bluuebunny/crossref_metadata_2025 huggingface dataset:
Glucose‐Activated Programmed Hydrogel with Self‐Switchable Enzyme‐Like Activity for Infected Diabetic Wound Self‐Adaptive Treatment
Authors: Yang Yutong , Fang Qingqing , Wang Jiaxin , Li Meng , Li Zhenlong , Xu Huiru , Huang Shengfei , Chen Jueying , Guo Baolin
Published: February 2025

The defective blood glucose regulation ability of diabetic patients leading to bacterial infection, cellular oxidative stress, and vascular damage results in delayed healing of chronic diabetic wounds. Here, a glucose‐activated self‐switching enzyme‐like activity programmed hydrogel is proposed to provide self‐regulated timely intelligent insulin release affected by blood glucose fluctuations, thereby forming feedback blood glucose management and exerting a full‐stage wound healing. The hydrogel is composed of Au─MoS2─phenylboronic acid nanozyme and insulin‐loaded nitroimidazole‐modified sodium alginate hypoxia‐sensitive microcapsules and penylboronic‐acid‐modified chitosan. It utilizes glucose as a sacrificial agent to generate antibacterial reactive oxygen species by recognizing the hyperglycemia environment, and releasing insulin for blood glucose regulation for up to 12 h with the help of the enzyme‐like catalysis‐generated hypoxia environment. In a normoglycemia environment, the hydrogel switches the enzyme‐like activity to supply oxygen, inhibiting further insulin release. The hydrogel achieves ≈3 times the wound recovery rate of commercial dressings through blood glucose regulation and improved wound microenvironment. The hydrogel has been proven to significantly improve the healing of chronic diabetic wounds by regulating the body's blood glucose homeostasis and implementing a staged healing treatment plan, providing a powerful solution for diabetic wound care.
Bionic Olfactory Neuron with In‐Sensor Reservoir Computing for Intelligent Gas Recognition
Authors: Wu Xiaosong , Shi Shuhui , Jiang Jingyan , Lin Dedong , Song Jian , Wang Zhongrui , Huang Weiguo
Published: February 2025

Gas sensing and recognition are closely related to the sustainable development of human society, current electronic noses (e‐noses) typically focus on detecting specific gases, with only a few capable of recognizing complex odor mixtures. Further, these sensors often struggle to distinguish between isomers and homologs, as these compounds usually have similar physical and chemical properties, yielding nearly identical sensor responses. Even the mammalian olfactory systems consisting of a large variety of receptor cells and efficient neuron networks sometimes fail in this task. The bottleneck stems from the inability to extract the fingerprints of these compounds and the inefficiency of signal processing. To address these limitations, a material‐device‐algorithm co‐design strategy is proposed that integrates an organic field‐effect transistor (OFET) array with in‐sensor reservoir computing (RC) and the k‐nearest neighbors (KNN) algorithm. Organic semiconductors diversify responses to different gases, while RC efficiently extracts spatiotemporal features with lower training costs and reduced energy overhead. This synergy achieves 100% classification accuracy for eight gases and 99.04% accuracy for a library of 26 gases, including mixtures, isomers, and homologs—among the highest reported accuracies. This work provides a groundbreaking hardware solution for bionic olfactory neurons with edge artificial intelligence (AI) functions, surpassing traditional e‐noses.
N‐Heterocyclic Carbene Organocatalysis Enabled Modular Synthesis of Fluorinated Isoflavonoids to Suppress Proliferation and Migration in Breast Cancer Cells
Authors: Liu Yan‐Qing , Fu Lei‐Lei , Hong Long‐Hai , Kou Xin‐Xin , Zhang Xiang , Zeng Rong , Zhen Yong‐Qi , Han Bo , Li Jun‐Long
Published: February 2025

Isoflavonoids represent a privileged scaffold among various bioactive natural products, rendering their structural diversification through green synthesis and subsequent biological evaluations a compelling research area. In this study, an NHC organocatalytic radical acylalkylation of 1,3‐enynes using salicylaldehydes is presented, followed by a cascade intramolecular annulation, yielding a series of fluorinated isoflavone derivatives with substantial yields under environmental‐friendly conditions. This approach, distinguished by its excellent modularity and high functional group tolerance, represents an unprecedented organocatalytic 1,3,4‐trifunctionalization of 1,3‐enynes designed for the green synthesis of bioactive isoflavones in a single step. Furthermore, it is demonstrated that these synthesized fluorinated isoflavonoids effectively suppress proliferation in breast cancer cells, with the most potent compound 8 also inhibiting migration in MDA‐MB‐231 cells.
Effect of solid surface properties on CO2 hydrate propagation and capillary mechanism
Authors: Rao Shihang , Li Zhenchao , Lu Hailong , Deng Yajun
Published: February 2025

The surface effect of certain material such as silicon wafer, quartz or mica on the formation of CO2 hydrate is studied by in situ visual observation of CO2 gas reacting with a water droplet in a restricted space. The results obtained show that the growing process of CO2 hydrate in a restricted space can be divided into two consecutive stages, hydrate covering at gas–liquid interface and hydrate spreading on solid surface. It is indicated that hydrate spreads on solid surface by continuous formation at the advancing frontier, suggesting that water for hydrate formation might be delivered through both lateral and vertical transmitting path, and lateral driving force for water migration might play a dominant role. Qualitative and quantitative analyses show that solid surface properties play a significant role on hydrate spreading process, probably affecting both the interfacial interaction of hydrates with solid surface and water moving process near solid surfaces.
Continuous Provisioning Increases Breeding Success of Black‐and‐White Snub‐Nosed Monkeys (Rhinopithecus bieti) in the Baima Snow Mountain Nature Reserve, Yunnan, China
Authors: Cao Li , Liu Feng , Guo Long‐Jie , Sun Qing‐Lei , Ge Sang , Li Bo‐Yan , Zhou Ying , Fang Xue‐Lan , Geng Ying , Song Wei‐Bin , Grueter Cyril C. , Li Yan‐Peng , Cui Liang‐Wei , Xiao Wen
Published: February 2025

