bluuebunny/crossref_metadata_2025 huggingface dataset:
Putting Patients First: Pragmatic Trials in Gynecologic Oncology
Authors: Hopkins Laura , Clemons Mark , Bemister Karen , Booth Chris , Kadar Shannon , Karanicolas Paul , Mulligan Julie , Savard Marie-France , Tannock Ian , Tone Alicia , MacKay Helen
Published: February 2025

In November 2024, the Society of Gynecologic Oncology of Canada hosted a 2-day, interdisciplinary Pragmatic Clinical Trials (PCTs) Workshop with the goal of launching an initiative to develop and promote PCTs within the Canadian gynecologic oncology research environment. The programme brought together multiple stakeholders, including patients with ovarian cancer, patient advocates, experts in PCTs, gynecologic oncologists, medical oncologists and clinical fellows. Foundational elements of pragmatism were emphasized in the context of the primary goal of PCTs, showing the real-world effectiveness of interventions in broad patient groups. Examples of how PCT outcomes can inform and influence clinical decision making and health policy were presented in the context of those outcomes that matter most to patients with cancer. The patients and patient advocates had the essential role of helping clinical investigators co-design PCT protocols to answer common, important, and practical questions that focus on outcomes that matter to patients. These endpoints included overall survival, quality of life and promotion of informed patient decision making. Tangible workshop outcomes included the development of several new proposals for PCTs inspirited and directed by the patient voice. Further educational initiatives to engage clinical gynecologic oncology investigators at all stages in their career are being planned.
Draft Genome Sequence Data of the Ensifer sp. P24N7, a Symbiotic Bacteria Isolated from Nodules of Phaseolus vulgaris Grown in Mining Tailings from Huautla, Morelos, Mexico
Authors: Ramírez-Trujillo José Augusto , Castillo-Texta Maria Guadalupe , Ramírez-Yáñez Mario , Suárez-Rodríguez Ramón
Published: February 2025

In this work, we report the draft genome sequence of Ensifer sp. P24N7, a symbiotic nitrogen-fixing bacterium isolated from nodules of Phaseolus vulgaris var. Negro Jamapa was planted in pots that contained mining tailings from Huautla, Morelos, México. The genomic DNA was sequenced by an Illumina NovaSeq 6000 using the 250 bp paired-end protocol obtaining 1,188,899 reads. An assembly generated with SPAdes v. 3.15.4 resulted in a genome length of 7,165,722 bp composed of 181 contigs with a N50 of 323,467 bp, a coverage of 76X, and a GC content of 61.96%. The genome was annotated with the NCBI Prokaryotic Genome Annotation Pipeline and contains 6631 protein-coding sequences, 3 complete rRNAs, 52 tRNAs, and 4 non-coding RNAs. The Ensifer sp. P24N7 genome has 59 genes related to heavy metal tolerance predicted by RAST server. These data may be useful to the scientific community because they can be used as a reference for other works related to heavy metals, including works in Huautla, Morelos.
The Role of Acute Phase Reactants, Including α1-Acid Glycoprotein, in Predicting Onset and Severity of Retinopathy of Prematurity
Authors: Nakazawa Yoko , Yasukawa Tsutomu , Goto Haruo , Kobayashi Satoru , Yokoi Kyoko
Published: February 2025

Background: Retinopathy of prematurity (ROP) is a serious disease causing blindness in childhood. Gestational age (GA) and birth weight are major factors associated with the development and progression of ROP, but postnatal systemic inflammation is also an important well-known risk factor. Methods: This study retrospectively analyzed the relationship between systemic inflammation and ROP severity using the corrected GA (CGA), which reflects the intrinsic immaturity of the infant, rather than days of life. Three acute phase reactants (APRs) were analyzed using discriminant probability and compared with conventional ROP prediction models: C-reactive protein, α1AG, and haptoglobin. Results: Alpha 1AG was the best predictor of ROP onset and progression, and could be predicted with blood samples up to 30 weeks (30 W) CGA (p = 0.006). Incorporation of APR into the conventional GA + body weight (BW), ROP score, and Children’s Hospital of Philadelphia (CHOP) predictive models improved the decision to treat (4–5% increase in discrimination probability) and helped determine whether treatment of ROP was necessary by CGA 30 W. Conclusions: Therefore, simply adding α1AG protein to the assessment is useful for predicting the need to treat ROP.
Desmosine: The Rationale for Its Use as a Biomarker of Therapeutic Efficacy in the Treatment of Pulmonary Emphysema
Authors: Cantor Jerome
Published: February 2025

Desmosine and isodesmosine (DID) are elastin-specific crosslinking amino acids that play a critical role in maintaining the structural integrity of elastic fibers, and their levels in body fluids may serve as biomarkers for alveolar wall injury. To support this concept, we present studies demonstrating the use of DID to detect elastic fiber damage that reflects distention and the rupture of airspaces. The emergence of airspace enlargement may be modeled by a percolation network describing the effect of changing proportions of intact and weak elastic fibers on the transmission of mechanical forces in the lung. Following the unraveling and fragmentation of weakened elastic fibers, the release of DID may correlate with an increasing alveolar diameter and provide an endpoint for clinical trials of novel agents designed to treat pulmonary emphysema. The limitations of the DID measurements related to specificity and reproducibility are also addressed, particularly regarding sample source and analytical techniques. Standardizing protocols to isolate and quantify DID may increase the use of this biomarker for the early detection of alveolar wall injury, which permits timely therapeutic intervention.
Prevention of White Spot Lesions Induced by Fixed Orthodontic Therapy: A Literature Review
Authors: Ludovichetti Francesco Saverio , Stellini Edoardo , Zuccon Andrea , Lucchi Patrizia , Dessupoiu Niccolò , Mazzoleni Sergio , Parcianello Roberta Gaia
Published: February 2025

