bluuebunny/crossref_metadata_2025 huggingface dataset:
Homophase bilayers: more than just the sum of their monolayers
Authors: Feuerbacher M.
Published: February 2025

Twisted homophase bilayers, stacks of two rotated monolayers such as graphene, exhibit remarkable physical properties absent in their constituent monolayers. The structure of bilayer systems is dominated by a moiré effect and critically depends on the twist angle. Quiquandon & Gratias [Acta Cryst. (2025), A81, 94–106] develop a crystallographic framework for rigorous description of the structure of bilayers, including systems without a coincidence lattice. They offer a set of tools that can describe the structure of any arbitrary bilayer system and enable the connection with its physical properties.
A Structured, Collaborative and Open Access Database of Food Policies in Europe: Introducing EU F‐POD
Authors: Benedetti Elena , Biondi Beatrice , De Nicolò Silvia , Mazzocchi Mario
Published: February 2025

This paper presents a new, open‐access database of food policies, the European Food Policy Database (EU F‐POD). It is a comprehensive and collaborative on‐line resource, and goes beyond a mere list of food policies by offering a structured collection of food policies classified by goals, targets, and instruments, drawing from existing and validated taxonomies. It consists of an organized and cohesive body of national and international laws, regulations, and provisions related to the food area, to facilitate consultation, interpretation and policy analysis. More specifically, it may help identify normative gaps, contradictions or overlaps between existing rules, and regulatory differences between states, fostering discussions among various multi‐sectoral actors. The EU F‐POD database is comprehensive in scope, ensuring the inclusion of policies for all objectives, targets, and instruments within its framework. We describe the EU F‐POD database, its structure, definition, and data collection strategy, including also some extraction examples to demonstrate the potential of such a tool to users. EU F‐POD was designed as an open access tool, so that a supervised, collaborative effort among researchers and experts can guarantee its future sustainability and updating.
Behaviors in the Slaughter Corridor, Carcass, and Meat Quality Traits of Anatolian, Italian, and Italian × Anatolian Crossbreds (F1) Water Buffaloes
Authors: Özdemir Seyfi , Kecici P. Dilara , Yalcintan Hulya , Ekiz Bulent
Published: February 2025

This study aimed to assess the slaughter corridor behavior, carcass characteristics, and meat quality of Anatolian, Italian, and Italian × Anatolian (F1) crossbred water buffaloes. The research involved Anatolian (n = 8), Italian (n = 10), and Italian × Anatolian crossbred (n = 8) water buffaloes, all of which had been used for milk production on a commercial farm before being culled and slaughtered. While water buffalo pass through the slaughter corridor, both the behaviors of the animals and the handling actions of the stockpersons were video recorded. Genotype had no significant influence on the scores for animal behaviors (AWBEH) and stockperson actions (AWACT). There were significant differences in carcass weight among the genotypes (p < 0.001), with the genotypes ranked from smallest to largest in carcass weight as follows: Anatolian, crossbred (F1), and Italian water buffaloes. Additionally, the EUROP fatness score was higher in carcasses from the Italian genotype compared to the Anatolian water buffaloes. Mean pH24h was lower in Italian water buffaloes than Anatolian ones. On the other hand, fat and meat color variables were not influenced by animal genotype. In conclusion, crossbreeding between Italian and Anatolian water buffaloes may increase carcass weight in crossbred (F1) genotype without altering meat quality or temperament.
Integrating data to assess occupancy patterns of an endangered bumble bee
Authors: Ellis Kristen S. , Otto Clint R. V. , Bailey Larissa L. , Smith Tamara A. , Choy Steven , Hatch Lauren
Published: February 2025

There is growing interest in integrating community science data with structured monitoring data to estimate changes in distribution patterns of imperiled species, including pollinators. However, significant challenges remain in determining how unstructured community science data should be incorporated into formal analyses of species distributions. We developed a dynamic framework for combining community science and structured monitoring data of bumble bees to estimate changes in occupancy of rusty‐patched bumble bees (Bombus affinis), a federally endangered species in the United States. We applied traditional metapopulation theory and accounted for imperfect detection to estimate site‐specific extirpation risk and colonization rates across the known distribution of B. affinis in the Upper Midwest (USA). Despite a 144% increase in presence‐only detections from 2017 to 2022, occupancy probabilities and the estimated number of occupied sites remained static or declined slightly across a 4‐state region during this period. Our results provide preliminary evidence that the probability of local extirpation risk of B. affinis increased in response to drought, but that effect was tempered with a high number of neighboring patches occupied by B. affinis (i.e., rescue effect). Our framework can be used by managers to track population recovery goals for B. affinis and other bumble bees of conservation concern. In addition, our study highlights the importance of accounting for imperfect detection and addressing spatial sampling biases in bumble bee monitoring efforts, particularly those for which a portion of the monitoring data are generated from community science projects.
Effectiveness of Interventions to Improve Coping and Resilience of Frontline Mental Healthcare Professionals Towards Workplace Violence on Psychiatric Wards—A Systematic Review
Authors: Doedens Paul , Kiel‐Clayton Laura M. , Daams Joost G. , de Haan Lieuwe
Published: February 2025