The high energy demands of primates during pregnancy and lactation often limit their breeding success due to the availability of food resources. Until now, few studies have focused on the effects of continuous provisioning on primate reproduction. To assess the impact of continuous provisioning on breeding success, we collected data on female reproductive status (primiparous or multiparous), maternal age of births, births, deaths, and sex of infants in a free‐ranging semi‐provisioned band (FSB) of Rhinopithecus bieti in China from 2010 to 2023. Our results indicate that provisioning significantly increases infant survival. After 8 years of provisioning, 11 females began a pattern of giving birth to infants in two continuous years, skipping reproduction in the third year, and resuming in the fourth year. Continuous provisioning led to a year‐by‐year reduction in the interbirth interval (IBI) and a gradual decrease in the primiparous age. The percentage of consecutively breeding females (CBFs) and their offspring increased annually and with the mother's ages. Conversely, the percentage of offspring from non‐consecutively breeding females (NBFs) decreased over time and with maternal age. Each CBF annually produced 9.4% more infants compared to NBFs. Compared to NBFs, CBFs had a higher maternal age at births, a higher fertility rate, a higher infant survival rate, and a 11.7% shorter IBI. Furthermore, compared to the non‐provisioned wild band (NPB), females in the FSB gave birth 128 days earlier, had an 18.9% annual increase in the number of offspring per female, and showed 1.2 times higher infant survival beyond 12 months. Our study demonstrates that provisioning significantly enhances reproductive success and population size. However, before promoting provisioning as a conservation tool to stabilize and recover endangered wildlife populations, it is essential to thoroughly evaluate its potential risks, such as nutritional imbalances, increased stress, and the transmission of diseases.
Thermally Induced Reversible Martensitic Phase Transition and Self‐Healing in Nickel Glycinamide Crystals
Authors: Vušak Darko , Naumov Panče , Jelčić Želimir , Matković-Čalogović Dubravka , Prugovečki Biserka
Published: February 2025

Martensitic phase transitions and self‐healing in molecular compounds are extremely rare, and while they carry potential for rapid energy transduction, they are currently found only by serendipity. Here, we report the observation of both phenomena in a coordination compound of glycinamide (Glyam), [Ni(H2O)2(Glyam)2]I2 (1). Upon cooling to 205–213 K, the high‐temperature polymorph of this material (1RT) transforms into twinned crystals of the low‐temperature polymorph (1LT(twinned)), while upon heating, it is converted back to 1RT in the temperature range 217–223 K. When this transformation occurs in single crystals, evolution of cracks is observed upon cooling that disappear upon heating. The forward transition 1RT→1LT(twinned) is completed in a few seconds, while the reverse one, 1LT(twinned)→1RT, proceeds up to several hours, contrary to the fast transition in polycrystalline samples. We determined the concomitant presence of 1RT and 1LT(twinned) in the same single crystal. The crystal structure analysis revealed complex inter‐ and intramolecular displacements of atoms during the transition. To the best of our knowledge, this is only the second report where a thermally induced reversible martensitic phase transition and self‐healing are observed in crystals of a coordination compound, and indicates the potential generality of these extraordinary phenomena.
A Versatile Carbonylative Approach to Ureas and Carbamates through Light Activated Nickel Catalyzed Formation of Aliphatic Isocyanates
Authors: Zhou Cuihan , Singh Dushyant , Arndtsen Bruce A.
Published: February 2025

We describe the development of a nickel‐catalyzed route to prepare aliphatic isocyanates via carbonylation chemistry. Unlike thermal reactions, where the affinity of Ni(0) for carbon monoxide has traditionally limited its use in carbonylations, mechanistic studies suggest that visible light excitation of a Xantphos‐bound nickel catalyst can enable a radical pathway for the carbonylation of alkyl halides, while the CO‐bound nickel drives the formation of a reactive acyl azide product for rapid Curtius rearrangement. Coupling this transformation with subsequent nucleophilic reactions has opened a unique and modular pathway to apply carbonylations to the synthesis of an array of diversely substituted, unsymmetrical ureas and carbamates, including those of relevance to drug design.
Ultrasensitive Gas Sensor of Mixed‐dimensional Heterostructures Combining Borophene and BC2N Quantum Dots: Enhanced Detection through Binary Cooperative Effects
Authors: Zhao Zhilin , Liu Xiang , Liu Yi , Wu Zitong , Xiong Ke , Tai Guoan
Published: February 2025

The emergence of mixed‐dimensional van der Waals heterostructures has inspired worldwide interests in recent years, opening up new avenues for potential nanotechnology applications. Herein, we proposed a mixed‐dimensional heterostructure composed of borophene sheets and BC2N quantum dots. The gas sensing performance of the heterostructure was evaluated through a combination of theoretical calculations and experimental methods. Specifically, first‐principles calculation results show that NO2 is the most strongly interacting molecule and induces the largest amount of charge transfer between the molecule and the heterostructure, suggesting exceptional sensitivity and selectivity of the heterostructure to NO2 gas. Following the theoretical insights, a borophene‐BC2N heterostructure gas sensor was developed and its gas detection abilities were assessed with exposure to various gases at room temperature. Remarkably, this sensor displayed a sensitivity of 1170% to 30 ppm NO2 and remain a high sensitivity of 108% even to 0.2 ppm NO2. These results highlight borophene‐BC2N heterostructure as a superior NO2 gas sensor, demonstrating enhanced sensing via BC2N quantum dots and integrated theoretical‐experimental approaches.
Water Main Break Rates in the United States and Canada
Authors: Barfuss Steven L. , Fugal Matthew
Published: February 2025

Key Takeaways

A 2023 report on US and Canada water main breaks is one of the most thorough and statistically important ever undertaken and compares trends from previous studies in 2012 and 2018.

