bluuebunny/crossref_metadata_2025 huggingface dataset:
Nutritional Diet Knowledge and Barriers to Dietary Recommendations Adherence Among Diabetic Patients in Central Region, Ghana: A Cross‐Sectional Study
Authors: Atuahene Margaret , Quarshie Frank , Gorleku Philip N. , Taylor Rahmat , Gorleku Maurice O. , Eshun Daniel , Asante Martin O. , Nyasem Francis K. , Otchere Joseph
Published: February 2025

Background and Aim

Diabetes mellitus (DM) presents significant health risks due to elevated blood sugar levels, necessitating adherence to dietary recommendations for effective management. However, diabetic patients often encounter barriers hindering their adherence to dietary guidelines. This study sought to investigate the determinants of good nutritional diet knowledge and adherence to dietary recommendations beyond the barriers faced by diabetic patients in Ghana.

Methods

This was a cross‐sectional prospective study that collected data using a tested and structured questionnaire from 100 diabetic patients from January 2024 to June 2024. Data was entered and analyzed using Microsoft Excel 2019 and SPSS (version 26). Bivariate and multivariable logistic regression was used to identify associations between dependent and independent variables. Statistical significance was set at a p‐value ≤ 0.05.

Results

The mean age of the participants was 56.97 ± 11.98 years. Overall, about 74.44% had good nutritional diet knowledge. Being female (adjusted odds ratio [AOR] = 0.65, 95% confidence interval [CI] = [0.41–0.83]), and having complete tertiary education (AOR = 2.05, 95% CI = 0.96–3.82) were the factors associated with good nutritional diet knowledge. About 39% stopped their dietary plan without informing their doctor, and 60% stopped when they felt their condition was under control. The overall adherence to dietary recommendations was poor as only 48% adhered to the recommendations. Being female (AOR = 0.83, 95% CI = [0.49–2.11]), being 75 years or older (AOR = 2.74, 95% CI = 0.99–4.14), and having good nutritional knowledge (AOR = 2.80, 95% CI = 1.61–4.16) were the factors associated with good adherence to dietary recommendation.

Conclusion

The participants had good nutritional diet knowledge but poor adherence to dietary recommendations. Being female and having completed tertiary education were the determinants of good nutritional diet knowledge while being female, being 75 years or older, and having good nutritional knowledge were the factors associated with good adherence. The leading adherence barriers were the discomforts associated with cooking meals that meet their dietary requirements, dietary restrictions, and financial difficulties.
Examining the Diffusion of Software‐as‐a‐Service (SaaS)‐Based Cloud Model Among Indian Firms: A Risk‐Based Perspective
Authors: Dutta Shubhendu
Published: February 2025

The study aims to identify the specific perceived risks that dissuade organizations from continuing the use of SaaS. Along with the inhibiting factors, the study also examines the role of IT governance in post adoption of SaaS. Based on the premise of prospect theory and resource based view, a mixed method study (quantitative study followed by a semi structured interview) was conducted with the IT leaders of SaaS consuming organizations to understand the phenomenon in the context. From our study, we found that among the various risks, financial risks and security and privacy risks have a greater influence on perceived risk and consequently on the intention to continuance use of SaaS. The study also reveals that the organizations are skeptical about increasing their usage level of SaaS, and they would do so on specific cases, which have less asset specificity. Further, it also indicates that regulated organizations are less inclined to increase their SaaS usage. To the best of our knowledge, this study is the first one on post adoption use of SaaS among Indian firms using the risk perspective.
All Good Things Come to an End: Emerging Strategic Patterns of Sunset Foundations
Authors: Hengevoss Alice , von Schnurbein Georg
Published: February 2025

Sunset foundations—foundations that exist for a limited time—are gaining increased attention in the discussion on impactful philanthropy. The idea is that having a limited organizational life span allows for greater impact. However, there is little knowledge on how leaders of these foundations navigate this sunset phase. Based on organizational development theory, we take a first step in investigating the causes that lead to the decision to sunset. We apply a multiple‐case study approach to analyze an international sample of 11 sunset foundations. We find that depending on the cause for the decision to close as well as the logic through which the remaining endowment is spent down, four distinct ideal‐typical sunset strategies emerge. The proposed strategic patterns refer to as Impact Accelerators, Urgency Responders, Resource Spenders, and Fade‐outs. This classification adds to a better understanding of the strategic and managerial requirements leaders of sunset foundations should consider and the intended impact goals connected to a sunset.
Early‐Onset Macrosomia, Advanced Brain Maturation, and Gonadoblastoid Testicular Dysplasia in a Fetus With a PTEN Variant
Authors: Lynch Danielle C. , Lee Anna F. , Castle Alison M. R.
Published: February 2025

We report a case of a male fetus with early‐onset macrosomia and a pathogenic variant in PTEN identified on a macrocephaly and overgrowth sequencing panel. The pregnancy ended at 25 weeks gestation. On post‐mortem examination, macrosomia was confirmed, and maturation of the brain was approximately 3 weeks ahead of that of the visceral organs. There was microscopic evidence of gonadoblastoid dysplasia, which is an extremely rare finding and has never been associated with PTEN hamartoma tumor syndrome (PHTS). To our knowledge, this is the first report of a prenatal phenotype with a heterozygous germline variant in PTEN.
cvrip: A Visual GUI Ripping Framework
Authors: Huang Heji , Qian Ju , Jia Wenduo , Jin Yiming
Published: February 2025