Objectives: This study aims to review the scientific literature on the prevention of white spot lesions (WSLs) associated with fixed orthodontic treatment. WSLs result from enamel demineralization and pose aesthetic and functional challenges. The study evaluates the effectiveness of various preventive interventions to reduce the risk of WSLs during orthodontic care. Methods: A comprehensive literature search was conducted using MeSH terms such as “white spot”, “fixed orthodontic treatment”, “CPP-ACP”, “topical fluoride”, and “demineralized lesion”, combined with the Boolean operator ‘AND’. Databases searched included PubMed, EMBASE, Scopus, and OpenGrey, focusing on studies published between January 2014 and September 2024. The inclusion criteria required studies to evaluate interventions aimed at reducing WSL risk in patients undergoing fixed orthodontic treatment. A total of 41 articles were screened, with 17 selected based on relevance and methodological rigor. Results: The review identified several effective strategies for preventing WSLs. Topical fluoride applications, particularly high-concentration varnishes, significantly reduced WSL prevalence, with some studies favoring fluoride varnish over other interventions. CPP-ACP and CPP-ACPF formulations demonstrated potential for remineralizing demineralized enamel, especially when combined with fluoride toothpaste. High-fluoride toothpaste and acidulated phosphate fluoride mouthwash were effective in reducing lesion incidence, emphasizing the importance of patient compliance in daily oral hygiene routines. Professional interventions, such as fluoride varnish applications, showed enhanced outcomes when re-applied periodically. Conclusions: Preventing WSLs during orthodontic treatment is crucial for ensuring the aesthetic and functional success of therapy. Strategies combining fluoride-based interventions with casein phosphopeptide formulations offer significant benefits. However, patient education and adherence to recommended oral hygiene practices remain critical. Further research is needed to compare the long-term effectiveness of these interventions and to explore new technologies for WSL prevention.
Analysis of Femoral Shaft Fractures in the Pediatric Population at a Tertiary Care Center: A Longitudinal Study
Authors: García-Benavides Pedro , Mora-Ríos Félix Gustavo , Zavala-Luna Nancy Daniela , Pérez-Jimenez Emilio Ignacio , Castro-Fuentes Carlos Alberto
Published: February 2025

Background: Femoral shaft fractures are very common in the pediatric population; however, information is scarce. Methods: A total of 189 pediatric patient records were reviewed to identify the characteristics of diaphyseal fractures, including origin, type, pattern, surgical technique, and complications. Descriptive statistics were used to calculate frequencies and percentages. Meanwhile, continuous and categorical variables were analyzed using logistic regression to compare the different types of fractures in the population. Results: The proportion of males was higher compared to females (2:1). The highest prevalence was observed in the 10–14-year-old age group (n = 71; 37.5%). The primary mechanism of injury was traffic accidents (n = 93; 49.2%). Left femoral shaft fractures (n = 101; 53.4%) were the most prevalent. Transverse patterns predominated among the identified fractures (n = 105; 55.6%), most of which were closed fractures. Among the complications, non-union was the most frequent (n = 13; 6.9%), followed by wound infections (n = 3; 1.5%). Obesity (p < 0.001) and overweight (p < 0.001) were statistically significant in the left-sided femoral shaft fracture group. Conclusions: Non-union was the main complication identified in our study population. Obesity and overweight were identified as predictive variables for left-sided femoral shaft fractures. Meanwhile, none of the injury mechanisms showed statistical significance. Diaphyseal fractures in the pediatric population are underestimated, as well as the predictors causing them. Therefore, it is necessary to establish better management strategies for this type of fracture in pediatric patients.
Energy vs. Precious Metals Funds Performance During Commodity Markets Volatility—Evidence from Poland
Authors: Moskal Agnieszka
Published: February 2025

Events of recent years, such as the COVID-19 pandemic and the war in Ukraine, have caused significant fluctuations in financial markets, including energy and precious metals markets. Many investors see commodity investments as a way to diversify portfolio risk. The article’s main aim was to evaluate the performance of Polish commodity funds and analyze how external factors influenced their investment results from 2020 to 2023. Using popular investment fund performance metrics, it was determined that precious metals funds could not be considered effective during the 2020–2023 period, whereas the opposite conclusion applied to energy commodity funds. Additionally, mixed linear regression models showed that the average performance of precious metals funds was significantly positively influenced by the price of gold. Meanwhile, the performance of the average energy commodity fund was significantly positively impacted by the CRB Commodity Index value. The conducted analysis demonstrates that mixed linear regression models can be successfully applied in evaluating the external factors influencing the efficiency of commodity funds, taking into account their capital allocation policies. The obtained results can be utilized by current and potential participants of commodity funds, investors seeking portfolio diversification opportunities, and commodity fund managers to maximize investment performance.
Spatial Effects and Mechanisms of the Digital Economy on Energy Efficiency: Empirical Findings from China
Authors: Zhang Rongbin , Wu Xiaoxiao , Chen Yifei
Published: February 2025

