bluuebunny/crossref_metadata_2025 huggingface dataset:
Development and evaluation of a polymer material‐based formulation for non‐surgical nasolabial fold reduction
Authors: Iida Masayuki , Hanada Yoko , Miyazaki Yukihiro , Shimpo Ayumi , Tsukahara Kazue , Yasu Tomoko , Takeda Kosuke , Nagai Yuko
Published: January 2025

Objective

Currently, nasolabial folds are mainly removed by invasive procedures, resulting in long‐lasting changes, as non‐surgical user‐implementable alternatives are scarce and inefficient. For example, the use of coating films for this purpose has thus far faced substantial difficulties because such films should combine the antithetical properties of shrinkability and flexibility. Herein, we challenge this status quo by identifying a polymer that simultaneously exhibits shrinkability and flexibility and using this polymer to develop a cosmetic formulation for immediate and non‐invasive nasolabial fold removal.

Methods

The developed formulation, namely a solution of norbornene/tris(trimethylsiloxy)silylnorbornene copolymer in disiloxane, was tested on a group of Japanese women using visual evaluation, three‐dimensional shape analysis and ultrasonography. The polymer film obtained upon drying the formulation was subjected to shrinkage and flexibility tests, and its synchronization with the skin was examined using optical microscopy. The free volume of the polymer films was evaluated using positron annihilation measurements and molecular dynamics simulations.

Results

Upon application, the liquid formulation rapidly dries to produce a skin‐synchronized polymer film that exhibits significant drying‐induced shrinkage without cracking, thereby exerting a lift‐up effect and inducing changes in the internal skin structure to efficiently reduce the nasolabial fold, providing a feeling of rejuvenation. On average, the proposed treatment decreases the nasolabial fold depth by 1 mm, increases the opening angle of the nasolabial fold by 11.5° and reduces the hypodermis thickness by 0.2 mm.

Conclusion

Our results facilitate the development of cosmetic products targeting the nasolabial fold and inspire further research in this field.
Internal structural changes in age‐related curved hair due to cyclical extension: An IR spectroscopy study
Authors: Fuse Naoya , Matsue Yukako , Morita Shigeaki
Published: January 2025

Objective

This study aimed to identify structural changes in age‐related curved hair (referred to as “YUGAMI” hair in Japanese) induced by cyclical extension using infrared (IR) spectroscopy coupled with chemometrics, such as multivariate curve resolution (MCR) and two‐dimensional correlation spectroscopy (2DCOS).

Methods

The hair fibres were stretched at a strain level of 0.3‐N, and this operation was counted as one cycle and was repeated 500 cycles. Every 25 cycles, IR spectra were obtained using an attenuated total reflection IR (ATR–IR) microscope. The spectra were analysed by MCR to investigate the structural changes of keratin protein inside of the hair. 2DCOS was conducted to investigate the genesis pathway of SO3H in the 1000–1150 cm−1 range and the change in the secondary structure of keratin protein of hair in the 1600–1700 cm−1 range.

Results

For age‐related curved hair, 0.3‐N strain levels increased the CH2 and C=O signals after 125 cycles and the SO3H signal after 225 cycles, but no architectural modifications were observed in straight hair. Two results were obtained from 2DCOS. One was cyclical extension increased the S–SO3H signal, followed by SO3H signal. The other in the 1600–1700 cm−1 range indicated an increase in the secondary structural motif and β‐structure after the formation of SO3H.

Conclusion

This study shows that the process of internal transformations can be split into three steps in age‐related curved hair caused by cyclical extension. The first step is the surface transfer of internal lipids, and the second step is two distinct patterns of disulfide bond cleavage: C–S and S–S fission. The final step is further transformation of the unravelled α‐helices into β‐structures which occurs above roughly 225 stretched. Our findings can be an effective factor in care the increase of curvature by cyclical extension such as everyday grooming.
Comparative Effectiveness of Mental Health Simulation Techniques in Nursing Education: A Systematic Review and Meta‐Analysis
Authors: Zhang Xiaoyu , Wang Hai
Published: January 2025

