bluuebunny/crossref_metadata_2025 huggingface dataset:
The Efficacy and Safety of Continuous Veno‐Venous Hemodiafiltration With High Cutoff Membrane Versus High Flux Membrane in Septic Acute Kidney Injury: A Randomized Controlled Study
Authors: Song Xiaowei , Liu Caihong , Zhang Min , Wei Wei , Yang Letian , Wang Bo , Huang Yongxiu , Song Guojiao , Wang Fang , Yang Yingying , Zhao Yuliang , Zhang Ling , Fu Ping
Published: February 2025

Background

The application of high cutoff (HCO) membranes for continuous renal replacement therapy remains unclear in septic acute kidney injury (S‐AKI) patients.

Methods

S‐AKI patients who received continuous veno‐venous hemodiafiltration (CVVHDF) were randomly assigned to the experimental group (HCO membrane) and the control group (high flux membrane, HF membrane). Interleukin‐6 (IL‐6) and tumor necrosis factor‐α (TNF‐α) in serum and waste fluid were measured at 0, 2, 12, and 24 h after CVVHDF initiation and the 28‐day mortality.

Results

Eleven patients were randomized to the HCO group, and 9 patients in the HF group, with a mean age of 54.9 ± 3.2 years and 6 patients (30%) being female. After 24 h of treatment with CVVHDF, there were significant reductions in serum IL‐6 and TNF‐α concentrations in the HCO group (p = 0.001, 0.015) and HF group (p = 0.004, 0.031). The serum IL‐6 reduction rate of the HCO group was significantly higher than that of the HF group (79.21% vs. 42.69%, p = 0.025), while serum TNF‐α reduction rates were comparable between the 2 groups. There were no significant changes in serum albumin after 24 h using either HCO membrane (28.7 ± 1.7 g/L vs. 32.7 ± 1.6 g/L, p = 0.138) or HF membrane (29.6 ± 1.1 g/L vs. 32.6 ± 1.3 g/L, p = 0.055). The two groups had similar 24‐h filter clotting rates and 28‐day mortality.

Conclusion

While CVVHDF with the HCO membrane and HF membrane both achieved significant reductions in serum cytokine levels, the HCO membrane was associated with a greater reduction rate in IL‐6 but not in TNF‐α. No difference was observed in serum albumin, mortality, or filter clotting.

Trial Registration

Registry number: ChiCTR2000039725
Sex Differences in the In‐Hospital Outcomes of Left Ventricular Assist Device Implantation: A Population‐Based National Inpatient Sample Study From 2015 to 2021
Authors: Li Renxi , Prastein Deyanira J. , Boyce Steven W.
Published: February 2025

Background

Left ventricular assist device (LVAD) implantation can be used to manage advanced heart failure. Debates over sex differences in postoperative outcomes of LVAD implantation remain contentious; there is limited evidence available from the continuous‐flow era, particularly following the introduction of third‐generation devices. This study aimed to conduct a comprehensive, contemporary, and population‐based analysis of the sex difference in the in‐hospital outcomes following LVAD implantations.

Methods

Patients who underwent LVAD implantation were selected from National Inpatient Sample from Q4 2015–2021. Multivariable logistic regression was used to compare in‐hospital outcomes between females and males, where demographics, socioeconomic status, primary payer status, hospital characteristics, comorbidities, and transfer/admission status were adjusted.

Results

There were 1201 (23.6%) female and 3881 (76.4%) male patients who underwent LVAD implantation. Females and males had comparable in‐hospital mortality, MACE, and stroke. However, females had higher diaphragmatic paralysis (aOR = 7.94, 95 CI = 1.46–43.48, p = 0.02). Meanwhile, females had lower cardiogenic shock (aOR = 0.85, 95 CI = 0.73–0.98, p = 0.02), renal complications (aOR = 0.72, 95 CI = 0.62–0.84, p < 0.01), and infection (aOR = 0.70, 95 CI = 0.58–0.86, p < 0.01). Females also had longer hospital length of stay (44.1 ± 40.0 vs. 38.8 ± 30.6 days, p = 0.01) and higher total hospital charges (1293779.0 ± 1182139.0 vs. 1172780.0 ± 917544.0 US dollars, p = 0.04).

Conclusion

In the contemporary era with the introduction of third‐generation devices, in‐hospital mortality and stroke after LVAD implantation continued to decrease and were comparable in both sexes. However, there are still notable sex‐based differences in the complications of LVAD implantation, which underscores the need for sex‐specific preoperative risk assessments and tailored perioperative management.
Uniportal S6 Segmentectomy for Newly Developed Lung Cancer in the Residual Left Lower Lobe Following Left Lingulectomy
Authors: Abe Sosei , Motokura Fumihito , Washida Yasuo , Hachitanda Yoichi , Tateishi Masaki , Hazeyama Takanori , Yamaguchi Junzo , Kawashita Yujo , Ueda Takashi , Sato Toshihiko
Published: February 2025

