bluuebunny/crossref_metadata_2025 huggingface dataset:
Unveiling the Strengthening and Ductility Mechanisms of a CoCr0.4NiSi0.3 Medium-Entropy Alloy at Cryogenic Temperatures
Authors: Zhang Li , Zhang Lingwei , Chen Xiang
Published: February 2025

Materials utilized in extreme environments, such as those necessitating protection and impact resistance at cryogenic temperatures, must exhibit high strength, ductility, and structural stability. However, most alloys fail to maintain adequate toughness at cryogenic temperatures, thereby compromising their safety during cryogenic temperature service. This study investigates the quasi-static mechanical properties of a CoCr0.4NiSi0.3 medium-entropy alloy (MEA) at room temperature, −75 °C, and −150 °C. The deformation behavior and mechanisms responsible for strengthening and toughening at reduced cryogenic temperatures are analyzed, revealing that decreasing cryogenic temperature enhances the strength of the as-cast MEA. Specifically, both the yield strength (YS) and ultimate tensile strength (UTS) of the MEA increase significantly with decreasing temperature during cryogenic tensile testing. Under tensile testing at −150 °C, the YS reaches 617.5 MPa, the UTS is 1055.0 MPa, and the elongation to fracture remains approximately 21.0% at both −150 °C and −75 °C. After cryogenic temperature tensile deformation, the matrix exhibits a dispersed distribution of nanoscaled tetragonal and orthorhombic phases, a coherent hexagonal close-packed phase, L12 phase and layered long-period stacking ordered (LPSO) structures, which are rarely observed in the cryogenic deformation of metals and alloys. The metastable phase evolution path of this MEA at cryogenic temperatures is closely associated with the decomposition of perfect dislocations into a/6<112> Shockley partial dislocations and their subsequent evolution at reduced cryogenic temperatures. At −75 °C, the a/6<112> Shockley partial dislocation interacts with the L12 phase to form antiphase boundaries (APBs) approximately 3 nm thick. At −150 °C, two phase transition paths from stacking faults (SFs) to nanotwins and LPSO occur, leading to the formation of layered LPSO structures and deformation-induced nanotwins. The dispersion of these coherent nanophases and nanotwins induced by the reduced stacking fault energy under cryogenic temperatures is the key factor contributing to the excellent balance of strength and plasticity in the as-cast MEA, providing an important basis for research on the cryogenic mechanical properties of CoCrNi-based MEAs.
A 50-Year Perspective on Changes in a Pacific Northwest Breeding Forest Bird Community Reveals General Stability of Abundances
Authors: Clements Nolan M. , Shen Fang-Yu , Robinson W. Douglas
Published: February 2025

Abundances of breeding forest birds have apparently declined in North America during the last five decades, possibly influenced by anthropogenic effects. We re-surveyed breeding birds in coniferous woodland plots initially surveyed in the late 1960s in western Oregon, USA. We aligned methods with those originally used and incorporated modern methods to estimate densities. To relate local results to regional trends, we compared them with Breeding Bird Survey (BBS) data. We assessed potential drivers of change for species exhibiting strong differences by relating bird density to changes in habitat and landscape composition. Eighty percent of species had densities similar to 50 years ago. Five of sixty-four species declined statistically significantly. Declines were poorly explained by changes in vegetation structure or landscape cover composition. Thirty-one species were apparently stable on plots but declined in the region. For a few species, comparisons of estimates should be viewed with caution as density estimates based on the original method were unusually high or low. Our modern estimates typically had measurement errors encompassing the 1960s estimates of density. We conclude that this Pacific Northwest bird community has remained similar through time despite 50 years of intensive forest management, indicating resilience to this level of anthropogenic activity.
Partition Function Zeros of Paths and Normalization Zeros of ASEPS
Authors: Burda Zdzislaw , Johnston Desmond A.
Published: February 2025

We exploit the equivalence between the partition function of an adsorbing Dyck walk model and the Asymmetric Simple Exclusion Process (ASEP) normalization to obtain the thermodynamic limit of the locus of the ASEP normalization zeros from a conformal map. We discuss the equivalence between this approach and using an electrostatic analogy to determine the locus, both in the case of the ASEP and the random allocation model.
Scoping Review on Digital Creativity: Definition, Approaches, and Current Trends
Authors: Samper-Márquez Juan José , Oropesa-Ruiz Nieves Fátima
Published: February 2025