GUI ripping explores the graphical user interface of an application to build a model which can express the application behavior. The ripped GUI model is useful in various software engineering tasks. Traditional GUI ripping techniques depend on the underlying GUI frameworks to provide the GUI structure information. They are difficult to work across platforms or on nonnative applications where the GUI structure information cannot easily be obtained. This work introduces cvrip, a visual GUI ripping framework, to address the problem. cvrip visually analyzes the GUI screen for ripping and does not rely on the underlying GUI frameworks. We introduce many new techniques to enable efficient visual GUI ripping, for example, a YOLO v5‐based model to detect executable widgets, a state recognition acceleration method for fast model updating, and several GUI exploration strategies taking the characteristics of imperfect visual analysis into account. Experiments are conducted to evaluate many technique choices in visual GUI ripping and compare the solution with the traditional style ripping. The results show that cvrip can get competitive exploration coverage compared to traditional approaches. This suggests visual GUI ripping is a direction worthy of more future studies.
Group Membership in Capital and Labour Earnings
Authors: Charles Aurelie
Published: February 2025

This chapter provides evidence of how group biases aggregate in the process of financial accumulation and the way they affect economic exchange over time. What can we learn on group behaviour from the demographics of capital and labour earnings historically, regionally, nationally and across borders? At the national level, what can we learn from the interdependence of earning trends between groups on the social entitlement rules to financial flows? Being able to map out the rules of legitimacy that are context-specific is key to understanding the tacit rules of human interactions and financial accumulation. Looking at the most visible (data-wise) part of the market economy, the relationships between the historical trends of labour and capital earnings are investigated by gender, race, nationality and occupation for the US, UK and France. It shows that there a two-tier economic system where earnings go in the hands of a few dominant groups at the top of the income distribution, while leaving labour earners with stagnant real-wages.
Patriarchy Has Produced the Patriacene: Can Gender Challenge Its Persistence?
Authors: Spring Úrsula Oswald
Published: February 2025

This chapter reviews the evolution of thePatriacene(1The author thanks an anonymous reviewer for the suggestion of the “Patriacene”, which better explains the links between the destruction of society and nature and violent patriarchal behaviour.) over the past 6000 years. The ‘system of rule’ changed from maternal clans to fratrilineal kinships, god-kings, pater familias, colonisation, capitalism, and multinational corporations. Patriarchy is based on violence, wars, and exploitation of humans and nature. Facing these imperialist powers, people in the Global South are helpless to limit the extraction and mistreatments. Thus, women experimented radical alternatives with gift economy, the Aymara’sCosmovisionof‘living well’ and theZapatista’s ‘leading by obeying’. They reversed violent accumulation by understanding that ‘there is no better life’, promoting subsistence production, inclusive education, traditional health care, and diverse productive activities. Their bottom-upcultural options against the Patriaceneare improving well-being, social care, local cohesion, sorority, and ecosystem restoration.
Einführung
Authors: Brecher Christian , Ott Gritt
Published: February 2025

Die spanende Bearbeitung von Bauteilen ist nach wie vor für Formgebungsprozesse alternativlos. Die verfolgte Problemlösestrategie orientiert auf Maßnahmen, die unter thermisch instationären Verhältnissen die Einhaltung der Bearbeitungsgenauigkeit bei gesteigerter Produktivität sicherstellen, ohne dass es zusätzlicher Energieaufwendungen für die Temperierung bedarf.
Effiziente transiente thermo-elastische Simulation von Werkzeugmaschinen
Authors: Naumann Andreas
Published: February 2025

Das Design und die prozessspezifische Optimierung von Werkzeugmaschinen erfordern eine detaillierte Modellierung des thermischen Verhaltens der Maschinenkomponenten. Insbesondere der Produktionsprozess, aber auch die zugehörigen Umgebungsbedingungen sind ein wesentlicher Bestandteil dieser Modelle. Die Kopplung der Maschinenkomponenten und die Parametrierung der Kopplungsmodelle stellen dabei eine besondere Herausforderung dar.
Thermische Vorsteuerung
Authors: Wenkler Eric , Ihlenfeldt Steffen
Published: February 2025

Dieses Kapitel zeigt, wie realitätsnahe aufgaben- und maschinenspezifische Verluste prognostiziert werden können. Die Verlustprognosen können bereits in der Planungsphase zur Reduktion thermischer Schwankungen eingesetzt werden, wodurch geringe Verbesserungen des Temperaturganges möglich werden. Deutlich mehr Wert besteht jedoch in der aufgezeigten Simulation der thermischen Beharrung und deren Nutzung für eine bedarfsgerechte Kühlstrategie.
Bewertungsmethodik
Authors: Wiemer Hajo , Fickert Axel , Gißke Carola
Published: February 2025

Die in den vorherigen Abschnitten dargestellten Lösungsverfahren decken ein breites Spektrum von Korrektur- und Kompensationsverfahren thermischer Fehler ab. Sie setzen an unterschiedlichen Punkten der thermo-elastischen Wirkungskette an. Einige Verfahren erfordern einen Eingriff in die Struktur der Werkzeugmaschine, andere arbeiten steuerungsbasiert. Während einige Verfahren auf Modelle und Simulationen zurückgreifen, sind umfassende Messungen die Voraussetzung für andere.
Effiziente Verhaltensanalyse von Strukturbauteilen
Authors: Penter Lars , Schroeder Steffen
Published: February 2025