Nearly 20%, or 452,000 miles, of water pipe are past their useful lives and need to be replaced, but they have not been because of a $452 billion shortfall in funding.

Of a total inventory of 2.3 million miles of pipe, 33% of all water mains are more than 50 years old, representing 770,000 miles at risk.

The United States and Canada experience 260,000 water main breaks annually with $2.6 billion in annual repair costs.
Challenges and Emerging Strategies of Immunotherapy for Glioblastoma
Authors: Xie Hai-Yan , Mao Mingchuan , Lei Yao , Ma Xianbin
Published: February 2025

Glioblastoma (GBM) is recognized as the most lethal primary malignant tumor of the central nervous system. Although traditional treatments can somewhat prolong patient survival, the overall prognosis remains grim. Immunotherapy has become an effective method for GBM treatment. Oncolytic virus, checkpoint inhibitors, CAR T cells and tumor vaccines have all been applied in this field. Moreover, the combining of immunotherapy with traditional radiotherapy, chemotherapy, or gene therapy can further improve the treatment outcome. This review systematically summarizes the features of GBM, the recent progress of immunotherapy in overcoming GBM.
The Impact of Pain on Everyday Activities of People With Hypermobility Spectrum Disorders or Hypermobility Ehlers Danlos Syndrome
Authors: Lindholm Susanne , Petersson Suzanne , Molander Peter , Björk Mathilda
Published: February 2025

Background

This study describes aspects of pain and how pain affects everyday life and examines the relation between chronic pain and activity limitations in people with hypermobility spectrum disorders (HSD) or hypermobility Ehlers Danlos syndrome (hEDS).

Methods

This cross‐sectional study used data from 2016 to 2021 obtained from the Swedish quality registry for pain rehabilitation (SQRP), comparing those with HSD/hEDS with the larger group of people with mixed chronic pain conditions as a reference group (RG).

Results

Of the 43,801 people registered in the SQRP, 1211 (2.8%) were diagnosed with HSD/hEDS (88.9% women). The mean age of the HSD/hEDS group was younger (36.3 ± 11.8) than the RG (45.7 ± 12.8). The HSD/hEDS group had a statistically significant (p < 0.001) earlier onset of pain (calculated in years) in contrast to the RG. In the HSD/hEDS group, 80.1% had persistent pain; in the RG, 74.2% had persistent pain. The HSD/hEDS group reported more pain locations (20.0 ± 7.9) than the RG (14.8 ± 8.8). The HSD/hEDS group reported more problems performing leisure, social, and household activities than the RG; however, pain intensity was statistically significantly lower (p < 0.001) in the HSD/hEDS related to the RG.

Conclusions

There were indications that pain affected daily activities for people with HSD/hEDS, who had earlier onset of pain, marked more pain locations, and had more persistent pain, but pain intensity was not as decisive in contrast to the RG.

Significance Statement

In a comparison yielding statistically significant results (p < 0.001), persons with hypermobility spectrum disorder (HSD) or hypermobility Ehlers‐Danlos syndrome (hEDS) reported earlier pain onset, longer pain durations, and a greater number of pain locations but surprisingly, lower pain intensity than the reference group which consisted of a mixed group of pain conditions. These pain characteristics affected daily activities, indicating a substantial impact on daily life for those with HSD/hEDS.
Developed liquified ethane production, storage and transportation using optimized liquefaction process: Design, energy optimization, and techno‐economic feasibility
Authors: Pirouzfar Vahid , Su Chia‐Hung
Published: February 2025

The main focus of this research is to develop techniques in order to select the best option for refrigeration and liquefaction processes using double‐walled tanks for storage and transport by means of different simulations as well as critical fluid conditions. Process simulation, energy analysis and economic evaluations have been applied to find the best process in this case study. Refprop, Aspen HYSYS, Aspen Process economic Analyzer software have been used for thermodynamic condition prediction, process simulation, and economic analysis, respectively. The results indicated that the best conditions for ethane storage and transport are achieved at the temperature ranging from −30 to −46°C in case of using liquefaction systems, which is attributable to the low energy consumption as well as low operating costs and low‐cost investment. This cost would be very significant in comparison with the increase in storage volume at very low temperatures. The direct capital cost of implementing these projects will be in the range of $ 27 ~ 41 million as well as the cost of preparing and transporting $ 310 ~ 475 per ton. Employed technique and developed flowsheets can be used as a useful tool for design and optimization of appropriate gas liquefaction processes membranes with effective performance for various industrial applications.
A Study on the Instability of the Surrounding Rock Mass of the Roadway Under Disturbing Load
Authors: Xu Hui , Bu Wankui , Qiu Jun , Ma Long , Qin Hao , Li Yajun , Zhang Weishe , Li Pengxiang , Zhang Dong , Li Peng , Jia Chen
Published: February 2025