Workplace violence (WPV) is a harmful phenomenon happening in psychiatric wards. Despite preventive efforts, mental health services cannot eliminate WPV. If mental health services can increase the coping and resilience of frontline mental healthcare professionals (FMHPs) towards WPV, it could contribute to their mental health and well‐being. To perform a systematic review of comparative studies on interventions to improve coping and resilience towards WPV aimed at FMHPs working in psychiatric wards. Systematic review on comparative intervention studies, with electronic searches in MEDLINE, Embase, Cochrane CENTRAL, PsycINFO and CINAHL. We registered our protocol in PROSPERO (CRD42022373757). Performing a meta‐analysis seemed not to be feasible, so we provided a narrative summary of the included studies, methodological quality and results. We included nine studies, with interventions focused on positive behavioural support, resilience enhancement and aggression management training. Most studies reported positive effects, though with a moderate to high risk of bias. Positive behavioural support, biofeedback and aggression management training are promising interventions in our review. Biofeedback interventions and positive behavioural support could be valuable additions to existing training programmes to improve coping and resilience. Future studies should focus on demonstrating the robustness of effects, the mechanism of increasing coping and resilience regarding WPV and the development and implementation of effective interventions.
Effectiveness of Physical Activity Interventions on Acute Inpatient Mental Health Units on Health Outcomes: A Systematic Review
Authors: Graham Michael , Hodgson Philip , Fleming Laura , Innerd Alison , Clibbens Nicola , Hope Wendy , Aston Luke , Glascott Michelle
Published: February 2025

Physical activity has been shown to improve outcomes across a range of physical and mental health conditions as an adjunct or standalone intervention for many mental disorders. The outcome and effectiveness of physical activity in acute mental health units are less well understood. Systematic searches were completed in three databases (CINAHL, MEDLINE, and PsycINFO). Eligible studies were published between March 2013 and February 2024, included a physical activity intervention for inpatients on acute mental health units, and reported primary quantitative, qualitative, or mixed methods data for patients between 18 and 65 years of age. Participants must have had a primary diagnosis of a mental health condition with or without physical comorbidities. Data extracted included reported components of the interventions and individual health outcomes. Methodological quality and risk of bias was assessed using the mixed methods appraisal tool and cochrane risk of bias tools for randomised and non‐randomised controlled trials. Twelve studies were identified for review (combined sample size of 560). Seven studies reported improvements in mental health outcomes, and two reported improvements in physical health outcomes in favour of the intervention group. There was a large variation between intervention characteristics and clarity in reporting. Assessment and measurement of outcomes contributed to a high risk of bias among included studies due largely to self‐assessment. Physical activity interventions on AMHUs have the potential to contribute to improvements in mental and physical wellbeing beyond that experienced from usual treatment practices (e.g., medication). However, further work is needed in the specific context of acute mental health units regarding the development and evaluation of physical activity interventions.
Perceptions, Contagion, and Civil Unrest
Authors: Abi‐Nassif Christophe , Islam Asif Mohammed , Lederman Daniel
Published: February 2025

This paper investigates the impact of citizens' perceptions of economic and political conditions on nonviolent uprisings. For a global sample of high‐income (Europe) and developing economies (Sub‐Saharan Africa, South Asia, East Asia and the Pacific, Latin America, and Middle East and North Africa), on average, negative perceptions of political conditions have a significant positive effect on the number of anti‐government protests and general strikes while negative perceptions of economic conditions do not, even after accounting for actual economic conditions and the quality of governance. This holds for European and high‐income countries but not for developing economies where both economic and political perceptions matter. The international contagion of protests attenuates this regional heterogeneity, possibly implying that in Europe, the incidence of uprisings in nearby countries tends to generate protests at home through its effect on political perceptions. This invites the possibility of countries perennially facing vicious cycles of protests. Overall, the effects of political perceptions and protest contagion are robust to the inclusion of numerous control variables, seemingly valid instrumental variables, alternative count‐data estimators, and sample composition.
Improving neurodiversity awareness in school students: a scoping review protocol
Authors: Hiremath Mandira , Freeman Nerelie , Al-Shawsh Mohammed , Ure Alexandra
Published: February 2025

Objective:

This scoping review aims to map and characterize existing programs present in mainstream schools internationally that are targeted at improving children’s awareness about neurodiversity.

Introduction:

Neurodiversity is a term used to describe human neurocognitive heterogeneity. Increased understanding and awareness about neurodiversity among school students has the potential to improve general student health and well-being. However, there is currently no standardized approach to raising children’s awareness about neurodiversity in schools and the associated literature is diffuse.

Inclusion criteria:

Literature will be included if it describes and/or evaluates programs designed to be delivered in mainstream schools aimed at increasing awareness of neurodiversity among students aged 5 to 18 years, regardless of geographical location. Published, unpublished, and gray literature from 2013 to the present will be considered.

Methods:

An academic literature search will be conducted across 5 databases: MEDLINE, CINAHL, PsycINFO, Embase, and ERIC. A gray literature search will also be performed across sources including ProQuest and Google Scholar, as well as targeted websites, expert opinion, and reference lists of relevant peer-reviewed literature. Articles will be selected based on eligibility criteria. Data extraction will be conducted independently by 2 extractors using a pre-determined form documenting study methods, population, interventions, and outcomes. Analysis and presentation of results will be reported according to the study objectives.