Simulation‐based training in mental health is increasingly recognised as an effective tool within nursing education. This systematic review and meta‐analysis aimed to evaluate the effectiveness of various simulation modalities, including standardised participants (SPs), role‐plays, virtual reality (VR), mannequins and voice simulations, in improving educational outcomes for nursing students. A comprehensive literature search was conducted to identify studies evaluating the impact of mental health simulation on nursing education. Data from 62 studies were extracted and analysed. The primary outcomes included knowledge, confidence, self‐efficacy, competence and anxiety. Meta‐analyses assessed both pretest/posttest changes and comparisons between simulation and control groups. Pretest/posttest analyses revealed significant improvements across multiple modalities: SPs enhanced knowledge (SMD = 1.26), confidence (SMD = 1.20), self‐efficacy (SMD = 0.94), attitude (SMD = 0.22), competence (SMD = 2.30) and anxiety reduction (SMD = −0.88). Role‐plays demonstrated gains in knowledge (SMD = 0.87), confidence (SMD = 1.24), self‐efficacy (SMD = 0.74), attitude (SMD = 0.53), competence (SMD = 0.82) and reduced anxiety (SMD = −0.73). VR improved knowledge (SMD = 0.86), self‐efficacy (SMD = 0.75) and competence (SMD = 0.69). Mannequins showed no significant changes in knowledge or competence. Voice simulations improved knowledge (SMD = 0.96). Comparisons with control groups indicated that SPs significantly increased knowledge (SMD = 1.31), competence (SMD = 1.51) and reduced anxiety (SMD = −2.01). Role‐plays enhanced knowledge (SMD = 1.03) compared with inactive controls; VR increased knowledge (SMD = 0.86) compared with controls. Mannequins showed no significant differences, and voice simulations lacked sufficient data for comprehensive analysis. This meta‐analysis underscores the value of simulation‐based training in mental health nursing education, with SPs proving particularly effective in enhancing clinical preparedness. Role‐plays, VR and voice simulations offer supplementary benefits but may require integration with more interactive methods for optimal impact. Future research should prioritise high‐quality randomised controlled trials, standardised simulation protocols and long‐term follow‐up to clarify the sustained effects of simulation training on clinical practice.
Hidden Factors of Limited Time and Busyness: A Qualitative, Multicentre Study of the Reasons for Missed Nursing Care
Authors: Voldbjerg Siri Lygum , Ellehave Sara Mandahl , Poulsen Ingrid , Eekholm Signe , Grønkjær Mette , Kusk Kathrine Hoffmann , Buus Amanda Agnes Østervig , Mainz Hanne , Haslund‐Thomsen Helle , Jørgensen Lone , Laugesen Britt
Published: January 2025

Aim

To explore nurses' perceptions of reasons for missed nursing care.

Design

A multicentre qualitative descriptive study was undertaken from August 2022 to January 2023.

Methods

Interpretive description methodology was used. Individual interviews were conducted with 36 registered nurses and eight licensed practical nurses working in medical, surgical and intensive care units at three public university hospitals in Denmark. Using a semi‐structured interview guide, nurses were asked to share their perceptions of reasons for missed care. The analysis was guided by an inductive thematic approach.

Results

The nurses' immediate responses to reasons for missed nursing care circulated around limited time and busyness. However, further analysis unfolded layers of reasons described within three themes: being challenged by workload and patients' diverse care needs; falling short on competencies; and being governed by organisational structures and decisions.

Conclusions

The study underlines that reasons for missed nursing care are multiple and complex and extend from an individual to an organisational level. They can therefore not be seen nor targeted isolated. Furthermore, there is a need to draw attention to organisation of care and nurses' clinical decision‐making to ensure that patient's fundamental care needs are met.

Implications for the Profession

Reducing missed nursing care calls for interventions that require nurses to change their working practices, roles and value perceptions. This study provides valuable insight into nurses' perspectives on reasons for missed nursing care, which is pertinent for designing interventions targeting missed nursing care.

Impact

The study provides insight into nurses' perceptions on reasons for missed nursing care within hospital settings. The findings of the study show that reasons for missed nursing care are multiple and complex and cannot be limited to time and busyness. The findings can be used to inform future interventions aimed at reducing missed nursing care.

Reporting Method

The reporting of the study followed the consolidated criteria for reporting qualitative research.

Patient or Public Contribution

No patient or public contribution.
Nurse‐Assisted Remote Patient Monitoring for Self‐Management Support to Patients With Long‐Term Illness—A Qualitative Multimethod Study
Authors: Wathne Hege , Storm Marianne , Morken Ingvild Margreta , Lunde Husebø Anne Marie
Published: January 2025

Aim

To explore patients and nurses' experiences of digital self‐management support following participation in a remote patient monitoring intervention.

Design

An exploratory qualitative multimethod study.

Methods

The study was conducted at two Norwegian university hospitals between January 2022 and February 2023. Data were obtained through semistructured interviews of 17 patients with heart failure, 10 patients surgically treated for colorectal cancer and eight nurses. The data collection also included excerpts from chat messages between patients and nurses obtained from the digital platform during January and February 2024. Data were analysed using abductive thematic analysis.

Results

The analysis revealed three themes: (1) raising illness awareness through RPM technology, (2) establishing a mutual collaboration in self‐management challenges and (3) fostering a continued engagement in health behaviour change. The themes captured patients and nurses' experiences of receiving and providing digital self‐management support. The analysis also identified a unifying key theme: ‘bridging technology and self‐management support through remote caring encounters’, which firmly connected the three themes.

Conclusion

Remote patient monitoring appeared to benefit both patients and nurses by altering patients' self‐management routines and the nurses' workflows. Furthermore, applying the theory of technological competency as caring in nursing to remote patient monitoring interventions may help ensure that the patient–nurse relationship is not weakened as technology advances.

Implications for the Profession and Patient Care

Remote patient monitoring interventions have the potential to become a valuable tool in modern healthcare, enabling effective communication and collaboration between patients and nurses while also ensuring patient‐centred care. However, future development of remote patient monitoring interventions should include nursing support.

Impact

This study addresses remote patient monitoring and digital self‐management support from the perspectives of both patients and nurses. The findings may have an impact on remote nursing, patient satisfaction and strategies to improve digital follow‐up care for patients with long‐term illnesses.

Reporting Method

The authors adhered to the EQUATOR guidelines through the SRQR reporting method.

