bluuebunny/crossref_metadata_2025 huggingface dataset:
Navigational Analysis of Legged Robot using the Modified African Vulture Optimization Algorithm
Authors: Das Pinaki , Parhi Dayal R. , Mahapatro Abhijit , Dash Himansu Sekhar , Prakash V. S. Surya
Published: February 2025

The main challenges in the legged robot are navigation, obstacle avoidance, and path development. This study uses a swarm intelligence based meta-heuristic technique the Modified African Vulture Optimization Algorithm (MAVOA), to address the optimum path planning problem. The developed algorithm imitates the foraging behaviour of vultures. The MAVOA dynamically adjusts the movement of vultures to equate exploration and exploitation. This technique is selected to get the optimum path by avoiding obstacles while navigating a legged robot in an unfamiliar, congested environment. When it comes to the legged robot navigation, the path planning problem is solved by selecting four governing constraints: front-side hurdle length (FHL), left-side hurdle length (LHL), right-side hurdle length (RHL), and the direction of turn (DT) that are considered as the inputs and outputs respectively. The main constraints of earlier researches on existing techniques are impotence to account for motion in new environments, challenges in navigating crowded and complex areas, and the need to optimize intricate pathways. The WEBOT software is chosen for simulating a navigation of a legged robot, and result of simulation is differentiated to experimental outputs configured in a lab setting. Both outcomes show that the legged robot successfully navigated to its objectives while avoiding impediments. After the findings were assessed, it was found that there was less than 5% difference between the output of the simulation and the experiment. The approach can be applied to multiple-purpose or discrete optimization issues and future complicated engineering and science disciplines.
The U-shaped Curve of Energy Supply in the First 72 Hours of Critical Illness May Apply Only to Patients with Normal Body Mass Index: A Post-hoc Analysis of a Prospective Observational Multicenter Study
Authors: Wang Youquan , Wang Yanjuan , Fu Yao , Bao Lingling , Zhang Dong , Li H
Published: February 2025

Objective
Nutritional support is crucial for critically ill patients. Body mass index (BMI) represents nutritional reserves to some extent, but it is unclear whether the U-shaped relationship between caloric delivery during the acute phase of critical illness and prognosis applies to patients across all BMI categories.
Methods
This secondary analysis of a multicenter prospective observational study, which included patients who were admitted to the intensive care unit (ICU) for at least 3 days. The patients were divided into two subgroups based on BMI: normal BMI and overweight (BMI > 25 kg/m²). We used univariate and multivariate Cox regression analyses to investigate the relationship between calorie delivery within the first 72 hours of ICU admission and 28-day mortality, and to explore whether a non-linear relationship exists between the two.
Results
A total of 361 patients were included in the final analysis, including 272 in the normal BMI subgroup and 89 in the overweight subgroup. In the normal BMI subgroup Cox regression, there was a significant non-linear relationship (P = 0.003) and association (P = 0.002) between daily delivered calories and 28-day mortality. Increasing the daily delivered calories from 0 to 18 kcal/kg/day was associated with decreasing mortality (hazard ratio (HR) 0.892, 95% CI 0.816–0.975), while the daily delivered calories > 18 kcal/kg/day was associated with increasing mortality (HR 1.116, 95% CI 1.016–1.227)); In the overweight subgroup, higher daily delivered calories was also observed to increase mortality (HR 1.124, 95% CI 1.043–1.211, P = 0.003), but this non-linear relationship disappeared (P = 0.466). After adjustment, the above results still hold up.
Conclusions
The U-shaped relationship between daily delivered calories within the first 72 hours of ICU admission and 28-day mortality in critically ill patients applies only to those with BMI < 25 kg/m², and no such U-shaped curve was observed in patients with BMI > 25 kg/m². Further research is still needed to validate this conclusion.
Thermodynamic analysis of liquid hydrogen production by using geothermal-based multigeneration plant
Authors: Cigerci Tuba , Yuksel Yunus Emre , Ozturk Murat
Published: February 2025

In this paper, a new geothermal energy-based multigeneration plant was designed to produce several valuable outputs, such as electricity, liquid hydrogen, freshwater, greenhouse heating, and cooling. This study aimed to find a solution regarding using fossil fuels to supply valuable products such as electricity, hydrogen, heating, and cooling. In addition, it was targeted to increase the geothermal energy systems’ efficiencies by integrating sub-systems into the geothermal power plant. To achieve the highly efficient multigeneration plant, an organic Rankine cycle, a greenhouse heating plant, a freshwater production plant, hydrogen production and liquefaction plants and a single-effect absorption cooling system were integrated into the injection well of the geothermal power source. Thermodynamic and parametric analyses were performed to evaluate the plant’s performance as well as environmental impact assessment and exergo-environmental analysis are done to see how the designed system operates environmental-friendly. According to the thermodynamic assessment results, the energy and exergy performances of the multigeneration plant were 59.14% and 54.83%, and the total electricity production rate was 1404 kW. Also, parametric analyses revealed that increasing reference temperature, geothermal mass flow rate and geothermal water temperature improved the overall system’s performance. These results imply that by controlling these indicators, the plant's performance can be optimized, leading to increased energy and exergy efficiencies and higher electrical energy production rates.
Dexamethasone-loaded platelet-inspired nanoparticles improve intracortical microelectrode recording performance
Authors: Shoffstall Andrew , Li Longshun , Hartzler Aniya , Menendez-Lustri Dhariyat , Zhang Jichu , Chen Alex , Lam Danny , Traylor Baylee , Quill Emma , Hoeferlin George , Pawlowski Christa , Bruckman Michael , Gupta Sen A. , Capadona Jeffrey
Published: February 2025