This review analyses the evolution of digital creativity from 2000 to 2022, defining it as a dynamic process where digital technologies foster collaboration, inclusion, self-expression, and automation. Based on 29 studies from databases such as Dialnet, UOC, Scopus, the Web of Science, and PsyINFO, and utilising the PRISMA and SPIDER methodologies, the research provides a comprehensive overview of the field. Digital creativity is described as the generation of new and valuable ideas, products, or solutions through digital tools that combine cognitive and socio-emotional skills in collaborative environments. Intuition, understood as the ability to make quick and effective decisions based on pattern recognition and prior experiences, plays a crucial role in the creative process. The study highlights its impact on education, enabling students to explore self-expression and solve problems creatively, merging analogue and digital creativity. In the professional realm, it optimises innovative processes, promoting efficiency and collaboration. The integration of emerging technologies, such as programming and 3D animation, in educational curricula is emphasised to prepare students for future challenges. Additionally, interdisciplinary research is advocated to ensure that digital tools amplify creativity, addressing ethical issues such as intellectual property and the social implications of automated creativity. Finally, the current trends such as game-based learning, innovation driven by social networks, and artificial intelligence are examined, proposing directions for future research.
AI and Eye Tracking Reveal Design Elements’ Impact on E-Magazine Reader Engagement
Authors: Šola Hedda Martina , Qureshi Fayyaz Hussain , Khawaja Sarwar
Published: February 2025

This study investigates the impact of intelligible background speech on reading disruption utilising neuromarketing methodologies, specifically an eye-tracking webcam (Tobii Sticky) and AI eye-tracking software (Predict, v.1.0.). A cohort of 144 participants from Oxford Business College underwent emotional impact testing, while an AI eye-tracking algorithm analysed attention patterns across 180,000 eye-tracking recordings. Two articles from OxConnect Magazine were presented in varying background formats. Python-based analysis revealed that the HND article consistently outperformed OxFoodbank in maintaining reader engagement and attention. The HND’s structured content yielded higher total attention (white: 49.43%, black: 48.19%) and end attention (white: 27.58%, black: 28.43%). Emotion analysis indicated that HND elicited a more neutral (white mean difference: 0.1514, black: 0.1008) and consistent emotional response, with reduced puzzlement (white mean difference: −0.3296, black: −0.0918). Furthermore, this demonstrates the effectiveness of integrating AI eye-tracking algorithms with webcam eye trackers for comprehensive reading behaviour analysis. These findings provide valuable insights for colleges developing e-magazines, offering evidence-based strategies to enhance student engagement and information retention. By implementing well-structured, visually appealing content, educational institutions can optimise their digital publications to maintain reader attention even in the presence of background distractions, ultimately improving the effectiveness of their e-magazines as educational tools.
Primary School Teachers’ Creative Self-Perception and Beliefs on Teaching for Creativity
Authors: Izquierdo-Sanchis Eva , Echegoyen-Sanz Yolanda , Martín-Ezpeleta Antonio
Published: February 2025

The recent Spanish education law, LOMLOE, highlights the importance of integrating creativity into all subjects in Primary Education. Teachers play a crucial role in this process, yet often lack adequate training, and research on their beliefs about creativity remains limited. This study examines the creative self-perception of Spanish in-service Primary Education teachers and their beliefs about teaching for creativity, using two previously validated instruments. The findings reveal a moderate self-perception of creativity across various domains, with significant gender differences, as well as a positive attitude towards teaching for creativity. No significant differences were found based on age or years of teaching experience, suggesting a static nature within the teaching profession, misaligned with emerging educational challenges. The correlational analysis indicates a positive relationship between creative self-perception and different dimensions of teaching for creativity, highlighting the importance of support from educational institutions. These findings advocate for continuous teacher training and resources to strengthen creativity-focused teaching practices.
Simplifying Data Processing in AFM Nanoindentation Experiments on Thin Samples
Authors: Kontomaris Stylianos Vasileios , Malamou Anna , Stylianou Andreas
Published: February 2025

When testing soft biological samples using the Atomic Force Microscopy (AFM) nanoindentation method, data processing is typically based on equations derived from Hertzian mechanics. To account for the finite thickness of the samples, precise extensions of Hertzian equations have been developed for both conical and parabolic indenters. However, these equations are often avoided due to the complexity of the fitting process. In this paper, the determination of Young’s modulus is significantly simplified when testing soft, thin samples on rigid substrates. Using the weighted mean value theorem for integrals, an ‘average value’ of the correction function (symbolized as g(c)) due to the substrate effect for a specific indentation depth is derived. These values (g(c)) are presented for both conical and parabolic indentations in the domain 0 < r/H ≤ 1, where r is the contact radius between the indenter and the sample, and H is the sample’s thickness. The major advantage of this approach is that it can be applied using only the area under the force–indentation curve (which represents the work performed by the indenter) and the correction factor g(c). Examples from indentation experiments on fibroblasts, along with simulated data processed using the method presented in this paper, are also included.
Stress and Anxiety Are Associated with Increased Metabolic Syndrome Risk Among Young Adults Living in the Deep South
Authors: Renna Megan E. , Wilbourne Faith N. , Johal Sonal , Fergerson Ava K. , Behringer Kylee F. , Brandner Caleb F. , Stavres Jon , Graybeal Austin J.
Published: February 2025