Review registration:

Open Science Framework https://osf.io/6b378
Microscopic Spray Characteristics of Dimethyl Ether and Diesel in Ambient Conditions
Authors: Agarwal Avinash Kumar , Kumar Vikram , Mehra Shanti , Valera Hardikk
Published: February 2025

A spray study is essential to understand the combustion and emissions from internal combustion engines (ICEs). It supports engine performance optimization and tailpipe emission reduction. The characteristics of the fuel spray determine the fuel–air mixing and essential requirements for efficient combustion. Thus, fuel spray characterization is necessary to understand the spray atomization and droplet velocity. Fuel properties, ambient conditions, fuel injection pressure, and injector nozzle design influence the spray characteristics. This experimental study used a mechanical injector to perform a comparative analysis of the microscopic spray characterization for dimethyl ether (DME) and diesel at fixed injection pressure and ambient conditions. Spray characterization was performed inside a constant volume spray chamber (CVSC) to assess spray droplet velocity and size distributions using a phase Doppler interferometer (PDI). Results showed that the DME spray droplet sizes were smaller than diesel due to differences in test fuel properties such as surface tension and viscosity. The number of smaller droplets in DME spray surpassed the numbers for diesel. This study showed that DME spray has exceptional evaporation/atomization properties, enhancing the fuel–air mixture's homogeneity, which improves the combustion, performance, and emissions of DME-fueled engines.
Multi-objective prediction of energy consumption of steam turbine system based on 660MW ultra-supercritical coal-fired unit
Authors: Wang Qiwei , Ma Xiaojing , Yu Kaifeng , Kari Tusongjiang
Published: February 2025

This study is aimed at the issue of energy waste resulting from significant fluctuations in the energy consumption of steam turbine system under the flexible peaking demands of coal-fired units. To accurately predict the energy consumption of these units across a wide range of load conditions, the energy consumption prediction model of eXtreme Gradient Boosting (XGBoost) steam turbine system is established. Firstly, the model variables are chosen based on the existing measurements and an analysis of the power plant. Meanwhile, the energy consumption dataset and its distribution are calculated by the Consumption Rate Analysis (CRA). Secondly, the model feature variables are screened by the Maximum Information Coefficient (MIC) and Kendall rank correlation coefficient, and the energy consumption prediction model of 660 MW steam turbine system based on XGBoost is established. Finally, the Bayesian Optimization (BO) algorithm is employed to determine the best hyperparameters of XGBoost model. Moreover, three energy consumption prediction models of MIC-BO-XGBoost are built for multi-objective prediction: independent modeling, chain modeling 1, and chain modeling 2. Chain modeling 2 is capable of forecasting the energy consumption of the steam turbine system in ultra-supercritical coal-fired units with greater precision under wide variations of load. It can provide the basis for the operation optimization of steam turbine system of subsequent coal-fired units.
Starship Super Heavy acoustics: Comparing launch noise from Flights 5 and 6
Authors: Gee Kent L. , Pulsipher Noah L. , Kellison Makayle S. , Hart Grant W. , Mathews Logan T. , Anderson Mark C.
Published: February 2025

This Letter analyzes launch noise from Starship Super Heavy's Flights 5 and 6. While Flight-5 data covered 9.7–35.5 km, the stations during Flight 6 spanned 1.0–35.5 km. A comparison of A-weighted and unweighted maximum and exposure levels is made between flights and with an updated environmental assessment (EA). Key findings include: (a) the two flights' noise levels diverge beyond 10 km, (b) EA models overestimate A-weighted metrics, and (c) the acoustic energy from a Starship launch is equivalent to 2.2 Space Launch System launches or ∼11 Falcon 9 launches. These measurements help predict Starship's noise levels around Kennedy Space Center.
Amplicon sequencing and culture-dependent approaches reveal core bacterial endophytes aiding freezing stress tolerance in alpine Rosaceae plants
Authors: Marian Malek , Antonielli Livio , Pertot Ilaria , Perazzolli Michele
Published: February 2025

Wild plants growing in alpine regions are associated with endophytic microbial communities that may support plant growth and survival under cold conditions. The structure and function of endophytic bacterial communities were characterized in flowers, leaves, and roots of three alpine Rosaceae plants in Alpine areas using a combined amplicon sequencing and culture-dependent approaches to determine the role of core taxa on plant freezing stress tolerance. Amplicon sequencing analysis revealed that plant tissue, collection site, and host plant are the main factors affecting the richness, diversity, and taxonomic structure of endophytic bacterial communities in alpine Rosaceae plants. Core endophytic bacterial taxa were identified as 31 amplicon sequence variants highly prevalent across all plant tissues. Psychrotolerant bacterial endophytes belonging to the core taxa of
Duganella
,
Erwinia
,
Pseudomonas
, and
Rhizobium
genera mitigated freezing stress in strawberry plants, demonstrating the beneficial role of endophytic bacterial communities and their potential use for cold stress mitigation in agriculture.

