bluuebunny/crossref_metadata_2025 huggingface dataset:
Dynamic behavior and strain rate sensitivity of lower-extremity metallic lattice bone implants fabricated by additive manufacturing: a focus on damping
Authors: Ghadami-Badrlou Siamak , Khajehzadeh Mohsen , Razfar Mohammad Reza
Published: February 2025

Purpose

This paper aims to study the elasto-dynamic behavior of additively manufactured metallic lattice implants and compare them with human lower-body bone. This work is a step toward producing implants with high similarity of material properties to bone by developing a dynamic design approach.

Design/methodology/approach

A suitable topology was selected and admissible design space was established. Implants were fabricated by selective laser melting. Material dynamics, including elastic modulus, damping and natural frequency, were analyzed with experimental and finite element method methodology.

Findings

Generally, porosity improves dynamic properties up to an optimum point, which depends on printability, that is, ∼70%. Regarding elastic modulus and natural frequency, it is possible to achieve enough similarity with bone. But, considering damping, the similarity is <23% and <12% with dry and fresh bone, respectively. Damping and strain rate sensitivity increase with porosity. The natural frequency decreases with porosity. Bone ingrowth into lattice implants improves damping substantially while increasing elastic modulus.

Originality/value

Designers, dominantly had quasi-static approach, which considered only elastic modulus. But, the human body is a dynamic structure and experiences dynamic loads; meanwhile, bone, with its damping and natural frequency, regulates dynamic events like shock absorption and elastic wave filtering. Importantly, bone cells sense no load in quasi-static loading and must receive impact loads near their natural frequencies and special accelerations to conduct optimum mechanotransduction. So, it is necessary to develop a dynamic strategy which is comprehensive and describes bone duties.
Analysing resilience of European beech tree to recurrent extreme drought events through ring growth, wood anatomy and stable isotopes
Authors: Zhang Guangqi , Bréda Nathalie , Steil Nicolas , Gaertner Pierre‐Antoine , Levillain Joseph , Ruelle Julien , Massonnet Catherine
Published: February 2025

Recent extreme drought events in Central Europe have caused widespread forest dieback with detrimental effects on forest functioning and carbon and water balance. This impact has been notable on European beech (Fagus sylvatica L.), particularly at the core of its distribution, causing concern among forest stakeholders and questions about the resilience capacity of beech trees. The objective of this study is to investigate the physiological processes linked to water and carbon constraints involved in the resilience of beech cambial growth to drought.

We selected 56 beech trees distributed in four plots in north‐eastern France with different soil water deficits characterized retrospectively by a water balance model. Functional traits including tree ring width, wood anatomical traits and stable isotopes (e.g. δ13C and δ18O) were measured to retrospectively assess the effect of recent recurrent drought in 2015, 2018–2020, and 2022.

Decreased tree growth and increased δ18O and intrinsic water use efficiency (iWUE) were observed due to soil water shortage, whereas xylem vessel size and theoretical specific xylem hydraulic conductivity (Kth) did not show obvious changes. Vessel density was negatively correlated with annual ring width index and was highly sensitive to drought. δ13C, δ18O and iWUE were not significantly related to tree ring width index. The plot that experienced the most severe drought intensity in 2018–2020 showed a significant decrease in tree growth resistance and resilience compared to its resistance and resilience during the 2015 drought event. Surprisingly, growth resilience was not associated with tree anatomical and isotopic traits.

Synthesis. Our results demonstrate that beech xylem structure responds to drought by adjusting the radial growth of tree rings with a relatively stable vessel diameter. Our study also highlights the impact of consecutive or recurrent drought in reducing beech tree resistance and resilience, particularly at sites with higher drought intensity. Tree resilience does not seem to involve changes in traits that would promote the hydraulic functioning to better cope with future soil water shortages.
Examining the Effectiveness and Acceptability of Internet‐Delivered Psychological Pain Management for Regional and Rural Australians With Chronic Pain
Authors: Dear Blake F. , Staples Lauren , Nielssen Olav , Titov Nickolai
Published: February 2025

Objective

To examine the characteristics, satisfaction levels and clinical outcomes of rural and remote Australians with chronic pain completing an internet‐delivered psychological pain management program (PMP).

Design

Longitudinal routine care cohort study.

Setting

An Australian national digital psychology service.

Participants

Patients in inner regional locations (n = 401), outer regional and remote locations (n = 198), and major cities (n = 968), who used the service over a 6‐year period.

Main Outcome Measures

Demographic and clinical data, patient‐reported satisfaction and improvements, and meaningful clinical improvements (≥ 30% improvement).

Results

Clinical improvements were observed from pre‐treatment to post‐treatment in pain‐related disability (32% [95% CI: 29, 34]), depression symptoms (44% [95% CI: 39, 49]), anxiety symptoms (43% [95% CI: 39, 47]), and average pain intensity (23% [95% CI: 21, 26]), which were maintained to 3‐month follow‐up. High levels of satisfaction and treatment completion were also observed. Minor demographic and clinical differences were observed. However, there were similar rates of clinical improvement, treatment satisfaction and treatment completion in all groups.