Energy efficiency plays a vital role in the transition towards carbon neutrality. The rapid rise of the digital economy as an emerging growth engine raises important questions about its capacity to enhance energy efficiency. Understanding this relationship is essential for advancing sustainable development and minimizing carbon emissions. Using spatial Durbin models, mediation models, and panel threshold models, this paper empirically examines the nonlinear impact of digital economy development on energy utilization efficiency, taking Chinese cities as case study areas. This research shows that there is a nonlinear U-shaped relationship between the digital economy and energy efficiency, characterized by initial suppression followed by promotion, while the digital economy’s impact on energy efficiency improvement in surrounding cities shows an inverted U-shaped relationship, demonstrating initial promotion followed by suppression. Heterogeneity studies found that digital economy development in eastern Chinese cities has a significant positive promotional effect on energy efficiency, while cities in central and western regions show a suppressive effect. Mechanism tests indicated that the digital economy enhances energy efficiency by promoting industrial structure upgrading and improving green technological progress. However, its impact is significantly affected by external factors and exhibits threshold effects—only when urban development levels cross specific threshold values can the digital economy generate a positive promotional effect on energy efficiency.
Evaluation of Airflow Distribution, Temperature, and Mean Age of Air Control in an Elevator Cabin
Authors: Aguirre Juan D. , Sánchez Enrique J. , Amaris Carlos , Jaramillo-Ibarra Julián E. , González-Estrada Octavio A.
Published: February 2025

The recent events impacting public health highlight the need for investigating airflow patterns in confined spaces like elevator cabins. It is essential to ensure proper ventilation, prevent the accumulation of contaminants, and ultimately promote a healthy indoor environment for occupants. In this study, an evaluation of the airflow distribution, temperature, and mean age of air control within an occupied elevator cabin is presented. For that, a CFD model that simulated the airflow patterns in an elevator cabin was developed, validated, and used to conduct the study under six air ventilation scenarios, involving mechanical ventilation with air curtains or displacement flows. The proposed ventilation configurations in Cases 2–6 enhanced the airflow circulation within the elevator. Among these configurations, Case 4, a case of displacement flow, exhibited the most favourable conditions, providing an ACH of 27.05, a mean air age of 84.45 s in the breathable plane, an air change effectiveness of 1.478, and a temperature of 25 °C near the doors and around the occupied zone. It is important to highlight Case 3, which had a lower ACH of 21.2 compared to Case 4. Despite this, Case 3 presented a mean average air age of approximately 122.84 s and an air change effectiveness of 1.309. Based on these findings, displacement ventilation (Case 4) is recommended as the most effective configuration, followed by Case 3, which also showed improved air circulation compared to the other scenarios. The results evidence that the ventilation configuration is particularly influential when aiming to promote air ventilation and improve air age conditions in elevator cabins.
Impact of Karst Rocky Desertification on N-Fixing Tree Species Root System and Bacteria
Authors: Yu Shuzhong , Guo Chunhui , Yao Xianyu
Published: February 2025

The study aimed to investigate the effect of soil textural or soil mineral fraction substrates (loam and gravel) from karst desertification areas on the rhizospheric and root-associated bacterial community structure of Dalbergia odorifera (an N-fixing tree), using high-throughput sequencing techniques, based on treatment methods of whole-root and two-chambered split-root systems. Further, this study determined the relative importance of the plant and substrate properties on the rhizospheric, non-rhizospheric and endospheric bacteria composition. The type of substrate exerts a significant influence on both rhizospheric and non-rhizospheric bacterial communities, whereas endophytic communities within the root system are predominantly determined by plant species rather than substrate type. The analysis revealed that endospheric bacterial diversity was considerably lower than that of rhizospheric and non-rhizospheric communities. Cluster analysis indicated that endospheric bacterial samples formed a distinct cluster, while rhizospheric and non-rhizospheric bacteria in the soil substrate grouped into one branch, and those in the gravel substrate formed another branch. In comparison to the gravel treatments, a reduced bacterial abundance was observed in the rhizosphere and non-rhizosphere of nitrogen-fixing plants in soil, potentially due to the interplay of lower nutrient availability and increased porosity in gravel treatments. Proteobacteria, which are involved in the nitrogen cycle, exhibited the highest abundance. In contrast, Acidobacteria, Firmicutes and other bacterial phyla involved in nutrient cycling demonstrated higher abundance, with their presence being more pronounced in extreme environments, such as gravel treatments, compared to soil substrates. These results suggest that nitrogen-fixing plants can respond to extreme environments by increasing bacterial abundance. The findings of this study provide a theoretical basis for the use of D. odorifera for ecosystem recovery and vegetation restoration.
Evidence for a Greater Pleistocene Distribution for the Copper Redhorse in North America (Catostomidae: Moxostoma hubbsi)
Authors: Armbruster Jonathan W. , Jenkins Robert E.
Published: February 2025