Eine begründete Bewertung, Auswahl und Auslegung von steuerungsbasierten Korrekturmaßnahmen erfordert eine breite Wissensbasis. Grundlage dafür sind Analysen des thermo-elastischen Maschinenverhaltens hinsichtlich der Ursache-Wirkungs-Zusammenhänge. Im Folgenden wird eine effiziente Modellierungs- und Simulationsmethodik, speziell für die thermische Analyse von Werkzeugmaschinen vorgestellt.
Modellierung von Kühlschmierstoffwirkung im Zerspanprozess
Authors: Bredthauer Marc , Liu Hui , Helmig Thorsten , Topinka Lukas , Brier Steffen , Regel Joachim , Mattfeld Patrick , Bergs Thomas , Barth Sebastian , Meurer Markus , Kneer Reinhold
Published: February 2025

Bei Zerspanungsprozessen wird die mechanische Energie in den Scher- und Reibzonen zwischen Werkzeug und Werkstück weitgehend in Wärme umgewandelt. Dadurch entstehen außerordentlich hohe mechanische und thermische Spannungen, die zu einer thermisch bedingten Verschiebung der Werkzeugspitze und damit zu einer geringeren Bearbeitungsgenauigkeit führen. Während der Zerspanung verursacht die Prozesswärme einen erheblichen Wärmeeintrag in das Werkzeug und sein Spannsystem.
Diskussion
Authors: Reimer Maximilian Vincent
Published: February 2025

Die Ergebnisse der Arbeit werden diskutiert und der zentrale Mehrwert herausgestellt.
Gravity and a universal cutoff for field theory
Authors: Caron-Huot Simon , Li Yue-Zhou
Published: February 2025

Abstract

We analyze the one-loop effects of massive fields on 2-to-2 scattering processes involving gravitons. It has been suggested that in the presence of gravity, any local effective field theory description must break down at the “species scale”. We first observe that unitarity and analyticity of the amplitude indeed imply a species-type bound GΛ
d−2
N ≤ O(1), where N counts parametrically light species and Λ is an energy scale above which new unknown ingredients must modify the graviton amplitude. To clarify what happens at this scale, we contrast the partial wave decomposition of calculated amplitudes with that of some ultraviolet scenarios: string theory and strongly interacting Planck-scale physics. Observing that the latter exhibit a markedly stronger high-spin content, we define nonperturbatively the high-spin onset scale Λo, which coincides with the string scale and higher-dimensional Planck scale in respective examples. We argue that, generally, no local field description can exist at distances shorter than 1/Λo.
Heavy neutron stars from light scalars
Authors: Balkin Reuven , Serra Javi , Springmann Konstantin , Stelzl Stefan , Weiler Andreas
Published: February 2025

Abstract

We study how light scalar fields can change the stellar landscape by triggering a new phase of nuclear matter. Scalars coupled to nucleons can develop a non-trivial expectation value at finite baryon density. This sourcing of a scalar reduces the nucleon mass and provides an additional energy density and pressure source. Under generic conditions, a new ground state of nuclear matter emerges, with striking implications for the configuration of stellar remnants. Notably, neutron stars in the new ground state can be significantly heavier than QCD equations of state currently predict. We also find hybrid stellar compositions and stable self-bound objects with sizes as small as the Compton wavelength of the scalar. We discuss several specific realizations of this scenario: the QCD axion and lighter generalizations thereof and linearly or quadratically coupled scalar fields effectively equivalent to a class of scalar-tensor modification of gravity. Lastly, we explore phenomenological signatures relevant to electromagnetic and gravitational wave observations of neutron stars, such as atypical compactness and instability gaps in radii.
Bundesweiter Vergleich zu heilkundlichen Maßnahmen durch Notfallsanitäterinnen und Notfallsanitäter
Authors: Dittmar Michael S. , Kraus Marina , Graf Bernhard M.
Published: February 2025

Hintergrund

Die heilkundliche Tätigkeit durch Notfallsanitäterinnen und Notfallsanitäter ohne notärztliche Anwesenheit basiert v. a. 1.) auf einer Delegation durch z. B. die Ärztliche Leitung Rettungsdienst oder 2.) auf eigenverantwortlicher Heilkundeausübung nach § 2a Notfallsanitätergesetz. Beide Möglichkeiten unterscheiden sich u. a. hinsichtlich der Verantwortung für die Indikationsstellung. Diese Arbeit gibt erstmals einen bundesweiten Überblick, wer welche Verantwortung im Rahmen der Behandlungsvorgaben für Notfallsanitäterinnen und Notfallsanitäter trägt.

Material und Methoden

Die Behandlungsalgorithmen zu 5 Krankheitsbildern wurden für alle Bundesländer hinsichtlich ihrer geografischen Gültigkeit, der Deklaration sowie des objektiven Charakters als Delegation der Ärztlichen Leitung Rettungsdienst oder entsprechend verantwortlicher Ärztinnen oder Ärzte (ÄLRD-Delegation) oder Heilkundeausübung (§ 2a NotSanG) und der Erstreckung auf Betäubungsmittel ausgewertet. Die Datenerhebung fand im Zeitraum von Dezember 2020 bis Juni 2022 statt.