Patient or Public Contribution

No patient or public contribution.
Three‐Dimensional Morphometrics Reveal Patterns of Unionid Shell Variation Along River Gradients
Authors: Sánchez González Irene , Bucholz Jamie R. , Hopper Garrett W. , Lozier Jeffrey D. , Atkinson Carla L.
Published: January 2025

Aim

Understanding the extent of morphological variation across diverse habitats and species can provide valuable insights into how organisms respond to environmental gradients. We quantified intraspecific morphological variation of unionid mussels and assessed how it varied in relation to genetic differentiation and environmental characteristics.

Location

Mobile and Tennessee River Basins, Alabama and Tennessee, U.S.A.

Taxon

Unionid mussels.

Methods

We used innovative three‐dimensional (3D) scanning techniques and 3D geometric morphometric analyses, genetic data and environmental variables to quantify morphological variation in seven freshwater mussel species populations and its relationship to genetic differentiation and environmental characteristics.

Results

Our findings indicate that shell morphological variation is correlated with environmental variables in four unionid species, and generally not related to genetic differentiation, improving our understanding of the mechanisms behind morphological variation. Three closely related species were more inflated in larger watersheds, while a more distantly related species, A. plicata, was more compressed in larger watersheds. River bankfull width was a significant factor in all models, highlighting the influence of high flow extremes on shell morphological variation.

Main Conclusions

Our findings suggest that environmental factors, particularly characteristics of river flow regimes, are the primary drivers of intraspecific shell morphological variation in unionid mussels, with genetic differentiation playing a less prominent role. Continuing to explore intraspecific trait variation along river gradients will improve our understanding of the ecological implications of shell morphological variation. Assessing the ability of organisms to morphologically adapt to environmental change can help us understand their resilience.
Financial Barriers to Expanded Birth Center Access in New Jersey: A Qualitative Thematic Analysis
Authors: Ofrane Rebecca H. , Rokicki Slawa , Kantor Leslie , Blumenfeld Julie
Published: January 2025

Introduction

Birth centers are an underused care setting with potential to improve birth experience and satisfaction. Both hospital‐based and freestanding birth centers operate with the midwifery model of care that focuses on safe, low‐intervention physiologic birth experiences for healthy, low‐risk pregnant people. However, financial barriers limit freestanding birth center sustainability and accessibility in New Jersey, especially for traditionally marginalized populations. This qualitative study explores the financial barriers faced by freestanding birth centers in order to expand access and choice for pregnant people in New Jersey.

Methods

Semistructured interviews were conducted with participants from 4 sectors: (1) birth center or health system, (2) policy‐adjacent philanthropy or research, (3) state departments, and (4) health insurance. Coding and analysis followed a reflexive thematic analysis process, resulting in the identification of 4 financial barriers to birth center access.

Results

Facility Medicaid reimbursement rates are a primary barrier for birth centers, along with startup and operating costs and, more indirectly, low supply of midwives and low patient demand for birth center care.

Discussion

New Jersey is well‐positioned to enact critical policies and programs that can improve out‐of‐hospital birth center access, based on the findings and recommendations from this research. Other states can follow suit in pursuit of solutions to improve maternal health access and equitable birth center sustainability.
Effect of Dietary Ketosis and Nicotinamide Riboside on Hippocampal Krebs Cycle Intermediates and Mitochondrial Energetics in a DNA Repair‐Deficient 3xTg/POLβ+/− Alzheimer Disease Mouse Model
Authors: Pawlosky Robert , Demarest Tyler G. , King M. Todd , Estrada Darlene , Veech Richard L. , Bohr Vilhelm A.
Published: January 2025

Alzheimer disease is a neurodegenerative pathology‐modifying mitochondrial metabolism with energy impairments where the effects of biological sex and DNA repair deficiencies are unclear. We investigated the therapeutic potential of dietary ketosis alone or with supplemental nicotinamide riboside (NR) on hippocampal intermediary metabolism and mitochondrial bioenergetics in older male and female wild‐type (Wt) and 3xTgAD‐DNA polymerase‐β‐deficient (3xTg/POLβ+/−) (AD) mice. DNA polymerase‐β is a key enzyme in DNA base excision repair (BER) of oxidative damage that may also contribute to mitochondrial DNA repair. Metabolic alterations imparted by ketosis and/or NR were assessed in 16 male and female groups, 4 Wt and 4 AD. At 73 weeks of age, mice were divided into: (A) carbohydrate diet (Carb); (B) Carb diet with NR (Carb‐NR); (C) Ket diet (Ket); and (D) Ket diet with NR (Ket‐NR) groups and remained on their respective treatments for 12 weeks. Mice were euthanized and hippocampi were rapidly removed and frozen. Glycolytic and TCA cycle intermediates were determined by quantitative GC–MS and the ratios of the mitochondrial free [NADox]/[NADHred] and coenzyme ubiquinone (CoQ/CoQH2) couples and the Gibbs free energy of the Complex I–II system of the electron transport chain (ETC) () were calculated from selected metabolites. Mice in Groups C and D had elevated blood ketones (1–2 mM). In most groupings, male mice had higher concentrations of TCA cycle intermediates than females. Moreover, higher concentrations of fumarate in Wt males were associated with elevations in the ΔG′ of Complex I–II compared to females. In Wt males, NR treatments were associated with elevated concentrations of α‐ketoglutarate and malate and linked to increased energy of Complex I–II. In AD males, both NR treatment and dietary ketosis restored the ΔG′ of Complex I–II, where the ratio of the CoQ/CoQH2 couple was oxidized and the [NADox]/[NADHred] couple was reduced. In AD females, only mice in the Ket diet group had a sufficiently reduced [NADox]/[NADHred] couple to restore the free energy profile.