Long-term robust intracortical microelectrode (IME) neural recording quality is negatively affected by the neuroinflammatory response following microelectrode insertion. This adversely impacts brain-machine interface (BMI) performance for patients with neurological disorders or amputations. Recent studies suggest that the leakage of blood-brain barrier (BBB) and microhemorrhage caused by the IME insertions lead to the increased neuroinflammation and reduced neural recording performance. Additionally, a sustained presence of activated platelets and coagulation factors is found near the insertion site. Thus, we hypothesized that the systemic administration of dexamethasone sodium phosphate-loaded platelet-inspired nanoparticle (SPPINDEX) can improve the neural recording performance of intracortical microelectrodes (IMEs) by promoting hemostasis, facilitating blood-brain barrier (BBB) healing, and achieving implant-targeted drug delivery. Leveraging the hemostatic and coagulation factor-binding properties of the platelet-inspired nanoparticle (PIN) drug delivery platform, SPPINDEX treatment can initially attenuate the invasion of neuroinflammatory triggers into the brain parenchyma caused by insertion-induced microhemorrhages or a compromised BBB. Furthermore, targeted delivery of the anti-inflammatory drug dexamethasone sodium phosphate (DEXSP) to the implant site via these nanoparticles can attenuate ongoing neuroinflammation, enhancing overall therapeutic efficacy. Weekly treatment with SPPINDEX for 8 weeks significantly improved the recording capabilities of IMEs compared to platelet-inspired nanoparticles alone (PIN), free dexamethasone sodium phosphate (Free DEXSP), and a diluent control trehalose buffer (TH), as assessed through extracellular single-unit recordings. Immunohistochemical analyses of neuron density, activated microglia/macrophage density, astrocyte density, and BBB permeability suggest that the improved neural recording performance may be attributed to reduced neuron degeneration, activated microglia and astrocytes at the implant interface caused by the decreased infiltration of blood-derived proteins that trigger neuroinflammation and the therapeutic effects from DEXSP. Overall, SPPINDEX treatment promotes an anti-inflammatory environment that improves neuronal density and enhances recording performance.
Epidemiological trends and burden of nutritional deficiencies among infants in India: Insights from the Global Burden of Disease study, 1990–2021
Authors: Roy Chandan
Published: February 2025

Background

Nutritional deficiencies among children remain a critical contributor to the disease burden in India. Therefore, this study analyzes the annual trends and burden of nutritional deficiencies and forecasts the prevalence of these deficiencies among infants in India.

Materials and Methods

We analyzed data from the Global Burden of Disease (GBD) 2021 study to assess temporal changes in the prevalence of nutritional deficiencies among infants in India from 1990 to 2021 using joinpoint regression analysis and the ARIMA model was applied for future trends. Additionally, subnational level performance of Sustainable Development Goals (SDGs) data were extracted from the National Institute for Transforming India (NITI) Aayog dashboard to understand the association between nutritional deficiencies and SDGs, illustrated through a heat map created using MS Excel.

Results

From 1990 to 2021, the prevalence of nutritional deficiencies among infants in India significantly declined from 798.69 (95% UI: 765.85 to 830.22) to 683.54 (95% UI: 664.02 to 702.93) per 1,000 live births, highlighted by an annual percentage change of -14.42. However, significant regional disparities in nutritional deficiencies persist across India. Notably, in 2021, Bihar [763.04 (95% UI: 723.24 to 799.46)], Jharkhand [756.8 (95% UI: 729.3 to 787.24)], and Uttar Pradesh [726.57 (95% UI: 697.24 to 758.62)] had the highest prevalence of nutritional deficiencies, while Mizoram [408.87 (95% UI: 367.44 to 455.12)] reported the lowest.
Conclusion
Nutritional deficiencies among infants in India remain a major public health challenge, with regional disparities suggesting a need to enhance primary healthcare services and strengthen nutritional support.
Influence of Glass Furnace Age, Cullet Share and Glass Color on the Glass Production Energy Efficiency
Authors: DEC Przemysław , SKOREK-OSIKOWSKA Anna
Published: February 2025

Glass manufacturing is a high-volume process during which large quantities of natural raw materials are turned into commercial products, with large amounts of non-renewable resources and energy consumed in the process. Therefore, it is critical to support the transition to higher levels of energy and material efficiency, CO2 emissions and increased resource productivity.

The main objective of this paper is to present the results of a simulated correlation study considering the age of the glass furnace, cullet share in the process and batch composition of the glass produced, and their influence on the coefficient of energy consumption. In this work, the quoted dependencies were observed. Identification of relations influencing energy consumption enables optimization of particular technological parameters of the process.