Uniportal video‐assisted thoracic surgery (VATS) has gained global popularity as a minimally invasive surgical approach and has been increasingly adopted for various procedures in Japan. The current case report focuses on the uniportal VATS treatment of a 71‐year‐old female diagnosed with a lesion in the left S6 2 years after undergoing left lingulectomy. The surgery was challenging due to the presence of strong adhesions, particularly in the pulmonary hilum region, thereby increasing the risk of bleeding. Uniportal VATS treatment was conducted to reduce invasiveness and facilitate early ambulation. The patient's postoperative recovery was smooth, and she remained recurrence‐free up to approximately 2 years after surgery. This case highlights the challenges of reoperation after anatomical lung resection and emphasizes the importance of surgical adaptability in uniportal VATS treatment for complex cases.
Skeletal deformities in Sparus aurata from Türkiye: Incidences from Bafa Lake and the Aegean Sea
Authors: Güçlü Salim Serkan , Jawad Laith A. , Koca Habil Uğur , Cilbiz Mehmet , Aydın Celalettin
Published: February 2025

The first record of the abnormalities ankylosis (fusion of vertebrae), lordosis (V‐shaped curvature of the vertebral column), kyphosis (Λ‐shaped curvature), and kypholordosis (the presence of both conditions) have been reported in two specimens of Sparus aurata collected from Bafa Lake and Bodrum‐Kıyıkışlacık Coast, Türkiye and used in this study. Both specimens displayed a severe level of deformity. All cases were non‐fatal as they occurred in subadult individuals. Assessment of abnormality in the studied specimen was carried out by the morphological diagnosis and using mammography. Externally, the two specimens have a deeper body than the normal specimen. There was significant osteological damage has been revealed by the mammography of these deformed specimens. The saddleback anomaly is in the anterior part of the spinous part of the dorsal fin that showed no missing spines. In addition, the lateral line was deformed in both specimens examined. In addition, there were several minor skeletal abnormalities. These anomalies have been considered an important indicator of environmentally induced stress on the wild fishes. Hence, the present finding highlights the need for closer monitoring of the marine environment and for the identification of the specific factor that causes these abnormalities.
Are attachment to parents and self‐efficacy linked with emerging adults' values of future expectations?
Authors: Reis Joana , Nunes Filipa , Matos Paula Mena , Mota Catarina Pinheiro
Published: February 2025

The instability and unpredictability of Western societies challenge how individuals plan their life courses shaping the expectations that emerging adults develop in their future. Although there is a well‐established interest in studying emerging adulthood, there is limited information regarding the role of family and individual contexts on how emerging adults perceive their futures. The current study examined the association between attachment to parents and emerging adults' values of future expectations (optimism, pessimism, and hope) and self‐efficacy's mediating role in that association. The sample was composed of 676 emerging adults, aged between 18 and 30 years (M = 23.04; SD = 3.37). Results showed that attachment to parents and self‐efficacy is associated with values of future expectations of emerging adults, and self‐efficacy mediates the following links: from the quality of the emotional bond with both parents and the separation anxiety regarding the mother to values of future expectations. These findings are discussed based on attachment theory.
Assessment of Spinster homologue 2 (Spns2)‐dependent transport of sphingosine‐1‐phosphate as a therapeutic target
Authors: Kharel Yugesh , Huang Tao , Dunnavant Kyle , Foster Daniel , Souza George M. P. R. , Nimchuk Katherine E. , Merchak Andrea R. , Pavelec Caitlin M. , Juskiewicz Zuzanna J. , Alexander Simon S. , Gaultier Alban , Abbott Stephen B. G. , Shin Jung‐Bum , Isakson Brant E. , Xu Wehao , Leitinger Norbert , Santos Webster L. , Lynch Kevin R.
Published: February 2025

Background and Purpose

Sphingosine‐1‐phosphate (S1P) receptor modulator (SRM) drugs suppress immune system function by disrupting lymphocyte trafficking, but SRMs are broadly immunosuppressive with on‐target liabilities. Another strategy to modulate the immune system is to block S1P transport. This study tests the hypothesis that blockers of S1P transport (STBs) mediated by Spinster homologue 2 (Spns2) approximate the efficacy of SRMs without their adverse events.

Experimental Approach

We have discovered and optimized STBs to enable investigations of S1P biology and to determine whether S1P transport is a valid drug target. The STB SLF80821178 was administered to rodents to assess its efficacy in a multiple sclerosis model and to test for toxicities associated with SRMs or Spns2‐deficient mice. Further, potential biomarkers of STBs, absolute lymphocyte counts (ALCs) in blood and S1P concentrations in plasma and lymph, were measured.

Key Results

SLF80821178 resembles SRMs in that it is efficacious in a standard multiple sclerosis model but does not evoke bradycardia or lung leakage, common to the SRM drug class. Also, chronic SLF80821178 administration does not affect auditory responses in adult mice despite the neurosensorial hearing defect observed in Spns2‐null mice. While both SRM and STB administration decrease ALCs, the maximal effect is less with an STB (45% vs. 90%). STBs have minimal effects on S1P concentration in plasma or thoracic duct lymph.

Conclusion and Implications

We found nothing to invalidate Spns2‐dependent S1P transport as a drug target. Indeed, STBs could be superior to SRMs as a therapy to modulate immune system function.
Biochemical and Structural Studies of Protein Tyrosine Phosphatase PTP‐PEST (PTPN12) in Search of Small Molecule Inhibitors
Authors: Johnson Delna , Dixit Madhulika , Kirubakaran Sivapriya
Published: February 2025

