services, enhance support from guardian lecturers, and foster positive engagement with parents to address the expectations and goals influencing students’ quality of life. These strategies aim to improve overall well-being and academic success among new nursing students.
Ambedkarite Student Movements and Indian University Campuses: A Brief History
Authors: Saurabh Amit Kumar
Published: February 2025

In the modern history of India, especially pre- and post-independence, history of student politics and movements remains an area that is less explored and needs further research and exploration, and within that history, that is, the history of student movements and politics, history of Ambedkarite student movements remains the least explored. Whatever little has been written on the mentioned subject focuses primarily on a particular geography and state. Therefore, this article is an attempt to fill this gap. This article presents a brief history of post-independence major Ambedkarite student movements (ASMs) that took place in different decades and parts of the country. As student movements are primarily associated with university campuses, this article also highlights the changes ASMs brought to the culture of the campuses in general and student politics in particular.
Racially Equitable Homeless Services: Exploring Organizational Characteristics
Authors: Thurman Whitney , Heitkemper Elizabeth , Hutson Tara , Wright Summer , Patten Amy , Kaltz Andrea
Published: February 2025

Purpose

Racial disparities in homelessness are pervasive and necessitate sustained effort on improving racial equity in homeless services. This study used a community-engaged approach and qualitative methods to describe the role of informal organizations identified by Black adults with lived experience of homelessness as preferred locations for accessing services and to explore the values and beliefs of these informal organizations. The study included representatives ( N = 19) of community organizations ( N = 17) in one southern city. Most participants ( n = 14, 73.6%) worked in paid positions and included executive directors as well as volunteers.

Findings

Thematic analysis identified three themes that characterized values and the ways in which these organizations interface with one another and with the formal homelessness response system (HRS): boots-on-the-ground, the homelessness response system is inequitable, and cautious collaboration. Findings reveal avenues through which local collaboration can be improved and potential policies to improve racial equity in homeless services.

Conclusions

Informal organizations fill critical gaps in services and can reach people experiencing homelessness who are unable or unwilling to access formal services. However, informal organizations often remain disconnected from the larger HRS which can exacerbate racial inequities. Community care hubs are a promising solution to incorporating smaller organizations and building a more integrated and equitable HRS.
Improving genomic prediction of vitamin C content in spinach using GWAS-derived markers
Authors: Rameneni Jana Jeevan , Islam A S M Faridul , Avila Carlos A. , Shi Ainong
Published: February 2025

Vitamin C (VC), also known as ascorbic acid and ascorbate, is a water-soluble antioxidant in plants that promotes skin health and immune function in humans. Spinach (Spinacia oleracea L.) is a leafy green widely consumed for its health benefits. Recent reports have shown that nutritional content, including VC, can be improved in spinach. However, due to its complex inheritance, new selection methods are needed to improve selection for cultivar development. In this study, single nucleotide polymorphism (SNP) markers identified by genome-wide association (GWAS) were used for genomic prediction (GP) to improve prediction accuracy (PA) for VC content in spinach. A set of 147,977 SNPs generated from whole genome resequencing was used for GWAS in a panel of 347 spinach genotypes by six GWAS models. Sixty-two SNP markers distributed on all six spinach chromosomes were associated with VC content. PA for the selection of VC content was estimated with fourteen random SNP sets across seven GP models. The results indicated that the PA can be > 40% after using 1,000 or more SNPs in six of the seven models tested; using GWAS-derived significant SNP markers PA increases to a high r-value up to 0.7 when using 62 associated SNP markers in Bayes ridge regression (BRR) model. Upon validation, identified accessions with high VC and high PA genomic selection model can be used in spinach breeding programs to develop high VC content cultivars.
Assessing the representativeness of large medical data using population stability index
Authors: Lu Sheng-Chieh , Song Wenye , Pfob Andre , Gibbons Chris
Published: February 2025

Background

Understanding sample representativeness is key to interpreting findings from epidemiological research and applying these findings to broader populations. Though techniques for assessing sample representativeness are available, they rely on access to raw data detailing the population of interest which are often not readily available and may not be suitable for comparing large datasets. In reality, population-based data are often only available in an aggregated format. In this study, we aimed to examine the capability of population stability index (PSI), a popular metric to assess data drift for artificial intelligence studies, in detecting sample differences using population-based data.