A pharyngeal jaw and loose pharyngeal teeth from Prairie Creek, Indiana, and loose pharyngeal teeth and two basioccipital pharyngeal processes from Bell Cave, Alabama, appear to be those of Moxostoma hubbsi (Copper Redhorse). Among suckers, only M. carinatum, M. hubbsi, M. robustum, and M. ugidatli have molariform teeth on their pharyngeal jaws, with M. hubbsi having the teeth of the largest relative size. Measurements of most of the teeth from Prairie Creek overlap with those of M. hubbsi, and the largest tooth from Bell Cave is the largest pharyngeal tooth measured. The more complete pharyngeal process of the basioccipital possesses a small condyle and stout processes along it that are indicative of M. hubbsi as well as a smaller centrum for articulation with the Weberian complex. Moxostoma hubbsi currently occupies an area around Montreal, Canada, that was glaciated at the time the fossils were laid down, and the area was later occupied by the Champlain Sea and Lampsilis Lake before becoming riverine about 6000–5000 years ago, meaning that M. hubbsi had to have arrived at its current distribution relatively recently and been extirpated from elsewhere.
Comparing the Drying Characteristics, Phytochemicals, and Antioxidant Characterization of Panax quinquefolium L. Treated by Different Processing Techniques
Authors: Li Meng , Liu Shuang , Wang Zhenqiang , Liu Feng , Dong Hongjing , Qiao Xuguang , Wang Xiao
Published: February 2025

American ginseng (AG) has long been used as an ingredient in the food and pharmaceutical industries because of its nutritional and economic value. AG is rich in nutrients, and its quality is greatly affected by how it is processed. However, there is a relative paucity of research on the comprehensive evaluation of different processing techniques of AG. This study evaluated the differences in quality formation and properties of low-temperature softened, blanched, steamed followed by hot air drying, and vacuum freeze-dried AG (LTS-HAD, BL-HAD, ST-HAD, and VFD, respectively). The results demonstrated that AGs treated with VFD had the fastest drying time (85 h) and succeeded in preserving the color and microstructure of fresh ginseng. The contents of ginsenoside Rg1 and Rb1 in LTS-HAD samples were 2.81 ± 0.01 mg/g and 10.68 ± 0.66 mg/g, respectively, which were significantly higher than those in VFD samples (p < 0.05). Moreover, ST-HAD samples had an attractive reddish-brown appearance and higher antioxidant activity. Simultaneously, the formation of the ginsenosides Rg6, (S) Rg3, (R) Rg3, Rk1, and Rg5 was discovered. BL-HAD samples had an intermediate quality among the above samples. A total of 58 volatile compounds were identified, including aldehydes (14), alcohols (13), ketones (10), esters (6), terpenes (6), acids (5), and heterocyclic compounds (4). PCA of ginsenosides and volatile components, as well as correlation analysis with color and antioxidant activity, resulted in the identification of different processed products and potential bioactive components.
Alginate Microbeads for Trapping Phenolic Antioxidants in Rosemary (Rosmarinus officinalis L.): Multivariate Optimization Based on Bioactive Properties and Morphological Measurements
Authors: Toprakçı Gizem , Toprakçı İrem , Şahin Selin
Published: February 2025

Medical and aromatic plant extracts are often very sensitive to environmental, gastrointestinal, and processing conditions despite their health benefits. Therefore, they can be rapidly inactivated. Microencapsulation is used to overcome such challenges. In this study, phenolic antioxidants from rosemary (Rosmarinus officinalis L.) were encapsulated in alginate beads by means of ionic gelation. A Box–Behnken design with response surface methodology (BBD–RSM) was used with three numeric factors (calcium chloride concentration, alginate concentration, and hardening time) to achieve the best formulation in terms of encapsulation efficiency, antioxidant activity, and morphological characteristics. Generally, the sodium alginate concentration of the microbeads was the most critical factor (p < 0.0001) for the quality of the products. The optimal encapsulation conditions were accessed using concentrations with almost 6% calcium chloride and 2% alginate, and a time of 10 min for bead hardening in order to obtain the highest responses (30.01% encapsulation efficiency, 7.55 mg-TEAC/g-DM of antioxidant activity value as measured by the DPPH method, a sphericity factor of 0.05, and a roundness of 0.78). At the optimum point, the microbeads were determined to be spherical in shape, and the bulk density value was measured as 0.34 ± 0.01 g/mL.
The Implementation of a Blended Counseling Intervention in Undergraduate Engineering Students: The Effect on Mental Health
Authors: Kalamatianos Antonios , Kounenou Kalliope , Pezirkianidis Christos
Published: February 2025

Background/Objectives: The accelerating global concern for the mental health of university students necessitates delivering intervention programs. The purpose of this study is to evaluate the effectiveness of a 5-week blended counseling group program, with two integrated approaches, positive psychology intervention and cognitive therapy, toward undergraduate engineering students’ depression, anxiety, and stress, from the Higher School of Pedagogical and Technological Education, Greece. Methods: Participants with a mean age of 21.12 (SD = 3.68) were administered the DASS-21. A two-way repeated-measures design was used and the two factors were condition and time. The subjects underwent two conditions, the experimental (n = 40), consisting of the civil and mechanical engineers, and the control (n = 52), that encompasses the electrical engineers. The three dependent variables, DASS-21 factors, were measured at three time points, at the beginning of the program, midway through the program, and at the end of the program. Results: The effect of the interaction between time and the conditions on DASS-21 depression and stress was significant. In particular, the experimental subgroups showed lower depression and stress at the end of the program in comparison with the control group. However, they did not demonstrate significantly lower scores on anxiety. Furthermore, the two intervention subgroups did not exhibit any significant mid- and post-test differences on all measures. Conclusions: In light of the obtained results, it can be concluded that the group counseling blended cognitive positive psychology program is an effective intervention.
Effects of Diabetes Knowledge and Attitudes Toward Internet Health Information on e-Health Literacy in Middle-Aged Patients with Diabetes
Authors: Lee Minsung , Shim Jaelan
Published: February 2025