IMPORTANCE

Freezing stress is one of the major abiotic stresses affecting fruit production in Rosaceae crops. Current strategies to reduce freezing damage include physical and chemical methods, which have several limitations in terms of costs, efficacy, feasibility, and environmental impacts. The use or manipulation of plant-associated microbial communities was proposed as a promising sustainable approach to alleviate cold stress in crops, but no information is available on the possible mitigation of freezing stress in Rosaceae plants. A combination of amplicon sequencing, culture-dependent, and plant bioassay approaches revealed the beneficial role of the endophytic bacterial communities in alpine Rosaceae plants. In particular, we showed that culturable psychrotolerant bacterial endophytes belonging to the core taxa of
Duganella
,
Erwinia
,
Pseudomonas
, and
Rhizobium
genera can mitigate freezing stress on strawberry seedlings. Overall, this study demonstrates the potential use of psychrotolerant bacterial endophytes for the development of biostimulants for cold stress mitigation in agriculture.
Amplicon microbiome sequencing of compost from conventional and redesigned compost buckets
Authors: Klosko Elizabeth , Hutchison Elizabeth , Almomani Ahmad
Published: February 2025

Here, we report using amplicon sequencing to assess microbial growth in both conventional and pyramid-shaped compost buckets. Proteobacteria and Firmicutes were the primary bacterial phyla present, and Ascomycota the primary fungal phylum present. Bucket shape did not significantly affect microbial community composition.
Complete genome sequence of chicken anemia virus from a field outbreak in Bangladesh
Authors: Akter Marjana , Hasan S. M. Nazmul , Jeba Nurejunnati , Mozumder Anandha , Mou Moslema Jahan , Araf Yusha , Mia Roni , Akter Sharmin , Salauddin Md. , Rahman Md Zaminur , Hossain Muhammad Shahdat , Saha Sukumar , Islam Tofazzal , Hossain Md. Golzar
Published: February 2025

Chicken anemia virus (CAV) causes immunosuppression and increased mortality in chickens globally, including Bangladesh. This report provides the complete genome sequence of a CAV strain from a recent outbreak on a Bangladeshi layer farm, contributing to the limited availability of published data on the CAV genome in the country.
Refining the genome of alkylbenzene-degrading
Rhodococcus
sp. DK17 and comparative analysis with genomes of its deletion mutants
Authors: Jeon Jehyun , Kim Dockyu , Kim Eungbin , Lee Yung Mi
Published: February 2025

Rhodococcus
sp. strain DK17 degrades various alkylbenzenes, including
o
-xylene, making it a potential biocatalyst for the production of fine chemicals. DK17 carries the degradative genes on linear mega-plasmids. Here, we present the refined DK17 genome and analyze the genetic variations in UV-induced mutants DK176 and DK180.
Complete genome sequences of 14 lytic bacteriophages against
Acinetobacter baumannii
from Kenya belonging to the genera
Obolenskvirus
and
Friunavirus
Authors: Mwai Felix , Kigen Collins , Makobe Celestine , Mutai Ivy , Georges Martin , Odoyo Erick , Gachoya Moses , Musila Lillian
Published: February 2025

We report the genome sequences of 14
Acinetobacter
phages isolated in Kenya, belonging to the genera
Friunavirus
and
Obolenskvirus
. They have double-stranded DNA with genome sizes between 39 and 45 kb and G + C content from 38% to 39%. The genomes contain 56 to 93 predicted coding sequences.
Coexistence of
tmexCD-toprJ
,
bla
NDM-1
, and
bla
PME-1
in multi-drug-resistant
Pseudomonas juntendi
isolates recovered from stool samples
Authors: Liu Wugao , Liu Yi , Jin Jing , Wu Ningjun , Wu Weiping , Qu Chunsheng
Published: February 2025

Pseudomonas juntendi
has received limited research attention, yet strains carrying multi-drug resistance genes pose a threat to global public health. We aimed to characterize the genome of two fecal-derived strains of
Pseudomonas juntendi
, both harboring
tmexCD-toprJ
,
bla
NDM-1
, and
bla
PME-1
on the chromosome, recovered from two patients. Average nucleotide identity (ANI) analysis showed that L4008hy and L4046hy were remarkably similar. They showed high levels of resistance to aztreonam, imipenem, ciprofloxacin, amikacin, piperacillin–tazobactam, ceftazidime–avibactam, and polymyxin B in antimicrobial susceptibility testing using agar dilution method and broth microdilution methods. Additionally, an integrative and conjugative element (ICE) similar to ICE
6660
was detected on the chromosome, which contains all resistance genes and has a relatively complete transfer module, and potential transfer mechanisms were identified. Phylogenetic analysis of
P. juntendi
reveals the genomic diversity of the species and sheds light on environmental–human transmission.

IMPORTANCE

Up to now, research on
Pseudomonas juntendi
is still very limited. Our findings suggest that
P. juntendi
commonly carries diversity resistance genes on chromosomes and is stably inherited, highlighting the need for further studies on the antimicrobial properties of this bacterium. The coexistence of
tmexCD-toprJ
,
bla
NDM-1
, and
bla
PME-1
on the chromosome in
P. juntendi
was reported for the first time. The identified integrative and conjugative element (ICE) contains all the identified resistance genes and serves as a vector for resistance gene transfer between bacteria.
P. juntendi
, which harbors multi-drug resistance genes, particularly those encoding carbapenemases, acts as a reservoir of resistance genes. Its spread in clinical settings poses additional challenges to treatment.
Zircon geochronology records frictional weakening and restrengthening during emplacement of the Sevier gravity slide, southwest Utah (USA)
Authors: Braunagel Michael , Malone David , Hacker David , Biek Robert , Rivera Tiffany , Loffer Zachary , Holliday McKenna , Griffith W. Ashley
Published: February 2025