Method

We obtained United States cancer statistics from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database. We queried the SEER 17-registry research database to obtain cancer count data by age, sex, and cancer site groups from the rate sessions of the SEER*State incidence database for 2000 and 2015 – 2020. We then calculated PSI scores to estimate yearly data distribution shift from 2015 to 2020 for each variable. We compared the PSI results to the Chi-Square and Cramér's V tests for the same comparisons.

Results

Scores for PSI comparing age, sex, and cancer site distribution between years ranged widely from 2.96 to less than 0.01. In line with our expectations, we found moderate to substantial differences in cancer population characteristics between 2000 and all other included years using PSI. Despite small effect sizes (Cramér's V 0.01 – 0.09), Chi-Square tests were significant for most comparisons, indicating likely type-I error caused by our large sample.

Conclusions

Population stability index can be used to examine sample differences in healthcare studies where only binned data are available or where large datasets may reduce the reliability of other metrics. Inclusion of PSI in epidemiological research will give greater confidence that results are representative of the general population.
Ganga hospital open injury severity score as a predictor of early failure of limb salvage among gustilo type III A and B tibia fractures in Uganda: a prospective cohort study
Authors: Okuku Maxwel Dancan , Kabuye Umaru , Khadolwa Stephen Angira , Aweis Abubakar Mohamed , Xaviour Okedi Francis , Abraha Demoz , Quealee Charles , Olasinde Anthony Ayotunde , Usman Ibe Michael
Published: February 2025

Background

Despite advances in antibiotic therapy and microsurgery, the management of Gustilo and Anderson type IIIA and B open tibia fractures continues to pose a considerable challenge in developing countries. This has evolved from historical immediate amputation to modern approaches that prioritize both aesthetics and functional outcomes. Nonetheless, a consensus on limb salvage versus amputation remains elusive, prompting the development of prognostic limb scoring systems. Our study assessed the predictive accuracy of the Ganga Hospital Open Injury Severity Score (GHOISS) for early failure of limb salvage in Gustilo type IIIA and B tibia injuries.

Methods

This was a prospective study that examined open tibia fractures at two tertiary hospitals in the emergency and orthopaedic units between June and October 2023. Fifty-three (26 IIIB and 27 IIIA) satisfied the study inclusion and exclusion criteria. Four injuries (type IIIA) in paediatric patients that had met the inclusion criteria were excluded from analysis to ensure homogeneity and generalizability of the results due to their small numbers. The severity of injury for each Gustilo type III A and B tibia fracture was determined using the GHOISS, and limb salvage decisions were made irrespective of the GHOISS. Follow-up was extended for up to fourteen days to assess the necessity of secondary amputation in salvaged limbs.

Results

Among 49 Gustilo type IIIA and B tibia fractures, 43 were successfully salvaged, while 6 necessitated amputation (4 primary, 2 secondary). A GHOISS of 13 demonstrated maximum specificity (90.7%) and sensitivity (83.3%) in predicting amputation, with an AUC of 0.923 (95% CI 0.804–0.977), indicating strong discriminatory accuracy.

Conclusion

The GHOISS reliably predicted outcomes in patients with Gustilo type IIIA and B tibia fractures, with a score of 13 demonstrating optimal sensitivity and specificity above which early failure of limb salvage is anticipated.
Phase one of a hybrid effectiveness-implementation study to assess the feasibility, acceptability and effectiveness of implementing seasonal malaria chemoprevention in Nampula Province, Mozambique
Authors: Baker Kevin , Pulido Tarquino Ivan Alejandro , Aide Pedro , Bonnington Craig , Rassi Christian , Richardson Sol , Nnaji Chuks , Roca-Feltrer Arantxa , Rodrigues Maria , Sitoe Mercia , Enosse Sonia , McGugan Caitlin , Saute Francisco , Matambisso Gloria , Candrinho Baltazar
Published: February 2025