Background/Objectives: Effective diabetes self-management requires useful knowledge and health-related literacy based on a positive attitude toward seeking health information on the Internet. Therefore, this study aimed to determine the relationship of e-health literacy (eHL) with diabetes knowledge and attitudes toward internet health information in middle-aged patients with diabetes and to identify factors influencing patient eHL. Methods: This descriptive correlational study included 185 middle-aged patients with diabetes being followed-up with in the outpatient endocrinology department at a South Korean university hospital between 14 January and 29 February 2024. Data were collected using self-report structured questionnaires and were analyzed using IBM SPSS 27.0. Results: eHL was positively correlated with diabetes knowledge (r = 0.31, p < 0.001) and attitudes toward internet health information (r = 0.62, p < 0.001). Diabetes knowledge was also positively correlated with attitudes toward internet health information (r = 0.25, p < 0.001). Attitudes toward internet health information (β = 0.55, p = <0.001), diabetes knowledge (β = 0.13, p = 0.040), and drinking status (β = 0.12, p = 0.044) were significant variables affecting eHL. Conclusions: The most influencing factor in eHL in middle-aged patients with diabetes is the patient’s attitudes toward internet health information; diabetes knowledge was identified as a significant predictor. To improve eHL in middle-aged patients with diabetes, it is important to develop nursing intervention strategies to help promote diabetes knowledge and positive attitudes toward internet health information. Healthcare providers should continuously monitor patients to ensure they acquire and utilize correct information.
Mediating Effect of IADL and Depression in the Relationship Between Ability to Perform Movements and Death Preparation in Elderly with Osteoarthritis or Rheumatoid Arthritis
Authors: Kwon Myoungjin , Kim Sun Ae , Kim Jiyoung
Published: February 2025

Background/Objectives: This study investigated the mediating effects of instrumental activities of daily living (IADL) and depression on the relationship between the ability to perform movements and death preparation among older adults with osteoarthritis (OA) or rheumatoid arthritis (RA). Methods: This study is a secondary analysis of data from the Ministry of Health and Welfare of Korea’s 5th (2020) survey of the elderly. It included 1483 elderly individuals with OA or RA. We measured the ability to perform movements, death preparation, IADL, and depression using validated scales. Hayes’ PROCESS Macro for SPSS model 6 was used to determine the mediating effects. Results: Death preparation exhibited significant differences based on satisfaction with economic conditions, fall experiences, and suicidal ideation. A significant correlation existed between the ability to perform movements, death preparation, IADL, and depression. IADL demonstrated a significant mediating effect between the ability to perform movements and death preparation. However, depression did not exhibit a significant mediating effect. Conclusions: IADL significantly mediates the relationship between movement ability and death preparation in elderly individuals with OA or RA. Lower movement ability was associated with higher death preparation and greater IADL dependence. However, contrary to expectations, depression did not show a significant mediating effect. These findings offer significant insights for developing interventions to enhance the quality of life and prepare for dignified death in elderly individuals with OA or RA. Future longitudinal studies are required to clarify the causal relationships and evaluate the efficacy of IADL enhancement programs.
Development of a Health Research Portfolio Based on Priority Topics for Peruvian Social Health Insurance (ESSALUD) in 2023–2025: A Collaborative Approach to Addressing Institutional and Public Health Challenges
Authors: Diaz-Obregón Daysi Zulema , Coila-Paricahua Edgar , Soto-Becerra Percy , Rojas César Alexander Ortiz , Murillo Carrasco Alexis G.
Published: February 2025

Background/Objectives: Addressing health research priorities in public institutions is crucial for efficient resource allocation and policy impact. This study aims to describe the development of Peru’s Social Health Insurance (ESSALUD) 2023–2025 research portfolio, which aligns with institutional priorities and focuses on improving decision-making for population health. Methods: The Health Research Directorate (DIS) of ESSALUD led a structured three-phase process, engaging multidisciplinary teams and utilizing a group model-building approach to generate research ideas. Twelve working groups were established, corresponding to ESSALUD’s prioritized health topics, to identify key institutional challenges and propose research ideas. Results: A total of 338 research ideas were generated from 217 identified problems. These ideas were classified using the UK Health Research Classification System (HRCS) and scored based on nine dimensions to prioritize execution. Research ideas primarily focused on health services (57.7%) and disease management (16.9%). High-priority topics included cancer, mental health, malnutrition, and antimicrobial resistance. As a result of this implementation, ESSALUD resources were positively concentrated in the HRCS research activities ‘Health and social care services research’ (51.85%) and ‘Etiology’ (44.44%) for the period 2023–2025. Conclusions: The development of ESSALUD’s research portfolio identified key areas such as health services, health economics, and prevention, essential for evidence-based decisions and sustainability. Multidisciplinary participation ensured solutions aligned with real needs, promoting equity and continuous improvement in Peru’s health system.
Examining the Impact of Pyramid Model Implementation to Deepen Social and Emotional Supports for Enrolled Children Within Early Intervention
Authors: Candelaria Margo , Sweeney Kate
Published: February 2025