Ergebnisse

Es wurden 112 Algorithmen mit 403 Einzelmaßnahmen analysiert. Für 11 Bundesländer wurden landesweit gültige, in 5 Ländern regional abweichende Behandlungsvorgaben gefunden. Der ÄLRD-Delegations- oder § 2a NotSanG-Status war in lediglich 40 % der einzelnen Maßnahmen explizit deklariert. Diese Deklaration zeigte in 93 % eine Übereinstimmung mit dem objektiven Charakter der Maßnahme. Eine eigenständige oder eigenverantwortliche Betäubungsmittelgabe durch NotSan ist in 6 Ländern vorgesehen.

Diskussion

In der Mehrheit der für NotSan vorgesehenen Maßnahmen ist nicht ersichtlich, ob diese in ÄLRD-Delegation oder nach § 2a NotSanG angewendet werden sollen. Eine entsprechende Deklaration durch die Ersteller könnte hier für mehr Klarheit bezüglich der Verantwortlichkeiten sorgen. Sowohl eine ÄLRD-Delegation als auch eine Betäubungsmittelgabe ohne Arztanwesenheit ist nicht in allen Bundesländern etabliert. Aufgrund der sich stetig weiterentwickelnden Rechtslage stellen sich die untersuchten Endpunkte in einzelnen Regionen mittlerweile anders dar.

Graphic abstract
Urinary Metabolomic Profile is Minimally Impacted by Common Storage Conditions and Additives
Authors: Weldon Kelly C. , Panitchpakdi Morgan , Caraballo-Rodríguez Andrés Mauricio , Wolfe Alan J. , Dorrestein Pieter C. , Brubaker Linda , Burnett Lindsey A.
Published: February 2025

Background

Metabolomics reflects the molecular communications within biological systems. Urine is a noninvasive biofluid, rich in metabolites that serve as potential biomarkers for human health and disease. The impact of storage conditions and DNA stabilizers for urine samples in metabolomic studies remain unclear.

Objective

To evaluate the impact of common storage conditions and the presence of a DNA stabilizer, AssayAssure® (Thermo Scientific), on the metabolite content of voided human urine.

Methods

We assessed the urinary metabolite composition under different storage conditions and with the addition of AssayAssure® to determine its effect on metabolomic analysis.

Results

Urinary metabolite composition remained consistent across different storage conditions. However, the addition of AssayAssure® significantly altered the metabolic profile due to adduct formation. Despite these alterations, the identification of parent metabolites was not compromised, and biological differences were still distinguishable.

Conclusion

These findings suggest that urine biobanked under the tested storage conditions is suitable for metabolomic analysis. The addition of AssayAssure® does not hinder the detection of parent metabolites, although it may affect the overall metabolic profile.
Unmarked simple length spectral rigidity for covers
Authors: Aougab Tarik , Lahn Max , Loving Marissa , Miller Nicholas
Published: February 2025

We prove that every closed, connected, orientable surface S of negative Euler characteristic admits a pair of finite-degree covers which are length isospectral over S but generically not simple length isospectral over S. To do this, we first characterize when two finite-degree covers of a connected, orientable surface of negative Euler characteristic are isomorphic in terms of which curves have simple elevations. We also construct hyperbolic surfaces X and Y with the same full unmarked length spectrum but so that for each k, the sets of lengths associated to curves with at most k self-intersections differ.
The role of resveratrol in delivering antioxidant, anti-inflammatory, and anti-apoptotic defense against nephrotoxicity generated by titanium dioxide
Authors: Basak Feyza , Kusat Tansu , Kahraman Tahir , Ersan Yusuf
Published: February 2025

Titanium dioxide is a prevalent food ingredient for human ingestion. We investigated the nephrotoxic effects of titanium dioxide in Wistar albino rats subjected to oral exposure for 14 days. The rats were categorized into four groups (n = 8): (1) control (saline solution), (2) exposure to titanium dioxide (30 mg/kg), (3) exposure to resveratrol (100 mg/kg), and (4) exposure to both titanium dioxide and resveratrol. The investigations revealed that the administration of titanium dioxide resulted in considerable histological abnormalities and a significant prevalence of apoptotic cells marked by caspase-3 in the titanium dioxide group, with a markedly elevated quantity and strong staining of cells reacting with 4-HN across the tissue in the kidney. Blood serum assessments revealed that BUN and creatinine levels were elevated in the titanium group relative to the other three groups, with a reduction in these levels observed in the group receiving both titanium and resveratrol (P < 0.05). The assessment of oxidative stress markers in kidney tissue revealed that GSH-Px and SOD activity considerably decreased in the titanium dioxide group relative to the other experimental groups. In contrast, MDA levels increased markedly (P < 0.05). The activities of GSH-Px and SOD were significantly elevated in the group receiving both titanium dioxide and resveratrol compared to the titanium dioxide-only group (P < 0.05). The analysis of inflammation markers TNF-α and IL-6 revealed a substantial rise in their levels in the titanium dioxide group compared to the other groups (P < 0.05).
Re-screening adherence to multi-target stool DNA test for colorectal cancer: real-world study in a large national population
Authors: Greene Mallik , Pew Timo , Dore Michael , Ebner Derek W. , Ozbay A. Burak , Johnson William K. , Kisiel John B. , Fendrick A. Mark , Limburg Paul
Published: February 2025

Purpose

Adherence to colorectal cancer (CRC) re-screening is essential to maximize screening effectiveness. This study assessed adherence to a multi-target stool DNA (mt-sDNA) test among previous users in the USA across different payer types.