The exceptional transport distance of long-runout landslides requires a mechanism for reduced frictional resistance to sliding. Here, we use zircons in the frictional wear products generated during emplacement of the Sevier gravity slide (southwest Utah, USA) to identify how the source of material evolves with transport distance and discuss how changes in frictional strength are reflected in this data set. Across the ∼38 km runout distance of the slide, basal wear products have unique zircon age distributions, or tectonic chronofacies, which capture changes in material sources and indicate poor mixing across the structure. Over much of this distance, basal material forms by breakdown of slide blocks, with little input from the underlying substrate. This suggests the basal slide plane has low frictional strength, buffering the substrate from deformation. We also observe a decrease in the mean age of zircons within the basal layer with increasing transport distance as abrasive wear is localized at the base of the overlying block during slip. Toward the distal portion of the slide, the amount of substrate zircons in the basal layer increases, consistent with greater frictional coupling during deceleration. Tying the unique tectonic provenance recorded by zircons within the basal layer of the Sevier gravity slide to larger deformation styles, we argue that the observed spatial evolution in frictional strength is consistent with widespread fluid pressurization.
Supplemental Material: Mantle transition zone water triggers lithospheric weakening and spreading
Authors: Qian Sheng-Ping , Gazel Esteban , al. et
Published: February 2025

Details of the study’s sample information, analytical methods, analytical data, and data plots.
Supplemental Material: Metamorphic evidence of the Kuunga orogeny in South China: High-pressure pelitic granulites and gneisses from the Gaozhou Complex
Authors: Li Chao , Tong Laixi , al. et
Published: February 2025

The supplemental material includes tables of rock and mineral compositions, geothermobarometry results, and zircon dating data. Figures show garnet and biotite compositions and metamorphic pseudosections. This material supports the main study by providing detailed data and analytical methods, reinforcing conclusions on high-pressure metamorphism and tectonics.
Unilobed rotational flap for traumatic scalp soft tissue loss
Authors: Hakeem Abdul , Khan Vakil , Sridhar Rachith , Anwer Majid
Published: February 2025

Soft tissue injuries of the head and neck are the most common injuries encountered in trauma emergency department, accounting for over 50% of injuries. Scalp soft tissue loss continues to pose a challenge for reconstruction due to limited skin mobility in the area. We present a case report involving two patients with traumatic soft tissue loss affecting the scalp who underwent rotational flap closure with favourable cosmetic results. Case 1: A male patient in his early 30s arrived at the emergency department with a history of road traffic accident, sustaining head injury. Soft tissue loss was noted on the left side of the fronto-parietal region, exposing the frontal bone. A rotational flap cover was performed using the unilobed technique. He was discharged on postoperative day 10. Case 2: A female patient in her late 40s presented to the emergency department with a history of a road traffic accident. Soft tissue loss was noted on the left side of the forehead, exposing the frontal bone. A unilobed rotational flap was successfully achieved with satisfactory cosmetic outcomes.
A complication of emergency caesarean section: delayed diagnosis of vesicouterine fistula with associated necrotising soft tissue infection and small bowel obstruction
Authors: Nagpal Aayush , Dholpuria Sakshi , Singh Devender , Chumber Sunil
Published: February 2025

Vesicouterine fistula (VUF) is a rare complication following caesarean sections, often presenting with the classic triad of Youssef syndrome (urinary incontinence with cyclic haematuria (menouria) and amenorrhoea) but sometimes without typical symptoms. We report a case of a woman in her early 30s who developed VUF after an emergency lower segment caesarean section, complicated by necrotising soft tissue infection (NSTI) of the left forearm. One week post-surgery, she presented with NSTI symptoms and haematuria, which were managed with broad-spectrum antibiotics and debridement. During her hospital stay, she experienced persistent urinary incontinence and burning micturition. Evaluation of these symptoms revealed acute intestinal obstruction, and a contrast CT indicated vesicouterine communication. Surgical exploration confirmed a perforated uterus with possible retained placental tissue, and a VUF. Subtotal hysterectomy and bladder repair were performed, and her recovery was smooth. This case underscores the importance of considering VUF in patients with post-caesarean urinary symptoms, despite its rarity.
Posterior reversible encephalopathy syndrome (PRES) with bilateral tonic pupils, vitreous haemorrhage and chorioretinopathy secondary to HELLP syndrome
Authors: Priya Sweksha , Gupta Abhishek , Singh Prabhakar , Chattopadhyay Mahuya
Published: February 2025

Visual disturbances in pregnancy can be highly variable and range from mild symptoms of photopsia, transient blurring of vision, field defects and rarely total blindness. Pre-eclampsia/eclampsia, posterior reversible encephalopathy syndrome (PRES), haemolysis, elevated liver enzymes and low platelets (HELLP) syndrome are all complications of pregnancy. Both PRES and HELLP are associated with visual loss and share common pathogenic mechanisms, such as the breakdown of the endothelial blood–brain barrier in PRES or the blood–retinal barrier in HELLP. We report a case of HELLP syndrome who presented with PRES with bilateral tonic pupils, vitreous haemorrhage and chorioretinopathy leading to bilateral blindness. Timely diagnosis with early supportive treatment resulted in the improvement to near-normal vision. This single case describes four different mechanisms of vision loss in the case of HELLP syndrome, that is, PRES along with bilateral tonic pupils, vitreous haemorrhage and hypertensive chorioretinopathy which have not been reported in the literature to date.
Mucosal angioleiomyoma: mucoscopic findings adding value to diagnosis
Authors: Fruchtman Harry , Peterson Danielle , Diamond Scott , Safai Bijan
Published: February 2025