PTP‐PEST (also known as PTPN12) regulates cellular signaling and transduction pathways by dephosphorylating its substrate. PTP‐PEST is considered an important drug target owing to its involvement in cancer progression and myocardial injury. Till now only a few inhibitors are currently being studied in the inhibition of PTP‐PEST, majorly belonging to the class of metal‐based drugs. In this study, we aimed to investigate small molecules that could potentially inhibit PTP‐PEST for further development of PTP‐PEST inhibitors. As an approach, we used an in silico molecular docking technique to screen an in‐house synthesized molecular library. Further, we validated the docking results by in vitro inhibition screening of the best molecules using the purified catalytic domain of human PTP‐PEST, which was over‐expressed in E.coli. We identified a myo‐inositol based derivative, J1‐65, which binds to PTP‐PEST and results in the competitive inhibition of the protein. Further, we confirmed this protein‐ligand binding using binding affinity studies based on protein thermal shift assay and in silico molecular dynamic simulations. Our efforts to discover a novel scaffold for inhibiting hPTP‐PEST mark a crucial stride in laying the groundwork for the future development of selective PTP‐PEST inhibitors.
Heterogenous impact of China's place‐based environmental regulations on its hog industry: A synthetic difference‐in‐differences approach
Authors: Cheng Nieyan , Zhang Wendong , Xiong Tao
Published: February 2025

Agricultural water pollution from the livestock industry is a growing concern in China and globally. Since 2014, China classified eight urban provinces in the southeast as a development control zone (DCZ), which prohibits new hog facility construction and encourages hog farms to relocate to other regions. Leveraging synthetic difference‐in‐differences (SDID), we systematically analyze the impacts of such place‐based regulations on the hog industry and water pollution, especially revealing heterogenous responses. Our results show that, on average, the regulations led to heterogenous reductions in hog inventories both within and across DCZ provinces, mainly resulting from the closures of existing hog farms. The effects range from a 2% increase to 40% hog inventory reduction, equivalent to a loss of over U.S. $5.06 billion in the DCZ hog sectoral revenue. We explore three channels to explain the heterogeneity: counties upstream of big cities, counties designated as main hog counties, and counties with drinking water sources serve as origins of the heterogenous effects. However, we find no significant water quality improvement.
Accuracy, Safety, and Efficiency in Robotic‐Assisted vs. Freehand Dental Implant Surgery: A 6‐Month Follow‐Up Randomized Controlled Trial
Authors: Chen Jiaxian , Wang Yulan , Bai Yi , Chen Yan , Chen Zhenqi , Yan Qi , Zhang Yufeng
Published: February 2025

Objectives

To assess the implant accuracy, safety, and efficiency between robotic‐assisted and freehand dental implant placement with a half‐year follow‐up.

Methods

Patients requiring single‐tooth implant restorations were recruited and randomized into two groups: robotic‐assisted surgery and freehand implant surgery. The accuracy of implant positioning was compared by assessing immediate postoperative CBCT scans against preoperative planning software. Intraoperative and postoperative complications were recorded, and data were analyzed using an intention‐to‐treat approach. The time required for implant placement in each group was documented. A 6‐month follow‐up measured the implant survival rates.

Results

The study included 24 patients (median age 36, 18 female). In the robotic‐assisted surgery group, the average platform global deviation, apex global deviation, and angular deviation were 0.70 ± 0.11 mm, 0.70 ± 0.12 mm, and 1.09° ± 0.67°, respectively. In the freehand implant surgery group, these measures were 1.24 ± 0.59 mm, 2.13 ± 1.26 mm, and 7.43° ± 6.12°, respectively, with statistically significant differences. Regarding the duration of surgery, the robotic‐assisted surgery group required 18.8 ± 4.89 min. Intraoperative and postoperative complications were similar across both groups, and the implant survival rate was 100% in both groups at the 6‐month follow‐up.

Conclusions

This study found that robot‐assisted implant placement offers higher accuracy in implant positioning compared to freehand placement, while requiring longer operation times. Future developments should focus on simplifying the registration and design of robot systems to enhance efficiency and facilitate their broader clinical adoption.
Navigating Diagnostic Uncertainty in Thyroid Nodules: The Critical Role of Cytology and Histology in Oncocytic and Rare Patterned Lesions
Authors: Townsend Jaiden , Perez‐Machado Miguel
Published: February 2025

This case report highlights the diagnostic challenges posed by thyroid nodules with indeterminate cytological features, emphasising the complementary roles of fine‐needle aspiration (FNA) cytology and histology. Through a detailed evaluation of a trabecular adenoma misclassified as oncocytic, the study underscores the importance of thorough histological assessment to avoid misdiagnosis and ensure accurate clinical management.
Exceptionally Preserved Setae: A Possible Morphological Synapomorphy of Cambrian Lophotrochozoans
Authors: Liang Yue , Topper Timothy P. , Holmer Lars E. , Hu Yazhou , Liu Fan , Zhang Zhifei
Published: February 2025

Cambrian Lagerstätten yield exceptionally preserved fossils that have greatly improved our understanding of the origin and evolution of animal groups. Brachiopoda, a phylum of bivalved marine invertebrates nested firmly within the lophotrochozoan protostomes, are widely recovered in such Lagerstätten. The marginal chitinous setae (or chaetae) of brachiopods are the most commonly described soft tissue and have been interpreted as performing a defensive and/or sensory role. Despite their relatively common appearance in Cambrian Lagerstätten, the origin, function, and evolution of setae in the Brachiopoda is poorly known. Here, we document exquisitely preserved setal structures from South China and Laurentia paleocontinents giving new insights into their formation, microstructure and preservation mode. New setae typically make their appearance within the follicle of a neighbouring older seta and then branches off laterally forming its own follicle. Setal microstructure is likely to be composed of many canals, highly comparable to setae of their recent counterparts. Moreover, setae recovered from these palaeo‐continents present different preservation: aside from the normal preservation of iron oxides and carbonaceous ingredients, some compositions of calcium are also detected in this originally chitinous organization. Investigating the evolutionary origins of chitinous setae, a specialized type found notably in lophotrochozoans such as brachiopods and annelids, reveals its presence in early Cambrian stem groups. This character likely serves as a morphological synapomorphy in lophotrochozoan evolution. However, the dearth of morpho‐ultrastructure and comparative studies in Cambrian fossils presents a challenge in fully understanding this evolutionary development.
Permanent intramural stenting with polyethylene catheter to resolve parotid salivary duct stenosis secondary to sialolithiasis
Authors: Lahuerta M. , Figoli M. , Vitale V. , Velloso Alvarez A.
Published: February 2025