Industrial companies are expected to reduce energy consumption in several ways, including technological improvements in production processes and recover lost energy, and recycling of recyclables from waste. Therefore, studies such as this one allow industrial companies to research and learn from, and implement solutions to meet global regulatory and market expectations.
New Approach for Calculation of Recycling Rates of Municipal Waste in the Circular Economy (CE)
Authors: DOROSZ Aneta , GENEROWICZ Agnieszka , KULTYS Henryk
Published: February 2025

In December 2020, new waste recycling targets were adopted for the functioning of municipal waste management systems, which are the result of the transformation of the Polish waste management system from a linear model into circular economy. Municipal waste management systems are very diverse, undergoing a constant evolution since 2013, i.e. since municipalities took over the management of the system, related to the collection, processing and disposal of waste, they must be effective, i.e. achieve the objectives of environmental policy. The assumptions of the European Union (EU) environmental policy, in particular new waste recycling rates set until 2035, determine the direction of development of waste management and at the same time the implementation of circular economy. The aim of the paper is to analyse the methods of calculating new recycling rates permitted by European law and to try to implement the methodology into national regulations. In addition, based on the available statistical data on the Polish municipal waste management system, the analysis was supplemented by simulation of solution enabling the achievement of high recycling levels in 2035.
Are Eco-Neighborhoods Health-Promoting Places? Case Study of ZAC Boucicat and ZAC Frequel-Fontarabe in Paris
Authors: TROJANOWSKA Monika
Published: February 2025

Eco-neighborhoods are constructed to answer the call to protect our planet, our common home. They were first initiated as a grassroots initiative by eco-enthusiast, and gradually adopted as national or regional strategies. Various methods for certification and labeling were created by international institutions and national governments which evaluate ecological, economical, and societal aspects of their design and functioning. The recognized gap in knowledge concerns the development of health-promoting places within eco-neighborhoods. In this paper, a comparative study of two small certified eco-neighborhoods in Paris – ZAC Boucicaut and ZAC Frequel-Fontarabe is presented. These neighborhoods were assessed with the universal standard for health-promoting places. The results suggest that within eco-neighborhoods it is possible to care for ecological aspects without compromising on health-promoting places.
Strategizing Sustainable Construction in Moscow and Moscow Region
Authors: Nikonorov Sergey , Kuteinikova Anastasia , Efrem Roman
Published: February 2025

This article describes the current strategizing of sustainable construction in Moscow and the Moscow Region and compares the Russian experience with the best practices in this sphere. The authors analyzed the economic feasibility, efficiency, and risks of introducing green technologies in the metropolitan construction sector. Moscow and the Moscow Region are gradually shifting to green methods. As new technologies penetrate all areas of public life, the state introduces sustainable technologies into urban development, e.g., electric cars, environmentally friendly public transport, green belts, etc. Despite these trends, the authorities and the population need more time to realize the importance of sustainable technologies in urban construction. The article offers some strategic recommendations for the development of green building in Moscow and the Moscow Region.
Influence of land use activities on predicted soil loss in a semi-arid river basin
Authors: Singh Vikram Gaurav , Kumar Nirmal , Acharki Siham , Singh Sudhir Kumar , Kulimushi Luc Cimusa , Olusola Adeyemi Oludapo , Choudhari Pandurang , Rawat Kishan Singh , Jodhani Keval H. , Gupta Nitesh , Omar Padam Jee
Published: February 2025

Soil loss due to land transformations is a serious issue confronting the globe nowadays. The research's main focus was to predict future land use and land cover (LULC) and quantify soil loss, which is exacerbated by excessive rainfall following uneven topography, intensive agriculture, and a lack of adequate watershed management strategies. The Landsat satellite data were classified using maximum likelihood algorithm, and future LULC (2030 and 2040) was quantified using TerrSet Land Change Modeler through Markov Chain Model. In addition, the RUSLE was applied to estimate soil loss based on LULC data from various years, and the results were evaluated using sediment observation data. In this research, the LS-factor has been quantified by employing open-source digital elevation models (DEMs) (SRTM, ASTER, MERIT, AW3D30, NASADEM, CARTOSAT, and TanDEM-X). Furthermore, hypsometry analysis was carried out to assess erosion vulnerability at the sub-watershed. The results showed that SRTM 30-m DEM-based soil loss corresponds to observation. Moreover, soil loss is estimated at 16.55 t/ha/year for 2015, whereas future soil loss may be reduced to 14.51 and 14.46 t/ha/year in 2030 and 2040, respectively.
Species of the genus Populus L. in green spaces in Lugansk
Authors:   Leningrad State University named after A.S. Pushkin, N. Kurdyukova Olga , G. Zarutskaya Yulia ,   Lugansk State Pedagogical University
Published: February 2025