This article presents a female patient in her 40s who presented with a tender violaceous bump on her upper right lip. Our primary differential diagnosis was an arteriovenous malformation. Punch biopsy revealed the lesion to be an angioleiomyoma (ALM). The punch biopsy was sufficient for the complete removal of the lesion, and the lesion did not recur to date. There were no complications. We discuss the dermatoscopic description of an ALM and its clinical picture.
Obesity with developmental delay in infancy: a rare cause not to miss—pseudohypoparathyroidism
Authors: Ahmed Anees F M , Thobias Rine Benson , Thirumavalavan Nilavan , Thangamani Santhosh , Nair Lal D V
Published: February 2025

Mild developmental delay in infants with obesity is often disregarded, attributing it to increased weight by parents and practitioners. We report an infant with obesity and gross motor delay after the first 6 months of age, seizures and obstructive sleep apnoea. The child was diagnosed with pseudohypoparathyroidism (PHP) and was medically managed with parenteral calcium, vitamin D and magnesium. Appropriate early interventions by developmental therapists addressing the developmental domains coordinated by developmental paediatricians and relevant drug and diet management corrected the delay. The child is followed up for soft tissue calcifications, kidney functions and skeletal health. This case highlights the importance of early recognition and comprehensive management of correctable conditions like PHP by developmental specialists rather than addressing only the developmental aspect of it.
Immune-mediated TTP secondary to checkpoint inhibitor use in a patient with stage IV melanoma
Authors: Parekh Deevyashali , Liu Michelle , Subedi Yadu Nanda , Basnet Alina
Published: February 2025

We describe the case of a middle-aged man with stage IV metastatic melanoma receiving ipilimumab/nivolumab combination therapy. Two weeks after receiving his third cycle of treatment, he presented to the emergency department with altered mental status, acute kidney injury, fever, anaemia with labs suggestive of haemolysis and a platelet count of 10. He had a calculated plasmic score of 6. A review of the peripheral smear confirmed the presence of schistocytes. He was treated with emergent plasma exchange, high-dose steroids, rituximab and caplacizumab throughout his hospitalisation. He had a good response to this treatment and was ultimately discharged to home 15 days later with a platelet count of greater than 200 and a high ADAMTS13 level in plasma (undetectable on admission).

A growing body of literature suggests the possibility of thrombotic thrombocytopenic purpura (TTP) secondary to immunotherapy use, and thus a high index of suspicion is needed in these patients for timely, life-saving treatment initiation.
Dental management of a young patient with Papillon-Lefèvre syndrome
Authors: Syed Fakeha Azhar , Arshad Hamza , Batool Itrat , Khalid Taimur
Published: February 2025

This report presents the case of a girl in early adolescence with symptoms suggestive of Papillon-Lefèvre syndrome (PLS) who remained undetected with poorly managed periodontitis until the advanced stage of alveolar resorption, leading to multiple tooth loss due to periodontitis. All remaining teeth had grade III mobility and negligible alveolar support, necessitating extraction. Conventional complete dentures were provided for functional and aesthetic rehabilitation. The literature review conducted to evaluate various dental treatment strategies and their outcomes for patients diagnosed with PLS at the deciduous or mixed dentition stage indicates that periodontal debridement with regular supportive periodontal therapy, antibiotic regimens and oral hygiene maintenance reinforcement can preserve teeth until late adolescence.
Congenital duodenal obstruction due to duodenal atresia along with annular pancreas, intestinal malrotation and preduodenal portal vein
Authors: Balasubramanian Satya , Ramasundaram Madhu , Sundaram Jegadeesh
Published: February 2025

A newborn delivered by emergency lower segment caesarean section at 35 weeks of gestation suspected duodenal atresia antenatally with maternal ultrasonogram showing double bubble sign. After birth, the baby was stabilised and taken up for laparotomy and was found to have duodenal atresia along with intestinal malrotation, annular pancreas and preduodenal portal vein (PDPV). Ladd’s procedure with Kimura’s duodenoduodenostomy was performed. In a similar previously reported case study, a gastrojejunostomy was conducted;5here, we were able to do a duodenoduodenostomy which is a better physiological anastomosis than a gastrojejunostomy since we achieved adequate duodenal mobilisation after the Ladd’s procedure. Postoperatively, the patient recovered well, tolerated feeds, passed stools and gained adequate weight.
The persistence of failure in water, sanitation and hygiene programming: a qualitative study
Authors: Barrington Dani J , Sindall Rebecca C , Chinyama Annatoria , Morse Tracy , Sule May N , Beale Joanne , Kativhu Tendai , Krishnan Sneha , Luwe Kondwani , Daudi Malolo Rossanie , Mcharo Onike , Odili Anthony C , Ravndal Kristin T , Rose Jo , Shaylor Esther , Wozei Eleanor , Chikwezga Faida , Evans Barbara E
Published: February 2025

Introduction

Unsafe water, sanitation and hygiene (WASH) causes millions of deaths and disability-adjusted life-years annually. Despite global progress towards universal WASH, much of WASH programming continues to fail to improve health outcomes or be sustainable in the longer term, consistently falling short of internal performance indicators and sometimes negatively impacting the well-being of local stakeholders. Although sector experts in high-income countries have often provided explanations for such failures, the opinions of those implementing WASH programming at the ground level are rarely published.