Background

Seasonal malaria chemoprevention (SMC) is a highly effective intervention for malaria prevention in high burden areas with seasonal transmission, historically implemented in the Sahel. Mozambique contributes to 4% of global malaria cases. Malaria Consortium, in partnership with the National Malaria Control Programme, conducted a two-year phased SMC study in Nampula province using sulfadoxine-pyrimethamine (SP) plus amodiaquine (AQ), or SPAQ, in children under five. Phase one results presented here highlight acceptability, feasibility, and protective effect of SMC.

Methods

A pragmatic type II hybrid effectiveness-implementation study design was adopted, using mixed methods. The study was conducted in three districts, utilizing: (1) non-randomized controlled trial reporting on malaria incidence; (2) drug resistance molecular marker study reporting on resistance marker changes over time; (3) coverage and quality assessment on the SMC distribution; and (4) a qualitative acceptability and feasibility assessment with stakeholders.

Results

Children who received SMC had 86% (hazard ratio 0.14, 95% CI 0.09–0.24) lower hazards of developing clinical malaria during the peak transmission season compared with children in the comparison district. Prevalence of SP molecular markers associated with resistance was high at baseline (K540E 66.1%). SMC achieved high coverage of eligible children over four cycles (87.7%, 95% CI 83.9–90.8%). Qualitative results indicate SMC was positively accepted by the targeted community.

Conclusions

Results suggest that SMC was effective at preventing clinical malaria, did not significantly impact resistance profile, and was feasible and acceptable in the context. Phase two will assess SMC impact in reducing malaria incidence and if chemoprevention efficacy of SPAQ is impacted by drug resistance and drug concentrations.
Improving research and development of wearable assistive and rehabilitation technologies: a systematic review on diversity factors
Authors: Lorke Mariya , Stefanou Thekla
Published: February 2025

This paper analyses diversity and intersectionality aspects in the R&D of wearable assistive and rehabilitation technologies (WEARTechs). We advocate for inclusive, innovative research that we hope will help bridge the gap between laboratories and the real world and reduce disparities in healthcare and technology development. We performed a systematic literature review of the intersections between assistive technologies and diversity and conducted a thematic analysis of the diversity factors identified in the literature. In addition, we carried out a supplementary literature search on WEARTechs to discover which, if any, diversity aspects are currently being reported on. Our findings indicate that diversity has not been addressed in the field of WEARTechs. There is not sufficient knowledge to determine, which diversity-related aspects researchers must consider when evaluating the performance of any specific WEARTech device. Nor about how these can be properly addressed in the R&D process. We, therefore, provide actionable recommendations on how to integrate diversity-relevant aspects at different R&D stages. We hope that our review will help scientists rethink and reformulate approaches to the R&D of WEARTechs and build the way towards more inclusive solutions. It is our belief that this will spark innovation and enhance discovery potential in the field.
New tetrahydroisoquinolines bearing nitrophenyl group targeting HSP90 and RET enzymes: synthesis, characterization and biological evaluation
Authors: Bakhite Etify A. , Hassanien Reda , Farhan Nasser , Sayed Eman M. , Sharaky Marwa
Published: February 2025