Sialolithiasis is an uncommon condition of the salivary gland in the horse, primarily affecting the parotid salivary duct. Clinical signs may include salivary stasis within the gland and potential progression to sialadenitis, facial draining tract or a permanent fistula. A 19‐year‐old Warmblood gelding was referred with septic sialadenitis of the right parotid gland. A 4 cm sialolith was detected radiographically and removed surgically. Although surgery was uneventful and patency of the salivary duct was assessed intraoperatively, mild accumulation of saliva within the gland was noted 1 day later. A stenosis caudal to where the sialolith was lodged was diagnosed through contrast radiography. Balloon dilatation of the stenosis was attempted unsatisfactorily, and a polyethylene catheter was placed and sutured to the oral mucosa to maintain the parotid emptying. A week later, the oral portion of the catheter was chewed by the horse, preventing catheter removal without surgery. Subsequently, ultrasonographic and radiographic re‐evaluations were performed routinely to assess the patency of the catheter or complications associated with long‐term placement. After 1 year, no salivary stasis in the gland or complications were observed. This is the first description of successful long‐term indwelling catheter placement to resolve stenosis of the salivary duct. This procedure may offer a simple, economical and safe option compared to more complicated or invasive techniques previously described in horses, with excellent functional and cosmetic results.
Muscle transposition graft for closure of a permanent tracheostoma in a Quarter Horse mare
Authors: Stemmet G. P. , Labens R.
Published: February 2025

Permanent tracheostomy is sometimes required in horses with severe and irreversible obstructive upper airway conditions. Abnormal respiratory noise and altered vocalisation may be of concern to owners and its influence on mare‐foal recognition and bonding should be considered. Reversal of a permanent tracheostoma in the horse has not been described. This case report presents the case of a 13‐year‐old Quarter Horse mare with a longstanding permanent tracheostoma that underwent primary surgical closure of the stoma 6 years after resolution of the underlying disease. It demonstrates the value of considering surgical closure of permanent stomata when underlying conditions have resolved or improved and animal welfare implications are observed.
Fatigue Short Crack Growth Prediction of Additively Manufactured Alloy Based on Ensemble Learning
Authors: Huang Qinghui , Hu Dianyin , Wang Rongqiao , Sergeichev Ivan , Sun Jingyu , Qian Guian
Published: February 2025

In situ fatigue crack propagation experiment was conducted on laser cladding with coaxial powder feeding (LCPF) K477 under various stress ratios and temperatures. Multiple crack initiation sites were observed by using in situ scanning electron microscopy (SEM). The fatigue short crack growth rate was measured, and the impacts of temperature and stress ratio on this growth rate were analyzed. Based on these experiments, the experimental data were expanded, and three ensemble learning algorithms, that is, random forest (RF), extreme gradient boosting (XGBoost), and light gradient boosting machine (LightGBM), were employed to establish a fatigue short crack growth rate model controlled by multiple parameters. It is indicated that the RF model performs the best, achieving a coefficient of determination (R2) of up to 0.88. The fatigue life predicted by the machine learning (ML) method agrees well with the experimental one.
Managing Helicobacter pylori as an Infectious Disease: Implementation of Antimicrobial Stewardship
Authors: Hsu Jen‐Yu , Wu Un‐In , Wang Jann‐Tay , Sheng Wang‐Huei , Chen Yee‐Chun , Chang Shan‐Chwen
Published: February 2025

Helicobacter pylori is prevalent globally and implicated in various gastric diseases and malignancies. Rising antibiotic resistance has increasingly compromised the effectiveness of standard H. pylori eradication therapies. This review explores the role of antimicrobial stewardship (AMS) as a structured approach to optimizing H. pylori management through the “5D” strategy: Diagnosis—utilizing advanced diagnostic tools to accurately detect bacterial resistance; Drug—selecting antibiotics tailored to resistance profiles and patient‐specific factors; Dosage—optimizing dosing and frequency based on pharmacokinetic properties to maximize efficacy; Duration—employing shorter treatment courses where supported by evidence; and Discontinuation—balancing the benefits and risks of repeated antibiotic treatments. We discuss recent advances in diagnostic technologies, such as polymerase chain reaction and next‐generation sequencing, and their impact on therapeutic decision‐making. Additionally, we evaluate treatment regimens, with a particular focus on emerging alternatives such as regimens containing potassium‐competitive acid blockers. Given the growing global resistance and limited pipeline for new antibiotics, we advocate for a more strategic and resource‐conscious approach to H. pylori management, integrating AMS principles within the “One Health” framework to address the pathogen's transmission across humans, animals, and the environment. With advancements in resistance testing and diagnostics, H. pylori therapies are likely to become increasingly personalized and precise. To achieve this, effective AMS implementation necessitates interdisciplinary collaboration to maximize therapeutic outcomes, minimize adverse effects, combat resistance, and reduce healthcare costs.
Patterns of Health Services and Medicine Utilisation by First‐Generation Pakistani Immigrants in New Zealand
Authors: Mann Noor A. , Khan Zain A. , Asghar Saima , Rani Afshan , Hussain Nadia , Akhtar Sumera S. , Heydon Susan , Anwar Mudassir
Published: February 2025

Introduction

The health‐seeking patterns of the increasing Pakistani migrant population in New Zealand (NZ) is a subject of limited research in current literature. Therefore, the study aimed to investigate and understand the patterns of health services utilisation and medicine usage among first‐generation Pakistani immigrants in NZ.