Background/Objectives: Early social and emotional well-being is crucial for child development with life-long outcomes. The Individuals with Disabilities Education Act (IDEA) Part C Early Intervention system, which federally mandates special education services for children ages birth to three, is one place where identifying and addressing early social emotional needs could be strengthened. Focusing on an implementation science approach, the Pyramid Model (PM) is examined to see how the model’s targeted implementation efforts over many years enhance a system’s capacity to identify and address social and emotional well-being in one state over five years. Methods: Implementation science methods were used to evaluate the impact of PM implementation over time in four independently operating sites within one state, emphasizing the use of coaching to support practice change, as well as fidelity tools and examination of system changes over time. Results: All sites increased capacity for PM implementation. Results varied by site but all sites were able to demonstrate improvement and higher fidelity implementation by the last year. Conclusions: The PM is an effective model to use within IDEA Part C programs to enhance capacity to identify and address social and emotional needs of children and families receiving services. Implementation factors are needed for success, including leadership support, organizational dynamics (e.g., creating dedicated time for staff to engage in training, external and internal coaching, and case reviews), committed funding, and dedicated support for implementation and evaluation.
Comprehensive Assessment of Neuropathy and Metabolic Parameters in Type 1 Diabetic Patients with or Without Using Continuous Glucose Sensors
Authors: Bordács Barbara , Várkonyi Ákos , Valkusz Zsuzsanna , Nyiraty Szabolcs , Pósa Anikó , Menyhárt Adrienn , Lengyel Csaba , Kempler Péter , Kupai Krisztina , Várkonyi Tamás
Published: February 2025

The present study was conducted in type 1 diabetic (T1DM) patients to evaluate the metabolic and glycemic control as well as the manifestations of neuropathy. The impact of continuous glucose monitoring (CGM) on the measured parameters was also analyzed. A total of 61 T1DM patients (age: 42.5 ± 1.8 years, DM duration: 22.8 ± 1.6 years, mean ± SE) participated in the study. In total, 24 patients had CGM sensors and 37 did not. Cardiovascular autonomic neuropathy was assessed using cardiovascular reflex tests. Peripheral sensory function was evaluated by a Neurometer and calibrated tuning fork on the upper and lower limbs. Metabolic status was characterized by the determination of triglycerides, high-density lipoprotein (HDL), low-density lipoprotein (LDL), total cholesterol, and glycated haemoglobin (HbA1c). A positive correlation was found between HbA1c and triglyceride levels (r = 0.28, p < 0.05). CGM users and non-users differed in triglyceride (0.9 ± 0.1 vs. 1.24 ± 0.12 mmol/L, p < 0.05), HDL cholesterol (1.7 ± 0.1 vs. 1.4 ± 0.1 p < 0.05 mmol/L), and HbA1c (7.5 ± 0.2 vs. 8.3 ± 0.3%, p < 0.05) levels as well. Significant differences were found for the Valsalva ratio, Neurometer, and calibrated tuning fork results between CGM users and non-users. This study found a significant correlation between HbA1c and triglyceride levels in T1DM. CGM use resulted in improved metabolic parameters and less autonomic and sensory nerve damage. As a novel finding, CGM is presumed to prevent both micro-, and macrovascular complications and, by this way, potentially reducing mortality rates.
Structural, Magnetic, Optical and Photocatalytic Properties of Co-Doped ZnO Nanocrystals
Authors: Acosta-Humánez Manuel Fernando , Magon Claudio J. , Montes-Vides Luis , Jiménez Juan , Almanza Ovidio
Published: February 2025

Energy levels associated with several crystalline defects, such as zinc (VZn) and oxygen (VO) vacancies, Zn and O interstitials (Zni and Oi respectively), Zn and O antisite defects, and charged oxygen vacancies Vo-, among others, are generated by the introduction of cobalt (Co) into the structure. The effective introduction of Co into the Zn occupancy site was evaluated by XRD and electron paramagnetic resonance. The EPR spectra remain consistent across all doping concentrations of Co2+ ions and revealed intriguing features linked to four distinct Co2+ paramagnetic centers; among them, a pair of Co2+ ions exhibited ferromagnetic coupling. ZnO nanocrystals doped with cobalt were produced by sol gel and their use as photocatalysts were evaluated in the degradation of the Congo red pollutant. The degradation efficiency improved by more than 50% when compared to the efficiency of pure ZnO nanocrystals at the same activity time.
Physical Activity or Inactivity and Fatigue in Children and Adolescents: A Cross-Sectional Study
Authors: Bricout Véronique-Aurélie , Nguyen Duy-Thai , Favre Juvin Anne
Published: February 2025