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Population Ageing and Entrepreneurship: Theory and Evidence From OECD Countries
Authors: Zhang Rui , Kang Mengyao
Published: January 2025

This paper studies how population ageing affects individuals' choice between entrepreneurship and employment with enterprises. We develop a theoretical model where individuals are different in their entrepreneurial ability. A representative worker integrates the professional status of all workers as: (1) a younger worker, (2) an older worker, and (3) a retiree. Entrepreneurs and workers are required to pay taxes to contribute to the pension fund. We find that a higher proportion of the elderly population leads to a lower proportion of individuals choosing to become entrepreneurs because of a higher tax burden. A higher pension replacement rate also discourages individuals from starting a business. Using data from OECD. Stat, Eurostat, and the World Bank database, our empirical results support the model's predictions.
Barriers and Enablers of Primary Healthcare Professionals in Health Research Engagement: A Systematic Review of Qualitative Studies
Authors: Matheson Mark , Skinner Ian W. , Vehagen Arianne , Auliffe Sean Mc , Malliaras Peter
Published: January 2025

Health professional engagement ensures relevant, clinically focused research that informs evidence‐based care. Research shows health professionals may not engage optimally in research. Understanding barriers and enablers influencing participation is necessary to enhance engagement. This systematic review explores these factors among primary healthcare professionals. We searched peer‐reviewed studies using CINAHL, Medline, and SCOPUS in February 2023, updated in June 2024. The review followed PRISMA and the ENTREQ checklist. Studies included those published in English, reporting factors influencing engagement among primary healthcare professionals. Qualitative data were extracted and thematically synthesized. Methodological quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklist. Nineteen studies were included. Enablers include individual positive attitudes and a scholarly environment. Barriers include negative attitudes, an unconducive environment, and system constraints. Primary health professionals view research engagement positively, recognizing its potential to enhance health outcomes, professional growth, and business performance. Balancing clinical responsibilities, workload and research is challenging. Targeted strategies promoting partnerships and stakeholder involvement can foster a scholarly environment and empower research engagement.
Fruit Cuticle Thickness and Anatomical Changes in Pedicel Xylem Vessels Influence Fruit Transpiration and Calcium Accumulation in Cranberry Fruit
Authors: Rojas‐Barros Pedro , Wernow Jane , Workmaster Beth Ann , Zalapa Juan , Devi Jyostna Mura , Atucha Amaya
Published: January 2025

Ca is a key nutrient for fruit quality due to its role in bonding with pectin in the cell wall, providing strength through cell‐to‐cell adhesion, thus increasing fruit firmness and extending post‐harvest life. However, Ca accumulation is mostly limited to the initial stages of fruit development due to anatomical and physiological changes that occur as fruits develop. The objective of this study was to evaluate fruit transpiration, cuticle thickness, and pedicel vessel changes during cranberry fruit development and the effect these parameters might have on Ca translocation. ‘Stevens’ cranberry fruits were collected weekly, starting seven days after full bloom (DAFB) until 70 DAFB. For each collection date, fruit transpiration was evaluated in the field, and samples were taken to analyze total fruit Ca content, stomata density, cuticle thickness, pedicel anatomical changes, and xylem functionality. Ca accumulation in the fruit exhibited a sigmoidal curve, beginning at 0.04 mg per berry at 7 DAFB, increasing to a maximum of 0.1 mg per berry at 28 DAFB, and remaining constant until harvest (70 DAFB). Fruit Ca accumulation was mostly explained by fruit transpiration, which exhibited a similar sigmoidal pattern. The rapid decline in fruit transpiration was largely modulated by increases in cuticle thickness, as well as anatomical changes in the pedicel xylem, thereby reducing the capacity to transport water and nutrients into the fruit. Thus, this research could help cranberry growers maximize fruit Ca content by prioritizing fertilization during the early stages of fruit development.
How to talk about crises? Leaders' narrative strategies during the COVID‐19 vaccination campaign in Italy and France
Authors: Mastroianni Laura , Profeti Stefania
Published: January 2025

Defined by threat, urgency, and uncertainty, crises produce opportunities for government leaders to exploit and create meaning around their policy decisions in such unstable circumstances. In narrating their preferred policy solutions, one of the tools governments can use is relying on evidence‐based information. However, some studies have also stressed the importance of recovering emotional inputs when directing the public toward policy compliance. Based upon this premise, we first propose an original typology intersecting evidence/emotions with loss/gain‐framed narrative dimensions, enriching the analytical tools available to the Narrative Policy Framework (NPF), especially when it is applied to studying and interpreting the formulation of policy narratives in times of crisis. We then propose a set of expectations that are empirically tested against the narrative strategies concerning the vaccination campaign during the COVID‐19 crisis in two European countries, Italy and France. By taking into account the official public statements of the executive leaders and health ministers, they have been analyzed through the Discourse Network Analyzer (DNA) software, incorporating our typology into the NPF coding scheme. The analysis shows that tracing leaders' policy narratives back to the evidence/emotion and gain/loss dimensions allows more nuanced differences to emerge that are not immediately observable by resorting to the NPF standard categories. Indeed, although the stories of vaccination against COVID‐19 told in the two countries are broadly similar in terms of the characters and the moral of the story, and emotion‐based narrative strategies prevail in both contexts, we observe a greater overall use of admonitions and scaring tactics in France than in Italy. Moreover, when looking at the evolution of strategies over time, the stability of gain‐framed narratives in the Italian case seems less consistent with the progressively more intrusive nature of the policy solutions adopted by the government.
Where Do We Go From Here? The Future of Gender and Negotiation Research
Authors: Elias Allison
Published: January 2025