Methods

Convenience and snowball sampling using social media platforms were used to conduct eleven semi‐structured interviews consisting of two participants per interview. The interviews were audio‐taped and transcribed verbatim. Data were analysed iteratively using an inductive thematic approach.

Results

Self‐medication emerged as a common practice by the majority of the participants and this practice stemmed from personal experiences, existing knowledge, and personal and cultural beliefs. However, participants had limited knowledge of the NZ health system and community pharmacy services and this led to conflicting expectations and outcomes. These factors serve as barriers to healthcare access for Pakistani immigrants and can result in adverse health outcomes and higher rates of dissatisfaction.

Conclusion

This study highlights the healthcare challenges and behaviours of Pakistani immigrants in NZ, emphasising their reliance on traditional remedies and self‐medication. While appreciating the quality of NZ's healthcare, participants faced barriers like cost and lack of awareness of pharmacy services. The findings call for culturally tailored strategies to improve accessibility and healthcare experiences for immigrants.

Patient or Public Contribution

Two individuals from the Pakistani community, not part of the study, contributed to the design by offering feedback and pilot testing the interview guide. Based on their input, adjustments were made to enhance the clarity of the questions from a patient's or public viewpoint. No new questions were proposed as a result of this feedback.
‘“Health” Is Just One Piece in the Puzzle of Wellbeing’: Shifting From Preventing Health Deterioration to Improving Wellbeing in a Participatory Action Research Project With Care‐Experienced Older People
Authors: Wallcook Sarah , Dahlkvist Ulla , Domeij Yvonne , Green Kerstin , Isaksson Gigi , Goliath Ida
Published: February 2025

Introduction

Prevention of health deterioration is a key policy objective in Sweden informed by active and healthy ageing initiatives. However, the perspectives of older people with mobility and health limitations on current prevention initiatives are seldom gained meaning these initiatives may fail to align to with the priorities of people whose health has ostensibly already deteriorated. We aimed to explore older care‐experienced people's perspectives on the topic of health deterioration prevention and highlight aspects that they think are important to prioritise.

Method

Eight older people with experience in giving or receiving formal or informal care were involved as lay co‐researchers in a participatory action research project that involved recruiting 11 further older informants to participate in peer interviews or complete a logbook. In a series of 13, 2‐h workshops held over 1 year, we undertook data generation, training, reflection and analytic activities inspired by framework analysis.

Findings

The lay co‐researchers found the topic of health deterioration to be negatively and narrowly focussed opting instead to pursue a focus on articulating aspects, or puzzle pieces, that influence the improvement of wellbeing. Six influential puzzle pieces (stigma, digitalisation, services, losses, meaning and interactions) were regarded as important to prioritise which together illustrated that wellbeing is continually shaped in an interplay with dominant, but manipulable, social norms.

Conclusion

This study highlights how the language of active and healthy ageing, which pervades policy and practice, is imbued with ageist and ableist subtexts that can influence older people's wellbeing and lead to exclusionary experiences in society. We highlight wider societal trends, particularly digitalisation and effectivisation, whose negative impact on older people's wellbeing could be mitigated through inclusive co‐design and resistance to normative influences.

Public Contribution

This project was initiated in dialogue with stakeholder representatives from pensioner organisations in a larger scale participatory action research project. The care‐experienced lay co‐researchers collaborated in all phases of this project—gaining funding, formulating research questions, planning the study design, generating data in peer interviews, analysing and interpreting data, disseminating findings, prioritising future research and co‐authoring articles.
DOMESTIC AND EXTERNAL SOVEREIGN DEBT
Authors: Di Casola Paola , Sichlimiris Spyridon
Published: February 2025

We develop a model that features costly market segmentation and financial repression to link domestic and external sovereign debt with default. In a financially repressed economy, a government that exploits its market power in the domestic economy can also increase its external debt capacity, owing to a novel, additional endogenous cost of default. A government forfeits the gains from trading in segmented debt markets when it defaults. Among other empirical regularities, our model can account for the heterogeneity in sovereign debt levels of nonadvanced economies, based on their level of financial development.
Drone‐enabled material handling in smart manufacturing
Authors: Jiménez‐Sarda Julio , Silva Daniel F. , Smith Alice E.
Published: February 2025