Background/Objectives: This study assessed the association among perceived stress, anxiety, and depression with both the metabolic syndrome (MetS) risk and diagnostic status among young adults in the Deep South. Methods: Participants included 132 young adults aged 18–39 (Mage = 27.73, SD = 11.11; MBMI = 27.6, SD = 6.8; 56.5% female; 55.7% White) living in Mississippi. In addition to completing self-report measures of perceived stress, anxiety, and depression, all of the participants underwent anthropometric, blood pressure, and fasting blood glucose and lipid assessments to ascertain the MetS status. The participants were provided with both a MetS diagnosis (defined as a dichotomous yes/no variable) as well as a continuous MetS risk severity score determined using existing equations. The risk scores ranged from −1 to +1, with positive scores indicating an increased risk for MetS. Results: After controlling for age, biological sex, race, medication use, and education level, multiple regression models revealed significant positive relationships between perceived stress (b = 0.03; p = 0.017) and anxiety symptoms (b = 0.01; p = 0.039) with the MetS severity. Perceived stress (p = 0.017) and anxiety symptoms (p = 0.043) were also significantly higher among participants with MetS compared to those without. There were no significant associations between the MetS severity and depressive symptoms, and no differences in depressive symptoms in participants with versus without MetS. Conclusions: The results highlight the role of stress and anxiety not only in MetS but in the overall metabolic risk among young adults living in the Deep South. The results highlight the importance of intervening on stress and anxiety early in adulthood to help mitigate cardiometabolic health risk.
Stable Isotope Investigations of Icicle Formation and Evolution
Authors: Brubaker Thomas , Krishnamurthy R. V.
Published: February 2025

Icicles are elongated structures formed from water flowing over hangings and crystallizing in sub-freezing conditions. These features are ubiquitous in several parts of the world that experience severe to moderate winter seasons. It has been suggested that they could be a source of recharge to groundwater. Icicles are presumed to affect groundwater quality via incorporation of atmospheric and roof top contaminants. Relatively little attention has been paid to these wintry features, insofar as only a few theoretical models have attempted to describe their formation. Stable isotope measurements (δ18O and δ2H) of icicles that were melted stepwise into fractions are presented as support for the models that invoke the rapid formation of icicles. Icicles exhibit minimal fraction to fraction isotope variation, suggesting a lack of isotope equilibrium and that kinetic effects dominate the freezing process. Deviations from the Global Meteoric Water Line (GMWL), which is similar to the Local Meteoric Water Line (LMWL), indicate that post-depositional processes, namely sublimation, may occur throughout the freezing process. Isotopic evidence lends support to a “growth-cessation-growth” variation of the already proposed methods of rapid icicle formation, where a cessation period occurs between pulses of rapid freezing during icicle growth.
Mental Health in Young Adult University Students During COVID-19 Lockdown: Associations with Physical Activity, Sedentary Behaviors and Sleep Quality
Authors: Silva Gustavo , Estima Francisco , Silva Ana Carvalhinho , Mota Jorge , Martins Clarice , Aires Luísa
Published: February 2025

This study analyzed associations between physical activity (PA), sedentary behaviors (SB), sleep, and mental health indicators in young adults during the COVID-19 lockdown (15 January–19 April 2021). The participants were 549 Portuguese university students (18–30 years, 57.7% male). Mental health was assessed using the DASS-21 for depression, anxiety, stress, and DASS-21 total score (DASSt). Physical activity (vigorous, moderate, walking) was measured with the IPAQ, while SB (e.g., sitting, screen time) and sleep were evaluated using self-reported measures and the Pittsburgh Sleep Quality Index (PSQI). Multiple linear regressions showed that sleep quality (β = 2.116), sitting time (ST; β = 0.451), vigorous PA (VPA; β = −0.005), and computer use for work/study (β = 0.444) were significantly associated with overall mental health, DASSt (R2 = 0.358). Sleep quality, sitting, and VPA were also linked to depression (R2 = 0.308), anxiety (R2 = 0.275), and stress (R2 = 0.338). Computer use for work/study was additionally associated with anxiety and stress. Overall, poor sleep quality, increased sitting, and computer use for work/study, alongside lower VPA, showed significant associations with poorer mental health outcomes. These findings highlight the importance of sleep, PA, and limiting sedentary behaviors, particularly during lockdowns, in mitigating mental health issues among Portuguese young adults.
Where Do Professional Sports Clubs and Organisations Sit Within a Local Health Promotion System? A Social Network Analysis Study
Authors: Brazier Jack , Murphy Joey , Foster Charlie , Townsend Nick
Published: February 2025

Professional sports clubs and organisations (PSCOs) have been identified as effective organisations for health promotion (HP); however, their position and connectivity within local HP systems is largely unknown. Our research aimed to explore (i) who identifies PSCOs as a key partner within the delivery of local HP projects, (ii) who they collaborate with, and (iii) their perceived importance by network members. A social network analysis survey was completed by eighteen stakeholders within a South West region of England. Few organisations identified PSCOs as a key partner; however, influential organisations, such as the local authority, reported ties to them. Generally, PSCOs were not identified by network stakeholders as key organisations in the dissemination of HP knowledge or resources, such as project delivery or staffing. Limited relationships with voluntary and health sector organisations existed, and fostering such multisectoral relationships should be a priority for PSCOs in the future. PSCOs were not clearly integrated within the local HP system sampled and are siloed within their local HP activities and delivery. Future research and practice should explore how PSCOs’ assets could be best utilised with local HP and contribute towards local and national health priorities.
The Combined Effects of Urine Zinc, Cadmium, Mercury, Lead, and Copper on Endometrial Cancer Staging
Authors: Haruna Issah , Broaddus Russell R. , Gladden Andrew B. , Subedi Kiran , Obeng-Gyasi Emmanuel
Published: February 2025