This review proposes future directions for gender and negotiation research in light of two important labor market trends: workforces that are increasingly diverse and career advancement that is more often required to be self‐directed. I argue that these two trends have implications for research, both in terms of places where the field seems to be moving and new areas that could be ripe for exploration. I begin by underscoring the importance of context when making claims about gender and negotiation. Then, using two broad banners, diversity and careers, I review discussions that are arising from novel intersections as well as the ways that the changing workplace is shaping future research directions.
Transvaginal Ultrasound Simulation: Educational Benefits on Obstetrics and Gynaecology Clerkship
Authors: Hartup Lindsay A. , Lewis Ariana L. , Medrano Gabriel A.
Published: January 2025

Background

Transvaginal ultrasound (TVUS) is the primary imaging modality in obstetrics and gynaecology (OB/GYN); however, it is highly user dependent. TVUS education for medical students is often sporadic and inconsistent. Simulation‐based training (SBT) is a well‐established innovation for learners to safely develop proficiency.

Approach

A TVUS curriculum was developed using motivational theory and SBT. Five 2‐h educational sessions were held at the beginning of five OB/GYN clerkships, including didactics on TVUS indications/technique, TVUS simulation and a pathology competition. A digital nine‐question survey assessing students' experience and comfort level with TVUS was administered after the clerkship. Students who completed their clerkship prior to the curriculum being delivered or were not present for it were administered the same survey. These students served as the control group.

Evaluation

Eighty‐nine of 111 (80.1%) students who participated in the curriculum and 77/211 (36.4%) who did not participate completed the postclerkship survey. Twenty‐seven of 84 (32.1%) in the simulation group who observed a TVUS performed one during their OB/GYN clerkship compared to 13/76 (17.1%) students in the control group (p = 0.04). Students present for the TVUS curriculum reported greater understanding of the TVUS they observed during their OB/GYN clerkship, OR 3.11 [1.71, 5.78] (p < 0.001); increased comfort recognising normal anatomy, OR 6.63 [3.55, 12.74] (p < 0.001); and gynecologic pathology, OR 7.56 [4.09, 14.33] (p < 0.001), on TVUS.

Implications

Implementation of TVUS simulation curricula should be considered in undergraduate medical education given the potential to improve educational experience during the OB/GYN clerkship.
Improving Examination Skills in Neuromuscular Disorders Through an Educational Video
Authors: Villar‐Quiles Rocio Nur , Bouaoud Jebrane , Foy Jean Philippe , Behin Anthony , Masingue Marion , Nguyen Tan Mai , Iniesto Miguel , Stojkovic Tanya , Idbaih Ahmed
Published: January 2025

Background

The acquisition of practical skills is a key objective of medical education. Improving knowledge and skills is essential for early diagnosis of patients suffering from neuromuscular (NM) diseases.

Approach

Multimedia tools have proved to be useful and effective for learning clinical skills. We developed a video to learn the NM examination, the main pathological signs and their semiological value.

We developed a video to learn the NM examination, the main pathological signs and their semiological value.

Evaluation

Twenty‐seven medical students (group A) watched the NM video. A control group (B, n = 15) watched a control video on OMS examination. Both groups filled out NM and control questionnaires before and after watching the video. Group A significantly improved their score on the NM questionnaire (6.36 ± 1.62 vs. 9.12 ± 0.69, p < 0.001) but not on the control questionnaire. Group B significantly improved the score on the control questionnaire (6.03 ± 1.39 vs. 8.22 ± 1.12, p < 0.0001) but not on the NM questionnaire. Students self‐scored their NM knowledge at 5/10 and 7.4/10 on a visual analogue scale (VAS) before and after watching the NM video. The overall usefulness of the NM video was scored 8.7/10. Students considered it useful for learning the NM examination, illustrating rare semiological signs, preparing for practical evaluations and reinforcing self‐confidence.

Implications

Didactic videos can be used to complement classical teaching to improve the learning of practical skills and to strengthen students' self‐confidence. They can also be useful for other medical disciplines and health professionals, improving the recognition and management of these rare diseases.
Persisting Gaps in Cytomegalovirus Prevention and Management After Solid Organ Transplantation in a Resource‐Limited Setting
Authors: Santoro‐Lopes Guilherme , Guimarães Luiz Felipe Abreu , Clemente Wanessa Trindade , Stucchi Raquel Silveira Bello , Abdala Edson , Santos Daniel Wagner de Castro Lima , Ferreira Gustavo Fernandes , Haddad Luciana Bertocco Paiva , Pierrotti Ligia Camera
Published: January 2025

Background

Cytomegalovirus (CMV) infection remains among the leading complications after solid organ transplantation (SOT). Large international surveys mainly focused on high‐income countries, detected considerable variability in the management of this infection after SOT. Limited data are available from resource‐limited settings.