Conclusions

The current findings further highlight the value of internet‐delivered psychological PMPs for Australians with chronic pain living in regional and remote parts of the country. Further work is needed to raise awareness about the availability of these effective programmes and to integrate their use with traditional pain management services.
Proinflammatory cytokines and neuropeptides in psoriasis, depression, and anxiety
Authors: Keenan Emily L. , Granstein Richard D.
Published: February 2025

Psoriasis vulgaris has established associations with psychiatric conditions such as depression, anxiety, and chronic stress. This review aims to evaluate current theories and evidence regarding the role of proinflammatory cytokines and neuropeptides in connecting systemic inflammation, psychological stress, and inflammatory skin diseases, namely psoriasis. A literature review was conducted to analyze studies that explore the connections between psoriasis, psychiatric conditions, and biological mediators, including inflammatory cytokines [interferon (IFN)‐γ, interleukin (IL)‐1, IL‐2, IL‐6, IL‐12, tumor necrosis factor (TNF)‐α, IL‐22, IL‐17], neuropeptides [calcitonin gene‐related peptide (CGRP), substance P (SP), and vasoactive intestinal peptide (VIP)], as well as the hypothalamic–pituitary–adrenal (HPA) axis. Existing literature indicates that psychiatric state can influence cutaneous conditions through immune, neural, and endocrine mediators. The elevated rates of anxiety and depression observed in psoriasis patients are likely due to both the inflammatory process itself and the chronic stress associated with disease management, highlighting the importance of managing stress, and addressing mental health to improve clinical outcomes. While the literature suggests proinflammatory cytokines and neuropeptides may be key links between systemic inflammation, psoriasis, and psychiatric comorbidities, further research is necessary to continue to elucidate physiological mechanisms and explore the potential for new treatment modalities.
“We are here too”: Experiences and perceived support needs of adolescent siblings of Paediatric oncology inpatients
Authors: Batchelor Rachel , Hotton Matthew , Harris Eloise , Lau‐Zhu Alex , David Annabel L.
Published: February 2025

Background

Adolescent siblings of children and young people (CYP) with cancer are at increased risk of psychosocial difficulties, yet many remain overlooked and unsupported. This project aimed to explore the experiences and perceived needs of adolescent siblings of paediatric oncology inpatients to inform service improvement recommendations for sibling support.

Methods

Semi‐structured interviews were conducted with 10 siblings of CYP previously admitted to a paediatric oncology ward. Interviews were transcribed verbatim and analysed using reflexive thematic analysis. The findings were reviewed in consultation with staff and used to identify pragmatic/feasible recommendations for improving sibling support, organized using the three‐tier ‘Pediatric Psychosocial Preventative Health Model’ (PPPHM; Families, Systems & Health, 2006, 24, 381).

Results

An overarching narrative of siblings wanting to feel part of the cancer journey was found, including their family's experience on the ward, with three key themes: (i) “what about me?”: overlooked and unseen, (ii) “always changing, never knowing”: the challenge of uncertainty and (iii) “let me be part of it all”: togetherness, communication and connection. These findings informed sibling support recommendations. Such recommendations included providing psychosocial screening, resources and opportunities for family time/communication and developmentally appropriate information to all siblings (universal support), monitoring psychosocial difficulties, siblings having someone to talk to and fostering family and peer connection for siblings requiring additional support (targeted support) and offering one‐to‐one psychological support and family therapy for persistent and/or escalating distress (clinical/treatment support).

Conclusions

Based on the experiences of siblings, a range of sibling support recommendations have been identified. Implementation and evaluation of these recommendations are warranted.
Adherence to Treatment in Allergic Rhinitis During the Pollen Season in Europe: A MASK‐air Study
Authors: Sousa‐Pinto Bernardo , Costa Elísio M. , Vieira Rafael José , Klimek Ludger , Czarlewski Wienczyslawa , Pfaar Oliver , Bedbrook Anna , Amaral Rita , Brussino Luisa , Kvedariene Violeta , Larenas‐Linnemann Desiree E. , Iinuma Tomohisa , Pham‐Thi Nhân , Regateiro Frederico S. , Taborda‐Barata Luis , Ventura Maria Teresa , Ansotegui Ignacio J. , Bergmann Karl C. , Canonica G. Walter , Cardona Victoria , Cecchi Lorenzo , Cherrez‐Ojeda Ivan , Cingi Cemal , Cruz Alvaro A. , Del Giacco Stefano , Devillier Philippe , Fokkens Wytske J. , Gemicioglu Bilun , Haahtela Tari , Ivancevich Juan Carlos , Kuna Piotr , Kraxner Helga , Laune Daniel , Louis Renaud , Makris Michael , Morais‐Almeida Mario , Mösges Ralph , Niedoszytko Marek , Papadopoulos Nikolaos G. , Patella Vincenzo , Pereira Ana Margarida , Reitsma Sietze , Robles‐Velasco Karla , Rouadi Philip W. , Samolinski Boleslaw , Sova Milan , Toppila‐Salmi Sanna K. , Sastre Joaquin , Valiulis Arunas , Yorgancioglu Arzu , Zidarn Mihaela , Zuberbier Torsten , Fonseca Joao A. , Bousquet Jean ,   the MASK‐air think tank
Published: February 2025

Background

Adherence to rhinitis treatment has been insufficiently assessed. We aimed to use data from the MASK‐air mHealth app to assess adherence to oral antihistamines (OAH), intra‐nasal corticosteroids (INCS) or azelastine‐fluticasone in patients with allergic rhinitis.