Endometrial cancer (EC) is a growing public health concern. This secondary data study of a case series leveraged existing samples and data to explore the potential link between exposure to heavy metals/essential elements and stage of EC. We analyzed urine samples from women with EC, measuring levels of toxic metals (cadmium, mercury, and lead) and essential elements (zinc and copper). Our findings revealed that higher levels of mercury, cadmium, and lead are associated with more advanced EC stages. Conversely, zinc showed a protective effect, potentially mitigating EC stage progression. Copper levels did not show a clear association with EC stage. These results highlight the potential impact of environmental exposures on EC stage and the crucial need for advanced statistical methods to understand the combined effects of these pollutants on health and the need for public health interventions. Further research is needed to explore the mechanisms by which these metals influence EC stage and long-term outcomes.
The Interaction Between Alcohol Misuse and Belongingness on Suicidal Ideation Among Military Personnel
Authors: García-Ramírez Grisel , Shamblen Stephen R. , Kaner Emily , Moore Roland S.
Published: February 2025

Previous research suggests a high prevalence of suicidal ideation among military personnel. Suicidal ideation is associated with suicide attempts and death. This study focused on the association between belongingness—a component of the Interpersonal Psychological Theory of Suicide—and alcohol misuse on suicidal ideation among the different categories of military branch and military service status. Using the Military Suicide Research Consortium Common Data Elements database (N = 2516), we conducted linear regression analyses to examine the moderating effect of belongingness and alcohol misuse on the association between military branch and military service status (i.e., Active Duty) on suicidal ideation. Results showed a negative significant association between belongingness and suicidal ideation, and a positive significant association between alcohol and suicidal ideation. The results indicated that alcohol misuse moderated the association between military branch and suicidal ideation, but did not moderate the association between military service status and suicidal ideation. Additionally, the results indicated that belongingness moderated the association between military branch and suicidal ideation and the association between military service status and suicidal ideation. The results highlight the differences across military branches and military service statuses and suggest the importance of developing tailored suicide prevention programs to address the specific needs of each military subpopulation.
Investigating Blood Biomarkers That Can Facilitate the Diagnosis of Meningitis—A Systematic Literature Review
Authors: Baran Jakub Marek , Porębska Adrianna , Lesisz Magdalena , Polak Katarzyna , Grodzka Olga , Domitrz Izabela
Published: February 2025

Meningitis is an inflammation of the meninges that can sometimes be a life-threatening disease. Therefore, fast and proper diagnosis with the implementation of adequate treatment is crucial in its management. Treatment depends on etiology, which can be viral, bacterial, fungal, and parasitic. Diagnosis is based on thorough clinical examination with a performance of lumbar puncture in the case of meningitis suspicion. This procedure, however, remains invasive with several contraindications and a need for a patient’s consent, which is not always given due to the patient’s fear of it, for instance. Thus, this systematic review aimed to summarize the available literature on the topic of blood biomarkers in meningitis differentiation. A selection process was performed by two authors independently in accordance with the Preferred Research Items for Systematic Reviews and Meta-analyses. Two databases were screened. It led to the identification of 863 articles, of which 43 were eventually included in the systematic review. The analysis resulted in identifying blood biomarkers in both adult and pediatric meningitis. Most studies focused on inflammatory markers, such as C-reactive protein and procalcitonin, from which procalcitonin showed better utility. Among other analyzed molecules were, for instance, interleukins, apolipoproteins, and microRNAs. Moreover, many researchers suggested that combining biomarkers or implementing novel technologies may lead to the best accuracy. However, many suggested methods lack validation, which stands in the way of making them widely used.
Seventh ISNS Reference Preparation for Neonatal Screening for Thyroid Stimulating Hormone, Phenylalanine, and 17α-Hydroxyprogesterone in Blood Spots
Authors: Schielen Peter C. J. I. , Webster Dianne , Loeber J. Gerard , Bonham James R.
Published: February 2025

The International Society for Neonatal Screening (ISNS) has supported the standardization of the measurement of key biochemical markers for the neonatal screening of diseases: thyroid-stimulating hormone (TSH) for congenital hypothyroidism, phenylalanine (PHE) for phenylketonuria, and 17α-hydroxyprogesterone (17OHP) for congenital adrenal hyperplasia. These diseases are commonly a part of neonatal screening panels worldwide. The ISNS provides a series of secondary reference materials to the manufacturers of neonatal screening reagents to assist in the production of calibration materials for kits. This technical note describes the manufacture of the seventh combined dried blood spot reference preparation for neonatal screening (RPNS) for these analytes.
When Time Matters: Exploring the Impact of Recall Techniques and Educational Levels on Witness Testimony Quality
Authors: Solà-Sales Sara , Alzetta Chiara , Moret-Tatay Carmen , Dell’Orletta Felice
Published: February 2025