Methods

A questionnaire‐based cross‐sectional study was performed. All transplant programs (TP) registered at the Brazilian Organ Transplantation Society (ABTO) were invited to participate.

Results

Sixty‐one TP participated in the study. Of these, 59 (97%) reported using at least 1 preventive strategy (prophylaxis or preemptive therapy [PET]). Prophylaxis was reported by only 39 (64%). PET was used by 52 (85%), predominantly for R+ recipients (n = 42/61; 70%). CMV monitoring was performed weekly in only 22 of 52 (42%) TP. This was significantly more common in TP reporting turnaround times ≤72 h for quantitative nuclear acid amplification tests (p < 0.001). Intravenous (IV) ganciclovir was the predominant drug chosen for prophylaxis (21/39 TP; 54%) and for PET (44/52 TP; 77%). Lack of regular access to valganciclovir was significantly associated with the choice of IV ganciclovir for prophylaxis and PET (p = 0.002 for both comparisons). Only 8 (13%) TP had access to molecular diagnostic tests for ganciclovir resistance, and 14 (23%) had access to effective therapy for highly resistant infections.

Conclusion

These results suggest that strategies to improve the management of CMV after SOT in such a resource‐limited setting are needed and should include not only targeted educational programs but also initiatives to tackle economic and structural barriers.

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PD‐L1, PD‐1, and CTLA‐4 mRNA In Situ Expression by Canine Oral Melanoma Cells and Immune Cells of the Tumour Microenvironment
Authors: Foiani Greta , Melchiotti Erica , Capello Katia , Porcellato Ilaria , Brachelente Chiara , Iussich Selina , Giacobino Davide , Morello Emanuela , Martano Marina , Buracco Paolo , Vascellari Marta
Published: January 2025

Canine oral melanoma (OM) exhibits poor prognosis and limited treatment options. The success of immune checkpoint inhibitors (ICIs) in human melanoma has driven interest in similar therapeutic approaches in the dog, although the immunosuppressive mechanisms adopted by canine OM remain unclear. This study aimed to evaluate the expression of the immune checkpoints PD‐1/PD‐L1 and CTLA‐4 by RNAscope in situ hybridization (ISH) in canine OM, to investigate their expression pattern and explore their potential role in melanoma progression. Twenty‐four formalin‐fixed, paraffin‐embedded canine OM were included in the study. PD‐L1 expression by tumour cells was detected in 100% melanomas (score 1–3), especially at the host‐tumour interface. PD‐1 and CTLA‐4 expression by tumour cells was detected in 13/24 (54%, score 1–2) and 18/24 (75%, score 1) melanomas, respectively. Dual ISH‐immunohistochemistry with Melanoma Triple Cocktail, CD3, CD20 and Iba1 demonstrated the expression of tested immune checkpoints in neoplastic and immune cells. Notably, PD‐1 and CTLA‐4 were predominantly expressed by tumour‐infiltrating T lymphocytes, while PD‐L1 was primarily expressed by tumour‐associated macrophages. PD‐1 expression in neoplastic cells was significantly correlated with mitotic count (p < 0.05), while no associations were found between immune checkpoint expression and disease‐free interval or overall survival. Whole tumour PD‐L1 and PD‐1 expression, assessed by image analysis, correlated to PD‐L1 scores in neoplastic cells and the grade of tumour‐infiltrating lymphocytes, respectively. Collectively, PD‐L1, PD‐1 and CTLA‐4 likely contribute to immunosuppression in canine OM. Further studies are warranted to investigate whether ISH can serve as a biomarker for selecting patients suitable for ICI treatment.
Analysis of the level of Permeability and Wayfinding of a Retirement Village: The Case of Kampung Admiralty, Singapore
Authors: Loh Wai Yee , Abdul Nasir Muhammad Hafeez , Hassan Ahmad Sanusi , Nordin Jestin , Fachrudin Hilma Tamiami
Published: January 2025

The dramatic rise in the aging population has become a formidable global phenomenon, especially in developing countries, including Malaysia. A retirement village or modern senior living facility is a new residential typology for older people to cater to an increasing number of aging population in Malaysia. This study investigates the spatial characteristics of sustainable design of aging facilities. A case study of the Kampung Admiralty in Singapore is chosen due to its prominence. The spatial design qualities of the selected case study are meticulously examined using the space syntax analysis to evaluate the level of permeability and wayfinding. A qualitative research method is applied via the space syntax’s justified graph and visibility graph analysis (VGA) using the DepthmapX simulation program. The outcome of the study finds that Kampung Admiralty is a well-designed retirement village typology embodying a spatial configuration that promotes social interaction among visitors and senior residents. Ultimately, the study underscores the overall space syntax performance of Kampung Admiralty, which is dominated by semi-public spaces accounting for 47.62% which corresponds to the 'easy' permeability and high level of clarity in the wayfinding. In essence, the study found that the Kampung Admiralty has excellent level of permeability and wayfinding in the spatial configuration to meet the basic needs of the elderly residents. Therefore, the spatial planning of Kampung Admiralty can become an outstanding reference when designing a retirement village in an urban area.
Exploring the Impact of Urban Transformation on Building Functions: A Case Study of Main Saddar Bazar Sialkot Cantt
Authors: Kazmi Ali , Malik Ilyas , Malik Sana
Published: January 2025