Methods

Data from Exact Sciences Laboratories LLC (01/01/2023–12/31/2023) were used. Insured patients (45–85 years) who were shipped an mt-sDNA test during the data coverage period and had previously completed mt-sDNA screening with a negative result ≥ 2.5 years prior were included. Mt-sDNA re-screening adherence rate and mean time to test return were compared across payer types, and their associations with patient characteristics were assessed using multivariable regression models.

Results

Of 793,567 patients (50–75 years: 89.0%; female: 62.0%), the re-screening adherence rate was 84.0% (from 66.5% for Medicaid to 90.2% for Medicare); mean (standard deviation) time to test return was 20.7 (20.8) days (from 19.2 [19.7] for Medicare to 22.4 [22.2] for Medicaid). Characteristics associated with higher likelihood of re-screening adherence included older ages (odds ratio [OR] = 1.25 and 1.11 for 65–75 and 76–85 years, respectively, relative to 45–49 years), living in a ZIP code with higher median household income (OR = 1.80 for > $200,000 relative to < $50,000), full digital outreach (OR = 1.84 relative to no digital outreach), and ≥ 3rd rounds of screening (OR = 2.44 relative to 2nd round of screening).

Conclusion

Adherence to CRC re-screening with mt-sDNA test was high across payer types, with sustained adherence in later rounds of screening. Strategies to improve re-screening rates in subgroups associated with lower re-screening adherence are warranted.
Chronic pain management for older adults in ambulatory care
Authors: Koios Daniela , Wenzel Arlett , Kuhnert Ronny , Rank Christina , Riemer Thomas Günther , Glawe Magdalena , Kreutz Reinhold , Dräger Dagmar
Published: February 2025

Chronic pain is a major health challenge in older populations and approaches to improve ambulatory care are urgently needed. We conducted a pragmatic trial to test whether staff-directed interventions can improve chronic pain management in older community-dwelling adults and thereby improve their pain situation. Participants of 22 ambulatory nursing services (clusters) were allocated to 3 study arms: I1 (individual intervention with recommendations for each participant’s physician and a newly trained pain nurse), I2 (digital training offered for participants’ physicians and nursing staff) and CG (control group). Survey-based face to face interviews were held at the participants’ homes. Descriptive statistics, ANOVA, and χ2-tests were utilized for data analysis. At baseline, 190 and at follow-up 144 participants were analyzed (24% dropout). Overall, the interventions were only implemented by a small proportion of involved staff. We found significant changes in documented nursing care in I1 but improvements regarding pain medication appropriateness or pain situations of participants could not be achieved. Structural challenges like time and staff shortages as well as the lack of billing options in ambulatory care were identified as major obstacles to substantially improve pain care. Policy makers need to enable appropriate compensation models for chronic pain care at home to enable aging in place for a growing population of older adults.
In-hospital outcomes of catheter ablation in atrial arrhythmias: a nationwide analysis of 2,901 patients with adult congenital heart disease compared to 787,995 without
Authors: Grundmann Sebastian , Kaier Klaus , Maier Alexander , Rilinger Jonathan , Steinfurt Johannes , Stiller Brigitte , Westermann Dirk , von zur Mühlen Constantin , Jäckel Markus
Published: February 2025

Background

Advances in pediatric cardiology and congenital heart surgery have increased the adult population with congenital heart disease (CHD), now facing long-term complications like atrial arrhythmias. Given the limited data and safety concerns in this unique and vulnerable patient group, this study analyzes in-hospital outcomes of atrial catheter ablation in CHD patients versus non-CHD patients from a German nationwide real-world registry.

Methods

Using health records, all atrial catheter ablation procedures in Germany from 2008 to 2021 were analyzed. After adjustment for confounders, safety performance endpoints were compared between patients with and without CHD.

Results

From 2008 to 2021, 790,896 patients underwent right or left atrial catheter ablation in Germany. Of these, 1004 patients were classified as simple CHD, 1,054 patients as moderate CHD and 843 patients as complex CHD. Age at time of procedure was lower with increasing complexity of the CHD. Atypical atrial flutter (5.5% vs. 21.8%; p < 0.001) and other atrial tachycardias (21.2% vs. 42.2%; p < 0.001) occurred more often in patients with complex CHD compared to patients without. Combined ablation in both atria was more often performed in complex CHD. Despite higher complexity, in-hospital mortality (< 0.2%) and other investigated complications were rare. After adjustment for baseline characteristics, type of arrhythmia and ablation location, the relative risk for serious adverse events (combination of mortality, stroke, intracerebral bleeding or pericardiocentesis) did not show a significant difference for patients with CHD.

Conclusion

Even in patients with CHD, complications are rare and after adjustment, no differences were identified concerning serious adverse events. Therefore, an ablation should not be generally avoided in patients with CHD due to concerns about complications although an individualized evaluation of the anatomy must be taken into account.

Graphical Abstract
Sex-related hormonal variances and clinical outcomes in TAVR patients
Authors: Mousa Basha Mustafa , Al-Kassou Baravan , Weber Marcel , Beiert Thomas , Bakhtiary Farhad , Zimmer Sebastian , Nickenig Georg , Goody Philip Roger , Shamekhi Jasmin
Published: February 2025

Background

Sex-related differences play a pivotal role in disease manifestation and outcome in patients with cardiovascular disease, including aortic valve stenosis (AS). However, data regarding sex-related hormonal differences in AS patients undergoing transcatheter aortic valve replacement (TAVR) is lacking.