The rock burst is one of the major dynamic disasters in deep underground engineering, such as coal mining, and has become a significant technical challenge urgently requiring solutions in rock mechanics and engineering. In the related research, there are many reports on the stability analysis of the laminar split structure under static loads and few reports on the stability analysis under dynamic loads. This paper addresses the stability of surrounding rock in deep roadways, focusing on the key factor of disturbed load. First, the paper theoretically establishes the control equation for analyzing the dynamic stability of the laminar split structure in the coal wall of roadway, deriving the minimum critical load for instability of the laminar split structure under two constraint conditions: simply supported at both ends and fixed at both ends. Second, using discrete element software, the paper analyzes the influence of disturbing load on the stability and energy accumulation characteristics of the surrounding rock of the roadway. It examines the variation patterns of stress in the surrounding rock, deformation of both sides and roof‐floor, distribution of plastic zones, and energy accumulation characteristics with respect to time t and the intensity of disturbing load pmax. Finally, the paper analyzes the stability of surrounding rock in a mine involved in a rock burst accident. The research results provide a basis and reference for analyzing the risk of rock burst under similar conditions.
Der Feuchtigkeitszustands‐Wert (MCV) im Erdbau
Authors: Henzinger Christoph
Published: February 2025

Bindige Böden eignen sich für den Einbau in Erdbauwerken insbesondere dann, wenn sie einen Wassergehalt nahe des Verdichtungsoptimums (Proctorversuch) aufweisen. Die Bestimmung des MCV (Moisture Condition Value, zu Deutsch „Feuchtigkeitszustands‐Wert“) eines Erdbaustoffs erlaubt die Beurteilung der Eignung in diesem Sinne, ohne dass der Wassergehalt und der optimale Wassergehalt (Proctorversuch) bestimmt werden müssen. Dies und die schnelle Versuchsdurchführung im Labor und im Feld machen den Versuch zu einem wertvollen Werkzeug, mit dem die erforderlichen Abläufe bei der Ausführung deutlich vereinfacht werden können. Das Verfahren wird aufgrund seiner Vorteile insbesondere in Großbritannien seit Jahrzehnten verwendet. Der Versuch ist in der europäischen Normung zum Erdbau zwar enthalten, ist in Deutschland und Österreich aber noch nicht bekannt. Im vorliegenden Beitrag wird das Verfahren gemeinsam mit Erfahrungen aus der Literatur und den Ergebnissen eigener Versuche vorgestellt.
3‐D Crustal Structure Modelling of the Proterozoic Cuddapah Basin, Its Regional Geodynamic Evolution and Columbia–Rodinia Connection
Authors: Singh Satendra , Chandrakala Koteswara , Pandey Om Prakash
Published: February 2025

The Cuddapah Basin located in the southern part of India, is one of the largest Proterozoic basins in the world. This basin witnessed multi‐stage growth that involved sedimentation, magmatism and tectonism. This region has been studied geophysically for over nine decades, nevertheless, its subsurface structural configuration, underlying crust–mantle structure and its evolutionary relationship with east Antarctica during the Columbia and Rodinia supercontinental assembly periods, remain an enigma. In the present study, we provide a 3‐D crustal structural configuration of this basin based on gravity modelling along 13 east–west and 3 north–south profiles, utilising density and subsurface depth constraints from crustal seismic studies. We have delineated the presence of a 15–20 km anomalously thick, high density differentiated magmatic layer above the Moho, which varies widely from 32 km below the Eastern Ghats Belt to about 50 km below the Nellore Schist Belt. It is invariably shallower at 37–38 km north of 14°45'N, compared with 43 to 46 km south of it, indicating possible tilting of the basin from north to south. Importantly, we also notice a high order translational movement of the crustal column across the Nallamalai Basin as revealed by conspicuous change in the Moho trend, which correlates with the absence of Eastern Ghats Belt for a distance of about 400 km south of Ongole, mimicking the translational movement. We infer that the Napier complex of east Antarctica, may form the missing part of Eastern Ghats Belt of India's east coast. Similarly, a high gravity over the Nellore Schist Belt region would possibly indicate presence of remanent slab material (or magmatic material) underneath which may be related to erstwhile supra‐subduction during the Rodinia supercontinental assembly period. The present study further suggests that the Iswarakuppam dome, located in northern part of the Nallamalai Basin, contains a thin veneer of Cumbum shale (5.10 km/s) followed by a high velocity (Vp: 5.70 km/s) sequences containing Bairenkonda quartzites and possibly mantle derived mafic rocks that may be correlatable with the sills of southwestern part of the Cuddapah Basin. This domal structure probably formed due to underthrusting of the western Cuddapah Basin and the collision of Nellore Schist Belt/Eastern Ghats Belt terrains after the cessation of supra‐subduction below eastern Dharwar Craton at the end of the Rodinia period (around 950 Ma).
Thermal Characteristics of Organic and Inorganic Eutectic Phase Change Materials Using T‐History and DSC Method During Solidification Phase
Authors: Srivastava Utkarsh , Sahoo Rashmi Rekha
Published: February 2025