Amidst labor shortages, increasing land prices, and other aspects of the post‐pandemic world, our logistics chain must consider new technological alternatives. Automated material handling equipment often requires valuable floor space and specialized layouts. Uncrewed aerial vehicles, popularly called drones, offer a flexible and cost‐effective alternative. To explore the potential benefits and challenges of such systems, we used a version of the multi‐trip vehicle routing problem with time windows to model two realistic manufacturing environments as use cases. We provide the mixed integer linear programming formulation of this problem and compare results with those of a human‐only based system in a detailed simulated environment. Furthermore, as a physical proof‐of‐concept, we outfitted a commercially available drone with pick‐up and carry capabilities. We found that, even with limited drone carrying capacity, there are economic benefits realized from time savings, compared to ground‐based material handling systems. Besides these time savings, drones are sustainable as they operate on battery power and do not impair the air quality or the traffic experienced on the ground.
Daily Evaluation Threat and Instability in the Ability Self‐Concept Among Stereotype‐Aware Women
Authors: Meinderts Iris , Veldman Jenny , Van Laar Colette
Published: February 2025

A clear and stable notion of one's abilities in a field is an important predictor of interest and motivation. The present study examines whether the development of this clear and stable ability self‐concept is undermined for people facing negative stereotyping because of exposure to daily evaluation threats. As such, the present study examines a novel explanation for the leaky pipeline phenomenon that members of negatively stereotyped groups disproportionally opt out of fields. A daily diary study among 205 female psychology students (N = 1390 data points) showed that awareness of ingroup‐stereotyping related to more daily fear that others negatively evaluate their statistical abilities. This daily evaluation threat related negatively, within and across days, to fluctuations in clarity and certainty of the ability self‐concept—indicating that the ability self‐concept is more unstable for people experiencing more daily evaluation‐threat. Lower clarity and certainty of the ability self‐concept was, in turn, related to lower statistics interest and motivation, speaking to the importance of a clear and stable ability self‐concept for goal pursuit.
Rehabilitation Management of Neck Pain—Development of a Diagnostic Framework Based on the Pain and Disability Drivers Management Model
Authors: Gerard Thomas , Naye Florian , Decary Simon , Langevin Pierre , Cook Chad , Tousignant‐Laflamme Yannick
Published: February 2025

Rationale

Neck pain is a major cause of disability worldwide, and current rehabilitation strategies show limited effectiveness. Subgrouping patients by their primary pain and disability drivers can help tailor treatments. At this end, the Pain and Disability Drivers Management (PDDM) was developed and has demonstrated preliminary effectiveness in the management of low back pain. Nevertheless, the PDDM model was only validated for this population. Adapting this framework to patients with neck pain would provide a more global view of the patient's experience of pain and support a genuine biopsychosocial intervention.

Aims and Objectives

The aim of this study was to develop and validate the content of the PDDM model for patients living with neck pain.

Methods

Through a modified DELPHI study design, participants with clinical and research expertize in rehabilitation of neck pain were invited to participate. A questionnaire was developed using literature reviews and endorsed by a steering committee. The relevance of each element of the newly adapted model was evaluated on a 4‐point Likert scale. An item reached consensus if it obtained the predefined threshold of > 78% “relevant” and “very relevant.” Participants left comments on terminology and recommended items to add in early rounds. Quantitative and qualitative analyses were performed.

Results

An invitation was sent to 1650 potential participants, from which 155 accessed the survey, 64 completed the first round and 55 the second round. A total of 70 elements met consensus and were distributed across six domains: “Nociceptive pain drivers”, “nociplastic pain drivers,” “drivers associated with neuropathic pain”, “comorbidity drivers”, “cognitive‐emotional drivers” and “environmental or lifestyle drivers, and social determinants of health.”

Conclusion

Through a modified DELPHI study, the PDDM model was updated and adapted to people with neck pain. Subsequent steps include clinical integration and measures of efficacy when used for assessment/treatment.
Long‐Term Liver Morbidity and Mortality After Hepatitis C Virus Elimination by Direct‐Acting Antivirals
Authors: Ogawa Eiichi , Kawano Akira , Kohjima Motoyuki , Koyanagi Toshimasa , Dohmen Kazufumi , Ooho Aritsune , Satoh Takeaki , Takahashi Kazuhiro , Furusyo Norihiro , Kajiwara Eiji , Azuma Koichi , Ichiki Yasunori , Sugimoto Rie , Amagase Hiromasa , Senju Takeshi , Tanaka Masatake , Nakamuta Makoto , Nomura Hideyuki , Hayashi Jun
Published: February 2025

Background and Aim

More accurate stratification of patients with chronic hepatitis C after permanent hepatitis C virus (HCV) clearance by direct‐acting antivirals (DAAs) is important for improving long‐term surveillance and treatment. The aim of this study was to stratify patients with chronic hepatitis C who are at risk of developing hepatocellular carcinoma (HCC) after HCV cure.

Methods

This multicenter, retrospective cohort study included 3177 consecutive adult chronic hepatitis C patients without decompensated cirrhosis who were treated with all‐oral DAAs. The primary study endpoints were long‐term cumulative de novo HCC incidence, HCC recurrence rates, and survival. Additionally, we analyzed the development of HCC by patients without cirrhosis, stratified by age and fibrosis status according to the FIB‐4 index.

Results

After exclusions, data from 3024 patients were available for analysis. The overall median follow‐up period was 6.5 years. None of the patients with non‐cirrhosis/FIB‐4 < 1.45 (n = 475) developed HCC regardless of background factors. For patients with non‐cirrhosis/FIB‐4 ≥ 3.25, older age had a greater impact on HCC incidence (log‐rank test: p = 0.038). In addition, metabolic factors, including body mass index and diabetes mellitus, were not related to HCC incidence. HCC recurrence commonly occurred within 5 years after HCV cure; nevertheless, HCV cure contributed to an improvement of survival rates.