Objectives

We aimed to assess sex-related hormonal variances in patients with severe symptomatic AS and to evaluate the impact of these hormonal differences on the clinical outcomes after TAVR.

Methods

In a total of 361 TAVR patients, we assessed the hormonal status, including cortisol, parathormone (PTH), insulin-like growth factor 1 (IGF-1), dehydroepiandrosterone sulfate (DHEAs), estradiol, progesterone and testosterone prior to TAVR. We compared baseline characteristics and outcome data according to sex and hormonal parameters. The primary endpoint was 1-year all-cause mortality according to sex; secondary endpoints included the risk of 1-year all-cause mortality in conjunction with hormone levels, with pre-specified cut-off values.

Results

Rates of 1-year all-cause mortality were comparable between the sexes (p = 0.285). Cox regression analysis revealed significant associations between 1-year mortality and levels of cortisol (HR 2.30; p = 0.007), PTH (HR 2.09; p = 0.019), DHEA-S (HR 0.47; p = 0.016), and IGF-1 (HR 0.42; p = 0.004) in the overall cohort. Elevated cortisol levels (p = 0.011), decreased DHEA-S levels (p = 0.007), and lower IGF-1 levels (p = 0.017) were significantly associated with higher rates of 1-year all-cause mortality in males. Conversely, higher PTH levels were significantly associated with an increased risk of 1-year mortality in females (p = 0.012).

Conclusion

Sex-specific hormonal differences significantly impact the prognosis of severe AS patients undergoing TAVR. Elevated cortisol levels and decreased DHEA-S and IGF-1 levels in males, as well as higher levels of PTH in females, were associated with an increased mortality risk.
Foodservice interventions and their influence on nutritional outcomes and satisfaction of adult oncology patients—a conceptual replication
Authors: Steer Belinda , Black Jacqueline , Cecchini Laura , Choo Clarissa , Dvarakesa Ana , Hill Martha , Ho Athena , Kennett Georgia , Woltersdorf Andre , Zilber Emily , Porter Judi
Published: February 2025

Background

Foodservices are vital components of care for oncology patients across all settings. This conceptual replication aimed to explore the influence of foodservice interventions across a range of nutritional outcomes and the satisfaction of hospitalised and ambulatory adult oncology patients.

Methods

The review protocol was registered with PROSPERO (CRD42023447351). Six databases were searched using search terms associated with the intervention and population. There were no restrictions on language or publication date. The inclusion criteria were applied to titles and abstracts, then full-text papers. All included papers were assessed for study quality. Outcome data were synthesised narratively, and vote counting was conducted based on the direction of effect.

Results

Eight studies testing the influence of a foodservice intervention were included. Interventions included technology advancement, high energy high protein meals and snacks, and patient-focused foodservice models. Study quality was assessed as positive for seven of the studies. Of nutritional outcomes reported (energy and protein intake, body weight, muscle mass), improvements were seen in all but one study. Except in one study, where reported, patient satisfaction improved as a result of the intervention.

Conclusion

Original research into the impact of systematic foodservice interventions has expanded in recent years. This conceptual replication found that the implementation of small, frequent high-energy high-protein meals and snacks, and patient-focused foodservice models may improve nutritional outcomes and satisfaction in both inpatient and ambulatory settings. Further large-scale research that explores multiple interventions and cost-effectiveness is required.
Safety and outcome of elective synthetic mesh repair for incisional ventral hernias in immunosuppressed patients – a retrospective propensity-score-matched analysis
Authors: Saidy Ramin Raul Ossami , Callister Yvonne May , Dittrich Luca , Eurich Dennis , Denecke Christian , Pratschke Johann , Raakow Jonas
Published: February 2025

Introduction

Incisional hernia remain an important complication after abdominal surgery. Repair often includes use of synthetic mesh, but certain risk factors for complication after mesh hernia repair have been described. Among these, immunosuppression due to co-existing conditions is hypothesized to increase postoperative complications, but data is scarce and contradicting. Therefore, the aim was to assess outcome after mesh hernia repair in immunosuppressed patients.

Material & methods

Patients with and without immunosuppression undergoing elective incisional hernia repair at our clinic between 2010 and 2019 were analyzed in this retrospective study. Pre-existing conditions, details of immunosuppression, postoperative course and outpatient follow-up for hernia recurrence were collected and impact of clinical variables on outcome was analyzed. Propensity score matching was performed for comparison of cohorts.

Results

Immunosuppression was associated with increased postoperative complications in the overall cohort of 732 patients undergoing incisional ventral hernia repair in univariate but not multivariate analysis (p = 0.036 and p = 0.25, respectively). Overall postoperative complications did not differ between patients with immunosuppression compared to the matched collective. However, use of > 2 immune suppressive agents and immunosuppression history > 48 months showed significant impact on postoperative complications in univariate and multivariate analysis (p = 0.003/p = 0.023 and p = 0.018/p = 0.03, respectively). Age (< 60 years), duration of surgery (> 120 min), midline hernia according to EHS classification and number of immunosuppressive agents administered were identified as important risk factors for recurrence in immunocompromised patients (p = 0.045, p = 0.023, p = 0.012 and 0.049, respectively).