Background/Objectives: Physical inactivity needs to be strategically addressed throughout adolescence because it is often accompanied by an alteration in the quality of life. Fatigue is one of the most common symptoms encountered in medical practice. However, little is known about the causal relationship between lifestyle and fatigue. The purpose of this study was to describe the prevalence of fatigue among children and adolescents and to investigate whether various sport types and training volume/week are related to increased fatigue over time while considering gender and age. Methods: A total of 1617 participants (mean age = 13.3 ± 1.9 years, 8.2 to 16.1) completed a questionnaire assessing their perception of fatigue and including questions regarding weekly physical practices and attitudes toward sports and health. The participants were secondary school students, whether or not they practiced sports, leisure activities, or music. Analyses of variance and Newman–Keul post-hoc tests were applied to assess differences between groups. A mediation model was used to determine the relationship between physical activity and fatigue score with the relevant role of mediating factors (physical activity level or physical activity type). Results: Older adolescents had significantly higher scores of fatigue than younger ones (28.9 ± 17.5 vs. 25.6 ± 16.6; p < 0.01). Girls had significantly higher scores of fatigue than boys (30.7 ± 17.5 vs. 23.8 ± 15.8; p < 0.001). Additionally, 10.7% of participants were sedentary and presented significantly higher scores of fatigue than participants in the Leisure (35.1 ± 18.2 vs. 29.4 ± 17.3; p < 0.001) and Sport groups (35.1 ± 18.2 vs. 25.3 ± 16.2; p < 0.0001). In the sedentary group, low physical activity was associated with a high score of fatigue; but in the Sport group, high physical activity was associated with a low score of fatigue. Conclusions: Fatigue is closely related to health, physical activity volume, gender, and age. Fatigue symptoms obtained through a questionnaire assessment can serve as an important index for health evaluation.
Video-Assisted vs. Robotic-Assisted Thoracoscopic Surgery in Lung Cancer: A Comprehensive Review of Techniques and Outcomes
Authors: Sbeih Dina , Idkedek Mayar , Abu Akar Firas
Published: February 2025

Lung cancer is the primary cause of cancer-related mortality globally; hence, several medical and surgical approaches have been developed for its management. This can be easily recognized with the evolution from the traditional open thoracotomy toward minimally invasive procedures—in particular, video-assisted thoracoscopic surgery (VATS) and robotic-assisted thoracoscopic surgery (RATS)—in treating lung cancer. There has been a lot of controversy around the advantages and limitations of these procedures. VATS has been proven to be beneficial in treating early-stage lung cancer. Yet, the restricted mobility of its instruments, as well as the lack of a three-dimensional visualization of anatomical components, make the new RATS desired. RATS uses advanced technology, which has resulted in an exceptional high-definition, three-dimensional image of the working field. This has also led to fine dissection with great precision and accuracy, better lymph node removal, reduced postoperative recovery time, and better outcomes. Compared to VATS, there is less blood loss, shorter hospital stays, and less pleural effusion drainage. Despite its higher cost due to the expensive surgical systems, training and maintenance fees, and longer operative time, RATS has started to gain more use, potentially enhancing patient outcomes as experience and technological improvements progress.
Comparison of Chest High-Resolution Computed Tomography Findings in Patients with Anti-Melanoma Differentiation-Associated Gene 5 Antibody-Positive and Antibody-Negative Progressive Pulmonary Fibrosis with Polymyositis/Dermatomyositis
Authors: Sato Noboro , Kotani Takuya , Koyama Mitsuhiro , Matsuda Shogo , Sakamoto Aya , Shou Yoshihiro , Oe Katsumasa , Takeuchi Tohru , Osuga Keigo
Published: February 2025

Background/Objectives: This study compared chest high-resolution computed tomography (HRCT) findings between patients with anti-melanoma differentiation-associated gene 5 (MDA5) antibody-positive and antibody-negative progressive pulmonary fibrosis (PPF) with polymyositis/dermatomyositis (PM/DM). Methods: Of the 85 patients with PM/DM-interstitial lung disease (ILD), 17 were anti-MDA5 antibody-positive, and 68 were antibody-negative. Among these, 5 anti-MDA5 antibody-positive and 9 antibody-negative cases met the criteria for PPF and were enrolled in the study. The chest HRCT findings and the duration from treatment initiation to the appearance of key fibrotic changes were analyzed. Results: In the anti-MDA5-positive group, all patients were diagnosed with PPF within 6 months of treatment initiation, compared to only 22.2% in the anti-MDA5-negative group. While there was no difference between the anti-MDA5 antibody-positive and antibody-negative groups in terms of chest HRCT findings associated with PPF, the duration to the appearance of increased traction bronchiectasis and bronchiolectasis, and new ground-glass opacity with traction bronchiectasis was significantly shorter in the anti-MDA5-positive group (p = 0.016 and p = 0.023, respectively). The appearance of new fine reticulations and increased coarseness of reticular abnormalities tended to be shorter in the anti-MDA5 antibody-positive group than in the antibody-negative group. Conclusions: Pulmonary fibrosis in patients with anti-MDA5 antibody-positive ILD can rapidly progress within 6 months, despite immunosuppressive therapy. Frequent HRCT monitoring and early combination therapy with antifibrotic agents are crucial for managing the progression of fibrosis.
Effects of Age and Muscle Activation on Three-Dimensional Spine Kinematics and Asymmetry in Elderly Adults
Authors: Rezaei Asghar , Cheng Chih-Hsiu , Pignolo Robert J. , Lu Lichun , Kaufman Kenton
Published: February 2025