In this study, new tetrahydroisoquinoline compounds were synthesized by reaction of 7-Acetyl-4-cyano-1,6-dimethyl-6-hydroxy-8- (3-nitrophenyl or 4-nitrophenyl)-5,6,7,8-tetrahydrosoquinoline-3(2H)-thiones with methyl iodide, chloro acetonitrile, ethyl chloroacetate to produce compounds 3–5 and reacted with N-arylchloroacetamides reagents to gave tetrahydroisoquinolin-3-ylthio) acetamides compounds 6a–c, 8a–b which can cyclized to 6,7,8,9-tetrahydrothieno[2,3-c]Isoquinoline-2-carboxamides compounds 7a–c, 9a–b. Also react with N-(benzthiazol-2-yl)-2-chloroacetamideto give compound 10. The structures of all newly synthesized compounds were characterized by elemental and spectral analyses. Also, most of the synthesized compounds were evaluated for their anticancer activities aganist MCF7 and HEPG2 cell lines. From the result we found that the most active compound against the MCF7 cell lines was compound 8b, and the most active compound against HEPG2 cell lines was compound 3. Then the effects of compound 3 on the HEPG2 cell line was investigated using an apoptotic Annexin V-FITC test and flow cytometry. Compound 3 induced a 59-fold increase in HEPG2 cell line apoptosis and cell cycle arrested at the G0-G1, G2/M phases. Moreover, the molecular docking study was applied and the result showed that compounds 8b bind to the RET enzyme with binding energies of − 6.8 kcal/mol in comparison with standard alectinib, which exhibits a binding energy of − 7.2 kcal/mol. Compound 3 can bind with HSP 90 with a binding energy (ΔG) of − 6.8 kcal/mol, which was comparable to the standard Onalespib (− 7.1 kcal/mol).

Graphical Abstract
Neuroprotective effects of berberine in preclinical models of ischemic stroke: a systematic review
Authors: Laein Ghasem Dolatkhah , Boumeri Elahe , Ghanbari Saghar , Bagherian Amin , Ahmadinasab Fatemeh , Poudineh Vahid , Payandeh Shima , Rashidi Negar
Published: February 2025

Background/Objective

Berberine, a naturally occurring alkaloid, has shown promise as a neuroprotective agent in preclinical models of ischemic stroke. This systematic review aims to comprehensively evaluate the neuroprotective effects of berberine in animal models of cerebral ischemia and elucidate its potential mechanisms of action.

Methods

A systematic search was conducted across nine databases, including PubMed, Embase, Cochrane CENTRAL, Web of Science, Scopus, ScienceDirect, Europe PMC, DOAJ, and Google Scholar, from inception to June 30, 2024. Controlled in vivo studies investigating the neuroprotective effects of berberine in animal models of focal cerebral ischemia were included. Two independent reviewers screened studies, extracted data, and assessed the risk of bias using the SYRCLE tool.

Results

Eighteen studies met the inclusion criteria, encompassing various animal models of ischemic stroke. Berberine treatment consistently resulted in significant reductions in infarct volume and improvements in neurological function compared to control groups. Specifically, berberine doses ranging from 10 mg/kg to 300 mg/kg significantly decreased infarct sizes (p < 0.05). Berberine also exhibited anti-inflammatory effects by reducing pro-inflammatory cytokines such as TNF-α, IL-1β, and IL-6, and downregulating the TLR4/NF-κB signaling pathway (p < 0.05). Antioxidant effects were evidenced by decreased malondialdehyde levels and increased antioxidant enzymes like superoxide dismutase and glutathione (p < 0.05). Additional findings from studies with smaller sample sizes indicated that berberine reduced apoptotic cell death by decreasing TUNEL-positive cells and modulating apoptosis-related proteins, including increasing Bcl-2 and decreasing cleaved caspase-3 levels (p < 0.05). Berberine also promoted neurogenesis and synaptic plasticity by increasing the expression of BDNF, TrkB, and synaptic proteins SYP and PSD95 (p < 0.05), and enhanced autophagic flux by modulating key autophagy markers (p < 0.05). The risk of bias varied among studies, with some lacking detailed reporting on randomization and blinding procedures.

Conclusion

Berberine demonstrates significant neuroprotective effects in preclinical models of ischemic stroke through multiple mechanisms, including anti-inflammatory, antioxidant, anti-apoptotic, and neuroregenerative actions. These findings support the potential of berberine as a multifaceted therapeutic agent for ischemic stroke. Further well-designed clinical trials are warranted to confirm its efficacy and safety in human patients.
Cell lineage-specific differences in clinical behaviour of non-functioning pituitary adenomas – A systematic review and meta-analysis
Authors: van der Hoeven Loren S , Slagboom Tessa N A , Malekzadeh Arjan , Hoogmoed Jantien , Drent Madeleine L , Aronica Eleonora , Stenvers Dirk Jan , Pereira Alberto M
Published: February 2025

Context

Immunohistochemistry (IHC) of cell lineage-specific transcription factors (TFs) has been added to the histopathological classification of pituitary adenomas since 2017, resulting in new histopathological subtypes of TF+/hormone- non-functioning pituitary adenomas (NFPAs) and a reduction in the prevalence of null cell adenomas (NCAs).