Conclusions

Age is a pivotal factor in predicting de novo HCC development following HCV cure in patients with moderate to advanced fibrosis. Conversely, patients with mild fibrosis (FIB‐4 < 1.45) may be eligible for discharge from specialized care after achieving HCV elimination.
Aligning Medications With What Matters Most: Conversations Between Pharmacists, People With Dementia, and Care Partners
Authors: Green Ariel R. , Rosado Rosalphie Quiles , Daddato Andrea E. , Wec Aleks , Gleason Kathy , McPhail Tobie Taylor , Merrey Jessica , Weffald Linda , Swarthout Meghan , Feeser Scott , Boyd Cynthia M. , Wolff Jennifer L. , Blinka Marcela D. , Bayliss Elizabeth A. , Boxer Rebecca S.
Published: February 2025

Introduction

Successful deprescribing for people with dementia (PWD) depends on communication about medication‐related priorities between PWD, care partners and clinicians. The objective of this study was to gain in‐depth knowledge of how elicitation of PWD and care partner medication‐related priorities during a deprescribing intervention shaped discussions with pharmacists about medications.

Methods

Qualitative analysis of audio‐recorded interactions between pharmacists and patient‐care partner dyads in a pilot study of a pharmacist‐led deprescribing intervention for PWD in primary care. Patients ≥ 65 years taking ≥ 7 medications and care partners were recruited from an integrated delivery system in Colorado and a community‐based medical practice in Maryland. Qualitative content analysis was used to analyze 82 transcripts from encounters with 55 patient‐care partner dyads.

Results

The mean (SD) age of PWD was 81 (8.1) years; 45% were women, 33% Black, and 15% Hispanic. PWD took an average of 13 (±5.3) medications at baseline. Care partners were on average 66 (13) years of age and most were spouses/partners of the PWD. Content analysis identified five themes: (1) Reducing medication‐related treatment burden; (2) Alleviating burdensome symptoms; (3) Maintaining cognition and function; (4) Discussion of tradeoffs; (5) Challenges to deprescribing. After eliciting patient and care partner priorities, pharmacists recommended both deprescribing and prescribing.

Conclusion

Findings from this secondary analysis of a pilot deprescribing intervention suggest eliciting medication‐related priorities of PWD and care partners can support goal‐concordant care. These results can inform development of interventions to optimize medications for this population.
Navigating an Uninformative Genomic Test Result: A Practical Guide
Authors: St Clair Laura , Wong Claire , Elliot Christopher , Jones Kristi J. , Shah Margit , Josephi‐Taylor Sarah , Sandaradura Sarah , Adès Lesley , Smith Janine , Sachdev Rani , Ma Alan
Published: February 2025

Background

Although genomic testing is increasingly standard of care for diagnosing children and adults with genetic conditions, over 50% of genomic testing will return an uninformative result.

Aim

To provide a practical guide for paediatricians on how to approach an uninformative genomic test result, and the pathways which may be available to uncover a genetic diagnosis for their patients.

Methods

Input from multiple genetics healthcare professionals including genetic counsellors, the literature, and a general paediatrician were used to construct this guide. We also provide a hypothetical case vignette, to further demonstrate the various options for a patient after receiving an uninformative result.

Results

There are several reasons why an underlying genetic diagnosis may not be diagnosed with current testing, including incomplete phenotyping, a different underlying genetic mechanism requiring specialised testing, and limitations in knowledge at the time of the test.

Conclusion

Uninformative results are very common, and it is important to understand these results in the context of the limitations of genomic testing. General paediatricians play an important role in supporting families through their diagnostic odyssey, as well as reassessing the phenotype, referring for sub‐specialty inputs, and discussion with local genetics services for consideration of alternative testing options or enrolment into research pathways.
Thermoregulatory Response, Growth Performance and Organ Weights of FUNAAB‐Alpha Chicken Genotypes Administered Sweet Citrus Peel Powder
Authors: Majekodunmi Bukola Christiana , Wheto Mathew , Oke Oyegunle Emmanuel , Akinjute Obafemi Foluso , Ojoawo Henry Temitope , Chika Chinedu Ruth , Adekunle Oluwatobiloba Motunrayo , Adeyeri Yusuf Oluwatobiloba , Abioja Monsuru Oladimeji
Published: February 2025