Mental reconstruction (MRC) and Free Recall (FR) have been recognized for enhancing the quality of witness statements. However, the mechanisms underlying this association remain insufficiently understood. This study explores how the time allocated to MRC and FR and variations in educational level influence the quality of eyewitness testimonies. Testimony quality is evaluated based on manually annotated content information provided by experts in testimony assessment, which measures adherence to the events. This is further complemented by fine-grained linguistic features, automatically extracted using linguistic analysis tools, to capture stylistic aspects. As a proof of concept, the analysis is performed on a corpus of 96 testimonies in Spanish describing two robbery cases. The results suggest that both mental reconstruction and narration times positively impact the accuracy of testimonies, as inaccuracies predominantly involve peripheral details. Furthermore, while the study confirms that educational level affects testimony quality, no significant differences were observed in the frequency of erroneous reports. This study contributes to the understanding of the relationship between cognitive strategies and the accuracy of witness statements, proposing an analysis approach applicable to forensic psychology for witness assessment.
A Stackelberg Game Model for the Energy–Carbon Co-Optimization of Multiple Virtual Power Plants
Authors: Xu Dayong , Li Mengjie
Published: February 2025

As energy and carbon markets evolve, it has emerged as a prevalent trend for multiple virtual power plants (VPPs) to engage in market trading through coordinated operation. Given that these VPPs belong to diverse stakeholders, a competitive dynamic is shaping up. To strike a balance between the interests of the distribution system operator (DSO) and VPPs, this paper introduces a bi-level energy–carbon coordination model based on the Stackelberg game framework, which consists of an upper-level optimal pricing model for the DSO and a lower-level optimal energy scheduling model for each VPP. Subsequently, the Karush-Kuhn-Tucker (KKT) conditions and the duality theorem of linear programming are applied to transform the bi-level Stackelberg game model into a mixed-integer linear program, allowing for the computation of the model’s global optimal solution using commercial solvers. Finally, a case study is conducted to demonstrate the effectiveness of the proposed model. The simulation results show that the proposed game model effectively optimizes energy and carbon pricing, encourages the active participation of VPPs in electricity and carbon allowance sharing, increases the profitability of DSOs, and reduces the operational costs of VPPs.
Analysis of Contact Noise Due to Elastic Recovery of Surface Asperities for Spherical Contact
Authors: Lee Bora , Kim Kyungseob , Kim Taewan
Published: February 2025

Contact noise, often arising from frictional vibrations in mechanical systems, significantly impacts performance and user experience. This study investigates the generation of contact noise due to the elastic recovery of surface asperities during spherical contact with rough surfaces. A numerical algorithm was developed to model the noise produced by the elastic–plastic deformation of asperities, incorporating surface roughness and normal load effects. Gaussian-distributed rough surfaces with varying Ra values (0.01–5 μm) were generated to analyze the interaction between a rigid sphere and the rough surface. Contact pressure, asperity deformation, and the resulting acoustic emissions were calculated. The results indicate that, as surface roughness and applied load increase, noise levels within the audible frequency range also rise, exceeding 70 dB under certain conditions. The transition from elastic to plastic deformation significantly influences the noise characteristics. Surfaces with Ra ≥ 0.1 μm showed a 10–15 dB increase in noise compared to smoother surfaces. These findings offer insights into optimizing surface parameters for noise reduction in rolling contact applications, providing a foundation for designing low-noise mechanical systems. Future experimental validations are expected to enhance the practical applications of this analytical framework.
Heart Rate Reduction and the Prognosis of Heart Failure Focused on Ivabradine
Authors: Kiuchi Shunsuke , Ikeda Takanori
Published: February 2025

Cardioprotective medications referred to as the fantastic four are used to treat heart failure (HF). Additionally, ivabradine can also be used if the heart rate (HR) is elevated. An elevated HR is a prognostic factor in HF patients, as well as in the general population. In both HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF), an elevated HR is associated with all-cause mortality, whereas cardiovascular death is only associated with the former. In addition, previous clinical trials revealed that ivabradine was useful only in HFrEF but not in HFpEF. Therefore, ivabradine is indicated for patients only with HFrEF. Moreover, ivabradine increases the stroke volume by ensuring an effective diastolic time as a result of the decreased HR. Including this effect, the introduction of ivabradine allowed for the discontinuation of dobutamine infusion used in HF patients and the uptitration of β-blockers in other reports. Additionally, ivabradine improves exercise tolerance and the subjective symptoms of HF. However, the effects of ivabradine on exercise tolerance remain poorly understood, and prospective clinical trials are underway. While these beneficial effects have been reported, side effects such as photopsia and atrial fibrillation have also been reported. It is important to use ivabradine appropriately in conjunction with standard HF treatment, including quadruple therapy.
Normal Values for Speckle-Tracking Echocardiography in Children: A Review, Update, and Guide for Clinical Use of Speckle-Tracking Echocardiography in Pediatric Patients
Authors: Cantinotti Massimiliano , Capponi Guglielmo , Marchese Pietro , Franchi Eliana , Santoro Giuseppe , Assanta Nadia , Gowda Kritika , Kutty Shelby , Giordano Raffaele
Published: February 2025