Currently, almost half of the world's population lives in urban areas, and it is projected that by 2050, about one-third of the global population will reside in cities. This significant urbanization trend is particularly noticeable in towns in the Global South. One such town is Sialkot, known as the city of Iqbal, an important city in the Punjab province of Pakistan. Sialkot has experienced significant physical expansion to accommodate its growing population. As land is a crucial resource for the city's expansion and residential development, Saddar Bazaar, located in the Sialkot Cantonment area, has become the central hub of this historic city. However, this rapid and uncontrolled urbanization has presented various challenges, including haphazard urban development, unregulated construction, and inappropriate changes in building function. This study examines the compatibility of traditional building functions, layouts, and components within Saddar Bazaar, Sialkot Cantt. It also investigates how changes in a building's function affect its components and, on a broader scale, how it impacts the residents. This study follows a qualitative research approach and employs a field survey as the primary data collection method. The survey combines a questionnaire and direct observation to achieve the research objective, highlighting the problems and challenges associated with urban development and tracking the transformation of a residential area into a commercial one. Data was collected by distributing questionnaires to a hundred residents who had lived in different parts of Sialkot for over two decades. Site observations were conducted at various times of the day from late 2021 to spring 2022. Statistical data analysis was performed using Microsoft Excel, and thematic analysis was used to group the qualitative findings. Based on the research findings, it can be concluded that features like Baraza exemplify the typical characteristics and layout of the transformation. Furthermore, this study proposes alternative solutions to address the challenges related to urbanization and commercialization, benefiting policymakers, academics, and citizens alike.
Biomechanical Analysis for Enhanced Expulsion-Proof Intervertebral Fusion Device
Authors: Tang Shaolong , Pan Dan , Chen Siyuan , Li Hengyuan , Ye Zhaoming
Published: January 2025

This study aimed to compare the sinking and shifting characteristics of an enhanced expulsion-proof intervertebral fusion device (EEIFD) with a traditional transforaminal lumbar interbody fusion device (TTLIFD). Five specimens of each device were selected for analysis. Four mechanical tests—compression, subsidence, expulsion, and torque—were conducted for each cage. Additionally, a blade-cutting torque test was performed on the EEIFD, with load–displacement curves and mechanical values recorded. In static axial compression, static subsidence, and dynamic subsidence tests, the EEIFD demonstrated performance comparable to the TTLIFD. In expulsion testing, the maximum expulsion force for the EEIFD when the blade was rotated out (534.02 ± 21.24 N) was significantly higher than when the blade was not rotated out (476.97 ± 24.45 N) (P = 6.81 × 10−4). Moreover, the maximum expulsion force for the EEIFD with blade rotation (534.02 ± 21.24 N) was significantly higher than that of the TTLIFD (444.01 ± 12.42 N) (P = 9.82 × 10−5). These findings indicated that the EEIFD effectively enhanced expulsion prevention and antisubsidence performance.
Evaluating the Biomechanical Effects and Real-World Usability of a Novel Ankle Exo for Runners
Authors: Nurse Cameron A. , Wolf Derek N. , Rodzak Katherine M. , Teater Rachel H. , Ice Chad C. , Fine Shimra J. , Holtzman Elisa C. , Zelik Karl E.
Published: January 2025

Achilles tendon overuse injuries are common for long-distance runners. Ankle exos (exoskeletons and exosuits) are wearable devices that can reduce Achilles tendon loading and could potentially aid in the rehabilitation or prevention of these injuries by helping to mitigate and control tissue loading. However, most ankle exos are confined to controlled lab testing and are not practical to use in real-world running. Here, we present the design of an unpowered ankle exo aimed at reducing the load on the Achilles tendon during running while also overcoming key usability challenges for runners outside the lab. We fabricated a 500-gram ankle exo prototype that attaches to the outside of a running shoe. We then evaluated the reliability, acceptability, transparency during swing phase, and offloading assistance provided during treadmill and outdoor running tests. We found that the exo prototype reliably assisted 95–99% of running steps during indoor and outdoor tests, was deemed acceptable by more than 80% of runners in terms of comfort and feel, and did not impede natural ankle dorsiflexion during leg swing for 86% of runners. During indoor tests, the exo reduced peak Achilles tendon loads for most participants during running; however, reductions varied considerably, between near zero and 12%, depending on the participant, condition (speed and slope) and the precise tendon load metric used. This next-generation ankle exo concept could open new possibilities for longitudinal and real-world research on runners, or when transitioning into the return-to-sport phase after an Achilles tendon injury.
We're All In This Together: Evaluating the Dynamics of Designers' Moods Throughout the Collaborative Design Process and Their Impact on Project Outcomes
Authors: Harris Megan , Toh Christine
Published: January 2025