Objective

To evaluate associations between expression of cell lineage-specific TFs by IHC and radiological invasion and prognosis of NFPAs.

Data sources

A literature search in Medline, Embase, and CENTRAL was performed from inception up to July 11th 2023.

Study selection

Eligible studies were cohort studies reporting on radiological invasion, recurrence and/or radiotherapy in patients with NFPAs who tested positive for one cell lineage-specific TF or negative for all three. Finally, 27 out of 1985 studies were included.

Data extraction

Two authors independently extracted data and critically appraised risk of bias using the QUIPS tool.

Data synthesis

Random-effects inverse variance models were used to pool effect sizes. Prevalence rate ratios (PRR) were calculated using the Mantel-Haenszel method. Cavernous sinus invasion was more prevalent in NCAs and TPIT+ NFPAs compared with SF1+ NFPAs (PRR 1.60, 95% confidence interval (CI) 1.22-2.08, I2 10%, 95% prediction interval (PrI) 1.23-2.06, p=0.0036, and PRR 1.43, 95% CI 1.21-1.70, I2 0%, 95% PrI 1.17-1.76, p=0.0017, respectively), and in NCAs compared with PIT1+ (PRR 1.44, 95% CI 1.01-2.06, I2 0%, 95% PrI 0.83-2.50, p=0.0454). Limited number of studies precluded data syntheses of recurrence and radiotherapy.

Conclusions

The use of cell lineage-specific TFs by IHC enables to detect histopathological subtypes of NFPAs with distinct clinical behaviour.
A study of the therapeutic effects of yoga on symptoms associated with ADHD in children: Systematic review and meta-analysis
Authors: Mu Xintong , Luo Yang , Jia HaiChang , Li Xinjia , Huang Jing
Published: February 2025

Background: Attention-deficit/hyperactivity disorder (ADHD) is a chronic developmental disorder with a high prevalence in children and the long-term nature of treatment. Although the use of yoga as a non-pharmacologic treatment is increasing in the ADHD population, the conclusion of its effectiveness in treating symptoms in children with ADHD remains to be explored.
Objective: The primary goal of this meta-analysis was to systematically summarize and analyze the efficiency of yoga in treating symptoms such as attention problems, emotional problems, and behavioral control in children with ADHD, as well as to serve as a guide for further studies and therapeutic procedures in the management of ADHD in children.
Materials and methods: This study was conducted using the Cochrane Handbook and the PRISMA Guidelines Statement for Systematic Reviews. A total of five databases, PubMed, Embase, Cochrane, Web of Science, and Ovid, were searched up to December 2024. Excel was utilized for data extraction, and Review Manager was used for data processing, analysis, and literature quality evaluation.
Results: In all, nine publications were enrolled in the study, and 285 participants—142 in the experimental group and 143 in the control group—met the inclusion requirements. The intervention lasted between 2 and 20 weeks, and all study participants were between the ages of 3 and 15. The outcome metrics consisted of measures of five ADHD-related symptoms: inattention, sustained attention, hyperactivity/impulsivity, emotional instability, and anxiety.
Conclusion: The intervention of yoga had an ameliorative effect on several symptoms of inattention, sustained attention, emotional instability, and hyperactivity/impulsivity in children with ADHD, but not statistically significant on anxiety symptoms.
Physical models and numerical modeling for 280 nm AlGaN-based emission-and-detection dual functional integrated devices by managing hole transport and recombination
Authors: Tian Kangkai , Pei Zhengwang , Feng Silu , Chu Chunshuang , Huang Fuping , Zhang Yonghui , Sun Xiao Wei , Zhang Zi-Hui
Published: February 2025