The temperature‐history (temp‐hist) method offers a straightforward and effective technique for ascertaining the thermal‐physical properties of phase change materials (PCMs). This study explores three combinations of eutectic phase change materials (EPCMs): organic–organic, organic–inorganic, and inorganic–inorganic, aiming to identify the most suitable EPCM based on their heat conduction coefficient, heat capacity, and enthalpy of fusion for the solidification process. The experimental findings revealed that inorganic–inorganic EPCM demonstrated significantly superior thermal conductivity. Specifically, they exhibited approximately four times a 25% higher heat conduction coefficient in both solid and liquid phases compared to combinations involving organic–organic and organic–inorganic EPCM blends. Specific heat capacities and enthalpies of fusion were also analyzed, with organic–organic EPCM demonstrating superior values. The enthalpy of fusion for organic–organic EPCM surpassed that of inorganic–inorganic EPCM by 27.94% and outperformed organic–inorganic EPCM by 10.96%. Nusselt numbers and heat transfer coefficients were determined, highlighting the superior convective heat transfer efficiency of inorganic–inorganic EPCM. The lowest endothermic peak is 45°C for inorganic–inorganic EPCM from DSC analysis. The EPCMs' latent heat, specific heat, and phase transition temperatures nearly match the standard DSC method, proving the reliability of the lab‐made T‐history configuration. The results highlight how EPCM composition is crucial for achieving top‐notch thermal performance, emphasizing how blending organic and inorganic materials enhances heat transfer and phase change stability.
Scientific approaches to defining HPV vaccine‐induced protective immunity
Authors: Lehtinen Matti , van Damme Pierre , Beddows Simon , Pinto Ligia A. , Mariz Filipe , Gray Penelope , Dillner Joakim
Published: February 2025

Seventeen years after the licensure of prophylactic human papillomavirus (HPV) L1 virus‐like‐particle vaccines, a defined antibody level that correlates with vaccine‐induced protection against HPV infections and associated neoplasia is missing. In contrast, correlates of protection have been defined for many viral vaccines, including for the hepatitis B virus (HBV) vaccine. This review includes lessons learned from vaccination against HBV and the use of an established protective HBV surface antigen antibody level: 10 mIU/mL, an overview of HPV infection‐induced and HPV vaccine‐induced antibody responses, successful efforts to establish international standardization of serological reagents and associated tools, and 15‐year vigilance of HPV vaccine‐induced antibody levels in a vaccination cohort against breakthrough infections. This report identifies progress but also gaps on the journey toward the definition of a HPV vaccine‐induced correlate of protection.
Revisiting the relationship between farmland prices and rents in Japan with time‐varying vector autoregressions
Authors: Ramsey A. Ford , Kuroiwa Kenichi
Published: February 2025

Past studies of agricultural land prices and rents in Japan focused on the temporal relations characterizing price and rent dynamics. Several authors have shown that farmland prices respond to shocks to rents, but not vice‐versa. We revisit this relationship with a Bayesian time‐varying parameter vector autoregression (TVP‐VAR). The TVP‐VAR provides nuance by permitting the relationship between prices and rents to vary through time and allowing for stochastic volatility. Impulse response functions indicate that rents adjust to price shocks, but prices do not adjust to rent shocks. The TVP‐VAR suggests both changes in volatility and time variation in the lag coefficients.
Prospective Relations Between Self‐Concept and Adolescent Physical Education Participation: A Sex Stratified Analysis
Authors: Sick Kelsey , Pila Eva , Gilchrist Jenna D. , Gohari Mahmood R. , Patte Karen A. , Leatherdale Scott
Published: February 2025

Introduction

Sustained participation in physical education classes during adolescence can help promote lifelong engagement in physical activity, which is vital for the physical and mental health of adolescents. Self‐concept, particularly in the domains of global and physical appearance self‐perceptions, has been identified as a key predictor of physical activity behavior. However, there is limited understanding of how these facets influence continued enrollment in physical education classes, especially across different sexes.

Methods

We used survey data from two cohorts that completed surveys in two consecutive school years (2016–17 and 2017–18; 2017–18 and 2018–19) to examine sex‐based differences in the association between global self‐concept, physical appearance self‐perceptions, and sustained enrollment in physical education classes during the transition from Grade 9 to Grade 10. The total sample included 7884 Canadian adolescents (mage = 14.4, SD = 0.5 years; 52.2% female). Using multiple logistic generalized estimating equation models, the analysis adjusted for school province, racial identity, and socioeconomic status to estimate the effects of self‐concept on physical education enrollment.

Results

Global self‐concept and physical appearance self‐perceptions declined from Grade 9 to 10 across both sexes, particularly among students who unenrolled from physical education after Grade 9. Interestingly, statistically significant odds ratios were observed for male adolescents but not for females. Higher global self‐concept levels in Grade 9 corresponded with increased odds of physical education enrollment in Grade 10 for male students. Similarly, males with more positive physical appearance self‐perceptions in Grade 9 predicted continued enrollment in physical education into grade 10, compared to males with lower physical appearance self‐perceptions.

Conclusion

During this critical transitional phase, global self‐concept and positive physical appearance self‐perceptions among males were prospectively linked to sustained participation in physical education classes into the subsequent year of high school, when physical education becomes an optional subject for most students. Such findings highlight the pivotal role of self‐concept in sustained physical activity and offer crucial insights for interventions aimed at enhancing physical education participation and fostering a lifelong engagement in physical activity.
Derotational osteotomy is a relevant procedure in the management of lateral patellar dislocation: An expert survey of the International Patellofemoral Study Group
Authors: Wierer Guido , Milinkovic Danko , Seitlinger Gerd , Liebensteiner Michael , Post William , Winkler Philipp W.
Published: February 2025

Purpose

To evaluate current knowledge and discover potential controversies in treating torsional deformities of the lower limb in patients with lateral patellar dislocation (LPD) among patellofemoral experts.

Methods

An online survey was distributed to all active International Patellofemoral Study Group (IPSG) members, representing an international sample of orthopaedic surgeons with a specific interest and experience in patellofemoral joint disorders. The survey included 21 single‐ and multiple‐choice questions and was distributed by email between 2022 and 2023.