Background. In urban green construction of Lugansk, the selection of fast-growing trees and shrubs with a high decorative effect is important. The purpose of the study is to establish the species composition, bioecological characteristics and decorative qualities of species of the Populus L. suitable for landscaping. Materials and methods. Floristic sur veys were carried out during March-November, in squares measuring 1×1 km. Dendrological and biometric records, observations and descriptions were carried out according to the meth ods of the Nikitsky Botanical Garden. Results. In the green spaces in Lugansk there were 9 taxon of the genus Populus L. – Populus alba L., Populus alba var. bolleana (Lauche) Ed. Otto, Populus tremula L., Populus deltoides W. Bartram ex Marshall, Populus nigra L., Pop ulus nigra var. italica (Moench) Koehne), Populus simonii Carrière, Populus × berolinensis K. Koch, Populus × canadensis Moench. In the conditions of Lugansk, these are dioecious, dioecious, deciduous, anemophilously pollinated, intensively growing, tall trees that retain intense leaf color throughout the growing season, and in the fall – a rich range of colors, but differ in different resistance to natural environmental and anthropogenic influences and une qual decorative advantages. Conclusions. All taxon Populus L. can withstand the conditions of an urban and industrial environment well, are characterized by intensive growth, relativel low demands on soil fertility, sufficient drought resistance, winter hardiness, are highly decorative and rightfully occupy a leading place in the green spaces of the city.
The Role of Immunosenescence and Inflammaging in the Susceptibility of Older Adults to SARS-CoV-2 Infection
Authors: Zia Aliabbas , Sahebdel Faezeh , Farkhondeh Tahereh , Pourbagher-Shahri Ali Mohammad , Samini Fariborz , Samarghandian Saeed
Published: February 2025

COVID-19 is an ongoing pandemic caused by the SARS-CoV-2 coronavirus that is
one of the most significant challenges to public health over the past few years. Most people
are vulnerable to SARS-CoV-2, but older adults are more vulnerable. Aging is one of the major
risk factors for the detrimental consequences of COVID-19, likely due to chronic inflammation
and immunosenescence, both of which are the characteristics of old age. Immunosenescence
refers to the weakening of the immune system with age while inflammaging describes
the low-grade chronic inflammation seen in older individuals. One key aspect of human
aging is immune deficiency. During aging, our body’s defense system weakens, resulting
in decreased responses to infection by novel pathogens and a reduced ability to become immunized.
The presence of chronic inflammation and viral infection in old age may cause several
adverse unpredictable outcomes increasing the propensity and severity of the disease and
requires to be considered, enabling people to better prepare for the potential consequences of
this ongoing pandemic. This requires consideration so that individuals can better be prepared
to address the potential consequences of this ongoing pandemic. In this review, we discuss the
clinical characteristics of elderly COVID-19 patients and survey the associated molecular
pathways that are pivotal for the interactions of the coronavirus and host cellular responses,
including immunosenescence, inflammation, telomere attrition, impaired autophagy, mitochondrial
dysfunction and alterations in major aging signaling pathways, which are crucial for
the discovery of new therapeutic and preventive methods in the ongoing pandemic.
Association of Hypertensive Disorders of Pregnancy and their Clinical Features with Peripartum Cardiomyopathy: A Systematic Review and Meta-analysis
Authors: Huang Wilbert , Syahruddin Siti Shofia , Johansyah Alexandra Aurelia , Suriadiredja Siti Saqinah , Santoso Dhanny Primantara Johari , Sasotya RM Sonny , Azis Muhammad Alamsyah , Pribadi Adhi , Prameswari Hawani Sasmaya
Published: February 2025

Background:

Peripartum Cardiomyopathy (PPCM) is a rare yet fatal cardiac disease
associated with pregnancy. PPCM has been shown to have similar etiopathogenesis with hypertensive
disorders of pregnancy (HDP). Hence, this study aims to study the association between
HDP and the development of PPCM.

Methods:

Three databases (PubMed, Scopus, Cochrane Library) were searched and screened
based on prespecified inclusion and exclusion criteria. Predictors of PPCM evaluated were HDP
(preeclampsia, superimposed preeclampsia, chronic hypertension, and gestational hypertension)
and its clinical features (severe preeclampsia, age, parity, serum creatinine, etc.). Data were analyzed
using the random effects model of pooled odds ratios (ORs) with the Mantel Haenszel
method, and publication bias was assessed with a funnel plot.

Results:

A total of 13 observational studies with 11,951 PPCM cases from 7 countries were
identified. All types of HDP were associated with significantly increased odds of developing
PPCM, and severe preeclampsia was associated with the highest OR of 13.33 (CI: 5.95 – 29.83,
p < 0.01). Additionally, superimposed preeclampsia, chronic hypertension, preeclampsia, and
lastly gestational hypertension were associated with increased odds of PPCM with OR 5.77,
4.73, 4.70, and 3.13, respectively. Other clinical features being statistically significant for
PPCM development included advanced age > 35 years and multiple pregnancies (p < 0.05). No
significant difference in creatinine level was found between PPCM and no PPCM group. No
publication bias was found based on funnel plot assessment.

Conclusion:

HDP, especially severe preeclampsia, is associated with increased odds of PPCM
development; hence, a low threshold for PPCM screening in this high-risk group is required.
Novel Drug Delivery for Treating Cartilage Injuries
Authors: Dortaj Hengameh , Zakizadeh Fatemeh , Izadi Sepideh , Dehghan Mehdi , Pourentezari Majid , Dortaj Sareh , Rajabi Ali
Published: February 2025