Background/Objectives: While speckle-tracking echocardiography (STE) is increasingly gaining acceptance in the medical community, establishing normal pediatric values and interpreting data derived from software provided by various vendors can pose significant challenges. This review aims to present an updated compilation of nomograms pertinent to speckle-tracking echocardiography. Methods: A review of research using three medical engine searches (National Library of Medicine, Science Direct, and Cochrane Library) for Medical Subject Headings (MeSH) and the free text terms “echocardiography”, “STE”, “normal values”, and ”children” was performed and refined by adding the keywords “nomograms”, “z-scores”, and “healthy children”. Results: A total of twenty-five studies were selected for the final analysis. Our research indicated that current nomograms provide adequate coverage of most strain parameters; however, those pertaining to the right ventricle and the atria are less numerous than those for the left ventricle. A noted trend suggests a decrease in strain values with advancing age and increasing body surface area; nevertheless, the relationships observed were weak and nonlinear. The absence of robust correlations between strain values and age and body size parameters hindered the generation of a Z-score possessing sufficient statistical power. Consequently, normal values are primarily represented as mean values accompanied by standard deviation. A comparative analysis of vendors demonstrated good agreement between different versions of the same platform for Philips (except for QLAB 5) and, similarly, between General Electric (GE) and TomTec. The limited data available regarding the comparison between GE and Philips revealed significant findings that warrant further investigation of differences. Conclusions: A comprehensive review and an updated list of current pediatric nomograms for STE measurements have been presented. This may serve as a valuable guide for accurately interpreting STE in pediatric patients with congenital and acquired heart disease.
Beyond the Graft: Recurrence of Interstitial Lung Diseases Post Transplant
Authors: Ntiamoah Prince , Mehta Atul C.
Published: February 2025

Interstitial lung diseases (ILDs) represent a heterogenous group of lung disorders marked by inflammation and/or fibrosis of the lung parenchyma, often leading to progressive shortness of breath and end-stage respiratory failure. In the U.S., ILDs affect approximately 650,000 individuals and cause approximately 25,000–30,000 deaths annually. Lung transplantation (LTx) offers definitive treatment for advanced ILD, with improved survival attributed to advancements in immunosuppression, organ preservation, surgical techniques, and postoperative care. However, disease recurrence in transplanted lungs remains a significant concern. Understanding the risk factors and mechanisms underlying recurrence is critical for refining recipient selection and improving outcomes. This review examines ILD recurrence post LTx and its implications for lung transplantation success.
Quality Assurance of a Hospital-Based Auditory Verbal Intervention for Children with Hearing Loss
Authors: Wischmann Signe , Samar Cecilia Fernandez , Hestbæk Marianne Kyhne , Serafin Stefania , Cayé-Thomasen Per , Percy-Smith Lone
Published: February 2025

Background: Auditory Verbal Therapy (AVT) has spread globally in the past few years due to its proven positive effect as a rehabilitation method for children with hearing loss (HL). In 2023, a three-year hospital-based AV intervention was implemented in Denmark as a government-funded offer to all children with HL. In the present study, we introduce and study a protocol for facilitating this implementation with a specific focus on clinical applicability and quality assurance. Methods: A working group was set up to drive the implementation process and establish a base for clinical collaboration and coproduction. The final protocol included (1) regular workshops and meetings with all AV specialists, (2) the creation of a database to collect data on the effect of the intervention, and (3) mandatory testing of the auditory skills and receptive vocabulary of the children with HL and a screening of their behavioural and emotional status with the Strengths and Difficulties Questionnaire (SDQ). Results: Data from 53 children with a mean age of 6.6 years were analysed in this study. Results from the SDQ showed that the children scored like the Danish norm on both the SDQ total difficulty score and SDQ prosocial score. Conclusions: This study’s findings indicate that children with HL, who participated in three years of hospital-based AV intervention, demonstrate the same emotional and behavioural problems and the same social strengths as their hearing peers. We hope that this study can inspire and guide others who want to implement an AV intervention in a hospital setting.
Maternal Phenylketonuria: Consequences of Dietary Non-Adherence and Gaps in Preconception Care—A Case Report
Authors: Donarska Julia , Szablewska Anna Weronika , Wierzba Jolanta
Published: February 2025