Conclusion

In this study, overall safety with desirable outcome of mesh implantation in immunosuppressed patients was documented. Furthermore, data suggested significant impact of number of immunosuppressive agents as a predicator of postoperative complications in this collective, possibly enabling risk stratification within this subgroup.
Epilepsy as primary tumor manifestation correlates with patient status, age, and tumor volume but not with survival in elderly glioblastoma patients: a retrospective bicentric analysis
Authors: Demetz Matthias , Hecker Constantin , Salim Hamza Adel , Krigers Aleksandrs , Steinbacher Jürgen , Machegger Lukas , Kerschbaumer Johannes , Buchta Melanie , Pöppe Johannes , Geiger Philipp , Spinello Antonio , Kraus Theo F. J. , Griessenauer Christoph J. , Thomé Claudius , Freyschlag Christian F. , Schwartz Christoph
Published: February 2025

Assessment of the potential impact of epilepsy as primary tumor manifestation on survival in elderly glioblastoma multiforme (GBM) patients. Two academic neurosurgical centers retrospectively analyzed all GBM patients aged 65 years and older with de-novo tumors, who underwent surgery between 2006 and 2021. Epidemiological, histopathological, imaging and survival data were obtained from patients’ electronic charts, and screened for the presence of epilepsy preoperatively and during follow-up. Patient status was assessed by the Karnofsky Performance Scale (KPS), epilepsy was evaluated using the Engel classification. Patients were categorized in an epilepsy cohort (i.e. patients with epilepsy as primary GBM manifestation, and a reference cohort (i.e. patients with no initial epilepsy). This study analyzed 451 GBM patients (55% males); median age at tumor diagnosis was 73 years. The epilepsy cohort was younger (71.0 vs. 74.0 year; p = 0.001), had better KPS (80 vs. 70; p = 0.039), and had smaller tumors (127 vs. 221 cm3; p = 0.001) compared to the reference cohort. There were no differences with regard to neurosurgical treatment (i.e. resection vs. biopsy), tumor biomarkers, surgery-associated complications, and performed adjuvant treatment (all p > 0.05). We did not detect a significant difference in median survival between the epilepsy and reference cohorts (8 vs. 6 months; p = 0.21). New epilepsy during follow-up often coincided with tumor recurrence/progression, but also did not significantly affect survival. The majority of patients (98%) achieved seizure freedom by a combination of tumor-specific treatments and antiseizure medication. Epilepsy as primary tumor manifestation does not correlate with survival in elderly GBM patients.
The Inner Ear and Aging Brain: A Cross-Sectional Study of Vestibular Function and Morphometric Variations in the Entorhinal and Trans-Entorhinal Cortex
Authors: Vania Claire J. , Padova Dominic , Ratnanather J. Tilak , Agrawal Yuri
Published: February 2025

Purpose

While the vestibular system is crucial for balance, posture, and stable vision, emerging evidence connects vestibular loss in older adults to spatial cognitive deficits. However, the specific neural pathways remain unclear. This study examines morphometric changes in the entorhinal cortex (ERC) and trans-entorhinal cortex (TEC), key regions in the vestibular spatial cognitive network, with vestibular function.

Methods

This cross-sectional study used T1-weighted MRI images and vestibular physiological data from 103 Baltimore Longitudinal Study of Aging participants (74 males and 29 females). Vestibular function was assessed through the cervical vestibular-evoked myogenic potential (cVEMP), ocular VEMP (oVEMP), and video head–impulse test (vHIT), examining both categorical presence/absence of responses and continuous measures (cVEMP amplitude, oVEMP amplitude, and VOR gain). Morphometric changes in the ERC and TEC were analyzed by examining surface expansions and contractions relative to average shapes.

Results

Reduced saccular function correlated with surface expansion in the left ERC’s pro-rhinal, right ERC’s intermediate caudal and superior regions, and right TEC’s sulcal region. The decreased utricular function was associated with surface contraction in the left lateral TEC, left ERC’s anterior sulcal and trans-entorhinal regions, and surface expansion in the lateral region of the left ERC. Reduced canal function showed surface contraction in the right ERC’s pro-rhinal and lateral regions and the right TEC’s posterior sulcal and trans-entorhinal regions.

Conclusion

These findings highlight the intricate link between vestibular function and ERC/TEC morphology, emphasizing their role in spatial and cognitive abilities. Future research will assess if structural changes due to vestibular loss contribute to cognitive deficits in aging and Alzheimer’s disease.
Life-cycle seismic resilience of deteriorating highway bridges under mainshock-aftershock sequences
Authors: Feng Ruiwei , Elghazouli Ahmed Y. , Li Yaohan , Dong You , Wang Zhengnan
Published: February 2025

Reinforced concrete highway bridges often experience seismic events coupled with progressive deterioration due to corrosion over their lifespan. In many cases, the seismic mainshocks are followed by significant aftershocks, causing cumulative damage that disrupts normal operations and delays the restoration of bridges. Current research however lacks detailed assessment of seismic resilience considering the effects of aftershocks and corrosion deterioration over the lifetime of bridges. This study proposes a methodology for evaluating the life-cycle seismic resilience of deteriorating structures under mainshock and aftershock (MS-AS) sequences. Three multi-span reinforced concrete highway bridges with different geometries are used as benchmarks. A suite of 80 pairs of ground motion sequences is selected for undertaking the resilience evaluations based on the seismic scenarios considered. The Park-Ang damage index is adopted for the purpose of quantifying the cumulative damage. Nonlinear dynamic analysis is used to provide detailed insights into the mechanisms through which the aftershocks affect the cumulative damage. Based on the results, time-dependent system fragility curves under MS-AS sequences are developed in conjunction with a cumulative damage capacity model for the bridge piers. The seismic resilience of the bridges is subsequently assessed under ground motion sequences at different service times, and the effects of aftershocks and corrosion-induced deterioration on the resilience are examined. Finally, the life-cycle seismic resilience of the deteriorating benchmark bridges under MS-AS sequences is evaluated using the suggested framework. It is shown that the influence of aftershocks on the cumulative damage depends on a number of inter-related factors, including the relative mainshock-aftershock intensity as well as the dynamic characteristics of the bridges. The findings highlight the merits of the proposed framework in evaluating the life-cycle seismic resilience of bridges for different hazard scenarios and deterioration conditions.
A review of threatened and poorly known samphires in Australia: their distribution, observed environmental threats and ecological responses
Authors: Monie Kristin , Turner Shane R. , Palmer Grant , Florentine Singarayer
Published: February 2025