Osteochondral injuries caused by trauma or osteoarthritis are joint diseases that impose significant social and economic burdens on modern society. The mechanisms of articular cartilage healing pose a crucial clinical challenge. Delivering cells and therapeutic factors to the injury site using various types of carriers is a novel approach that promotes tissue regeneration. Multiple factors are involved in the cartilage regeneration process; however, uncontrolled delivery of drugs, growth factors, and other mechanisms may not only diminish the full repair potential of damaged cartilage but also lead to undesirable morphological effects. New approaches, such as targeted smart drug de-livery, may enhance the therapeutic potential of intra-articular agents by prolonging the half-life of selected drugs within the joint and specific tissues. This review will discuss the roles of various bio-logics in cartilage regeneration, as well as different delivery methods for achieving effective healing responses.
Analysis of Carbapenemase and Extended-Spectrum Beta-Lactamases- producing Cephalosporin-resistant Strain of Escherichia coli and Klebsiella pneumoniae among Children in a Tertiary Care Centre, South India
Authors: Thattil Santhosh J. , Ajith Thekkuttuparambil A. , Dhanaraj Suresh
Published: February 2025

Background:

The incidence of Extended-Spectrum Beta-Lactamase (ESBL)- and carbapenemase-producing enterobacteriaceae in enterobacterales is increasing globally, pos-ing a threat to health. Schoolchildren under adolescence show a gradual increase in immunity, and respiratory infections like pneumonia and others are more prevalent in children under five-years of age. However, gastrointestinal disorders primarily affect children under one-year of age.

Aims:

The study aimed to analyze the Extended-spectrum Beta-Lactamase (ESBL) and car-bapenemase-producing cephalosporin-resistant strain of Escherichia coli and Klebsiella pneumoniae, isolated from various specimens of hospitalized children below ten years of age.

Methods:

A cross-sectional study on laboratory reports of positive culture specimens from children below ten years of age was conducted to analyze the cephalosporin-resistant strains of E. coli and K. pneumoniae between July, 2023 and July, 2024 in the Microbiology depart-ment of a tertiary care hospital central Kerala, South India. The cephalosporin-resistant strain was analyzed for carbapenemase or ESBL presence using a double disc synergy test. The data were subjected to statistical analysis.

Results:

A total of 1636 culture reports were analyzed, and growth was found in 672 (41%) specimens. Among the cephalosporin-resistant 187 strains (66%), E. coli and K. pneumoniae were 106 (57%) and 81 (43%), respectively. A significant difference (p <0.05) was noted between cephalosporin-resistant and sensitive E. coli among the various age groups. The dif-ference between cephalosporin-resistant and susceptible K. pneumoniae across different age groups, however, was negligible (p>0.05). Carbapenemase and ESBL-producing E. coli and K. pneumoniae were 39%, 29%, and 48%, respectively. The carbapenemase and ESBL-pro-ducing strains were more in children below one year. An insignificant difference (p>0.05) between ESBL (+) and ESBL (-) E. coli or K. pneumoniae was found among various age groups. A similar observation was found between carbapenemase [+] and carbapenemase (-) E. coli or K. pneumoniae. According to the effect value (Cramer's V) determined for each comparison, the association was either very weak or negligible.

Conclusion:

The cephalosporin-resistant strains (66%) of E. coli and K. pneumoniae were 57% and 43%, respectively. Specimens of children below one year of age showed more inci-dence of ESBL-producing K. pneumonia (67%) and carbapenemase-producing E. coli (68%).
Environmental and Economic Impacts of End-tidal Control of Volatile Anesthetics: A Scoping Review and Analysis
Authors: Beard John W. , Kennedy R. Ross , Philip James H. , Erslon Mary , Jiao Weiqi , Hyatt Hayden W. , Yapici Halit O.
Published: February 2025

Objective

This review aimed to assess the environmental and economic impacts of End-tidal Control (ET control) compared to manual clinician administration of inhaled anesthetics.

Methods

A scoping literature review was conducted to evaluate the consumption of anesthetic agents when using the Et Control software medical device compared to standard care (manual clinician adjustments) and the associated environmental/economic outcomes. Data were pooled across studies, and standardized mean difference, non-standardized weighted mean difference, and relative reduction in anesthetic agent usage between Et Control and manual adjustments were calculated. Annual reductions in hospital costs and greenhouse gas emissions for a representative 592-bed academic medical center were calculated.

Results

Eight out of the ten identified studies demonstrated that Et Control reduced anesthetic agent usage rates compared to manual administration. Based on the compiled evidence, Et Control results in a mean decrease of anesthetic agent usage by 32.2% for desflurane, 30.1% for isoflurane, and 4.1% for sevoflurane. The annual cost-savings and environmental impact for a large academic medical center using Et Control instead of manual administration is conservatively estimated to be $95,536 ($16,136 per 100 beds), with greenhouse gas emissions reduced by 434,345 kg (73,360 per 100 beds) in CO2 equivalencies (~100 motor vehicle emissions annually).

Conclusion

Our focused review and analysis indicate that Et Control reduces greenhouse gas emissions of anesthesia practice while also conferring cost-savings. The ability of semi-closed loop anesthesia systems to facilitate low-flow anesthesia warrants the need for future research to understand the full scope of environmental and economic impacts.
Developing a Smart Sensing Sock to Prevent Diabetic Foot Ulcers: Qualitative Focus Group and Interview Study
Authors: Corser Jenny , Yoldi Irantzu , Reeves Neil D , Culmer Pete , Venkatraman Prabhuraj D , Orlando Giorgio , Turnbull Rory Peter , Boakes Paul , Woodin Eric , Lightup Roger , Ponton Graham , Bradbury Katherine
Published: February 2025

Background

Diabetic foot ulcers are common and costly. Most cases are preventable, although few interventions exist to reliably support patients in performing self-care. Emerging technologies are showing promise in this domain, although patient and health care provider perspectives are rarely incorporated into digital intervention designs.