Results

Thirty‐five members (54%) completed the questionnaire. The responding experts conduct a hip–knee–ankle magnetic resonance imaging or computed tomography following first‐time and recurrent patellar dislocation based on clinical examination (43% and 49%, respectively), routinely (6% and 23%, respectively), or not at all (51% and 29%, respectively). Two thirds of the experts perform derotational osteotomies of the femur, and 37% perform derotational osteotomies of the tibia. Most of these surgeons (61% and 69%, respectively) perform less than five derotational osteotomies of the femur or tibia per year. The most important factors for performing derotational osteotomy are abnormal torsion (100%), abnormal gait pattern (57%), revision cases (74%) and recurrent patellar instability (61%). Most surgeons (65%) agree on a cut‐off value of >30° of femoral ante‐torsion and >35° of external tibial torsion to perform derotational osteotomy, but the preferred measurement techniques vary.

Conclusion

Torsional deformities of the lower limb are a clinically relevant topic in the management of patients with recurrent LPD. Although the caseload is low, most experts perform derotational osteotomies. Diagnostic and therapeutic algorithms overlap widely between surgeons, but the indication and cut‐off values for performing derotational osteotomy must be further established.

Study Design

Survey.

Level of Evidence

Level V.
Which treatment strategy for irreparable rotator cuff tears is most cost‐effective? A Markov model‐based cost‐utility analysis comparing superior capsular reconstruction, lower trapezius tendon transfer, subacromial balloon spacer implantation and reverse shoulder arthroplasty
Authors: Oeding Jacob F. , Kunze Kyle N. , Pareek Ayoosh , Samuelsson Kristian
Published: February 2025

Purpose

Treatment options for irreparable rotator cuff tears (IRCTs) remain controversial and include superior capsular reconstruction (SCR), lower trapezius tendon transfer (LTTT), subacromial balloon spacer (SABS), and reverse shoulder arthroplasty (RSA). Despite reports of positive treatment responses with all approaches, the relative clinical benefit in the context of associated cost has not been well delineated. The purpose of this study was to determine the most cost‐effective treatment strategy among SCR, LTTT, SABS, and RSA for patients with massive IRCTs.

Methods

A Markov Chain Monte Carlo probabilistic model was developed to evaluate the outcomes and costs of 1000 simulated patients undergoing either SCR, LTTT, SABS, or RSA for massive IRCTs. Upfront costs, health utility values, and reoperation rates including revisions and conversion to RSA were derived from the published literature. Outcome measures included costs, quality‐adjusted life years (QALYs), and the incremental cost‐effectiveness ratio (ICER).

Results

Mean total costs of SCR, RSA, LTTT, and SABS were $30,540 ± 5,770, $26,896 ± 5,622, $25,819 ± 4,325, and $16,412 ± 2,583, respectively. On average, total QALYs from SCR, RSA, LTTT, and SABS were 6.17 ± 0.53, 3.78 ± 0.38, 5.33 ± 0.49, and 5.59 ± 0.48. Overall, SCR was determined the preferred, most cost‐effective strategy in 60% of patients included in the microsimulation model, with SABS the optimal strategy in 31% of cases and LTTT the optimal strategy in 9% of cases.

Conclusion

SCR was found to be the most cost‐effective treatment option for IRCTs based on the current microsimulation and probabilistic sensitivity analyses, although LTTT and SABS were also found to be cost‐effective in select patients. Given that this statistical model does not consider the unique experiences of individual patients, shared decision‐making remains an important component in determining the optimal treatment strategy for IRCTs.

Level of Evidence

Level III, economic decision model.
Integrated multi‐month dispensing for HIV and hypertension in South Africa: A model of epidemiological impact and cost‐effectiveness
Authors: Jo Youngji , Rosen Sydney , Nichols Brooke E. , Jamieson Lise , Lekodeba Nkgomeleng , Horsburgh Robert
Published: February 2025

Introduction

In the current era of universal antiretroviral treatment (ART), health systems have the dual challenge of a growing number of people living with HIV and on ART who are also receiving chronic, life‐long treatment for non‐communicable diseases. Current evidence suggests that 6‐month multi‐month dispensing (6MMD) can maintain at least equivalent clinical outcomes to conventional care and reduce costs, but little is known when integrating 6MMD for multiple conditions. We examined the cost‐effectiveness of integrated multi‐month drug dispensing for people living with HIV and hypertension.

Methods

Using an age‐ and sex‐specific hybrid decision tree and Markov state‐transition model, we constructed a 100,000‐person simulated population cohort who may develop HIV and hypertension and initiate treatment at clinics in South Africa over a 10‐year time horizon. We assessed the incremental costs and effectiveness of 6MMD versus conventional care from a health system perspective under different conditions of care‐seeking, eligibility and uptake of 6MMD for clinically stable patients. Model inputs were sourced from previously published literature. 6MMD was defined as reducing the frequency of clinic visits by increasing the number of medications dispensed to stable patients at each visit from 3 to 6 months. For the integrated 6MMD, we assumed that comorbid patients receive both HIV and hypertension drugs at the same facility on the same day.

Results

Our study demonstrates that integrated 6MMD for HIV and hypertension in South Africa can avert between 0.8 and 1 DALYs and increase health systems costs between $24 and $49 per patient per year, compared to the status quo. One‐way sensitivity analysis showed that HTN drug cost and prevalence of HIVHTN and HIV were key drivers in the cost per DALYs averted. Overall, integrated 6MMD with a greater proportion of well‐controlled patients and lower mortality rates led to greater cost savings or better cost‐effectiveness (less than $50 per DALY averted) across a wide range of loss‐to‐follow‐up (LTFU) factor variation.