Methods

We included regular European MASK‐air users with self‐reported allergic rhinitis and reporting at least 1 day of OAH, INCS or azelastine‐fluticasone. We assessed weeks during which patients answered the MASK‐air questionnaire on all days. We restricted our analyses to data provided between January and June, to encompass the pollen seasons across the different assessed countries. We analysed symptoms using visual analogue scales (VASs) and the combined symptom‐medication score (CSMS), performing stratified analyses by weekly adherence levels. Medication adherence was computed as the proportion of days in which patients reported rhinitis medication use. Sensitivity analyses were performed considering all weeks with at most 1 day of missing data and all months with at most 4 days of missing data.

Results

We assessed 8212 complete weeks (1361 users). Adherence (use of medication > 80% days) to specific drug classes ranged from 31.7% weeks for azelastine‐fluticasone to 38.5% weeks for OAH. Similar adherence to rhinitis medication was found in users with or without self‐reported asthma, except for INCS (better adherence in asthma patients). VAS and CSMS levels increased from no adherence to full adherence, except for INCS. A higher proportion of days with uncontrolled symptoms was observed in weeks with higher adherence. In full adherence weeks, 41.2% days reported rhinitis co‐medication. The sensitivity analyses displayed similar results.

Conclusions

A high adherence was found in patients reporting regular use of MASK‐air. Different adherence patterns were found for INCS compared to OAH or azelastine‐fluticasone that are likely to impact guidelines.
Hemodynamic and Pharmacokinetic Interactions of TPN171 with Alcohol in Healthy Male Subjects
Authors: Cheng Jie , Qian Hongjie , Wang Yu , Liang Liyu , Xu Wenjing , Liu Ye , Chen Qian , Yu Chen , Duan Huaqing , Wang Zhen , Wang Hang , Jia Jingying
Published: February 2025

This study aimed to evaluate the effects of the concomitant administration of TPN171 and alcohol on hemodynamic and pharmacokinetic characteristics in healthy Chinese male subjects. Fifteen eligible subjects were randomly assigned to one of three sequences, each comprising three treatments: Treatment A (placebo +0.5 g/kg alcohol), Treatment B (TPN171 + 0.5 g/kg alcohol), and Treatment C (TPN171 + placebo). Enrolled subjects were administered with 10 mg TPN171 and/or 0.5 g/kg alcohol in fasting state in a randomized crossover design. Blood pressure, pulse rate (PR), blood samples, and breath alcohol test were measured at designated time points for hemodynamic and pharmacokinetic analyses. Compared with 10 mg TPN171 alone, administration of 10 mg TPN171 + 0.5 g/kg alcohol significantly lowered the area under the effect–time curve from 0 to 4 h (AUEC0‐4h) of systolic blood pressure (95% confidence interval [CI]: −29.75 to −0.83, p = 0.039) and significantly increased AUEC0–4h of PR (95% CI: 7.47–28.92, p = 0.003). Compared with 0.5 g/kg alcohol alone, administration of 10 mg TPN171 + 0.5 g/kg alcohol contributed to significantly higher maximal increase of PR (95% CI: 2.78–9.44, p = 0.002) and AUEC0‐4h of PR (95% CI: 1.08–24.52, p = 0.035). Alcohol had no influence on the pharmacokinetics of TPN171, and vice versa. Though the concomitant administration of TPN171 and alcohol induced a more pronounced increase in PR, this did not result in clinical symptoms or heart rate increase‐related adverse events, indicating that the combined use was generally safe and well‐tolerated.
Does habitat or climate change drive species range shifts?
Authors: Lyn Morelli Toni , Hallworth Michael T. , Duclos Timothy , Ells Adam , Faccio Steven D. , Foster Jane R. , McFarland Kent P. , Nislow Keith , Ralston Joel , Ratnaswamy Mary , Deluca William V. , Siren Alexej P. K.
Published: February 2025

A primary prediction of climate change ecology is that species will track their climate niche poleward and upslope. However, studies have shown species responding in surprising ways. In this study, we aim to understand the impact of global change on species ranges by considering both climate and habitat changes. Using occupancy analysis of acoustic survey data in the mountains of the northeastern United States, we tested specific predictions of range responses to warming (shifting upslope), precipitation change (shifting downslope), and forest composition change (shifting downslope). We found that American red squirrels Tamiasciurus hudsonicus, key nodes in northern North American food webs, are not tracking increasing temperatures upslope, despite substantial warming in recent decades. Structural equation modeling indicates that red squirrel abundance is primarily influenced by red‐spruce forest cover, which has shifted downslope with recovery from historical logging and acid deposition. Accounting for the multiple dimensions of global change will enable better predictions and more effective conservation strategies.
Dispersal rather than climate and local environment constrains non‐marine snail fauna in west Greenland
Authors: Horsák Michal , Horsáková Veronika , Samaš Peter , Divíšek Jan , Coles Brian , Nekola Jeffrey C.
Published: February 2025