Objective

This study explored patient and health care provider feedback on a smart sensing sock to detect shear strain and alert the wearer to change their behavior (ie, pause activity and check their feet) and considered how patient experience and attitudes toward self-care are likely to impact uptake and long-term effective engagement with the device to curate guiding principles for successful future intervention development.

Methods

This qualitative study combined semistructured interviews and a focus group alongside a participant advisory group that was consulted throughout the study. In total, 20 people with diabetic neuropathy (n=16, 80% with history of diabetic foot ulcers) and 2 carers were recruited directly from podiatry clinics as well as via a recruitment network and national health mobile app for one-to-one interviews either in person or via landline or video call. A total of 6 podiatrists were recruited via professional networks for 1 virtual focus group. Participants were asked about their experience of diabetic foot health and for feedback on the proposed device, including how it might work for them in daily life or clinical practice. The data were analyzed thematically.

Results

Three main themes were generated, each raising a barrier to the use of the sock complemented by potential solutions: (1) patient buy-in—challenged by lack of awareness of risk and potentially addressed through using the device to collect and record evidence to enhance clinical messaging; (2) effective engagement—challenged by difficulties accepting and actioning information and requiring simple, specific, and supportive instructions in line with podiatrist advice; and (3) sustained use—challenged by difficulties coping, with the possibility to gain control through an early warning system.

Conclusions

While both patients and podiatrists were interested in the concept, it would need to be packaged as part of a wider health intervention to overcome barriers to uptake and longer-term effective engagement. This study recommends specific considerations for the framing of feedback messages and instructions as well as provision of support for health care providers to integrate the use of such smart devices into practice. The guiding principles generated by this study can orient future research and development of smart sensing devices for diabetic foot care to help optimize patient engagement and improve health outcomes.
A Phenomenological Study on Patient Experience with Extraction Retraction Orthodontic Regret (Preprint)
Authors: Antepyan-Ruckenstein Jeremy
Published: February 2025

BACKGROUND

Extraction retraction orthodontic (ERO) practices are commonly used to treat every malocclusion. Occasionally, patients express dissatisfaction over previous ERO treatment.

OBJECTIVE

This study investigates patient experience who have had ERO intervention and expressed regret or dissatisfaction with this treatment.

METHODS

Semi-structured interviews were conducted with patients who have expressed regret over past ERO treatment. Interpretive phenomenological analysis (IPA) was used to derive themes from transcripts.

RESULTS

Eleven participants were recruited, gave ongoing informed consent, and participated in the semi-structured interview process. Six major themes were identified through IPA: “ERO Treatment Course”, “Lack of Informed Consent”, “Ocean of Grief and Trauma”, “Multifaceted Health Complaints”, “Finding Solutions and Coping Strategies”, and “Wishing There Was a Better Way”. Participants felt like they were not able to give informed consent for ERO due to a number of different reasons such as being too young, not being given accurate information on the risks, or being influenced parentally, culturally, or by the provider. Participants regret ERO due to a number of multifaceted health complaints including but not limited to sleep breathing disorders, craniofacial pain patterns, neuropsychobehavioural symptoms, and negative aesthetic outcomes, that they believe results from ERO.

CONCLUSIONS

Patient regret following extraction retraction orthodontics is due to a lack of informed consent and negative health effects.

CLINICALTRIAL

CSREB 2022-12-001
Enhancing Pulmonary Disease Prediction Using Large Language Models with Feature Summarization and Hybrid Retrieval-Augmented Generation (Preprint)
Authors: Li Ronghao , Mao Shuai , Zhu Congmin , Yang Yingliang , Tan Chunting , Li Li , Mu Xiangdong , Liu Honglei , Yang Yuqing
Published: February 2025

BACKGROUND

The rapid advancements in natural language processing (NLP), particularly the development of large language models (LLMs), have opened new avenues for managing complex clinical text data. However, the inherent complexity and specificity of medical texts present significant challenges for the practical application of prompt engineering in diagnostic tasks.

OBJECTIVE

To address these limitations, this study proposes a novel prompt engineering strategy that integrates feature summarization, chain of thought (CoT) reasoning, and a hybrid retrieval-augmented generation (RAG) framework.

METHODS

A feature summarization approach, leveraging TF-IDF and K-means clustering, was employed to extract and distill key radiological findings. Simultaneously, the hybrid RAG framework combined dense and sparse vector representations to enhance LLMs’ comprehension of disease-related text. The proposed strategy was evaluated using a multicenter dataset containing radiology reports on pneumonia, tuberculosis, and lung cancer, with three state-of-the-art LLMs: GLM-4-plus, GLM-4-air, and GPT-4o.

RESULTS

Comparative analyses were performed against a BERT-based prediction model and various other prompt engineering techniques. Our strategy achieved superior performance, attaining an accuracy of 0.8947 and an F1 score of 0.8887 on the primary dataset, alongside an accuracy of 0.9167 and an F1 score of 0.8631 on an external validation dataset of radiology reports.