Background: Maternal phenylketonuria (PKU), a metabolic disorder caused by defective phenylalanine hydroxylase activity, requires strict lifelong dietary management to prevent toxic phenylalanine accumulation. During pregnancy, non-adherence to a low-phenylalanine diet can lead to maternal PKU syndrome, resulting in severe neonatal complications, including microcephaly, congenital heart defects, and growth restrictions. Despite advances in metabolic management and preconception care guidelines, adherence remains a significant challenge, particularly among adults transitioning out of pediatric care. This case report examines the clinical consequences of dietary non-adherence in maternal PKU, highlighting the importance of preconception education, metabolic monitoring, and multidisciplinary care in preventing adverse neonatal outcomes. Methods: Using the CARE guidelines, we present the clinical course of a male neonate born to a mother with untreated PKU. Results: The analysis incorporates maternal dietary history, prenatal care details, and neonatal outcomes. Additionally, a review of current literature on maternal PKU management and outcomes contextualizes the findings. The neonate, delivered at 38 weeks via cesarean section, exhibited low birth weight (2150 g), severe microcephaly (head circumference: 28 cm), microphthalmia, and septal heart defects. Maternal dietary non-adherence, beginning in late adolescence, contributed to significantly elevated phenylalanine levels during pregnancy (>20 mg/dL). Prenatal care was initiated in the 23rd week of gestation, delaying dietary intervention. The mother reported limited understanding of the teratogenic risks associated with poor dietary control, which was compounded by gaps in preconception counseling and care continuity. Conclusions: This case underscores the critical need for comprehensive preconception education and lifelong metabolic management for women with PKU. Early and sustained dietary adherence is essential to mitigate neonatal risks. Public health initiatives should prioritize access to preconception care, enhance patient education, and establish robust multidisciplinary support systems to optimize maternal and neonatal outcomes. Addressing barriers such as delayed care initiation and limited dietary support can significantly reduce the burden of maternal PKU syndrome.
Successful Treatment of MEK Inhibitor-Induced Paronychia in Neurofibromatosis with Photodynamic Therapy: A Case Report and Review of the Therapeutic Options
Authors: Ambrogio Francesca , Perillo Teresa , Bonamonte Domenico , De Marco Aurora , Tirone Benedetta , Laface Carmelo , Cazzato Gerardo , Foti Caterina , Mortato Edoardo
Published: February 2025

Background/Objectives: Selumetinib, a MEK1/2 inhibitor, is commonly used for treating neurofibromatosis type 1 (NF1) and is associated with cutaneous side effects such as paronychia and periungual granulomas. These complications can be painful and difficult to manage, often leading to the discontinuation of treatment. The objective of this study was to evaluate the effectiveness of photodynamic therapy (PDT) as a novel treatment for MEKi-induced paronychia in a patient with NF1. Methods: We present a case report of an 18-year-old patient with NF1 who developed painful periungual granulomas on the toenails after 12 months of Selumetinib therapy. PDT was administered using methyl aminolevulinate (METVIX®) as the photosensitizing agent, followed by treatment with a red LED light source (630 nm, 37 J/cm2 for 8 min and 30 s). The patient was followed up for two months post-treatment and then at two years. Results: After a single PDT session, the patient exhibited complete clinical remission of the periungual granulomas and associated pain. No recurrence of the lesions was noted during the two-year follow-up. The patient tolerated the procedure well, reporting only mild discomfort during treatment. Conclusions: PDT appears to be an effective, minimally invasive treatment for Selumetinib-induced paronychia and periungual granulomas. This case demonstrates that PDT can provide a complete resolution of symptoms with a single treatment session, offering an alternative to more invasive procedures. Further studies with larger cohorts are needed to establish PDT as a standard treatment option for this condition.
The Impact of Seasonality on Mental Health Disorders: A Narrative Review and Extension of the Immunoseasonal Theory
Authors: Modzelewski Stefan , Naumowicz Maciej , Suprunowicz Maria , Oracz Aleksandra Julia , Waszkiewicz Napoleon
Published: February 2025

The impact of weather on mental illness is widely debated, but the mechanism of this relationship remains unclear. The immunoseasonal theory suggests that in winter, a T-helper 1 (Th1) response predominates, impairing Prefrontal Cortex (PFC) control, which exacerbates symptoms of depression, while after it, in summer, a Th2 response predominates in immunologically prone individuals, activating cortical and mesolimbic centers, which can exacerbate symptoms of psychosis. In this paper, we aim to describe the validity of this theory through a narrative review of data related to weather and immunology in psychiatry. This review extends existing literature by integrating immunological findings with psychiatric seasonality research, offering a mechanistic perspective that links Th1/Th2 shifts to specific symptom exacerbations. Winter Th1 severity may worsen depression and anxiety, while summer Th2 dominance appears to be associated with exacerbations of schizophrenia, mania, impulsivity, and suicide risk. It is possible that the mechanism of Th1 response potentiation and deterioration of PFC function is common to most psychiatric entities and is nonspecific. This suggests that seasonal immune dysregulation may play a broader role in psychiatric disorders than previously recognized, challenging the idea that seasonality impacts only selected conditions. Characteristic dysfunctions within an individual determine further differences in clinical manifestations. The mechanism of Th2 potentiation may not be limited to mania and psychosis but may also be associated with increased impulsivity and suicide risk. If the immunoseasonal theory is confirmed, selected immunological markers could be used not only in the diagnosis of psychiatric exacerbations but also in predicting symptom fluctuations and tailoring treatment strategies. This could enable more personalized interventions, such as seasonally adjusted medication dosing or targeted anti-inflammatory therapies. While this mechanism seems plausible, further research, especially analyzing markers of inflammatory and anti-inflammatory responses, is needed to better understand and confirm it.
Normative Data of Supraspinatus Muscle Shear Wave Elastography in Healthy Shoulders: A Cross-Sectional Study
Authors: Pérez-Porta Irene , Bueno-Horcajadas Ángel Luis , García-Pérez Fernando , Martínez-Ponce Diana Cecily , Corrales-Mantecón Silvia , Flórez-García Mariano Tomás , Velasco-Arribas María
Published: February 2025