In this work, physical models for 280 nm AlGaN-based light emitting diode (LED) with monolithically integrated photodetector (PD) having the same multiple quantum wells (MQWs) structure have been established for the first time, with the aid of which, numerical calculations have been studied. Asymmetric MQWs have been proposed to improve the optoelectronic coupling efficiency, i.e., the active region is divided into a detection region with thick quantum wells and an emission region with thin quantum wells. The calculated results indicate that thin quantum wells help to suppress the quantum-confined Stark effect (QCSE) and enhance the transverse-electric (TE) polarized light intensity simultaneously. Besides, owing to the modulated effect by quantum well thickness on the energy level for the quantized states, the Stokes shift between the emission spectra and optical absorption spectra can be effectively suppressed. However, it also finds that when the quantum well in the emission region is thinned to 1 nm, the capture capability for holes is weakened and more holes will escape from the emission region and are injected into the detection region. Therefore, we propose linearly increasing the Al composition of quantum barriers in the emission region along [0001] direction, and the positive polarization bulk charges can be generated therein, which increases the valence barrier height for holes and prevents holes from escaping. Thanks to the enhanced IQE and suppressed Stokes shift, the photocurrent level for the on-chip PD gets increased. Our studies also report that although thin quantum wells suppress the Stokes shift and increase the photon-generated carriers, the built-in electric field in the PN junction can be simultaneously screened by the more photon-generated carriers. This sacrifices the on/off speed for the on-chip PD. The proposed structure with Al-composition-graded quantum barriers will retrieve the built-in electric field, which helps to increase the on/off speed for the on-chip PD.
Comparative efficacy of different antihypertensive drug classes for stroke prevention: A network meta-analysis of randomized controlled trials
Authors: Yu Ding , Li Jun-xia , Cheng Yuan , Wang Han-dong , Ma Xin-di , Ding Tao , Zhu Zhong-ning
Published: February 2025

Objective

The study aimed to compare the effectiveness of various antihypertensive drugs in preventing strokes in hypertensive patients.

Methods

We conducted a comprehensive search of PubMed, Embase, the Cochrane Library, and ClinicalTrials.gov to identify randomized controlled trials (RCTs) investigating the efficacy of antihypertensive drugs in stroke prevention from inception until April 2023. A network meta-analysis in a Bayesian framework was performed using the random-effects model.

Results

This study included 88 RCTs involving 487,076 patients to investigate the effects of antihypertensive drugs in preventing stroke. Among these trials, 58 RCTs specifically focused on comparing the impact of such drugs on hypertensive subjects. In overall population, Angiotensin-converting enzyme inhibitor (ACEIs), Angiotensin receptor blockers (ARBs), Calcium channel blockers (CCBs), and Diuretics (DIs) demonstrated superiority over placebo in in reducing stroke, all-cause mortality, and cardiovascular mortality. CCBs and DIs outperformed β adrenergic receptor blockers (BBs), ACEIs, and ARBs in stroke reduction. However, when focusing on hypertensive patients, ACEIs, CCBs, and DIs proved superior to placebo in reducing stroke, all-cause mortality, and cardiovascular mortality. ARBs reduced stroke and all-cause mortality but lacked efficacy in reducing cardiovascular mortality. Of the various CCB subclasses, only the Dihydropyridines displayed efficacy in preventing stroke, all-cause mortality, and cardiovascular mortality. Among diuretic subclasses, thiazide-type DIs exhibited no efficacy in preventing all-cause mortality. ACEIs+CCBs were more effective than ACEIs or ARBs monotherapy in reducing stroke, more effective than ACEIs, ARBs, CCBs, or DIs monotherapy in reducing all-cause mortality, and more effective than ARBs in reducing cardiovascular mortality.

Conclusion

These findings suggest that ACEIs, dihydropyridine CCBs, and thiazide-like diuretics may provide superior prevention against stroke, all-cause mortality, and cardiovascular mortality in hypertensive patients. Combinations of ACEIs and CCBs may provide enhanced protection of stroke than ACEIs or ARBs monotherapy.