CONCLUSIONS

These findings highlight the potential of LLMs to revolutionize pulmonary disease prediction, particularly in resource-constrained settings, by surpassing traditional models in both accuracy and flexibility. The proposed prompt engineering strategy not only improves predictive performance but also enhances the adaptability of LLMs in complex medical contexts, offering a promising tool for advancing disease diagnosis and clinical decision making.
Adolescents Engagement to Promote Maternal and Newborn Health Services in Bangladesh: The Case of Faridpur District
Authors: Julfiker Faridul
Published: February 2025

In Bangladesh, adolescent-related development projects usually focus on adolescent health, education, well-being, and protection. These development projects are implementing by national and international development organizations and the government. In most cases, the adolescent groups are the project participants and beneficiaries. Besides the beneficiary, they can play a significant role in promoting development services as health-seeking behaviours, especially maternal and newborn health (MNH) in the community. Lack of engagement initiatives and information about their social role and responsibilities prevents them from using their agency and expectance in society to increase services for poor and marginalized communities. To address this issue, Save the Children International engaged adolescents through project intervention for using adolescent agencies to promote MNH services from public health facilities.
Real-Time Math Solver Using Hand Gestures with Al
Authors: Jagtap Sakshi
Published: February 2025

Handwritten gesture recognition is an area of rapid growth within the fields of artificial intelligence (AI) and machine
learning, presenting significant opportunities for use in education, human-computer interaction, and digital note-taking. This
paper provides an overview of the methods and strategies employed in AI-ML models to recognize and interpret handwritten
gestures, with a particular emphasis on mathematical symbols, numbers, and related gestures. Furthermore, the paper explores
how deep learning techniques influence gesture recognition accuracy and classification. Additionally, it aims to aid in
advancing more accurate and optimized handwritten gesture recognition systems, ultimately benefiting applications in both
academic and professional settings.
The impact of digital transformation in management accounting on governance efficiency: The intermediary role of accounting information quality
Authors: Oanh Le Thi Tu , Ngoc Bui Thi , Dung Ngo Tien , Trang Nguyen Thanh , Anh Vu Thi Kim
Published: February 2025

This study aims to evaluate the impact of digital transformation in management accounting on the management efficiency of enterprises, with the intermediary role of accounting information quality. The study is based on the theoretical model proposed by Hasan (2023) and Phornlaphatrachakorn and Na Kalasindhu (2020, 2021) regarding the influence of digital transformation in accounting. The research utilized a quantitative approach, employing the linear structural equation model (SEM) and survey data from 320 enterprises in Hanoi, Vietnam. The findings revealed the acceptance of four hypotheses, suggesting the following: the direct positive impact of digital transformation in accounting on the quality of accounting information and business ME; quality of accounting information has a direct positive impact on corporate governance efficiency; digital transformation in accounting has indirect implications on corporate governance efficiency with the mediating role of accounting information quality. This study contributes to empirical research on the application of digital transformation in various fields while enhancing confidence in digital technology.
Die „Gymnastik des Allgemeinen“: (moralische) Bildung in der ökonomischen Sphäre.
Authors: Dummer Niklas , Müller Johanna , Prix Lea
Published: February 2025

Der Artikel diskutiert Hannes Kuchs Kritik an der in liberalen Gerechtigkeitstheorien vertretenen Annahme, dass ökonomisches Verhalten leitende und politisch-moralische Normen getrennt voneinander zu betrachten sind. Gegen diese Annahme argumentiert Kuch in seiner Studie „Wirtschaft, Demokratie und liberaler Sozialismus“ dafür, dass die ökomische Sphäre eine zentrale Rolle für die Ermöglichung und Verwirklichung demokratischer Gerechtigkeit spielt. Dabei problematisiert Kuch, dass die ökonomische Sphäre in ihrer gegenwärtigen Gestalt einen überwiegend negativen Einfluss auf die moralische Bildung der Subjekte hat. Hieran anknüpfend attestiert Kuch der politischen Sphäre ein normatives Primat, während er der ökonomischen Sphäre ein empirisches Primat hinsichtlich der moralischen Bildung der Subjekte zuschreibt. Die KommentatorInnen kritisieren       Kuchs Position dahingehend, dass sie einen problematischen Gegensatz zwischen einer amoralischen ökonomischen Sphäre und einer idealisierten moralischen politischen Sphäre postuliert. Neben einem binnenlogisch-argumentativen Problem erweist sich diese Darstellung insbesondere hinsichtlich der Analyse real-politischer und global-ökonomischer Machtverhältnisse als problematisch. Die KommentatorInnen plädieren daher für eine differenziertere Analyse, die die moralische Ambivalenz der beiden Sphären und ihre moralisch bildenden und destruktiven Potenziale anerkennt.
Kapitaleigentum, Ausbeutung und Marktethos
Authors: Derpmann Simon
Published: February 2025