Background/Objectives: In the shoulder region, shear wave elastography (SWE) has been used to obtain data from multiple muscles. However, there is still a lack of evidence regarding normative values for the supraspinatus muscle. The aim of this study is to estimate the range of normative values and to evaluate the relationship between SWE measurements and isometric strength. Methods: A cross-sectional study with 46 healthy subjects was conducted. Data regarding the SWE of supraspinatus muscle at rest and during contraction and isometric elevation strength were collected. Ordinal cumulative probability models were implemented to calculate normative values based on age and sex. Results: There was a significant increase in muscle stiffness from rest to contraction (3.97; 95% CI, 3.52 to 4.43), but there were no differences between males and females. The ordinal regression models showed a relationship between age and SWE at rest (coefficient, 0.08; 95% CI, 0.01 to 0.14), but not during contraction, and there was no significant age–sex interaction. Normative values of the median and 25th and 75th percentiles were provided based on individuals’ age and sex. There was no correlation between SWE measurements and strength values. Conclusions: Normative values for supraspinatus muscle SWE measurements at rest and during contraction were obtained. These data can help clinicians to interpret measurements of their patients with shoulder disorders.
Chronic Post-Traumatic Aortic Isthmus Pseudoaneurysm After Conservative Management of Grade II Injury: Why Is Continuous Follow-Up Mandatory?
Authors: Sica Simona , Tinelli Giovanni , Borghese Ottavia , Dimri Manav , Dvir May , Minelli Fabrizio , Rizza Antonio , Bruno Piergiorgio , Massetti Massimo , Tshomba Yamume
Published: February 2025

Background: Grade I-II blunt traumatic aortic injuries (BTAIs) are typically managed conservatively, but their long-term progression is poorly understood. Chronic pseudoaneurysms may develop years after the injury, often remaining asymptomatic and being incidentally diagnosed. Methods: Two cases of post-traumatic aortic pseudoaneurysms, detected 20 and 25 years following conservatively managed BTAIs, are reported. Additionally, a comprehensive review of all post-traumatic pseudoaneurysms reported in the MedLine (PubMed.gov, U.S. National Library of Medicine, National Institute of Health) database between January 1984 and December 2024 was performed. Results: Both our patients underwent successful hybrid procedures, with no complications at the 1- and 4-year follow-ups. Our literature review identified 37 patients across 22 studies, with 32.4% presenting asymptomatically or incidentally diagnosed through routine imaging, between 1 month and 50 years after the initial trauma. In 37.8% of cases, the patients underwent open or endovascular repair. Conclusions: This case series and literature review emphasize the importance of long-term follow-up for patients with conservatively managed BTAIs, as chronic complications such as aortic pseudoaneurysms can arise decades later. Continuous surveillance is critical to ensure early detection and management.
Osteoporosis and Rheumatoid Arthritis: Mechanisms Underlying Osteoclast Differentiation and Activation or Factors Associated with Hip Fractures
Authors: Miyamoto Takeshi
Published: February 2025

Osteoporosis is defined as a condition of increased risk of fracture due to decreased bone strength. In developed countries, the number of patients with osteoporosis and fragility fractures has been increasing in recent years due to the growing elderly population, posing a social challenge not only to fracture patients and their families but also to the social healthcare economy. Osteoporosis can be divided into two categories: primary osteoporosis caused by aging or menopause and secondary osteoporosis caused by metabolic or inflammatory diseases or drugs such as glucocorticoids. The majority of patients have primary osteoporosis, and the pathogenesis of postmenopausal osteoporosis and factors associated with fragility fractures in the elderly have been elucidated. On the other hand, rheumatoid arthritis (RA) is one of the causes of secondary osteoporosis. RA is a chronic inflammatory disease characterized by joint swelling and destruction. Most often, treatment focuses on suppressing these symptoms. However, physicians should be aware of the risk of osteoporosis in RA patients, because (1) RA is a chronic inflammatory disease, which itself can be a risk factor for osteoporosis; (2) glucocorticoids, which are sometimes administered to treat RA, can be a risk factor for osteoporosis; and (3) patients with RA are becoming older, and aging is an osteoporosis risk factor. A comprehensive understanding of the pathogenesis of osteoporosis and its fragility fractures requires elucidating the mechanisms underlying osteoclast activation, which drives their development. Furthermore, identifying the factors associated with fragility fractures is essential. This review summarizes the pathogenesis of osteoporosis, the factors associated with fragility fractures, and the associations between RA and osteoporosis development.
Hydrodynamic Circulation Modelling in the Marine Environment
Authors: Androulidakis Yannis , Makris Christos
Published: February 2025

Modelling hydrodynamic circulation in the marine environment is one of the most challenging topics in the marine sciences [...]