The biota of North Atlantic islands evokes intriguing questions on its evolution, colonisation routes, and an equilibrium between dispersal limitation and climatic/habitat constraints. While good data on non‐marine snails exist for most of the islands, the data for Greenland were observed mainly between 1850 and 1900. The recorded species have been described as Greenland endemics, but this conclusion has never been fully questioned based on evidence. It can be assumed that these passively dispersing invertebrates are in fact of North American origin, due to the shortest distance to the mainland across the Davis Strait. To answer these questions, we collected the snail fauna at 72 sites of five locations across west Greenland. Our sampling revealed a very species‐poor fauna, consisting of two aquatic and four terrestrial snail species. Based on mitochondrial and nuclear DNA sequences, the phylogenetic reconstruction and haplotype analysis showed that these taxa are either North American (all aquatic) or European (all terrestrial) in origin. None of them appeared to be endemic to Greenland and they were not even genetically distinct from the mainland populations. At both the macro and habitat scale, the Greenland snail fauna was found to be only a small fraction of the mainland species pool based on climate mapping and analysis of habitat requirements. While it appears to be limited mainly by dispersal, a detailed analysis of bird migration routes and intensity could not explain a puzzling difference in the biogeographical origin of the aquatic and terrestrial components. Terrestrial snails mimic the pattern seen in non‐flying beetles, while the aquatic that of some flying insects. The results are a strong reminder that simple linear distance does not make a barrier, and that the barrier permeability can differ even within a group sharing the same dispersal mode and potential.
Potential of Mussel Habitat Enhancement to Alleviate Eutrophication in Nutrient‐Enriched Estuaries
Authors: Cottingham Alan , Bossie Andrew , Valesini Fiona , Maus Charles , Cronin‐O'Reilly Sorcha , Tweedley James R. , Galimany Eve
Published: February 2025

Through altered freshwater flow regimes and excessive anthropogenic nutrient input, many estuaries around the world are showing signs of eutrophication. As shellfish can alleviate some of these issues through their water filtration capacity, shellfish habitat restoration efforts have increased markedly in the past decade. This study quantifies, for the first time, the water filtration capacity of the Black Pygmy Mussel Xenostrobus securis and the potential for habitat enhancement to alleviate eutrophication issues in a hypereutrophic estuary in south Western Australia. Substrate, comprising coir matting, was deployed by community volunteers in four‐panel arrangements in the rivers of the Swan‐Canning Estuary onto which X. securis recruited naturally. In the Swan River, average mussel densities were 3377 individuals m−2, based on 10% mat coverage. River water comprised relatively high particulate organic matter (POM) concentrations, particularly in spring (up to 9.2 mg L−1). Standardised clearance rates (CR; g−1 mussel tissue) were typically greater (> 5.0 L h−1) in summer when chlorophyll a concentrations, salinities and water temperature were elevated, whereas CR was often < 2.0 L h−1 in early spring. In the Swan River, it was estimated that for every square metre of habitat enhanced, 9.2 × 105 L of water could be potentially cleared during spring and 1.7 × 106 L over summer, the latter incorporating 5.3 kg of organic matter into mussel biomass. On a larger scale, 1000 m2 of deployed habitat over the course of summer has the potential to clear 24.5% of the volume of the tidal portion of the Swan River and 64.4% of the volume of the smaller Canning River. The results thus demonstrate the efficacy of using cost‐effective soft substrates deployed by community volunteers to enhance habitat for mussels and its potential to assist in alleviating eutrophication issues.
Associations of Inflammatory Markers With Neurological Dysfunction and Prognosis in Patients With Progressive Stroke
Authors: Wang Yingying , Zhang Zhouao , Hang Xiaoyu , Wang Wei
Published: February 2025

Objective

This study aimed to explore the associations between inflammatory markers and the severity of early neurological dysfunction and prognosis in patients with progressive stroke (PS) and evaluated the predictive value of inflammatory markers for PS.

Methods

Among 711 acute ischemic stroke (AIS) patients, 210 patients with PS and 501 patients without PS were included. Six inflammatory markers, including neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), lymphocyte to monocyte ratio (LMR), systemic immune‐inflammation index (SII), systemic inflammatory response index (SIRI), and pan‐immune‐inflammation value (PIV), were measured and compared between two groups. Correlation analysis was used to analyze the correlation between inflammatory markers and early neurological dysfunction in patients with PS. Univariate and multivariate regression analyses were applied to screen the factors for the prognosis of PS patients. The receiver operating characteristic (ROC) curve was utilized to evaluate the predictive value for the prognosis of PS patients.

Results

Elevated levels of NLR, LMR, SII, and PIV were observed in PS patients. Correlation analysis revealed positive correlations between NLR, PLR, SII, SIRI, PIV, and early neurological deficits, while LMR showed a negative correlation in PS patients. Multivariate analysis identified LMR and the National Institutes of Health Stroke Score (NIHSS) as independent risk factors for poor outcome of PS patients. The predictive value of LMR alone was limited (AUC = 0.59), but combining it with NIHSS improved predictive accuracy (AUC = 0.73) (p < 0.05).