In this paper, we use sentiment analysis to understand the change in moods of individual designers and teams throughout a collaborative design project. Although there is much research on design psychology, the impact of psychological and emotional characteristics on creativity, and group affective tone, there is limited longitudinal research on the dynamic nature of mood and affective tone over the course of a design project. This leaves a gap in our understanding of how the complex emotional states and interactions of emotional states among team members affect the ability of the team to work together effectively and achieve expected design outcomes. Research that fills this gap can help improve design outcomes and educational strategies. Thus, a longitudinal study was conducted using the self-reflections of student teams collected from three different points over the course of a semester-long design project, to understand how the variation in designers' moods during a collaborative project design activities influence design project outcomes and quality of collaborative work. Our results show that time was a significant predictor of change in moods amongst teams, but not for individuals. We also show that divergence of team members' moods with respect to tone, positive tone, and negative emotion were negatively related to project outcomes. These results provide a foundation for future systematic investigations of team-based affect on design outcomes and show how design can be viewed through the lens of Symbolic Interactionism, evident in how team members create meaning and shared understanding within the design context.
On the Climbing Ability of Passively Suspended Tracked Robots
Authors: Reina Giulio , Mantriota Giacomo
Published: January 2025

This article investigates the obstacle-climbing ability of a novel passively articulated robot, Polibot, which is compared to a standard tracked robot using a fixed-wheel configuration. Two test cases are analyzed: the traverse of a single obstacle and the navigation upward along a vertical surface. Both scenarios are analytically solved using a quasistatic Newton–Euler approach. The dynamic equilibrium of the system is also defined using an energetic approach, focusing on the energy loss from the wheel-ground slippage. Understanding the role played by the different energy components contributes to shedding light on the fundamental mechanisms underlying the negotiation of obstacles and highly challenging terrain, in general, by suspended tracked robots. Finally, experimental results are presented to validate the proposed approach in real-world conditions.
Flow Diverter Technology for the Treatment of Intracranial Aneurysms: A Review
Authors: Gopisetty Shrimai , Budidi Uday Kumar , Shaik Khasim Beebi
Published: January 2025

The treatment of Intracranial aneurysms has evolved substantially over the past two decades, transitioning from open skull surgery to less invasive endovascular techniques. The rapid advancement of various endovascular procedures is the main impetus driving this evolution. The flow-diverting devices are less invasive and cost-effective than endovascular approaches like clipping, platinum coiling, and stent-assisted coiling. Flow diverters are endovascular devices inserted into the brain artery to restrict blood flow to an aneurysm, promoting gradual thrombus formation within an aneurysm sac. While using the current generation flow diverters in treating diverse aneurysms appears to be efficient, each device is different in design, material composition, occlusion rate and deployment system. At times, it becomes challenging to determine the most appropriate device best suited for every patient because of these distinguished factors. To address this, the present review aims to provide a comprehensive overview of ten flow-diverting devices. It explains their design specifications, material compositions, six-month and one-year occlusion rates, and their respective advantages and limitations. By offering a detailed analysis of these devices, this review seeks to empower researchers and neurosurgeons alike. Researchers can stay abreast of the latest advancements in flow-diverting technology, while neurosurgeons can make informed decisions when selecting the most appropriate device for each patient’s specific needs.
Experimental Study on Controlling Flow Separation of Compressor Cascades With Self-Excited Sweeping Jet Actuator
Authors: Zeng Cong , Chen Shaowen , Zheng Longye , Zhang Yimin , Wang Shiqi
Published: January 2025

The sweeping jet actuator (SJA), widely studied as a potential flow control method in compressors and turbines, results in unnecessary performance losses due to its requirement for additional energy and mass input. In this study, a self-excited sweeping jet actuator (SSJA) method was introduced to enhance the application feasibility of SJA. The SSJA was arranged inside the blade, utilizing the pressure difference between the pressure and suction surfaces; therefore, additional energy input is no longer necessary. Wind tunnel tests were conducted to explore the effects and mechanisms of SSJA layout, size, and pressure difference between the blade surfaces in controlling flow separation in a compressor cascade with controlled diffusion airfoils (CDAs). Key aerodynamic parameters were measured using a five-hole pressure probe, and oil-flow visualization was also performed to represent flow characteristics. Results show that by using SSJA in the compressor cascade, a significant reduction of 27.04% of the total pressure loss coefficient at 2 deg incidence was obtained. This control effect has great potential for application in the field of passive flow control. The streamwise vortices (SVs) induced by SSJA enhance the momentum exchange between the mainstream and the boundary layer near the suction surface, which reduces the suction side boundary layer separation and thus greatly reduces the flow losses. In addition, due to the different flow separation characteristics and actuation conditions at different incidences, the SSJA flow control effect is sensitive to incidences.
A primer on low-carbon design in architectural acoustics using a case study of residential floors
Authors: Murphy Kristen R. , Broyles Jonathan M.
Published: January 2025

Designers are increasingly tasked to reduce the carbon footprint of buildings. While core disciplines (e.g., mechanical and structural) are determining sustainable design strategies, understanding the environmental impacts of architectural acoustics is nascent. Yet, acoustic design decisions provide opportunities to minimize building carbon emissions while ensuring suitable acoustic performance. In response, this paper first motivates the need for design synergies between architectural acoustics and sustainability practices. Second, this paper educates and equips acousticians to participate in sustainable design decisions by demonstrating a life cycle assessment framework to inform the selection of low-carbon floor-ceiling assemblies in residential buildings while satisfying sound isolation requirements.