Background/Objectives: Limited spinal range of motion (ROM) is linked to low back disorders, emphasizing the need to maintain mobility in the elderly. This study measured maximum spinal ROM, asymmetrical patterns, and the effects of age and muscle activation on spinal mobility. Methods: Forty healthy participants aged 50 and older were recruited. An optical motion capture system recorded three-dimensional coordinates of reflective markers placed on spinal landmarks. Asymmetry was analyzed in sidebending and axial rotation. Electromyography (EMG) data were collected bilaterally from paraspinal muscles at L3 during flexion, extension, sidebending, and axial rotation. Results: Trunk ROM averaged 111° in flexion, 38° in extension, 46° in sidebending, and 87° in axial rotation. Kinematic asymmetry was observed in sidebending and axial rotation. ROM decreased with age in flexion motion (p ≤ 0.04). EMG activity was significantly correlated with ROM data for all combined motions (p = 0.0002). The strongest EMG signal was recorded during flexion, whereas the weakest signal was observed during extension. EMG activity also correlated with kinematic asymmetry (p ≤ 0.03). Conclusions: Age and muscle activation significantly influence spinal ROM in the elderly. Lumbar kinematic asymmetry can be partially attributed to paraspinal muscle activation, underscoring the importance of analyzing asymmetrical motions in conjunction with EMG activity.
Predominant Pneumococcal Serotypes in Isolates Causing Invasive Disease in a Spanish Region: An Examination of Their Association with Clinical Factors, Antimicrobial Resistance, and Vaccination Coverage
Authors: Diab-Casares Laura , Tormo-Palop Nuria , Hernández-Felices Fco Javier , Artal-Muñoz Violeta , Floría-Baquero Pedro , Martin-Rodríguez José Luis , Medina-González Rafael , Cortés-Badenes Sonia , Fuster-Escrivá Begoña , Gil-Bruixola Ana , López-Hontangas José Luis , Roig-Sena Fco Javier , Vanaclocha-Luna Herme , Guna-Serrano Remedio , Gimeno-Cardona Concepción
Published: February 2025

Background: Streptococcus pneumoniae (S. pneumoniae) remains a leading cause of morbidity and mortality, particularly among vulnerable populations. This study investigates the epidemiology of pneumococcal serotypes associated with invasive pneumococcal disease (IPD) in the Comunidad Valenciana (CV) region, Spain, analysing 1587 isolates collected from 2014 to 2023. Methods: Serotyping and antimicrobial susceptibility testing were performed, and whole-genome sequencing was conducted on 104 isolates to explore their clonal relationships. Results: The most prevalent serotype was serotype 8 (17.5%), followed by serotype 3 (14.7%), with a notable increase in serotype 8 cases from 2019 onwards and a decline in serotype 19A being observed. Age distribution played a role, as serotype 8 was more frequent in individuals over ten years old. The overall recovery rate was 72%, while serotypes 3 and 15A exhibited the highest mortality rates. The vaccination coverage was highest among children under five, underscoring the need for continued surveillance to evaluate vaccine effectiveness. The antimicrobial resistance was most pronounced for erythromycin (20%) and clindamycin (16%), with serotypes 19A and 6C displaying the highest resistance levels. Whole-genome sequencing identified sequence type (ST) 53 and ST180 as the predominant STs for serotypes 8 and 3, respectively, mirroring global trends. Conclusions: These findings emphasize the necessity of continuous monitoring to inform vaccination policies and antimicrobial strategies, to ensure effective disease control and improved patient outcomes.
Reply to Mikhail et al. Comment on “Krysik et al. Clinical Outcomes and Early Postoperative Complications in Boston Type I Keratoprosthesis Implantation: A Retrospective Study. J. Clin. Med. 2024, 13, 6710”
Authors: Krysik Katarzyna , Miklaszewski Piotr , Gadamer Anna Maria , Janiszewska-Bil Dominika , Lyssek-Boroń Anita , Dobrowolski Dariusz , Grabarek Beniamin Oskar , Wylęgała Edward
Published: February 2025

We appreciate the insightful comments from Mikhail et al [...]
Left Ventricular Thrombosis in Ischemic and Non-Ischemic Cardiomyopathies: Focus on Evidence-Based Treatment
Authors: Catalani Filippo , Sarzilla Simone , Will Massimiliano , Pedrazzini Giovanni , Demarchi Andrea
Published: February 2025

Left ventricular thrombosis (LVT) is one of the most feared complications of both ischemic and non-ischemic cardiopathy, and despite its incidence having decreased over the years (mostly due to novel reperfusion therapies in acute coronary syndromes), it is still not negligible. If transthoracic echocardiography, possibly with the adjunction of echo contrast, represents the cornerstone in LVT diagnosis, sometimes it is found to be nonconclusive and advanced cardiovascular imaging, namely cardiac magnetic resonance, needs to be performed to fully exclude intraventricular masses or to better characterize them. Vitamin K antagonists always represented the anticoagulant of choice for the treatment of LVT; however, the recent spread of direct oral anticoagulants (DOACs) pushed clinicians to adopt them also in this setting despite the absence of robust evidence in their favor. If the optimal duration of anticoagulation for the treatment of LVT in non-ischemic cardiopathy is still a matter of debate, an initial treatment of 3–6 months seems to be reasonable in the setting of ischemic cardiopathy, with possible extension according to the follow-up findings. High-quality randomized studies are strongly needed to evaluate the potential role of prophylactic anticoagulation in high-risk patients and provide conclusive evidence for the use of DOACs in LVT treatment.