Conclusion

These findings suggest that inflammatory markers, particularly LMR, should be considered in PS management, and their combination with NIHSS enhances outcome prediction.
An Experimental Study on the Fatigue Response of Hybrid Additively Manufactured 1.2343 Hot Work Steel ‐ MARAGING Steel MS1
Authors: Croccolo Dario , Ćirić‐Kostić Snežana , De Agostinis Massimiliano , Fini Stefano , Mele Mattia , Bogojević Nebojša , Sinđelić Vladimir , Olmi Giorgio
Published: February 2025

Hybrid additive manufacturing consists of upgrading wrought material by an additive process, adding stacked layers through the melting and sintering of a different material powder. A literature survey indicates that fatigue data for hybrid additively manufactured parts are currently missing. This paper is focused on the fatigue response of 1.2343 hot work steel, upgraded by a maraging steel MS1 powder processed by laser powder bed fusion, and finally heat‐treated complying with the specifications from the powder supplier. Results, supported by microscopy SEM analyses, indicate the fatigue response is significantly reduced if compared to that of plain additively manufactured MS1. This is due to the joint between the two materials acting as a weak point, where the porosity of MS1 is incremented with respect to specifications. Moreover, due to the unavailability of a heat treatment that is suitable for both the involved materials, the hot work steel side exhibits poor hardness.
Taking a Pause: Co‐Designing a Reflection Tool for Meaning Creation in Patients With Type 2 Diabetes
Authors: Kim Hyeryoung
Published: February 2025

Objectives

This study aims to explore how the design of a self‐reflection tool can assist patients with type 2 diabetes (T2D) by facilitating and sustaining their reflective practices in the context of diabetes care. Specifically, the study seeks to examine how patients utilize self‐reflection tools, identify aspects they feel improve diabetes management, and uncover the opportunities and challenges they encounter when integrating such tools into their daily lives.

Methods

The research involved two phases: first, the preliminary development of a self‐reflection tool prototype and second, the exploration of user experience. During the second phase, five patients with T2D participated in three interview sessions bi‐weekly over the period of 6 weeks. The interviews were transcribed and thematically coded, and affinity diagramming was then used to synthesize the data.

Results

Four main themes emerged from the interviews. The designed self‐reflection tool was found to have the potential to enhance participants’ motivation for engaging in diabetes management by improving diabetes management, initiating self‐reflection, facilitating new thoughts and meanings, and providing opportunities for the patients to share their reflections.

Conclusions

The designed self‐reflection tool helped patients with T2D by encouraging them to adopt a more positive mindset and supporting them in addressing challenges related to their diabetes management. The study suggests that there is promising potential for the self‐reflection tool to evolve into a reflection‐sharing tool that can be shared with other patients.

Patient or Public Contribution

Participants with T2D took part in the designed interviews, and their experiences and comments meaningfully contributed to enriching the co‐design of the self‐reflection tool. The suggested potential for this tool to be expanded into a reflection‐sharing tool is also significant.
Migration diplomacy and Greek–Turkish relations: A three‐level game analysis
Authors: Tsourapas Gerasimos
Published: February 2025

Migration diplomacy has become a critical element of contemporary geopolitics, yet its complex dimensions remain underexplored. This article introduces a novel three‐level game framework to examine how foreign policy strategies leverage cross‐border mobility across domestic, bilateral and supranational dimensions. The 2020 Greek–Turkish border crisis serves as a case study to investigate how domestic political imperatives, bilateral disputes and engagement with European institutions shaped the two government' strategies. The study integrates process tracing with diverse multi‐source data – including policy documents, media analysis and stakeholder interviews – to demonstrate how migration crises function as instruments of geopolitical contestation. This framework is also applied to cases, such as Morocco–Spain, Tunisia–EU and Belarus–EU, advancing theoretical and empirical understandings of migration diplomacy. The article provides fresh insights into the interplay between domestic politics, bilateral relations and supranational governance, illustrating how migration diplomacy is both a reflection and a driver of contemporary power dynamics in global geopolitics.
Monitoring the Sustainability of a Breastfeeding Guideline During the COVID‐19 Pandemic: A Mixed‐Methods Study
Authors: Harillo‐Acevedo David , Molina‐Rodríguez Alonso , Ramos‐Morcillo Antonio Jesús , Suárez‐Cortes María , Ruzafa‐Martínez María
Published: February 2025

Aim

To analyse the impact of the COVID‐19 pandemic on the sustainability of a breastfeeding (BF) clinical practice guideline (CPG) for women without COVID‐19, throughout the 5 waves of the pandemic.

Desing

A mixed‐methods design was utilised.

Methods

For the quantitative approach, an interrupted time series design was utilised, as well as the analysis of CPG sustainability reports as a qualitative approach. The study setting was in a health area in the Spanish health system from April 2019, until October 2021. The sample was composed of 2239 mother–infant dyads.

Results

The exclusive‐BF rate at hospital discharge obtained values between 90% and 94.8%, without statistically significant changes. A significant increase in the risk of not starting BF in the first feeding was observed (adjusted odds ratio = 9.36; 95% CI: 1.04–84.13), between the pre‐pandemic period and the first wave. Skin‐to‐skin contact (SSC) decreased in the first wave to 82.20%, and the oscillations observed throughout the pandemic were not statistically significant. In general, the qualitative indicators were maintained. A decrease was observed in the spaces used for postpartum care due to the re‐assigning to the intensive care unit. Also, the acquisition of materials and equipment decreased.

Conclusions

The measures implemented for the sustainability of the BF CPG during the 5 waves of the pandemic were positive. The programmes of implementation of BF guidelines were shown to resist the COVID‐19 pandemic.