Australia is home to a rich assemblage of samphires (Tecticornia and Salicornia spp.) which are largely endemic, inhabiting saline and semi-saline areas across climatically diverse regions. While these plants are adapted to harsh conditions, they are vulnerable to the effects of climate change which is anticipated to exacerbate existing management and environmental pressures. Despite the threatened and priority status of many samphires, there is an overall lack of knowledge surrounding their distribution, ecology and responses to environmental threats, data which we believe is critical to support their conservation and management. We have compiled and critically assessed peer-reviewed and online grey literature and databases to provide an overview of threatened and poorly known samphires in Australia, with particular reference to their distribution, threats and ecological responses. Of the 58 species and 19 subspecies recorded in Australia, two are federally listed as threatened, eight have a formal conservation listing in at least one state or territory, and 25 are recognised as data deficient or priority taxa. Five samphire communities are also listed as threatened and seven are considered Priority Ecological Communities. We found gaps in data relevant to these threatened and priority species, with 40% having fewer than 20 distribution records available nationally. Species were distributed across 11 Conservation Management Zones (and 27 biogeographic regions). Despite their legislative protection, few species have management or recovery plans or peer reviewed ecological studies to guide conservation and management efforts. We propose further research to support effective management of these unique species and ecological communities.
A Value-Free, Diversity-Sensitive Measure of Freedom
Authors: Côté Nicolas
Published: February 2025

Numerous philosophers and economists have argued that the extent of one’s freedom depends in part on how diverse one’s options are. However, such efforts have met resistance from political philosophers who regard diversity-sensitive measures of freedom as objectionably value-laden. I present a new way of incorporating diversity considerations in the measure of freedom that is scrupulously value-neutral. It is also quite successful in capturing common intuitions about freedom and diversity: in particular, it is sensitive to the degree of dissimilarity between extremal and non-extremal options.
Max-semistable extreme value laws for autoregressive processes with Cantor-like marginals
Authors: Sterk Alef E.
Published: February 2025

This paper considers a family of autoregressive processes with marginal distributions resembling the Cantor function. It is shown that the marginal distribution is in the domain of attraction of a max-semistable distribution. The main result is that the extreme value law for the autoregressive process is obtained by including an extremal index in the law for an i.i.d. process with the same marginal distribution. Connections with extremes in deterministic dynamical systems and the relevance of max-semistable distributions in that context are also pointed out.
Advanced gC3N4/ZnCuFe2O4 composite photocatalysts for effective methylene blue degradation
Authors: Yaşar Dilaver , Kavgacı Mustafa , Eskalen Hasan , Yaykaşlı Hakan
Published: February 2025

In this study, a gC₃N₄/Zn₀.₅Cu₀.₅Fe₂O₄ composite photocatalyst was synthesized to evaluate its efficacy in degrading methylene blue (MB) dye under visible light. The photocatalyst, prepared using mechanical milling techniques, demonstrated enhanced photocatalytic performance due to the synergistic effects of its components. The degradation efficiency for MB was measured at 95.41% with the 1g1ZCF composite (1:1 weight ratio of gC₃N₄ and Zn₀.₅Cu₀.₅Fe₂O₄) under Xenon lamp irradiation for 90 min. The corresponding reaction rate constant was calculated as 0.03174 min⁻1, outperforming the pristine Zn₀.₅Cu₀.₅Fe₂O₄ and 2g1ZCF composites, which achieved degradation rates of 89.2% and 92.16%, respectively. The structural, morphological and optical properties of the synthesized samples were investigated by characterization techniques such as XRD, FESEM, FTIR and UV–Vis spectroscopy. XRD analyses revealed that the ZnCuFe₂O₄ nanoparticles exhibit a cubic spinel structure. FESEM investigations demonstrated that the gC₃N₄ nanosheets are uniformly coated with clustered ZnCuFe₂O₄ nanoparticles. The EDS spectra of the nanocomposites confirmed the presence of Zn, Cu, Fe, and O elements. Furthermore, an examination of colour tone changes indicated a noticeable reduction in the yellowness index of the samples upon the incorporation of gC₃N₄.The composites exhibited reduced bandgaps, with values of 1.92 eV for 1g1ZCF compared to 2.32 eV for pure Zn₀.₅Cu₀.₅Fe₂O₄. The material's recyclability was evaluated over five cycles, maintaining significant activity with a slight decrease attributed to catalyst loss. This work highlights the potential of gC₃N₄/Zn₀.₅Cu₀.₅Fe₂O₄ composites as efficient and recyclable photocatalysts for wastewater treatment applications, providing a promising solution to mitigate environmental pollution from dye contaminants.