Thermoregulatory response and growth performance of FUNAAB‐Alpha chickens administered sweet citrus peel powder (SCPP) were investigated in a twelve weeks experiment. A total of 360 1‐day‐old FUNAAB Alpha chicks were used for the study, comprising 120 birds per genotype: Normal feather (NF), Naked neck (NN) and Frizzle feather (FF). Birds were randomly allotted into 12 treatment groups: NF: 0 g, 3 g, 6 g and 9 g of SCPP, NN: 0 g, 3 g, 6 g and 9 g of SCPP, FF: 0 g, 3 g, 6 g and 9 g of SCPP. Each treatment was replicated thrice with 10 birds per replicate. No (p > 0.05) interactive and main effect of genotype and dosage of SCPP was observed on the Rectal temperature, Skin temperatures under wing and of the breast among the treatments. Similar (p > 0.05) interactive effect was observed on the respiratory rate (RR), however, higher (p < 0.001) RR was recorded in NN and FF compared with NF. Birds in the control group had the highest (p < 0.005) RR compared with birds administered 3 g and 9 g of SCPP/L of water. Interaction and main effect of SCPP dosage on heterophil (H), lymphocyte (L) and heterophil lymphocyte ratio (H/L) were not significant (p > 0.05) across the treatment groups. However, genotype significantly (p < 0.000) influenced H, L and H/L. The FF and NN had significantly (p < 0.000) lower H/L compared with the NF. Higher (p < 0.000) weight gain (WG) was observed in FF and NN compared to NF chickens. Significantly (p < 0.020) lower FCR was observed in 6 g/L (2.26), 3 g/L (2.65) and 9 g/L (2.66) of FF compared with NF on 9 g/L (4.03). Dosage of SCPP significantly (p < 0.001) influenced the relative weights of the intestine. In conclusion, lower H/L, higher WG and better FCR were observed in the NN and FF genotypes with the best FCR recorded at 6 g SCPP/L of water.
Essential Oil of Bay Laurel (Laurus nobilis) Enhances Growth and Immunity in Cold‐Stressed Nile Tilapia (Oreochromis Niloticus)
Authors: Shehata Akram Ismael , Shahin Shimaa A. , Taha Sara Ahmed , Elmaghraby Ayaat M. , Alhoshy Mayada , Soliman Ali A. , Amer Asem A. , Hendy Amany M. , Gewaily Mahmoud S. , Teiba Islam I. , El Basuini Mohammed F.
Published: February 2025

Bay laurel (Laurus nobilis) essential oil is known for its antimicrobial, anti‐inflammatory, and antioxidant properties. This study examined the effects of L. nobilis oil (LN) on Nile tilapia (Oreochromis niloticus) under cold stress conditions (16°C). Tilapia (initial weight, 5.02 ± 0.02 g) were acclimatized to 16°C for 14 days before being fed diets containing 0, 0.5, 1.0, 1.5, 2.0, and 2.5 g/kg LN oil for 84 days. The 1.5 g/kg LN oil group exhibited the highest final body weight and weight gain (p ≤ 0.05), while survival rates peaked at 1 g/kg. Biometric indices and feed efficiency were significantly enhanced, particularly at 1.5 g/kg (p ≤ 0.05). Histological analysis revealed improved intestinal and hepatic structures in LN‐supplemented groups, although mild alterations were observed at 2.0 and 2.5 g/kg. Blood biochemical analysis showed increased total protein and reduced cholesterol in supplemented groups. Immune responses, including serum lysozyme activity and bacterial inhibition, were significantly enhanced at 1.5 g/kg or higher (p ≤ 0.05). Antioxidant enzyme activities, including superoxide dismutase (SOD) and catalase (CAT), increased (p ≤ 0.05) with LN oil supplementation, while malondialdehyde (MDA) levels decreased, indicating reduced oxidative stress. Gene expression analysis demonstrated increased insulin‐like growth factor 1 and glucose transporter 4 levels with 1.5 g/kg LN oil, and tumor necrosis factor‐alpha expression decreased at higher dosages. Dietary LN oil, particularly at 1.5 g/kg, enhances growth, immunity, and antioxidant defense in Nile tilapia under cold stress. Future studies should optimize dosages and explore broader applications across species and conditions.
FGF21 Analogues in Patients With Metabolic Diseases: Systematic Review and Meta‐Analysis of Randomised Controlled Trials
Authors: Theofilis Panagiotis , Oikonomou Evangelos , Karakasis Paschalis , Pamporis Konstantinos , Dimitriadis Kyriakos , Kokkou Eleni , Lambadiari Vaia , Siasos Gerasimos , Tsioufis Konstantinos , Tousoulis Dimitris
Published: February 2025

Background and Aims

Liver‐related complications are frequent in patients with metabolic diseases, with limited treatment options currently available. This systematic review and meta‐analysis aimed to assess the effect of fibroblast growth factor‐21 (FGF21) analogues on hepatic steatosis, inflammation and fibrosis in patients with metabolic diseases.

Methods

We conducted a systematic literature search in Pubmed, Scopus and Web of Science for randomised controlled trials (RCTs) assessing the effect of FGF21 analogues on hepatic steatosis evaluated by hepatic fat fraction (HFF), inflammation and fibrosis compared to placebo. Adverse events (AEs) were also recorded.

Results

Treatment with FGF21 analogues was associated with metabolic‐associated steatohepatitis (MASH) resolution without fibrosis worsening (5 studies, risk ratio [RR] 4.40, 95% confidence interval [CI]: 2.41, 8.03, p < 0.001) and fibrosis improvement by 1 grade without MASH worsening (6 studies, RR 1.79, 95% CI: 1.24, 2.59, p = 0.002). FGF21 analogues significantly lowered HFF compared to placebo (6 studies, SMD ‐1.08, 95% CI: −1.28, −0.88, p < 0.001), while patients receiving FGF21 analogues were more likely to exhibit a reduction in HFF by 30% (10 studies, RR 4.08, 95% CI: 3.08, 5.40, p < 0.001) or 50% (6 studies, RR 10.43, 95% CI: 5.47, 19.87, p < 0.001). HFF normalisation (≤ 5%) was more frequently achieved with FGF21 analogues (6 studies, RR 14.58, 95% CI: 4.70, 45.18, p < 0.001). The results remained robust after sensitivity analyses. Serious AE and AE leading to drug discontinuation were similar in patients receiving FGF21 analogues or placebo.

Conclusions

FGF21 analogues can reduce hepatic steatosis, inflammation and fibrosis in patients with metabolic diseases, representing a possible treatment option for steatotic liver disease.