Impact

Our findings contribute to the understanding and evolution of the main indicators of the sustainability of a BF CPG on COVID‐19 context, providing details on the magnitude of the effect and the process of change.

Reporting Method

The Preferred Reporting Items for observational studies (STROBE) checklist was followed.

Patient or Public Contribution

No Patient or Public Contribution.
Frailty and Social Isolation in Breast Cancer Patients: The Moderated Mediating Role of Self‐Perception of Aging and Menopausal Symptoms
Authors: Zhang Ye , Wei Xiaoying , Zhang Ni , Zhang Yiheng , Li Na , Zhang BaoYi , Zhang Meifen
Published: February 2025

Aims

To investigate the status of social isolation among middle‐aged and elderly breast cancer patients and identify its influencing factors. Additionally, to explore the mediating role of self‐perception of aging between frailty and social isolation, as well as the moderating effect of menopausal symptoms.

Design

A cross‐sectional study guided by the Strengthening the Reporting of Observational Studies in Epidemiology.

Methods

This study was conducted on middle‐aged and elderly breast cancer patients from September 2022 to February 2023 in Guangzhou, China. Related data were assessed by structural questionnaires. Correlation analysis and regression analysis were performed by SPSS 26.0 while PROCESS macro v4.0 was used to test the moderated mediation model.

Results

Breast cancer patients aged 45–82 years experienced moderate social isolation. It was influenced by educational level, residence, menopause symptoms, self‐perception of aging, and frailty. The moderated mediation model involving self‐perception of aging and menopausal symptoms for explaining how frailty causes social isolation was supported. The mediating role of self‐perception of aging gradually strengthens as menopausal symptoms become severe.

Conclusion

Social isolation resulting from frailty in middle‐aged and elderly breast cancer patients is mediated by self‐perception of aging, with menopausal symptoms amplifying this effect. Interventions focused on improving self‐perception of aging and managing menopausal symptoms may help reduce social isolation by mitigating the impact of frailty.

Impact

This study highlights the importance of addressing frailty, self‐perception of aging, and menopausal symptoms in clinical nursing practice, which may help reduce social isolation among breast cancer patients.

Patient or Public Contribution

Patients contributed by completing the questionnaire, ensuring the accuracy and completeness of the information with assistance from the research team.
Effectiveness of an Intervention to Prevent Ultra‐Processed Foods and Added Sugar in the First Year of Life: A Multicentre Randomised Controlled Trial in Brazil
Authors: Baratto Paola S. , Hoffman Daniel J. , Valmórbida Júlia L. , Leffa Paula S. , Feldens Carlos A. , Vitolo Márcia R.
Published: February 2025

Background

The early consumption of ultra‐processed foods (UPFs) and added sugars (AS) has been linked to adverse outcomes in infancy. The objective of this study was to determine the effectiveness of a dietary counselling strategy to prevent the consumption of UPFs and AS in the first year of life.

Methodology

A multicentre randomised controlled trial was conducted with 516 mother–child pairs in three state capitals of Brazil. Mothers were randomly assigned to the control group (CG) or intervention group (IG) after childbirth. The IG received orientation based on UNICEF dietary guidelines and five monthly telephone calls to reinforce the intervention. Dietary intake was measured using food introduction questionnaires and 24‐h recalls during home visits at 6 and 12 months. Between‐group differences were analysed by generalised estimating equations and presented as mean difference (95% CI).

Results

Children in the IG had lower UPF intake at 6 and 12 months of age (−20.69 g/day; 95% CI: −37.87 to −3.50; p = 0.018 and −32.51 g/day; 95% CI: −61.03 to −3.99; p = 0.025) and lower AS intake at 12 months of age (−4.92 g/day; 95% CI: −9.43 to −0.41; p = 0.033). The intervention also had a positive impact on the period of exclusive breastfeeding, reducing the offer of infant formula, cow's milk, and toddler milk in the first year of life.

Principal Conclusions

The dietary counselling strategy was effective at preventing the early consumption of UPFs and AS in the first year of life. Future research should focus on social and cultural barriers to improve adherence to infant feeding interventions.
Management of paradoxical tensions in industrial symbiosis: An exploration at the inter‐organizational level
Authors: Alosi Alice , Katana Katrin , Annunziata Eleonora , Mirata Murat , Rizzi Francesco , Frey Marco
Published: February 2025

Industrial symbiosis (IS) is becoming a prominent inter‐organizational approach for improved resources utilization and reduced emissions. IS literature and development efforts focus on interventions needed to overcome or eliminate various barriers, but pay inadequate attention to paradoxes that cannot be suppressed over time and require management. This study combines literature on paradox theory and IS, exploring the identification and management of paradoxical tensions in eight case studies. The results show that IS relationships trigger paradoxical tensions at the strategic and operational levels, surfaced within and between the organizations. These tensions seem to emerge from, and connected to, the persistence of a cooperation–competition paradox within organizations, when engaging with IS partners contradicts with an organization's competitiveness on the market. The study also provides insights into paradoxical tension management within and between organizations in IS relationships by, for example, shifting partner expectations in favor of IS development, separating responsibilities for IS and core activities between departments, or addressing diverging objectives between partners over time. Both at organizational and inter‐organizational levels open dialogue, transparency, and collaboration appear to play key roles in tension management. The study emphasizes the pivotal role of active paradoxical tension management—both internally at strategic and operational levels and externally with partners and facilitators.
Gendered time use, body mass index, and well‐being among adolescents in resource‐poor settings in India: The adverse role of domesticity
Authors: Ganguly Dibyasree , Vikram Kriti
Published: February 2025