Methods

In 2020, we purposively recruited 108 front-line WASH professionals in Malawi, South Africa, Tanzania and Zimbabwe to participate in 96 in-depth interviews, explaining why they believe WASH failure persists. Through participatory analysis, including framework analysis with additional axial coding and member-checking of our findings, we determined the core reasons for WASH failure as perceived by participants.

Results

Interviewees reported poor engagement and commitment of intended users, unrealistic and idealistic expectations held by funders and implementers, and a general lack of workforce and financial capacity as significant contributors to WASH failure. Our analysis shows that these issues stem from WASH programming being implemented as time and budget-constrained projects. This projectisation has led to reduced accountability of funders and implementers to intended users and a focus on measuring inputs and outputs rather than outcomes and impacts. It has also placed high expectations on intended users to sustain WASH services and behaviour change after projects officially end.

Conclusions

Our findings imply that WASH programming needs to move away from projectisation towards long-term investments with associated accountability to local governments and longitudinal measurements of WASH access, as well as realistic considerations of the needs, abilities and priorities of intended users. Funders need to reconsider the status quo and how adjusting their systems could support sustainable WASH services.
Insights from the NHS England Clinical Entrepreneur Programme
Authors: Holland Brown Tamsin Mary , Sullivan Polly , Sullivan Poppy
Published: February 2025

The clinical entrepreneur programme (CEP) plays a role in supporting, reatining and empowering NHS staff by fostering innovation within the healthcare system. Established to address systemic barriers that often lead clinicans to leave the NHS to pursue entrepreneurial endeavours, the CEP enables staff to develop and implement transformative healthcare solutions while remaining within the NHS workforce. This not only benefits the innovators but strengthens the NHS by promoting a culture of continuous improvement and adaptation to emerging medical technologies.

A strength of the CEP is its inclusivity of a diverse range of clinical and non-clinical staff and students. Student Selected Component (SSC) projects have also been supported cultivating digital health competencies, quality improvement awareness, research skills and translational capabilities.

Beyond individual development, the CEP contributes to broader NHS transformation through initiatives such as NHS InSites and collaboration with Health Innovation Networks (HINs) and NHS Trusts, aiming to contribute to real-world adoption of solutions.

With over 1000 alumni and growing, the CEP has retained and reintegrated healthcare professionals within the NHS, while supporting new innovations to reach patients. This reinforces a progressive NHS ecosystem that values and integrates clinical innovation and entrepreneurship.
UK-based clinical testing programme for somatic and germlineBRCA1/2, ATMandCDK12mutations in prostate cancer: first results
Authors: Evans D Gareth , Burghel George , Schlecht Helene , Sachdeva Ashwin , Hudson Andrew , Parikh Omi , Lalloo Fiona , Bristow Robert , Woodward Emma R
Published: February 2025

Objective

GermlineBRCA2pathogenic variants (PVs) are known to cause ~4% of prostate cancer, but other homologous repair genes,BRCA1, ATM, PALB2and Lynch syndrome genes are also involved. Our objective was to assess the contribution of germline and somatic gene variants to prostate cancer.

Methods and analysis

We reviewed germline/tumour DNA testing from 450 localised or metastatic prostate cancer cases in NW England mainly from 2022 to 2024. ORs for additional genes used detection rates in controls from the BRIDGES study.

Results

450 cases underwentBRCA1/2germline/somatic testing with 2 germline PVs inBRCA1(0.4%) and 27 inBRCA2(6.0%)—total 6.4% and 6/328 (1.8%) inATM. There were 280 metastatic prostate cancer samples tested with 11 (4%) somaticBRCA2and 7 (2.7%) somaticATMidentified with 1 somaticBRCA1. Total PVs inBRCA2were 31/280 (11%), including germline and indeterminate.CDK12somatic PVs were found in 9/220 (4.1%), including 2 digenic withBRCA2and 2 which were biallelic.

Conclusion

In this continuous clinical evaluation,BRCA2is the most frequently identified prostate cancer gene with over 10% involvement in metastatic disease.BRCA2andCDK12somatic PVs do not appear to be mutually exclusive.BRCA1does not appear to be a significant contributor to prostate cancer progression.
Depression among individuals with disabilities: a community-based cross-sectional study in Nepal
Authors: Ghimire Apekshya , Mishra Durga Kumari Khadka
Published: February 2025

Objective

To assess the prevalence of depression and its associated factors among individuals with disabilities.

Design

Cross-sectional study.

Setting

Community-based study conducted in Ilam municipality, Nepal, from October to November 2019.

Participants

The study was conducted among 164 people with physical, hearing and vision-related disabilities. Participants were selected through a simple random sampling method using the sampling frame obtained from Ilam municipality.