In Wirtschaft, Demokratie und liberaler Sozialismus argumentiert Hannes Kuch für die gerechtigkeits- und sittlichkeitstheoretischen Stärken des liberalen Sozialismus. Kuch verteidigt diese Alternative zum Kapitalismus insbesondere gegen die Eigentumsdemokratie, die aus seiner Sicht anfälliger für das Aufkommen von Ausbeutung und die Herausbildung gerechtigkeitsadverser Dispositionen unter ihren TeilnerhmerInnen ist. Allerdings sind aus liberaler Perspektive die Einbußen, die mit der grundlegenden Einschränkung von Kapitaleigentum und Vertragsfreiheit einhergehen, nicht zu unterschätzen.
Islet Transplantation Versus Standard of Care for Type 1 Diabetes Complicated by Severe Hypoglycemia From the Collaborative Islet Transplant Registry and the T1D Exchange Registry
Authors: Rickels Michael R. , Ballou Cassandra M. , Foster Nicole C. , Alejandro Rodolfo , Baidal David A. , Bellin Melena D. , Eggerman Thomas L. , Hering Bernhard J. , Kandeel Fouad , Brand Adam , Miller Kellee M. , Barton Franca B. , Payne Elizabeth H.
Published: February 2025

OBJECTIVE

Islet transplantation was recently US Food and Drug Administration approved for adults with type 1 diabetes complicated by recurrent severe hypoglycemia events (SHEs). We sought to understand the long-term benefit for glycemic control and risk of immunosuppression to kidney function associated with islet transplantation compared with ongoing standard of care.

RESEARCH DESIGN AND METHODS

We performed a case-control analysis of prospectively collected data from patients in the Collaborative Islet Transplant Registry (CITR) with at least one SHE in the year (2000–2014) before transplantation (cases) and compared them with data from patients in the T1D Exchange (T1DX) Registry with at least one SHE in the year (2010–2012) before enrollment (controls), with both cohorts observed over 5 years. SHEs were restricted to those resulting in seizure or loss of consciousness.

RESULTS

Cases from CITR (n = 71) compared with controls from T1DX (n = 213) more often achieved the primary outcome of HbA1c <7.0% and absence of an SHE (71–80 vs. 21–33% over 5 years; P < 0.001) and the outcome of HbA1c ≤6.5% and absence of an SHE (60–75% vs. 10–20%; P < 0.001) while requiring significantly less insulin (majority in CITR were insulin independent). Kidney function, measured by estimated glomerular filtration rate, declined from baseline to a greater extent in CITR than in T1DX (−8.8 to −20 vs. −1.3 to −6.5 mL ⋅ min−1 ⋅ 1.73 m−2 over 5 years; P < 0.001).

CONCLUSIONS

Islet transplantation for adults with type 1 diabetes complicated by SHEs results in near-normal glycemic control in the absence of SHEs more often than observed with standard of care, but at the cost of greater reduction in kidney function.
The Glycemic Impact of Protein Ingestion in People With Type 1 Diabetes
Authors: Dao Giang M. , Kowalski Greg M. , Bruce Clinton R. , O’Neal David N. , Smart Carmel E. , Zaharieva Dessi P. , Hennessy Declan T. , Zhao Sam , Morrison Dale J.
Published: February 2025

In individuals with type 1 diabetes, carbohydrate is commonly recognized as the primary macronutrient influencing postprandial glucose levels. Accumulating evidence indicates that protein ingestion also contributes to the increment in postprandial glucose levels, despite endocrine and metabolic responses different from those with carbohydrate ingestion. However, findings regarding protein ingestion’s glycemic effect in people with type 1 diabetes are equivocal, with the magnitude of glycemic response seemingly dependent on the rate of absorption and composition of protein ingested. Therefore, the aim of this article is to outline the physiological mechanisms by which ingested protein influences blood glucose regulation in individuals with type 1 diabetes and provide clinical implications on use of dietary protein in the context of glycemic management. Specifically, protein ingestion raises plasma amino acid levels, which directly or indirectly (via gut hormones) stimulates glucagon secretion. Together with the increase in gluconeogenic precursors and an absent endogenous insulin response in individuals with type 1 diabetes, this provides a synergistic physiological environment for increased endogenous glucose production and subsequently increasing circulating glucose levels for several hours. While there is a dearth of well-controlled studies in this area, we provide clinical implications and directions for future research regarding the potential for using ingestion of fast-absorbing protein (such as whey protein) as a tool to prevent and mitigate overnight- and exercise-induced hypoglycemia in people with type 1 diabetes.
The Interconnected Complexity of Diabetes and Depression
Authors: Beverly Elizabeth A. , Gonzalez Jeffrey S.
Published: February 2025

Diabetes and depression have a bidirectional relationship, with negative impacts on glycemia, self-care, long-term complications, quality of life, and mortality. This review highlights key aspects of the interconnected and complex relationship between diabetes and depression, including how it affects health outcomes, depression duration and recurrence, age-specific manifestations, and recommendations for screening and nonpharmacological treatment.
Autonomous Artificial Intelligence for Diabetic Eye Disease Testing Improves Access and Equity in the Pediatric and Adult Populations: The Johns Hopkins Medicine Experience
Authors: Liu T.Y. Alvin , Wolf Risa M.
Published: February 2025

This article discusses the implementation and impact of autonomous artificial intelligence (AI) systems for diabetic eye disease testing at the Johns Hopkins Medicine health system, highlighting improvements in screening rates, access to care, and health equity for underserved populations. The AI technology has been effective in both adult and pediatric populations and has reduced disparities and increased follow-up with eye care professionals. While considering the challenges and successes of this approach, this article also highlights the potential long-term impact of AI systems in improving visual health outcomes for people with diabetes in diverse health care settings.