We investigated how adolescents' time allocation across daily activities influences their body mass index and well‐being by paying explicit attention to gender and activities relevant to low‐ and middle‐income countries (LMICs). We hypothesized that the inequitable domestic burden shouldered by girls adversely affects their health and well‐being. Using data from three waves of the Young Lives Longitudinal Survey (2009, 2013, and 2016) tracking 1891 children aged 8, 12, and 15 from predominantly rural, low‐income households from South India, we analyzed gendered time use patterns and their implications. Girls spent more time on caregiving, housework, and studying at home, while boys allocated more time to school, leisure, and sleep. Random effects models revealed that time spent on caregiving and housework increased the likelihood of being overweight or obese among girls, whereas leisure time reduced it. Time in school was positively associated with girl's thinness, as was time spent on sleep for both boys and girls. Gender moderated the effects of time spent on housework and unpaid economic tasks on thinness, reducing its likelihood for girls. Subjective well‐being improved with time spent in school and studying for all adolescents. Fixed effects models revealed it worsened for girls engaged in paid work and boys engaged in leisure. Longer sleep hours improved boys' well‐being. These findings underscore that gendered time use patterns, particularly girls' unequal burden of domestic responsibilities, contribute to their increased risk of overweight and obesity. Addressing these disparities is crucial for improving adolescents' health and well‐being in resource‐poor settings in LMICs.
Trends of Large for Gestational Age and Macrosomia and Their Mediating Effect on the Association Between Diabetes Mellitus and Obstetric Hemorrhage
Authors: Chen Peiran , Mu Yi , Xie Yanxia , Wang Yanping , Liu Zheng , Li Mingrong , Liang Juan , Zhu Jun
Published: February 2025

This study aimed to determine the prevalence of large for gestational age (LGA) and macrosomia in China from 2012 to 2021 and explore if LGA and macrosomia mediate the relationship between diabetes mellitus in pregnancy (DIP) and obstetric haemorrhage. The overall annual change rate (ACR) was calculated, and stratification analysis was performed. Mediation analysis assessed the influence of LGA and macrosomia in the association between DIP and obstetric haemorrhage. The nationwide prevalence of LGA and macrosomia was 15.8% and 6.8%, respectively. The ACR for LGA was 0.71% (95% CI, 0.66%–0.76%); pre‐2016, −0.44% (95% CI, −0.63% to −0.25%); post‐2016, −0.29% (95% CI, −0.39% to −0.19%). The ACR for macrosomia was −1.17% (95% CI, −1.24% to −1.09%); pre‐2016, −0.73% (95% CI, −1.03% to −0.43%); post‐2016, −2.42% (95% CI, −2.59% to −2.26%). In western and rural area, the ACR for LGA was 1.94% (95% CI, 1.84%–2.05%) and 1.81% (95% CI, 1.73%–1.89%), and LGA was increasing among these women in the post‐2016 period. About 7.0% of pregnant women had DIP, and the LGA and macrosomia prevalences among women with DIP were 23.7% and 10.0%, respectively. In the mediation analysis, the total excess risk associated with DIP on obstetric haemorrhage was approximately 0.21 and the proportion mediated by LGA and macrosomia was 12.10% and 11.81%, respectively. In rural areas, the proportion mediated by LGA and macrosomia was amplified to 18.34% and 16.40%. Macrosomia rates declined steadily, but LGA rates increased slightly in disadvantaged areas. LGA and macrosomia mediated the association between DIP and obstetric haemorrhage, and the mediating effect intensified in rural regions. Addressing LGA warrants management for at‐risk fetuses.
Engagement
Authors: Foruzan Sahar
Published: February 2025

Community engagement, an often‐repeated phrase across academic and government sectors, is a deceptively simple, pretty phrase. Frequently it is discussed as a practice anyone can do and a nice add‐on to an existing project. However, practicing community engagement in research in a meaningful way requires a perspective shift in the way the research is done, a series of commitments to ethical relations with the communities involved and impacted by a project and its outcomes, and the solo and collective work of reflection. This article offers a look into community engagement from the perspective of a graduate student learning what it means to do this kind of work in the time of the COVID‐19 pandemic. I outline how community engagement is defined and practiced by scholars in anthropology and other fields and discuss the performance and institutionalization of community engagement. Guided by Juanita Sundberg's concept of homework, I reflect on lessons learned in the process of conducting community‐engaged research that can have an impact.
Solidarity
Authors: Syvertsen Jennifer
Published: February 2025

What if as researchers we do not share the same experiences or belong to the same structurally marginalized communities with whom we work, yet we recognize an urgent collective need to address health injustices? In this essay, I reflect on what it means for academic researchers to work in solidarity with communities. Drawing on my community‐based research on opioid overdose and harm reduction, I think about solidarity as a form of pedagogy that does not rely on notions of similarity, but rather recognizes the incommensurability of differences as part of an interlinked struggle. This approach to building solidarity is grounded in social relationships, empathy, and reciprocity and calls for collective action. Reflecting on the importance of harm reduction and the relationships we develop with people who use drugs and bear the brunt of politically‐induced suffering is not just an academic exercise, but a possibility for building life‐sustaining solidarity. In the case of the ongoing overdose crisis that has devastated communities, finding new ways to reclaim and enact solidarity is critical if our goal is collective survival.
Care
Authors: Vázquez Evelyn
Published: February 2025