Main outcome measure

Depression and its associated factors among people with disabilities. Depression was assessed via a validated Nepali version of the Hospital Anxiety and Depression Scale. Data collection was based on a pretested structured questionnaire.

Results

The prevalence of depression was 39% among people with disabilities, and 29.9% of the respondents were in borderline depression. In an unadjusted analysis, depression was significantly (p<0.05) associated with comorbidities, absence of medical intervention, severe disabilities and disabilities acquired at birth. After adjusting for individual-level factors (age, sex, education, employment and physical activities), the level of disability and treatment accessibility were significantly associated with depression. After adjusting for family and community-level factors (economic status, experience of violence and social participation), depression remained significantly associated (p<0.05) with having comorbidities, absence of medical intervention and presence of very severe disabilities. When adjusting for both individual-level and community-level factors, the level of disability continued to show a significant association with depression (OR 6.36 (moderate vs mild), 2.11 (severe vs mild) and 13.3 (very severe vs mild), overall p-value of 0.045). Across all three adjusted models, the level of disability was significantly associated with depression (p<0.05).

Conclusion

Depression is one of the major global public health concerns, with people with disabilities being particularly vulnerable. Ensuring the health and well-being of people with disabilities requires focused attention and strategic planning, emphasising disease prevention, health promotion and improved access to care.
Accuracy of machine learning methods in predicting prognosis of patients with psychotic spectrum disorders: a systematic review
Authors: Tay Jing Ling , Ang Yun Ling , Tam Wilson W S , Sim Kang
Published: February 2025

Objectives

We aimed to examine the predictive accuracy of functioning, relapse or remission among patients with psychotic disorders, using machine learning methods. We also identified specific features that were associated with these clinical outcomes.

Design

The methodology of this review was guided by the Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy.

Data sources

CINAHL, EMBASE, PubMed, PsycINFO, Scopus and ScienceDirect were searched for relevant articles from database inception until 21 November 2024.

Eligibility criteria

Studies were included if they involved the use of machine learning methods to predict functioning, relapse and/or remission among individuals with psychotic spectrum disorders.

Data extraction and synthesis

Two independent reviewers screened the records from the database search. Risk of bias was evaluated using the Quality Assessment of Diagnostic Accuracy Studies tool from Cochrane. Synthesised findings were presented in tables.

Results

23 studies were included in the review, which were mostly conducted in the west (91%). Predictive summary area under the curve values for functioning, relapse and remission were 0.63–0.92 (poor to outstanding), 0.45–0.95 (poor to outstanding), 0.70–0.79 (acceptable), respectively. Logistic regression and random forest were the best performing algorithms. Factors influencing outcomes included demographic (age, ethnicity), illness (duration of untreated illness, types of symptoms), functioning (baseline functioning, interpersonal relationships and activity engagement), treatment variables (use of higher doses of antipsychotics, electroconvulsive therapy), data from passive sensor (call log, distance travelled, time spent in certain locations) and online activities (time of use, use of certain words, changes in search frequencies and length of queries).

Conclusion

Machine learning methods show promise in the prediction of prognosis (specifically functioning, relapse and remission) of mental disorders based on relevant collected variables. Future machine learning studies may want to focus on the inclusion of a broader swathe of variables including ecological momentary assessments, with a greater amount of good quality big data covering longer longitudinal illness courses and coupled with external validation of study findings.

PROSPERO registration number

The review was registered on PROSPERO, ID: CRD42023441108.
Optimising timely and safe oxygen delivery systems for enhanced patient care: a quality improvement project at Wallaga University Comprehensive Specialized Hospital, 2024
Authors: Bayisa Gedefa , Edessa Dechassa , Limenu Kebena , Deyasa Meskerem , Gobana Ganna , Obsa Dereje , Tilahun Temesgen , Enkossa Gurmessa , Takele Amsalu , Gonfaa Lammii , Abera Tsega , Dereje Olbirat , Regasa Misganu Teshoma
Published: February 2025

In a hospital setting, the supply and utilisation of oxygen are crucial for high-quality healthcare. This quality improvement project aimed to increase the rate of timely and safe oxygen delivery from 30% to 75% at Wallaga University Comprehensive Specialized Hospital from 1 January to 30 June 2024.

Using the Plan-Do-Study-Act (PDSA) cycle, the project team identified root causes through fishbone and driver diagrams. Key interventions included staff orientation on safe handling of oxygen devices, clear job descriptions for compliance, improved handover processes between shifts, regular maintenance and inventory checks, increasing the number of oxygen cylinders, using hospital vehicles for transport and establishing a communication system with suppliers for timely requests.

Results showed that the inventory of regular oxygen delivery devices improved to 76%, with equipment checks conducted 65% of the time. Emergency preparedness reached 20%, and onsite training for staff achieved 75%. Oxygen usage monitoring was nearly perfect at 99%, with delivery times reduced to 1 day for 70% of orders. A standard protocol for oxygen supply and use was established, resulting in a significant increase in timely and safe oxygen delivery from 30% to 75%.

This project effectively optimised oxygen supply management, highlighting the importance of proactive management, communication and continuous monitoring in building a reliable oxygen therapy service. Improvements in inventory management and delivery efficiency were facilitated by a dedicated dashboard, standardised operating procedures and comprehensive staff training.