Conclusions

By better controlling disease among patients already in care, integrated 6MMD can be more beneficial than the status quo treatment by resulting in fewer cases of LTFU and fewer deaths through high‐quality care.
Integrating hepatitis C testing and treatment into routine HIV care in Cameroon is feasible
Authors: Kowo Mathurin Pierre , Coyer Liza , Sini Victor , Kafack Carole Assontsa , Metomo Gabriella Yelheen , Wafeu Guy S. , Njouom Richard , Boers Alexander , Coutinho Roel , Njoya Oudou , Kouanfack Charles ,   the DHEPC project team
Published: February 2025

Introduction

Hepatitis C virus (HCV) prevalence and adverse outcomes are higher among people with human immunodeficiency virus (HIV) than people without HIV. Yet, HCV prevalence among people with HIV in Cameroon remains unknown, with HCV diagnosis and treatment largely inaccessible due to care centralization by specialists with high out‐of‐pocket costs. Integration of HCV services into routine HIV care by general practitioners could improve diagnosis and treatment coverage. We aimed to examine HCV prevalence and treatment cure rate among people with HIV attending 11 HIV clinics in the Centre Region of Cameroon.

Methods

We offered HCV rapid antibody testing, and, if positive, RNA testing to all persons ≥21 years, on HIV ART for ≥6 months and with suppressed HIV RNA (<1000 copies) who attended HIV counselling and treatment appointments between 20 April 2021 and 31 May 2022. Participants with an HCV RNA positive test received 12 weeks of pangenotypic sofosbuvir/velpatasvir. We calculated the cure rate as the proportion of participants with a sustained virological response 12 weeks after treatment completion (SVR12) among all starting and completing treatment.

Results

We tested 8266 persons for HCV antibodies, 316 (3.8%, 95% CI = 3.4−4.3%) of whom were anti‐HCV positive. Of these, 286 (90.5%) were sampled for HCV RNA, 20 (6.3%) ineligible, 5 (1.6%) declined, 4 (1.3%) left before sampling and 1 (0.3%) had an unknown reason. Among 286 sampled, 251 (87.8%) had detectable HCV RNA. Of these, 173 (68.9%) enrolled for treatment, 55 (21.9%) were eligible but not enrolled (49 lost‐to‐follow‐up, 6 denied) and 23 (9.2%) were ineligible. Of 173 enrolled, 165 completed treatment, 6 were lost‐to‐follow‐up and 2 were excluded due to treatment interruption. SVR12 was achieved in 93.6% (n = 162; 95% CI: 88.9–96.8%) of those enrolled and 98.2% (95% CI: 94.8–99.6%) of treatment completers. All three initially not achieving SVR12 were cured with second‐line treatment (sofosbuvir/velpatasvir/voxilaprevir).

Conclusions

Our study demonstrates the viability of integrating HCV testing and treatment into routine HIV care in Cameroon, yielding new HCV diagnoses and high cure rates. Cameroon can use this strategy to achieve HCV elimination goals, although improvements in testing uptake, diagnosis and treatment access, and laboratory capacity are needed.
Implantable cardiac defibrillator outcomes in octogenarians
Authors: Stringer Bryan , MacLeod Luke , Kaldas Fady , Krishnasamy Gayuni , Khan Habib Rehman
Published: February 2025

Background

Implantable cardiac defibrillators (ICDs) are essential for preventing sudden cardiac death. Despite inclusion in national guidelines, older adults are often underrepresented in trials. Evaluating ICD use in the aging population, particularly with advancements in heart failure treatment, is crucial.

Objective

This study examines outcomes in octogenarians undergoing ICD implantation for primary and secondary prevention, focusing on ICD therapies and mortality timing.

Methods

A retrospective observational study at a single Canadian academic center included patients ≥80 years old at ICD implantation, excluding those with <30 days follow‐up. Data on demographics, comorbidities, mortality, and ICD therapies were collected from electronic medical records. Clinical frailty was assessed using the Dalhousie Clinical Frailty Scale.

Results

We identified 143 patients (mean age 82.6 ± 2.2 years, 14% female) from May 2015 to October 2023. ICDs were implanted for primary prevention in 63 patients (44%) and secondary prevention in 80 patients (56%). Thirty‐seven patients were excluded due to insufficient follow‐up. ICD therapies occurred in 30 patients (25%) through anti‐tachycardia pacing (ATP) and in 19 patients (18%) through shocks. The mean time to first ATP was 16.9 ± 21.0 months, and to first shock, 21.2 ± 23.6 months. Among 66 patients with mortality data, 19 (24%) died at 31.3 ± 30.4 months. Patients with non‐ischemic cardiomyopathy experienced earlier shocks (7.7 vs. 32.2 months, p < 0.05).

Conclusion

Elderly patients undergoing ICD implantation have multiple comorbidities and competing causes of mortality. Device use is overall infrequent but occurs well before observed mortality. Prospective clinical trials are needed to determine ICD benefits in this age cohort.
Prenatal Diagnosis and Classification of Type I Persistent Left Superior Vena Cava
Authors: Li Tian‐gang , Wei Chuan‐min , Wu Wen‐rui , Sheng Yu‐Wu
Published: February 2025

Objective

This study aimed to assess the utility of two‐dimensional (2D) ultrasonography in diagnosing and classifying fetal type I persistent left superior vena cava (PLSVC).

Methods

The diameter (D1) of the coronary sinus (CS) was measured in the four‐chamber view and the diameter (D2) of the PLSVC was measured in the three‐vessel trachea view; the ratio of the diameter of CS to PLSVC (D1/D2) and the ratio of gestational week (GA)/D1 and GA/D2 were calculated to analyze the correlation between measurement and classification of type I PLSVC.