This article critiques “care” within the neoliberal university through two questions: What is the meaning of “care” in a neoliberal university? How is the neoliberal university addressing the social and structural factors that prevent scholars from marginalized communities from succeeding in higher education? It condemns the superficial care promoted by the neoliberal university, which prioritizes competition, prestige, and productivity over genuine support. Participatory‐action research challenges these practices by centering marginalized voices. The study included 10 participants (7 women, 2 men, 1 non‐binary), all low‐income, first‐generation college students. Using PhotoVoice, a participatory‐action research method, participants documented their social connectedness, sense of belonging, and mental health in graduate education. Their narratives revealed neglect and invisibility, highlighting the negative effects of limited resources, precarious working conditions, financial instability, food insecurity, and inadequate housing on their well‐being and quality of life. The article argues that neoliberal universities perpetuate neglect and avoid addressing structural issues like structural racism and settler colonialism. It proposes self‐reflexivity, intentionality, and collective resistance as transformative care practices essential for dismantling oppressive systems. These practices offer a revolutionary approach to resisting neoliberalism and fostering community‐based care, healing the symbolic, psychological, and emotional harm caused by neoliberal policies. Transformative care is crucial to foster health equity and collective healing in higher education.
Knowledge and Perceptions of Supplemental Nutrition Assistance Program‐Eligible Purchases: A Survey of US Midwestern College Students
Authors: Chrisman Matthew , Landry Matthew J. , Klobodu Seth , Bailey Dylan
Published: February 2025

Little is known regarding the intrastudent barriers to accessing and utilising the Supplemental Nutrition Assistance Program (SNAP). To examine college students' knowledge of allowable items and perception of what items should be allowed for purchase with (SNAP) benefits, particularly by food security status and enrolment in SNAP in the past 12 months, a cross‐sectional, online survey was conducted among 844 college students from nine higher education institutions in a single Midwestern state. Many students were unaware that certain food items were already covered by SNAP, leading them to express a desire for these items to be included. Additionally, there were misconceptions about the eligibility of nonfood items for purchase using SNAP benefits. Beyond traditional food items, students highly desired the inclusion of necessities such as toiletries and cooking equipment. Improved outreach and educational campaigns could be developed to clarify the eligible items and scope of the programme, enabling students to make informed decisions about their SNAP benefit usage.
Optimized LED phototherapy induces ROS‐mediated membrane damage in Trichophyton rubrum for effective onychomycosis treatment
Authors: Li Angze , Ren Yi , Peng Zhenjian , Liu Shangfeng , Liu Muqing
Published: February 2025

Onychomycosis, predominantly induced by Trichophyton rubrum, is a pervasive nail disorder within dermatology known for its high relapse rates and suboptimal patient adherence to treatment regimens. While photomedicine has emerged as a promising therapeutic modality, efficiency reductions are common due to deck obstruction in conventional light therapy. The spectral flexibility of LEDs offers a compelling solution, allowing for deeper deck penetration while maintaining efficacy. We have developed an advanced LED system with optimized optical parameters and have elucidated the antimicrobial mechanisms underlying this technology. Our research shows that an optimal wavelength of 405 nm, an energy density of 396 J/cm2, and an average light intensity of 140 mW/cm2 demonstrate superior efficacy in treating onychomycosis. The antifungal mechanism of our pulsed LED system involves the induction of reactive oxygen species (ROS) within fungal mycelia, ultimately resulting in membrane damage. These insights highlight the potential of LED lighting systems as a novel antimicrobial strategy, offering a promising avenue for the treatment of onychomycosis.
All you'll feel is doom and gloom: Multiple perspectives on the associations between economic anxiety and conspiracy beliefs
Authors: Adamus Magdalena , Chayinska Maria , Šrol Jakub , Adam‐Troian Jais , Ballová Mikušková Eva , Teličak Peter
Published: February 2025

The article investigates whether and how adherence to conspiracy beliefs (CBs) about COVID‐19 pandemic might be associated with (and cause) economic anxiety over various cultural settings and time. First, we examined the extent to which CBs predicted economic anxiety using the European Social Survey data, round 10, from 17 countries (Study 1). Second, using data from a balanced (in terms of age, gender, education, and region) Slovak sample, we employed a cross‐lagged panel analysis to determine the direction of the association between adherence to CBs and economic anxiety (Study 2). Study 1 revealed that adherence to CBs was significantly associated with higher levels of economic anxiety across cultural contexts. Study 2 compellingly showed that adherence to CBs increased the sense of economic anxiety over time, whereas the reverse causal path from economic anxiety to CBs was consistently nonsignificant. This work provides evidence that adherence to CBs may be increasingly associated with adverse subjective appraisals of economic realities. We discuss how our results can contribute to the understanding that curbing adherence to CBs could also alleviate the sense of economic anxiety. Finally, we recommend a research agenda to better understand the psychological boundary mechanisms accounting for these effects.