Results

Compared the parameter of Ia and Ib Group, the differences in D1, D2, GA/D1, and GA/D2 were statistically significant (P < .05). D1 and D2 are independent factors for the differential diagnosis of type I PLSVC, with odds ratios (OR) of 5.397 and 2.661, respectively, and both are statistically significant (P < .05). The nomogram model exhibited superior performance in diagnosing type I PLSVC, with the highest AUC value of 0.853, a sensitivity of 96.55%, and a specificity of 66.25%.

Conclusion

The combination of D1, D2, GA/D1, and GA/D2 is valuable for diagnosing and classifying fetal type I PLSVC, demonstrating significant clinical application value.
Partial Hölder regularity for asymptotically convex functionals with borderline double‐phase growth
Authors: Chang Wenrui , Zheng Shenzhou
Published: February 2025

We study partial Hölder regularity of the local minimizers with to the integral functional in a bounded domain for . Under the assumption of asymptotically convex to the borderline double‐phase functional
where satisfies VMO in and is continuous in , respectively, and is a strongly log‐Hölder continuous function, we prove that the local minimizer of such a functional is locally Hölder continuous with an explicit Hölder exponent in an open set with for some small , where denotes ‐dimensional Hausdorff measure.
The Genetics of 241 Fetuses With Talipes Equinovarus: A 8‐Year Monocentric Retrospective Study
Authors: Pan Pingshan , Huang Dongbing , Wei Jiangxuan , He Wei , Huang Peng , Yi Sheng , Huang Jing , Meng Dahua , Tan Shuyin , Li Xinyan , Wei Hongwei , Wang Linlin
Published: February 2025

Objective

This study aims to investigate the utility of chromosomal microarray analysis (CMA) and whole exome sequencing (WES) in fetuses diagnosed with talipes equinovarus (TE), as well as to explore the genetic factors contributing to TE.

Methods

The study reviewed a total of 241 fetuses with TE between January 2015 and December 2023, categorizing them into two groups based on the absence or presence of additional ultrasound anomalies: 163 cases (67.6%) in the isolated TE group and 78 cases (32.4%) in the syndromic TE group. Karyotyping and CMA were performed for all cases, with WES being performed for 18 cases that had normal karyotype and CMA results.

Results

The results indicated a total detection rate of 16.2% (39/241) using karyotyping and CMA. Furthermore, the detection rates of karyotyping and CMA in the isolated TE group and syndromic TE group were 10.4% (17/163) and 28.2% (22/78) respectively, showing a statistically significant difference (p < 0.05). WES was conducted on 18 fetuses with normal karyotyping and CMA results. A total of six cases, consisting of five cases with pathogenic single nucleotide variant (SNV) and one case of variants of uncertain significance (VUS), were identified, resulting in a detection rate of 33.3% (6/18). The identified SNVs was associated with the RIT1, GNPNAT1, PEX1, RYR1, ASCC1, and GDAP1 genes. The detection rates of WES in the isolated TE group and syndromic TE group were 25% (1/4) and 35.7% (5/14) respectively, with no statistically significant difference (p > 0.05). The overall diagnostic yield of genetic testing was 18.7% (45/241) in fetuses with TE.

Conclusion

When prenatal ultrasound identifies fetal TE, chromosome karyotyping and CMA should be considered as the first‐line diagnostic tests. Unlike previous studies, this study recommended WES in cases of normal CMA results for both isolated and syndromic fetal TE.
Lesion segmentation method for multiple types of liver cancer based on balanced dice loss
Authors: Xie Jun , Zhou Jiajun , Yang Meiyi , Xu Lifeng , Li Tongtong , Jia Haoyang , Gong Yu , Li Xiansong , Song Bin , Wei Yi , Liu Ming
Published: February 2025

Background

Obtaining accurate segmentation regions for liver cancer is of paramount importance for the clinical diagnosis and treatment of the disease. In recent years, a large number of variants of deep learning based liver cancer segmentation methods have been proposed to assist radiologists. Due to the differences in characteristics between different types of liver tumors and data imbalance, it is difficult to train a deep model that can achieve accurate segmentation for multiple types of liver cancer.

Purpose

In this paper, We propose a balance Dice Loss(BD Loss) function for balanced learning of multiple categories segmentation features. We also introduce a comprehensive method based on BD Loss to achieve accurate segmentation of multiple categories of liver cancer.

Materials and methods

We retrospectively collected computed tomography (CT) screening images and tumor segmentation of 591 patients with malignant liver tumors from West China Hospital of Sichuan University. We use the proposed BD Loss to train a deep model that can segment multiple types of liver tumors and, through a greedy parameter averaging algorithm (GPA algorithm) obtain a more generalized segmentation model. Finally, we employ model integration and our proposed post‐processing method, which leverages inter‐slice information, to achieve more accurate segmentation of liver cancer lesions.

Results

We evaluated the performance of our proposed automatic liver cancer segmentation method on the dataset we collected. The BD loss we proposed can effectively mitigate the adverse effects of data imbalance on the segmentation model. Our proposed method can achieve a dice per case (DPC) of 0.819 (95%CI 0.798–0.841), significantly higher than baseline which achieve a DPC of 0.768(95%CI 0.740–0.796).

Conclusions

The differences in CT images between different types of liver cancer necessitate deep learning models to learn distinct features. Our method addresses this challenge, enabling balanced and accurate segmentation performance across multiple types of liver cancer.